Qualificação do acolhimento e do atendimento da população trans pelos profissionais do Sistema Único de Saúde (SUS) : uma cartilha

INTRODUÇÃO/CONTEXTO: Os conhecimentos e as atitudes dos profissionais de saúde ao interagir com a população trans nem sempre se coadunam com o esperado sob o ponto de vista da integralidade e da competência desejadas em um sistema de saúde que preze a integralidade, o respeito e a dignidade humana. A disseminação de informação de qualidade pode contribuir para modificar a situação vigente rumo a patamares mais adequados. OBJETIVO: Elaborar uma cartilha para qualificação do acolhimento e atendimento da população trans para profissionais da saúde do Sistema Único de Saúde (SUS). METODOLOGIA: Revisão de literatura direcionada para a elaboração de cartilha, de janeiro de 2010 a outubro de 2021. Foram utilizados os termos “transexual” e “pessoas trans” para a busca, cada qual associado às expressões “discriminação em serviços de saúde” e “acesso à saúde”, nos idiomas português e inglês na Biblioteca Virtual em Saúde, PubMed e Google Scholar. RESULTADOS/DISCUSSÃO: Para elaboração da cartilha, foram apresentados e discutidos tópicos relativos a população trans sob o ponto de visto de histórico e contextos recentes; papel do Sistema Único de Saúde (SUS); desigualdades no sistema público de saúde brasileiro; Iniquidades no sistema público de saúde brasileiro e na área da saúde mental; saúde da mulher transexual no Brasil; e saúde do homem transexual no Brasil. CONSIDERAÇÕES FINAIS: Como produto do Mestrado Profissional, foi elaboradad um cartilha que considerou aspectos de conteúdo, linguagem, organização, layout, ilustração, aprendizagem e motivação. Materiais educativos como recursos na educação em saúde tem assumido um papel importante no processo de ensino-aprendizagem, principalmente em intervenções terapêuticas que abordam segmentos populacionais. Embora haja algumas limitações decorrentes, as cartilhas permitem às equipes de trabalhadores uma leitura posterior, reforçando as informações necessárias, servindo como guia de orientações para casos de dúvidas e auxiliando nas tomadas de decisões do cotidiano.INTRODUCTION/CONTEX: The knowledge and attitudes of health professionals when interacting with the trans population are not always consistent with what is expected from the point of view of completeness and competence desired in a health system that values comprehensiveness, respect and human dignity. The dissemination of quality information can help change the current situation towards more adequate levels. OBJECTIVE: To develop a booklet for qualifying the reception and care of the trans population for health professionals from the Unified Health System (SUS). METHODOLOGY: Literature review aimed at preparing a booklet, from January 2010 to October 2021. The terms "transsexual" and "trans people" were used for the search, each one associated with the expressions "discrimination in health services" and “access to health”, in Portuguese and English in the “Biblioteca Virtual de Saúde – BVS” (Virtual Health Library), PubMed and Google Scholar. RESULTS/DISCUSSION: For the preparation of the booklet, topics related to the trans population were presented and discussed from the point of view of history and recent contexts; role of the Unified Health System (SUS); inequalities in the Brazilian public health system; Inequities in the Brazilian public health system and in the area of mental health; transsexual women's health in Brazil; and health of transsexual men in Brazil. FINAL CONSIDERATIONS: As a product of the Professional Masters, a booklet was created that considered aspects of content, language, organization, layout, illustration, learning and motivation. Educational materials as resources in health education have assumed an important role in the teaching-learning process, especially in therapeutic interventions that address population segments. Although there are some resulting limitations, the booklets allow teams of workers to read them later, reinforcing the necessary information, serving as a guide for cases of doubt and helping in daily decision-making

Transvesical endoscopic port in abdominal surgery: an updated perspective

Transvesical endoscopic port in abdominal surgery: an updated perspective.Natural orifice transluminal endoscopic surgery (NOTES) generated a huge hope among surgeons because it promised scarless surgery and eventually less pain and surgical stress. However, serious limitations regarding reliable visceral closing methods remain unsolved. This article provides an update in development and future applications of transvesical access in the field of surgery.(undefined

SOFRIMENTO E CONTRADIÇÃO: O SIGNIFICADO DA MORTE E DO MORRER PARA ENFERMEIROS QUE TRABALHAM NO PROCESSO DE DOAÇÃO DE ÓRGÃOS PARA TRANSPLANTE

