Factores que influyen en el desarrollo de la comprensión lectora, en alumnos de cuarto año de enseñanza básica en lenguaje y comunicación, año 2010 del Instituto O'Higgins de Maipú.

Tesis (Magíster en Gestión Pedagógica y Curricular con Mención en Lenguaje)La presente investigación pretende dar a conocer los factores que influyen en el desarrollo de la comprensión lectora en alumnos de cuarto años básico en Lenguaje y Comunicación del Instituto O’Higgins de Maipú. Colegio particular subvencionado perteneciente a la Red EducaUC, Chile. Las razones por las cuales se emprende esta investigación se albergan en la necesidad de saber por qué los estudiantes del cuarto año de enseñanza básica, no desarrollan óptimamente la comprensión lectora en Lenguaje y Comunicación, por ende deberían evidenciar una comprensión lectora satisfactoria de acuerdo a su nivel. Esto se evidenció a comienzos del año 2010, cuando se desarrollaron actividades diagnósticas orientadas a la comprensión lectora, en la asignatura de Lenguaje y Comunicación. De los cuales, el 76% presentan una lectura inicial baja, y el resto una lectura intermedia baja, por lo que no lograron desarrollar actividades de comprensión lectora de acuerdo a las exigencias propias del nivel, afirmando un atraso en el desarrollo pedagógico por parte de los educandos. Entonces, esta indagación determinará los factores que influyen en el desarrollo de la comprensión lectora en Lenguaje y Comunicación en los alumnos de cuarto año básico B del instituto O’Higgins. La metodología que se efectuará es de carácter histórico y empírico en el cuál se realizará un análisis histórico-lógico, entrevistas y análisis documental respectivamente. Está enfocada al análisis de antecedentes de cómo la dirección, coordinación y docentes del establecimiento desarrollaron la comprensión lectora en Lenguaje y Comunicación, en el curso mencionado, a partir de la gestión educativa, metodología de trabajo y actividades directas en aula, durante los años 2007 al 2009, periodo en el que EducaUC se hace cargo de la dirección del establecimiento, Instituto O’Higgins de Maipú, el cual se tomará como resultados para argumentar esta investigación

Multi-Head Graph Convolutional Network for Structural Connectome Classification

We tackle classification based on brain connectivity derived from diffusion magnetic resonance images. We propose a machine-learning model inspired by graph convolutional networks (GCNs), which takes a brain connectivity input graph and processes the data separately through a parallel GCN mechanism with multiple heads. The proposed network is a simple design that employs different heads involving graph convolutions focused on edges and nodes, capturing representations from the input data thoroughly. To test the ability of our model to extract complementary and representative features from brain connectivity data, we chose the task of sex classification. This quantifies the degree to which the connectome varies depending on the sex, which is important for improving our understanding of health and disease in both sexes. We show experiments on two publicly available datasets: PREVENT-AD (347 subjects) and OASIS3 (771 subjects). The proposed model demonstrates the highest performance compared to the existing machine-learning algorithms we tested, including classical methods and (graph and non-graph) deep learning. We provide a detailed analysis of each component of our model

Absceso hepático piógeno roto: reporte de caso

Liver abscess is an uncommon pathology caused by the invasion of amebic, pyogenic or fungal microorganisms into the healthy parenchyma of the liver. We present the clinical case of a 27-year-old male adult with alcoholism and occasional smoking, with no other associated comorbidities, who was admitted to the General Hospital of Tecamachalco, Puebla, Mexico, for generalized abdominal pain and intolerance to oral administration for 4 days. CT scan interpretation showed data suggestive of hepatic abscess in segments VI and VII of the liver with abundant fluid in the abdomino-pelvic cavity. Exploratory laparotomy was performed with the finding of rupture of a ruptured pyogenic liver abscess, drainage and cleaning of the abdominal cavity was performed, antimicrobial therapy was started with satisfactory evolution and discharge without complications. In this patient there were no findings of lesion or cause of migration of the infection from another abdominal organ to the liver, confirming the unknown origin.Liver abscess is an uncommon pathology caused by the invasion of amebic, pyogenic or fungal microorganisms into the healthy parenchyma of the liver. We present the clinical case of a 27-year-old male adult with alcoholism and occasional smoking, with no other associated comorbidities, who was admitted to the General Hospital of Tecamachalco, Puebla, Mexico, for generalized abdominal pain and intolerance to oral administration for 4 days. CT scan interpretation showed data suggestive of hepatic abscess in segments VI and VII of the liver with abundant fluid in the abdomino-pelvic cavity. Exploratory laparotomy was performed with the finding of rupture of a ruptured pyogenic liver abscess, drainage and cleaning of the abdominal cavity was performed, antimicrobial therapy was started with satisfactory evolution and discharge without complications. In this patient there were no findings of lesion or cause of migration of the infection from another abdominal organ to the liver, confirming the unknown origin

