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Currently, a great deal of controversy exists regarding the real forces generated in drawbeads during sheet metal forming processes. The present work focuses on the analysis of the uplift force. First, a detailed literature review is carried out to analyse previous experimental procedures used to measure uplift forces. It is found that previous setups do not perfectly replicate the real geometry of industrial drawbeads. In order to obtain reliable forces, an experimental drawbead tester capable of adequately replicating industrial drawbeads is developed. Later, a variety of steels ranging from mild steels to 3rd-generation ultra-high-strength steels are tested and reliable uplift and also restraining force values are obtained. The main purpose of the work is to share with the research community reliable experimental data that allows precise evaluation of the accuracy of current drawbead models and that supports the generation of new numerical and equivalent drawbead models. In parallel to the experimental procedure, a step forward in the understanding of the drawbead closing phenomena is also achieved through a 2D numerical model. The main purpose of the model is to identify the variables that greatly affect uplift force. Going beyond previous studies, in which some variables were analysed, the present work covers, in a holistic manner, the impact that material properties, the geometry of drawbeads and contact behaviour between sheet and drawbead have on the uplift force. It is determined that surprisingly minor geometrical deviations in the drawbead nominal geometry have a large impact on the uplift force.

Background We aimed to examine whether using a high fraction of inspired oxygen (FIO2) in the context of an individualised intra- and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. Methods We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. Results We enrolled 740 subjects: 371 in the high FIO2 group and 369 in the low FIO2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59–1.50; P=0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48–1.25; P=0.38) and myocardial ischaemia (0.6% [n=2] vs 0% [n=0]; P=0.47) did not differ between groups. Conclusions An oxygenation strategy using high FIO2 compared with conventional FIO2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found. Clinical trial registration NCT02776046.

EnglishWe are currently faced with an unequal distribution of employment opportunities, which has led to a rethinking of the Employment Sharing measures, as a means of reallocating in a balanced way job opportunities really available to all jobseekers. This involves: rearranging working time, leading to a new work distribution; adapting a greater number of working people to this new time of work; ensuring quality of employment and wages; and protecting quality of life and well-being of working people. Nowadays we recognize two types of measures that contribute to distribution of employment: On the one hand, measures of pure distribution, creating new employment; on the other, distribution measures in order to maintain existing employment. All of them classified into four main sections on the Map of Measures for the Distribution of Employment we have designed. In this article we present what these measures are and how they have been applied in organizations in Gipuzkoa from 2008 to 2014, highlighting the case of the social economy and the gender point of view. euskaraKrisian lan egiteko aukeren banaketa desorekatua denez, enplegua banatzeko neurriak planteatzen dira lan egiteko benetako aukerak modu orekatuan birbanatzeko lanpostu eske dabiltzan pertsona guztien artean. Horrek berekin dakar: lan denbora berrantolatzea, lana beste era batera banatzeko; lan denbora berri horretara langile gehiago egokitzea; enpleguaren eta soldaten kalitatea bermatzea; eta langileen bizi kalitatea eta ongizatea babestea. Egungo egoeran, bi neurri mota ezagutzen ditugu lanaren banaketan laguntzen dutenak: Alde batetik, banaketa huts-hutseko neurriak, enplegua sortzen dutenak. Eta beste aldetik dagoen enplegua mantentzeko balio duten banaketa neurriak, eta guzti horiek lau sail nagusitan sailkatuta agertzen dira guk diseinatutako Enplegu banatzeko neurrien mapan. Artikulu honetan azaltzen ditugu zeintzuk dira neurri horiek eta nola aplikatu dira 2008tik 2014raino Gipuzkoako erakundeetan, azpimarratzen gizarte ekonomiaren kasua eta generoaren ikuspuntua.