Objectives: To identify the perception and the sentiments of the nurses, in relation to death and dying, who work with the harvesting of organs for transplant. Methods: This is a descriptive research utilizing a qualitative approach. Ten (10) semi-structured interviews were performed, recorded on video-cassette, and the data were analyzed following the analysis of the speeches according to Bardin. Results: Three categories emerged: Category 1 – The significance of death is represented by the following subcategories: Finality, Rebirthing and Contradiction; Category 2 – The significance of donation, is represented by the following subcategories: Solidarity and Generosity, Chance of Life and Contradiction; Category 3 – Existing conflicts among nurses who work in the process of harvesting organs is represented by the following subcategories: Interpersonal relations with the family of the donator, caring for the donor in detriment of the donation, suffering at work, trying to maintain control, criticizing the process of harvesting organs and searching for meaning in their work. Conclusion: From analyzing the content according to the Bardin’s method of processing data, it can be inferred that professionals involved in harvesting organs need to be fully aware that they can compromise their own mental and physical health when encountering these frequent existential conflicts and moral dilemmas.Objetivo: Identificar la percepción y los sentimientos de los enfermeros que trabajan en la captación de órganos para trasplantes en relación a la muerte y al morir. Método: Trátase de una investigación descriptiva con abordaje cualitativo. Fueron realizadas 10 entrevistas semi-estructuradas, grabadas en cinta-cassette, y los datos discutidos a partir del análisis de los discursos según Bardin. Resultados: Emergieron tres categorías: Categoría 1 - El significado de la muerte, constituida por las subcategorías: Finitud, Renacimiento y Contradicción; Categoría 2 – El significado de la donación, con las subcategorías: Solidaridad y desprendimiento, Oportunidad de vida e Contradicción; Categoría 3 – Conflictos vivenciados por el enfermero en el proceso de trabajo en la captación de órganos, teniendo como subcategorías: Estando con la familia del donador, Cuidando del donador en detrimento de la donación, Sufriendo en el trabajo, Intentando preservarse, Criticando el proceso de captación y Buscando el sentido del trabajo. Conclusión: A partir del análisis de los contenidos según las orientaciones del método de proceso de datos de Bardin, podemos inferir que los profesionales de captación de órganos necesitan ser cuidados por vivenciar conflictos existenciales y dilemas morales con mucha frecuencia en sus quehaceres, pudiendo comprometer su propia salud mental y física.Objetivo: identificar a percepção e os sentimentos dos enfermeiros que trabalham na captação de órgãos para transplante em relação à morte e o morrer. Método: trata-se de uma pesquisa descritiva com abordagem qualitativa. Foram realizadas 10 entrevistas semi-estruturadas, gravadas em fita cassete, e os dados analisados a partir da análise dos discursos. Resultados: emergiram três categorias: Categoria 1 – O significado da morte, constituída pelas subcategorias: Finitude, Renascimento e Contradição; Categoria 2 – O significado da doação, com as subcategorias: Solidariedade e desprendimento, Chance de vida e Contradição; Categoria 3 – Conflitos vivenciados pelo enfermeiro no processo de trabalho na captação de órgãos, tendo como subcategorias: Estando com a família do doador, Cuidando do doador em detrimento a doação, Sofrendo no trabalho, Tentando preservar-se, Criticando o processo de captação e Buscando o sentido do trabalho. Conclusão: os profissionais de captação de órgãos necessitam ser cuidados por vivenciarem conflitos existenciais e dilemas morais com grande freqüência em seu fazer, podendo comprometer sua saúde mental e física

Reflecting polarizing beam splitter

We propose and experimentally demonstrate the use of metal-covered lamellar relief gratings as a polarizing beam splitter operating at a single wavelength near Littrow incidence. We report the characteristics of a grating produced by holography and reactive ion etching that was calculated for operation as beam Splitter at lambda = 633 nm (for a He-Ne laser). (C) 1997 Optical Society of America.22420320

Target score—a proteomics data selection tool applied to esophageal cancer identifies glut1-sialyl tn glycoforms as biomarkers of cancer aggressiveness

