Convivencia escolar en el logro de aprendizajes en estudiantes del VII ciclo de secundaria, Santa Anita - 2022

El problema de la investigación se focalizó en conocer las dificultades que presentan los estudiantes cuando socializan al desarrollar sus aprendizajes. Objetivo: La investigación tuvo como objetivo determinar la influencia de la convivencia escolar en el logro de aprendizajes en estudiantes del VII ciclo de secundaria. Metodología: La indagación es de tipo aplicado, con diseño no experimental, transeccional, correlacional causal; asimismo, se contó con una muestra de 184 colaboradores que fueron evaluados con un cuestionario de convivencia escolar a través del formulario Google forms; además, se utilizó los resultados de logros obtenidos por los estudiantes en el primer bimestre de las áreas de comunicación, ciencias sociales y desarrollo personal, ciudadana y cívica. Resultados: los hallazgos develan que existe influencia de la inconstante convivencia escolar en la variable aprendizaje con un p=0.000 <0.05; asimismo el estadístico Cox y Snell evidenció que la potencia de influencia de la inconstante antecedente sobre la consecuente alcanzo un 18,9%. Conclusión: por tanto, se concluyó que la convivencia escolar influye en el logro de aprendizajes de los participantes de esta indagación

Projection of Potential Reimbursement of a Post-Hospital Discharge Pharmacist Operated Medication Management Service

Abstract Category: Practice Innovation / Performance Improvement (PI) Purpose: It is well established in the literature that pharmacists providing medication therapy management services (MTM) post-hospital discharge can improve medication adherence and safety, as well as decrease Emergency Department visits and readmissions. Although the evidence supports these programs, the number of patients receiving such services is very limited, mainly due to cost. The purpose of this study is to determine if enough revenue can be generated to sustain a post-discharge pharmacist driven medication therapy management program. Methods: A prospective review of patients discharged from medical/surgical units for an 11 months period is being conducted. Two hundred fifty patients will be randomly selected. Demographics and financial information will be recorded. Patients with insurance that provides MTM services, with 8 or more prescription medications, and 3 or more chronic conditions will be considered qualifying patients. Cost of operating the program will be based on the average pharmacist salary and benefits. A fee of $75 for conducting a Complete Medication Review (CMR) will be used to calculate reimbursement. Findings: Using a randomization formula, 55 patients have been selected to determine if they would qualify for MTM services. Eleven patients (20$65.00 per hour to operate the program and an average reimbursement fee of $75.00 per (CMR), the number needed to cover the daily cost of operating the program on a full-time basis was calculated to be 7 patients CMR’s per day. Discussion: The findings of this study suggest that the reimbursement produced can help offset the cost of operating the service on an hour per hour basis. It was estimated that a minimum of seven patient CMR’s must be performed per day to cover the cost of operating the MTM program with a dedicated full-time pharmacist. The study data suggests an average of six patients per day may be eligible but this does not include willingness of patients to participate or if they are receiving MTM services elsewhere. Modifications to decrease the cost of operating the program include: decreasing the number of hours per day used for this program, decreasing the number of days the services are rendered, and incorporating pharmacy students and residents under the supervision of a pharmacist to provide the service. Implications for Practice: The implementation of a medication therapy management program at West Kendall Baptist Hospital, can help resolve medication related problems post discharge, improve patient’s adherence to treatment, potentially decrease readmissions and generate sufficient pharmacy revenue to support the program on a part-time basis

Validación con datos in-situ de alturas de ola obtenidas mediante radar altimétrico

