Difficulties to identify and pronounce the sounds /s/ and /z/ as EFL students in the second semester 2013, belonging to the Saturday program of the English Major at UNAN MANAGUA

One major concern about the EFL Saturday courses at UNAN-Managua is if the students are acquiring a good level of proficiency on pronunciation. It is a strong belief that EFL learners have great difficulties on pronunciation due to negative transfer; especially with difficult twin sounds which do not have an equivalent in the mother tongue of non-native speakers. This research was applied to a group of 15 students of the Saturday program of the English Major at UNAN. To this purpose were applied one survey to the students, two interviews, and several class observations. There were interesting findings about the subject and the most important is the concern to create phonological awareness in the students to improve their pronunciation

Propuesta de proyecto arquitectónico del Complejo Deportivo Multidisciplinario Integral, Alcaldía Municipal de San Miguel, El Salvador

RESUMEN: El presente documento contiene la elaboración y formulación de la propuesta arquitectónica del complejo deportivo, exponiendo la planificación social/deportiva y la operatividad del desarrollo físico como componentes principales para su consolidación. Con ello, contribuir como detonante urbanístico para la estructuración inicial del desarrollo local en la ciudad de San Miguel, esta propuesta consiste en diseñar un complejo deportivo de carácter social, abierto a la población en general, con espacios públicos dignos para los atletas y población en general, generando condiciones apropiadas para el funcionamiento específico de cada actividad planificada a realizarse en él, que incluye contar con las condiciones para albergar competiciones internacionales de estricta altura. OBJETIVO. Generar espacios con condiciones dignas para desarrollar actividades deportivas y recreativas para los usuarios. Además, consultar y aplicar compendios normativos, reglamentos institucionales, códigos y disposiciones técnicas de principios de diseño concernientes al proyecto. METODOLOGÍA. El método para implementar en el desarrollo de la investigación es el Método Deductivo, se basa en un sistema ordenado, con lo que se pretende aprovechar al máximo los recursos con los cuales se cuenta para la elaboración del estudio. CONCLUSIÓN. De manera satisfactoria se resuelve que la propuesta desarrollada es viable, factible y pertinente, beneficiando a la población en general; adulto, adulto mayor, joven y niño. La actividad física es considerada vital para tener una vida saludable, sin duda es un proyecto imperativo para el desarrollo de las nuevas generaciones de atletas, tomando en cuenta la interdisciplinariedad con la que cuenta la propuesta de complejo deportivo. ABSTRACT: This document contains the elaboration and formulation of the architectural proposal for complex sports, proposing the social / sports planning and the physical development operation as main components for its consolidation. With this, contributing as an urban trigger for the initial structuring of local development in San Miguel, this proposal consists of designing a complex sport of a social nature, open to the general population, with decent public spaces for athletes and general population, generating conditions fulfilled for the specific operation of each planned activity to be carried out in it, which includes having the conditions to host international competitions of strict height. OBJECTIVE. Generate spaces with decent conditions to develop sports and recreational activities for users. In addition, consult and apply normative compendia, institutional regulations, codes and technical provisions of design principles concerning the project. METHODOLOGY. The method to implement in the development of the research is the deductive Method, it is based on an orderly system, with which it is intended to make the most of the resources available for the preparation of the study. CONCLUSION. In a satisfactory manner, it is resolved that the proposal developed is viable, feasible and pertinent, benefiting the population in general; adult, senior, youth and child. Physical activity is considered vital to have a healthy life, it is undoubtedly an imperative project for the development of new generations of athletes, taking into account the interdisciplinarity that the sports complex proposal ha

Anestesia Regional vs. Anestesia Geral em Procedimentos Ginecológicos: Análise Comparativa

