Adición de aluminato de estroncio en la elaboración de adoquines de concreto para la mejora en la señalización horizontal de una ciclovía en Lima 2019

El presente trabajo de investigación analiza la factibilidad de la adición de aluminato de estroncio en una relación de 30 por ciento con el peso del material cementante en la elaboración de adoquines de concreto, buscando que estos adoquines de concreto fotoluminiscente cumpla con las especificaciones técnicas estipulas por la Norma española UNE 23035 y la Norma peruana NTP 339.064, esta señalización horizontal fotoluminiscente tendrá como objetivo iluminar la demarcación de una ciclovía ubicada en Lima 2019 con el fin de aportar una señalización horizontal de alta duración e iluminada de manera autónoma en horas nocturnas. Se procedió a realizar el diseño de mezcla para la elaboración de los adoquines de concreto fotoluminiscente obteniendo la cuantificación de los materiales a usar, luego de ello se logró concluir mediante el análisis de artículos científicos sobre la adición de material en la elaboración de bloques de pavimentos que las propiedades físicas y mecánicas del concreto varían pero dentro de los rangos permisibles por las normas citadas basándose a los resultados obtenidos en el laboratorio, sin embargo la relación del aluminato de estroncio en 30 por ciento en peso del material cementante proporciona las iluminancia necesaria para cumplir la normativa española referida a señalización fotoluminiscente.The present research work analyzes the feasibility of adding strontium aluminate in a relationship of 30 percent with the weight of the cementitious material in the manufacture of concrete pavers, seeking that these photoluminescent concrete pavers meet the technical specifications stipulated by The Spanish Norm UNE 23035 and the Peruvian Norm NTP 339.064, this photoluminescent horizontal signaling will aim to illuminate the demarcation of a bicycle path located in Lima 2019 in order to provide a long-lasting and autonomously illuminated horizontal signaling at night. We proceeded to carry out the mix design for the preparation of the photoluminescent concrete paving blocks, obtaining the quantification of the materials to be used, after which it was possible to conclude by analyzing scientific articles on the addition of material in the preparation of pavement blocks that the physical and mechanical properties of concrete vary but within the ranges allowed by the cited standards based on the results obtained in the laboratory, however the ratio of strontium aluminate to 30 weight percent of the cementitious material provides the necessary illuminance to Comply with the Spanish regulations regarding photoluminescent signage

Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study

Background Dental disease is more extensive in adults with chronic kidney disease, but whether dental health and behaviors are associated with survival in the setting of hemodialysis is unknown. Study Design Prospective multinational cohort. Setting & Participants 4,205 adults treated with long-term hemodialysis, 2010 to 2012 (Oral Diseases in Hemodialysis [ORAL-D] Study). Predictors Dental health as assessed by a standardized dental examination using World Health Organization guidelines and personal oral care, including edentulousness; decayed, missing, and filled teeth index; teeth brushing and flossing; and dental health consultation. Outcomes All-cause and cardiovascular mortality at 12 months after dental assessment. Measurements Multivariable-adjusted Cox proportional hazards regression models fitted with shared frailty to account for clustering of mortality risk within countries. Results During a mean follow-up of 22.1 months, 942 deaths occurred, including 477 cardiovascular deaths. Edentulousness (adjusted HR, 1.29; 95% CI, 1.10-1.51) and decayed, missing, or filled teeth score ≥ 14 (adjusted HR, 1.70; 95% CI, 1.33-2.17) were associated with early all-cause mortality, while dental flossing, using mouthwash, brushing teeth daily, spending at least 2 minutes on oral hygiene daily, changing a toothbrush at least every 3 months, and visiting a dentist within the past 6 months (adjusted HRs of 0.52 [95% CI, 0.32-0.85], 0.79 [95% CI, 0.64-0.97], 0.76 [95% CI, 0.58-0.99], 0.84 [95% CI, 0.71-0.99], 0.79 [95% CI, 0.65-0.95], and 0.79 [95% CI, 0.65-0.96], respectively) were associated with better survival. Results for cardiovascular mortality were similar. Limitations Convenience sample of clinics. Conclusions In adults treated with hemodialysis, poorer dental health was associated with early death, whereas preventive dental health practices were associated with longer survival

Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study

BackgroundDental disease is more extensive in adults with chronic kidney disease, but whether dental health and behaviors are associated with survival in the setting of hemodialysis is unknown.Study DesignProspective multinational cohort.Setting & Participants4,205 adults treated with long-term hemodialysis, 2010 to 2012 (Oral Diseases in Hemodialysis [ORAL-D] Study).PredictorsDental health as assessed by a standardized dental examination using World Health Organization guidelines and personal oral care, including edentulousness; decayed, missing, and filled teeth index; teeth brushing and flossing; and dental health consultation.OutcomesAll-cause and cardiovascular mortality at 12 months after dental assessment.MeasurementsMultivariable-adjusted Cox proportional hazards regression models fitted with shared frailty to account for clustering of mortality risk within countries.ResultsDuring a mean follow-up of 22.1 months, 942 deaths occurred, including 477 cardiovascular deaths. Edentulousness (adjusted HR, 1.29; 95% CI, 1.10-1.51) and decayed, missing, or filled teeth score ≥ 14 (adjusted HR, 1.70; 95% CI, 1.33-2.17) were associated with early all-cause mortality, while dental flossing, using mouthwash, brushing teeth daily, spending at least 2 minutes on oral hygiene daily, changing a toothbrush at least every 3 months, and visiting a dentist within the past 6 months (adjusted HRs of 0.52 [95% CI, 0.32-0.85], 0.79 [95% CI, 0.64-0.97], 0.76 [95% CI, 0.58-0.99], 0.84 [95% CI, 0.71-0.99], 0.79 [95% CI, 0.65-0.95], and 0.79 [95% CI, 0.65-0.96], respectively) were associated with better survival. Results for cardiovascular mortality were similar.LimitationsConvenience sample of clinics.ConclusionsIn adults treated with hemodialysis, poorer dental health was associated with early death, whereas preventive dental health practices were associated with longer survival

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2

Alirocumab and cardiovascular outcomes after acute coronary syndrome

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Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome

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