Corrosion behavior of boride diffusion layer on CoCrMo alloy surface

87-95In the present study, the corrosion behaviour of CoCrMo ASTM F75 alloy with boride diffusion layer and under simulated physiological conditions has been investigated using electrochemical methods. Corrosion has been analyzed using Tafel and electrochemical impedance spectroscopy (EIS) curves. The corrosion resistance optimization of boride diffusion layer on ASTM F-75 alloy using a central composite design (CCD) in response surface methodology (RSM) has been studied. A boronizing thermochemical treatment has been carried out at different temperatures, time periods and paste mass. The roughness for samples subjected to boride annealing has been higher than that of the unboride sample. X-ray diffraction (XRD) measurement has shown that the boride layer of the sample at least consists of a mixture of CoB and CrB phases. The EIS and Tafel curves results have suggested that boride ASTM F75 alloy has not been a suitable candidate for orthopedics applications

Corrosion behavior of boride diffusion layer on CoCrMo alloy surface

In the present study, the corrosion behaviour of CoCrMo ASTM F75 alloy with boride diffusion layer and undersimulated physiological conditions has been investigated using electrochemical methods. Corrosion has been analyzed usingTafel and electrochemical impedance spectroscopy (EIS) curves. The corrosion resistance optimization of boride diffusionlayer on ASTM F-75 alloy using a central composite design (CCD) in response surface methodology (RSM) has beenstudied. A boronizing thermochemical treatment has been carried out at different temperatures, time periods and paste mass.The roughness for samples subjected to boride annealing has been higher than that of the unboride sample. X-ray diffraction(XRD) measurement has shown that the boride layer of the sample at least consists of a mixture of CoB and CrB phases.The EIS and Tafel curves results have suggested that boride ASTM F75 alloy has not been a suitable candidate fororthopedics applications

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

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

5to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

El V Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2019, realizado del 6 al 8 de febrero de 2019 y organizado por la Universidad Politécnica Salesiana, ofreció a la comunidad académica nacional e internacional una plataforma de comunicación unificada, dirigida a cubrir los problemas teóricos y prácticos de mayor impacto en la sociedad moderna desde la ingeniería. En esta edición, dedicada a los 25 años de vida de la UPS, los ejes temáticos estuvieron relacionados con la aplicación de la ciencia, el desarrollo tecnológico y la innovación en cinco pilares fundamentales de nuestra sociedad: la industria, la movilidad, la sostenibilidad ambiental, la información y las telecomunicaciones. El comité científico estuvo conformado formado por 48 investigadores procedentes de diez países: España, Reino Unido, Italia, Bélgica, México, Venezuela, Colombia, Brasil, Estados Unidos y Ecuador. Fueron recibidas un centenar de contribuciones, de las cuales 39 fueron aprobadas en forma de ponencias y 15 en formato poster. Estas contribuciones fueron presentadas de forma oral ante toda la comunidad académica que se dio cita en el Congreso, quienes desde el aula magna, el auditorio y la sala de usos múltiples de la Universidad Politécnica Salesiana, cumplieron respetuosamente la responsabilidad de representar a toda la sociedad en la revisión, aceptación y validación del conocimiento nuevo que fue presentado en cada exposición por los investigadores. Paralelo a las sesiones técnicas, el Congreso contó con espacios de presentación de posters científicos y cinco workshops en temáticas de vanguardia que cautivaron la atención de nuestros docentes y estudiantes. También en el marco del evento se impartieron un total de ocho conferencias magistrales en temas tan actuales como la gestión del conocimiento en la universidad-ecosistema, los retos y oportunidades de la industria 4.0, los avances de la investigación básica y aplicada en mecatrónica para el estudio de robots de nueva generación, la optimización en ingeniería con técnicas multi-objetivo, el desarrollo de las redes avanzadas en Latinoamérica y los mundos, la contaminación del aire debido al tránsito vehicular, el radón y los riesgos que representa este gas radiactivo para la salud humana, entre otros

