Comparison of Chemical and Mechanical Surface Treatments on Metallic Precision Spheres for Using as Optical Reference Artifacts

[EN] The improvement of industrial manufacturing processes requires measurement procedures and part inspection tasks to be faster and faster while remaining effective. In this sense, the capabilities of noncontact measuring systems are of great help, not only because of the great amount of data they provide but also for the ease of the integration of these systems as well as their automation, minimising the impact on the industry. This work presents a comparative study on the influence of two surface treatments performed on low-cost, high-precision metallic spheres on the suitability of these spheres to be used as artefacts for the calibration of optical sensors, specifically laser triangulation sensors. The first surface treatment is sandblasting (a mechanical process), whose effect has been studied and presented in previous work. The second treatment focused on in this paper is acid etching (a chemical process). The comparison has been performed by evaluating the same metrological characteristics on two identical groups of spheres of similar type (diameter and accuracy), each of which was subjected to a different treatment. It was necessary to obtain the reference values of the metrological parameters with high accuracy, which involved measuring the spheres with a coordinate measuring machine (CMM) by contact probing. Likewise, spheres were scanned by a laser triangulation sensor mounted on the same CMM. The results derived from both the contact and laser measurements and before and after treating the surfaces were used to compare four parameters: point density, sphere diameter, sphere form deviation, and standard deviation of the best-fit sphere to the corresponding point cloud. This research has revealed that acid etching produces better optical qualities on the surfaces than the mirror-like original ones, thus enhancing the laser sensor capturing ability. However, such chemical etching has affected the metrological characteristics of the spheres to a greater extent than that produced by sandblasting. This difference is due to the variability of the chemical etching, caused by the high aggressiveness of the acid, which makes the process very sensitive to the time of exposure to the acid and the orientations of the spheres in the bath.SIUniversity Institute of Industrial Technology of Asturias, IUTA, through the research project ref. SV-21-GIJON-1-06

Laser line scanner aptitude for the measurement of Selective Laser Melting parts

[EN] When looking for any metrological verification of parts manufactured by metal laser printing with optical equipment, it is necessary to ensure the traceability of the measurements that can be obtained. The difficulty of this process lies in the fact that these measurements are obtained on point clouds captured from surfaces with high form errors and poor surface finishes, even when this type of surface usually undergoes processes to improve the surface finish, such as sandblasting. This research focuses precisely on the analysis of the metrological suitability of a laser line scanner (laser triangulation sensor) on parts manufactured by Selective Laser Melting (SLM). The study starts from the design of a test part specifically oriented to the printing process with SLM metal powder bed. This test part was printed in 17-4PH stainless steel and then sandblasted. The test part was measured in a Coordinate Measuring Machine (CMM), obtaining reference GD&T values. The measurement was carried out under pre-sandblasting ("as built") and post-sandblasting conditions, thus providing interesting information about the erosion rate of this post process. A state-of-the-art laser sensor was employed for the metrological comparison, mounted on the same available CMM that was used for contact measurements. In this research three analyses were carried out: the quality of 3D metal printed parts with respect to CAD model, the effect of the sandblasting post-process, and the accuracy of the measurements obtained with the laser line sensor. In addition, this work conducts an in-depth study about the influence of point cloud treatment and filtering procedures, by comparing the filtering methods applied by different reverse engineering software packages. The study leads to the conclusion that filters based on the standard deviation of the point cloud are the best candidates in order to obtain laser measurements closer to the contact measurements.SIAuthors thank to the financial support provided by the Junta de Castilla y León (project LE027P17-FEDER funds) and also to two student grants awarded by the University Institute of Industrial Technology of Asturias (IUTA, ref. SV-19-GIJON-1-14) and by the Young researcher mobility program of SIF (Manufacturing Engineering Spanish Society)

Calcineurin inhibitors' impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain

Patients undergoing lung transplantation (LTx) need administration of immunosuppressive therapy following the procedure to prevent graft rejection. However, these drugs are not exempt from potential risks. The development of cardiovascular risk factors and impaired renal function in the post-transplantation period are conditions that may be favoured by the use of calcineurin inhibitor (CNI) drugs which could have repercussions on the quality of life and the post-transplantation evolution. To evaluate the cardiovascular and renal toxicity following the administration of CNI as maintenance immunosuppression in lung transplant recipients (LTRs) we reviewed a total number of 165 patients undergoing LTx between 01/01/2015 and 08/12/2018. They were divided into two groups according to the CNI drug administrated: cyclosporine (CsA-group) with 11 patients or tacrolimus (Tac-group), with 154 patients. We evaluated the de novo occurrence of arterial hypertension (HTN), diabetes mellitus (DM), hyperlipidemia and impaired renal function after initiation of CNI administration. In addition to that, the time until each of these events was assessed. A higher rate for developing HTN (p < 0.001) and impaired renal function (p = 0.047) was observed within the CsA-group. The new onset of hyperlipidemia was similar between both CNI groups and de novo appearance of DM was only documented in those LTRs receiving tacrolimus. In this LTRs retrospective study, it was observed that having ? 4 tacrolimus trough levels above the upper limit of the proposed interval for each specific post-LTx period was associated with an increased risk for developing renal impairment. No other statistically significant association was found between supratherapeutic CNIs blood levels and the evaluated toxicities