Objective: The aim of the article is to conduct a comparative review between regional and general anesthesia in gynecological procedures, exploring intraoperative risks, complications, patient satisfaction, and economic impacts. The goal is to provide a comprehensive analysis to guide clinical decision-making, considering both clinical and economic aspects in the choice of the most appropriate anesthetic modality. Introduction: The importance of choosing between regional and general anesthesia in gynecological procedures is emphasized. It underscores the complexity of the decision, considering risks, complications, and the need for a personalized approach. The significance of a comprehensive analysis is highlighted to guide clinical practices and promote informed decisions in the pursuit of safe and effective anesthesia. Methodology: An integrative review was conducted on the PubMed, Scielo, and BVS databases, using specific terms such as "Regional Anesthesia," "General Anesthesia," and "Gynecological Surgical Procedures." The use of boolean operators AND and OR was adopted to refine the search, aiming to identify relevant clinical studies, systematic reviews, integrative reviews, and meta-analyses, with priority given to original articles. Conclusion: The review highlights the complexity in choosing between regional and general anesthesia in gynecological procedures, emphasizing risks, patient satisfaction, and economic impacts. Flexibility in approach, effective communication, and strategies for financial optimization are crucial for patient-centered anesthesia practice. The ongoing pursuit of a balance between clinical efficacy and economic efficiency is fundamental to enhance the quality of anesthesia care.Objetivo: O objetivo do artigo é realizar uma revisão comparativa entre anestesia regional e geral em procedimentos ginecológicos, explorando riscos intraoperatórios, complicações, satisfação da paciente e impactos econômicos. O intuito é fornecer uma análise abrangente para orientar a tomada de decisão clínica, considerando aspectos clínicos e econômicos na escolha da modalidade anestésica mais apropriada. Introdução: Destaca-se a importância da escolha entre anestesia regional e geral em procedimentos ginecológicos. Enfatiza a complexidade da decisão, considerando riscos, complicações e a necessidade de uma abordagem personalizada. Importância da análise abrangente para orientar práticas clínicas e promover decisões informadas na busca por uma anestesia segura e eficaz. Metodologia: Conduziu-se uma revisão integrativa nas bases de dados PubMed, Scielo e BVS, empregando termos específicos como "Anestesia Regional," "Anestesia Geral," e "Procedimentos Cirúrgicos em Ginecologia." A utilização de operadores booleanos AND e OR foi adotada para aperfeiçoar a busca, visando identificar estudos clínicos, revisões sistemáticas, revisões integrativas e meta-análises pertinentes, com prioridade para artigos originais. Conclusão: A revisão evidencia a complexidade na escolha entre anestesia regional e geral em procedimentos ginecológicos, ressaltando riscos, satisfação da paciente e impactos econômicos. A flexibilidade na abordagem, comunicação eficaz e estratégias para otimização financeira são cruciais para uma prática anestésica centrada no paciente. A constante busca por equilíbrio entre eficácia clínica e eficiência econômica é fundamental para aprimorar a qualidade dos cuidados anestésicos

Hotspots of biogeochemical activity linked to aridity and plant traits across global drylands

