An?lisis prospectivo del sector de comida r?pida en Lima : 2014-2030

La comida r?pida o fast food lleg? al Per? en la d?cada de 1980, cuando el derrumbe de torres el?ctricas, los apagones en las ciudades, el toquede queda y la inflaci?n galopante se impon?an. Hoy, la comida r?pida es uno de los negocios de mayor expansi?n. Considerado como una alternativa por un sector de la poblaci?n o como un problema por otro, lo cierto es que el n?mero de sus locales se ha incrementado en la ciudad de Lima, donde se presenta el mayor consumo del pa?s (65% del total nacional). Sin embargo, en la actualidad existe cierta incertidumbre respecto de lo que ocurrir? en los pr?ximos a?os, porque se pueden observar intentos del Estado por intervenir el negocio en defensa de la salud de los peruanos, principalmente de los ni?os. Esta investigaci?n tiene como objetivo principal desarrollar un an?lisis prospectivo para determinar el escenario m?s probable en Lima al a?o 2030 para el sector de comida r?pida. En este trabajo se est? considerando que para esa fecha se encontrar? a un consumidor m?s exigente ante los temas de comida saludable, existir?n nuevas leyes que controlen el aporte nutricional de los alimentos, impuestos y multas adicionales, e ingredientes alternativos menos da?inos que la tecnolog?a desarrollar?, as? como la presencia de nuevas enfermedades. Igualmente, tiene por finalidad que los diferentes actores puedan convertir sus oportunidades y dem?s factores identificados en una ventaja competitiva que les sirva para incursionar en este interesante mercado con un concepto innovador, ecol?gico, social y cultural. Por ello, busca aportar a la planificaci?n del futuro para los actores y las empresas que operan en el sector de comida r?pida

Personalized Feedback on Staff Dose in Fluoroscopy-Guided Interventions: A New Era in Radiation Dose Monitoring

Radiation safety and protection are a key component of fluoroscopy-guided interventions. We hypothesize that providing weekly personal dose feedback will increase radiation awareness and ultimately will lead to optimized behavior. Therefore, we designed and implemented a personalized feedback of procedure and personal doses for medical staff involved in fluoroscopy-guided interventions. Medical staff (physicians and technicians, n = 27) involved in fluoroscopy-guided interventions were equipped with electronic personal dose meters (PDMs). Procedure dose data including the dose area product and effective doses from PDMs were prospectively monitored for each consecutive procedure over an 8-month period (n = 1082). A personalized feedback form was designed displaying for each staff individually the personal dose per procedure, as well as relative and cumulative doses. This study consisted of two phases: (1) 1-5th months: Staff did not receive feedback (n = 701) and (2) 6-8th months: Staff received weekly individual dose feedback (n = 381). An anonymous evaluation was performed on the feedback and occupational dose. Personalized feedback was scored valuable by 76% of the staff and increased radiation dose awareness for 71%. 57 and 52% reported an increased feeling of occupational safety and changing their behavior because of personalized feedback, respectively. For technicians, the normalized dose was significantly lower in the feedback phase compared to the prefeedback phase: [median (IQR) normalized dose (phase 1) 0.12 (0.04-0.50) A mu Sv/Gy cm(2) versus (phase 2) 0.08 (0.02-0.24) A mu Sv/Gy cm(2), p = 0.002]. Personalized dose feedback increases radiation awareness and safety and can be provided to staff involved in fluoroscopy-guided interventions

A machine-learning based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease

Background: Mechanisms of myocardial ischemia in obstructive and non-obstructive coronary artery disease (CAD), and the interplay between clinical, functional, biological and psycho-social features, are still far to be fully elucidated. Objectives: To develop a machine-learning (ML) model for the supervised prediction of obstructive versus non-obstructive CAD. Methods: From the EVA study, we analysed adults hospitalized for IHD undergoing conventional coronary angiography (CCA). Non-obstructive CAD was defined by a stenosis < 50% in one or more vessels. Baseline clinical and psycho-socio-cultural characteristics were used for computing a Rockwood and Mitnitski frailty index, and a gender score according to GENESIS-PRAXY methodology. Serum concentration of inflammatory cytokines was measured with a multiplex flow cytometry assay. Through an XGBoost classifier combined with an explainable artificial intelligence tool (SHAP), we identified the most influential features in discriminating obstructive versus non-obstructive CAD. Results: Among the overall EVA cohort (n = 509), 311 individuals (mean age 67 ± 11 years, 38% females; 67% obstructive CAD) with complete data were analysed. The ML-based model (83% accuracy and 87% precision) showed that while obstructive CAD was associated with higher frailty index, older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was associated with a higher gender score (i.e., social characteristics traditionally ascribed to women) and with a cytokine signature characterized by IL-18, IL-8, IL-23. Conclusions: Integrating clinical, biological, and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of these associations. Clinical trial registration: NCT02737982

The Sex-Specific Detrimental Effect of Diabetes and Gender-Related Factors on Pre-admission Medication Adherence Among Patients Hospitalized for Ischemic Heart Disease: Insights From EVA Study

Background: Sex and gender-related factors have been under-investigated as relevant determinants of health outcomes across non-communicable chronic diseases. Poor medication adherence results in adverse clinical outcomes and sex differences have been reported among patients at high cardiovascular risk, such as diabetics. The effect of diabetes and gender-related factors on medication adherence among women and men at high risk for ischemic heart disease (IHD) has not yet been fully investigated.Aim: To explore the role of sex, gender-related factors, and diabetes in pre-admission medication adherence among patients hospitalized for IHD.Materials and Methods: Data were obtained from the Endocrine Vascular disease Approach (EVA) (ClinicalTrials.gov Identifier: NCT02737982), a prospective cohort of patients admitted for IHD. We selected patients with baseline information regarding the presence of diabetes, cardiovascular risk factors, and gender-related variables (i.e., gender identity, gender role, gender relations, institutionalized gender). Our primary outcome was the proportion of pre-admission medication adherence defined through a self-reported questionnaire. We performed a sex-stratified analysis of clinical and gender-related factors associated with pre-admission medication adherence.Results: Two-hundred eighty patients admitted for IHD (35% women, mean age 70), were included. Around one-fourth of the patients were low-adherent to therapy before hospitalization, regardless of sex. Low-adherent patients were more likely diabetic (40%) and employed (40%). Sex-stratified analysis showed that low-adherent men were more likely to be employed (58 vs. 33%) and not primary earners (73 vs. 54%), with more masculine traits of personality, as compared with medium-high adherent men. Interestingly, women reporting medication low-adherence were similar for clinical and gender-related factors to those with medium-high adherence, except for diabetes (42 vs. 20%, p = 0.004). In a multivariate adjusted model only employed status was associated with poor medication adherence (OR 0.55, 95%CI 0.31–0.97). However, in the sex-stratified analysis, diabetes was independently associated with medication adherence only in women (OR 0.36; 95%CI 0.13–0.96), whereas a higher masculine BSRI was the only factor associated with medication adherence in men (OR 0.59, 95%CI 0.35–0.99).Conclusion: Pre-admission medication adherence is common in patients hospitalized for IHD, regardless of sex. However, patient-related factors such as diabetes, employment, and personality traits are associated with adherence in a sex-specific manner

The effect of different storage conditions and duration on the fracture strength of three types of translucent fiber posts