Automatic geometry-based estimation of the locus coeruleus region on T1-weighted magnetic resonance images

The locus coeruleus (LC) is a key brain structure implicated in cognitive function and neurodegenerative disease. Automatic segmentation of the LC is a crucial step in quantitative non-invasive analysis of the LC in large MRI cohorts. Most publicly available imaging databases for training automatic LC segmentation models take advantage of specialized contrast-enhancing (e.g., neuromelanin-sensitive) MRI. Segmentation models developed with such image contrasts, however, are not readily applicable to existing datasets with conventional MRI sequences. In this work, we evaluate the feasibility of using non-contrast neuroanatomical information to geometrically approximate the LC region from standard 3-Tesla T1-weighted images of 20 subjects from the Human Connectome Project (HCP). We employ this dataset to train and internally/externally evaluate two automatic localization methods, the Expected Label Value and the U-Net. For out-of-sample segmentation, we compare the results with atlas-based segmentation, as well as test the hypothesis that using the phase image as input can improve the robustness. We then apply our trained models to a larger subset of HCP, while exploratorily correlating LC imaging variables and structural connectivity with demographic and clinical data. This report provides an evaluation of computational methods estimating neural structure

Long-term Clinical and Cost-effectiveness of Early Endovenous Ablation in Venous Ulceration: A Randomized Clinical Trial

Importance One-year outcomes from the Early Venous Reflux Ablation (EVRA) randomized trial showed accelerated venous leg ulcer healing and greater ulcer-free time for participants who are treated with early endovenous ablation of lower extremity superficial reflux.Objective To evaluate the clinical and cost-effectiveness of early endovenous ablation of superficial venous reflux in patients with venous leg ulceration.Design, Setting, and Participants Between October 24, 2013, and September 27, 2016, the EVRA randomized clinical trial enrolled 450 participants (450 legs) with venous leg ulceration of less than 6 months’ duration and superficial venous reflux. Initially, 6555 patients were assessed for eligibility, and 6105 were excluded for reasons including ulcer duration greater than 6 months, healed ulcer by the time of randomization, deep venous occlusive disease, and insufficient superficial venous reflux to warrant ablation therapy, among others. A total of 426 of 450 participants (94.7%) from the vascular surgery departments of 20 hospitals in the United Kingdom were included in the analysis for ulcer recurrence. Surgeons, participants, and follow-up assessors were not blinded to the treatment group. Data were analyzed from August 11 to November 4, 2019.Interventions Patients were randomly assigned to receive compression therapy with early endovenous ablation within 2 weeks of randomization (early intervention, n = 224) or compression with deferred endovenous treatment of superficial venous reflux (deferred intervention, n = 226). Endovenous modality and strategy were left to the preference of the treating clinical team.Main Outcomes and Measures The primary outcome for the extended phase was time to first ulcer recurrence. Secondary outcomes included ulcer recurrence rate and cost-effectiveness.Results The early-intervention group consisted of 224 participants (mean [SD] age, 67.0 [15.5] years; 127 men [56.7%]; 206 White participants [92%]). The deferred-intervention group consisted of 226 participants (mean [SD] age, 68.9 [14.0] years; 120 men [53.1%]; 208 White participants [92%]). Of the 426 participants whose leg ulcer had healed, 121 (28.4%) experienced at least 1 recurrence during follow-up. There was no clear difference in time to first ulcer recurrence between the 2 groups (hazard ratio, 0.82; 95% CI, 0.57-1.17; P = .28). Ulcers recurred at a lower rate of 0.11 per person-year in the early-intervention group compared with 0.16 per person-year in the deferred-intervention group (incidence rate ratio, 0.658; 95% CI, 0.480-0.898; P = .003). Time to ulcer healing was shorter in the early-intervention group for primary ulcers (hazard ratio, 1.36; 95% CI, 1.12-1.64; P = .002). At 3 years, early intervention was 91.6% likely to be cost-effective at a willingness to pay of £20 000 ($26 283) per quality-adjusted life year and 90.8$45 995) per quality-adjusted life year.Conclusions and Relevance Early endovenous ablation of superficial venous reflux was highly likely to be cost-effective over a 3-year horizon compared with deferred intervention. Early intervention accelerated the healing of venous leg ulcers and reduced the overall incidence of ulcer recurrence

