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Under the sponsorship of the U.S. National Science Foundation, a workshop on emerging research opportunities in ceramic and glass science was held in September 2016. Reported here are proceedings of the workshop. The report details eight challenges identified through workshop discussions: Ceramic processing: Programmable design and assembly; The defect genome: Understanding, characterizing, and predicting defects across time and length scales; Functionalizing defects for unprecedented properties; Ceramic flatlands: Defining structure-property relations in free-standing, supported, and confined two-dimensional ceramics; Ceramics in the extreme: Discovery and design strategies; Ceramics in the extreme: Behavior of multimaterial systems; Understanding and exploiting glasses and melts under extreme conditions; and Rational design of functional glasses guided by predictive modeling. It is anticipated that these challenges, once met, will promote basic understanding and ultimately enable advancements within multiple sectors, including energy, environment, manufacturing, security, and health care.

Honey from the western region of Paraná receives the seal of origin and in-process denomination of origin because it is mostly produced in permanent preservation areas, adherence to hygiene and sanitary standards, proper management techniques and agro-industrial management. The objective of this study was to verify the microbiological quality of honey produced by beekeepers associated with Cooperative. Sixty-seven honey samples were evaluated for microbiological quality, and the mean values observed to total aerobic mesophiles were 2.52 log CFU/g; Clostridium spp. 1.46 log CFU/g; total coliforms 0.78 log CFU/g; fecal coliforms 0.50 log CFU/g; total yeasts 0.46 log CFU/g, and 2.95 log CFU/g total molds. The evaluations showed the incidence of anaerobic mesophilic in 70% of the samples, Clostridium spp. 77%; total coliforms 60%, fecal coliforms 62%, molds 83% and 34% yeasts. Five genera of the isolated molds commonly found in honey were Fusarium spp. 0.35 log CFU/g; Aspergillus spp. 0.52 log CFU/g; Cladosporium spp. 1.2 log CFU/g, Phoma spp. 0.71 log CFU/g and 0.16 log CFU/g Penicillium spp. Multivariate analysis showed the formation of two groups and indicated the heterogeneity in the bacterial load of the samples. Although microbiological analyses were not mandatory for honey, these results demonstrated the hygienic-sanitary quality of the samples of honey produced. For the reduction of secondary-origin microorganisms, the handlers were recommended to follow the sanitary hygiene norms and handling techniques.

En Ecuador el crédito comercial actúa como fuente de financiación entre las pequeñas empresas, sin embargo, existe evidencia acerca del bajo acceso y uso de este tipo de crédito por parte de las pertenecientes al sector de manufacturas, además de que provoca un efecto positivo en la producción de las mismas. El presente trabajo revisa datos secundarios de fuentes oficiales analizando la evolución de la relación entre la producción, medida por sus ventas, y las cuentas por pagar a proveedores e instituciones financieras (2007-2017) de las pequeñas empresas manufactureras ecuatorianas. Se observó que existe una relación directa-positiva de los ingresos y el uso del crédito de proveedores. A través de una modelación econométrica que postula una extensión a la función de producción Cobb-Douglas de carácter modificada, se consideró como argumento adicional la variable “S” crédito de proveedores. Mediante entrevistas en profundidad a gerentes de pequeñas empresas, se exploraron los factores que determinan el uso de crédito de proveedores como alternativa de financiamiento. De esta manera se pudo caracterizar el crédito comercial acorde con la facilidad de obtención, orígenes, fidelidad, mecanismo de pago, que son aspectos que influyen en la decisión del volumen del crédito y el plazo a convenir para tal operación. Así mismo se pudo evidenciar las limitaciones que los empresarios tienen para el acceso hacia el crédito bancario. || In Ecuador the commercial credit acts as a financing source between the small companies, however, exists evidence about the low access and uses of this type of credit by firms belonged to manufacturing sector, furthermore it causes a positive effect on the production of them. In this paper, a review of secondary data from official sources was developed in which series of evolution data about the relationship between production, measured by sales, and accounts payable to suppliers and financial institutions were analyzed. (2007-2017) of the small Ecuadorian manufacturing companies, it was observed that there is a direct-positive relationship between income and the use of credit from suppliers. Through an econometric modeling that postulates an extension to the Cobb-Douglas production function of a modified nature, the variable "S" supplier credit was considered as an additional argument. Through in-depth interviews with managers of small companies, the factors that determine the use of credit from suppliers as an alternative to financing were explored. In this way, commercial credit could be characterized according to the ease of obtaining, origins, loyalty, payment mechanism, that they are aspects that influence in the decision of the volume of the credit and the term to agree for such operation; Likewise, it was possible to demonstrate the limitations that entrepreneurs have for access to bank credit, such as guarantees, high interest rates and non-competitive conditions.

