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When this document was initially conceived, the main foreseen contents were linked to the (potentially differentiated) emotional needs of women and men in automated vehicles. The research and work developed during the DIAMOND project has contributed to widen the scope of this report to other fields beyond that of the emotions. In this sense, such aspects as the unfairness and inequality present in current cars need to be highlighted in a work of these characteristics. In addition, as Connected Automated Vehicles (CAVs) are still a product that is under development, we have considered it interesting to mention tools and methodologies in the guidelines that could be used to gain more knowledge of the needs and requirements of potential CAV passengers, especially girls and women. By doing so, we wanted to provide useful information which could contribute to improving fairness and equality in autonomous vehicles based on human factors and participatory design. This report contains the complete contents of the guidelines entitled ���Autonomous vehicles through gender perspective glasses. Designing a more inclusive and gender-fair autonomous car���. The structure of the guidelines is based on the following main blocks: Introduction and definitions Results and recommendations Although we are aware that the information presented in this report covers only a tiny albeit important part of all that is going on in the field of CAVs, our purpose is in any case multiple: Those familiar with the concepts of gender equality and fairness will be able to gain technical knowledge about CAVs, and to understand how their vision and knowledge is important to develop better vehicles. Those familiar with the automotive sector and those who are aware of all the challenging developments taking place in autonomous vehicles will benefit by its human-centered approach which stresses women���s needs and perceptions. Those absolutely new to either of the two fields will discover to what degree the development of the automotive sector means a breakthrough in terms of the traditional concept of a privately owned vehicle. They will also identify the potential of applying the concepts of equality and fairness to such a technological field.

Background: Drug provocation tests (DPTs) are considered the gold standard for diagnosing beta-lactam allergy. However, positive results tend to be mild and difficult to interpret. This study aimed to describe pediatric patients with a presumedly positive or inconclusive DPT, assess the decision to repeat the DPT, and describe its its outcome. Methods: Retrospective review of alt presumedly positive or inconclusive DPTs performed in six pediatric allergy clinics from 2017 to 2019. We describe the interpretation of results, focusing on the decision to repeat the DPT and its outcome. Results: Of 439 children challenged with a beta-lactam, 26 (5.9%) with a presumedly positive or inconclusive result were included in this study. Most were girls (n = 16, 61.5%), and the median age was 5 years (range 1-13). The initial DPT used amoxicillin (n = 13, 50.0%), amoxicillin-clavulanic acid (n = 12, 46.2%), or cefadroxil (n = 1, 3.8%). Reactions were early (n = 11, 42.3 %), delayed (n = 14, 53.8 %), or not registered (n = 1, 3.8 %), but mild in all cases. A second confirmatory DPT was proposed in 19 patients (73.1%) and performed in 17 patients (65.4%). Nine DPTs were performed from 1 day to 4 months after the first DPT, and the remaining eight took place 6 months to 2 years later. Fifteen children tolerated the drug in the second DPT: 88.2% of those reevaluated and 57.5% of the whole study group. Conclusion: The positive predictive value of DPT may be lower than expected. Given the mildness of observed reactions, a second confirmatory DPT is warranted within a few weeks or months. (C) 2022 Codon Publications. Published by Codon Publications.

Purpose The main objective of this article was to offer practical suggestions, given the existing evidence, for identifying and managing bacterial impetigo, abscess, and cellulitis in ambulatory and hospital settings. Methods Five Italian pediatric societies appointed a core working group. In selected conditions, specially trained personnel evaluated quality assessment of treatment strategies according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Only randomized controlled trials (RCTs) and observational studies were included for quality assessment according to the GRADE methodology. MEDLINE, Ovid MEDLINE, EMBASE, and Cochrane Library databases were searched with a strategy combining MeSH and free text terms. Findings The literature review included 364 articles focusing on impetigo, skin abscess, and cellulitis/orbital cellulitis. The articles included for quality assessment according to the GRADE methodology for impetigo comprised 5 RCTs and 1 observational study; for skin abscess, 10 RCTs and 3 observational studies were included; for cellulitis and erysipelas, 5 RCTs and 5 observational studies were included; and for orbital cellulitis, 8 observational studies were included. Recommendations were formulated according to 4 grades of strength for each specific topic (impetigo, skin abscesses, cellulitis, and orbital cellulitis). Where controversies arose and expert opinion was considered fundamental due to lack of evidence, agreement according to Delphi consensus recommendations was included. Implications Based on a literature review and on local epidemiology, this article offers practical suggestions for use in both ambulatory and hospital settings for managing the most common bacterial SSTIs.