Construcción de un diccionario didáctico digital para la mejora del aprendizaje del latín y estudio preliminar de su extensión a otras lenguas

Los objetivos de este proyecto son la creación de una versión digital, disponible en línea y en abierto, de un diccionario basado en un modelo inédito lexicográfico y cognitivo y el estudio preliminar de su generalización a otras lenguas. La eficacia didáctica del modelo de diccionario ha sido probada en este curso académico experimentalmente para la enseñanza presencial del latín utilizando una versión en papel. La idea es construir una versión digital para que el alumno pueda utilizarlo tanto para el trabajo en el aula como para el trabajo personal y estudiar si es viable su aplicación general al estudio de otras lenguas, especialmente de las lenguas modernas. El diccionario en formato digital proporcionaría, frente al papel, tres ventajas significativas: (1) aumentar su accesibilidad lo que facilitaría su uso en cualquier momento y lugar, (2) ayudar al alumno con dificultades a nivelarse puesto que podría usarlo para repetir los ejercicios de aprendizaje tantas veces como lo necesite, y, (3), servir de base para llevar a cabo acciones educativas basadas en la autoformación en línea que faciliten y fomenten el aprendizaje del latín en particular y de otras lenguas si el resultado del estudio preliminar es positivo respecto a su generalización

International Consensus Document on Obstructive Sleep Apnea

El objetivo principal de este documento internacional de consenso sobre apnea obstructiva del sueno es proporcionar unas directrices que permitan a los profesionales sanitarios tomar las mejores decisiones en la asistencia de los pacientes adultos con esta enfermedad según un resumen crítico de la literatura más actualizada. El grupo de trabajo de expertos se ha constituido principalmente por 17 sociedades científicas y 56 especialistas con amplia representación geográfica (con la participación de 4 sociedades internacionales), además de un metodólogo experto y un documentalista del Centro Cochrane Iberoamer icano. El documento consta de un manuscrito principal, con las novedades más relevantes del DIC, y una serie de manuscritos online que recogen las búsquedas bibliográficas sistemáticas de cada uno de los apartados del DIC. Este documento no cubre la edad pediátrica ni el manejo del paciente en ventilación mecánica crónica no invasiva (que se publicarán en sendos documentos de consenso aparte)

Artificial intelligence within the interplay between natural and artificial computation:Advances in data science, trends and applications

Artificial intelligence and all its supporting tools, e.g. machine and deep learning in computational intelligence-based systems, are rebuilding our society (economy, education, life-style, etc.) and promising a new era for the social welfare state. In this paper we summarize recent advances in data science and artificial intelligence within the interplay between natural and artificial computation. A review of recent works published in the latter field and the state the art are summarized in a comprehensive and self-contained way to provide a baseline framework for the international community in artificial intelligence. Moreover, this paper aims to provide a complete analysis and some relevant discussions of the current trends and insights within several theoretical and application fields covered in the essay, from theoretical models in artificial intelligence and machine learning to the most prospective applications in robotics, neuroscience, brain computer interfaces, medicine and society, in general.BMS - Pfizer(U01 AG024904). Spanish Ministry of Science, projects: TIN2017-85827-P, RTI2018-098913-B-I00, PSI2015-65848-R, PGC2018-098813-B-C31, PGC2018-098813-B-C32, RTI2018-101114-B-I, TIN2017-90135-R, RTI2018-098743-B-I00 and RTI2018-094645-B-I00; the FPU program (FPU15/06512, FPU17/04154) and Juan de la Cierva (FJCI-2017–33022). Autonomous Government of Andalusia (Spain) projects: UMA18-FEDERJA-084. Consellería de Cultura, Educación e Ordenación Universitaria of Galicia: ED431C2017/12, accreditation 2016–2019, ED431G/08, ED431C2018/29, Comunidad de Madrid, Y2018/EMT-5062 and grant ED431F2018/02. PPMI – a public – private partnership – is funded by The Michael J. Fox Foundation for Parkinson’s Research and funding partners, including Abbott, Biogen Idec, F. Hoffman-La Roche Ltd., GE Healthcare, Genentech and Pfizer Inc

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe

COVID-19 outbreaks in a transmission control scenario: challenges posed by social and leisure activities, and for workers in vulnerable conditions, Spain, early summer 2020

Severe acute respiratory syndrome coronavirus 2 community-wide transmission declined in Spain by early May 2020, being replaced by outbreaks and sporadic cases. From mid-June to 2 August, excluding single household outbreaks, 673 outbreaks were notified nationally, 551 active (>6,200 cases) at the time. More than half of these outbreaks and cases coincided with: (i) social (family/friends’ gatherings or leisure venues) and (ii) occupational (mainly involving workers in vulnerable conditions) settings. Control measures were accordingly applied