The information technology infrastructure library (ITIL) standard describes processes that should be implemented in Information Technology (IT) departments for proper operations management, which includes human resources management, economic management, and strategic management, among others. This should be especially considered in the business management of industries with no relation to information technologies (IT), such as tourism and hospitality companies. This work aims to present a method to establish the order of adoption of the IT management processes in companies that belong to the tourism industry. We conducted a survey to obtain the necessary data and developed a methodology that is based on an optimization procedure. This procedure generates the optimal sequence of IT tasks to adopt in a generic small company in the tourism industry. The methodology was then applied to a representative tourism company. Through the sequence obtained, it is shown that it is necessary to implement operative processes, and subsequently, strategic processes. A comparative study was developed to find the differences with other authors’ proposals. The most important result we found was the possibility of efficient use of organizations’ information to build an optimized list of IT procedures to improve their administration. The obtained list of processes is specific for each organization, and not dependent on the solutions offered by other authors who proposed a general or underoptimal list of processes.

El presente artículo tiene como objetivo identificar los perfiles de los diferentes segmentos de turistas que visitan el destino turístico Trinidad de Cuba, declarada Patrimonio de la Humanidad por la UNESCO en 1998. La metodología parte de un análisis factorial exploratorio y luego una clasificación basada en un algoritmo mixto: clasificación jerárquica con el método de Ward y agregación alrededor de centros móviles (K-medias), se realizó una encuesta aplicada por cuestionario a 484 turistas y excursionistas que visitan el destino por motivaciones turísticas. Los resultados obtenidos permitieron la identificación de dos segmentos de turistas: Turismo cultural patrimonial y Turismo de Naturaleza, que según los resultados de los test estadísticos, ambos grupos difieren significativamente en cuanto a sus rasgos demográficos; características del viaje; relación con el producto o servicio (motivaciones) y evaluación y fidelidad del destino. Este artículo brinda información relevante a actores territoriales involucrados en el turismo, para que puedan mejorar la calidad de sus productos y servicios. Permite renovar productos segmentados para alcanzar un mejor posicionamiento turístico en correspondencia con los perfiles de turistas y el mercado objetivo

El objetivo de esta investigación es analizar el efecto que tiene el canal del crédito en la determinación del precio de la vivienda nueva en Medellín - Colombia. Utilizando un modelo de ecuaciones simultáneas, estimado por sistema de ecuaciones aparentemente no relacionadas y mínimos cuadrados en tres etapas, los principales resultados evidencian que la tasa de interés hipotecaria y el Fondo de Reserva para la Estabilización de la Cartera Hipotecaria (FRECH) son las variables que presentan mayor efecto sobre los precios de la demanda de vivienda nueva; mientras que la tasa de interés presenta una relación inversa con la demanda de vivienda, el FRECH tiene una relación positiva. Una caída del 1% de la tasa de interés hace que el precio del M2 aumente en $COP 46.865. Esto resalta la importancia que tiene el canal del crédito para incentivar el sector constructor de una economía. Además, por medio de un modelo de vectores autorregresivos estructurales, encontramos que el impacto de un choque de la Unidad de Valor Real (UVR) sobre el precio de la vivienda nueva en Medellín es que el precio del metro cuadrado es elástico ante variaciones en la UVR en el corto plazo (2 meses). || We analyze the credit channel effects on new residential property prices in Medellín, Colombia, using a simultaneous equations model. Our empirical results show that the main determinants of new residential properties prices are mortgage interest rates and the availability of government sponsored subsidies to homebuyers (GS). An increase of one percent in mortgage interest rates reduces the demand of new residential properties and increases their price by COP $46,865 per square meter. Greater availability of government of GS increases the demand for new residential properties. Using a structural VAR, we find that a positive shock to a proxy for the real interest rate (unit of real value, URV) of one standard deviation leads to a reduction of the price of new residential properties in Medellín.