Esophageal cancer (EC) is a life-threatening disease, demanding the discovery of new biomarkers and molecular targets for precision oncology. Aberrantly glycosylated proteins hold tremendous potential towards this objective. In the current study, a series of esophageal squamous cell carcinomas (ESCC) and EC-derived circulating tumor cells (CTCs) were screened by immunoassays for the sialyl-Tn (STn) antigen, a glycan rarely expressed in healthy tissues and widely observed in aggressive gastrointestinal cancers. An ESCC cell model was glycoengineered to express STn and characterized in relation to cell proliferation and invasion in vitro. STn was found to be widely present in ESCC (70% of tumors) and in CTCs in 20% of patients, being associated with general recurrence and reduced survival. Furthermore, STn expression in ESCC cells increased invasion in vitro, while reducing cancer cells proliferation. In parallel, an ESCC mass spectrometry-based proteomics dataset, obtained from the PRIDE database, was comprehensively interrogated for abnormally glycosylated proteins. Data integration with the Target Score, an algorithm developed in-house, pinpointed the glucose transporter type 1 (GLUT1) as a biomarker of poor prognosis. GLUT1-STn glycoproteoforms were latter identified in tumor tissues in patients facing worst prognosis. Furthermore, healthy human tissues analysis suggested that STn glycosylation provided cancer specificity to GLUT1. In conclusion, STn is a biomarker of worst prognosis in EC and GLUT1-STn glycoforms may be used to increase its specificity on the stratification and targeting of aggressive ESCC forms.The authors wish to acknowledge the Portuguese Foundation for Science and Technology (FCT) for the human resources grants: PhD grant SFRH/BD/111242/2015 (AP), SFRH/BD/146500/2019 (MRS), SFRH/BD/142479/2018 (JS), SFRH/BD/105355/2014 (RA) and FCT assistant researcher grant CEECIND/03186/2017 (JAF). FCT is co-financed by European Social Fund (ESF) under Human Potential Operation Programme (POPH) from National Strategic Reference Framework (NSRF). The authors also acknowledge FCT the funding for CI-IPOP research unit (PEst-OE/SAU/UI0776/201) and LAQV-REQUIMTE research unit (UIDB/50006/2020), the Portuguese Oncology Institute of Porto Research Centre (CI-IPOP-29-2016-2020; CI-IPOP-58-2016-2020; CI-IPOP-Proj.70-bolsa2019-GPTE) and PhD Program in Biomedical Sciences of ICBAS-University of Porto. The author also thanks “Early stage cancer treatment, driven by context of molecular imaging (ESTIMA)” framework (NORTE-01-0145-FEDER-000027) and IPO-Score (DSAIPA/DS/0042/2018) for financial support. This work was financed by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020 and by Portuguese funds through FCT/MCTES—Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior. The authors also acknowledge support from the Portuguese League against Cancer grant LPCC-NRN-2020 (DF)

Ocean-wide tracking of pelagic sharks reveals extent of overlap with longline fishing hotspots

Overfishing is arguably the greatest ecological threat facing the oceans, yet catches of many highly migratory fishes including oceanic sharks remain largely unregulated with poor monitoring and data reporting. Oceanic shark conservation is hampered by basic knowledge gaps about where sharks aggregate across population ranges and precisely where they overlap with fishers. Using satellite tracking data from six shark species across the North Atlantic, we show that pelagic sharks occupy predictable habitat ‘hotspots’ of high space use. Movement modelling showed sharks preferred habitats characterised by strong sea-surface-temperature gradients (fronts) over other available habitats. However, simultaneous Global Positioning System (GPS) tracking of the entire Spanish and Portuguese longline-vessel fishing fleets show an 80% overlap of fished areas with hotspots, potentially increasing shark susceptibility to fishing exploitation. Regions of high overlap between oceanic tagged sharks and longliners included the North Atlantic Current/Labrador Current convergence zone and the Mid-Atlantic Ridge south-west of the Azores. In these main regions, and sub-areas within them, shark/vessel co-occurrence was spatially and temporally persistent between years, highlighting how broadly the fishing exploitation efficiently ‘tracks’ oceanic sharks within their space-use hotspots year-round. Given this intense focus of longliners on shark hotspots our study argues the need for international catch limits for pelagic sharks and identifies a future role of combining fine-scale fish and vessel telemetry to inform the ocean-scale management of fisheries