Thermoregulation mechanisms and perspectives for validating thermal windows in pigs with hypothermia and hyperthermia: An overview

Specific anatomical characteristics make the porcine species especially sensitive to extreme temperature changes, predisposing them to pathologies and even death due to thermal stress. Interest in improving animal welfare and porcine productivity has led to the development of various lines of research that seek to understand the effect of certain environmental conditions on productivity and the impact of implementing strategies designed to mitigate adverse effects. The non-invasive infrared thermography technique is one of the tools most widely used to carry out these studies, based on detecting changes in microcirculation. However, evaluations using this tool require reliable thermal windows; this can be challenging because several factors can affect the sensitivity and specificity of the regions selected. This review discusses the thermal windows used with domestic pigs and the association of thermal changes in these regions with the thermoregulatory capacity of piglets and hogs

Comparison of coronary angiography and intra-coronary ultrasound as "gold standard" in the diagnosis of post cardiac transplantation vasculopathy

Indexación: Web of Science; ScieloAntecedentes: La Vasculopatía del injerto (VDI) es la principal causa de muerte tardía del trasplante cardiaco (TX). Un diagnóstico precoz de esta complicación tendría un impacto en la terapia y pronóstico de esta afección. El ultrasonido intracoronario (IVUS), permite un diagnóstico precoz y certero de VDI, pero en la mayoría de los centros aún se utiliza la coronariografía. Objetivo: Evaluar la validez de la coronariografía en el diagnostico de VDI en pacientes trasplantados cardiacos, comparado con el IVUS. Metodología: Estudio transversal, en el cual se analizó una muestra de 36 pacientes con un tiempo promedio de trasplante de 3,7 ± 3,7 años, a quienes se realizó simultáneamente un examen de coronario-grafía y un IVUS. Se evaluó la reproducibilidad contrastando los resultados de la interpretación visual de la coronariografía versus la coronariografía con análisis cuantitativo. Se calculó la Sensibilidad, Especificidad, Valores predictivos (VPP, VPN), Likelihoods y el coeficiente de equivalencia de Spearman-Brown. Resultados: La coronariografía cualitativa mostró ser más exacta que la cuantitativa, con una sensibilidad 30,4% [95% IC= 11,6 - 49,2], una especificidad 92,3% [95% IC= 77,8 - 106,7], VPP 87,5% [95% IC= 64,5 - 110,4], VPN 42,8% [95% IC= 24,5 - 61,1], LR (+) 3,9 [95% IC 0,55 - 28,7] y un LR (-) 0,75 [95% IC= 0,55 - 1,03]. La coronariografía cualitativa y cuantitativa son moderadamente equivalentes con un coeficiente de equivalencia Spearman Brown de 0,65. Conclusión: La validez y la reproducibilidad de la coronariografía en el paciente con TX es moderada y debería ser complementada con IVUS para el diagnóstico de VDI.Background: Graft vasculopathy (GV) is the main cause of late death following cardiac transplantation (TX). Early diagnosis of this condition may have an impact upon treatment and prognosis of this complication. Intravascular ultrasound (IVUS) allows an early and accurate diagnosis of GV. However, most centers continue to use coronary angiography for this purpose. Aim: to evaluate coronary angiography for the diagnosis of GV in relation to IVUS in post TX patients. Methods: In a cross-sectional study the results of coronary angiography and IVUS, used as gold standard, were compared in 36 patients with a mean post TX follow up of 3.7 ± 3.7 years. Results were compared between visual and quantitative coronary angiography. Sensitivity, specificity, positive and negative predictive values (PPV, NPV), likelihood ratios and the equivalence Spearman-Brown coefficient were calculated. Results: Visual evaluation of coronary angiography was more accurate than quantitative coronary angiography. The sensitivity for GV was 30.4% (95% C.I. 11.6 - 49.2), specificity 92.3% (95% C.I. 77.8 - 106.7), PPV 87.5% (95% C.I. 64.5 - 110.4, NPP 42.8% (95% C.I. 24.5 - 61.1), likelihood ratio (+) 3.9 (95% C.I. 0.55 - 28.7), likelihood ratio (-) 0.75 (95% C.I. 0.55 -1.03). The Spearman Brown coefficient between visual and quantitative coronary angiography evaluation was 0.65. Conclusion: Accuracy and reproducibility of coronary angiography in the evaluation of GV is limited. IVUS should be used for better identification of GV.http://ref.scielo.org/6ncn6