Objectives: Modern implant coatings may increase osteointegration of orthopedic implants thereby achieving earlier secondary stability and reducing implant loosening. The most effective materials and optimal characteristics are currently unknown. This study aims to assess the effect of thin coatings[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019)

We present a numerical procedure for elastic and non linear analysis (including fracture situations) of solid materials and structures using the Discrete Element Method (DEM). It can be applied to strongly cohesive frictional materials such as concrete and rocks. The method consists on defining the non-local constitutive equations at the contact interfaces between discrete particles using the information provided by the stress tensor over the neighbour particles. The method can be used with different yield surfaces and in the paper it is applied to the analysis of fracture of concrete samples. Good comparison with experimental results is obtained.

Brash ice is the accumulation of floating ice made up of blocks no larger than two meters across. Navigation in brash ice is becoming more usual as new navigation routes are being opened in the Artic regions. This navigation brings new concerns regarding the interaction of ice blocks with the ship. This work presents recent advances towards the development of a computational model for simulation of this navigation condition including the interaction among the ship and the ice blocks. The computational tool developed in this work is based on the coupling of a Semi-Lagrangian Particle Finite Element Method (SL-PFEM) with a multi rigid-body dynamics tool. The Particle Finite Element Method (Idelsohn et al. 2004)is a versatile framework for the analysis of fluid-structure interaction problems. The PFEM combines Lagrangian particle-based techniques with the advantage of the integral formulation of the Finite Element Method (FEM). It has been shown (Idelsohn et al. 2014 andNadukandi et al. 2017) to successfully simulate a wide variety of complex engineering problems, e.g. free-surface/multi-fluid flows with violent interface motions, multi-fluid mixing and buoyancy-driven segregation problems etc. The latest development within the framework of the PFEM is the X-IVAS (eXplicit Integration along the Velocity and Acceleration Streamlines) scheme. It is a semi-implicit scheme built over a Semi-Lagrangian (SL) formulation of the PFEM. In this work, the SL-PFEM model has been coupled with a multibody dynamics solver, able to handle the interactions between thousands of bodies, representing the different ice blocks. The interaction between the fluid flow and the ice blocks is taking into account by enriching the finite element space at the boundaries of the different blocks. This work is part of the research project NICESHIP sponsored by the U.S. Office of Naval Research under Grant N62909-16-1-2236.

Se describen los conceptos básicos del método de partículas y elementos finitos (PFEM) para análisis de flujos de fluidos en lámina libre y su interacción con objetos sólidos y estructuras flotantes o sumergidas. Se presentan diversas aplicaciones del PFEM en los ámbitos de la ingeniería de puertos e hidráulica y al estudio de la caída de una avalancha sobre un embalse.

Background: The 2014 Guidelines for the Management of Patients with Valvular Heart Disease require to know the probability of success and operative mortality of Mitral Valve Repair (MVR) for Degenerative Mitral Insufficiency (DMI) at a given institution. Aim: To assess the probability of success, operative mortality and long-term results of MVR for DMI. Patients and methods: The database of the Cardiovascular Surgery Service was reviewed for the period December 1991 to December 2013. Long-term survival information was obtained from death certificate records of the Chilean Identification Service. Results: One hundred forty seven patients with DMI were identified, all operated by one author (RZ). In 28 (19%) the mitral valve was replaced, including three patients in whom a MVR was intended without success. A successful MVR was performed in 119 patients (81%). The probability of a successful MVR was 97.5% (119 of 122). Prolapsed posterior leaflet was present in 81% and annulus dilatation in 60% of cases. The most frequent surgical procedures were quadrilateral resection (83%) and chordal transfer (13%). A mitral annuloplasty was performed in 92% of cases. Operative mortality was 0.8%. At the end of a 9.9 (0 – 22.7) years follow-up, 87 patients (73%) were alive and mean survival was 16.9 years. Survival rates at 5, 10, 15 and 20 years were 91%, 78%, 71% and 50%, respectively. Six patients were re-operated, due to mitral valve dysfunction in three. Mean re-operation free survival was 21.4 years. Echocardiographic follow-up was 75% completed at an average of 64 months; 84% of cases had no or only 1+ mitral regurgitation. Conclusions: In our experience, MVR for DMI had an operative mortality below 1% and a probability of success greater than 95%, with excellent long-term results.