Dietary carotenoid-rich oil supplementation improves exercise-induced anisocytosis in runners: influences of haptoglobin, MnSOD (Val9Ala), CAT (21A/T) and GPX1 (Pro198Leu) gene polymorphisms in dilutional pseudoanemia (sports anemia)

Physical training induces beneficial adaptation, whereas exhaustive exercises increase reactive oxygen-species generation, thereby causing oxidative damage in plasma and erythrocytes, fractions susceptible to lipid peroxidation. Pequi (Caryocar brasiliense Camb.) is a Brazilian Cerrado fruit containing a carotenoid-rich oil. The aim was to investigate the effects of pequi-oil on exercise-induced oxidative damage in plasma and erythrocytes, after running in the same environment and undergoing weekly training under the same conditions as to type, intensity and length. Evaluations were accomplished after outdoor running on flat land before and after ingestion of 400 mg pequi-oil capsules for 14 days. Blood samples were taken after running and submitted to TBARS assay and erythrogram analysis. Haptoglobin, MnSOD (Val9Ala), CAT (21A/T) and GPX1 (Pro198Leu) gene polymorphisms were priorly investigated, so as to estimate genetic influence The reduction in erythrocytes, hemoglobin and hematocrit after pequi-oil treatment was notably associated with higher plasma expansion. Except for MCHC (mean corpuscular hemoglobin concentration) and RDW (red cell distribution width), the results were influenced by the polymorphisms studied. The best response to pequi-oil was presented by MnSOD Val/Val, CAT AA or AT genotypes and the GPX1 Pro allele. The significantly lower RDW and higher MHCH values were related to pequi-oil protective effects. Pequi oil, besides possessing other nutritional properties, showed protective blood effects

Sliding Wear Behavior of Al2O3-TiO2 Coatings Fabricated by the Suspension Plasma Spraying Technique

