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Cumplidos los tres primeros meses de Daniel Noboa como presidente del Gobierno de Ecuador, este artículo investiga y analiza la comunicación audiovisual llevada a cabo en este periodo por las tres cuentas oficiales protagonistas de la comunicación del Gobierno del Ecuador: Presidencia, Secretaría de Comunicación y la personal del presidente, en la red social con mayor énfasis audiovisual: TikTok. Se realiza un análisis cuantitativo del alcance e impacto de las cuentas, y un análisis cualitativo de los contenidos publicados, las temáticas abordadas y el estilo comunicativo con el fin de conocer cómo se ha adaptado la comunicación pública a los formatos y canales digitales, en específico a TikTok, identificada como la plataforma más influyente actualmente para la difusión de contenido audiovisual. El análisis muestra las diferencias entre las tres cuentas oficiales de TikTok evidenciando el alcance y el impacto de los distintos contenidos y formatos utilizados, demostrando una estrategia conjunta para las cuentas institucionales y una diferencia muy amplia con la comunicación personal del presidente.

Resumen: Introducción: La displasia del desarrollo de la cadera se trata de una patología relativamente frecuente y es una causa importante de discapacidad si no se trata de la forma adecuada. Existen una serie de factores de riesgo que aumentan la probabilidad de presentar una displasia de caderas, pero la mayoría de los afectados no los presentan. Por ello, la exploración física es fundamental para su diagnóstico. No obstante, el número de ecografías solicitadas parece ser muy superior al que sería necesario, según los hallazgos clínicos. Material y métodos: Estudio observacional descriptivo retrospectivo de los recién nacidos pertenecientes al área de referencia de un hospital terciario. Se recogieron las ecografías de caderas realizadas en nuestro centro durante el periodo de estudio, así como los diagnósticos de displasia durante dicho periodo para comprobar la frecuencia de presentación de los factores de riesgo y los hallazgos clínicos, además del número de ecografías solicitadas en este periodo y su rendimiento. Resultados: Se incluyeron un total de 456 recién nacidos a los que se realizaron un total de 530 ecografías de caderas. Tres de las 12 displasias detectadas en este tiempo presentaban factores de riesgo, el resto de los pacientes fue diagnosticado por la clínica. Conclusiones: Los protocolos de screening son implementados de forma adecuada en nuestro medio, aunque sin la exploración física detallada no sería posible la detección precoz de la displasia, evitando con ello secuelas a largo plazo. No obstante, el número de ecografías de caderas solicitadas es muy superior al que se esperaría, dado el bajo porcentaje de displasias halladas. Abstract: Introduction: Developmental dysplasia of the hip is a common cause of disability among children. Early detection leads to better prognosis. There are some risk factors that increase the possibility of developing a dysplasia. But not every child with developmental dysplasia has them. This means that physical examination is still very useful to detect them. However, based on clinical findings, the amount of requested ultrasound seems higher than it would be necessary. Methods: Retrospective cohort study of infants born in a single tertiary care centre. Babies in which hip ultrasound was performed were included. During the period of study, patients with diagnosis of developmental hip dysplasia were also included, as well as the amount of ultrasounds requested during this period, and their efficiency. Results: Out of the 456 new-borns included, 530 hip ultrasounds were performed. Just 3 of the total 12 dysplasias had risk factors. The others were diagnosed through clinical examination. Conclusions: Screening protocols are useful to detect hip dysplasia but clinical examination is very important to detect those cases without risk factors. However, the number of tests is higher than expected according to the diagnosed dysplasias.

