ABSTRACT Sugar cane bagasse ash (SA) is the result of the incineration of residues in the production of sugar which has as its final disposal the sanitary landfills generating environmental impacts. The practice of the circular economy for using SA ash as a stabilizer of clay soils in highway bases and sub-bases requires the study of the potential of ash as an alternative cement. Soil stabilization is commonly done with the addition of cement or lime; however, the production of these materials releases CO2 into the atmosphere. This research estimates the potential use of SA ash as a cementing agent considering the physical, hydraulic, and mechanical properties of clay soil mixed with percentages of 6, 8, and 10% of Uncalcined Sugarcane Bagasse Ash (USA) and Calcined Sugarcane Bagasse Ash (CSA). X-ray fluorescence spectrometry (FRX), methylene blue value test, specific gravity, dry unit weight, granulometric analysis, and Atterberg limits tests were carried out to evaluate the physical properties of the mixtures. One-dimensional consolidation tests, soil water characteristic curves (SWCC), standard Proctor compaction, unconfined compression, and direct shear were carried out to estimate the mechanical and hydraulic properties of the mixtures. An improvement in the physical, hydraulic, and mechanical properties was found with the addition of USA and CSA. Finally, based on the analysis of the physical, hydraulic, and mechanical properties of the Soil-USA and soil-CSA samples, it was determined that the best option as an alternative cementitious agent is found in the 8% Soil-CSA mixture due to the improvement in the plasticity index, gravity density, angle of friction, cohesion, and unconfined compressive in comparison with the other samples and the original soil. However, it is essential to mention that this cementitious addition can prejudice the hydraulic properties and consolidation process. It is vital to consider those parameters when realizing any geotechnical design with this mixture.

RESUMEN Introducción: Los materiales de desecho pueden ser una alternativa para el aprovechamiento y transformación de elementos de uso diario, con el uso de metodologías de diseño y la clasificación de materiales provenientes de diferentes sectores de la industria que pueden ser aprovechados por sus características estético-formales, para alargar su ciclo de vida. Objetivo: Encontrar materiales de desecho en el Área Metropolitana del Valle de Aburrá que puedan ser aprovechados para el diseño en el sector moda, se elaboró una investigación donde se analizaron potenciales aprovechamientos de materias primas para ser resignificadas a partir de elementos de desecho y desuso, para esto se visitaron 10 empresas dedicadas a la reconexión de materiales reciclables, se recopiló información como imágenes y datos en las visitas. Materiales y métodos: Se aplicó una metodología de corte cualitativo y experimental, donde se registró, sistematizó y caracterizó el material encontrado con la Rueda de LiDs, identificando los cuatro materiales con mayores cantidades reportadas en el mapeo de la información, con los resultados, se elaboraron talleres de creación con materiales provenientes del sector textil para generar propuestas experimentales con este tipo de materiales. Resultados: En total, se registraron 76 materiales, pertenecientes a 6 sectores productivos. Los principales materiales encontrados fueron PET, papel/ cartón, metales ferrosos y no ferrosos. Analizando los cuatro residuos más representativos del sector textil, se pudo reconocer que estos materiales representan un gran potencial de resignificación para reconcebir nuevos objetos de moda, evidenciado en los resultados de los laboratorios experimentales desarrollados. Conclusiones: A través de la exploración de materiales y prácticas de diseño, es posible recuperar estos elementos con procesos tradicionales de transformación y fabricación en la creación de nuevos productos, además proponer la parametrización de piezas estandarizadas basadas en patrones de elementos en la investigación de la Industria 4.0.