[EN] The friction and dry sliding wear behavior of alumina and alumina-titania near-nanometric coatings were examined. Coatings were obtained by the suspension plasma spraying technique. Dry sliding wear tests were performed on a ball-on-disk tribometer, with an Al2O3 ball as counterpart material, a normal load of 2 N, a sliding distance of 1200 m and a sliding speed of 0.1 m/s. The effect of including TiO2 in the fabricated coatings on friction coefficient behavior, wear rates and wear damage patterns was determined. The addition of TiO2 to the coatings was found to greatly increase wear resistance by, for example, 2.6-fold for 40 wt% of TiO2. The analysis of the wear surface was correlated with microstructural parameters, mechanical properties and wear rates.The authors wish to thank for the Spanish Ministry of Economy and Competitiveness (MAT2012-38364-C03) and the Autonomous Government of Valencia for funding for the stay in SPCTS-UMR CNRS (France), and the French FCENANOSURF consortium funded by the French Ministry and Industry and local governments of Region Centre and Region Limousin.Klyatskina, E.; Espinosa Fernández, L.; Darut, G.; Segovia López, EF.; Salvador Moya, MD.; Montavon, G.; Agorges, H. (2015). Sliding Wear Behavior of Al2O3-TiO2 Coatings Fabricated by the Suspension Plasma Spraying Technique. Tribology Letters. 59(1):1-9. https://doi.org/10.1007/s11249-015-0530-5S19591Pawlowski, L.: The Science and Engineering of Thermal Spray Coatings. Wiley: Hoboken (2008)Lampe, Th, Eisenberg, S., Cabeo, E.R.: Plasma surface engineering in the automotive industry—trends and future prospective. Surf. Coat. Technol. 174–175, 1–7 (2003)Wang, Y., Jiang, S., Wang, M., Wang, S., Xiao, T.D., Strutt, P.R.: Abrasive wear characteristics of plasma sprayed nanostructured alumina/titania coatings. Wear 237, 176–185 (2000)Kabacoff, L.T.: Nanoceramic coatings exhibit much higher toughness and wear resistance than conventional coatings. AMPITAC Newslett. 6(1), 37–42 (2002)Wang, M., Shaw, L.L.: Effects of the powder manufacturing method on microstructure and wear performance of plasma sprayed alumina–titania coatings. Surf. Coat. Technol. 202, 34–44 (2007)Shaw, L.L., Goberman, D., Ren, R., Gell, M., Jing, S., Wang, Y., Xiao, T.D., Strutt, P.R.: The dependency of microstructure and properties of nanostructured coatings on plasma spray conditions. Surf. Coat. Technol. 130, 1–8 (2000)Dahotre, N.B., Nayak, S.: Nanocoatings for engine application. Surf. Coat. Technol. 194(1), 58–67 (2005)Sathish, S., Geetha, M., Aruna, S.T., Balaji, N., Rajam, K.S., Asokamani, R.: Sliding wear behavior of plasma sprayed nanoceramic coatings for biomedical applications. Wear 271, 934–941 (2011)Pawlowski, L.: Finely grained nanometric and submicrometric coatings by thermal sparing: a review. Surf. Coat. Technol. 202, 4318–4328 (2008)Xiao, D., Wang, Y., Strutt, P.: Fabrication and evaluation of plasma sprayed nanostructured alumina–titania coatings with superior properties. Mater. Sci. Eng. 301, 80–89 (2001)Tjong, S.C., Chen, H.: Nanocrystalline materials and coatings. Mater. Sci. Eng. 45, 1–88 (2004)Fauchais, P., Montavon, G., Bertrand, G.: From powders to thermally sprayed coatings. J. Therm. Spray Technol. 19, 56–80 (2010)Lima, R.S., Marple, B.R.: Thermal spray coatings engineered from nanostructured ceramic agglomerated powders for structural, thermal barrier and biomedical applications: a review. J. Therm. Spray Technol. 16, 40–63 (2007)Fauchais, P., Etchart-Salas, R., Delbos, C., Tognonvi, M., Rat, V., Coudert, J.F., Chartier, T.: Suspension and solution plasma spraying of finely structured layers: potential application to SOFCs. J. Phys. D Appl. Phys. 40, 2394–2406 (2007)Ramachandran, K., Selvajaran, V., Ananthapadmanabhan, P.V., Sreekumar, K.P.: Microstructure, adhesion, micro hardness, abrasive wear resistance and electrical resistivity of the plasma sprayed alumina and alumina–titania coatings. Thin Solid Films 315, 144–152 (1998)Lee, S.W., Morillo, C., Lira-Olivares, J., Kim, S.H., Sekino, T., Niihara, K., Hockey, B.J.: Tribological and microstructural analysis of Al2O3/13TiO2 nanocomposites to use in femoral head of hip replacement. Wear 225, 1040–1044 (2003)Dejang, N., Watcharapasorn, A., Wirojupatump, S., Niranatlumpong, P., Jiansirisomboon, S.: Fabrication and properties of plasma-sprayed Al2O3/TiO2 composite coatings: a role of nano-sized TiO2 addition. Surf. Coat. Technol. 