Crisis, Living Conditions and Health in Mexico: New Challenges for Social Policy

In the last 30 years, Mexico has faced major crises in its political, economic, and social life. These crises have affected living conditions and health. With the implementation in the 1980's of structural adjustment and economic stabilization policies, Mexico saw a rapid growth of poverty accelerating trends toward social polarization and social division. The current crisis, fueled by deregulation of the global financial markets, only deepens the tendency towards economic stagnation. It has led to an increase in unemployment, worsening income inequalities, and generalized inflation. The increase in food prices, in particular, has made life more difficult for the Mexican population. The crisis has had a palpable and concrete impact on living conditions, health status, and food security for diverse social groups

Análisis cualitativo del abasto de medicamentos en México: evaluación en los servicios a población no asegurada A qualitative approach to drug supply in Mexico: evaluation in the services for population with no medical insurance

OBJETIVO. Identificar las principales problemáticas que muestra la cadena de abasto de medicamentos (CAM) en los Sistemas Estatales de Salud (SESA), estableciendo la relación que guardan con la tercerización. MATERIAL Y MÉTODOS. Se entrevistó a funcionarios de los SESA y de hospitales y centros de salud de una muestra de 12 entidades durante la primera mitad de 2008. Las transcripciones de las entrevistas se procesaron en el programa de análisis cualitativo Atlas.ti 5.0; el análisis se orientó a reconstruir las fases de la CAM e identificar las problemáticas narradas por los informantes mediante el enfoque fenomenológicodeanálisisdel discurso. RESULTADOS. Existe una marcada tendencia a sustituir el modelo convencional por otro caracterizado por una mayor participación de proveedores privados; los modelos muestran problemáticas particulares que no parecen derivarse del grado de tercerización. CONCLUSIÓN. El abasto de medicamentos en los SESA estudiados difiere según la modalidad adoptada; la tercerización no está exenta de problemáticas y no parece resolver totalmente las dificultades identificadas en las formas convencionales.<br>OBJECTIVE. To identify the main problems that the drug supply chain (DSCh) faces in the state health systems (SHS); establishing how they relate to the degree of outsourcing. MATERIAL AND METHODS. Officials of the SHS hospitals and health centers were interviewed in a sample of 12 entities during the first half of 2008. Transcripts of the interviews were processed through the qualitative analysis program Atlas.ti 5.0; the analysis was aimed at reconstructing the phases of DSCh for identifying problems narrated by informants using the phenomenological approach to discourse analysis. RESULTS. There is a marked tendency to replace the conventional model by one that is characterized by greater involvement of private providers; all the models show specific problems that might be derived from the degree of outsourcing. CONCLUSION. The supply of drugs in the studied SHS differ from the pattern implemented according to the modality adopted; outsourcing is not exempt of problems and does not seem to fully resolve the difficulties encountered in conventional ways

Impacto de los factores de riesgo en osteoporosis sobre la densidad mineral ósea en mujeres perimenopáusicas de la Ciudad de Querétaro, México