Androgen stimulates growth of mouse preantral follicles in vitro: Interaction with follicle-stimulating hormone and with growth factors of the TGFβ super family

Androgens are essential for the normal function of mature antral follicles but also have a role in the early stages of follicle development. Polycystic ovary syndrome (PCOS), the most common cause of anovulatory infertility, is characterized by androgen excess and aberrant follicle development that includes accelerated early follicle growth. We have examined the effects of testosterone and dihydrotestosterone (DHT) on development of isolated mouse preantral follicles in culture with the specific aim of investigating interaction with follicle-stimulating hormone (FSH), the steroidogenic pathway, and growth factors of the TGFβ superfamily that are known to have a role in early follicle development. Both testosterone and DHT stimulated follicle growth and augmented FSH-induced growth and increased the incidence of antrum formation among the granulosa cell layers of these preantral follicles after 72 hours in culture. Effects of both androgens were reversed by the androgen receptor antagonist flutamide. FSH receptor expression was increased in response to both testosterone and DHT, as was that of Star, whereas Cyp11a1 was down-regulated. The key androgeninduced changes in the TGFβ signaling pathway were down-regulation of Amh, Bmp15, and their receptors. Inhibition of Alk6 (Bmpr1b), a putative partner for Amhr2 and Bmpr2, by dorsomorphin resulted in augmentation of androgen-stimulated growth and modification of androgen-induced gene expression. Our findings point to varied effects of androgen on preantral follicle growth and function, including interaction with FSH-activated growth and steroidogenesis, and, importantly, implicate the intrafollicular TGFb systemas a keymediator of androgen action. These findings provide insight into abnormal early follicle development in PCOS

Strategies for Hypothermia Compensation in Altricial and Precocial Newborn Mammals and Their Monitoring by Infrared Thermography

Publication history: Accepted - 18 May 2022; Published - 23 May 2022.Thermoregulation in newborn mammals is an essential species-specific mechanism of the nervous system that contributes to their survival during the first hours and days of their life. When exposed to cold weather, which is a risk factor associated with mortality in neonates, pathways such as the hypothalamic–pituitary–adrenal axis (HPA) are activated to achieve temperature control, increasing the circulating levels of catecholamine and cortisol. Consequently, alterations in blood circulation and mechanisms to produce or to retain heat (e.g., vasoconstriction, piloerection, shivering, brown adipocyte tissue activation, and huddling) begin to prevent hypothermia. This study aimed to discuss the mechanisms of thermoregulation in newborn domestic mammals, highlighting the differences between altricial and precocial species. The processes that employ brown adipocyte tissue, shivering, thermoregulatory behaviors, and dermal vasomotor control will be analyzed to understand the physiology and the importance of implementing techniques to promote thermoregulation and survival in the critical post-birth period of mammals. Also, infrared thermography as a helpful method to perform thermal measurements without animal interactions does not affect these parameters.Non

The Staphylococcus aureus Network Adaptive Platform Trial Protocol: New Tools for an Old Foe

Staphylococcus aureus bloodstream (SAB) infection is a common and severe infectious disease, with a 90-day mortality of 15%-30%. Despite this, <3000 people have been randomized into clinical trials of treatments for SAB infection. The limited evidence base partly results from clinical trials for SAB infections being difficult to complete at scale using traditional clinical trial methods. Here we provide the rationale and framework for an adaptive platform trial applied to SAB infections. We detail the design features of the Staphylococcus aureus Network Adaptive Platform (SNAP) trial that will enable multiple questions to be answered as efficiently as possible. The SNAP trial commenced enrolling patients across multiple countries in 2022 with an estimated target sample size of 7000 participants. This approach may serve as an exemplar to increase efficiency of clinical trials for other infectious disease syndromes