Blanca Murillo-Ortiz,1 Sandra Martínez-Garza,1 David Suárez García,1 Rosa del Carmen Castillo Valenzuela,2 Juan Francisco García Regalado,2 Gerardo Cano Velázquez1 1Institute Mexican of Social Security, Department Oncology, Unit of Research in Clinical Epidemiology, 2Department of Medical Sciences, University of Guanajuato, León Guanajuato, Mexico Introduction: Several studies have reported an increase in breast cancer (BC) risk when patients are carriers of the CYP19 TTA polymorphism with ≥10 repeats; moreover, it has been reported that telomere length is associated with a higher susceptibility of developing cancer. Objective: The objective of this study was to understand the relationship between CYP19 TTTA repetition polymorphism and telomere length and its effects on serum estradiol, estrone and follicle-stimulating hormone (FSH). Materials and methods: A total of 180 postmenopausal healthy and 70 BC-diagnosed women were included. Telomere length was determined through real-time quantitative polymerase chain reaction, and aromatase polymorphism was analyzed through DNA; both samples were obtained from circulating leukocytes. Serum estrone, estradiol and FSH were determined by enzyme-linked immunosorbent assay. Results: Patients with a BC diagnosis showed >10 repetitions more frequently, compared with that of healthy women (50% vs 23%, Χ2 =11.44, p=0.0007). A significant difference in telomere length between healthy and BC women was observed (5,042.7 vs 2,256.7 pb, Z=4.88, p10 repeats. Moreover, telomere length showed an inverse relationship with the number of repeats of the aromatase polymorphism in healthy women (R2=0.04, r= -0.24); in contrast, BC patients did not display this relationship. In addition, telomere length presented an inverse relationship with serum levels of estradiol and estrone in BC patients (p=0.02). Conclusion: Telomere length is shorter in BC patients than in healthy patients. The CYP19 TTTA repeat polymorphism is associated with serum levels of estradiol and estrone in both healthy women and BC patients, being higher in those with polymorphism carriers >10 repeats. Telomere length has an inverse correlation with the number of repeats of the aromatase polymorphism in healthy women but not in BC women. Estradiol and estrone levels in BC women have an inverse relationship with telomere length. Keywords: telomere length, CYP19 polymorphism, breast cancer

Uno de los sectores económicos estratégicos más importantes en cualquier economía es el Mercado de Energía Mayorista, cuya característica fundamental es que se trata de un mercado oligopolístico, provocado por la barrera de entrada que supone tener economías de escala. De esta manera, los agentes pueden presentar comportamientos estratégicos que contribuyen a la maximización de sus utilidades, los cuales se ven reflejados en la oferta diaria del precio y de la cantidad de energía por hora en cada una de sus centrales de generación. En este trabajo se presenta una metodología para la estimación de los precios diarios a los que ofertan la energía que producen los principales recursos hídricos y térmicos en Colombia. Se emplean dos herramientas de Inteligencia Artificial: la Lógica Difusa y las Redes Neuronales. Dichas técnicas resultan ser parcialmente efectivas para seguir las tendencias de dichos precios. También se comparan los resultados con los de modelos autorregresivos, que resultan ser inapropiados para el caso de estudio. || One of the most important economic strategic sectors in any economy is the electricity market. Its main feature is its oligopolistic character favoured by the returns to scale which act as an entry barrier. As a result, the energy generators can use their power market in order to increase their benefits through the daily offered price and quantity of energy for each of their power plants. This paper presents a methodology for estimating the daily offered price of the most important power stations in Colombia (hydraulic and thermal) by applying artificial intelligence techniques: Fuzzy Logic and Neural Networks. Such techniques are found to be partially useful particularly for price tendencies. It also compares the results with autoregressive models that turned out inappropriate for the case of study.

Cuando ocurre infección por el virus de hepatitis A (VHA), virus de hepatitits B (VHB), virus de hepatitis C (VHC) virus de hepatitis D o virus de hepatitis E (VHE) el cuadro clínico y bioquímico es similar, por lo que se hace necesario recurrir a pruebas de laboratorio diferentes a las de función hepática para identificar con certeza el agente etiológico; dentro de estas se encuentran: la serología, que permite detectar antígenos virales o anticuerpos contra estos y las pruebas moleculares que permiten detectar el genoma viral. Para diagnosticar la existencia de una infección actual por alguno de estos virus basta con la realización de pruebas serológicas, excepto en el caso del infección por VHC para la que es necesario realizar detección del genoma viral. Las pruebas moleculares son de gran utilidad para el seguimiento y la toma de decisiones terapéuticas en los pacientes con infección crónica por VHB o VHC.