Adherence to Enhanced Recovery Protocols (ERPs) is associated with faster functional recovery, better patient satisfaction, lower complication rates and reduced length of hospital stay. Understanding institutional barriers and facilitators is essential for improving adherence to ERPs. The purpose of this study was to identify institutional factors associated with adherence to an ERP for colorectal surgery.A secondary analysis of a nationwide study was conducted including 686 patients who underwent colorectal surgery across twenty-one institutions in Spain. Adherence to ERPs was calculated based upon the components recommended by the Enhanced Recovery After Surgery (ERAS®) Society. Institutional characteristics (i.e., case volume, ERP duration, anesthesia staff size, multidisciplinary meetings, leadership discipline) were captured from each participating program. Multivariable regression was performed to determine characteristics associated with adherence.The median adherence to ERAS was 68.2% (IQR 59.1%-81.8%). Multivariable linear regression revealed that anesthesiologist leadership (+5.49%, 95%CI +2.81% to +8.18%, P 0.01), duration of ERAS implementation (+0.46% per year, 95%CI +0.06% to +0.86%, P 0.01) and the use of regular multidisciplinary meetings (+4.66%, 95%CI +0.06 to +7.74%, P 0.01) were independently associated with greater adherence. Case volume (-2.38% per 4 cases weekly, 95%CI -3.03 to -1.74, P 0.01) and number of anesthesia providers (-1.19% per 10 providers, 95%CI +2.23 to -8.18%, P 0.01) were negatively associated with adherence.Adherence to ERPs is strongly associated with anesthesiology leadership, regular multidisciplinary meetings, and program duration, whereas case volume and the size of the anesthesia staff were potential barriers. These findings highlight the importance of strong leadership, experience and establishing a multidisciplinary team when developing an ERP for colorectal surgery.

Steel has been used in vehicles from the automotive industry’s inception. Different steel grades are continually being developed in order to satisfy new fuel economy requirements. For example, advanced high strength steel grades (AHSS) are widely used due to their good strength/weight ratio. Because each steel grade has a different microstructure composition and hardness, they show different behaviors when they are subjected to different strain paths. Similarly, the friction behavior when using different contact pressures and sliding velocities is considerably altered. Third generation steels present high yield strength together with high elongation capacity and strain hardening. Thus, it is logical to think that elastic modulus reduction and Bauschinger effect are important aspects when stamping these materials. Furthermore, high contact pressures arise when forming these steels and friction coefficient may significantly influence the numerical results. Stamping forming processes are nowadays usually optimized by numerical tools such as Finite Element Models. In order to get reliable results, these numerical tools require proper material and contact models in order to correctly predict the real behavior and flow of the materials. In the present paper, Fortiform 1050 material is deeply characterized using uniaxial and cyclic tension-compression tests. Friction coefficient is obtained using strip drawing tests. These results have been used to calibrate mixed kinematic-hardening material models as well as the friction. Finally, the geometrical accuracy of the different material models has been obtained by means of the comparison of the numerical predictions with experimental demonstrators obtained using a U-Drawing tester.

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.

The finite element simulation has become an essential tool for the proper design of big size automotive components stamping tooling and their process optimization. Although big improvements have been made in the last years in terms of material and tribological modelling, the accuracy of the current models should be further improved to estimate the final post-forming springback of these components, in both AHSS and mild steels.In the present paper the forming of a B-Pillar reinforcement is numerically analyzed using a DX54D mild steel and a TRIP800 high strength steel. In the first part, the influence of the elastic behavior including variable young modulus, the yield criteria and the hardening law on the final springback is studied for both materials. Secondly, the friction coefficient is defined constant and pressure dependent and springback variation is analyzed in function of this variable.In order to stablish the material and friction variables and their typical deviation, results obtained from material characterization and strip drawing tests are used.

Objective The number of indications for total hip replacement (THR) and total knee replacement (TKR) surgery is increasing. Enhanced recovery after surgery (ERAS) represents the next step in the evolution of standardised care. The primary aim of this study is to measure the in-hospital 30-day medical and surgical postoperative complications rate. The study's secondary aims are to determine the length of stay, 30-day mortality rate, 30-day reoperation and readmission rates, the ERAS overall compliance and predefined ERAS individual items compliance. Methods This multicentre, prospective, observational study will include adult patients (aged >18 years) undergoing elective THR and TKR surgery. Consecutive patients undergoing surgery within the 2-month data collection period will be included. Centres that offer the THR and/or TKR surgery will be eligible to participate. The data collection will be done through an online data collection form via a secure, password-protected platform at each centre with predefined data fields. Results Ethical approval for this study has been obtained from the Comite de Etica de la Investigacion de la Comunidad Autonoma de Aragon (C.P.-C.I. PI18/135; on 23 May 2018). It was prospectively registered on 27 June 2018, at www.clinicaltrials.gov with identification no. NCT03570944. Conclusion The study will be disseminated through the SPARN-RedGERM, SEDAR, GERM and through social media. Peer-reviewed publications will be published under corporate authorship, including POWER.2 Study Group and SPARN-RedGERM.

Frequency Response Analysis is a well-known technique for the diagnosis of power transformers. Currently, this technique is under research for its application in rotary electrical machines. This paper presents the application of FRA to the diagnosis of poles of the field winding of synchronous machines. Numerous tests have been performed with ground fault and inter-turn fault in a pole of the field winding of a large commercial size synchronous generator. This technique has been validated through numerous experimental laboratory tests in a pole of a 40 MVA synchronous generator with satisfactory results.

