Rationale and Study Design for an Individualized Perioperative Open Lung Ventilatory Strategy in Patients on One-Lung Ventilation (iPROVE-OLV).

OBJECTIVE: The aim of this clinical trial is to examine whether it is possible to reduce postoperative complications using an individualized perioperative ventilatory strategy versus using a standard lung-protective ventilation strategy in patients scheduled for thoracic surgery requiring one-lung ventilation. DESIGN: International, multicenter, prospective, randomized controlled clinical trial. SETTING: A network of university hospitals. PARTICIPANTS: The study comprises 1,380 patients scheduled for thoracic surgery. INTERVENTIONS: The individualized group will receive intraoperative recruitment maneuvers followed by individualized positive end-expiratory pressure (open lung approach) during the intraoperative period plus postoperative ventilatory support with high-flow nasal cannula, whereas the control group will be managed with conventional lung-protective ventilation. MEASUREMENTS AND MAIN RESULTS: Individual and total number of postoperative complications, including atelectasis, pneumothorax, pleural effusion, pneumonia, acute lung injury; unplanned readmission and reintubation; length of stay and death in the critical care unit and in the hospital will be analyzed for both groups. The authors hypothesize that the intraoperative application of an open lung approach followed by an individual indication of high-flow nasal cannula in the postoperative period will reduce pulmonary complications and length of hospital stay in high-risk surgical patients.

On the Beat Detection Performance in Long-Term ECG Monitoring Scenarios.

Despite the wide literature on R-wave detection algorithms for ECG Holter recordings, the long-term monitoring applications are bringing new requirements, and it is not clear that the existing methods can be straightforwardly used in those scenarios. Our aim in this work was twofold: First, we scrutinized the scope and limitations of existing methods for Holter monitoring when moving to long-term monitoring; Second, we proposed and benchmarked a beat detection method with adequate accuracy and usefulness in long-term scenarios. A longitudinal study was made with the most widely used waveform analysis algorithms, which allowed us to tune the free parameters of the required blocks, and a transversal study analyzed how these parameters change when moving to different databases. With all the above, the extension to long-term monitoring in a database of 7-day Holter monitoring was proposed and analyzed, by using an optimized simultaneous-multilead processing. We considered both own and public databases. In this new scenario, the noise-avoid mechanisms are more important due to the amount of noise that exists in these recordings, moreover, the computational efficiency is a key parameter in order to export the algorithm to the clinical practice. The method based on a Polling function outperformed the others in terms of accuracy and computational efficiency, yielding 99.48% sensitivity, 99.54% specificity, 99.69% positive predictive value, 99.46% accuracy, and 0.85% error for MIT-BIH arrhythmia database. We conclude that the method can be used in long-term Holter monitoring systems.

Internal Sulphate Attack in Masonry Mortars with Thaumasite Formation.

The present paper focuses on the study of mortar samples where expansions with thaumasite formation occur as a consequence of sulphate attack. The samples correspond to a masonry mortar used in a rural construction located in the Spanish province of Toledo made of cement with limestone filler addition CEM II/AL. Composition and microstructure of the mortars have been analysed by means of scanning electron microscopy (SEM) using secondary and backscattered electrons (BSE) and X-ray diffraction (XRD). The results show that aggregates are contaminated with gypsum, which is the source of the sulphates for the internal attack. It seems that thaumasite is formed through an ettringite transformation where aluminium atoms are replaced with silicon atoms by means of a solid solution. The study highlights that thaumasite can be formed in warm weather through an internal sulphate attack due to gypsum contamination of aggregates.

Mechanical Behavior of Calcium Sulphate Modified with Citric Acid and with Added Carbon Fibers.

The study and subsequent analysis of the interaction of calcium sulfate with added citric acid and with two additional proportions of carbon fibers of different lengths has been based on the IMR and D Method for its realization. The purpose of this work is the study of the physical and mechanical behavior of the resulting material between the intimate mixture of calcium sulfate with additives and carbon fibers, justifying said work with a link to the Sustainable Development Goals (SDG) regarding the benefits that the Calcium sulfate has contributed to civil society since times dating back to ancient Egypt. We find ourselves with a material of which the energy used in its manufacture is far from that required by steel or cement, and construction with this new compound is in a much higher stage than construction with adobe. Therefore, this is a compound that can be developed for a wide variety of applications. The novelty of this study is the inclusion of polymeric fibers in a material used over the centuries to improve its mechanical properties. With these improvements we will be able to reduce thicknesses in manufacturing, which implies a reduction in manufacturing energy and weight structures in buildings, which should be studied and analyzed in the future. The kneading of calcium sulfate with long fibers at high percentages complicates not only the results, but also the manufacturing process. As representative results of the study, we can indicate that a composite material with high mechanical capacity has been achieved, with maximum values of flexural strength of 8.12 N/mm2 and compression strength of 17.58 N/mm2.

Procesos de comunicación que se desarrollan en el deporte escolar / Communication process that take place in school sport

El propósito del presente informe de investigación se elabora en concordancia con los anteriores proyectos sobre la caracterización de las prácticas y procesos educativos que se propician en la práctica del deporte escolar, en el marco del énfasis de investigación Deporte y Escuela de la Especialización en Pedagogía del Entrenamiento Deportivo de la Universidad Pedagógica Nacional, como un intento por caracterizar los procesos del orden comunicativo que se propician entre el docente y los niños, niñas y jóvenes que realizan prácticas de deporte escolar. Identificar como se desarrollan los procesos de comunicación en la práctica del deporte escolar, posibilita analizar la incidencia que tienen estos en la formación de los niños y niñas participantes; en especial, interpretando que la acción educativa y formativa es un acto esencialmente comunicativo, y, de acuerdo a cómo se desarrolle dicho proceso, se establecerán formas de relación. En consecuencia, la dinámica comunicativa que establezca el docente - entrenador en la sesión de práctica, incidirá en los roles de los niños y niñas, quienes, por lo general, se limitan a la ejecución de tareas motoras, planteadas en función de la adquisición de destrezas técnico-deportivas, descuidando o ignorando la formación integral de los alumnos. El proyecto de investigación se desarrolló bajo un enfoque mixto y metodología de tipo descriptiva, con recopilación de información que se analizó de manera cuantitativa y cualitativa, para dar respuesta a la caracterización de los procesos de comunicación que se propician, desde la práctica del deporte, en la escuela.

The intention of the present report of investigation, in agreement with the previous projects the characterization of the practices and educative processes that are caused actually of the sport in the school, within the framework of the investigation emphasis on Sport and School of the Specialization of the Pedagogical Sport Training of the Universidad Pedag¢gica Nacional, makes an attempt to characterize the processes of communicative order that are propitiate between the teachers and childrend and teenagers involved that realize practices of the sport in the school.Identify how the communication processes are developed at the practice of the sport in the school, enable to analyze the incidence that those have on the formation of children involved on it; especially to perform that the formative and educational action is an essentially communicative act, and depending how the process develop on it, There will have established ways of relation. As a conseuence, according to the communicative dynamic, proposed by the teacher – trainer of the practices sessions, will be influenced in the roles of the children, those without to reach a generalization, have been limited to the execution of motor tasks, thought at the acquisition of technical-sports skills, not taking care or ignoring the integral formation of the students The investigation project was developed under a mixed approach and descriptive metodology, with a recopilation of some information, analyzed on a quantitative and qualitative way for answer the characterization of communication processes that propitiate from the practice of the sport in the school.

Estudio de un nuevo foco de lishmaniasis visceral en el estado Falcón Venezuela: registro de un caso / Study on a new focus of visceral leishmaniasis in Falcón state Venezuela: record of a case

Se registró un caso infantil de leishmaniasis visceral procedente del caserío “Los Pozones”, municipio Buchivacoa ubicado al occidente del Estado Falcón, Venezuela, a finales del año 2002. Se presentan resultados de un estudio epidemiológico en la localidad, realizado durante el año siguiente la detección del caso. El estudio incluyó un muestreo serológico a 110 humanos de diversos grupos etarios y a 10 perros, utilizando tres pruebas inmunodiagnósticas (TAD, IFI y ELISA). Además se realizaron capturas de flebotominos en refugios naturales y con trampa lumínica de Shannon cada dos meses durante un año, detectándose la presencia dominante de Lutzomyia evansi (62.7%) sobre Lutzomyia longipalpis (37.3%). La zona de vida donde se enclava la localidad rural estudiada corresponde a un bosque seco espinoso. El estudio serológico arrojó valores de seroprevalencia humana y canina para Leishmania del 17,3% y 50%, respectivamente. Estos hallazgos sugieren la existencia de un nuevo foco de LV en la parte occidental del estado Falcón, Venezuela, el cual requiere más investigación.