ABSTRACT Introduction: The waste materials can be an alternative to create and transform elements that you use daily. With the use of design methodologies and the classification of the materials of the industry, it can be used for formal aesthetic characteristics to extend their life cycle. Objective: Find waste materials in the metropolitan area of the Aburrá valley that will be used for a new design in the fashion sector, a research was developed and were analyzed to use of raw materials to create a new thing from waste and the elements that were not used. Ten companies was visited that used recyclable materials. The gathered of information and images and datas during the visit. Material and methods: A methodology of qualitative and experimental cut was applied. With the use of LiDs wheel all materials were observed, systematized and characterized. Was possible to identify the four materials with greater quantities during this research. To get the results it was conducted workshops to elaborate the creation with textile industry materials to create design proposals with the materials. Results: 76 materials were registered, belonging to 6 productive sectors. The main materials found were PET, paper / cardboard, ferrous and non-ferrous metals. Analyzing the four most representative residues of the textile sector, it was possible to recognize that these materials represent a great potential for resignification to reconceive new fashion objects, evidenced in the results of the experimental laboratories developed. Conclusions: Thorough exploration of materials and design practices, it is possible to recover these elements using traditional processes of transformation and manufacturing and creating new products. Also it was proposed the parameterization of standardized pieces based on patterns of elements in future research of the industry 4.0.

RESUMO Introdução: Os resíduos de materiais podem ser uma alternativa para o aproveitamento e transformação de elementos de uso diário, com a utilização de metodologias de design e a classificação de materiais de diferentes setores da indústria que podem ser utilizados pelas suas características estético-formais para prolongar seu ciclo de vida. Objetivo: Encontrar resíduos na Região Metropolitana do Vale do Aburra que possam ser aproveitados como insumo no design de produtos no setor de moda. Foi realizada uma investigação onde foram analisados os usos potenciais de resíduos de matérias-primas para serem redefinidos em objeto novos. Para isso, foram visitadas 10 coleta de materiais residuais, informações como imagens e dados foram coletados durante as visitas. Materiais e métodos: Foi aplicada uma metodologia de corte qualitativo e experimental. Alguns materiais representativos com maiores quantidades reportadas no mapeamento de informações das principais categorias de resíduos foram analisados na roda dos LIDs. Finalmente, com os quatro resíduos mais representativos do setor têxtil, foram desenvolvidos laboratórios de experimentação. Resultados: No total, foram registrados 76 materiais, pertencentes a 6 setores produtivos. Os materiais encontrados no maior canto dos centros foram plásticos do tipo PET, papel / papelão, metais ferrosos e não ferrosos. Analisando os quatro resíduos mais representativos do setor têxtil, foi possível reconhecer que estes materiais representam um grande potencial de resignificação para (re) conceber novos objetos de moda, evidenciado nos resultados dos laboratórios experimentais desenvolvidos. Conclusões: Por meio da exploração de materiais e práticas de design, é possível recuperar esses elementos com processos tradicionais de transformação e manufatura na criação de novos produtos, além de propor a parametrização de peças padronizadas com base em padrões de elementos na investigação do Indústria 4.0.

Abstract Loeys-Dietz syndrome is a rare autosomal dominant connective tissue disorder characterized by vascular, skeletal, craniofacial and cutaneous abnormalities. During pregnancy, women with this syndrome have an increased risk of aortic aneurysm and dissection, preterm birth, uterine rupture and postpartum hemorrhage. Appropriate preconceptional, pregnancy and postpartum evaluation, counseling and surveillance by a specialized and multidisciplinary team might improve maternal and pregnancy outcomes. We present two cases of pregnant women with this syndrome surveilled at a tertiary high-risk obstetrics center. Both delivered at term without major complications.

presented to our emergency department with a sudden late postpartum haemorrhage 30 days after a caesarean section. The transvaginal ultrasound examination revealed a pulsatile and tortuous vessel in the inner third of the posterior uterine wall with an increased peak systolic velocity and a low-resistance waveform. The diagnosis of subinvolution of the placental site was suspected and a Foley catheter with 40cc of normal saline was used as uterine tamponade. After the tamponade, the bleeding subsided. The Foley catheter was removed after 48 hours. Revaluation with ultrasound showed no evidence of abnormal vessels in the myometrium.