Steel has been used in vehicles from the automotive industry’s inception. Different steel grades are continually being developed in order to satisfy new fuel economy requirements. For example, advanced high strength steel grades (AHSS) are widely used due to their good strength/weight ratio. Because each steel grade has a different microstructure composition and hardness, they show different behaviors when they are subjected to different strain paths. Similarly, the friction behavior when using different contact pressures is considerably altered. In the present paper, four different steel grades, ZSt380, DP600, DP780 and Fortiform 1050 materials are deeply characterized using uniaxial and cyclic tension-compression tests. Coefficient of friction (COF) is also obtained using strip drawing tests. These results have been used to calibrate mixed kinematic-hardening material models as well as pressure dependent friction models. Finally, the geometrical accuracy of the different material and friction models has been evaluated by comparing the numerical predictions with experimental demonstrators obtained using a U-Drawing tester.

Background The effects of individualised perioperative lung-protective ventilation (based on the open-lung approach [OLA]) on postoperative complications is unknown. We aimed to investigate the effects of intraoperative and postoperative ventilatory management in patients scheduled for abdominal surgery, compared with standard protective ventilation. Methods We did this prospective, multicentre, randomised controlled trial in 21 teaching hospitals in Spain. We enrolled patients who were aged 18 years or older, were scheduled to have abdominal surgery with an expected time of longer than 2 h, had intermediate-to-high-risk of developing postoperative pulmonary complications, and who had a body-mass index less than 35 kg/m(2). Patients were randomly assigned (1: 1: 1: 1) online to receive one of four lung-protective ventilation strategies using low tidal volume plus positive end-expiratory pressure (PEEP): open-lung approach (OLA)-iCPAP (individualised intraoperative ventilation [individualised PEEP after a lung recruitment manoeuvre] plus individualised postoperative continuous positive airway pressure [CPAP]), OLA-CPAP (intraoperative individualised ventilation plus postoperative CPAP), STD-CPAP (standard intraoperative ventilation plus postoperative CPAP), or STD-O-2 (standard intraoperative ventilation plus standard postoperative oxygen therapy). Patients were masked to treatment allocation. Investigators were not masked in the operating and postoperative rooms; after 24 h, data were given to a second investigator who was masked to allocations. The primary outcome was a composite of pulmonary and systemic complications during the first 7 postoperative days. We did the primary analysis using the modified intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT02158923. Findings Between Jan 2, 2015, and May 18, 2016, we enrolled 1012 eligible patients. Data were available for 967 patients, whom we included in the final analysis. Risk of pulmonary and systemic complications did not differ for patients in OLA-iCPAP (110 [46%] of 241, relative risk 0.89 [95% CI 0.74-1.07; p=0.25]), OLA-CPAP (111 [47%] of 238, 0.91 [0.76-1.09; p=0.35]), or STD-CPAP groups (118 [48%] of 244, 0.95 [0.80-1.14; p=0.65]) when compared with patients in the STD-O-2 group (125 [51%] of 244). Intraoperatively, PEEP was increased in 69 (14%) of patients in the standard perioperative ventilation groups because of hypoxaemia, and no patients from either of the OLA groups required rescue manoeuvres. Interpretation In patients who have major abdominal surgery, the different perioperative open lung approaches tested in this study did not reduce the risk of postoperative complications when compared with standard lung-protective mechanical ventilation.

This research studies the effect of considering an advanced variable friction coefficient on the springback prediction of stamping processes. Traditional constant coefficient of friction considerations are being replaced by more advanced friction coefficient definitions. The aim of this work is to show the influence of defining a pressure dependent friction coefficient on numerical springback predictions of a DX54D mild steel, a HSLA380 and a DP780 high strength steel. The pressure dependent friction model of each material was fitted to the experimental data obtained by Strip Drawing tests. Then, these friction models were implemented in a numerical simulation of a drawing process of an industrial automotive part. The results showed important differences between defining a pressure dependent friction coefficient or a constant friction coefficient.

This paper deals with a combined superplastic forming and diffusion bonding (SPF and DB) process in an Inconel superalloy (In718). The steps of the validation of this process prior to its implementation at a production scale are covered in the paper. A great effort has been dedicated to the optimization of the SPF finite element (FE) simulations, which are an essential part at both the design and manufacturing stages. This task has been carried out by taking into account the program parameters and the material model, in order to minimize a given error function. The material model was generated through lab scale trials, and introduced in ABAQUS FE code through subroutines. Fine grained (standard SPF) In718 presents an acceptable superplastic behaviour which allows for the design of complex components involving localized high strain areas, where final sheet thickness predictions become essential for the design of a component.