Introduction: Developmental dysplasia of the hip is a common cause of disability among children. Early detection leads to better prognosis. There are some risk factors that increase the possibility of developing a dysplasia. But not every child with developmental dysplasia has them. This means that physical examination is still very useful to detect them. However, based on clinical findings, the amount of requested ultrasound seems higher than it would be necessary. Methods: Retrospective cohort study of infants born in a single tertiary care centre. Babies in which hip ultrasound was performed were included. During the period of study, patients with diagnosis of developmental hip dysplasia were also included, as well as the amount of ultrasounds requested during this period, and their efficiency. Results: Out of the 456 newborns included, 530 hip ultrasounds were performed. Just 3 of the total 12 dysplasias had risk factors. The others were diagnosed through clinical examination. Conclusions: Screening protocols are useful to detect hip dysplasia but clinical examination is very important to detect those cases without risk factors. However, the number of tests is higher than expected according to the diagnosed dysplasias. Resumen: Introducción: La displasia del desarrollo de la cadera se trata de una patología relativamente frecuente y es una causa importante de discapacidad si no se trata de la forma adecuada. Existen una serie de factores de riesgo que aumentan la probabilidad de presentar una displasia de caderas, pero la mayoría de los afectados no los presentan. Por ello, la exploración física es fundamental para su diagnóstico. No obstante, el número de ecografías solicitadas parece ser muy superior al que sería necesario según los hallazgos clínicos. Material y métodos: Estudio observacional descriptivo retrospectivo de los recién nacidos pertenecientes al área de referencia de un hospital terciario. Se recogieron las ecografías de caderas realizadas en nuestro centro durante el periodo de estudio, así como los diagnósticos de displasia durante dicho periodo para comprobar la frecuencia de presentación de los factores de riesgo y los hallazgos clínicos, además del número de ecografías solicitadas en este periodo y su rendimiento. Resultados: Se incluyeron un total de 456 recién nacidos a los que se realizaron un total de 530 ecografías de caderas. Tres de las 12 displasias detectadas en este tiempo presentaban factores de riesgo, el resto de los pacientes fue diagnosticado por la clínica. Conclusiones: Los protocolos de screening son implementados de forma adecuada en nuestro medio, aunque sin la exploración física detallada no sería posible la detección precoz de la dysplasia, evitando con ello secuelas a largo plazo. No obstante, el número de ecografías de caderas solicitadas es muy superior al que se esperaría, dado el bajo porcentaje de displasias halladas.

Background and Purpose: European Guidelines recommend early evaluation of diuresis and natriuresis after the first administration of diuretic to identify patients with insufficient diuretic response during acute heart failure. The aim of this work is to evaluate the prevalence and characteristics of patients with insufficient diuretic response according to this new algorithm.Methods: Prospective observational single centre study of consecutive patients with acute heart failure and congestive signs. Clinical evaluation, echocardiography and blood tests were performed. Diuretic naïve patients received 40 mg of intravenous furosemide. Patients on an oupatient diuretic regimen received 2 times the ambulatory dose. The diuresis volume was assessed 6 h after the first loop diuretic administration, and a spot urinary sample was taken after 2 h. Insufficient diuretic response was defined as natriuresis

Resumen: Objetivo: Investigar la influencia externa tanto lunar como climatológica en la frecuencia de partos. Incluye fuerza gravitacional lunar mediante apogeo y perigeo lunar apenas investigado. Material y métodos: Estudio retrospectivo mediante revisión de historias clínicas de todos los partos únicos de inicio espontáneo durante un periodo de 4 años (2015-2018). Se analiza estadísticamente la relación de los partos mediante coeficiente de nacimientos con variables cualitativas lunares (4 fases clásicas, apogeo-perigeo lunar y superlunas) y variables cuantitativas atmosféricas (presiones atmosféricas medias, temperatura media y velocidad media del viento). Resultados: No se encontró relación entre las variables estudiadas y el coeficiente de nacimientos. Se encontró periodicidad de partos con más nacimientos en los meses de mayo y junio. Conclusión: Pese al mito existente de la influencia meteorológica y, sobre todo, lunar en los partos, no se encuentra razón estadística que lo apoye. Además de las fases clásicas, la fuerza gravitacional lunar tampoco parece desencadenar el parto. Abstract: Objective: To investigate the influence of external factors such as lunar and meteorological effects on the frequency of birth deliveries. It includes the lunar gravitational force using the scarcely investigated lunar apogee and perigee (furthest and closest distance to earth, respectively). Material and methods: A retrospective study was conducted by reviewing the medical records of all spontaneous single deliveries during a 4 year period (2015-2018). A statistical analysis was performed on the relationship of the deliveries using birth rates with qualitative lunar variables (four classic phases, lunar apogee- perigee, and super moons) and quantitative atmospheric variables (mean atmospheric pressures, mean temperature, and mean wind velocity). Results: No relationship was found between the variables studied and the birth rate. There were periods with more births in the months of May and June. Conclusion: Despite the myth on the meteorological, and in particular, the lunar influence on birth deliveries, no statistical association was found to support this. Furthermore, the classic moon phases and the lunar gravitational force do not seem to trigger birth delivery either.