Resumo Objetivo A Classificação de Robson é um instrumento reprodutível, clinicamente relevante e prospectivo proposto pela Organização Mundial de Saúde (OMS) para avaliar, monitorar e comparar as taxas de cesarianas.Oobjetivo do presente estudo é analisar a taxa de cesarianas ao longo de 3 anos de acordo com a Classificação de Robson e identificar os grupos que contribuíram mais significativamente para essa taxa. Métodos Recolhemos dados relativos aos partos ocorridos entre 2014 e 2016 em um hospital terciário de Portugal e classificamos todas as grávidas de acordo com a Classificação de Robson. Analisamos a taxa de cesarianas em cada grupo. Resultados Incluímos dados relativos a 6,369 partos. Os grupos 1 (n = 1,703), 2 (n = 1,229) e 3 (n = 1,382) representaram 67.7% da população obstétrica. A taxa de cesarianas foi de 25% (n = 1,594). Os grupos 1, 2, 5 e 10 contribuíram para 74.2% da taxa de cesarianas. Conclusão Tal como esperado, os grupos 1, 2, 5 e 10 foram os quemais contribuíram para a taxa de cesarianas. Aumentar o número de partos vaginais nestes grupos, principalmente nos grupos 2 e 5, poderá contribuir para a redução da taxa de cesarianas.

Abstract Objective The Robson 10 group classification system (RTGCS) is a reproducible, clinically relevant and prospective classification system proposed by the World Health Organization (WHO) as a global standard for assessing, monitoring and comparing cesarean section (CS) rates. The purpose of the present study is to analyze CS rates according to the RTGCS over a 3-year period and to identify the main contributors to this rate. Methods We reviewed data regarding deliveries performed from 2014 up to 2016 in a tertiary hospital in Portugal, and classified all women according to the RTGCS. We analyzed the CS rate in each group. Results We included data from 6,369 deliveries. Groups 1 (n = 1,703), 2 (n = 1,229) and 3 (n = 1,382) represented 67.7% of the obstetric population. The global CS rate was 25% (n = 1,594). Groups 1, 2, 5 and 10 were responsible for 74.2% of global CS deliveries. Conclusion As expected, Groups 1, 2, 5 and 10 were the greatest contributors to the overall CS rate. An attempt to increase the number of vaginal deliveries in these groups, especially in Groups 2 and 5, might contribute to the reduction of the CS rate.

Resumo Introdução A indução do trabalho de parto é uma prática comum e sua associação com o aumento da taxa de cesarianas tem sido questionada. O presente estudo surge com o objetivo de avaliar o impacto da indução do trabalho de parto na taxa global de cesarianas e de analisar as taxas de cesarianas de acordo com o método de indução do trabalho de parto utilizado e com o grupo de Robson. Métodos Realizamos umestudo retrospectivo cominclusão de grávidas submetidas a indução do trabalho de parto em um hospital terciário em 2015 e 2016. Todas as mulheres forram classificadas de acordo com a classificação de Robson. As taxas de cesarianas foram analisadas e comparadas em função do método de indução de trabalho de parto utilizado. Resultados Foram incluídos 1.166 casos. A taxa de cesarianas após a indução do trabalho de parto foi de 20,9%, correspondendo a 23,1% do total de cesarianas realizadas em 2015 e 2016. Os grupos 5 e 8 da classificação de Robson foram os que apresentaram as maiores taxas de cesarianas (65,2% e 32,3%, respectivamente). O grupo 2 foi o que mais contribuiu para a taxa global de cesarianas, por representar 56,7% do total da população. As prostaglandinas intravaginais foram o método mais utilizado (77%). O cateter de Foley transcervical foi o método mais utilizado no grupo 5 e as prostaglandinas intravaginais nos restantes. A taxa de cesarianas foi superior quando se utilizou o cateter de Foley transcervical (34,1%). Conclusão A indução do trabalho de parto com cateter de Foley transcervical associou-se a uma maior taxa de cesarianas, em provável relação com a sua maior utilização no grupo 5.