Elasto–plastic behavior of the third generation Fortiform 1050 steel has been analysed using cyclic tension–compression tests. At the same time, the pseudo elastic modulus evolution with plastic strain was analysed using cyclic loading and unloading tests. From the experiments, it was found that the cyclic behavior of the steel is strongly kinematic and elastic modulus decrease with plastic strain is relevant for numerical modelling. In order to numerically analyse a U-Drawing process, strip drawing tests have been carried out at different contact pressures and Filzek model has been used to fit the experimental data and implement a pressure dependent friction law in Autoform software. Finally, numerical predictions of springback have been compared with the experimentally ones obtained using a sensorized U-Drawing tooling. Different material and contact models have been examined and most influencing parameters have been identified to model the forming of these new steels.

BACKGROUND:Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia. METHODS:Consecutive patients scheduled for major abdominal surgery were submitted to low-VT ventilation (6 ml·kg-1) and standard PEEP of 5 cmH2O (pre-RM, n = 36). After 30 min estabilization all patients received a RM and were randomly allocated to either continue with the same PEEP (RM-5 group, n = 18) or to an individualized open-lung PEEP (OL-PEEP) (Open Lung Approach, OLA group, n = 18) defined as the level resulting in maximal Cdyn during a decremental PEEP trial. We compared the effects on driving pressure and lung efficiency measured by volumetric capnography. RESULTS:OL-PEEP was found at 8±2 cmH2O. 36 patients were included in the final analysis. When compared with pre-RM, OLA resulted in a 22% increase in compliance and a 28% decrease in driving pressure when compared to pre-RM. These parameters did not improve in the RM-5. The trend of the DP was significantly different between the OLA and RM-5 groups (p = 0.002). VDalv/VTalv was significantly lower in the OLA group after the RM (p = 0.035). CONCLUSIONS:Lung recruitment applied during low-VT ventilation improves driving pressure and lung efficiency only when applied as an open-lung strategy with an individualized PEEP in patients without lung diseases undergoing major abdominal surgery. TRIAL REGISTRATION:ClinicalTrials.gov NCT02798133.

We investigated whether individualized positive end-expiratory pressure (PEEP) improves oxygenation, ventilation, and lung mechanics during one-lung ventilation compared with standardized PEEP.Thirty patients undergoing thoracic surgery were randomly allocated to the study or control group. Both groups received an alveolar recruitment maneuver at the beginning and end of one-lung ventilation. After the alveolar recruitment maneuver, the control group had their lungs ventilated with a 5 cm·H2O PEEP, while the study group had their lungs ventilated with an individualized PEEP level determined by a PEEP decrement trial. Arterial blood samples, lung mechanics, and volumetric capnography were recorded at multiple timepoints throughout the procedure.The individualized PEEP values in study group were higher than the standardized PEEP values (10 ± 2 vs 5 cm·H2O; P0.001). In both groups, arterial oxygenation decreased when bilateral-lung ventilation was switched to one-lung ventilation and increased after the alveolar recruitment maneuver. During one-lung ventilation, oxygenation was maintained in the study group but decreased in the control group. After one-lung ventilation, arterial oxygenation was significantly higher in the study group (306 vs 231 mm·Hg, P = 0.007). Static compliance decreased in both groups when bilateral-lung ventilation was switched to one-lung ventilation. Static compliance increased significantly only in the study group (P0.001) after the alveolar recruitment maneuver and optimal PEEP adjustment. The alveolar recruitment maneuver did not decrease cardiac index in any patient.During one-lung ventilation, the improvements in oxygenation and lung mechanics after an alveolar recruitment maneuver were better preserved by ventilation by using individualized PEEP with a PEEP decrement trial than with a standardized 5 cm·H2O of PEEP.

New materials are been introduced on the car body in order to reduce weight and fulfil the international CO2 emission regulations. Among them, the application of aluminum alloys is increasing for skin panels. Even if these alloys are beneficial for the car design, the manufacturing of these components become more complex. In this regard, numerical simulations have become a necessary tool for die designers. There are multiple factors affecting the accuracy of these simulations e.g. hardening, anisotropy, lubrication, elastic behavior. Numerous studies have been conducted in the last years on high strength steels component stamping and on developing new anisotropic models for aluminum cup drawings. However, the impact of the correct modelling on the latest aluminums for the manufacturing of skin panels has been not yet analyzed. In this work, first, the new AC600 aluminum alloy of JLR-Novelis is characterized for anisotropy, kinematic hardening, friction coefficient, elastic behavior. Next, a sensitivity analysis is conducted on the simulation of a U channel (with drawbeads). Then, the numerical an experimental results are correlated in terms of springback and failure. Finally, some conclusions are drawn.

