Ignition delay of reactivity controlled compression ignition (RCCI) for the mixture of diesel fuel and ethanol in a rapid compression machine / Atraso de ignição de ignição por compressão controlada de reatividade (RCCI) para a mistura de combustível diesel e etanol em uma máquina de compressão rápida

The power generation, used to promote comfort, mobility and others continually grows. To solve this growing demand, efforts have been directed towards the development of new energy sources, preferably renewable, and better ways of energy conversion by increasing the processes efficiencies. A good example of this is the gradual shift from conventional and highly inefficient vehicles, being replaced by hybrids or purely electrics. But even with gradual migration for more efficient energy use, we will continue depending of traditional fuels therefore it is necessary to develop more efficient and less polluting ways to use these sources. Thus, this work aims to study alternative ways of converting energy contained in fuels used in internal combustion engines by use of combustion mode RCCI, two fluids with different cetane numbers are introduced into the combustion chamber at different times with the purpose of burning the fuel with lower cetane number. Therefore, for combustion mode RCCI, the SOI of fuel with lower enthalpy of vaporization and the start of combustion must be determined to determine the ignition delay. The results show the ignition delays for the different techniques of injection of fuels with compression ratios of 16:1 and 20:1

Peritoneal dialysis associated-peritonitis: a preventable complication

Peritoneal dialysis is useful renal replacement therapy for patients with end-stage chronic kidney disease. Latin America has 30% of the world population in peritoneal dialysis and within these countries Mexico covers 73% of them. In our country, the Mexican institute of social security (IMSS by its Spanish acronym) serves more than half of the Mexican population that requires renal replacement therapy. In 2014 it represented 15% of total annual cost of the institution. Peritonitis in peritoneal dialysis is the main complication seen in this renal replacement therapy with morbidity and mortality from 2 to 6%. The epidemiology of peritonitis associated with peritoneal dialysis varies according to the continent, country and dialysis center. The rate of peritonitis per year of each center reflects their quality of care. The prevention, diagnosis and treatment of peritonitis impact in the quality of life of the patient, the success of renal replacement therapy, public health costs and associated mortality. This review addresses the epidemiology, diagnosis, treatment, and preventive measures of peritonitis, focused on the procedures for improving the standards of care

Live lecture screencast recording: a proposal to simplify the tasks associated with content production for video-teaching

Se trata de un resumen (Abstract) de la contribución. El acuerdo de transferencia de copyright del trabajo completo es incompatible con el depósito del mismo en RIUMA.Se describe la implementación inicial de un método simplificado de grabación en directo de sesiones de clase en asignaturas de las Escuelas de Ingeniería de la Universidad de Málaga. La simplificación se logra al incorporar en la actividad diaria del aula ciertas características típicas de la grabación en diferido de mini videos docentes. En una configuración mínima se graba únicamente el audio y el video en pantalla de la clase, evitando los desafíos técnicos y las dificultades que implica la grabación de otros elementos como la pizarra. Esto implica el uso de anotaciones en pantalla en tiempo real para reemplazar completamente las anotaciones en la pizarra.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. I Plan Propio Integral de Docencia. Universidad de Málaga. Universidad de Málaga. Vicerectorado de Personal Docente e Investigador, Proyectos de Innovación Educativa (PIE 17-018

Direct assessment of the sensitivity drift of SQM sensors installed outdoors

Long-term monitoring of the evolution of the artificial night sky brightness is a key tool for developing science-informed public policies and assessing the efficacy of light pollution mitigation measures. Detecting the underlying artificial brightness trend is a challenging task, since the typical night sky brightness signal shows a large variability with characteristic time scales ranging from seconds to years. In order to effectively isolate the weak signature of the effect of interest, determining the potential long term drifts of the radiance sensing systems is crucial. If these drifts can be adequately characterized, the raw measurements could be easily corrected for them and transformed to a consistent scale. In this short note we report on the progressive darkening of the signal recorded by SQM detectors belonging to several monitoring networks, permanently installed outdoors for periods ranging from several months to several years. The sensitivity drifts were estimated by means of parallel measurements made at the beginning and at the end of the evaluation periods using reference detectors of the same kind that were little or no exposed to weathering in the intervening time. Our preliminary results suggest that SQM detectors installed outdoors steadily increase their readings at an average rate of +0.034 magSQM/arcsec2 per MWh/m2 of exposure to solar horizontal global irradiation, that for our locations translates into approximately +0.05 to +0.06 magSQM/arcsec2 per year.This work was supported in part by Xunta de Galicia, grant ED431B 2020/29. J.Z. acknowledges the support from ACTION, a project funded by the European Union H2020-SwafS-2018-1-824603, RTI2018-096188-B-I00 and S2018/NMT-4291 (TEC2SPACE-CM). Part of this work was developed in the framework of the Spanish Network for Light Pollution Studies (REECL).Peer ReviewedPostprint (published version

Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis

Background Falls are a serious problem for hospitalized patients, reducing the duration and quality of life. It is estimated that over 84% of all adverse events in hospitalized patients are related to falls. Some fall risk assessment tools have been developed and tested in environments other than those for which they were developed with serious validity discrepancies. The aim of this review is to determine the accuracy of instruments for detecting fall risk and predicting falls in acute hospitalized patients. Methods Systematic review and meta-analysis. Main databases, related websites and grey literature were searched. Two blinded reviewers evaluated title and abstracts of the selected articles and, if they met inclusion criteria, methodological quality was assessed in a new blinded process. Meta-analyses of diagnostic ORs (DOR) and likelihood (LH) coefficients were performed with the random effects method. Forest plots were calculated for sensitivity and specificity, DOR and LH. Additionally, summary ROC (SROC) curves were calculated for every analysis. Results Fourteen studies were selected for the review. The meta-analysis was performed with the Morse (MFS), STRATIFY and Hendrich II Fall Risk Model scales. The STRATIFY tool provided greater diagnostic validity, with a DOR value of 7.64 (4.86 - 12.00). A meta-regression was performed to assess the effect of average patient age over 65 years and the performance or otherwise of risk reassessments during the patient’s stay. The reassessment showed a significant reduction in the DOR on the MFS (rDOR 0.75, 95% CI: 0.64 - 0.89, p = 0.017). Conclusions The STRATIFY scale was found to be the best tool for assessing the risk of falls by hospitalized acutely-ill adults. However, the behaviour of these instruments varies considerably depending on the population and the environment, and so their operation should be tested prior to implementation. Further studies are needed to investigate the effect of the reassessment of these instruments with respect to hospitalized adult patients, and to consider the real compliance by healthcare personnel with procedures related to patient safety, and in particular concerning the prevention of falls

Systemic Corticosteroids in Patients with Bronchial Asthma: A Real-Life Study

25 p.Objectives: The objective of the present study was to determine the use of systemic corti-costeroids (SCs) in patients with bronchial asthma using big data analysis. Methods: We performed an observational, retrospective, noninterventional study based on secondary data captured from free text in the electronic health records. This study was per-formed based on data from the regional health service of Castille-La Mancha (SESCAM), Spain. We performed the analysis using big data and artificial intelligence via Savana® Manager version 3.0. Results: During the study period, 103 667 patients were diagnosed with and treated for asthma at different care levels. The search was restricted to patients aged 10 to 90 years (mean age, 43.5 [95%CI, 43.4-43.7] years). Of these, 59.8% were women. SCs were taken for treatment of asthma by 58 745 patients at some point during the study period. These patients were older, with a higher prevalence of hypertension, dyslipidemia, diabetes, ob-esity, depression, and hiatus hernia. SCs are used frequently in the general population with asthma (31.4% in 2015 and 39.6% in 2019). SCs were prescribed mainly in primary care (59%), allergy (13%) and pulmonology (20%). The frequency of prescription of SCs had a direct impact on the main associated adverse effects. Conclusion: In clinical practice, SCs are frequently prescribed to patients with asthma, especially in primary care. Use of SCs is associated with a greater number of adverse events. It is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care

Improvement In Diagnosis And Treat-to-target Management Of Hyperuricemia In Gout: Results From The Gema-2 Transversal Study On Practice

The objective of the study was to evaluate changes regarding main European League Against Rheumatism (EULAR) recommendations on diagnosis and treatment of gout compared to a previous assessment. The GEMA-2 (Gout Evaluation and MAnagement) is a transversal assessment of practice for gout by rheumatologists. Main outcome variables were improvement of the previous GEMA assessment regarding the rate of crystal-proven diagnosis and that reaching therapeutic serum urate target below 6 mg/dl at last visit. Other management variables (prophylaxis, treatment of flares, lifestyle change advice) were also evaluated along with general characteristics. The sample was powered to include at least 483 patients for up to 50% change. Data on management of 506 patients were retrieved from 38 out of 41 rheumatology units that participated in the previous GEMA audit. Crystal-proved diagnosis rate increased from 26% to 32% (31% improvement) and was higher in gout-dedicated practices; ultrasonography contributed to diagnosis in less than 1% of cases. Therapeutic serum urate at last visit improved from 41% to 64% of all patients (66% of patients on urate-lowering medications), in any case over 50% improvement from the previous assessment. The use of any urate-lowering medication available was not prescribed as per label dosing in patients who failed to achieve target serum urate. Clinical inertia to increase doses of either allopurinol or febuxostat was still present in clinical practice. Over 50% improvement in targeting therapeutic serum urate has been observed, but clinical inertia is still present. Diagnosis is still mostly clinically based, ultrasonography not being commonly contributive. Menarini Espaa

Footprint preparation with nanofractures in a supraspinatus repair cuts in half the retear rate at 1-year follow-up. A randomized controlled trial

Purpose: To evaluate if adding nanofractures to the footprint of a supraspinatus tear repair would have any effect in the outcomes at one-year follow-up. Methods: Multicentric, triple-blinded, randomized trial with 12-months follow-up. Subjects with isolated symptomatic reparable supraspinatus tears smaller than 3 cm and without grade 4 fatty infiltration were included. These were randomized to two groups: In the Control group an arthroscopic supraspinatus repair was performed; in the Nanofracture group the footprint was additionally prepared with nanofractures (1 mm wide, 9 mm deep microfractures). Clinical evaluation was done with Constant score, EQ-5D-3L, and Brief Pain Inventory. The primary outcome was the retear rate in MRI at 12-months follow-up. Secondary outcomes were: characteristics of the retear (at the footprint or at the musculotendinous junction) and clinical outcomes. Results: Seventy-one subjects were randomized. Two were lost to follow-up, leaving 69 participants available for assessment at 12-months follow-up (33 in the Control group and 36 in the Nanofracture Group). The Nanofracture group had lower retear rates than the Control group (7/36 [19.4%] vs 14/33 [42.4%], differences significant, p = 0.038). Retear rates at the musculotendinous junction were similar but the Nanofracture group had better tendon healing rates to the bone (34/36 [94.4%] vs. 24/33 [66.71%], p = 0.014). Clinically both groups had significant improvements, but no differences were found between groups. Conclusion: Adding nanofractures at the footprint during an isolated supraspinatus repair lowers in half the retear rate at 12-months follow-up. This is due to improved healing at the footprint

Enriched mannose glycosylation contributes to Act d 2 allergenicity.

Allergens are responsible for the Th2 response in patients as part of complex mixtures of proteins, fatty acids and other molecules. Plant allergens have hitherto been included in several protein families that share no common biochemical features. Their physical, biochemical and immunological characteristics have been widely studied, but no definite conclusion has been reached about what makes a protein an allergen. N-glycosylation is characteristic of plant allergen sources but is not present in mammals

Outcomes of abdominal wall reconstruction in patients with the combination of complex midline and lateral incisional hernias.

Background The best treatment for the combined defects of midline and lateral incisional hernia is not known. The aim of our multicenter study was to evaluate the operative and patient-reported outcomes using a modified posterior component separation in patients who present with the combination of midline and lateral incisional hernia. Methods We identified patients from a prospective, multicenter database who underwent operative repairs of a midline and lateral incisional hernia at 4 centers with minimum 2-year follow-up. Hernias were divided into a main hernia based on the larger size and associated abdominal wall hernias. Outcomes reported were short- and long-term complications, including recurrence, pain, and bulging. Quality of life was assessed with the European Registry for Abdominal Wall Hernias Quality of Life score. Results Fifty-eight patients were identified. Almost 70% of patients presented with a midline defect as the main incisional hernia. The operative technique was a transversus abdominis release in 26 patients (45%), a modification of transversus abdominis release 27 (47%), a reverse transversus abdominis release in 3 (5%), and a primary, lateral retromuscular preperitoneal approach in 2 (3%). Surgical site occurrences occurred in 22 patients (38%), with only 8 patients (14%) requiring procedural intervention. During a mean follow-up of 30.1 ± 14.4 months, 2 (3%) cases of recurrence were diagnosed and required reoperation. There were also 4 (7%) patients with asymptomatic but visible bulging. The European Registry for Abdominal Wall Hernias Quality of Life score showed a statistically significant decrease in the 3 domains (pain, restriction, and cosmetic) in the postoperative score compared with the preoperative score. Conclusion The different techniques of posterior component separation in the treatment of combined midline and lateral incisional hernia show acceptable results, despite the associated high complexity. Patient-reported outcomes after measurement of the European Registry for Abdominal Wall Hernias Quality of Life score demonstrated a clinically important improvement in quality of life and pain.post-print2.323 K