Abstract Objective Induction of labor (IL) is a common obstetric procedure, but it is questionable whether or not it results in higher cesarean section (CS) rates. The present study aims to evaluate the impact of IL in the overall CS rates and to analyze these rates according to the method of IL employed and to the Robson group in which it was applied. Methods We have conducted a retrospective study including pregnant women whose labor was induced at a tertiary hospital in 2015 and 2016. All women were classified according to the Robson Classification System (RCS). The CS rates were analyzed and compared regarding the method of IL employed. Results A total of 1,166 cases were included. The CS rate after IL was 20.9%, which represented 23.1% of the total of CSs performed in 2015 and 2016. The highest CS rates were recorded in RCS groups 5 (65.2%) and 8 (32.3%). Group 2 was the highest contributor to the overall CS rate, since it represented 56.7% of the population. The intravaginal prostaglandins method was the most used (77%). Transcervical Foley catheter was the preferredmethod in group 5 and intravaginal prostaglandins in all the other groups. The CS rate was higher when transcervical Foley catheter was used (34.1%). Conclusion Transcervical Foley catheter induction was associated with a higher rate of CS, probably because it was the preferred method used in group 5.

We report a lifesaving multidisciplinary approach to a ruptured subcapsular liver hematoma during the third trimester of pregnancy associated to a HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome. Surgical treatment was performed and both mother and newborn survived. High diagnostic suspicion was crucial to the emergent case management. These patients should be treated in a setting in which adequate supportive care and multidisciplinary teams are available.

Se evaluó la validez del índice energía-proteína (IEP) en la identificación de la malnutrición por exceso en 163 niños entre 4 y 6 años, de bajo estrato socioeconómico en la ciudad de Valencia, Estado Carabobo, Venezuela. Se tomó peso, talla, brazo y pliegues subcutáneos. Se calculó el Peso para la Talla (P/T), área grasa (AG) e IEP. Se consideró en déficit a todo sujeto con P/T £ p10, normalidad P/T >p10 y £ p90 y en exceso aquel con P/T y AG >p90. Se calculó la distribución percentilar del IEP por edad y género, considerando bajo la norma £ p10, normal >p10 y £ p90 y sobre la norma >p90. Su validez se analizó a través de la sensibilidad, especificidad y razón de verosimilitud positiva (RV+) y negativa (RV-). Las pruebas de t de Student y ANOVA se utilizaron para comparaciones de grupos (p< 0,05). Según el diagnóstico nutricional, un 27,60% de los niños presentaron déficit, 66,88% normalidad y 5,52% exceso. El IEP reportó un 7,36% en bajo la norma, 82,20% normal y 10,44% sobre la norma. El IEP disminuyó con la edad en los varones y presenta diferencias por género en el grupo de 6 años, siendo significativamente mayor en las niñas. Para identificar el exceso, la sensibilidad fue del 77% y la especificidad del 93%, con una RV+ de 11. Finalmente, un IEP sobre la norma fue 11 veces más probable en un sujeto con exceso que en otro en normalidad. Para el déficit, las pruebas no cumplieron los requisitos de utilidad.

The validity of the energy/protein index (EPI) in the detection of overweight was assessed in 163 low income children (four to six years old) from Valencia, Venezuela. Weight, height, arm circumference, and skinfolds were taken. Weight for height (W/H), limb fat area (LFA), and EPI were calculated. All subjects with W/H £ p10 were considered deficient, with W/H between >p10 and £ p90 normal, and with W/H and LFA >p90 in excess. Percentile distribution of EPI for age and gender was calculated, regarding below the norm all subjects £ p10, normal those > p10 and £ p90, and above the norm those >p90. Validity was assessed through sensibility, specificity, and likelihood ratio. Student´s t test and ANOVA were used for group comparisons (p< 0.05). According to the nutritional diagnosis, 27.60% of the children were deficient, 66.88% normal, and 15.52% in excess. According to the EPI, 7.36% of the sample was considered below the norm, 82.20% normal, and 10.44% above the norm. The EPI decreased with age in boys, and in the 6 years old group was significantly higher for girls. Lastly, an EPI above the norm is eleven times more likely to occur in a subject considered in excess than in subjects considered normal. For deficiency, the tests did not meet the expected values.