Background: In Chile, gallbladder cancer (GBC) is one of the most important causes of death and gallstone disease (GSD) is its main risk factor. Abdominal ultrasonography (AU) is used for the diagnosis of GSD and cholecystectomy is used to prevent it. Aim: To estimate GSD prevalence in the general population and to assess the diagnostic and therapeutic coverage of GSD as a preventive strategy for GBC in Chile. Material and Methods: A standardized digestive symptoms questionnaire of The 2009-2010 Chilean National Health Survey was answered by 5412 adults over 15 years old. Self-reports of AU, GBD and cholecystectomies were recorded. Results: The prevalence of biliary-type pain was 7.1%. During the last five years, the prevalence of AU was 16%. GSD was reported in 20% of these tests and 84% of them were asymptomatic. The prevalence of AU was significantly lower in Araucania region and among people with less than 12 years of education. Life cholecystectomy prevalence was 11% and reached 40% in people aged over 60 years. Women accounted for 75% of total cholecystectomies. Twenty-one percent of individuals who referred biliary-type pain, were studied with an AU. Only 60% of people with GSD confirmed by AU underwent a cholecystectomy. Conclusions: GSD affects at least 27% of the Chilean adult population. Important deficits and inequities in GSD diagnostic and therapeutic coverage were identified.

Background: Mitral valve repair is the preferred procedure for the surgical treatment of mitral valve insufficiency (MI), procedure that we initiated 20 years ago. Aim: To assess our experience and long-term results of mitral valve repair. Patients and Methods: The database of the cardiology department was reviewed for the period between December 1991 and December 2012. A total of 322 patients aged 18 to 89 years (62% males) undergoing mitral valve repair were identified. Long-term survival information was obtained consulting death certificate records of the Chilean Identification Service. The latest echocardiogram available was analyzed. Results: MI was degenerative in 144 patients (45%) and ischemic in 104 (32%). A prosthetic ring was used in all ischemic and in 92% of non-ischemic MI. Operative mortality was 7.5%, 13% in ischemic and 4.4% in non-ischemic MI (p < 0.01). Overall long-term survival was 14.1 years; 9.3 and 16 years for ischemic and non-ischemic MI, respectively (p < 0.001). Survival at 5, 10, 15 and 20 years was 79, 63, 54 and 42%, respectively. For degenerative MI survival at 5 and 10 years was 90 and 76% and for ischemic MI, it was 64 and 44%, respectively (p < 0.001). On a multivariate analysis the main predictors of late mortality were age, associated valvular disease and ischemic etiology. Echocardiographic follow-up was available for 223 patients; MI was absent in 53% and was mild in 29%. Conclusions: In a 20 years follow-up, mitral valve repair for MI had excellent long-term survival and echocardiographic results. The most common etiologies of MI were degenerative and ischemic diseases. The latter had a worst prognosis. The main predictors of long term mortality were age, associated valvular disease and ischemic etiology.

