Early Identification of Unbalanced Freight Traffic Loads Based on Wayside Monitoring and Artificial Intelligence.

The identification of instability problems in freight trains circulation such as unbalanced loads is of particular importance for railways management companies and operators. The early detection of unbalanced loads prevents significant damages that may cause service interruptions or derailments with high financial costs. This study aims to develop a methodology capable of automatically identifying unbalanced vertical loads considering the limits proposed by the reference guidelines. The research relies on a 3D numerical simulation of the train-track dynamic response to the presence of longitudinal and transverse scenarios of unbalanced vertical loads and resorting to a virtual wayside monitoring system. This methodology is based on measured data from accelerometers and strain gauges installed on the rail and involves the following steps: (i) feature extraction, (ii) features normalization based on a latent variable method, (iii) data fusion, and (iv) feature discrimination based on an outlier and a cluster analysis. Regarding feature extraction, the performance of ARX and PCA models is compared. The results prove that the methodology is able to accurately detect and classify longitudinal and transverse unbalanced loads with a reduced number of sensors.

Diagnostic reference levels and complexity indices in interventional radiology: a national programme.

OBJECTIVES: To propose national diagnostic reference levels (DRLs) for interventional radiology and to evaluate the impact of the procedural complexity on patient doses. METHODS: Eight interventional radiology units from Spanish hospitals were involved in this project. The participants agreed to undergo common quality control procedures for X-ray systems. Kerma area product (KAP) was collected from a sample of 1,649 procedures. A consensus document established the criteria to evaluate the complexity of seven types of procedures. DRLs were set as the 3rd quartile of KAP values. RESULTS: The KAP (3rd quartile) in Gy cm2 for the procedures included in the survey were: lower extremity arteriography (n = 784) 78; renal arteriography (n = 37) 107; transjugular hepatic biopsies (THB) (n = 30) 45; biliary drainage (BD) (n = 314) 30; uterine fibroid embolization (UFE) (n = 56) 214; colon endoprostheses (CE) (n = 31) 169; hepatic chemoembolization (HC) (n = 269) 303; femoropopliteal revascularization (FR) (n = 62) 119; and iliac stent (n = 66) 170. The complexity involved the increases in the following KAP factors from simple to complex procedures: THB x4; BD x13; UFE x3; CE x3; HC x5; FR x5 and IS x4. CONCLUSIONS: The evaluation of the procedure complexity in patient doses will allow the proper use of DRLs for the optimization of interventional radiology. KEY POINTS: • National DRLs for interventional procedures have been proposed given level of complexity • For clinical audits, the level of complexity should be taken into account. • An evaluation of the complexity levels of the procedure should be made.

A universal dose-response curve for radiochromic films.

PURPOSE: This paper presents a model for dose-response curves of radiochromic films. It is based on a modified version of single-hit model to take into account the growth experienced by lithium salt of pentacosa-10,12-diynoic acid polymers after irradiation. METHODS: Polymer growth in radiochromic films is a critical phenomenon that can be properly described by means of percolation theory to provide an appropriate distribution function for polymer sizes. Resulting functional form is a power function featuring a critical exponent and two adjustable parameters. Moreover, these parameters act as scaling factors setting a natural scale for sensitometric curves where the dependence on channel sensitivity is removed. A unique reduced response curve is then obtained from all the color channels describing film behavior independently of film dosimetry system. RESULTS: Resulting functional form has been successfully tested in several sensitometric curves from different Gafchromic EBT models, providing excellent agreement with experimental data in a wide dose range up to about 40 Gy and low dose uncertainty. CONCLUSIONS: The model presented in this paper describes accurately the sensitometric curves of radiochromic films in wide dose ranges covering all typical ranges used in external radiotherapy. Resulting dose uncertainty is low enough to render a reasonably good performance in clinical applications. Due to cross-correlation, only one of the adjustable parameters is totally independent and characterizes film batches.

Anestesia general y hemorragia obstétrica con transfusión en la cesárea. Experiencia durante un año en un hospital universitario / General anaesthesia and obstetric bleeding in caesarean section. One year's experience in a university hospital

Introducción. La hemorragia obstétrica es una causa frecuente de mortalidad y morbilidad en el mundo. La anestesia general es cada vez menos frecuente para la cesárea. Nuestro objetivo es analizar la incidencia, causas y factores de riesgo asociados a la anestesia general en la cesárea, y la prevalencia de hemorragia obstétrica (HO), sus factores de riesgo y los predictores de HO poscesárea junto al uso de hemoderivados en la población de estudio. Material y métodos. Se ha realizado un estudio retrospectivo de los informes de alta de la URPA durante el año 2008. Resultados. El 12,4% de nuestras pacientes requirieron anestesia general. El fallo del catéter epidural como causa de anestesia general, fue poco frecuente (2,8%) y dentro de los estándares recomendados. Conclusiones. Las indicaciones de cesárea más frecuentes bajo anestesia general incluyeron principalmente urgencias vitales, que coincide con los factores de riesgo de anestesia general más significativos (alteraciones de la coagulación, hemorragia del tercer trimestre, riesgo de pérdida de bienestar fetal y preeclampsia grave). La anestesia general es un factor de riesgo de transfusión, como también lo es las alteraciones de la placentación y la preeclampsia(AU)