Objective: To investigate the influence of external factors such as lunar and meteorological effects on the frequency of birth deliveries. It includes the lunar gravitational force using the scarcely investigated lunar apogee and perigee (furthest and closest distance to earth, respectively). Material and methods: A retrospective study was conducted by reviewing the medical records of all spontaneous single deliveries during a 4 year period (2015–2018). A statistical analysis was performed on the relationship of the deliveries using birth rates with qualitative lunar variables (four classic phases, lunar apogee- perigee, and super moons) and quantitative atmospheric variables (mean atmospheric pressures, mean temperature, and mean wind velocity). Results: No relationship was found between the variables studied and the birth rate. There were periods with more births in the months of May and June. Conclusion: Despite the myth on the meteorological, and in particular, the lunar influence on birth deliveries, no statistical association was found to support this. Furthermore, the classic moon phases and the lunar gravitational force do not seem to trigger birth delivery either. Resumen: Objetivo: Investigar influencia externa tanto lunar como climatológica en la frecuencia de partos. Incluye fuerza gravitacional lunar mediante apogeo y perigeo lunar apenas investigado. Material y métodos: Estudio retrospectivo mediante revisión de historias clínicas de todos partos únicos de inicio espontaneo durante un periodo de 4 años (2015–2018). Se analiza estadísticamente la relación de los partos mediante coeficiente de nacimientos con variables cualitativas lunares (cuatro fases clásicas, apogeo-perigeo lunar y superlunas) y variables cuantitativas atmosféricas (presiones atmosféricas medias, temperatura media y velocidad media de viento). Resultados: No se encontró relación entre las variables estudiadas y el coeficiente de nacimientos. Se encontró periodicidad de partos con más nacimientos en los meses de mayo y junio. Conclusión: Pese al mito existente de la influencia meteorológica y, sobre todo, lunar en los partos, no se encuentra razón estadística que lo apoye. Además de las fases clásicas, la fuerza gravitacional lunar tampoco parece desencadenar el parto.

This paper focuses on the calibration of heat source parameters to reproduce temperatures and distortions in welded joints. Specifically, the proposed methodology, which combines the Finite Element Method and Design of Experiments, is applied to calibrate a T-joint dissimilar titanium laser welding process. The thermal problem is addressed using a 3D transient model with a Conical Gaussian heat flux, and the mechanical problem is tackled using a 3D elastic-plastic model. A Fractional-Factorial Design is performed to define a set of thermo-mechanical uncoupled models. Finally, optimal parameter combinations that replicate experimental data are identified. This methodology allows automation that replaces the traditional trial and error process, which frequently does not provide good results, is an exhausting task and requires a dubious amount of time.

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Introduction: Early-onset neonatal sepsis refers to an infection which starts during the first 72 h of birth, and can lead to significant morbidity and mortality. Scientific evidence shows that infected infants present with symptoms during the first hours after delivery. There has been a significant decrease in this condition with the implementation of guidelines for its prevention. However, international guidelines still recommend the evaluation of these infants using painful tests. Material and methods: A prospective cohort study was conducted on all asymptomatic infants born at >35 weeks gestation with one or more risk factors in a single tertiary care centre from 2011 to 2015. They were periodically observed in newborn nursery from admission until discharge looking for signs of infection. Results: Out of the 9,424 babies born during this period, 1,425 were included in the study. A total of 53 infants were admitted to the neonatal unit, half of them because of sepsis suspicion. Finally, just 7 were discharged with the diagnosis of sepsis. All these 7 presented with symptoms during their first 72 h of life. No sepsis was reported in asymptomatic infants. Conclusions: Truly infected infants present with symptoms during their first hours of life. This study supports the observation of infants at risk as a safe practice to detect early-onset sepsis. Resumen: Introducción: La sepsis vertical precoz es una causa importante de morbimortalidad neonatal. La evidencia científica apunta a que la mayoría de los recién nacidos infectados presentan síntomas en las primeras horas de vida. Tras la aplicación de las medidas para la prevención de sepsis vertical y el descenso en su incidencia, se han propuesto cambios en el manejo de estos niños. No obstante, la realización de exploraciones complementarias dolorosas aún sigue siendo una práctica muy extendida. Material y métodos: Estudio prospectivo realizado entre 2011 y 2015. Se incluyó a todos los recién nacidos con edad gestacional ≥ 35 semanas, asintomáticos al nacimiento que presentaban uno o más factores de riesgo infeccioso. Durante su estancia en maternidad se realiza observación clínica periódica para la detección de síntomas compatibles con infección. Resultados: De los 9.424 recién nacidos en este periodo, 1.425 cumplían los criterios de inclusión del estudio; 53 pacientes precisaron ingreso, la mitad de ellos por sospecha de infección, confirmándose finalmente solo en 7 este diagnóstico. Todos los pacientes presentaron clínica en las primeras 72 h de vida. Conclusiones: Los niños con factores de riesgo infeccioso que desarrollan una infección presentan clínica de forma precoz en las primeras horas tras el nacimiento. Este trabajo apoya la observación clínica estrecha como medida suficiente y segura para la detección de la sepsis neonatal precoz.

