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Spiral plate heat exchangers should be efficient devices because they are widely employed in the petrochemical and food industries; furthermore, their operation has a direct impact on electricity consumption in such sectors. For those reasons, this article aims to improve the efficiency of heat exchangers by means of optimization techniques. Using as an objective function the maximization of the overall heat transfer coefficient of a spiral plate heat exchanger. The mathematical formulation includes several variables in the problem: width, length, spacing between the plates, and plate thickness. And as a set of constraints the heat duty and the pressure drop, along with technical considerations associated with this type of system. The General Algebraic Modelling System (GAMS) was purposed as a solution method and compared with the Particle Swarm Optimization (PSO) algorithm, a Genetic Algorithm (GA), the original design proposed by Minton, and the Tuned Wind-Driven Optimizer (TWDO). Results show that the purposed method obtains the highest value of objective function being 1.5% better than the best of the used comparison methods with a computing time of 1e-4s, finding a solution with high quality at a low computational cost.

This paper presents an electronic training instrument for taekwondo athletes. The proposed prototype was inspired by the electronic body protector (EBP) used in previous Olympic games. Besides counting points, our prototype measures the energy of each strike, providing information to coaches about every strike's force and location in real-time. The prototype consists of a transmitter module installed inside a chest protector, a receptor module, and a human-machine interface (HMI). The proposed prototype aims to provide coaches and athletes with a tool for monitoring and improving the taekwondo technique.

Bovine paratuberculosis or Johne's disease is caused by Mycobacterium avium subsp. paratuberculosis (MAP), which affects domestic and wild ruminants around the world. The clinical presentation of MAP infection is characterized by chronic diarrhea unresponsive to treatment. The objective of the present study was to investigate the seroprevalence and risk factors associated with bovine paratuberculosis in cattle herds of Tuta, Boyacá, Colombia. This descriptive cross-sectional study with simple random sampling was performed on 882 blood samples taken from cattle of different racial and age groups. Blood samples were processed using an indirect enzyme-linked immunosorbent assay (PARACHEK® 2 Kit, Prionics AG, Switzerland). The obtained data were analyzed by the statistical software Epi Info. In this study, a general seroprevalence of 3.1% was found, and seropositivity in females was 3.6%. The highest prevalence of antibodies against MAP was in individuals > 4 years (5%) and the Jersey breed (4.8%). Therefore, the age of over 4 years was identified as a risk factor associated with MAP. Moreover, a statistical association was found between management and biosafety variables, such as pen management (p = 0.012), feeding with concentrate (p = 0.012), and the presence of diarrhea on the farm (p = 0.048). It could be concluded that the disease is present in Tuta, however, considering factors, such as the chronicity of the disease and the diagnostic method used, it is expected that the number of infected animals is much higher than presented in this research.

Pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT) has a prognostic value in locally advanced rectal cancer (LARC). This study aimed to evaluate the ability to predict pCR using inflammatory markers, valuable to select the most adequate treatment strategy.

Patients undergoing primary tumor resection after long-cycle NCRT at a single center (2012 to 2018) were retrospectively collected (n=130). Patient demographics, preoperative laboratory measurements, tumor characteristics, treatment strategy and postoperative anatomopathologic variables were collected. The association of factors to CPR was examined using binary logistic regression and odds ratio (OR) (95% confidence interval) and the discriminative capacity with ROC curve.

Out of 130 patients 42 pCRs occurred, a 32.3% of the sample. Variables identified as useful to predict pCR were total neutrophil count (

The absolute neutrophil count better predicts pCR than the rest of inflammatory indexes in selected patients with LARC who underwent long-cycle NCRT. The association of a neutrophil count less than 6400 cells/mm3, absence of diabetes and intravenous 5-FU NCRT strategy showed a relevant increase of the pCR.

The number of multiple pregnancies has been significantly increased in the last decades due to assisted reproduction techniques development. Compared to singleton, twins and multiple pregnancies are associated to more complications and risks for both mother and children. The objective of this study was to examine the proportion of patients preferring a multiple birth over a singleton after an IVF/ICSI attempt, their reasons and the influence of socio-demographic and clinical parameters on their preference.
A prospective study was conducted in two different Spanish centers in 2014; a public university hospital and a private clinic, with different populations and embryo transfer policies. In order to evaluate patients and partners attitudes towards twins and singletons, an anonymous 10-question survey was conducted and 399 were invited to participate.
58.2% of participants preferred having twins to having one child at a time and 4.8% preferred triplets. Primary reasons for preferring twins were "avoiding a new IVF/ICSI attempt" (61.6%), "I like the idea of having twins" (27.3%), "avoiding the waiting list" (5.8%), and "in my opinion with the latest technology, the rate and severity of complications in multiple pregnancies are low" (5.2%). The multivariate analysis showed that the only significant parameter related to a preference for multiplets was the transfer of women’s own fresh embryos (OR=3.31).
Twin pregnancy risks are not perceived as important by the majority of IVF/ICSI couples, and many of them specifically prefer twins. In our opinion, much more information is needed highlighting the multiple pregnancy risks and that information should come from medical sources besides general media.

