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This research investigates the development of a semi-active piezoelectric friction damper for controlling the seismic response of large-scale structures. The proposed device is made of Duplex steel and leads to high friction capacity, which can be developed either in passive or semi-active modes. For the later, piezoelectric actuators react against a stiff clamping system and apply a variable normal force on the multiple contact surfaces. To validate the design, a prototype, which contact surfaces were made of stainless steel and brake pad material, was built and tested in both friction modes. Moreover, an analytical model of the damper was developed to estimate the performance of the piezoelectric actuators within the clamping system. Experimental results showed that the proposed device achieves a force range factor of 1.9. These experimental results also compare well with those obtained from the analytical model of the damper. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Introduction: Appendicitis is the leading cause of surgical acute abdomen in pediatrics. During the COVID-19 pandemic, management strategies were reassessed and the number of visits to the emergency department dropped down, which may be associated with delayed diagnoses and complications. The objective of this study was to analyze the impact of the pandemic on children with acute appendicitis., Methods: Analytical, retrospective, comparative study of pediatric patients with acute appendicitis in the 5 months of COVID-19 lockdown versus the same period in the previous year. Incidence, clinical data, stage, surgical approach, and complications were analyzed., Results: The total number of appendicitis cases went down by 25% (n = 67 versus n = 50 in 2020). The mean time to consultation was 24 hours in both periods (p = 0.989). The incidence of peritonitis was 44% (n = 22) versus 37% (n = 22) (p = 0.22) in 2019. No differences were observed in terms of appendicitis stage based on surgery reports. In 2019, all surgeries were laparoscopic; while in 2020, only 42% (n = 21). The incidence of complications was 6% versus 7.5% in the previous period (p = 0.75). One patient was COVID-19 positive., Conclusion: Although in our population the number of appendicitis cases dropped down, consultation was not delayed. The greater impact was associated with the reformulation of management strategies, in which the laparoscopic approach is avoided to reduce virus transmission., Competing Interests: None, (Sociedad Argentina de Pediatría.)

The incidence of pediatric cardiac arrest is unknown; its main etiologies are congenital heart diseases, cardiomyopathies, and ventricular arrhythmias. An electrocardiogram (ECG) is a diagnostic method that may allow to detect them in an early manner and reduce morbidity and mortality. The objective of this study was to describe pediatric residents' skills to determine if an ECG was normal or abnormal and make an accurate electrocardiographic diagnosis before and after an educational intervention. First-year pediatric residents participated in this study. An assessment including 12 ECG tracings was done before and after an educational module, and scores were compared using the t-test for paired data. No differences were observed between both assessments regarding the interpretation of ECG as normal or abnormal (p: 0.42). However, a statistically significant difference was observed in definitive diagnoses (p < 0.002). Definitive electrocardiographic diagnoses improved after the implementation of an educational module., Competing Interests: None, (Sociedad Argentina de Pediatría.)

Health care providers' involvement is critical for quality of care improvement. Nevertheless, most residency programs do not include this topic. The objective is to describe an educational experience on quality of care improvement for residents. The development of an improvement cycle was included in the second year syllabus of the pediatric residency program. A handbook and an online course were provided. Over 12 months, 10 proposals were designed on therapeutic and diagnostic approaches, effective communication, patient admission and logistics; they were based on sentinel events, incident reports, direct observation, and patients' complaints. Multidisciplinary working teams were formed. Health care protocols were agreed and processes were standardized. A program based on educational goals for continuous quality improvement allowed residents to acquire theoretical training and practical experience on the topic., Competing Interests: None, (Sociedad Argentina de Pediatría.)

Introduction: Advances in diagnostic methods, surgical techniques and postoperative intensive care have significantly increased the survival rates for children with congenital heart disease. In this context, long term sequelae acquired greater relevance. Health-related quality of life (HRQOL) is a concept that helps to measure the impact of chronic diseases. The purpose of the current study was to describe HRQOL in children with congenital heart disease that undergo cardiac surgery during their first year of life., Methods: A cross-sectional observational study was conducted between August 2017 and December 2018 at a University General Hospital. PedsQL 4.0 Generic Core Scales were used. Children with congenital heart disease between 2 and 4 years old who had cardiac surgery during their first year of life and healthy children were included. Scores were compared with T-test or Wilcoxon according to the observed distribution. p value < 0.05 was considered significant., Results: A total of 31 children with congenital heart disease (26 % with a single ventricle) and 62 healthy children were enrolled. The first surgery was in the neonatal period in 61.3 %. Our study showed no statistical differences (p = 0.10) between HRQOL Total Scale Score of children with congenital heart disease compared to healthy children. However, lower scores were observed with statistically significant differences in social (p = 0.0092) and school (p = 0.0001) scales., Conclusions: Our cohort of children diagnosed with congenital heart disease has a global quality of life comparable with healthy children except in social and school functioning scales., Competing Interests: None, (Sociedad Argentina de Pediatría.)

Ménétrier's disease is a protein losing gastroenteropathy. Defined as a rare entity with an unknown cause, most of the reported cases have been associated with viral infections. In pediatric patients, it is characterized by an acute onset with a benign and self-limiting course. It is characterized by thickened gastric folds that generally involve the body and the gastric fundus, associated with hypoalbuminemia due to the loss of serum protein through the mucosa. The following are two clinical cases of infant Ménétrier syndrome associated with cytomegalovirus infection., (Sociedad Argentina de Investigación Odontológica.)

According to the Association of American Medical Colleges, there are thirteen core Entrustable Professional Activities (EPAs) that medical graduates should be able to perform in their first day of residency, without direct supervision. In Argentina EPAs are not clearly defined. Moreover, there is no local data about the need of supervision regarding these activities. The aim of this study was to assess residents' and teaching physicians' estimations about the level of supervision that physicians in their first month of residency needed in order to perform EPAs. A cross-section study was conducted. First-year medical residents and teaching physicians were included. Electronic or paper surveys were sent, asking the level of supervision the participants estimated that residents needed to perform the 13 core EPAs, during their first month of residency. Participation was voluntary and anonymous. There were significant differences between the opinion of residents (n = 71) and teaching physicians (n = 39), for 11 out of 13 EPAs. More than half of the teaching physicians considered that residents needed direct supervision when performing EPAs, except for asking clinical questions and looking for evidence. Most residents thought that they required direct supervision in 6 EPAs. In conclusion, medical residents perceived the need of lower levels of supervision when compared to teaching physicians, who considered that medical graduates were not capable of performing most EPAs without direct supervision upon entering residency. Thus, it would be important to improve the procedures to evaluate the competences of medical graduates in order to establish more accurate supervision levels.

Introduction: Latex allergy is common in the hospital setting., Objetive: To describe the clinical situation of three pediatric interns with latex allergy and the prevention strategies implemented during clinical clerkships in pediatric and neonatal intensive care units., Patients, Methods, and Outcomes: The three interns referred symptom exacerbation during their internship program. Diagnosis was confirmed based on a compatible history and positive specific immunoglobulin E. A semi-structured interview was done to describe perceptions about prevention strategies, the personnel were trained, and nitrile gloves were provided for carrying out procedures. Interns completed their clinical clerkships without having allergic reactions. Positive aspects referred by interns were that they felt cared for and experienced an improved quality of life; negative aspects were a bad predisposition and resistance against change among some other interns. Strategies designed to this end permitted interns to continue their internship program., (Sociedad Argentina de Pediatría)