Los rádares altimétricos a bordo de satélites artificiales, han sido diseñados para dar información precisa de la altura del nivel del mar, la altura de ola significante y la velocidad del viento sobre la superficie del mar. En los estudios, tanto anteriores como actuales, se observan problemas en las regiones costeras, donde las medidas del altímetro tienen menor precisión y una mayor dificultad a la hora de interpretar estos datos. Estos inconvenientes son debidos a dos factores principales. En primer lugar, la contaminación de la señal radar debido a la cercanía de la costa. En segundo lugar, inexactitudes en las correcciones de marea y troposférica húmeda. A estos problemas se añade la complejidad de la zona de estudio, al ser una región con una amplia gama de procesos hidrodinámicos con diversas escalas espacio-temporales. Tener acceso a información exacta en la costa, con las condiciones que conlleva, tiene una gran importancia debido al enorme interés económico-estratégico de la zona litoral. Este interés hace que surjan nuevas estrategias para generar productos altimétricos optimizados para tales condiciones. Las medidas de la altura de ola significante y su variabilidad en las áreas costeras son usadas para muchos propósitos (por ejemplo, análisis del transporte de sedimento, setup de la ola y tormentas de marea), y para la validación/calibración de modelos (pronóstico de oleaje, circulación oceánica). Estas aplicaciones sirven para un amplio rango de propósitos sociales relevantes, tales como el diseño de estructuras de ingeniería en alta mar, la protección de las zonas costeras, rutas para los buques y la planificación de las operaciones en el océano. Muchos estudios se han dedicado a la validación de los datos de la altura de ola significante dados por el radar altimétrico a bordo de satélites artificiales, utilizando observaciones in-situ. El objetivo de esta ponencia es exponer una metodología para validar los datos de altura de oleaje proporcionados por el radar altimétrico RA-2 a bordo del satélite ENVISAT, a partir de datos in-situ medidos por una boya, y su aplicación a un caso particular

Diseño del plan de desarrollo institucional de la empresa Constructora Avenida 29 LTDA

Las reflexiones realizadas en torno a la planeación organizacional se han constituido en motivo de reflexión para muchas empresas, porque a partir de ella se solucionan los problemas y se identifican las necesidades que tiene pasa así determinar el rumbo que debe tomar, los comportamientos y los ajustes que se requieren con miras a no desaparecer del mercado competitivo actual. Es así como en la empresa Constructora Avenida 29 Ltda., se propone aplicar los principios de la. planeación estratégica con miras a formular el Plan de Desarrollo Institucional, que obedece a una necesidad u obligación que tiene hoy las empresas para cumplir con su labor social de una manera más eficaz y eficiente y, de esta manera, tener mayores posibilidades de sobrevivir en un mercado altamente competitivo y turbulento. de tal forma este trabajo investigativo trata entonces de identificar y ejecutar las acciones básicas que lleven a la empresa por el camino que le brinde mejores oportunidades para su desarrollo y para la reali7adón del potencial de cada miembro y equipo de trabajo dentro de un marco de participación comprometida y consciente. Pues como dice David Noel Ramírez: 'Es increíble que la mayoría de las organizaciones no cuentan con una misión, pero lo más preocupante es lo que ello implica o conlleva, es decir, no se tiene ni idea de adónde se quiere ir, qué se pretende, cuál es la razón de ser de la organizació

Clinical and Laboratory Development of Echinocandin Resistance in Candida glabrata: Molecular Characterization

The pathogenic yeast Candida glabrata has become a public health issue due to the increasing number of echinocandin resistant clinical strains reported. In this study, acquisition and development of resistance to this antifungal class were studied in serial C. glabrata isolates from five patients admitted in two Spanish hospitals with a resistant profile against echinocandins associated with different mutations in hot-spot 1 of FKS2 gene. For two of these patients susceptible FKS wild-type isolates obtained prior to resistant ones were also investigated. Isolates were genotyped using multilocus sequence typing and microsatellite length polymorphism techniques, which yielded comparable results. Susceptible and resistant isolates from the same patient had the same genotype, being sequence type (ST) 3 the most prevalent among them. Isolates with different FKS mutations but the same ST were present in the same patient. MSH2 gene alterations were also studied to investigate their correlation with antifungal resistance acquisition but no association was found with antifungal resistance nor with specific genotypes. In vitro exposure to increasing concentrations of micafungin to susceptible isolates developed colonies carrying FKS mutations in agar plates containing a minimum concentration of 0.06 mg/L of micafungin after less than 48 h of exposure. We investigated the correlation between development of resistance and genotype in a set of susceptible strains after being in vitro exposed to micafungin and anidulafungin but no correlation was found. Mutant prevention concentration values and spontaneous growth frequencies after selection with both echinocandins were statistically similar, although FKS mutant colonies were more abundant after micafungin exposure (p < 0.001). Mutation S663P and F659 deletion were the most common ones found after selection with both echinocandins.This work was supported by the Fondo de Investigación Sanitaria (Grant FI14CIII/00025 to OR-M and research projects PI13/02145 and PI16CIII/00035 to AA-I), and also supported by the Plan Nacional de I+D+i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI RD16CIII/0004/0003) – co-financed by the European Development Regional Fund “A way to achieve Europe,” Operative Program Intelligent Growth 2014–2020.S

