5,717 research outputs found

    Calcined clayey soils as a potential replacement for cement in developing countries

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    Concrete is the building material with the greatest potential for meeting the increasing housing demand in developing countries. Locally available materials should be considered as cement replacement in order to lower the costs and the environmental impact associated with the production of cement. Hence, this study investigated the potential use of calcined clayey soils to be used as reactive mineral admixtures in concrete, with special emphasis on a Cuban clayey soil. The study of the thermal behaviour of common clay types such as kaolinite, illite and montmorillonite was of key importance for the understanding of more complex locally available soils generally composed of a mixture of clays with companion minerals and impurities. Clays were calcined at temperatures ranging from 500°C to 1000°C. The characterization of the raw and calcined clays included XRD, TGA, DTA, NMR, PSD, BET and SEM. The study of the pozzolanic activity was done in cement pastes by replacing 30% of cement by calcined clays at a water/binder ratio of 0.4. Curing was done in water at 30°C to simulate the Cuban climate. CH depletion was monitored using XRD and TGA up to 90 days. The degree of hydration of the clinker component was assessed by BSE-image analysis. The identification of the hydrated phases in pastes was done by XRD, NMR and SEM. Long-term Isothermal Calorimetry as well as chemical shrinkage allowed the chemical contribution of the pozzolans to be identified independently of the filler effect and the hydration of cement.. To see how did the different reactivities of calcined clays translate into mechanical properties, standard mortar bars (w/b 0.5) were prepared and cured under the same conditions as the pastes for testing in compressive strength at 1, 7, 28 and 90 days. Sorptivity measurements were also performed to assess the durability properties. Kaolinite was found to have the highest potential for activation when calcined in the range of 600°C to 800°C. Locally available clays with only around 40% of kaolinite showed good pozzolanic properties in pastes. The time at which the pozzolanic activity starts to be significant varied between 1 and 7 days. Calcined clays in cement tend to favour the formation of AFm phases such as hemicarboaluminate or monocarboaluminate. Strätlingite was also detected by 27Al NMR. The Compressive strength of mortars incorporating kaolinite-based calcined clays was systematically similar or higher than the 100% OPC mortar from around 7 days and the sorptivity of the blended systems was reduced. These studies indicate that locally available calcined clayey soils have significant potential for replacing cement in concrete

    Remote (250 km) Fiber Bragg Grating Multiplexing System

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    We propose and demonstrate two ultra-long range fiber Bragg grating (FBG) sensor interrogation systems. In the first approach four FBGs are located 200 km from the monitoring station and a signal to noise ratio of 20 dB is obtained. The second improved version is able to detect the four multiplexed FBGs placed 250 km away, offering a signal to noise ratio of 6–8 dB. Consequently, this last system represents the longest range FBG sensor system reported so far that includes fiber sensor multiplexing capability. Both simple systems are based on a wavelength swept laser to scan the reflection spectra of the FBGs, and they are composed by two identical-lengths optical paths: the first one intended to launch the amplified laser signal by means of Raman amplification and the other one is employed to guide the reflection signal to the reception system

