El monólogo de la Reina

¿A quien se le ocurre? Una sólo puede llamarse Reina por dos razones: una, porque fuera la primogénita de un idiota y la otra, porque la madre –grandísima tonta– se impusiera. Así es que en realidad es una sola y triste razón. Una se llama Reina porque sus padres no tienen imaginación, sentido de la ubicación, ni sensatez

MÉTODOS DE INMERSIÓN PARA LOGRAR LA EFICIENCIA EN EL IDIOMA INGLÉS EN ESTUDIANTES DE NIVEL UNIVERSITARIO EN CIUDAD DE PANAMÁ

An average college student in Panama City has spent approximately twelve years studying English as a subject at school. University will add more of these courses and still, many professionals feel they need to spend money in private lessons to learn how to use the language. Others don’t need that much energy to have a conversation, read, and write in English. Which are the keys to build confidence and be able to use it as a foreign or second language? Some students tell us what they do to practice it and improve each day.  En la ciudad de Panamá, un estudiante promedio con nivel educativo de universidad ha pasado aproximadamente 12 años tomando la materia inglesa en el colegio. En la universidad añadirá hasta seis materias de inglés y, aun así, muchos profesionales perciben que deben invertir en lecciones privadas para aprender a utilizar el idioma. Otras personas no parecen necesitar tanta energía para mantener una conversación, leer y escribir en inglés. ¿Cuáles son las claves para lograr confianza y ser capaz de usarlo como idioma extranjero o segundo idioma? Algunos estudiantes nos cuentan qué hacen para practicar y mejorar cada día

Modelación de los atributos que inciden en la elección del consumidor de alimentos funcionales

El presente trabajo de Investigación tuvo como objetivo estimar un modelo que permite determinar los atributos que inciden en la elección del consumidor de alimentos funcionales. La investigación fue de tipo descriptivo, explicativo y predictivo. La muestra utilizada en la investigación fue de 623 encuestados que acudieron a realizar sus compras en los supermercados de Plaza Vea, Tottus y Metro de la Ciudad de Chiclayo. Se administró un cuestionario estructurado y validado con la finalidad de obtener datos para la aplicación del modelo de Regresión Logística. Se llegó a determinar que dentro de los atributos intrínsecos que inciden en la elección del consumidor de alimentos funcionales fueron el sabor, el color y el precio mientras que los atributos extrínsecos que inciden en la elección del consumidor fueron la información en las etiquetas y presentación de los productos. Adicionalmente, otros factores no incluidos en las dos categorías anteriores que también influyen en la elección son el sexo, ingresos económicos y el cuidado de la salud de los consumidores

NATURAL HISTORY AND RISK FACTORS OF BEDSIDE PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBES IN THE ICU

INTRODUCTION: There is a paucity of literature describing patients receiving bedside placed percutaneous endoscopic gastrostomy (PEG) tubes in an intensive care unit (ICU) setting. This study aims to describe the natural history, and risk factors for complications for ICU patients requiring bedside PEG tube placement in a Level I trauma center. METHODS: Adult patients with bedside placed PEG tubes from 1/1/2017 to 1/1/2022 were identified through retrospective chart review. Patients with at least 6 months of follow up were included in this study. Descriptive statistics were used to illustrate the cohort\u27s natural history. Multivariable logistic regression models adjusting for patient demographics, comorbidities, and index hospitalization factors were fitted to identify risk factors predictive of 6-month all cause complications. Major complications were those requiring invasive intervention. RESULTS: 144 patients were included in this study. Pertinent cohort characteristics include mean age 55.8 years (IQR: 45.6-68.2), 63.9% male sex, 54.9% black race, 28.7% had prior inpatient hospitalization in the past 6 months, 43.4% were transferred from outside hospitals. The most common indications were respiratory failure (31.9%) and blunt trauma (22.9%). The 6-month rate of all-cause and major complication rates were 12.5% and 7.6%, respectively. The most common complications following bedside PEG tube placement were tube dislodgement (44.4%) and surrounding organ injury (27.7%). No deaths associated with PEG tube placement in our study. Bedside PEG tubes were placed on hospital day 15.4 [IQR: 9.7-20.7] and total hospital stay was 34.6 days [IQR: 21.6-43.7]. The most common disposition was to long-term care facility (55.6%). Significant risk factors associated with 6-month all-cause complications include history of diabetes (OR: 5.8, P = 0.038 [95% C.I. 1.1-30.1]). Risk factors for 6-month major complications include prior hospitalization (OR: 5.9, P = 0.05, [95% C.I. 1.01-34]), and increasing serum creatinine (OR: 5.8, P = 0.02, [95% C.I. 1.3-26.6]). CONCLUSIONS: History of diabetes, prior hospitalization, and elevated serum creatinine were associated with increased rates of 6-month complications among ICU patients receiving bedside PEG tubes in our cohort

