The “Top-Down” Approach to the Evaluation of Children with Febrile Urinary Tract Infection

The evaluation of children presenting with urinary tract infection (UTI) has long entailed sonography and cystography to identify all urological abnormalities that might contribute to morbidity. The identification of vesicoureteral reflux (VUR) has been of primary concern since retrospective studies from the 1930s to 1960s established a strong association between VUR, recurrent UTI, and renal cortical scarring. It has been proposed that all VUR carries a risk for renal scarring and, therefore, all VUR should be identified and treated. We will not discuss the controversies surrounding VUR treatment in this review focusing instead on a new paradigm for the evaluation of the child with UTI that is predicated on identifying those at risk for scarring who are most deserving of further evaluation by cystography

Experimental study of R1234yf as a drop-in replacement for R134a in a domestic refrigerator

This paper presents an experimental study for three identical domestic refrigerators using R1234yf as a drop-in replacement for R134a. An alternative methodology was proposed to estimate the optimal mass charge for R1234yf; with the use of such methodology, new evidences were sought on the thermal behavior of the refrigerator compartments as well as at the heat exchangers. Additionally, energy performance for both refrigerants was measured, and, finally, a TEWI analysis was conducted. For the type of refrigerator evaluated, results showed that R1234yf presented an average (for the 3 refrigerators) of 0.4 °C for the fresh food compartment, and 1.2 °C for the freezer, among different charges with respect to R134a. The optimal charge for R1234yf was 92.2 g, which is about 7.8% lower than the one for R134a, which represents a small increase of 4% in energy consumption in comparison to R134a. Finally, the TEWI analysis for the R1234yf was 1.07% higher than the R134a.We thank Universidad de Guanajuato for the support in the realization of this research. We also want to thank the Company Honeywell (through Marco García) for the donation of the refrigerant R1234yf, and to acknowledge the support of Mabe TyP in the performing of the tests. The authors wish to thank to Montoro Sanjosé Carlos Rubín for their support in the editing of the English-language version of this paper

An Econometric Analysis of the Impact of Technology on the Work Lives of Truck Drivers

We investigate the relationship between technology and drivers’ work lives using data from the UMTIP Driver Survey. Focusing first on which types of drivers are more likely to use satellite technology, we find that drivers in private carriage, union drivers, and those paid by the hour or as percent of revenue are least likely to drive trucks equipped with SBS. The largest firms are most likely to equip their trucks with SBS, providing some evidence of scale effects of this technology. There is also evidence that SBS technology is used as a substitute for experience. Examining the impact of satellite technology on worker outcomes, we find that SBS does more than simply lower drivers’ pay. Consistent with the skill-bias hypothesis, drivers who use satellite systems may be paid less per mile. In contrast, drivers on satellite-equipped trucks realize 17.6% higher annual earnings. The higher earnings are due to the increased mileage of such drivers, about 22,000 additional miles per year. Part of this mileage gain is explained by efficiencies provided by these systems, but drivers with satellites also work 14% more hours weekly. The increased hours would account for approximately 60 percent of the increase in mileage; the remaining 40 percent is associated with improved productivity and is captured entirely by the firm. The overall finding, that technology improves productivity and earnings but intensifies and lengthens the workday, is consistent with sociological studies of technology (Graham, 1995)

Treatment with Haemodiafiltration Stabilises Vascular Stiffness (Measured by Aortic Pulse Wave Velocity) Compared to Haemodialysis.

Background/Aims: Cerebrovascular diseases such as stroke are increased in dialysis patients, and haemodiafiltration has been reported to reduce cerebrovascular mortality compared to haemodialysis. We wished to determine whether haemodiafiltration improves arterial stiffness. Methods: We audited aortic pulse wave velocity (PWV) measurements 6 months apart in 3 cohorts of patients: 69 treated with haemodialysis, 78 who converted from haemodialysis to haemodiafiltration and 142 treated with haemodiafiltration. Results: Cohorts were well matched for age (means ± SD: haemodialysis 64 ± 15 years vs. haemodialysis to haemodiafiltration 64 ± 17 years vs. haemodiafiltration 67 ± 16 years), sex (male 65 vs. 59 vs. 63%), diabetes (45 vs. 56.4 vs. 44%) and body mass index (26 ± 6 vs. 26 ± 5 vs. 26 ± 5), respectively. Systolic blood pressure did not differ over time (haemodialysis 143 ± 25 vs. 146 ± 27 mm Hg, haemodialysis to haemodiafiltration 153 ± 26 vs. 154 ± 25 mm Hg, haemodiafiltration 149 ± 31 vs. 148 ± 30 mm Hg) or between groups. Aortic PWV significantly increased in the haemodialysis group (9.5 ± 1.9 vs. 10.2 ± 2.2 m/s, p < 0.01) and haemodialysis to haemodiafiltration group (9.4 ± 1.9 vs. 10.1 ± 2.2 m/s, p < 0.01), but did not change with haemodiafiltration (9.9 ± 2.1 vs. 10.1 ± 2.2 m/s). Conclusions: Aortic PWV, a measure of vascular stiffness, stabilised with haemodiafiltration. Our preliminary findings require further investigation to determine how haemodiafiltration may potentially improve vascular stiffness. © 2014 S. Karger AG, Basel