Es indispensable evaluar los factores de riesgo en osteoporosis, principalmente los modificables, como: los estilos de vida, para prevenirla, ya que es un grave problema de salud p&uacute;blica. Se estudiaron 805 mujeres (35-55 a&ntilde;os) de la ciudad de Quer&eacute;taro, M&eacute;xico. Se obtuvieron datos personales, historia familiar, h&aacute;bitos como: fumar, actividad f&iacute;sica, consumo de alcohol y de cafe&iacute;na (refresco de cola y caf&eacute;). Las participantes completaron el cuestionario de riesgo de osteoporosis (19 factores, con uno, existe riesgo) (International Osteoporosis Foundation). Se evalu&oacute;: &Iacute;ndice de Masa Corporal (IMC), riesgo cardiovascular y complexi&oacute;n corporal (Talla/Circunferencia de mu&ntilde;eca). Se realiz&oacute; una densitometr&iacute;a &oacute;sea (DXA) en dos regiones diagn&oacute;sticas: columna lumbar y cadera total y las participantes se clasificaron en: densidad mineral &oacute;sea (DMO) normal, DMO baja y osteoporosis. La prevalencia de osteoporosis fue de 7% y de DMO baja fue de 34%, predominantemente en regi&oacute;n lumbar y en aquellas con menopausia. La edad fue mayor en mujeres osteopor&oacute;ticas (51 a&ntilde;os) y el 85% menop&aacute;usicas, con valores menores de: peso, talla, IMC, circunferencia de cintura y cadera, que las normales. Los factores de riesgo modificables que aumentaron el riesgo fueron: bajo peso, fumar y consumo de refresco de cola con 6,5, 1,2 y 1,4 (raz&oacute;n de momios) respectivamente (p&lt;0,05). Factores no modificables significativos: menopausia (quir&uacute;rgica), historia de fractura y riesgo de osteoporosis. Se concluye que dentro de los factores de riesgo modificables para la prevenci&oacute;n de osteoporosis de mayor impacto en esta muestra son: bajo peso, cigarrillo y el refresco de cola.It is essential to evaluate osteoporosis risk factors, mainly the modifiable, like the lifestyle, in Mexican women in order to prevent it, since it is a serious public health problem.We studied 805 women (35-55 years old) in the City of Queretaro, M&eacute;xico. We obtained: personal data, family history, habits, such as smoking, alcohol, caffeine (coffee and soft drink of cola) and physical activity. Participants complete the questionnaire on 19 risk factors for osteoporosis (International Osteoporosis Foundation) one of them with risk. We evaluated: body mass index (BMI), cardiovascular risk and corporal complexion. Bone densitometry was performed in two diagnostic regions: lumbar spine and total hip and participants were classified as normal bone mass density (BMD), low BMD and osteoporosis. The prevalence of osteoporosis was 7% and of low BMD was 34%, predominantly in the lumbar region and in those with menopause. In osteoporotic women, the age was higher (51 years) and 85% menopausal women, also lower values of weight, height, BMI, waist circumference and hip than women with normal bone mass density. The significantly modifiable risk factors were: low weight, smoking and consumption of soft drink of cola with 6,5, 1,2 and 1,4 (odds ratio), respectively (p &lt;0,05). The significantly non-modifiable risk factors were: menopause (surgical), history of fracture and risk. It is concluded that within the modifiable risk factors for the prevention of osteoporosis, those with the greatest impact were low weight, cigarette and soft drink of cola

La dimensión alimentaria en la evaluación de la marginación municipal

Las condiciones desiguales limitan el desarrollo en las comunidades, lo cual da como resultado la insatisfacción de necesidades básicas y se produce la marginación poblacional. Esto restringe el desarrollo productivo en los países o en sus regiones al crear la exclusión de grupos poblacionales al desarrollo o al disfrute de sus beneficios. La alimentación y la nutrición ocupan un lugar relevante en la consecución del desarrollo de una población.Actualmente, hasta nuestro conocimiento en México, en ninguna medida de marginación se considera la dimensión alimentaria; el objetivo delpresente estudio, por consiguiente, fue incluir la dimensión alimentaria en la evaluación de la marginación municipal y observar si sucede un cambioen el nivel de marginación, considerando nuestro planteamiento integrador e innovador por tener como finalidad el evaluar, de una manera holística,la marginación y darle la importancia que debe tener la dimensión alimentaria en la medición de la pobreza. Se estudiaron 7.606 familias pertenecientesa 50 municipios del Estado de Nuevo León, México. Se calculó de nuevo el índice de marginación (IM) incluyendo la dimensión alimentaria, representada por medio de la información arrojada por el Í ndice de consumo de macronutrientes (ICM), el cual fue obtenido mediante la recopilaciónde la dieta, en el nivel familiar, al utilizar un recordatorio de 24 horas.Al incluir la dimensión alimentaria en la medición de la marginación municipal, el 33,3% de los municipios aumentó el nivel de marginación en el área urbana, mientras que, en el área rural, el 58,5% de los municipios tuvo dicho aumento. En síntesis, al incluir la dimensión alimentaria en la medición de la marginación municipal, se modifica el nivel de marginación