Introducción: El dolor es uno de los síntomas más frecuentes e importantes en el paciente hospitalizado, con una frecuencia hasta de 76.9%. El adecuado control del mismo es uno de los objetivos terapéuticos más buscados. Para lograr este objetivo, frecuentemente suelen usarse dosis inadecuadas de analgésicos, lo cual ocasiona reacciones adversas en los pacientes. El objetivo de este trabajo fue identificar los analgésicos de mayor uso en el paciente adulto hospitalizado y el rango de dosis de los mismos en un hospital de cuarto nivel de la ciudad de Bogotá. Métodos: Estudio observacional descriptivo de corte transversal en pacientes hospitalizados mayores de 18 años, con prescripción de analgésicos; seleccionados por muestreo aleatorio estratificado según servicio, entre julio a diciembre de 2013. Se evaluaron los analgésicos y las dosis prescritas, comparándolas con las dosis diarias máximas descritas para cada uno. El análisis de las variables sociodemográficas y farmacológicos se realizó con STATA 12. Resultados: Se evaluaron 355 historias clínicas de pacientes, encontrando 555 prescripciones de analgésicos. Los más usados fueron acetaminofén en 186 casos (33,5%) y tramadol en 167 (30,1%). El uso de tramadol y acetaminofén se encontró en un rango de dosis adecuado en el 99,4% y 90,9% respectivamente. Los otros opiáceos utilizdos diferentes a tramadol, se encontraron en el rango de dósis según indica la literatura. Se reportaron 2 casos con prescripción de 4 analgésicos y un caso con 5 analgésicos simultáneos. Conclusiones: Los analgésicos más utilizados en el paciente hospitalizado pertenecen al escalón I y II de la escala del manejo del dolor de la OMS, siendo los más frecuentes acetaminofén y tramadol. El uso de antiinflamatorios no esteroideos fue escaso, siendo el más relevante entre estos, diclofenaco. Las dosis utilizadas de analgésicos en general fueron adecuadas, pero para dipirona se observó sobredosificación muy frecuente. El analgésico para el cual hay un mayor porcentaje de casos de subdosificación fue butilbromuro de hioscina. Introduction: Pain is one of the most common and important symptoms inpatients, with a frequency of up to 76.9%. Proper control of the same is one of the most sought therapeutic targets. To achieve this goal, often inadequate doses of analgesics used, which causes adverse reactions in patients. The aim of this study was to identify the most widely used analgesics adult inpatient and the dose range of them at a hospital in fourth level of Bogota. Methods: Descriptive observational cross-sectional study inpatients over 18 years with prescription painkillers, selected by stratified random sampling according to service, from July to December 2013. Painkillers and prescribed doses were evaluated and compared with the maximum daily doses described for each one. The analysis of the sociodemographic and pharmacological variables was performed using STATA 12, Results: Medical records of 355 patients were evaluated, finding 555 prescription painkillers. The most used were acetaminophen in 186 cases (33.5%) and tramadol 167 (30.1%). The use of tramadol and acetaminophen was found an appropriate range of doses in 99.4% and 90.9% respectively. Two cases with 4 prescription painkillers and a case with 5 concurrent analgesics were found. Conclusions: The most commonly used in hospitalized patients analgesics belonging to stage I and II of the scale of pain management WHO, being the two main acetaminophen and tramadol. The use of NSAIDs was rare, the most important among these, diclofenac. Analgesic doses used were generally adequate, but dipyrone overdosing very frequently observed. The analgesic for which there is a higher percentage of cases of underdosing was hyoscine butylbromide.

Introducción: El dolor es uno de los síntomas más frecuentes e importantes en el paciente hospitalizado, con una frecuencia hasta de 76.9%. El adecuado control del mismo es uno de los objetivos terapéuticos más buscados. Para lograr este objetivo, frecuentemente suelen usarse dosis inadecuadas de analgésicos, lo cual ocasiona reacciones adversas en los pacientes. El objetivo de este trabajo fue identificar los analgésicos de mayor uso en el paciente adulto hospitalizado y el rango de dosis de los mismos en un hospital de cuarto nivel de la ciudad de Bogotá. Métodos: Estudio observacional descriptivo de corte transversal en pacientes hospitalizados mayores de 18 años, con prescripción de analgésicos; seleccionados por muestreo aleatorio estratificado según servicio, entre julio a diciembre de 2013. Se evaluaron los analgésicos y las dosis prescritas, comparándolas con las dosis diarias máximas descritas para cada uno. El análisis de las variables sociodemográficas y farmacológicos se realizó con STATA 12. Resultados: Se evaluaron 355 historias clínicas de pacientes, encontrando 555 prescripciones de analgésicos. Los más usados fueron acetaminofén en 186 casos (33,5%) y tramadol en 167 (30,1%). El uso de tramadol y acetaminofén se encontró en un rango de dosis adecuado en el 99,4% y 90,9% respectivamente. Los otros opiáceos utilizdos diferentes a tramadol, se encontraron en el rango de dósis según indica la literatura. Se reportaron 2 casos con prescripción de 4 analgésicos y un caso con 5 analgésicos simultáneos. Conclusiones: Los analgésicos más utilizados en el paciente hospitalizado pertenecen al escalón I y II de la escala del manejo del dolor de la OMS, siendo los más frecuentes acetaminofén y tramadol. El uso de antiinflamatorios no esteroideos fue escaso, siendo el más relevante entre estos, diclofenaco. Las dosis utilizadas de analgésicos en general fueron adecuadas, pero para dipirona se observó sobredosificación muy frecuente. El analgésico para el cual hay un mayor porcentaje de casos de subdosificación fue butilbromuro de hioscina. Introduction: Pain is one of the most common and important symptoms inpatients, with a frequency of up to 76.9%. Proper control of the same is one of the most sought therapeutic targets. To achieve this goal, often inadequate doses of analgesics used, which causes adverse reactions in patients. The aim of this study was to identify the most widely used analgesics adult inpatient and the dose range of them at a hospital in fourth level of Bogota. Methods: Descriptive observational cross-sectional study inpatients over 18 years with prescription painkillers, selected by stratified random sampling according to service, from July to December 2013. Painkillers and prescribed doses were evaluated and compared with the maximum daily doses described for each one. The analysis of the sociodemographic and pharmacological variables was performed using STATA 12, Results: Medical records of 355 patients were evaluated, finding 555 prescription painkillers. The most used were acetaminophen in 186 cases (33.5%) and tramadol 167 (30.1%). The use of tramadol and acetaminophen was found an appropriate range of doses in 99.4% and 90.9% respectively. Two cases with 4 prescription painkillers and a case with 5 concurrent analgesics were found. Conclusions: The most commonly used in hospitalized patients analgesics belonging to stage I and II of the scale of pain management WHO, being the two main acetaminophen and tramadol. The use of NSAIDs was rare, the most important among these, diclofenac. Analgesic doses used were generally adequate, but dipyrone overdosing very frequently observed. The analgesic for which there is a higher percentage of cases of underdosing was hyoscine butylbromide.

