EFECTO DE DECOLORACIÓN POR PLASMA NO TÉRMICO EN COLORANTES TEXTILES DISUELTOS: NEGRO ÁCIDO 194

Artículo de investigaciónIn this work, we show that cold plasma (electrical discharge) acting on the liquidatmosphere interface can change some macroscopic and microscopic parameters of wastewater with dissolved dyes, a process characterized by the study of physical and chemical variables, such as the voltage and current of the electrical discharge, temperature, volume, absorbance, electrical conductivity, pH, chemical oxygen demand (COD), and total organic carbon (TOC). The dye used is Acid Black 194 (AB194) in a water solution (250 mL) with a concentration of 0.1 mM and the addition of FeSO4 at 1.0 mM. The initial values of pH and electrical conductivity were 2.54 and 1.55 S/cm, respectively, at a temperature of 21.5 ºC. Nonthermal plasma was generated with a DC power supply at a potential of 700 V and 133 mA, which was maintained throughout the process, until an exposure time of 45 min. This physicochemical method is environmentally friendly because it does not generate polluting waste.UAEM 4307/2017/CI

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Control estadístico de procesos y análisis de problemas en el tratamiento térmico de piezas de acero en la empresa Aceros Chilca SAC, Lima – 2021

La presente investigación tuvo como objetivo general aplicar control estadístico de procesos para identificar problemas en el tratamiento térmico de las piezas de acero en la empresa Aceros Chilca SAC, Lima 2021. El control estadístico de procesos consta de técnicas y herramientas de recolección de datos y análisis con respecto a la variación de un proceso para medir y controlar sus desviaciones que en el tiempo afectan la característica de calidad de requerimiento del cliente, que en nuestro caso se trata de encontrar las causas de las alteraciones de la dureza de las piezas de acero fundidas por los diversos procesos de tratamiento térmico. La metodología aplicada fue de observación y análisis de datos históricos con programas de Excel y Minitab, los resultados arrojaron que para la dimensión carta de control el proceso se encuentra inestable por causas comunes y para capacidad potencial y real del proceso se identificó que el proceso no es capaz de cumplir con el requerimiento de durezas de los clientes, determinándose que los problemas de la baja y alta dureza están ubicadas en la 3 M, la medición, método y maquinaria tales como que no se cumple con el tiempo de enfriamiento en soplado, temperatura alta y baja al revenido, mala ubicación de las campaña de soplado, entre otras; por lo cual se recomienda mejorar los controles de los tiempos, temperaturas y recortar la distancia de los ventiladores hacia los hornos de tratamiento térmico.The present investigation had as a general objective to apply statistical process control to identify problems in the heat treatment of steel parts in the company Aceros Chilca SAC, Lima 2021. Statistical process control consists of techniques and tools for data collection and analysis regarding the variation of a process to measure and control its deviations that affect the quality characteristic of the client's requirement over time, which in our case is to find the causes of changes in the hardness of cast steel parts by various heat treatment processes. The methodology applied was observation and analysis of historical data with Excel and Minitab programs, the results showed that for the control letter dimension the process is unstable due to common causes and for potential and real capacity of the process it was identified that the process does not It is capable of meeting the hardness requirements of customers, determining that the problems of low and high hardness are located in 3M, the measurement, method and machinery such as that the cooling time in blowing is not met, high and low tempering temperature, bad location of the blowing campaign, among others; For this reason, it is recommended to improve the controls of times, temperatures and cut the distance of the fans to the heat treatment furnace

Plasma diagnostics of glow discharges in mixtures of CO2 with noble gases

This study presents the plasma diagnostics of a glow discharge produced in two different mixtures, CO 2 /He and CO 2 /Ar, at a constant pressure of 1.5 Torr. The experiment was conducted to determine the carbon dioxide decomposition in the plasma by using the optical emission spectroscopy ( OES ) method through identifying lines and emission bands in the spectra. In addition, an electrical characterization of the mixture plasma was made by the determination of ion density ( n i ) and the electronic temperature ( T e ) , estimated through a double Langmuir probe. The electronic temperature for the mixture plasma was in the range of 2.07-5.37 eV, and the ion density between 2 . 15 × 10 9 and 18 . 70 × 10 9 particles/cm 3 . The principal bands and lines identified in the OES correspond to CO + 2 , CO 2 , CO + , CO, O*, O 2 , O + 2 , C 2 , He* and Ar*

Changes in bioactive compounds during fermentation of cocoa (Theobroma cacao) harvested in Amazonas-Peru

Cocoa (Theobroma cacao) is the main raw material for the production of chocolate; it is considered the food of the gods, as it possesses a diversity of bioactive compounds beneficial to human health. The abundance of bioactive compounds, among others, is conditioned by the post-harvest processing of cocoa beans, and fermentation is a major step in this regard. Consequently, this research evaluated the changes in phenolic compounds and methylxanthines occurred in the fermentation of Criollo and CCN-51 cocoa beans, varieties of great commercial interest for the cocoa-growing areas of Peru. For this purpose, samples were taken every 12 h of cocoa beans under fermentation for 204 h in which phenols (gallic acid, caffeic acid, catechin, and epicatechin) and methylxanthines (theobromine, caffeine and theophylline) were quantified by ultra-high performance liquid chromatography (UHPLC); total polyphenols by Folin Ciocalteu; antioxidant capacity by DPPH free radical capture method; total anthocyanins; pH; titratable acidity; and fermentation rate of beans. We found that during fermentation, phenolic content, antioxidant activity, and methylxanthines of cocoa beans decreased; on the other hand, the anthocyanin content increased slightly. Indeed, at distinctly degree, fermentation influences bioactive compounds in cocoa beans, depending on the variety cultivated

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially