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El presente artículo tiene por finalidad determinar si el mantenimiento vial se asocia significativamente con la satisfacción del usuario en Lima Metropolitana 2023. El método utilizado fue el hipotético-deductivo, muestra 100 usuarios, el diseño fue no experimental, de tipo descriptivo correlacional, desarrollado en la aplicación y las herramientas con dos cuestionarios y hojas de recolección de datos, los cuales fueron agregados en SPSS y Microsoft Excel luego de crear base de datos. Los resultados en el coeficiente de correlación Rho de Spearman de 0,919 establece una relación altamente significativa entre el mantenimiento rutinario y la satisfacción del usuario. Se concluyó que la gestión del mantenimiento es inadecuada en las vías investigadas. Los datos relacionados con la satisfacción del usuario muestran un coeficiente de correlación positivo de 0,891 y un resultado de significación bilateral de 0,000.

In this meta-analysis, we analyzed the efficacy and safety of anterior vertebral body tethering in patients with adolescent idiopathic scoliosis.We performed a literature search and analyzed the following data: baseline characteristics, efficacy measures (corrections of the main thoracic curve, proximal thoracic curve, and thoracolumbar curve, thoracic kyphosis, lumbosacral lordosis, rib hump, lumbar prominence and SRS-22 scores, and complications. Analyses were performed with Cochrane's Review Manager version 5.4.Twelve studies met the inclusion criteria. Significant corrections of the main thoracic (MD 22.51, 95% CI 12.93 to 32.09) proximal thoracic (MD 10.14°, 95% CI 7.25° to 13.02°), and thoracolumbar curve (MD 12.16, 95% CI 9.14 to 15.18) were found. No statistically significant corrections were observed on the sagittal plane assessed by thoracic kyphosis (MD - 0.60°, 95% CI - 2.45 to 1.26; participants = 622; studies = 4; I2 = 36%) and lumbosacral lordosis (MD 0.19°, 95% CI - 2.16° to 2.54°). Significant corrections were identified for rib hump (MD 5.26°, 95% CI 4.19° to 6.32°) and lumbar prominence (MD 1.20°, 95% CI 0.27° to 2.13°) at final follow-up. Significant improvements of total SRS-22 score (MD - 0.96, 95% CI - 1.10 to - 0.83) were achieved at final follow-up. The most common complication was overcorrection (8.0%) and tether breakage (5.9%), with a reoperation rate of 10.1%.Anterior vertebral body tethering is effective to reduce the curve in the coronal plane and clinical deformity. Maximum correction is achieved at one year. The method should, however, be optimized to reduce the rate of complications.

In this meta-analysis, we aim to compare ketamine use versus a control group (saline solution) during induction of anesthesia in adolescent idiopathic scoliosis patients undergoing fusion surgery in terms of postoperative opioid consumption, pain control, and side effects.A PubMed search of studies published over the last 20 years using the descriptor/terms "ketamine AND scoliosis" was performed. Baseline characteristics of each article were obtained and efficacy measures analyzed (morphine equivalent treatment at 24, 48, and 72 h postoperatively, complications (vomiting/nausea and pruritus), length of hospital stay (days); and pain score (VAS)) (Review Manager 5.4 software package).Five randomized clinical trials were included. Morphine administration showed statistically significant differences at 24 and 48 h (MD - 0.15, 95% CI - 0.18 to - 0.12) and (MD - 0.26, 95% CI - 0.31 to - 0.21) between the ketamine and control (saline solution), respectively. No intergroup differences were found regarding nausea/vomiting and pruritus (OR 0.77, 95% CI 0.35 to 1.67) and (OR 0.71, 95% CI 0.31 to 1.62), respectively, same as for the pain score (MD - 0.75, 95% CI - 1.71 to 0.20).The use intraoperative and postoperative continuous low doses of ketamine significantly reduces opioid use throughout the first 48 h in patients with AIS who undergo posterior spinal fusion.

In the present scenario, citizens' concern about environment preservation creates a necessity to mature more ecological and energy-efficient manufacturing processes and materials. The usage of glass fiber reinforced polymer (GFRP) is one of the emerging materials to replace the traditional metallic alloys in the automotive and aircraft industries. However, it has been comprehended to arise a sustainable substitute to conventional emulsion-based coolants in machining processes for dropping the destructive effects on the ecosystem without degrading the machining performance. So, in this study, the comparison of the two sustainable cutting fluid approaches, i.e., dry and LCO2, has been presented based on machining performance indicators like temperature, modulus of cutting force, tool wear, surface roughness, power consumption, and life cycle assessment (LCA) analysis for end milling of GFRP. The cutting condition of LCO2 has been found to be superior in terms of machining performance by providing 80% of lower cutting zone temperature, tool wear, 5% lower modulus of cutting force, and reduced surface roughness with 9% lower power consumption that has been observed in the case of LCO2 in comparison with dry machining. However, to compress the CO2 for converting in liquid form, a higher amount of energy and natural resources is consumed resulting in a higher impact on the environment in comparison with dry machining. Considering the 18 impact categories of ReCiPe midpoint (H) 2016, 95% higher values of impacts have been observed in the case of LCO2 in comparison with dry machining. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. The authors received financial support from Basque Government in the Excellence University Group system call, grant IT 1573-22.