Background: The 2014 Guidelines for the Management of Patients with Valvular Heart Disease require to know the probability of success and operative mortality of Mitral Valve Repair (MVR) for Degenerative Mitral Insufficiency (DMI) at a given institution. Aim: To assess the probability of success, operative mortality and long-term results of MVR for DMI. Patients and Methods: The database of the Cardiovascular Surgery Service was reviewed for the period December 1991 to December 2013. Long-term survival information was obtained from death certificate records of the Chilean Identification Service. Results: One hundred forty seven patients with DMI were identified, all operated by one author (RZ). In 28 (19%) the mitral valve was replaced, including three patients in whom a MVR was intended without success. A successful MVR was performed in 119 patients (81%). The probability of a successful MVR was 97.5% (119 of 122). Prolapsed posterior leaflet was present in 81% and annulus dilatation in 60% of cases. The most frequent surgical procedures were quadrilateral resection (83%) and chordal transfer (13%). A mitral annuloplasty was performed in 92% of cases. Operative mortality was 0.8%. At the end of a 9.9 (0 - 22.7) years follow-up, 87 patients (73%) were alive and mean survival was 16.9 years. Survival rates at 5, 10, 15 and 20 years were 91%, 78%, 71% and 50%, respectively. Six patients were re-operated, due to mitral valve dysfunction in three. Mean re-operation free survival was 21.4 years. Echocardiographic follow-up was 75% completed at an average of 64 months; 84% of cases had no or only 1+ mitral regurgitation. Conclusions: In our experience, MVR for DMI had an operative mortality below 1% and a probability of success greater than 95%, with excellent long-term results.

Background: In Chile, gastric cancer (GC) is a major cause of cancer related deaths. The current screening strategy consists of an upper gastrointestinal endoscopy (UGE) for people aged 40 years or more with epigastric pain. Aim: To evaluate the diagnostic coverage of the use of UGE for early detection of GC in Chile. Material and Methods: As part of the digestive module of the 2009-10 National Health Survey, 5293 adults over 15 years were asked about the presence of epigastric pain, possible upper gastrointestinal bleeding (PUGB), use of proton pump inhibitors (PPIs) or histamine H2-receptor antagonists (H2RAs), family history of GC and having performed an UGE. Results: Persistent epigastric pain was observed in 3.4% of the population. PUGB signs were observed in 3.3% of the population. The prevalence of PPIs and H2RAs use was 4.3% and 2.2% respectively, reaching 21.6% in people aged 70 years and older. Life span prevalence of UGE was 18.3%, with differences by region, health insurance and educational level. UGE coverage in people aged 40 years or older with and without persistent epigastric pain was 14.4% and 3.2% respectively (Odds ratio 4.8, p < 0.01). The prevalence of UGE was similar among people with or without PUGB or family history of CG. Conclusions: The estimated coverage of the current GC prevention strategy in Chile is 14.4%, evaluated at a population level. Further studies are required to determine the impact of this strategy on early GC diagnosis and mortality.