Introduction. Obstetric haemorrhage is an important worldwide cause of morbidity and mortality. General anaesthesia for caesarean section is rarely used. Our goal is to analyse the incidence, causes and risk factors associated with general anaesthesia for caesarean section, and the prevalence of obstetric haemorrhage (HO), its risk factors and predictors of post-caesarean HO together with the use of blood in our hospital population. Methods. A retrospective study was conducted on all caesarean section discharge reports from PACU in 2008. Results. General anaesthesia was required in 12.4% of the patients. Epidural catheter failure as a cause of general anaesthesia was infrequent (2.8%) and within the recommended standards. Conclusions. The most frequent indications for caesarean section under general anaesthesia included mainly life-threatening emergencies, and the most important risk factors for general anaesthesia, including coagulation disorders, bleeding in the third trimester, foetal distress and severe pre-eclampsia. General anaesthesia is a risk factor for transfusion, as is abruptio placentae, placenta previa and pre-eclampsia(AU)

[General anaesthesia and obstetric bleeding in caesarean section. One year's experience in a university hospital]. / Anestesia general y hemorragia obstétrica con transfusión en la cesárea. Experiencia durante un año en un hospital universitario.

INTRODUCTION: Obstetric haemorrhage is an important worldwide cause of morbidity and mortality. General anaesthesia for caesarean section is rarely used. Our goal is to analyse the incidence, causes and risk factors associated with general anaesthesia for caesarean section, and the prevalence of obstetric haemorrhage (HO), its risk factors and predictors of post-caesarean HO together with the use of blood in our hospital population. METHODS: A retrospective study was conducted on all caesarean section discharge reports from PACU in 2008. RESULTS: General anaesthesia was required in 12.4% of the patients. Epidural catheter failure as a cause of general anaesthesia was infrequent (2.8%) and within the recommended standards. CONCLUSIONS: The most frequent indications for caesarean section under general anaesthesia included mainly life-threatening emergencies, and the most important risk factors for general anaesthesia, including coagulation disorders, bleeding in the third trimester, foetal distress and severe pre-eclampsia. General anaesthesia is a risk factor for transfusion, as is abruptio placentae, placenta previa and pre-eclampsia.

Status of radiation protection at different hospitals in Nepal.

Nepal has a long history of medical radiology since1923 but unfortunately, we still do not have any Radiation Protection Infrastructure to control the use of ionizing radiations in the various fields. The objective of this study was an assessment of the radiation protection in medical uses of ionizing radiation. Twenty-eight hospitals with diagnostic radiology facility were chosen for this study according to patient loads, equipment and working staffs. Radiation surveys were also done at five different radiotherapy centers. Questionnaire for radiation workers were used; radiation dose levels were measured and an inventory of availability of radiation equipment made. A corollary objective of the study was to create awareness in among workers on possible radiation health hazard and risk. It was also deemed important to know the level of understanding of the radiation workers in order to initiate steps towards the establishment of Nepalese laws, regulation and code of radiological practice in this field. Altogether, 203 Radiation workers entertained the questionnaire, out of which 41 are from the Radiotherapy and 162 are from diagnostic radiology. The radiation workers who have participated in the questionnaire represent more than 50% of the radiation workers working in this field in Nepal. Almost all X-ray, CT and Mammogram installations were built according to protection criteria and hence found safe. Radiation dose level at the reference points for all the five Radiotherapy centers are within safe limit. Around 65% of the radiation workers have never been monitored for radiation. There is no quality control program in any of the surveyed hospitals except radiotherapy facilities.

Clinically important molecular features of Peruvian colorectal tumours: high prevalence of DNA mismatch repair deficiency and low incidence of KRAS mutations.

BACKGROUND: The incidence of colorectal cancer (CRC) in Peru has been increasing, and no data have been published on the molecular features. We explored the most relevant genetic events involved in colorectal carcinogenesis, with clinical implications. METHODS: Using immunohistochemistry for mismatch-repair (MMR) proteins (MLH1, MSH2, MSH6, and PMS2) and microsatellite instability analysis, we evaluated the status of 90 non-selected CRC Peruvian patients followed in a nationwide reference hospital for cancer (INEN, Lima). Tumours with loss of hMLH1 were evaluated further for hMLH1 promoter hypermethylation and all cases were evaluated for the presence of KRAS and BRAF-V600E mutations. RESULTS: MMR deficiency was found in 35 (38.8%) patients. We identified an unexpected association between MMR deficiency and older age. Among the 14 cases with loss of MLH1, 10 samples exhibited hypermethylation. Of the 90 cases evaluated, 15 (16.7%) carried KRAS mutations; we found one previously unreported mutation (G13R). CONCLUSIONS: Peruvian CRC tumours exhibited the highest prevalence of MMR deficiency reported to date. The expected hereditary component was also high. The age of onset of these MMR deficient tumours was greater than that observed for non-MMR deficient cases, suggesting the ineffectiveness of the Bethesda criteria for Lynch syndrome screening in Peru. Prospective studies are warranted to define the molecular characteristics of CRC in this population.