In this paper we present a simplified and useful model of the human body movement based on the full gait cycle description, called the Mean Double Step (MDS). It enables the parameterization and simplification of the human movement. Furthermore it allows a description of the gait cycle by providing standardized estimators to transform the gait cycle into a periodical movement process. Moreover the method of simplifying the MDS model and its compression are demonstrated. The simplification is achieved by reducing the number of bars of the spectrum and I or by reducing the number of samples describing the MDS both in terms of reducing their computational burden and their resources for the data storage. Our MDS model, which is applicable to the gait cycle method for examining patients, is non-invasive and provides the additional advantage of featuring a functional characterization of the relative or absolute movement of any part of the body.

Engineers often conduct energy audits in buildings in use with the aim of improving the energy consumption of the facilities. The problem with this traditional approach is that the audits take place at a given instant in time. Subsequently, it is necessary to track the amount of energy continuously consumed in buildings in order to deal with an energy efficiency problem. This paper proposes the continuous assessment of energy efficiency in buildings using different energy rating factors. These factors have already been presented in other works by the authors, and the usefulness of these factors for assessing the energy performance of buildings and identifying wasted energy has been proven. This article presents the results of applying the methodology in 55 buildings located on the Universitat Politècnica de València campus during an entire year., This research work has been possible with the support of the Universitat Politecnica de Valencia through grant CE19990032.

Taekwondo, originally a Korean martial art, is well known for its kicks. One of the most frequently used kicks in competition is Bandal Chagui or roundhouse kick. Excellence in Taekwondo relies on the ability to make contact with the opponent's trunk or face with enough force in as little time as possible, while at the same time avoiding being hit. Thus, the distance between contestants is an important variable to be taken into consideration. Thirty-one Taekwondo athletes in two different groups (expert and novice, according to experience in competition) took part in this study. The purpose of this study was to examine both impact force and execution time in a Bandal Chagui or roundhouse kick, and to explore the effect of execution distance in these two variables. A new model was developed in order to measure the force exerted by the body on a load. A force platform and a contact platform were used to measure these variables. The results showed that there are no significant differences in terms of impact force in relation to execution distance in expert competitors. Significant and positive correlations between body mass and impact force (p

The aim of this paper is to describe a new Stereovision Laboratory. It was designed and constructed by the authors of the paper in the University of Valencia. It consists of four cameras with its special equipment, a moving track, hardware and software for calculation and visualization. The tests carried out on the measurement stand lead to obtain the set of data describing the movement of human body. The stored data serves to analyze static and dynamic behavior of some parts of human body like arms, legs or vertebral column. Special software was design in order to do visual inspection of the movement and to select a proper data.© (2006) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

ResumenSe estudia la rentabilidad social del Programa de Detección Precoz y Tratamiento de dos enfermedades metabólicas, la fenilcetonuria y el hipotiroidismo congènito, en la Comunidad Autónoma Vasca, en vigor desde noviembre de 1982.La técnica utilizada es el análisis coste-beneficio. Los costes sociales de detección y tratamiento se comparan con los beneficios sociales de la prevención del retardo mental (1984 y 1985). Los Índices beneficio-coste (BC) y el valor actual neto (VAN) muestran que el programa es rentable excepto cuando los valores futuros de costes y beneficios son descontados a tasas elevadas. Los resultados del estudio son consistentes con los obtenidos por otras evaluaciones económicas de este tipo de programas.En términos de coste-efectividad, el coste de prevenir un caso de subnormalidad se estimó en 3.300.000 ptas., lo que podría interpretarse como un limite inferior a la valoración social de la prevención de la deficiencia mental.SummaryThe efficiency of an early screening and treatment Programme for two Metabolic disorders, phenylketonuria and congenita! hypothyroidism running since November 1982 in the Basque Country, is analysed.The cost-benelit analysis technique is used. The social costs of screening and treatment are compared with the social benefits for the prevention of mental handicap (1984-1985). Benefit-cost ratios and the net present value shows the social efficiency of the programme except when high discount rates have been used for discounting future costs and benefits. That conclusion is consistent with the results of other cost-benefit studies.In terms of cost-effectiveness the cost per child with mental handicap prevented was estimated on 3.300.000 ptas. That could be seen as the lowest social value for the prevention of a child with mental handicap.