Model of organizational management: barriers and opportunities in thecreation and strengthening of an institutional network of healthresearch. Descriptive study of transverse cutting

La gestión implica comprender la lógica de las instituciones para poder construir redes de trabajo que significan interrelación entre sujetos, organizaciones e instituciones, considerar las micro prácticas locales para la implementación de prácticas contextualizadas Objetivo: describir los factores que favorecen y/u obstaculizan la constitución de una red institucional de investigación para la salud, desde las percepciones de los distintos actores del ministerio de salud de las provincias del nuevo cuyo y de las instituciones académicas de Mendoza

Modelo de gestión organizacional: barreras y oportunidades en la conformación y fortalecimiento de una red institucional de investigación en salud

En este proyecto se pretende describir los factores que favorecen y/u obstaculizan la constitución de una red institucional de investigación para la salud, desde las propias expresiones de los actores/agentes del Estado (Ministerio de Salud) y de las instituciones académicas de la provincia de Mendoza. Es un estudio descriptivo de corte transversal, que realizará un análisis centrado en el concepto de problema, desde la concepción de planificación situacional. Se utilizarán técnicas de recolección de información con una metodología mixta cuanti y cualitativa. La población accesible de este estudio está conformada por las áreas de investigación formalmente establecidas, por norma, de los ministerios de Salud de las provincias de Mendoza, San Luis y La Rioja y las Universidades con sus unidades académicas y/o facultades del sector público y privado de la provincia de Mendoza, quedando excluidas las universidades y/o facultades que no posean carreras afines a la salud de la provincia de Mendoza, y el área de investigación del ministerio de Salud de San Juan por no contar con referente técnico de investigación a nivel ministerial. Se pretende indagar sobre factores que permitan la posterior elaboración de indicadores para medir las acciones de la red local y la posible construcción de una red regional como política de Salud

Slag corrosion of alumina-magnesia-carbon refractory bricks: Experimental data and thermodynamic simulation

Alumina-magnesia-carbon (AMC) bricks are used in steelmaking ladles, where they are part of the bottom and sidewalls working linings. These refractories can be corroded by liquid slag, especially during tapping and casting. In order to contribute with information regarding the reaction mechanisms and the formed phases when they are in contact with a molten slag, the slag corrosion at high temperatures of three AMC refractories is analyzed in this paper. A crucible test was performed at 1600 °C using an industrial basic slag, and the results were compared with those obtained in testing at 1450 °C. In addition, thermodynamic simulations of the slag-refractory contact were performed using FactSage software and a model which considers the global chemical composition of each refractory. Differences in the materials wear associated with differences in composition were predicted by the simulation. Other determining factors, such as microstructure and texture of the evaluated AMC refractories, were also discussed.Fil: Muñoz, Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; ArgentinaFil: Camelli, Silvia. Instituto Argentino de Siderurgía; ArgentinaFil: Tomba Martinez, Analia Gladys. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; Argentin

On the use of macro synthetic fibres in precast tunnel segments

The effectiveness of tunnel segments reinforced with 12 kg/m3 polymeric macro-fibres in addition to a minimum steel reinforcement ratio has been assessed. Precast tunnel segments have been adopted to test this fibre-reinforced solutions for structural elements, in which the longitudinal reinforcement has been designed to comply only with EC2 minimum reinforcement requirements for no seismic design situations. This experimental campaign is the final step of a wider research, aimed at investigating an optimized mixture for the use of the polymeric fibres ISTRICE, as well as investigating the performance of some structural elements such as slabs, beams and tunnel segments, which are produced by using such a mix design. The experimental programme has been devised in such a way that in a first stage the structural behaviour of a fibre-reinforced tunnel segment has been first of all investigated under a 3 point bending test at 7 days after casting, mainly to underline the behaviour that this element would have in an initial movement phase. In a second stage the effectiveness of the fibre reinforced solution has been checked testing the tunnel segment under a lateral compression at 28 days, to highlight the behaviour of the element during the assembly stage with the advancing of the TBM. The results, analysed in terms of maximum load bearing capacity and crack openings highlight the effectiveness of the proposed structural polymeric fibre-reinforced concrete combined with a minimum steel reinforcement solution, which, also in view of their easiness of execution and reduced invasiveness, can stand as a reliable alternative to traditional reinforced tunnel segments

Slag corrosion of alumina-magnesia-carbon refractory bricks by different approaches

Laboratory static and dynamic tests are currently used to evaluate the corrosion resistance of refractory materials used in steelmaking vessel linings. Nevertheless, there are not many available studies aimed at comparing the influence of different experimental testing conditions in the corrosion process. In this study, a detailed comparison is made between a static and a dynamic slag-corrosion test of an AMC refractory material performed at 1600 °C and also between the results obtained from each test. Differences in the wear and the distribution of new solid phases in the corroded material were identified; a more controlled slag/refractory contact was attained in the static test, while oxidation and erosion resistance were determining material characteristics in the dipping test. The results obtained in a previous post-mortem study of the same type of brick were analyzed in light of those reported in this paper, thus improving our understanding of the in-service wear of AMC refractories.Fil: Calvo, Walter Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; ArgentinaFil: Moliné, Marcos Nahuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; ArgentinaFil: Camelli, Silvia. Universidad Tecnológica Nacional; ArgentinaFil: Tomba Martinez, Analia Gladys. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; Argentin

The impact of COVID-19 on rehabilitation and proposal for a new organization: A report from Lombardy, Italy