Modelo dietético de los universitarios / Dietary model of college students

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Descripción del valor y relación de la proteína C reactiva y los lípidos según historia del tabaquismo / Description of the value and relationship of reactive C protein and lipids according to the background of smoking habit

El objetivo del estudio es comprobar si el tabaco altera la relación entre PCR y los valores de triglicéridos, colesterol total y sus fracciones, en una población fumadora sana. Material y método. Se realiza un estudio observacional transversal en 800 sujetos sanos, 200 fumadores y 344 no fumadores y 256 exfumadores. Para la determinación de la PCR se utilizó el test Tina-quanta CRP (Látex) HS. Resultados. La concentración de PCR fue mayor en los fumadores que en los no fumadores (p<0,01). La concentración de triglicéridos fue mayor en los fumadores que en los no fumadores (p<0,001), así como la cifra de LDL-c (P<0,05). No se encontraron diferencias significativas en el colesterol total entre ambos grupos. La fracción HDL-c se encontraba disminuida en los fumadores con respecto a los no fumadores (p<0,001). Existe una correlación positiva, tanto en fumadores como en no fumadores, entre PCR y cifras de triglicéridos (p<0,001), y negativa con HDL-c (p<0,001). No se encontró una asociación lineal entre la PCR y el colesterol total, ni entre la PCR y el LDL-c en no fumadores. La PCR se encuentra asociada estadísticamente con la LDL en los fumadores (p<0,001). Conclusiones. Las concentraciones séricas de PCR, triglicéridos y LDL-c se encuentran más elevadas en los fumadores que en los no fumadores sanos. Los niveles de HDL son más bajos en la población fumadora sana. Los niveles de PCR aumentan al incrementarse los triglicéridos y tienen una relación inversa con los niveles de HDL-c en ambas poblaciones. Los niveles de PCR y LDL-c se encuentran asociados estadísticamente sólo en la población fumadora (AU)

The aim of this study is to verify whether cigarette smoking alters the relation between C-reactive protein (CRP) and triglycerides, HDL and LDL-cholesterol plasma concentration in a healthy population. Population and methods. This is a cross sectional study conducted in a sample of 800 collective healthy aircraft workers, 200 smokers, 344 non-smokers and 254 exsmokers. They all undertook a complete annual clinical, psychological and analytical examination. C-reactive protein was determined by test Tina-quanta CRP (Látex) HS. Results. Serum CRP concentration was significantly higher in smokers than in non-smokers (p<0,01). Serum concentration of triglycerides and LDL levels were higher in smokers (p<0,01), as well as LDL levels (p<0,05). No statistically differences in total cholesterol levels between smokers and non-smokers were found. HDL fraction was lower in smokers compared to non smokers (p<0,01). CPR and triglycerides levels were positively correlated in both smokers as non-smokers, and there was a negative association with the HDL fraction. In non-smokers, no association was encountered between CPR and cholesterol levels, or PCR with the LDL. However, CRP was statistically related to LDL in smokers (p<0,01).Conclusion. Healthy smokers have a higher serum concentration of CRP, LDL and triglycerides, whilst HDL levels are lower. Levels of CRP increase with triglycerides and have an inverse relationship with the levels of HDL in smokers and non-smokers. Levels of CRP and LDL are statistically related only in smokers (AU)

Servicio de Medicina Interna y Unidad de Cuidados Paliativos / Department of Internal Medicine and Unit Palliative Care

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[Newborn infants diagnosed prenatally with uropathies]. / Estudio de los recién nacidos diagnosticados prenatalmente de uropatías.

UNLABELLED: A clinical study of 111 newborns (NB) with prenatal diagnosis (PD) of urinary tract pathology was performed. The weight and size at birth, physical examination, incidence of uropathies, associated malformations and postnatal diagnostic studies were analyzed. MATERIAL AND METHODS: All data corresponding to 111 neonates with PD of urinary tract pathology were submitted to the Student's t and Chi square tests and contingency tables. RESULTS: Uropathies were more frequent in male NB (69%) and on the left side (2/1). Pyelocaliceal dilatation (PCD) was present in 46% of the patients. The mean weight and size was normal. However, NB with PCD had a mean weight of 249 grams below that observed in the remaining group (p = 0.016). Thirteen newborns (12%) had associated anomalies. An abdominal mass was present in 17 neonates with obstructive uropathies (15%). Serum urea and creatinine were normal in 101 neonates (91%). SUMMARY: 1) PCD is the most frequent uropathy diagnosed prenatally. 2) The incidence of fetal uropathies, diagnosed prenatally, is higher in males. 3) The left side is more frequently involved. 4) The mean weight and size of NB with uropathies is normal. 5) The mean weight of NB with DCP is 249 grams lower than the rest of the group. 6) Serum urea and creatinine were found elevated only in severe bilateral obstructive uropathies.