Para evaluar la relación entre el índice de masa corporal (IMC) materno al comienzo del embarazo y la antropometría del recién nacido (RN), se estudiaron 105 binomios (madre-recién nacidos) en una Maternidad pública de Valencia, Venezuela (1998-2002). Se registró el peso y talla en mujeres adultas que acudieron al primer control prenatal entre las semanas 10 y 15 de gestación y su IMC se caracterizó a través de la referencia de Atalah (Bajo peso, Normalidad y Sobrepeso). Sus hijos (RN a término) fueron evaluados calculando su edad gestacional por el método de Capurro y se registró su peso, talla y circunferencia cefálica, con caracterización nutricional a través de una referencia venezolana. Se consideró RN "pequeño para edad gestacional" (PEG) aquel con peso al nacer £ percentil 10 y "grande para edad gestacional" (GEG) aquel con peso ³ percentil 90. Para las comparaciones de grupo se utilizó el análisis de varianza de un factor (ANOVA) y la prueba Post Hoc de Tukey. Se observó un 41,9% de madres en "Bajo peso" y un 13,4% de RNPEG. Hubo diferencias significativas (p<0,05) al comparar los valores de peso y de talla del RN según IMC materno "Bajo peso" con "Normalidad" y "Sobrepeso". Se evidenció una elevada prevalencia de déficit nutricional materno desde el inicio del embarazo, así como una relación entre el IMC materno y la antropometría de sus recién nacidos.

Summary To assess the relationship between maternal body mass index (BMI) at early gestation and the newborns’ anthropometry, 105 mother-infant dyads from a public Maternity Hospital in Valencia Venezuela, were studied during 1998-2000. Weight and height of adult women between 10 and 15 weeks of gestation were used to calculate BMI according to Atalah’s reference (Low weight, Normal, Over weight). Term newborns were assessed using gestational age calculated according to the Capurro method. Their weight, height, and head circumference were recorded, and were characterized using a Venezuelan reference. Newborns whose birth weight (BW) was £ 10th percentile were considered "small for gestational age" (SGA), and those with BW³ 90th percentile as "large for gestational age" (LGA). One-way ANOVA and Tukey’s Post Hoc test were used for group comparisons. There were 41.9% of "low weight" mothers, and 13.4% of SGA newborns. There were differences in the newborns’ weight and height according to "Low weight" maternal BMI with "Normal" and "Over weight" maternal BMI (p<0.05). A high prevalence of nutritional deficit was observed from the beginning of the gestational period, as well as a relationship between maternal BMI and the newborn’s anthropometry.

Con la finalidad de analizar las divergencias en la clasificación antropométrica del recién nacido (RN) según diferentes valores de referencias, se evaluaron 102 RN en la Maternidad pública "Dr. Armando Arcay" de la ciudad de Valencia (1998-2002). Se tomó el peso, talla, circunferencia cefálica y del brazo al nacer. La clasificación antropométrica se realizó a través del indicador "Peso para la edad gestacional" y se utilizó la referencia venezolana de Henríquez, además de Lubchenco y Williams, esta última recomendada por la OMS. La edad gestacional se calculó por Capurro, tomando solo RN de 40 semanas. Se consideró pequeño para edad gestacional (PEG) al RN con peso al nacer £ p10 de los valores de referencia y grande para edad gestacional (GEG) al RN ³ p90. El Kappa se utilizó para conocer el grado de acuerdo. La prevalencia del PEG fue mayor para Williams (25,5%), seguido de Lubchenco (16,7%) y Henríquez (13,7%). Situación contraria ocurrió con los GEG. El mejor acuerdo se presentó entre Henríquez y Lubchenco (Kappa=0,71). Este estudio evidenció divergencias en la clasificación antropométrica del RN al utilizar valores internacionales y locales, lo que sugiere la necesidad de identificar la referencia que permita garantizar el adecuado diagnóstico nutricional.