Plasmatic level of neurosin predicts outcome of mild cognitive impairment

<p>Abstract</p> <p>Background</p> <p>Mild Cognitive Impairment (MCI) is a disorder considered to be a transitional stage from health to dementia. Diagnosis of dementias at these early stages is always troublesome because the pathophysiologic events leading to dementia precede clinical symptoms. Thus, the development of biomarkers that can be used to support the diagnosis of dementias at early stages is rapidly becoming a high priority. We have recently reported the value of measuring plasmatic levels of neurosin in the diagnosis of Alzheimer's disease (AD). The aim of this study is to determine whether measuring plasmatic concentration of neurosin is a valuable test to predict progression of MCI.</p> <p>Methods</p> <p>Plasmatic neurosin concentrations were measured in 68 MCI patients and 70 controls subjects. Blood samples were obtained at the beginning of the study. Sixty six patients diagnosed with MCI were observed for 18 months. In 36 patients a second blood sample was obtained at the endpoint.</p> <p>Results</p> <p>The mean value of plasmatic neurosin concentration differs significantly between MCI patients who converted to Dementia with vascular component, those who converted to AD, or those who remained at MCI stage. The relative risk of developing Dementia with vascular component when neurosin levels are higher than 5.25 ng/ml is 13 while the relative risk of developing mild AD when neurosin levels are lower than 5.25 ng/ml is 2. Increases in the levels of neurosin indicate progression to Dementia with vascular component.</p> <p>Conclusion</p> <p>The measurement of plasmatic neurosin level in patients diagnosed with MCI may predict conversion from MCI to Dementia with vascular component. A single measurement is also valuable to estimate the risk of developing AD and Dementia with vascular component. Finally, repeated measurement of plasmatic neurosin might be a useful test to predict outcome in patients with MCI.</p

microRNA Expression and Its Association With Disability and Brain Atrophy in Multiple Sclerosis Patients Treated With Glatiramer Acetate.

Background: MicroRNAs are small non-coding RNA that regulate gene expression at a post-transcriptional level affecting several cellular processes including inflammation, neurodegeneration and remyelination. Different patterns of miRNAs expression have been demonstrated in multiple sclerosis compared to controls, as well as in different courses of the disease. For these reason they have been postulated as promising biomarkers candidates in multiple sclerosis. Objective: To correlate serum microRNAs profile expression with disability, cognitive functioning and brain volume in patients with remitting-relapsing multiple sclerosis. Methods: Cross-sectional study in relapsing-remitting multiple sclerosis patients treated with glatiramer acetate. Disability was measured with Expanded Disability Status Scale (EDSS) and cognitive function was studied with Symbol Digit Modalities Test (SDMT). Brain volume was analyzed with automatic software NeuroQuant® . Results: We found an association between miR.146a.5p (rs:0.434, p=0.03) and miR.9.5p (rs:0.516, p=0.028) with EDSS; and miR-146a.5p (rs:-0.476, p=0.016) and miR-126.3p (rs:-0.528, p=0.007) with SDMT. Regarding to the brain volume, miR.9.5p correlated with thalamus (rs:-0.545, p=0.036); miR.200c.3p with pallidum (rs:-0.68, p=0.002) and cerebellum (rs:-0.472, p=0.048); miR-138.5p with amygdala (rs:0.73, p=0.016) and pallidum (rs:0.64, p=0.048); and miR-223.3p with caudate (rs:0.46, p=0.04). Conclusions: These data support the hypothesis of microRNA as potential biomarkers in this disease. More studies are needed to validate these results and to better understand the role of microRNAs in the pathogenesis, monitoring and therapeutic response of multiple sclerosis.post-print1410 K

Serial clinical and echocardiographic evaluation in children with Marfan syndrome