O objetivo do presente ensaio foi testar quatro tipos comerciais de cúpulas distintas quanto à coloração, altura, volume e diâmetro, na aceitação das larvas transferidas e na produção de geléia real e rainhas. A cúpula que apresentou maior aceitação foi a alaranjada (55,6%), seguida da amarela (37,3%), azul (36,5%) e branca (26,9%). As cúpulas que apresentaram maior peso de geléia real foram branca (347,7 mg), alaranjada (312,3 mg), amarela (284,0 mg) e azul (202,8 mg). O peso das larvas retiradas no momento da coleta de geléia real não apresentou diferença nas cúpulas de diferentes colorações sendo, em média, 42,0 ± 49,6 mg. O peso das rainhas recém-emergidas foi maior na cúpula branca (190,2 mg), seguida da alaranjada (181,0 mg), amarela (175,4 mg) e azul (147,5 mg). O volume das realeiras não apresentou diferença nas cúpulas de diferentes colorações sendo, em média, 822,5 mm³. Com relação às cúpulas de cera, tanto a porcentagem de aceitação quanto a quantidade de geléia real produzida não apresentaram diferença entre os tratamentos. A porcentagem de aceitação nas cúpulas de cera maiores foi 18,2% e nas cúpulas menores, 12,1%. A quantidade de geléia real produzida nas cúpulas de cera menores foi 151,4 mg e nas maiores foi 137,5 mg. As cúpulas branca, alaranjada e amarela apresentaram maior quantidade de geléia real por cúpula (347,7 mg, 312,3 mg e 284,0 mg, respectivamente), entretanto, a maior quantidade total de geléia real produzida por colméia, foi obtida com as cúpulas alaranjadas (1389,40 mg). Para a produção de rainhas também sugere-se o uso das cúpulas alaranjadas

Abstract In 2009, a newly discovered human retrovirus, xenotropic murine leukemia virus (MuLV)-related virus (XMRV), was reported by Lombardi et al. in 67% of persons from the US with chronic fatigue syndrome (CFS) by PCR detection of gag sequences. Although six subsequent studies have been negative for XMRV, CFS was defined more broadly using only the CDC or Oxford criteria and samples from the US were limited in geographic diversity, both potentially reducing the chances of identifying XMRV positive CFS cases. A seventh study recently found polytropic MuLV sequences, but not XMRV, in a high proportion of persons with CFS. Here we tested blood specimens from 45 CFS cases and 42 persons without CFS from over 20 states in the United States for both XMRV and MuLV. The CFS patients all had a minimum of 6 months of post-exertional malaise and a high degree of disability, the same key symptoms described in the Lombardi et al. study. Using highly sensitive and generic DNA and RNA PCR tests, and a new Western blot assay employing purified whole XMRV as antigen, we found no evidence of XMRV or MuLV in all 45 CFS cases and in the 42 persons without CFS. Our findings, together with previous negative reports, do not suggest an association of XMRV or MuLV in the majority of CFS cases.

Abstract Xenotropic murine leukemia virus-related virus (XMRV) is a retrovirus implicated in prostate cancer and chronic fatigue syndrome (CFS). Press releases have suggested that it could contribute to autism spectrum disorder (ASD). In this study we used two PCR assays and one antibody assay to screen 25 blood samples from autistic children born to mothers with CFS and from 20 mixed controls including family members of the children assayed, people with fibromyalgia and people with chronic Lyme disease. Using a real-time PCR assay, we screened an additional 48 South Carolina autism disorder samples, 96 Italian ASD samples, 61 South Carolina ASD samples and 184 healthy controls. Despite having the ability to detect low copy number XMRV DNA in a large background of cellular DNA, none of the PCR assays found any evidence of XMRV infection in blood cells from patients or controls. Further, no anti-XMRV antibodies were detected, ruling out possible low level or abortive infections in blood or in other reservoirs. These results imply that XMRV is not associated with autism.

