Electro-mechanical characterisation and damage monitoring by acoustic emission of 3D-printed CB/PLA

Even though the influence of the printing direction on the mechanical properties of 3D-printed samples by fused filament fabrication is established in the literature, very little is known about mechanical and electrical coupling. In this study, electrically conductive polylactic acid filled with carbon black particles undergoes monotonic and repeated progressive tensile loading to better understand the influence of the printing direction on the electro-mechanical properties of three-dimensional-printed samples. The objective is to analyse the electro-mechanical behaviour of this composite for its potential application as an actuator. The classical laminate theory is also applied to evaluate the relevance of this theory in predicting the mechanical characteristics of this material. In addition, a comprehensive damage analysis is performed using acoustic emission, infrared thermography, scanning electron microscopy, and X-ray microcomputed tomography imaging. Results show that the degradation of the mechanical and electrical properties is highly influenced by the printing direction. The appearance and development of crazes in 0° filaments are highlighted and quantified. The conclusions drawn by this study underline the interest in using longitudinal and unidirectional printing directions to improve the conductive path within the samples. Furthermore, the evolution of the resistance throughout the experiments emphasizes the need to control the implemented voltage in the design of future electro-thermally triggered actuators

Unidad de Continuidad Asistencial Primaria-Interna del Hospital Universitario de Guadalajara (UCAPI): 10 años de experiencia

La atención sanitaria se realiza, mayoritariamente, siguiendo un modelo convencional, en el que la Atención Primaria y la Atención Especializada actúan como compartimentos estancos, con graves carencias en la relación entre ambos niveles asistenciales. Esta situación origina una serie de disfunciones, sobre todo en los pacientes con múltiples patologías crónicas, que repercuten directamente en la calidad de su atención, en la sobrecarga de los diferentes circuitos asistenciales y en el consumo de recursos por parte del Sistema Sanitario. Ante esta realidad, en 2006 se crea en el Servicio de Medicina Interna del Hospital Universitario de Guadalajara la Unidad de Continuidad Asistencial Primaria-Medicina Interna (UCAPI), que supone una reorganización de la estructura, permitiendo combinar el modelo asistencial convencional propio de esta especialidad con un nuevo marco de trabajo que favorezca la coordinación con Atención Primaria mediante la figura del médico internista de referencia, a través de la consultoría telefónica, sesiones clínicas compartidas entre ambos equipos, autogestión de las agendas e integración de consultas con el empleo del hospital de día y camas de hospitalización. Con este nuevo modelo se logra mejorar la atención a los pacientes pluripatológicos y a los pacientes en fase diagnóstica no demorable, reduciendo visitas a urgencias hospitalarias y optimizando los recursos de hospitalización.Health care is carried out, mostly, following a conventional model, in which primary care and specialised care act as almost isolated compartments, with severe deficiencies in the relationship between both levels of care. This reality directly impacts on the quality of patient care, on the present overloaded healthcare circuits and on the consumption of the Healthcare System´s resources. As a result of the aforementioned situation, in 2006, the Internal Medicine Department of the University Hospital of Guadalajara, created the Primary Care-Internal Medicine Continuity Unit (UCAPI). This new clinical unit involves a reorganization of the structure, which permits to combine the conventional care model of this speciality with the new one. The established synergy favours the coordination with Primary Care through the figure of the consultant internist. This new model requires four basics elements to be in place: telephone consulting, clinical meetings with primary care teams, self-management of agendas as well as integration of the assistance in the medical office with the use of day hospital and conventional inpatient beds. With this new model, it is possible to improve the care of patients with multiple chronic diseases and that of those in which diagnosis must not be delayed thus, avoiding patients going to the hospital emergency department and optimizing hospitalization resources

Different tissue reaction of oesophagus and diaphragm after mesh hiatoplasty. Results of an animal study

<p>Abstract</p> <p>Background</p> <p>Laparoscopic mesh-reinforcement of the hiatal region in the treatment of gastroesophageal reflux disease (GERD) and paraesophageal hernia (PEH) reduces the risk of recurrence. However, there are still controversies about the technique of mesh placement, shape, structure and material. We therefore compared tissue integration and scar formation after implantation of two different polypropylene-meshes in a rabbit model.</p> <p>Methods</p> <p>A total of 20 female chinchilla rabbits were included in this study. Two different meshes (Polypropylene PP, Polyglecaprone 25 Composite PP-PG) were implanted on the abdominal diaphragm around the oesophagus. After 3 months the implanted meshes were excised en-bloc. Histological and morphological analyses were carried out accordingly proliferation rate, apoptosis and collagen type I/III ratio.</p> <p>Results</p> <p>Regarding proliferation rate of oesophagus PP (9.31 ± 3.4%) and PP-PG (13.26 ± 2.54%) differ in a significant (p = 0.0097) way. In the diaphragm we found a significant (p = 0.00066) difference between PP (9.43 ± 1.45%) and PP-PG (18.73 ± 5.92%) respectively. Comparing oesophagus and diaphragm we could prove a significant difference within PP-PG-group (p = 0.0195). Within PP-group the difference reached no statistical significance (p = 0.88). We found analogous results regarding apoptosis.</p> <p>Furthermore, there is a significant (p = 0.00013) difference of collagen type I/III ratio in PP-PG (12.28 ± 0.8) compared to PP (8.44 ± 1,63) in case of oesophageal tissue. Concerning diaphragm we found a significant difference (p = 0.000099) between PP-PG (8.85 ± 0.81) and PP (6.32 ± 1.07) as well.</p> <p>Conclusion</p> <p>The histologic and morphologic characteristics after prosthetic enforcement of the hiatus in this animal model show a more distinct tissue integration using PP-PG compared to PP. Additionally, different wound healing and remodelling capability influence tissue integration of the mesh in diaphragm and oesophagus.</p

Network analysis of mood symptoms in adolescents with or at high risk for bipolar disorder

ObjectivesNetwork analyses of psychopathology examine the relationships between individual symptoms in an attempt to establish the causal interactions between symptoms that may give rise to episodes of psychiatric disorders. We conducted a network analysis of mood symptoms in adolescents with or at risk for bipolar spectrum disorders.MethodsThe sample consisted of 272 treatment-seeking adolescents with or at high risk for bipolar disorder who had at least subsyndromal depressive or (hypo)manic symptoms. Based on symptom scores assessed via semi-structured interviews, we constructed the network of depressive and manic symptoms and identified the most central symptoms and symptom communities within the network. We used bootstrapping analyses to determine the reliability of network parameters.ResultsSymptoms within the depressive and manic mood poles were more related to each other than to symptoms of the opposing mood pole. Four communities were identified, including a depressive symptom community and three manic symptom communities. Fatigue and depressed mood were the strongest individual symptoms within the overall network (ie the most highly correlated with other symptoms), followed by motor hyperactivity. Mood lability and irritability were found to be "bridge" symptoms that connected the two mood poles.ConclusionsSymptoms of activity/energy (ie&nbsp;fatigue and hyperactivity) and depressed mood are the most prominent mood symptoms among youth with bipolar spectrum disorders. Mood lability and irritability represent potential warning signs of emergent episodes of either polarity. Targeting these central and bridge symptoms would lead to more efficient assessments and therapeutic interventions for bipolar disorder