OBJECTIVE: To describe the clinical cardiac manifestations and temporal evolution of Marfan syndrome in children; to estimate the incidence of annuloaortic ectasia and mitral valve prolapse; and to evaluate tolerability and efficacy of beta-blockers in these patients. METHODS: During one year, 21children with Marfan syndrome underwent serial clinical and echocardiographic examinations. Echocardiograms assessed: the presence of mitral valve prolapse, aortic root diameter, mitral and aortic valves regurgitation, and aortic enlargement during beta-blocker therapy. Eleven patients had two measurements of the aortic root taken one year apart. RESULTS: The children were asymptomatic throughout the study. Mitral prolapse was found in 11 (52%) children. Annuloaortic ectasia occurred in 16 (76%) patients and found to be mild in 42.8%, moderate in 9.5%, and severe in 23.8%. One of these patients underwent aortic valve replacement and repair of the ascending aorta by the Bentall-De Bono technique, with good results. Heart rate decreased by 13.6% (from 85 to 73 bpm; p < 0.009) with the use of beta-blockers; however, aortic root diameter increased by 1.4 mm/year (p<0.02). One child could not be given beta-blockers due to bronchial asthma, and no significant side effects were observed in the remaining children, including one who also had bronchial asthma. CONCLUSION: The children remained asymptomatic throughout the study, the use of beta-blockers led to a significant decrease in heart rate, and no significant adverse effects were observed. Contrary to the literature, incidence of annuloaortic ectasia was high among the study population, greater than that of mitral valve prolapse, even during beta-blocker therapy.OBJETIVO: Descrever a apresentação clínica cardiológica e a evolução temporal, estimar a incidência de ectasia ânulo-aórtica e de prolapso da valva mitral, e avaliar a tolerância e a efetividade dos betabloqueadores em crianças com síndrome de Marfan. MÉTODOS: Foram submetidas a exame clínico e ecocardiográfico seriado, durante um ano, 21 crianças com síndrome de Marfan. No ecocardiograma foram analisados: presença de prolapso mitral, diâmetro da raiz aórtica, refluxos das valvas mitral e aórtica, e o crescimento dos diâmetros aórticos na vigência de betabloqueadores. Em 11 pacientes foi possível obter duas medidas da raiz aórtica no intervalo de um ano. RESULTADOS: Durante o estudo as crianças não apresentaram sintomas. Prolapso mitral foi encontrado em 11 (52%) crianças. Ectasia ânulo-aórtica ocorreu em 16 (76%) pacientes, sendo de grau discreto em 42,8%, moderado em 9,5%, e importante em 23,8%. Um desses pacientes foi submetido com sucesso à cirurgia de Bentall DeBono. Com o uso de betabloqueador a freqüência cardíaca diminuiu 13,6% (de 85 para 73 bpm; p < 0,009), mas houve um crescimento da raiz aórtica de 1,4 mm/ano (p < 0,02). Uma criança não pôde receber betabloqueador em razão de asma brônquica, e não foram observados efeitos colaterais significativos nas outras crianças, incluindo uma com asma brônquica. CONCLUSÃO: Os resultados obtidos sugerem que, no período observado, as crianças permaneceram assintomáticas, o uso de betabloqueadores diminuiu significativamente a freqüência cardíaca e não se acompanhou de efeitos adversos significativos. Ao contrário da literatura, a incidência de ectasia ânulo-aórtica foi elevada e maior do que a de prolapso valvar mitral, tendo crescimento mesmo na vigência de uso eficaz de betabloqueador.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Microstructural Development in a TRIP-780 Steel Joined by Friction Stir Welding (FSW): Quantitative Evaluations and Comparisons with EBSD Predictions

The present work describes the effect of FSW on the result microstructure in the stir zone (SZ), thermo-mechanically affected zone (TMAZ), heat affected zone (HAZ) and base metal (BM) of a TRIP-780 steel. X-ray diffraction (XRD), optical microscopy (OM) and EBSD were used for determinations retained austenite (RA) in the SZ, It was found that the amount of RA developed in SZ was relatively large, (approximately 11% to 15%). In addition, recrystallization and the formation of a grain texture were resolved using EBSD. During FSW, the SZ experienced severe plastic deformation which lead to an increase in the temperature and consequently grain recrystallization. Moreover, it was found that the recrystallized grain structure and relatively high martensite levels developed in the SZ lead to a significant drop in the mechanical properties of the steel. In addition, microhardness profiles of the welded regions indicated that the hardness in both the SZ and TMAZ were relatively elevated confirming the development of martensite in these regions. In particular, to evaluate the mechanical strength of the weld, lap shear tensile test was conducted; exhibited the fracture zone in the SZ with shear fracture with uniformly distributed elongation shear dimples