This study proposes simulating the cooking of eggs by modeling fluid egg products as phase-change materials (PCMs) within a computational fluid dynamics (CFD) model. A simplified physical prototype was built to conduct experiments to tune a simpler version of the mathematical model. The information was later used to build a complete mathematical model of a real egg that was compared with experimental data. Phase transition temperature ranges, and the energy required to initialize the transition were specified. Heat transfer coefficients were estimated for both models. Experiments for thermal processing and phase change were conducted at temperatures between 90 and 100 °C. The real egg model was validated with experimental data reported elsewhere. The simulations assess the time required to cook an egg (800-1200 s), demonstrating a homogeneous increase in temperature and phase transition. However, potential overestimation in simulations was observed, likely due to differences in quantifying techniques and non-uniform cooking processes., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Microlattices hold significant potential for developing lightweight structures for the aeronautics and astronautics industries. Laser Powder Bed Fusion (LPBF) is an attractive method for producing these structures due to its capacity for achieving high-resolution, intricately designed architectures. However, defects, such as cracks, in the as-printed alloys degrade mechanical properties, particularly tensile strength, and thereby limit their applications. This study examines the effects of microlattice architecture and relative density on crack formation in the as-printed 718 superalloy. Complex microlattice design and higher relative density are more prone to large-scale crack formation. The mechanisms behind these phenomena are discussed. This study reveals that microlattice type and relative density are crucial factors in defect formation in LPBF metallic alloys. The transmission electron microscopy observations show roughly round γ″ precipitates with an average size of 10 nm in the as-printed 718 without heat treatment. This work demonstrates the feasibility of the additive manufacturing of complex microlattices using 718 superalloys towards architectured lightweight structures.

Ceramic materials with high strength and chemical inertness are widely used as engineering materials. However, the brittle nature limits their applications as fracture occurs before the onset of plastic yielding. There has been limited success despite extensive efforts to enhance the deformability of ceramics. Here we report a method for enhancing the room temperature plastic deformability of ceramics by artificially introducing abundant defects into the materials via preloading at elevated temperatures. After the preloading treatment, single crystal (SC) TiO 2 exhibited a substantial increase in deformability, achieving 10% strain at room temperature. SC α-Al 2 O 3 also showed plastic deformability, 6 to 7.5% strain, by using the preloading strategy. These preinjected defects enabled the plastic deformation process of the ceramics at room temperature. These findings suggest a great potential for defect engineering in achieving plasticity in ceramics at room temperature.

The electrochemical response characteristics of existing and emerging porous electrode theory (PET) models was benchmarked to establish a common basis to assess their physical reaches, limitations, and accuracy. Three open source PET models: dualfoil, MPET, and LIONSIMBA were compared to simulate the discharge of a LiMn 2 O 4 -graphite cell against experimental data. For C-rates below 2C, the simulated discharge voltage curves matched the experimental data within 4% deviation for dualfoil, MPET, and LIONSIMBA, while for C-rates above 3C, dualfoil and MPET show smaller deviations, within 5%, against experiments. The electrochemical profiles of all three codes exhibit significant qualitative differences, despite showing the same macroscopic voltage response, leading the user to different conclusions regarding the battery performance and possible degradation mechanisms of the analyzed system., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Currently, the modeling of complex chemical-physical processes is drastically influencing industrial development. Therefore, the analysis and study of the combustion process of the boilers using machine learning (ML) techniques are vital to increase the efficiency with which this equipment operates and reduce the pollution load they contribute to the environment. This work aims to predict the emissions of CO, CO 2 , NOx, and the temperature of the exhaust gases of industrial boilers from real data. Different ML algorithms for regression analysis are discussed. The following are input variables: ambient temperature, working pressure, steam production, and the type of fuel used in around 20 industrial boilers. Each boiler's emission data was collected using a TESTO 350 Combustion Gas Analyzer. The modeling, with a machine learning approach using the Gradient Boosting Regression algorithm, showed better performance in the predictions made on the test data, outperforming all other models studied. It was achieved with predicted values showing a mean absolute error of 0.51 and a coefficient of determination of 99.80%. Different regression models (DNN, MLR, RFR, GBR) were compared to select the most optimal. Compared to models based on Linear Regression, the DNN model has better prediction performance. The proposed model provides a new method to predict CO 2 , CO, NOx emissions, and exhaust gas outlet temperature., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Direct access to internal temperature readings in lithium-ion batteries provides the opportunity to infer physical information to study the effects of increased heating, degradation, and thermal runaway. In this context, a method to insert temperature sensors into commercial 18650 cells to determine the short- and long-term effects through characterization testing is developed. Results show that sensor insertion only causes a decrease in capacity of 0.5-2.3%, and an increase in DC resistance of approximately 15 mΩ. The temperatures of the modified cells are approximately 0.5 °C higher than the control cells, the difference between the internal and external temperature readings of the modified cells is approximately 0.4 °C, and the modified cells exhibit the same temperature behavior and trend during cycling as the control cells. The cells are able to operate and collect data for 100-150 cycles before their capacities fade and resistances increase beyond what is observed in the control cells. The results of the testing show that cells modified with internal temperature sensors provide useful internal temperature data for cells that have experienced little or no cyclic aging., (© 2023. Springer Nature Limited.)