Italy has been one of the first-hit and most affected countries worldwide by the coronavirus disease 2019 (COVID-19) outbreak, and Lombardy accounts for almost half of all Italian cases. Vulnerable population is the one suffering the most from the current epidemic, without guaranteed access to basic needs. This aspect becomes critical for people experiencing disability, either due or not to COVID-19. To face the pandemic, all the regional health system services, rehabilitation ones included, were forced to radically adapt their operating paradigm and even sometimes to leave their intrinsic mission. The Italian Society of Physical and Rehabilitation Medicine (SIMFER) since the beginning of the outbreak was profoundly involved in the clinical and organizational response to COVID-19. The Lombardy regional group cooperated strictly and continuously with the national group to coordinate rehabilitation processes region wide. The paper presents a brief report of our field experience describing the phases faced since the beginning of the pandemic and suggesting the organizational strategies that could be useful in rehabilitation services for both inpatients and outpatients. Springing from literature and the experience of the Lombardy section of SIMFER, this paper should help clinicians to respond to the need of the disabled patient facing the new COVID-19 outbreak

Cystic fibrosis transmembrane conductance regulator functional evaluations in a G542X+/- IVS8Tn:T7/9 patient with acute recurrent pancreatitis

BACKGROUND: Acute recurrent pancreatitis (ARP) is characterized by episodes of acute pancreatitis in an otherwise normal gland. When no cause of ARP is identifiable, the diagnosis of "idiopathic" ARP is given. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene increase the risk of ARP by 3- to 4-times compared to the general population, while cystic fibrosis (CF) patients present with a 40- to 80-times higher risk of developing pancreatitis. CASE SUMMARY: In non-classical CF or CFTR-related disorders, CFTR functional tests can help to ensure a proper diagnosis. We applied an individualized combination of standardized and new CFTR functional bioassays for a patient referred to the Verona CF Center for evaluation after several episodes of acute pancreatitis. The CFTR genotype was G542X+/- with IVS8Tn:T7/9 polymorphism. The sweat (Cl-) values were borderline. Intestinal current measurements were performed according to the European Cystic Fibrosis Society Standardized Operating Procedure. Recent nasal surgery for deviated septum did not allow for nasal potential difference measurements. Lung function and sputum cultures were normal; azoospermia was excluded. Pancreas divisum was excluded by imaging but hypoplasia of the left hepatic lobe was detected. Innovative tests applied in this case include sweat rate measurement by image analysis, CFTR function in monocytes evaluated using a membrane potential-sensitive fluorescent probe, and the intestinal organoids forskolin-induced swelling assay. CONCLUSION: Combination of innovative CFTR functional assays might support a controversial diagnosis when CFTR-related disorders and/or non-classical CF are suspected

Methodological recommendations for trials of psychological interventions

Recent years have seen major developments in psychotherapy research that suggest the need to address critical methodological issues. These recommendations, developed by an international group of researchers, do not replace those for randomized controlled trials, but rather supplement strategies that need to be taken into account when considering psychological treatments. The limitations of traditional taxonomy and assessment methods are outlined, with suggestions for consideration of staging methods. Active psychotherapy control groups are recommended, and adaptive and dismantling study designs offer important opportunities. The treatments that are used, and particularly their specific ingredients, need to be described in detail for both the experimental and the control groups. Assessment should be performed blind before and after treatment and at long-term follow-up. A combination of observer- and self-rated measures is recommended. Side effects of psychotherapy should be evaluated using appropriate methods. Finally, the number of participants who deteriorate after treatment should be noted according to the methods that were used to define response or remission

Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump

OBJECTIVES: Although the intra-aortic balloon pump (IABP) has been the most widely adopted temporary mechanical support device in cardiac surgical patients, its use has declined. The current study aimed to evaluate the occurrence and predictors of early mortality and complication rates in contemporary cardiac surgery patients supported by an IABP. METHODS: A multicentre, retrospective analysis was performed of all consecutive cardiac surgical patients receiving perioperative balloon pump support in 8 centres between January 2010 to December 2019. The primary outcome was early mortality, and secondary outcomes were balloon-associated complications. A multivariable binary logistic regression model was applied to evaluate predictors of the primary outcome. RESULTS: The study cohort consisted of 2615 consecutive patients. The median age was 68 years [25th percentile 61, 75th percentile 75 years], with the majority being male (76.9%), and a mean calculated 30-day mortality risk of 10.0%. Early mortality was 12.7% (n = 333), due to cardiac causes (n = 266), neurological causes (=22), balloon-related causes (n = 5) and other causes (n = 40). A composite end point of all vascular complications occurred in 7.2% of patients, and leg ischaemia was observed in 1.3% of patients. The most important predictors of early mortality were peripheral vascular disease [odds ratio (OR) 1.63], postoperative dialysis requirement (OR 10.40) and vascular complications (OR 2.57). CONCLUSIONS: The use of the perioperative IABP proved to be safe and demonstrated relatively low complication rates, particularly for leg ischaemia. As such, we believe that specialists should not be held back to use this widely available treatment in high-risk cardiac surgical patients when indicated

Methodological Recommendations for Trials of Psychological Interventions

Recent years have seen major developments in psychotherapy research that suggest the need to address critical methodological issues. These recommendations, developed by an international group of researchers, do not replace those for randomized controlled trials, but rather supplement strategies that need to be taken into account when considering psychological treatments. The limitations of traditional taxonomy and assessment methods are outlined, with suggestions for consideration of staging methods. Active psychotherapy control groups are recommended, and adaptive and dismantling study designs offer important opportunities. The treatments that are used, and particularly their specific ingredients, need to be described in detail for both the experimental and the control groups. Assessment should be performed blind before and after treatment and at long-term follow-up. A combination of observer-and self-rated measures is recommended. Side effects of psychotherapy should be evaluated using appropriate methods. Finally, the number of participants who deteriorate after treatment should be noted according to the methods that were used to define response or remission