Leptin resistance is associated with lower reproductive efficiency, with deficiencies in embryo viability and growth leading to low prolificacy and high incidence of intrauterine growth restriction.

We aimed to investigate the underlying mechanisms of the leptin-resistance, evaluating the antioxidant homeostasis of leptin-resistant and lean swine fetuses.

The study included 70 plasma samples from fetuses at day 62 of gestation (mid-pregnancy), from breeds with (Iberian breed; n=35) and without leptin resistance (25% Large White x 25% Landrace x 50% Pietrain; n=35). The antioxidant status of the plasma samples was determined by photoinduced chemiluminescence whilst systemic oxidative stress was assessed determining plasma hydrogen peroxide concentration by enzimoimmunoassay.

Plasma total antioxidant capacity was significantly lower in leptin-resistant fetuses (p=0.003), whilst systemic oxidative stress was increased (p=0.02).

Our results indicate key differences in the antioxidant status in pregnancies affected by leptin resistance.

Planning a layout of construction temporary facilities (CTFs), a specific construction site layout problem, is crucial to the successful completion of large-scale construction projects. Despite considerable research undertaken, mutual relationships and conflicts between the layout planner and other pre-planning task stakeholders (i.e., for the scheduling of construction activities or the material purchase) are not yet addressed in the layout process. Resolving conflicts is crucial to the layout optimization and this study is among the first to plan appropriate CTF layouts by taking bi-stakeholder conflict resolution into account. A new bi-level mathematical method is developed based on the resolution of conflicts between the CTF layout planner and the material purchase stakeholder, and thus providing an example for future layouts with bi-stakeholder conflicts. In this method, a bi-level programming model is first established to model layout-related goals, constraints, and conflicts. Second, a bi-level genetic algorithm is proposed to solve the model for appropriate layouts. To demonstrate the applicability of the proposed method, the method is applied to design a CTF layout for the construction of a practical dam project. The results demonstrated that an appropriate layout and a satisfactory purchase plan were determined, and conflicts between the CTF layout and the material purchase were prevented. The contributions of the method are the ability to capture the mutual conflicts of the CTF layout and the material purchase in the bi-level model, the capacity to develop a more efficient and realistic layout, and the practicality to guide planners in other situations.

Health in All Policies (HiAP) has gained attention as a potential tool to address complex health and societal challenges at global, regional, national and subnational levels. In a recent article, Lawless et al propose an evaluation framework developed in the context of the South Australia HiAP initiative. Strategies, mediators, activities and impacts identified in the framework could potentially be useful for evaluating HiAP in other settings. Creating and sustaining political will, managing conflicts of interest and achieving financially, politically and conceptually sustainable HiAP initiatives are challenges that could be further strengthened in the current framework.

Between August 1945 and February 1950, the Nazi concentration camp of Buchenwald was turned into the Soviet Special Camp Number 2 by the Soviet secret service to house individuals perceived as opponents of the Soviet system. We have investigated the system of health care for psychiatric patients in this camp. We have consulted and reviewed the archives of Buchenwald concentration camp (Arkiv der Gedenkstatte Buchenwald). Archival documents regarding the Soviet period have been partially declassified recently. During its five years of operation, 28 455 prisoners were held. In Buchenwald, psychiatric patients were held in the Psychiatric Station (barrack VIIc), guarded by a neuropsychiatrist and a nurse. The number of inmates who passed through this station is unknown, however, at one point there were more than 60. The medical system run in Gulags for decades was already exported to camps created in German territory after the end of the war. The internment of dissidents in psychiatric centers was a common practice of the Soviet authorities.

Sucrose is the most widely used sweetener in food and pharmaceuticals. Quantitative solubility values of this excipient in aqueous polyethylene glycol (PEG) mixtures is not abundant. Thus, the main objective of this research was to determine and correlate the equilibrium solubility of sucrose in {PEG 200 (or 400) water} mixtures at 298.2 K.
Shaken flask method was used to determine isothermal solubility. Concentration measurements were performed by means of density determinations. Jouyban-Acree model was used to correlate both solubility sets.
Solubility of sucrose decreases non-linearly with the addition of either PEG200 or PEG400 to water. Jouyban-Acree model correlates solubility values with mixtures composition for both cosolvent systems. Moreover, apparent specific volume of sucrose were also calculated from density and compositions.
Useful solubility values of sucrose at equilibrium in aqueous mixtures of PEG200 and PEG400, as well as their volumetric contributions to saturated solutions are reported.