Protein-DNA interactions are determinant of the regulation of gene expression in living organisms. Luminescence studies have been used in a wide range of techniques to identify how gene transcription can be regulated by proteins such as transcription factors (TFs). Despite the great advances in the use of luciferases as reporters in the performance of this mechanism, some of them still have disadvantages that have been tried to be solved by the generation of new luciferases that induce a more stable and perfectly visualizable reaction. NanoLuc is a recently described luciferase that has been characterized by its efficient, stable, and powerful luminescence. These qualities have been considered to create a new and efficient reporter system to detect protein-DNA interactions. In this chapter, we take advantage of NanoLuc and describe its use in a reliable procedure to detect protein-DNA interactions in Nicotiana benthamiana extracts and entire leaves., (© 2023. Springer Science+Business Media, LLC, part of Springer Nature.)

The quantification of microstructural properties to optimize battery design and performance, to maintain product quality, or to track the degradation of LIBs remains expensive and slow when performed through currently used characterization approaches. In this paper, a convolution neural network-based deep learning approach (CNN) is reported to infer electrode microstructural properties from the inexpensive, easy to measure cell voltage versus capacity data. The developed framework combines two CNN models to balance the bias and variance of the overall predictions. As an example application, the method was demonstrated against porous electrode theory-generated voltage versus capacity plots. For the graphite|LiMn[Formula: see text]O[Formula: see text] chemistry, each voltage curve was parameterized as a function of the cathode microstructure tortuosity and area density, delivering CNN predictions of Bruggeman's exponent and shape factor with 0.97 [Formula: see text] score within 2 s each, enabling to distinguish between different types of particle morphologies, anisotropies, and particle alignments. The developed neural network model can readily accelerate the processing-properties-performance and degradation characteristics of the existing and emerging LIB chemistries., (© 2022. The Author(s).)

Aims: The study assessed the association between the presence of type2 diabetes mellitus (T2DM) and mortality in women with breast cancer (BC)., Methods: A matched pair case-control study was conducted at the State Cancer Center, which is located in Xalapa, Veracruz, Mexico. It was matched by age (±3 years) within a cohort of 1442 patients with BC. Descriptive statistics were performed. Analysis through paired odds ratio (OR and multivariate analyses were used to calculate the association between BC mortality and the variables studied., Results: 166 cases and 166 controls with confirmed diagnosis of BC were studied, with a mean age of 52.9 ± 11.9 years. The T2DM was associated with an increased mortality of women with BC (OR = 1.75 95 %CI 1.06-2.89). Similarly, metastasis (OR = 14.17 95 %CI 6.19-32.342), advanced clinical stage (OR = 3.04 95 %CI 1.45 - 6.38), and the molecular subtypes Her2 (OR = 2.0 95 %CI 1.02-3.92), and triple negative (OR = 3.54 95 %CI 1.72-7.32). There was no difference in mean glucose between cases and controls (208.9 ± 132 vs 194.4 ± 90.4 mg/dL, respectively)., Conclusion: T2DM was found to be a relevant risk factor for BC mortality in this Mexican population. Thus, it is important to consider the presence and evolution of DM in the prevention programs, diagnostic algorithms and treatments established for BC., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Discrete-event simulation (DES) is a stochastic modeling approach widely used to address dynamic and complex systems, such as healthcare. In this review, academic databases were systematically searched to identify 231 papers focused on DES modeling in healthcare. These studies were sorted by year, approach, healthcare setting, outcome, provenance, and software use. Among the surveys, conceptual/theoretical studies, reviews, and case studies, it was found that almost two-thirds of the theoretical articles discuss models that include DES along with other analytical techniques, such as optimization and lean/six sigma, and one-third of the applications were carried out in more than one healthcare setting, with emergency departments being the most popular. Moreover, half of the applications seek to improve time- and efficiency-related metrics, and one-third of all papers use hybrid models. Finally, the most popular DES software is Arena and Simul8. Overall, there is an increasing trend towards using DES in healthcare to address issues at an operational level, yet less than 10% of DES applications present actual implementations following the modeling stage. Thus, future research should focus on the implementation of the models to assess their impact on healthcare processes, patients, and, possibly, their clinical value. Other areas are DES studies that emphasize their methodological formulation, as well as the development of frameworks for hybrid models.