OBJECTIVES: (a) To evaluate the effects of storage duration, storage condition and type of fiber post on post fracture strength. (b) To morphologically evaluate the post structure before and after storage. METHODS: Three types of fiber posts were divided in different groups (n=14) according to the storage duration (1, 6, 12 months), and storage condition (dry at 37 degrees C; saline water at 37 degrees C; mineral oil at 37 degrees C and storage inside the roots of extracted human teeth immersed in saline water at 37 degrees C). Specimens were loaded in a universal testing machine with a compressive load until fracture. A 3-way ANOVA and Tukey's test (alpha=.05) were used to compare the effect of the experimental factors on the fracture strength. Two posts of each group were observed before and after the storage using a scanning electron microscope. RESULTS: Storage conditions and post type, had a significant effect on post fracture strength (p<0.05). The interaction between these factors was significant (p<0.05). Water storage significantly decreased the fracture strength, regardless of the post type and the storage duration. Storage inside roots, in oil, and at dry conditions did not significantly affect post fracture strength. SEM micrographs revealed voids between fibers and resin matrix for posts stored in water. Posts stored under the other conditions showed a compact matrix without porosities. SIGNIFICANCE: Fiber posts placed inside human root canals immersed in water are not affected by the detrimental effect of water

Stiffness effect of using polywave or monowave LED units for photo-curing different bulk fill composites

We investigated three bulk fill composites (Mat1, Mat2, Mat3) cured by two polywave (Poly1, Poly2) and one monowave (Mono) lamps. We used infrared spectroscopy, nanoindentation and atomic force microscopy to assess degree of conversion (DC), stiffness, and roughness after polishing, respectively. Mat2 exhibited the highest DC with Poly1 and second highest with Mono, however was the less stiff. Both Mat1 and Mat3 showed highest DC with Poly2, while Poly1 scored better than Mono. Mat3 scored better than Mat1 and was the third highest when cured with Poly2. For each composite cured by different lamps the stiffness ranked same as the DC. However, roughness did not correlate with hardness. Absolute stiffness value depends on composite formulation. Polywave lamps work better than monowave but not in all cases, as Mat2 showed higher DC with Mono than with Poly2. However, all lamps guarantee a DC 6550% but Mono for Mat1

The influence of operator variability on adhesive cementation of fiber posts

Purpose: The aim of this study was to evaluate the influence of the operator's experience on the outcome of fiber post cementation using an etch-and-rinse acetone-based adhesive. Materials and Methods: Fifteen human anterior teeth were used in the study. One trained operator performed the endodontic procedures and prepared the roots for the insertion and cementation of the posts. At this point, teeth were divided into 3 groups and distributed to 3 operators to lute the posts: an expert operator (EO), a moderately experienced operator (ME), and an operator with a low level of experience (LE). Quartz fiber posts (DT Light Post #1 or #2, RTD) were used. Posts were cemented using Prime&Bond NT Dual Cure adhesive system (Dentsply Caulk) in combination with the dual-curing resin cement Calibra (Dentsply Caulk). The post retention was assessed with the "thin-slice" push-out test. One-way ANOVA was performed to examine the effect of the operator on push-out strength, followed by post-hoc multiple comparisons using Tukey's test, with the significance level set at alpha = 95%. Results: The results of push-out strength testing were as follows: EO (12.44 +/- 3.63 MPa), ME (11.68 +/- 2.64 MPa), LE (11.18 +/- 3.12 MPa). No statistically significant differences were determined among the three groups. Conclusion: There was no statistically significant difference in the retention measured for fiber posts luted by operators with different levels of clinical experience. Given the parameters of this investigation, the level of operator experience in luting fiber posts does not affect post retention under laboratory conditions

Valutazione della forza di adesione di differenti resine composite utilizzate nel restauro di monconi su perni in fibra.

6nonenoneVANO M; TOGNINI F; C. GORACCI; GABRIELE M; BOSCO M; FERRARI MVano, M; Tognini, F; Goracci, Cecilia; Gabriele, M; Bosco, M; Ferrari, Marc

Bacterial adhesion on direct and indirect dental restorative composite resins: An in vitro study on a natural biofilm

Both direct and indirect techniques are used for dental restorations. Which technique should be preferred or whether they are equivalent with respect to bacterial adhesion is unclear