Resumen: Introducción: La sepsis vertical precoz es una causa importante de morbimortalidad neonatal. La evidencia científica apunta a que la mayoría de los recién nacidos infectados presentan clínica en las primeras horas de vida. Tras la aplicación de las medidas para la prevención de sepsis vertical y el descenso en su incidencia, se han propuesto cambios en el manejo de estos niños. No obstante, la realización de exploraciones complementarias dolorosas aún sigue siendo una práctica muy extendida. Material y métodos: Estudio prospectivo realizado entre 2011 y 2015. Se incluyó a todos los recién nacidos con edad gestacional ≥ 35 semanas, asintomáticos al nacimiento que presentaban uno o más factores de riesgo infeccioso. Durante su estancia en maternidad se realiza observación clínica periódica para la detección de síntomas compatibles con infección. Resultados: De los 9.424 recién nacidos en este periodo, 1.425 cumplían los criterios de inclusión del estudio; 53 pacientes precisaron ingreso, la mitad de ellos por sospecha de infección, confirmándose finalmente solo en 7 este diagnóstico. Todos los pacientes presentaron clínica en las primeras 72 h de vida. Conclusiones: Los niños con factores de riesgo infeccioso que desarrollan una infección presentan clínica de forma precoz en las primeras horas tras el nacimiento. Este trabajo apoya la observación clínica estrecha como medida suficiente y segura para la detección de la sepsis neonatal precoz. Abstract: Introduction: Early-onset neonatal sepsis refers to an infection which starts during the first 72 hours of birth, and can lead to significant morbidity and mortality. Scientific evidence shows that infected infants present with symptoms during the first hours after delivery. There has been a significant decrease in this condition with the implementation of guidelines for its prevention. However, International guidelines still recommend the evaluation of these infants using painful tests. Material and methods: A prospective cohort study was conducted on all asymptomatic infants born at > 35 weeks gestation with one or more risk factors in a single tertiary care centre from 2011 to 2015. They were periodically observed in newborn nursery from admission until discharge looking for signs of infection. Results: Out of the 9,424 babies born during this period, 1425 were included in the study. A total of 53 infants were admitted to the neonatal unit, half of them because of sepsis suspicion. Finally, just 7 were discharged with the diagnosis of sepsis. All these 7 presented with symptoms during their first 72 hours of life. No sepsis was reported in asymptomatic infants. Conclusions: Truly infected infants present with symptoms during their first hours of life. This study supports the observation of infants at risk as a safe practice to detect early-onset sepsis.

The dimensions and weight of machines, structures, and components that need to be transported safely by road are growing constantly. One of the safest and most widely used transport systems on the road today due to their versatility and configuration are modular trailers. These trailers have hydraulic pendulum axles that are that are attached in pairs to the rigid platform above. In turn, these modular trailers are subject to limitations on the load that each axle carries, the tipping angle, and the oil pressure of the suspension system in order to guarantee safe transport by road. Optimizing the configuration of these modular trailers accurately and safely is a complex task. Factors to be considered include the load’s characteristics, the trailer’s mechanical properties, and road route conditions including the road’s slope and camber, precipitation and direction, and force of the wind. This paper presents a theoretical model that can be used for the optimal configuration of hydraulic cylinder suspension of special transport by road using modular trailers. It considers the previously mentioned factors and guarantees the safe stability of road transport. The proposed model was validated experimentally by placing a nacelle wind turbine at different points within a modular trailer. The weight of the wind turbine was 42,500 kg and its dimensions were 5133 × 2650 × 2975 mm. Once the proposed model was validated, an optimization algorithm was employed to find the optimal center of gravity for load, number of trailers, number of axles, oil pressures, and hydraulic configuration. The optimization algorithm was based on the iterative and automatic testing of the proposed model for different positions on the trailer and different hydraulic configurations. The optimization algorithm was tested with a cylindrical tank that weighed 108,500 kg and had dimensions of 19,500 × 3200 × 2500 mm. The results showed that the proposed model and optimization algorithm could safely optimize the configuration of the hydraulic suspension of modular trailers in special road transport, increase the accuracy and reliability of the calculation of the load configuration, save time, simplify the calculation process, and be easily implemented.