Structure and evolution of low-mass W UMa type systems -- II. with angular momentum loss

In a preceding paper, using Eggleton's evolution code we have discussed the structure and evolution of low-mass W UMa type contact binaries without angular momentum loss (AML). The models exhibit cyclic behavior about a state of marginal contact on a thermal time-scale. Part of the time of each cycle is spent in contact and part in a semi-detached state. According to observations, W UMa systems suffer AML. We present the models of low-mass contact binaries with AML due to gravitational wave radiation (GR) or magnetic stellar wind (MSW) are presented. We find that gravitational radiation cannot prevent the cyclic evolution of W UMa systems, and the effect of gravitational radiation on the cyclic behavior of contact binary evolution is almost negligible. We also find that the most likely AML mechanism for W UMa systems is magnetic braking, and that magnetic braking effects can increase the period of the cyclic evolution, and shorten the fraction of the time spent in the poor thermal contact state. If W UMa stars do not undergo cyclic evolution, and their angular momentum loss is caused simultaneously by MSW of both components, we find that the value of the parameter, $\lambda$, should be taken a larger value in comparison with those derived from observations of single stars. This indicates that the AML efficiency in W UMa systems may be lowered in comparison with non-contact stars because of the less mass contained in the convective envelopes of the components in W UMa systems. If W UMa systems lose their angular momentum at a constant rate. An angular momentum rate of $\frac{{\rm dln}J}{{\rm d}t}\approx 1.6\times 10^{-9} {\rm yr^{-1}}$ can prevent the cyclic behaviour of the model, and the model can keep in good contact with an essentially constant depth of contact.Comment: 18 pages, 12 figures, accepted by MNRA

Parsing with Multilingual BERT, a Small Corpus, and a Small Treebank

Pretrained multilingual contextual representations have shown great success, but due to the limits of their pretraining data, their benefits do not apply equally to all language varieties. This presents a challenge for language varieties unfamiliar to these models, whose labeled \emph{and unlabeled} data is too limited to train a monolingual model effectively. We propose the use of additional language-specific pretraining and vocabulary augmentation to adapt multilingual models to low-resource settings. Using dependency parsing of four diverse low-resource language varieties as a case study, we show that these methods significantly improve performance over baselines, especially in the lowest-resource cases, and demonstrate the importance of the relationship between such models' pretraining data and target language varieties.Comment: In Findings of EMNLP 202

Prevalence of HIV in mental health service users: a retrospective cohort study.

Objective To examine the prevalence of HIV in a cohort of people who have used secondary mental health services in the UK. Design Retrospective cohort study. Setting Routinely collected clinical data from secondary mental health services in South London, UK available for research through the Clinical Record Interactive Search tool at the National Institute for Health and Care Research Maudsley Biomedical Research Centre were matched with pseudonymised national HIV surveillance data held by the UK Health Security Agency using a deterministic matching algorithm. Participants All adults aged 16+ who presented for the first time to mental health services in the South London and Maudsley (SLaM) National Health Service Trust between 1 January 2007 and 31 December 2018 were included. Primary outcome Point prevalence of HIV. Results There were 181 177 people who had contact with mental health services for the first time between 2007 and 2018 in SLaM. Overall, 2.47% (n=4481) of those had a recorded HIV diagnosis in national HIV surveillance data at any time (before, during or after contact with mental health services), 24.73 people per 1000. HIV point prevalence was highest in people with a diagnosed substance use disorder at 3.77% (n=784). A substantial percentage of the sample did not have a formal mental health diagnosis (27%), but even with those excluded, the point prevalence remained high at 2.31%. Around two-thirds of people had their diagnosis of HIV before contact with mental health services (67%; n=1495). Conclusions The prevalence of HIV in people who have had contact with mental health services was approximately 2.5 times higher than the general population in the same geographical area. Future work should investigate risk factors and disparities in HIV outcomes between those with and without mental health service contact

