Comparison of Mechanical Properties of Hemp-Fibre Biocomposites Fabricated with Biobased and Regular Epoxy Resins.

Bio- and green composites are mainly used in non-structural automotive elements like interior panels and vehicle underpanels. Currently, the use of biocomposites as a worthy alternative to glass fibre-reinforced plastics (GFRPs) in structural applications still needs to be fully evaluated. In the current study, the development of a suited biocomposites started with a thorough review of the available raw materials, including both reinforcement fibres and matrix materials. Based on its specific properties, hemp appeared to be a very suitable fibre. A similar analysis was conducted for the commercially available biobased matrix materials. Greenpoxy 55 (with a biocontent of 55%) and Super Sap 100 (with a biocontent of 37%) were selected and compared with a standard epoxy resin. Tensile and three-point bending tests were conducted to characterise the hemp-based biocomposite.

Development and Feasibility of an App to Decrease Risk Factors for Type 2 Diabetes in Hispanic Women With Recent Gestational Diabetes (Hola Bebé, Adiós Diabetes): Pilot Pre-Post Study.

BACKGROUND: Hispanic women have increased risk of gestational diabetes mellitus (GDM), which carries an increased risk for future type 2 diabetes, compared to non-Hispanic women. In addition, Hispanic women are less likely to engage in healthy eating and physical activity, which are both risk factors for type 2 diabetes. Supporting patients to engage in healthy lifestyle behaviors through mobile health (mHealth) interventions is increasingly recognized as a viable, underused tool for disease prevention, as they reduce barriers to access frequently experienced in face-to-face interventions. Despite the high percentage of smartphone ownership among Hispanics, mHealth programs to reduce risk factors for type 2 diabetes in Hispanic women with prior GDM are lacking. OBJECTIVE: This study aimed to (1) develop a mobile app (¡Hola Bebé, Adiós Diabetes!) to pilot test a culturally tailored, bilingual (Spanish/English) lifestyle program to reduce risk factors for type 2 diabetes in Hispanic women with GDM in the prior 5 years; (2) examine the acceptability and usability of the app; and (3) assess the short-term effectiveness of the app in increasing self-efficacy for both healthy eating and physical activity, and in decreasing weight. METHODS: Social cognitive theory provided the framework for the study. A prototype app was developed based on prior research and cultural tailoring of content. Features included educational audiovisual modules on healthy eating and physical activity; personal action plans; motivational text messages; weight tracking; user-friendly, easy-to-follow recipes; directions on building a balanced plate; and tiered badges to reward achievements. Perceptions of the app's acceptability and usability were explored through four focus groups. Short-term effectiveness of the app was tested in an 8-week single group pilot study. RESULTS: In total, 11 Hispanic women, receiving care at a federally qualified community health center, aged 18-45 years, and with GDM in the last 5 years, participated in four focus groups to evaluate the app's acceptability and usability. Participants found the following sections most useful: audiovisual modules, badges for completion of activities, weight-tracking graphics, and recipes. Suggested modifications included adjustments in phrasing, graphics, and a tiering system of badges. After app modifications, we conducted usability testing with 4 Hispanic women, with the key result being the suggestion for a "how-to tutorial." To assess short-term effectiveness, 21 Hispanic women with prior GDM participated in the pilot. There was a statistically significant improvement in both self-efficacy for physical activity (P=.003) and self-efficacy for healthy eating (P=.007). Weight decreased but not significantly. Backend process data revealed a high level of user engagement. CONCLUSIONS: These data support the app's acceptability, usability, and short-term effectiveness, suggesting that this mHealth program has the potential to fill the gap in care experienced by Hispanic women with prior GDM following pregnancy. Future studies are needed to determine the effectiveness of an enhanced app in a randomized controlled trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT04149054; https://clinicaltrials.gov/ct2/show/NCT04149054.

Progressive edemas and generalized telangiectasia: A presentation of Intravascular B-cell Lymphoma.

Intravascular B-cell Lymphoma is a rare lymphoproliferative disorder with a none specific clinical presentation. The association of cutaneous telangiectasia-like lesions and elevated inflammatory markers should be guaranteed a skin biopsy.

Melanoma anorrectal en paciente nonagenaria / Anorectal melanoma in a nonagenarian patient

No disponible

Estilos de liderazgo que ejercen las enfermeras jefes que laboran en los Servicios de Hospitalización del segundo nivel de atención, según la percepción de los estudiantes / Styles of leadership exercised by the chiefs nurses working in the hospitalization services of the second level of care, according to the perception of students

La presente investigación tuvo como objetivo determinar los Estilos de Liderazgo que ejercen las enfermeras jefes que laboran en un servicio de hospitalización según la percepción de los estudiantes de enfermería de la UNMSM; con el propósito de proporcionar información válida a las instancias correspondientes a fin de que los hallazgos constituyan las bases sobre las cuales se pueda plantear estrategias tendentes a los estilos de liderazgo que se va a ejercer en las instituciones educativas las cuales deben ser aprendidas y ejercidas por parte de los futuros enfermeros. Es de tipo cuantitativo y el método es descriptivo exploratorio, la población estuvo constituida por 68 alumnos del quinto año de la E.A.P.E. de la UNMSM de ambos sexos. Se usó como instrumento la Escala Likert modificada. Luego de analizar los resultados se llegó a las siguientes conclusiones: La mayoría opinan que el Estilo de liderazgo que predominan en las Enfermeras jefes que laboran en el centro hospitalario es la Transformacional. Además dentro de las características encontramos un gran porcentaje que opinan que es medianamente favorable para el carisma y para la inspiracional hay una gran mayoría que opina que es medianamente favorable con tendencia a lo favorable, para la estimulación intelectual una gran mayoría opinan que es medianamente favorable y para la consideración individualizada en su mayoría opinan que es medianamente favorable.