Abstract To examine discrepancies in the anthropometric classifications of at term newborns using different reference values, 102 newborns were studied, from a public Maternity Hospital in Valencia Venezuela (1998-2000). Weight, height, and mid-upper arm circumference were assessed. "Weight for gestational age" was used as an indicator for anthropometric classification, using the Venezuelan reference of Henríquez; as well as Lubchenco’s and William’s, this last recommended by WHO. The Capurro method was used to assess gestational age, including in the study only those infants born at 40 weeks. Newborns, whose birth weight was £ the 10th percentile of the different reference values, were considered small for gestational age (SGA). Those with birth weight ³ the 90th percentile were classified as large for gestational age (LGA). Kappa coefficient was used to determine which of the references showed the best agreement. The SGA newborn prevalence was higher when using William’s reference (25.5%), followed by Lubchenco’s (16.7%), and Henríquez’s with the lowest prevalence (13.7%). The best agreement was between Henríquez and Lubchenco (Kappa= 0.71). Opposite results were found for LGA newborns. This study showed discrepancies in the newborns’ anthropometric classification when using local and international reference values, suggesting the need to identify the reference that provides an adequate nutritional diagnosis.

Para caracterizar el estado nutricional a un grupo de recién nacidos (RN) venezolanos se utilizaron indicadores antropométricos tradicionales, de proporcionalidad y composición corporal. La muestra fue de 137 RN a término, producto de embarazo simple, hijos de madres controladas en la "Maternidad Dr. Armando Arcay" de la ciudad de Valencia. Se tomó el peso (P), talla (T), circunferencia cefálica (CC), media del brazo (CMB) y pliegues subcutáneos en las primeras 24 horas del nacimiento. Edad gestacional por el método de Capurro. Se calcularon los indicadores Peso, Talla y Circunferencia cefálica para la edad gestacional, índice ponderal, área grasa (AG) y muscular (AM), comparándolos con un valor de referencia venezolano. Se consideró pequeño para edad gestacional (PEG) a todo RN con un Peso para la edad gestacional, P £ percentil 10 (8,6%). Adecuado para edad gestacional (AEG) P > percentil 10 y < percentil 90 (85,6%) y Grande para edad gestacional (GEG) P ³ al percentil 90 (5,8%). Con la talla para edad gestacional, circunferencia cefálica e índice ponderal, los PEG se clasificaron en simétricos y asimétricos. Los varones presentaron valores mas altos que las niñas con diferencias en P, T, CC, CMB y AM. Hubo diferencias significativas en todas las variables entre los RNPEG con los AEG y los GEG. El uso de la proporcionalidad y la composición corporal mejoró la caracterización nutricional antropométrica inicial, por lo tanto, se sugiere su incorporación para un diagnóstico nutricional del recién nacido más preciso.

This study intends to nutritionally characterize a group of Venezuelans newborns through different anthropometric indices (traditional, of body composition, and of proportionality). 137 term singletons, born to mothers that attended "Maternidad Dr. Armando Arcay" in Valencia were assessed. Weight, height, head circumference, mid-upper arm circumference, and subcutaneous skinfolds were taken during the first 24 hours of birth. The Capurro method was used to assess gestational age. Weight-for-gestational age, height-for-gestational age, head circumference-for-gestational age, ponderal index, fat mass, and fat free mass were calculated and compared to a Venezuelan reference value. Using the weight-for-gestational age index, newborns whose birth weight (BW) was £ the 10th percentile were considered "small for gestational age" (SGA) (8.6%); those whose BW > the 10th percentile and < the 90th percentile were classified as "adequate for gestational age" (AGA) (85.6%); and those with BW ³ the 90th percentile as "large for gestational age" (LGA) (5.8%). With the indices height-for-gestational age, head circumference, and the ponderal index, newborns were categorized as symmetric or asymmetric. Males showed higher values than females, with significant differences for weight, height, head circumference, mid-upper arm circumference, and fat free mass. There were significant differences for all variables between SGA, AGA, and LGA newborns. The use of body composition and proportionality indices allowed for a better anthropometrical characterization, which suggests their inclusion for an effective nutritional diagnosis.