Efectividad del uso de materiales didácticos en la enseñanza de Gramática en 9° grado del turno matutino, en el Instituto Benjamín Zeledón, en el municipio del Tuma La Dalia, departamento de Matagalpa, II semestre, 2016

En el presente estudio se desarrolló el subtema Efectividad del uso de material didáctico en la enseñanza de gramática en 9º grado “A”, turno matutino del Instituto Benjamín Zeledón , disciplina de Lengua y Literatura, municipio de El Tuma La Dalia, segundo semestre, 2016. Este trabajo se ha hecho con el propósito de analizar la Efectividad del uso de material didáctico en la enseñanza de gramática en 9º grado “A”, turno matutino del Instituto Benjamín Zeledón. Ha sido de gran importancia la realización de este estudio, ya que ha permitido analizar la efectividad de los materiales didácticos utilizados en la enseñanza de la gramática, razón por el cual se desarrollará un plan de capacitación que contribuirá a que los docentes de Lengua y Literatura fortalezcan sus habilidades, o destrezas así como de una serie de estrategias metodológicas sugeridas en cuanto a la elaboración de materiales didácticos creativos que estén acorde al contexto de los estudiantes, permitiéndoles a los maestros desarrollar el proceso de enseñanza más dinámico sin caer en la enseñanza tradicional. Con base a los resultados obtenidos de los instrumentos aplicados, se concluye que: Los materiales didácticos utilizados en la enseñanza de la gramática son: material pertinente e informativo (libro de texto, folletos, fotocopias y Paleógrafos).se guiadamente se encontraron las siguientes fortalezas en la utilización de los materiales didácticos las cuales fueron: dinamismo en la enseñanza del contenido gramatical, comprensión de los contenidos, haciendo uso adecuado del tiempo y clases emotivas, cabe mencionar que no por perecer simples o tradicionales los materiales pertinentes que utilizo el docente del Instituto Benjamín Zeledón, no convirtieron las clase en aburridas ya que se constató que los estudiantes centraron su atención durante la clase y se desarrolló un proceso de enseñanza y aprendizaje satisfactorio, tomando en cuenta la habilidad del docente para trabajar y guiar la enseñanza . De igual manera se encontraron las siguientes dificultades: demanda de tiempo por parte del docente ya que éste necesita hacer una programación previa y constar que posibles materiales puede usar para desarrollar el contenido, falta de interés de parte del docente en elaborar material didáctico, para dar respuesta a las dificultades encontradas, se propuso un plan de capacitación con el fin de fortalecer las habilidades del profesor cuando utiliza materiales didáctico

Clinical effect of obesity on N-terminal pro-B-type natriuretic peptide cut-off concentrations for the diagnosis of acute heart failure

AIMS Obese patients have lower natriuretic peptide concentrations. We hypothesized that adjusting the concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for obesity could further increase its clinical utility in the early diagnosis of acute heart failure (AHF). METHODS AND RESULTS This hypothesis was tested in a prospective diagnostic study enrolling unselected patients presenting to the emergency department with acute dyspnoea. Two independent cardiologists/internists centrally adjudicated the final diagnosis using all individual patient information including cardiac imaging. NT-proBNP plasma concentrations were applied: first, using currently recommended cut-offs; second, using cut-offs lowered by 33% with body mass index (BMI) of 30-34.9 kg/m$^{2}$ and by 50% with BMI ≥ 35 kg/m$^{2}$ . Among 2038 patients, 509 (25%) were obese, of which 271 (53%) had AHF. The diagnostic accuracy of NT-proBNP as quantified by the area under the receiver-operating characteristic curve was lower in obese versus non-obese patients (0.890 vs. 0.938). For rapid AHF rule-out in obese patients, the currently recommended cut-off of 300 pg/ml achieved a sensitivity of 96.7% (95% confidence interval [CI] 93.8-98.2%), ruling out 29% of patients and missing 9 AHF patients. For rapid AHF rule-in, the age-dependent cut-off concentrations (age 75 years: 1800 pg/ml) achieved a specificity of 84.9% (95% CI 79.8-88.9%). Proportionally lowering the currently recommended cut-offs by BMI increased sensitivity to 98.2% (95% CI 95.8-99.2%), missing 5 AHF patients; reduced the proportion of AHF patients remaining in the 'gray zone' (48% vs. 26%; p = 0.002), achieving a specificity of 76.5% (95% CI 70.7-81.4%). CONCLUSIONS Adjusting NT-proBNP concentrations for obesity seems to further increase its clinical utility in the early diagnosis of AHF

Cardiac myosin-binding protein C in the diagnosis and risk stratification of acute heart failure