This research had objectives to determine the leadership styles exerted by the head nurses who working in inpatient service as perceived by nursing students of San Marcos nurses, for the purpose of providing accurate information to the appropriate authorities so that the findings constitute the basis on which to plan strategies aimed at leadership styles to be exercising in health institutions by head nurses. It is quantitative and descriptive exploratory method, the population consisted of 68 students in the fifth year of E.A.P.E. of the UNMSM of both sexes. I was used as an instrument modified Likert Scale. After analyzing the results reached the following conclusions: Most believe that the leadership style prevailing in the heads Nurses who work in the hospital is Transformational. Besides the features found in a large percentage who think that is fairly favorable for the inspirational charisma and there is a large majority that believes that it is fairly favorable prone to favorable intellectual stimulation for a large majority think that is fairly favorable and individualized consideration mostly think that is fairly favorable.

Changes in the redox status and inflammatory response in handball players during one-year of competition and training.

The present research was designed to evaluate the adaptive responses to oxidative stress and inflammation in handball players subjected to well-controlled training intervals over one-year of competition. Seven blood samples were collected over the season of the study, approximately one a month. Plasma lipid peroxidation, nitrite, cytokines (IL-1ß, IL-6, INFγ and TNFα), and the glutathione cycle in erythrocytes, were measured. Exercise intensity, measured with the Borg's scale, increased significantly up to the middle of the competition season, coinciding with maximal creatine kinase and lactate dehydrogenase values, and then decreased at the end of the study. The inflammatory markers including nitrite, IL-1ß, IL-6, and, to a lesser extent INFγ, increased early in the training season, and remained elevated until the end of the study. TNFα, however, remained low during the season. The oxidative stress response included a transient increase of the glutathione disulphide/glutathione ratio and glutathione reductase activity at the beginning of the study, returning to basal values somewhat later. Glutathione peroxidase also increased at the end of the training season, and lipid peroxidation levels remained low during the athletic season. These results suggest that well-trained athletes were best adapted to the oxidative response, although the beneficial effects of some of the inflammatory cytokines on skeletal muscle myogenesis and repair cannot be ruled out.

TELMA: Technology-enhanced learning environment for minimally invasive surgery.

BACKGROUND: Cognitive skills training for minimally invasive surgery has traditionally relied upon diverse tools, such as seminars or lectures. Web technologies for e-learning have been adopted to provide ubiquitous training and serve as structured repositories for the vast amount of laparoscopic video sources available. However, these technologies fail to offer such features as formative and summative evaluation, guided learning, or collaborative interaction between users. METHODOLOGY: The "TELMA" environment is presented as a new technology-enhanced learning platform that increases the user's experience using a four-pillared architecture: (1) an authoring tool for the creation of didactic contents; (2) a learning content and knowledge management system that incorporates a modular and scalable system to capture, catalogue, search, and retrieve multimedia content; (3) an evaluation module that provides learning feedback to users; and (4) a professional network for collaborative learning between users. Face validation of the environment and the authoring tool are presented. RESULTS: Face validation of TELMA reveals the positive perception of surgeons regarding the implementation of TELMA and their willingness to use it as a cognitive skills training tool. Preliminary validation data also reflect the importance of providing an easy-to-use, functional authoring tool to create didactic content. CONCLUSION: The TELMA environment is currently installed and used at the Jesús Usón Minimally Invasive Surgery Centre and several other Spanish hospitals. Face validation results ascertain the acceptance and usefulness of this new minimally invasive surgery training environment.

Dependencia funcional y deterioro cognitivo de pacientes con cáncer avanzado atendidos en domicilio / Functional dependence and cognitive deterioration in patients with advanced cancer cared for at home

Objetivo: Evaluar la dependencia funcional y el deterioro cognitivo de los pacientes con cáncer avanzado atendidos en sus domicilios dentro de un programa de cuidados paliativos desarrollado por una Unidad de Hospitalización a Domicilio perteneciente a un hospital de tercer nivel (agudos). Pacientes y métodos: Se analizaron 3063 pacientes que corresponden a la totalidad de enfermos de cáncer avanzado atendidos por la unidad entre enero 2000 y diciembre de 2009. Resultados: Se destaca la fuerte dependencia física y el marcado deterioro cognitivo de los pacientes al ingreso en el programa. La estancia media fue de 12 días (desviación estándar 18). El 57.5% de los pacientes falleció en su propio domicilio, el 12% reingresó en nuestro hospital y el 11% fue derivado a una unidad de cuidados paliativos de hospital sociosanitario. Los pacientes que fallecieron en el domicilio eran mayores (72 años) que los que reingresaron en el hospital (68) (p < 0.01) y al ser incluidos en el programa presentaban mayor nivel de dependencia funcional y deterioro cognitivo. Conclusiones: La complejidad relacionada con la dependencia funcional y el deterioro cognitivo de los pacientes y, como consecuencia, con la carga de cuidados que necesitan no determina el lugar de la muerte. La edad de los enfermos es un factor modulador de la ubicación del paciente a lo largo de la evolución de su enfermedad.