The effects of inspiratory muscle training in older adults

Purpose: Declining inspiratory muscle function and structure and systemic low-level inflammation and oxidative stress may contribute to morbidity and mortality during normal ageing. Therefore, we examined the effects of inspiratory muscle training (IMT) in older adults on inspiratory muscle function and structure and systemic inflammation and oxidative stress, and re-examined the reported positive effects of IMT on respiratory muscle strength, inspiratory muscle endurance, spirometry, exercise performance, physical activity levels (PAL) and quality of life (QoL). Methods: Thirty-four healthy older adults (68 ± 3 years) with normal spirometry, respiratory muscle strength and physical fitness were divided equally into a pressure-threshold IMT or sham-hypoxic placebo group. Before and after an 8 week intervention, measurements were taken for dynamic inspiratory muscle function and inspiratory muscle endurance using a weighted plunger pressure-threshold loading device, diaphragm thickness using B-mode ultrasonography, plasma cytokine concentrations using immunoassays, DNA damage levels in peripheral blood mononuclear cells (PBMC) using Comet Assays, spirometry, maximal mouth pressures, exercise performance using a six minute walk test, PAL using a questionnaire and accelerometry, and QoL using a questionnaire

Comprehensive analysis of design principles in the context of Industry 4.0

[ES] Los sistemas de producción han evolucionado los últimos años gracias a avances tecnológicos recientes e innovaciones en el proceso de manufactura. El termino Industria 4.0 se ha convertido en prioridad y objeto de estudio para empresas, centros de investigación y universidades, sin existir un consenso generalmente aceptado del término. Como resultado es difícil diseñar e implementar soluciones de Industria 4.0 a nivel académico, científico o empresarial. La contribución de este documento se centra en proporcionar un análisis del significado e implicaciones de Industria 4.0 y exponer de forma detallada 17 principios de diseño fundamentales obtenidos a través de un estudio de mapeo sistemático. Estos principios son eficiencia, integración, flexibilidad, descentralización, personalización, virtualización, seguridad, es holística, orientada a servicios, ubicua, colaborativa, modular, robusta, utiliza información en tiempo real, toma decisiones optimizadas por datos, equilibra la vida laboral y es autónoma e inteligente. A través de estos principios, ingenieros e investigadores están capacitados para investigar e implementar escenarios apropiados de Industria 4.0.[EN] Production systems have evolved in the last years thanks to the recent technological advances and innovations in the manufacturing process. The Industry 4.0 term has become a priority and object of study for companies, research centers and universities, but there is not a generally accepted consensus for the term. As a result, is difficult design and implementation appropriate Industry 4.0 solutions at academic, scientific or business level. The contribution of this paper focuses on providing an analysis of Industry 4.0 meaning and implications and exposes in detail 17 fundamental design principles obtained by a systematic mapping study method. These principles are efficiency, integration, flexibility, decentralization, personalization, virtualization, security, is holistic, ubiquitous, collaborative, modular, robust, use information in real time, makes optimized decisions driven by data, is service-oriented, work life balance and is autonomous and intelligent. With these design principles, engineers and researchers have the capacity to research and implement appropriate Industry 4.0 scenarios.Belman-Lopez, CE.; Jiménez-García, JA.; Hernández-González, S. (2020). Análisis exhaustivo de los principios de diseño en el contexto de Industria 4.0. Revista Iberoamericana de Automática e Informática industrial. 17(4):432-447. https://doi.org/10.4995/riai.2020.12579OJS432447174Ahmad, A., & Babar, M. (2016). 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