Desempeño profesional de los bibliotecarios escolares de Secundaria Básica del municipio Majagua

At Junior High Schools in Majagua municipality some insufficiencies are found in training school librarians to meet their technical and methodological functions; thus in order to enhance the transformations in the quality of education, the scientific and methodological work was designed and implemented with the objective of proposing actions to increase the preparation of school librarians and the quality of their professional performance.En las escuelas de la enseñanza Secundaria Básica del municipio Majagua se manifiestan insuficiencias en la preparación de los bibliotecarios escolares para el cumplimiento de las funciones técnicas y metodológicas; a fin de favorecer las transformaciones en la calidad de la educación, se diseñó y ejecutó el trabajo científico metodológico con el objetivo de proponer acciones para elevar la preparación del bibliotecario escolar y la calidad de su desempeño profesional

Riesgo de resangrado en el paciente con hemorragia digestiva alta no varicosa

 Introducción: la probabilidad de recidiva está presente en cerca de 80% de los pacientes que presentan episodio de hemorragia digestiva alta no varicosa (HDA-NV). Objetivo: determinar el riesgo de resangrado mediante el empleo de la Escala de Rockall completa. Material y Métodos: se realizó un estudio prospectivo de corte transversal que incluyó a todos los pacientes con episodio de HDA-NV en el período entre septiembre 2011 y marzo 2013 en el Hospital Clínico Quirúrgico “Dr. Luis Díaz Soto”. Se utilizó la Escala de Rockall para determinar el índice de Rockall, que permitió agrupar a los pacientes en grupos de riesgo bajo, intermedio y alto. La evaluación de la eficacia en la estimación del riesgo de resangrado se realizó mediante el análisis por curva de ROC. Resultados: la estratificación en grupos de riesgo mostró el predominio de los casos con riesgo bajo (53 pacientes, 44,9%) o intermedio (47 casos, 39,8%), mientras que solo 18 casos (15,3%) se encontraron en riesgo alto. Sin embargo, 38,8% de los que se encontraron en este grupo presentaron un nuevo episodio hemorrágico. La capacidad predictiva de la Eescala de Rockall para el resangrado fue buena (ABC: 0,821, IC 95%: 0,664-0,977). El valor de corte con mayor eficacia fue 5, con un índice de Youden de 0,53. La sensibilidad fue de 63% y la especificidad de 83%. Conclusiones: con la Escala de Rockall completa se identifican correctamente los pacientes con probabilidad de que ocurra resangrado, por lo que puede ser introducido en la práctica clínica de la iinstitución.Palabras clave: Hemorragia digestiva alta no varicosa, Escala de Rockall, pronóstico. ABSTRACT  Introduction: the probability of recurrence is present in near of 80% of the patients with upper non-variceal digestive bleeding. Objective: to determine the rebleeding risk applying the complete Rockall score in patients with upper non-variceal gastrointestinal bleeding. Material and Methods: a retrospective analysis was carried out in 118 patients admitted to the emergency room and endoscopy unit of “Dr. Luis Díaz Soto” hospital with non-variceal upper gastrointestinal bleeding between September 2011 and March 2013.The Rockall scores were calculated and patients were divided into three risk categories: low risk, moderate risk and high risk. Receiver operating characteristic (ROC) curves were plotted for rebleeding. The discriminative accuracy of the risk scores was assessed by the area under the ROC curve. Results: high clinical Rockall scores &gt;5 were associated with rebleeding. The accuracy of the complete Rockall score in predicting rebleeding was good (area under ROC: 0,821, IC 95%: 0,664-0,977). The sensitivity was of a 63 % and the specificity of 11, 8 %, j= 0, 53. Conclusions: the Rockall score is clinically useful, rapid and accurate in predicting rebleeding, by what it can be entered in the clinical practice of this hospital.  Keywords: Rockall score, prognosis, upper non-variceal gastrointestinal bleeding. </p

Effect of excess weight and immune-related adverse events on the efficacy of cancer immunotherapy with anti-PD-1 antibodies