204, 1651–1657 (2010)Yimaz, S.: An evaluation of plasma sprayed coatings based on Al2O3 and Al2O3–13wt% TiO2 with bond coat on pure titanium substrate. Ceram. Int. 35, 2017–2022 (2009)Fervel, V., Normand, B., Coddet, C.: Tribological behavior of plasma sprayed Al2O3-based cermet coatings. Wear 230(1), 70–77 (1999)Vargas, F., Ageorges, H., Fauchais, P., López, M.E.: Mechanical and a tribological performance of Al2O3 coatings elaborated by flame and plasma spraying. Surf. Coat. Technol. 205, 1132–1136 (2010)Bacciochini, A., Ilavsky, J., Montavon, G., Denoirjean, A., Ben-ettouil, F., Valette, S., Fauchais, P., Wittmann-teneze, K.: Quantification of void network architectures of suspension plasma-sprayed (SPS) yttria-stabilized zirconia (YSZ) coatings using ultra-small-angle X-ray scattering (USAXS). Mater. Sci. Eng. 528, 91–102 (2010)ASTM International: ASTM G99-03: Standard test method for wear testing with a pin-on-disc apparatus. ASTM annual book of standards. ASTM International: West Conshohocken (2003)Lancaster, K.: The influence of substrate hardness on the formation and endurance of molybdenum disulphide films. Wear 10, 103–107 (1967)Fauchais, P., Rat, V., Delbos, C., Fazilleau, J., Coudert, J.F., Chartier, T., Bianchi, L.: Understanding of suspension plasma spraying of finely structured coatings for SOFC. IEEE Plasma Sci. 33(2), 920–930 (2005)Bannier, E., Vicent, M., Rayón, E., Benavente, R., Salvador, M.D., Sánchez, E.: Effect of TiO2 addition on the microstructure and nanomechanical properties of Al2O3 suspension plasma sprayed coatings. Appl. Surf. Sci. 316, 141–146 (2014)Darut, G., Klyatskina, E., Valette, S., Carles, P., Denoirjean, A., Montavon, G., Ageorges, H., Segovia, F., Salvador, M.D.: Architecture and phases composition of suspension plasma sprayed alumina–titania sub-micrometer-sized coatings. Mater. Lett. 67, 241–244 (2012)Fauchais, P., Montavon, G.: Latest developments in suspension and liquid precursor thermal spraying. J. Therm. Spray Technol. 19(1–2), 226–239 (2010)Darut, G., Ben-Ettouli, F., Denoirjean, A., Montavon, G., Ageourges, H., Fauchais, P.: Dry sliding behavior of sub-micrometer-sized suspension plasma sprayed ceramic oxide coatings. J. Therm. Spray Technol. 19, 275–285 (2010)Tingaud, O., Bacciochini, A., Montavon, G., Denoirjean, A., Fauchais, P.: Suspension DC plasma spraying of thick finely-structured ceramic coatings: process manufacturing mechanisms. Surf. Coat. Technol. 203, 2157–2161 (2009)Guesama, S., Bounazef, M., Nardin, P., Sahraoui, T.: Wear behavior of alumina–titania coatings: analysis of process and parameters. Ceram. Int. 32, 13–19 (2006)Espinosa-Fernández, L., Borrell, A., Salvador, M.D., Gutierrez-Gonzalez, C.F.: Sliding wear behavior of WC–Co–Cr3C2–VC composites fabricated by conventional and non-conventional techniques. Wear 307, 60–67 (2013)Zhang, J., Moslehy, F.A., Rice, S.L.: A model for friction in quasi-steady-state. Part I. Derivation. Wear 149, 1–12 (1991)Zhang, J., Moslehy, F.A., Rice, S.L.: A model for friction in quasi-steady-state sliding Part II. Numerical results and discussion. Wear 149, 13–25 (1991)Bolelli, G., Cannilo, V., Lusvarghi, L., Manfredini, T.: Wear behaviour of thermally sprayed ceramic oxide coatings. Wear 261, 1298–1315 (2006)Normand, B., Fervel, V., Coddet, C., Nikitine, V.: Tribological properties of plasma sprayed alumina–titania coatings: next term role and control of the microstructure. Surf. Coat. Technol. 123, 278–287 (2000)Hutchings, I.: Tribology: friction and wear of engineering materials. Mater. Des. 13, 187 (1992)Ahn, J., Hwang, B., Song, E.P., Lee, S., Kim, N.J.: Correlation of microstructure and wear resistance of Al2O3–TiO2 coatings plasma sprayed with nanopowders. Metall. Mater. Trans. A 37, 1851–1860 (2006)Erickson, L.C., Hawthorne, H.M., Troczynski, T.: Correlations between microstructural parameters, micromechanical properties and wear resistance of plasma sprayed ceramic coatings. Wear 250, 569–575 (2001)Song, E.P., Ahn, J., Lee, S., Kim, N.J.: Microstructure and wear resistance of nanostructured Al2O3–8 wt%TiO2 coatings plasma-sprayed with nanopowders. Surf. Coat. Technol. 201, 1309–1315 (2006)Tucker Jr., R.C.: ASM Handbook Volume 5A: Thermal Spray Technology. ASM International, Materials Park (2013)Stachowiack, G.W., Batchelor, A.: Engineering Tribology Handbook. Elsevier-Butterworth-Heineman: Oxford (2005)Fischer, T.E., Zhu, Z., Kim, H., Shin, D.S.: Genesis and role of wear debris in sliding wear of ceramics. Wear 245, 53–60 (2000)Lima, R.S., Moureau, C., Marple, B.R.: HVOF-sprayed coatings engineered from mixtures of nanostructured and submicron Al2O3–TiO2 powders: an enhanced wear performance. J. Therm. Spray Technol. 16, 866 (2007