14 páginas.- 4 figuras.- 67 referencias.- The online version contains supplementary material available at https://doi.org/10.1038/s41477-024-01670-7Perennial plants create productive and biodiverse hotspots, known as fertile islands, beneath their canopies. These hotspots largely determine the structure and functioning of drylands worldwide. Despite their ubiquity, the factors controlling fertile islands under conditions of contrasting grazing by livestock, the most prevalent land use in drylands, remain virtually unknown. Here we evaluated the relative importance of grazing pressure and herbivore type, climate and plant functional traits on 24 soil physical and chemical attributes that represent proxies of key ecosystem services related to decomposition, soil fertility, and soil and water conservation. To do this, we conducted a standardized global survey of 288 plots at 88 sites in 25 countries worldwide. We show that aridity and plant traits are the major factors associated with the magnitude of plant effects on fertile islands in grazed drylands worldwide. Grazing pressure had little influence on the capacity of plants to support fertile islands. Taller and wider shrubs and grasses supported stronger island effects. Stable and functional soils tended to be linked to species-rich sites with taller plants. Together, our findings dispel the notion that grazing pressure or herbivore type are linked to the formation or intensification of fertile islands in drylands. Rather, our study suggests that changes in aridity, and processes that alter island identity and therefore plant traits, will have marked effects on how perennial plants support and maintain the functioning of drylands in a more arid and grazed world.This research was supported by the European Research Council (ERC grant 647038 (BIODESERT) awarded to F.T.M.) and Generalitat Valenciana (CIDEGENT/2018/041). D.J.E. was supported by the Hermon Slade Foundation (HSF21040). J. Ding was supported by the National Natural Science Foundation of China Project (41991232) and the Fundamental Research Funds for the Central Universities of China. M.D.-B. acknowledges support from TED2021-130908B-C41/AEI/10.13039/501100011033/Unión Europea Next Generation EU/PRTR and the Spanish Ministry of Science and Innovation for the I + D + i project PID2020-115813RA-I00 funded by MCIN/AEI/10.13039/501100011033. O.S. was supported by US National Science Foundation (Grants DEB 1754106, 20-25166), and Y.L.B.-P. by a Marie Sklodowska-Curie Actions Individual Fellowship (MSCA-1018 IF) within the European Program Horizon 2020 (DRYFUN Project 656035). K.G. and N.B. acknowledge support from the German Federal Ministry of Education and Research (BMBF) SPACES projects OPTIMASS (FKZ: 01LL1302A) and ORYCS (FKZ: FKZ01LL1804A). B.B. was supported by the Taylor Family-Asia Foundation Endowed Chair in Ecology and Conservation Biology, and M. Bowker by funding from the School of Forestry, Northern Arizona University. C.B. acknowledges funding from the National Natural Science Foundation of China (41971131). D.B. acknowledges support from the Hungarian Research, Development and Innovation Office (NKFI KKP 144096), and A. Fajardo support from ANID PIA/BASAL FB 210006 and the Millennium Science Initiative Program NCN2021-050. M.F. and H.E. received funding from Ferdowsi University of Mashhad (grant 39843). A.N. and M.K. acknowledge support from FCT (CEECIND/02453/2018/CP1534/CT0001, SFRH/BD/130274/2017, PTDC/ASP-SIL/7743/2020, UIDB/00329/2020), EEA (10/CALL#5), AdaptForGrazing (PRR-C05-i03-I-000035) and LTsER Montado platform (LTER_EU_PT_001) grants. O.V. acknowledges support from the Hungarian Research, Development and Innovation Office (NKFI KKP 144096). L.W. was supported by the US National Science Foundation (EAR 1554894). Y.Z. and X.Z. were supported by the National Natural Science Foundation of China (U2003214). H.S. is supported by a María Zambrano fellowship funded by the Ministry of Universities and European Union-Next Generation plan. The use of any trade, firm or product names does not imply endorsement by any agency, institution or government. Finally, we thank the many people who assisted with field work and the landowners, corporations and national bodies that allowed us access to their land.Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Les complexes L. donovani et L. infantum : implications taxinomiques, biogeographiques et epidemiologiques : a propos de l'analyse enzymatique de 548 souches de l'Ancien et du Nouveau Monde

SIGLECNRS T Bordereau / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Biología de las especies de phassus y Aeputus (Lepidoptera Hepialidae) en localidades de elevación media en Costa Rica

Moreno Chavarría, G. (1989). Biología de las especies de phassus y Aeputus (Lepidoptera Hepialidae) en localidades de elevación media en Costa Rica. [Tesis de Licenciatura. Universidad Nacional, Costa Rica]. Repositorio Académico Institucional.La familia Hepialidae, en los pisos premontano y montano bajo de Costa Rica tiene como representantes los géneros Aepytus y Phassus, los cuales presentan diferenciación morfológica entre sí en cuanto a la venación alar y forma de las antenas. En la investigación se mencionan las especies Aepytus terea, Aepytus sp. (Hojancha). Aepytus sp. (Santiago Oeste). Aepytus sp. (Monteverde), Phassus (Hepialus) pharus, Phassus (Hepialus) sp.. Phassus triangularis y Phassus sp. Las condiciones climaticas de las localidades que habitan los hospederos vegetales que atacan, brindan una noción de los requerimientos abióticos y especificidad de hospedero, variando en cada caso.The Hepialidae family, in the premontane and lower montane floors of Costa Rica, has as representatives the genera Aepytus and Phassus, which present morphological differentiation from each other in terms of wing venation and antenna shape. The research mentions the species Aepytus terea, Aepytus sp. (Hojancha). Aepytus sp. (Santiago Oeste). Aepytus sp. (Monteverde), Phassus (Hepialus) pharus, Phassus (Hepialus) sp .. Phassus triangularis and Phassus sp. The climatic conditions of the localities inhabited by the attacking plant hosts provide a notion of abiotic requirements and host specificity, varying in each case.Universidad Nacional (Costa Rica)Escuela de Ciencias Biológica