Uso de estrategias didácticas innovadoras para optimizar los niveles de comprensión lectora de textos narrativos

La investigación realizada tuvo como objetivo, Establecer en qué medida el uso de estrategias didácticas optimizan los niveles de comprensión lectora de textos narrativos. La metodología que sustenta este estudio, tiene enfoque cuantitativo, va a permitir cuantificar datos obtenidos de la aplicación de instrumentos de un pre y post test, estableciendo resultados con sus indicadores para luego ser insumos de las conclusiones a raíz de la muestra de estudio. Se trató de una investigación con diseño cuasi experimental, que trabajó con variables independiente y dependiente. Su trabajo con una población de cuatro secciones, correspondiendo a 115 estudiantes, varones y mujeres; Para recolectar información se elaboró y aplicó un test sobre lectura el mismo que fue validado por expertos y determinado su índice de confiabilidad, la aplicación se hizo a nivel de pre y post test, aplicando asimismo Estrategias Didácticas, los estudiantes se mostraron muy activos trabajando lecturas a modo de juego y demostrando interés por leer. Se llegó a concluir que la aplicación de Estrategias Didácticas, produjo efectos óptimos en la comprensión lectora de los estudiantes que integraron el grupo experimental, logrando alcanzar el nivel crítico

Construcción del túnel del Proyecto Hidroeléctrico Victoria.

El presente trabajo de investigación trata sobre la construcción del Túnel de conducción del Proyecto Hidroeléctrico Victoria ubicado en la Parroquia de Cuyuja - Cantón Quijos - Provincia del Napo. En obra se constató los métodos constructivos aplicados en el proceso de excavación del Túnel, los cuales son: 1.- Excavación con fresadora, 2.-Excavación Combinada de Fresado y Voladura, 3.- Excavación Convencional con Voladuras. Tales métodos fueron propuestos en función del material a excavarse, rocas con Esquistos Grafiticos cuarcitos y sericiticos de mala calidad, rocas tipo IV, III y II. En la construcción del túnel se obtuvieron datos en duración para las actividades de los ciclos de excavación, para así determinar los rendimientos en obra de los tres métodos constructivos antes mencionados.The current research work is on the construction of the flow tunnel for Proyecto Hidroeléctrico Victoria located in Cuyuja Parish – Quijos Canton – Napo Province. Fort the work, constructive methods applied in the tunnel excavation process: 1.- Excavation with milling machine, 2.- Conbined Excavation, milling and blast, 3.- Convetional Excavation with Blasts. Such methods were proposed due to material existing in the place where excavation shall take place, rocks with schist graffitists, poor quartzite and sericitic, rocks type IV, III and II. In the Construction of the tunnel, data were obtained regarding duration of activities of excavation cycles, in order to determine performances of the work with the abovementioned three constructive methods

La metodología utilizada por los maestros en el desarrollo de la expresión oral de los estudiantes del séptimo año de educación básica en las escuelas pluridocentes pertenecientes a la red escolar autónoma rural Nuevo Ecuador de la UTE No 10, del recinto Buenos Aires, cantón Puerto Quito, provincia de Pichincha durante el año lectivo 2006-2007.

Determinar la metodología que utilizan los maestros en el desarrollo de la expresión oral en los estudiantes del séptimo año de educación básica de las escuelas pluridocentes pertenecientes a la Red Escolar Autónoma Rural “Nuevo Ecuador”, de la UTE Nº 10, de la Provincia de Pichincha.La presente investigación tiene como finalidad elaborar una guía metodológica para los profesores de séptimo año de educación básica para desarrollar la comunicación oral de los estudiantes, aportar al proceso de enseñanza aprendizaje de la asignatura de lenguaje y comunicación como refuerzo para el dominio de la expresión oral, la cual está fundamentada en el aprendizaje constructivista que permitirá mejorar la calidad educativa

Oxaliplatin-Associated Takotsubo Cardiomyopathy in a Patient with Metastatic Gastric Cancer: A Case Report

We present the case of a 64-year-old female with stage IV gastric adenocarcinoma, pulmonary, and abdominal wall metastases, and no history of cardiovascular disease. In palliative care, she received systemic cytotoxic treatment with fluorouracil, leucovorin, oxaliplatin, and docetaxel protocol, which was well tolerated over five cycles. During cycle 6, she presented with cardiovascular symptoms with hemodynamic consequences while receiving oxaliplatin injection without docetaxel or 5-fluorouracil. She was transferred to the emergency department and then to the intensive care unit. She developed no complications during the hospital stay and was discharged after 10 days with preserved systolic function and no structural changes at the myocardial level. The electrocardiogram, echocardiogram, cardiac catheterization, and magnetic resonance imaging findings indicated an oxaliplatin-associated Takotsubo syndrome. The immunochemistry analysis showed PD-L1 expression level TPS: 40% and the foundation one genomic profiling revealed high mutation load, microsatellite instability, and HER2 not found. The patient is currently asymptomatic and on pembrolizumab monotherapy with good tolerance and partial treatment response

Comparison of body mass index (BMI) with the CUN-BAE body adiposity estimator in the prediction of hypertension and type 2 diabetes

Background Obesity is a world-wide epidemic whose prevalence is underestimated by BMI measurements, but CUN-BAE (Clínica Universidad de Navarra - Body Adiposity Estimator) estimates the percentage of body fat (BF) while incorporating information on sex and age, thus giving a better match. Our aim is to compare the BMI and CUN-BAE in determining the population attributable fraction (AFp) for obesity as a cause of chronic diseases. Methods We calculated the Pearson correlation coefficient between BMI and CUN-BAE, the Kappa index and the internal validity of the BMI. The risks of arterial hypertension (AHT) and diabetes mellitus (DM) and the AFp for obesity were assessed using both the BMI and CUN-BAE. Results 3888 white subjects were investigated. The overall correlation between BMI and CUN-BAE was R2 = 0.48, which improved when sex and age were taken into account (R2 > 0.90). The Kappa coefficient for diagnosis of obesity was low (28.7 %). The AFp was 50 % higher for DM and double for AHT when CUN-BAE was used. Conclusions The overall correlation between BMI and CUN-BAE was not good. The AFp of obesity for AHT and DM may be underestimated if assessed using the BMI, as may the prevalence of obesity when estimated from the percentage of BF

Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial

Patients with venous thromboembolism (VTE) require immediate treatment with anticoagulants such as acenocoumarol. This multicentre randomised clinical trial evaluated the effectiveness of a dosing pharmacogenetic algorithm versus a standard-of-care dose adjustment at the beginning of acenocoumarol treatment. We included 144 patients with VTE. On the day of recruitment, a blood sample was obtained for genotyping (CYP2C9*2, CYP2C9*3, VKORC1, CYP4F2, APOE). Dose adjustment was performed on day 3 or 4 after the start of treatment according to the assigned group and the follow-up was at 12 weeks. The principal variable was the percentage of patients with an international normalised ratio (INR) within the therapeutic range on day 7. Thirty-four (47.2%) patients had an INR within the therapeutic range at day 7 after the start of treatment in the genotype-guided group compared with 14 (21.9%) in the control group (p = 0.0023). There were no significant differences in the time to achieve a stable INR, the number of INRs within the range in the first 6 weeks and at the end of study. Our results suggest the use of a pharmacogenetic algorithm for patients with VTE could be useful in achieving target INR control in the first days of treatment

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group