C-reactive protein as a potential biomarker for disease progression in dengue: a multi-country observational study.

BACKGROUND: Dengue infection can cause a wide spectrum of clinical outcomes. The severe clinical manifestations occur sufficiently late in the disease course, during day 4-6 of illness, to allow a window of opportunity for risk stratification. Markers of inflammation may be useful biomarkers. We investigated the value of C-reactive protein (CRP) measured early on illness days 1-3 to predict dengue disease outcome and the difference in CRP levels between dengue and other febrile illnesses (OFI). METHOD: We performed a nested case-control study using the clinical data and samples collected from the IDAMS-consortium multi-country study. This was a prospective multi-center observational study that enrolled almost 8000 participants presenting with a dengue-like illness to outpatient facilities in 8 countries across Asia and Latin America. Predefined severity definitions of severe and intermediate dengue were used as the primary outcomes. A total of 281 cases with severe/intermediate dengue were compared to 836 uncomplicated dengue patients as controls (ratio 1:3), and also 394 patients with OFI. RESULTS: In patients with confirmed dengue, median (interquartile range) of CRP level within the first 3 days was 30.2 mg/L (12.4-61.2 mg/L) (uncomplicated dengue, 28.6 (10.5-58.9); severe or intermediate dengue, 34.0 (17.4-71.8)). Higher CRP levels in the first 3 days of illness were associated with a higher risk of severe or intermediate outcome (OR 1.17, 95% CI 1.07-1.29), especially in children. Higher CRP levels, exceeding 30 mg/L, also associated with hospitalization (OR 1.37, 95% CI 1.14-1.64) and longer fever clearance time (HR 0.84, 95% CI 0.76-0.93), especially in adults. CRP levels in patients with dengue were higher than patients with potential viral infection but lower than patients with potential bacterial infection, resulting in a quadratic association between dengue diagnosis and CRP, with levels of approximately 30 mg/L associated with the highest risk of having dengue. CRP had a positive correlation with total white cell count and neutrophils and negative correlation with lymphocytes, but did not correlate with liver transaminases, albumin, or platelet nadir. CONCLUSIONS: In summary, CRP measured in the first 3 days of illness could be a useful biomarker for early dengue risk prediction and may assist differentiating dengue from other febrile illnesses

Functional antibody and T-cell immunity following SARS-CoV-2 infection, including by variants of concern, in patients with cancer: the CAPTURE study

Patients with cancer have higher COVID-19 morbidity and mortality. Here we present the prospective CAPTURE study (NCT03226886) integrating longitudinal immune profiling with clinical annotation. Of 357 patients with cancer, 118 were SARS-CoV-2-positive, 94 were symptomatic and 2 patients died of COVID-19. In this cohort, 83% patients had S1-reactive antibodies, 82% had neutralizing antibodies against WT, whereas neutralizing antibody titers (NAbT) against the Alpha, Beta, and Delta variants were substantially reduced. Whereas S1-reactive antibody levels decreased in 13% of patients, NAbT remained stable up to 329 days. Patients also had detectable SARS-CoV-2-specific T cells and CD4+ responses correlating with S1-reactive antibody levels, although patients with hematological malignancies had impaired immune responses that were disease and treatment-specific, but presented compensatory cellular responses, further supported by clinical. Overall, these findings advance the understanding of the nature and duration of immune response to SARS-CoV-2 in patients with cancer