Emerging GPS devices enable new data collection opportunities for transit performance monitoring. In addition to the fact that GPS devices can replace labor-intensive survey techniques, they also collect traffic information throughout transit routes that the traditional fixed loop detectors cannot. If public transit vehicles are equipped with GPS devices, it is possible to monitor the performance of public transit services throughout the routes and alert the associated authorities at significantly lower costs about potential problems for corrective actions to be taken. Transantiago, a major public transit service provider in Santiago, Chile, has recently installed GPS sensors on all its vehicles which provides an excellent venue on which an innovative transit monitoring methodology can be modeled and applied. This paper first conducts current-status analysis on distributions of headways throughout a route in Santiago by processing extensive raw GPS data from transit vehicles. Then, unique transit headway adherence indices are developed with respect to the expected passenger waiting time and are presented in forms of two-dimensional tempo-spatial graphs. The analysis of real-life data collected from bus GPS probes in Santiago, Chile indicates that GPS devices in transit buses can effectively provide the proposed performance measures throughout the route on a daily basis.

The mitogenic effect of the analogous insulin glargine is currently under debate since several clinical studies have raised the possibility that insulin glargine treatment has a carcinogenic potential in different tissues. This study aimed to evaluate the Igf-1r, Insr, and Igf-1 gene expression in colon and liver of streptozotocin-induced diabetic rats in response to insulin glargine, neutral protamine Hagedorn (NPH) insulin, and metformin treatments.
Male Wistar rats were induced during one week with streptozotocin to develop Type 2 Diabetes (T2D) and then randomly distributed into four groups. T2D rats included in the first group received insulin glargine, the second group received NPH insulin, the third group received metformin; finally, untreated T2D rats were included as the control group. All groups were treated for seven days; after the treatment, tissue samples of liver and colon were obtained. Quantitative PCR (qPCR) was performed to analyze the Igf-1r, Insr and Igf-1 gene expression in each tissue sample.
The liver tissue showed overexpression of the Insr and Igf-1r genes (P>0.001) in rats treated with insulin glargine in comparison with the control group. Similar results were observed for the Insr gene (P>0.011) in colonic tissue of rats treated with insulin glargine.
These observations demonstrate that insulin glargine promote an excess of insulin and IGF-1 receptors in STZ-induced diabetic rats, which could overstimulate the mitogenic signaling pathways.

The main goal of physical therapy is to help the patient gain a better health status. Several studies have investigated the use of reminders to prevent such failures on the patients’ side. This article presents a systematic review of the literature concerning reminders in physical therapy.
Databases were searched until May 2017 and literatures were found from April 1992 until 2017. The literature recruitment strategy was based on applying several keywords and Medical Subject Heading (MeSH) combination running against title and abstract, including concepts such as reminder, physical therapy. The finally selected articles were categorized through reminder aspects such as how, who feedback. Data were extracted according to PRISMA guidelines.
In 47% of studies, the reminder was sent to the patients, 29% to the physical therapists and 12% to the caretaker team. In 24% of the studies, paper-based letters were main medium for reminders while the rest were various types of media like emails and SMS mobile text messages. 35% of the articles showed positive effects of the reminders.
Many reminder methods consisted of SMS, phone calls, letters, emails and notices on the wall were used in physical therapy. Reminders may be used to improve patient's adherence to exercise programs.

One of the most important factors influencing the track maintenance is the transitions between parts of the track with different vertical stiffness. The dynamic forces in the super-structure, i.e. from rail to ballast/slab and subgrade, including every layer under ballast/slab until natural ground, are influenced by the type of materials, layer configuration and geometry. One way to mitigate track transition problems is to have a more gradual transition with a reduced stiffness differential. The aim of this research is to reduce vertical transient stresses and displacements under track supports at track transition areas by combining different structural configurations. For this purpose, the train-track dynamic interaction in the transition zones with different vertical stiffness values is analysed using a finite element software. A high-speed train moving on a slab and ballasted track is considered travelling in both directions. The effect of different structural track designs is studied in realistic operation scenarios. The results allow concluding that the sleeper displacements and ballast stresses can be significantly reduced in the transition zones by making small changes in the track structural elements.

Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosis predisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concern before performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often been considered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequate procedures in order to avoid concomitant instrumentation. As the population ages and the expectations of older patients increase, the demand for surgical treatment in older patients with osteoporosis and spinal degenerative diseases becomes progressively more important. Nowadays, advances in surgical and anesthetic technology make it possible to operate successfully on elderly patients who no longer accept disabling physical conditions. This article discusses the biomechanics of the osteoporotic spine, the diagnosis and management of osteoporotic patients with spinal conditions, as well as the novel treatments, recommendations, surgical indications, strategies and instrumentation in patients with osteoporosis who need spine operations.

Chemotherapy-induced peripheral neuropathy (CIPN) is frequent in children with acute lymphoblastic leukemia (ALL). Neurological manifestations can be grouped into one of the three functional divisions of the peripheral nervous system (PNS): sensory, motor and autonomic. One of the chemotherapeutic agents used in ALL is vincristine which has been associated with neuropathy in these children. This type of neuropathy can be transient but also leave permanent sequels that decrease patient’s quality of life.
To know the frequency and type of neuropathy induced by chemotherapy in a subpopulation of Mexican pediatric patients with acute lymphoblastic leukemia.
A cross-sectional study was conducted. There were included all pediatric patients with ALL diagnosed de novo from 2010 to December 31, 2013 who met the selection criteria. Descriptive statistics were used to determine the frequency and type of CIPN and information was described according to different clinical variables, type of treatment, risk classification, and ALL subtype according to the immunophenotype.
A total of 32 patients with acute lymphoblastic leukemia were included, mainly of early pre-B immunophenotype (93.8%), being 59.4% classified as high risk patients at the time of diagnosis. CIPN of sensory type was 78.1%, motor 34.3% and autonomic 40.6%. A significant proportion of patients (46.9%) were examined during maintenance phase.
To our knowledge, this is the first study to report the frequency and type of CIPN in a subpopulation of Mexican children with acute lymphoblastic leukemia. Frequency of CIPN was higher than that reported in other populations. By considering that prognosis of a patient presenting CIPN could be considered as favorable after treatment suspension (in most cases), it is not always reversible and affects patient’s quality of life. Therefore, it is necessary for all patients with ALL to be periodically monitored during treatment through neurological examination for detecting and immediately initiating their rehabilitation treatment.

Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosis predisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concern before performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often been considered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequate procedures in order to avoid concomitant instrumentation. As the population ages and the expectations of older patients increase, the demand for surgical treatment in older patients with osteoporosis and spinal degenerative diseases becomes progressively more important. Nowadays, advances in surgical and anesthetic technology make it possible to operate successfully on elderly patients who no longer accept disabling physical conditions. This article discusses the biomechanics of the osteoporotic spine, the diagnosis and management of osteoporotic patients with spinal conditions, as well as the novel treatments, recommendations, surgical indications, strategies and instrumentation in patients with osteoporosis who need spine operations.

Leishmaniasis represents a serious threat to the health as one of the most important neglected tropical diseases as designated by the World Health Organization. The disease is endemic in 82 countries, among them Tunisia is an indigenous area for cutaneous Leishmaniasis. In a previous work, two tritepenic acids namely oleanolic and maslinic acids have been isolated from olive leaf extract. In the present paper, the in vitro activity against amastigotes stage of Leishmania (L.) infantum and Leishmania (L.) amazonensis was investigated. Maslinic acid showed the highest activity, against L. amazonensis, with an IC50 of 1.417 ±0.401 µg/ml and a selectivity index of 9.405. Although, the oleanolic acid exhibit a better activity against L. infantum with an IC50 of 0.999 ± 0.089 µg/ml and selectivity index of 8.111.

Postoperative bleeding of more than 10% of circulating blood volume (CBV) within the first six hours after a cardiac surgery with cardiopulmonary bypass (CBS) is one of the most frequent complications associated with postoperative morbidity and mortality in children.
This study aimed to identify specific risk factors for the development of this complication in a subpopulation of Mexican pediatric patients.
A nested case-control study was conducted at a tertiary level pediatric intensive care unit (PICU) of Mexico City. Cases were those children who developed bleeding of more than 10% of circulating blood volume (CBV) within the first six hours after the surgery and controls were all those children who did not presented this complication. Bivariate and logistic regression analyses were performed. A P-value less than 0.05 was considered as statistically significant.
Results showed that 33% (n = 21) of included children developed significant bleeding in the first six hours after the cardiac surgery. The main risk factors for developing this complication were the cyanotic congenital heart disease (P 60 minutes (P = 0.01), intraoperative bleeding volume (P = 0.04), and an initial activated clotting time > 140 seconds (P An important proportion of patients developed postoperative significant bleeding. Risk factors identified in the present study could help to identify and close monitor a subgroup of children at high risk for the development of this complication.

