Characterization of historical mortars from the Portuguese Citadel in Ksar Seghir (Morocco)

UID/HIS/04666/2019Ksar Seghir was a privileged place to control the Strait of Gibraltar throughout the centuries, being implanted in its southern bank, nowadays in Moroccan territory. Its prominence led to the construction of a unique circular wall and monumental doors during the Marinid dynasty in the late 13th century. The defensive system was later reformulated during the Portuguese occupation between 1458 and 1550, which sought a technical update, namely the introduction of new defensive devices adapted for artillery, that was gaining importance in the Mediterranean context. After its abandonment by the Portuguese, the town remained unoccupied, being today an archaeological site. Since 2008, the Moroccan government has undertaken a program to value the site and its structures, namely through various conservation and restoration actions. From 2011 a team of Moroccan and Portuguese researchers began a project to deepen the study and restore Ksar Seghir’s archaeological contexts, which led to the characterization of its structures, specifically the type of construction materials and techniques used. One of our main focuses has been the defensive system, for its impressiveness and historical richness. In this context, the work that is being carried out at Laboratory HERCULES, aims the material study of several mortar samples, collected from the Portuguese Citadel. The analytical methodology employed is an adaptation of standard analytical procedures used in historical mortars studies. The results of textural, mineralogical and chemical characterization allow, among others, the identification of mortars binder and aggregates and also the determination of the binder: aggregates ratio. This provides useful information regarding the history and the construction techniques of the different spots according to its purpose.Moreover, the acquisition of data on the mortars textural, chemical and mineralogical features is essential to assist conservatorrestorers in the correct choice and production of replacement and/or repair mortars that are compatible from a physical as well as chemical point of view with the original ones.publishersversionpublishe

Fibre reinforced mortar application for out-of-plane strengthening of schist walls

The aim of the present work is to assess the effectiveness of an innovative strengthening technique for the rehabilitation of masonry buildings deficiently prepared to resist to loading conditions typical of seismic events. This technique is based on the application of outer layers of fibre reinforced mortar (FRM) by spray technology and it is used for increasing the load carrying capacity and deformation ability of masonry elements. For this purpose three almost real scale schist walls prototypes were strengthened and tested. The experimental program is described and the relevant results are presented and discussed. For estimating the properties of the schist walls and FRM taking into account the application conditions, the tested prototypes were simulated with a FEM-based computer program that has constitutive models for the simulation of the nonlinear behaviour of these materials. By using the derived properties, a parametric study was conducted to identify the influence of the FRM properties on the performance of the proposed strengthening system.The author wish to acknowledge CiviTest, Lda (Jesufrei, Portugal) for supporting the experimental program, the sustain provided by INOTEC - Innovative material of ultra-high ductility for the rehabilitation of the built patrimony, QREN project number 23024, and the collaboration of the companies Owens Corning, Exporplas, Sika, Chryso and SECIL for providing, respectively, glass fibres, polypropylene fibres, superplasticizers, Viscous Modifier Agent, and Cement. The authors further wish to acknowledge the Erasmus Plus and Placement Mobility Programs among the University of Ferrara (Italy), the University of Minho (Portugal) and the CiviTest Lda (Portugal) which made this international cooperation possible

A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURO bservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry

Aims: Given the advances in atrial fibrillation (AF) management and the availability of new European Society of Cardiology (ESC) guidelines, there is a need for the systematic collection of contemporary data regarding the management and treatment of AF in ESC member countries. Methods and results: We conducted a registry of consecutive in- and outpatients with AF presenting to cardiologists in nine participating ESC countries. All patients with an ECG-documented diagnosis of AF confirmed in the year prior to enrolment were eligible. We enroled a total of 3119 patients from February 2012 to March 2013, with full data on clinical subtype available for 3049 patients (40.4% female; mean age 68.8 years). Common comorbidities were hypertension, coronary disease, and heart failure. Lone AF was present in only 3.9% (122 patients). Asymptomatic AF was common, particularly among those with permanent AF. Amiodarone was the most common antiarrhythmic agent used (~20%), while beta-blockers and digoxin were the most used rate control drugs. Oral anticoagulants (OACs) were used in 80% overall, most often vitamin K antagonists (71.6%), with novel OACs being used in 8.4%. Other antithrombotics (mostly antiplatelet therapy, especially aspirin) were still used in one-third of the patients, and no antithrombotic treatment in only 4.8%. Oral anticoagulants were used in 56.4% of CHA 2DS2-VASc = 0, with 26.3% having no antithrombotic therapy. A high HAS-BLED score was not used to exclude OAC use, but there was a trend towards more aspirin use in the presence of a high HAS-BLED score. Conclusion: The EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot Registry has provided systematic collection of contemporary data regarding the management and treatment of AF by cardiologists in ESC member countries. Oral anticoagulant use has increased, but novel OAC use was still low. Compliance with the treatment guidelines for patients with the lowest and higher stroke risk scores remains suboptimal. © The Author 2013

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access