Cardiac myosin-binding protein C (cMyC) seems to be even more sensitive in the quantification of cardiomyocyte injury vs. high-sensitivity cardiac troponin, and may therefore have diagnostic and prognostic utility.; In a prospective multicentre diagnostic study, cMyC, high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma concentrations were measured in blinded fashion in patients presenting to the emergency department with acute dyspnoea. Two independent cardiologists centrally adjudicated the final diagnosis. Diagnostic accuracy for acute heart failure (AHF) was quantified by the area under the receiver operating characteristic curve (AUC). All-cause mortality within 360 days was the prognostic endpoint. Among 1083 patients eligible for diagnostic analysis, 51% had AHF. cMyC concentrations at presentation were higher among AHF patients vs. patients with other final diagnoses [72 (interquartile range, IQR 39-156) vs. 22 ng/L (IQR 12-42), P < 0.001)]. cMyC's AUC was high [0.81, 95% confidence interval (CI) 0.78-0.83], higher than hs-cTnT's (0.79, 95% CI 0.76-0.82, P = 0.081) and lower than NT-proBNP's (0.91, 95% CI 0.89-0.93, P < 0.001). Among 794 AHF patients eligible for prognostic analysis, 28% died within 360 days; cMyC plasma concentrations above the median indicated increased risk of death (hazard ratio 2.19, 95% CI 1.66-2.89; P < 0.001). cMyC's prognostic accuracy was comparable with NT-proBNP's and hs-cTnT's. cMyC did not independently predict all-cause mortality when used in validated multivariable regression models. In novel multivariable regression models including medication, age, left ventricular ejection fraction, and discharge creatinine, cMyC remained an independent predictor of death and had no interactions with medical therapies at discharge.; Cardiac myosin-binding protein C may aid physicians in the rapid triage of patients with suspected AHF

A large margin algorithm for automated segmentation of white matter hyperintensity

Precise detection and quantification of white matter hyperintensity (WMH) is of great interest in studies of neurological and vascular disorders. In this work, we propose a novel method for automatic WMH segmentation with both supervised and semi-supervised large margin algorithms provided by the framework. The proposed algorithms optimize a kernel based max-margin objective function which aims to maximize the margin between inliers and outliers. We show that the semi-supervised learning problem can be formulated to learn a classifier and label assignment simultaneously, which can be solved efficiently by an iterative algorithm. The model is learned first via the supervised approach and then fine-tuned on a target image by using the semi-supervised algorithm. We evaluate our method on 88 brain fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) images from subjects with vascular disease. Quantitative evaluation of the proposed approach shows that it outperforms other well known methods for WMH segmentation

Mixtures of Chemical Pollutants at European Legislation Safety Concentrations: How Safe Are They?

The risk posed by complex chemical mixtures in the environment to wildlife and humans is increasingly debated, but has been rarely tested under environmentally relevant scenarios. To address this issue, two mixtures of 14 or 19 substances of concern (pesticides, pharmaceuticals, heavy metals, polyaromatic hydrocarbons, a surfactant, and a plasticizer), each present at its safety limit concentration imposed by the European legislation, were prepared and tested for their toxic effects. The effects of the mixtures were assessed in 35 bioassays, based on 11 organisms representing different trophic levels. A consortium of 16 laboratories was involved in performing the bioassays. The mixtures elicited quantifiable toxic effects on some of the test systems employed, including i) changes in marine microbial composition, ii) microalgae toxicity, iii) immobilization in the crustacean Daphnia magna, iv) fish embryo toxicity, v) impaired frog embryo development, and vi) increased expression on oxidative stress-linked reporter genes. Estrogenic activity close to regulatory safety limit concentrations was uncovered by receptor-binding assays. The results highlight the need of precautionary actions on the assessment of chemical mixtures even in cases where individual toxicants are present at seemingly harmless concentration

Mixtures of chemical pollutants at European legislation safety concentrations: how safe are they?

The risk posed by complex chemical mixtures in the environment to wildlife and humans is increasingly debated, but has been rarely tested under environmentally relevant scenarios. To address this issue, two mixtures of 14 or 19 substances of concern (pesticides, pharmaceuticals, heavy metals, polyaromatic hydrocarbons, a surfactant, and a plasticizer), each present at its safety limit concentration imposed by the European legislation, were prepared and tested for their toxic effects. The effects of the mixtures were assessed in 35 bioassays, based on 11 organisms representing different trophic levels. A consortium of 16 laboratories was involved in performing the bioassays. The mixtures elicited quantifiable toxic effects on some of the test systems employed, including i) changes in marine microbial composition, ii) microalgae toxicity, iii) immobilization in the crustacean Daphnia magna, iv) fish embryo toxicity, v) impaired frog embryo development, and vi) increased expression on oxidative stress-linked reporter genes. Estrogenic activity close to regulatory safety limit concentrations was uncovered by receptor-binding assays. The results highlight the need of precautionary actions on the assessment of chemical mixtures even in cases where individual toxicants are present at seemingly harmless concentrations

The Ups and Downs in Women's Employment: Shifting Composition or Behavior from 1970 to 2010?

This paper tracks factors contributing to the ups and downs in women’s employment from 1970 to 2010 using regression decompositions focusing on whether changes are due to shifts in the means (composition of women) or due to shifts in coefficients (inclinations of women to work for pay). Compositional shifts in education exerted a positive effect on women’s employment across all decades, while shifts in the composition of other family income, particularly at the highest deciles, depressed married women’s employment over the 1990s contributing to the slowdown in this decade. A positive coefficient effect of education was found in all decades, except the 1990s, when the effect was negative, depressing women’s employment. Further, positive coefficient results for other family income at the highest deciles bolstered married women’s employment over the 1990s. Models are run separately for married and single women demonstrating the varying results of other family income by marital status. This research was supported in part by an Upjohn Institute Early Career Research Award