The anesthetic block of the inferior alveolar nerve (IAN) is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

A new species of the genus Stigmaeus, S. brasiliensis sp. nov. is described based on females, males and deutonymphs, collected from the São Paulo state, Brazil.

Acute gastroenteritis (AGE) has a great impact on children less than five years of age, producing high levels of morbidity and mortality. Worldwide, AGE is mainly related to viruses, mainly rotavirus but human adenovirus (HAdV) in particular as an important etiologic agent. Among HAdV species F, genotypes 40 and 41 are responsible for a high number of diarrhea cases, mainly in children under 2 years of age. Two hundred and fifty four fecal samples were analyzed using conventional PCR to detect and characterize enteric HAdV in children less than five years diagnosed with AGE and recruited between 2012 and 2013 through the Sentinel Surveillance Program from Bogota DC, Colombia. Fourteen samples (5.51%) were positive for HAdV. Species-specific detection showed one HAdV-A sample, four HAdV-B samples, two HAdV-D samples, two HAdV-E samples, and five HAdV-F samples. HAdV-F samples were subjected to conventional PCR in order to identify genotypes 40 and 41. All HAdV-F samples were genotype 40, except for one sample coinfected with both genotypes (40 and 41). Our results show that enteric HAdV are important agents in the etiology of AGE in children less than 5 years old. Moreover, the species-specific PCR analysis demonstrated that species other than HAdV- F which are tightly associated with respiratory tract disease, could infect and produce gastrointestinal tract disorders.

Argemone mexicana is a Papaveracea plant; some reports have shown their antibacterial, anti-cancer, sedative and probably anti-anxiety properties. From their aerial parts, flavonoids and alkaloids have been isolated, which are intrinsically related to some actions on the central nervous system. The aim of this study was to evaluate the anxiolytic-like effects of the plant, using its ethanolic extract and alkaloid-enriched extract obtained from fresh leaves.
Material and Phytochemical screening was carried out together with evaluation of antioxidant capacity and the enrichment of alkaloids present in the extract. Subsequently, 100 and 200 mg/kg doses of ethanolic extract and alkaloid-enriched extract (200 µg/kg) were intraperitoneally administered to female Wistar rats, which were exposed to elevated plus maze (EPM) test. Picrotoxin (1 mg/kg), a non-competitive gamma-aminobutyric acid A (GABAA) chloride channel antagonist, was used in experimental procedures to evaluate if this receptor is involved in the anxiolytic-like effects of A. mexicana. To discard motor effects associated with the treatments, the rats were evaluated by the locomotor activity test.
Only the ethanolic extract at 200 mg/kg and alkaloid-enriched extract (200 µg/kg) produced anxiolytic-like effects similarly to diazepam 2 mg/kg on EPM test, without affecting locomotor activity. Meanwhile, the administration of picrotoxin blocked anti-anxiety effect of alkaloid-enriched extract of the plant.
These results showed that A. mexicana is a potential anxiolytic agent and we suggest that this effect is mediated by the GABAA receptor. These effects are related to the presence of alkaloids.

Odontogenic tumors constitute a group of heterogeneous lesions of benign and malignant neoplasms with variable aggressiveness. Ameloblastomas are a group of benign but locally invasive neoplasms that occur in the jaws and are derived from epithelial elements of the tooth-forming apparatus. We previously described orosomucoid-1 protein expression in odontogenic myxomas. However, whether orosomucoid-1 is expressed in other odontogenic tumors remains unknown. Since orosomucoid-1 belongs to a group of acute-phase proteins and has many functions in health and disease, we identified and analyzed orosomucoid-1 expression in ameloblastoma variants and ameloblastic carcinoma using western blot and immunohistochemical techniques. Thirty cases of ameloblastoma were analyzed for orsomucoid-1; five specimens were fresh for western blot study (four benign ameloblastomas and one ameloblastic carcinoma), and 25 cases of benign ameloblastoma for immunohistochemical assays. Orosomucoid-1 was widely expressed in each tumor variant analyzed in this study, and differential orosomucoid-1 expression was observed between benign and malignant tumor. Orosomucoid-1 may play an important role in the behavior of ameloblastomas and influence the biology and development of the variants of this tumor.

With the vast capability to treat a wide array of maladies, the US health care system stands at the forefront of innovation and technological advancement. Yet, despite the improvement in the oral health status of the population in its entirety, there exist profound and persistent disparities in dental care throughout the US. Although health care disparities is a multifaceted issue with a wide array of implications, population-based public health programs, federal agencies, and educational institutions should be responsible for instituting new methods to alleviate the plight of the people.