Immunotherapy is an effective treatment in advanced cancer, although predictors of response are limited. We studied whether excess weight influences the efficacy outcomes of immunotherapy. We have also evaluated the combined prognostic effect of excess weight and immune-related adverse events (irAEs). Efficacy of anti-PD-1 treatment was evaluated with both objective radiological response (ORR) rate and progression-free survival (PFS), and toxicity with irAEs. We studied the association between excess weight and ORR, PFS or irAEs. 132 patients diagnosed with advanced cancer were included. Median body mass index (BMI) was 24.9 kg/m2. 64 patients had normal weight (BMI&lt;25 kg/m2), and 64 patients had excess weight (BMI≥25 kg/m2). Four patients had underweight and were excluded from further analysis. ORR was achieved in 50 patients (38.0%), median PFS was 6 months. 44 patients developed irAEs (33.3%). ORR was higher in excess weight patients than in patients with normal weight (51.6% vs 25.0%; OR 3.45, p = .0009). PFS was improved in patients with excess weight (7.25 months vs 4 months, HR 1.72, p = .01). The incidence of IrAEs was not different in patients with excess weight (54.5% vs 43.2%, p = .21). When high BMI and irAEs were combined, we observed a marked prognostic trend in ORR rate (87.5% vs 6.2%; OR 161.0, p &lt; .00001), and in PFS (14 months vs 3 months; HR 5.89, p &lt; .0001). Excess weight patients with advanced cancer that receive single-agent anti-PD-1 antibody therapy exhibit a significantly improved clinical outcome compared with normal BMI patients. This association was especially marked when BMI and irAEs were considered combined.This study was funded in part by the project Discovery, Validation and Implementation of Biomarkers for Precision Oncology [PIE15/00068], and the project FIS PI17/01865 from the Instituto de Salud Carlos III, Ministerio de Economia y Competitividad, awarded to RC, and the projects [JR 17/00007 and PI17/008], awarded to NRL

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe

An embedding technique to determine ττ backgrounds in proton-proton collision data

An embedding technique is presented to estimate standard model tau tau backgrounds from data with minimal simulation input. In the data, the muons are removed from reconstructed mu mu events and replaced with simulated tau leptons with the same kinematic properties. In this way, a set of hybrid events is obtained that does not rely on simulation except for the decay of the tau leptons. The challenges in describing the underlying event or the production of associated jets in the simulation are avoided. The technique described in this paper was developed for CMS. Its validation and the inherent uncertainties are also discussed. The demonstration of the performance of the technique is based on a sample of proton-proton collisions collected by CMS in 2017 at root s = 13 TeV corresponding to an integrated luminosity of 41.5 fb(-1).Peer reviewe

Measurement of the Splitting Function in &ITpp &ITand Pb-Pb Collisions at root&ITsNN&IT=5.02 TeV

Data from heavy ion collisions suggest that the evolution of a parton shower is modified by interactions with the color charges in the dense partonic medium created in these collisions, but it is not known where in the shower evolution the modifications occur. The momentum ratio of the two leading partons, resolved as subjets, provides information about the parton shower evolution. This substructure observable, known as the splitting function, reflects the process of a parton splitting into two other partons and has been measured for jets with transverse momentum between 140 and 500 GeV, in pp and PbPb collisions at a center-of-mass energy of 5.02 TeV per nucleon pair. In central PbPb collisions, the splitting function indicates a more unbalanced momentum ratio, compared to peripheral PbPb and pp collisions.. The measurements are compared to various predictions from event generators and analytical calculations.Peer reviewe

Measurement of nuclear modification factors of gamma(1S)), gamma(2S), and gamma(3S) mesons in PbPb collisions at root s(NN)=5.02 TeV

The cross sections for ϒ(1S), ϒ(2S), and ϒ(3S) production in lead-lead (PbPb) and proton-proton (pp) collisions at √sNN = 5.02 TeV have been measured using the CMS detector at the LHC. The nuclear modification factors, RAA, derived from the PbPb-to-pp ratio of yields for each state, are studied as functions of meson rapidity and transverse momentum, as well as PbPb collision centrality. The yields of all three states are found to be significantly suppressed, and compatible with a sequential ordering of the suppression, RAA(ϒ(1S)) > RAA(ϒ(2S)) > RAA(ϒ(3S)). The suppression of ϒ(1S) is larger than that seen at √sNN = 2.76 TeV, although the two are compatible within uncertainties. The upper limit on the RAA of ϒ(3S) integrated over pT, rapidity and centrality is 0.096 at 95% confidence level, which is the strongest suppression observed for a quarkonium state in heavy ion collisions to date. © 2019 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP3.Peer reviewe