    Genomic and immune landscape Of metastatic pheochromocytoma and paraganglioma

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    Adrenal gland diseases; Cancer genomics; Prognostic markersMalalties de les glàndules suprarenals; Genòmica del càncer; Marcadors pronòsticsEnfermedades de las glándulas suprarrenales; Genómica del cáncer; Marcadores pronósticosThe mechanisms triggering metastasis in pheochromocytoma/paraganglioma are unknown, hindering therapeutic options for patients with metastatic tumors (mPPGL). Herein we show by genomic profiling of a large cohort of mPPGLs that high mutational load, microsatellite instability and somatic copy-number alteration burden are associated with ATRX/TERT alterations and are suitable prognostic markers. Transcriptomic analysis defines the signaling networks involved in the acquisition of metastatic competence and establishes a gene signature related to mPPGLs, highlighting CDK1 as an additional mPPGL marker. Immunogenomics accompanied by immunohistochemistry identifies a heterogeneous ecosystem at the tumor microenvironment level, linked to the genomic subtype and tumor behavior. Specifically, we define a general immunosuppressive microenvironment in mPPGLs, the exception being PD-L1 expressing MAML3-related tumors. Our study reveals canonical markers for risk of metastasis, and suggests the usefulness of including immune parameters in clinical management for PPGL prognostication and identification of patients who might benefit from immunotherapy.This work was supported by Project PI17/01796 and PI20/01169 to M.R. [Instituto de Salud Carlos III (ISCIII), Acción Estratégica en Salud, cofinanciado a través del Fondo Europeo de Desarrollo Regional (FEDER)], Paradifference Foundation [no grant number applicable to M.R.], Pheipas Association [no grant number applicable to M.R.], the Clinical Research Priority Program of the University of Zurich for the CRPP HYRENE to F.B., the Deutsche Forschungsgemeinschaft (DFG) within the CRC/Transregio 205/1 (Project No. 314061271-TRR205 to to F.B., M.F., N.B., and G.E.) and the Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Science and Innovation (Project No. PID2019-111356RA-I00 to G.M.). B.C. was supported by the Rafael del Pino Foundation (Becas de Excelencia Rafael del Pino 2017). A.M.M.-M. was supported by CAM (S2017/BMD-3724; TIRONET2-CM). A.F.-S. and J.L. received the support of a fellowship from La Caixa Foundation (ID 100010434; LCF/BQ/DR21/11880009 and LCF/BQ/DR19/11740015, respectively). M.M., S.M., and M.S. were supported by the Spanish Ministry of Science, Innovation and Universities “Formación del Profesorado Universitario— FPU” fellowship with ID number FPU18/00064, FPU19/04940 and FPU16/05527. A.D.-T. is supported by the Centro de Investigacion Biomédica en Red de Enfermedades Raras (CIBERER). L.J.L.-G. was supported both by the Banco Santander Foundation and La Caixa Postdoctoral Junior Leader Fellowship (LCF/BQ/PI20/11760011). C.M.-C. was supported by a grant from the AECC Foundation (AIO15152858 MONT). We thank the Spanish National Tumor Bank Network (RD09/0076/00047) for the support in obtaining tumorsamples and all patients, physicians and tumor biobanks involved in the study

    R2 prime (R2') magnetic resonance imaging for post-myocardial infarction intramyocardial haemorrhage quantification.

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    To assess whether R2* is more accurate than T2* for the detection of intramyocardial haemorrhage (IMH) and to evaluate whether T2' (or R2') is less affected by oedema than T2* (R2*), and thus more suitable for the accurate identification of post-myocardial infarction (MI) IMH. Reperfused anterior MI was performed in 20 pigs, which were sacrificed at 120 min, 24 h, 4 days, and 7 days. At each time point, cardiac magnetic resonance (CMR) T2- and T2*-mapping scans were recorded, and myocardial tissue samples were collected to quantify IMH and myocardial water content. After normalization by the number of red blood cells in remote tissue, histological IMH increased 5.2-fold, 10.7-fold, and 4.1-fold at Days 1, 4, and 7, respectively. The presence of IMH was correlated more strongly with R2* (r = 0.69; P = 0.013) than with T2* (r = -0.50; P = 0.085). The correlation with IMH was even stronger for R2' (r = 0.72; P = 0.008). For myocardial oedema, the correlation was stronger for R2* (r = -0.63; P = 0.029) than for R2' (r = -0.50; P = 0.100). Multivariate linear regressions confirmed that R2* values were significantly explained by both IMH and oedema, whereas R2' values were mostly explained by histological IMH (P = 0.024) and were little influenced by myocardial oedema (P = 0.262). Using CMR mapping with histological validation in a pig model of reperfused MI, R2'more accurately detected IMH and was less influenced by oedema than R2* (and T2*). Further studies are needed to elucidate whether R2' is also better suited for the characterization of post-MI IMH in the clinical setting.This study was partially supported by a competitive grant from the Carlos III Institute of Health-Fondo de Investigacion Sanitaria and the European Regional Development Fund (ERDF/FEDER) (PI16/02110), the Spanish Ministry of Science, Innovation and Universities (MICIU), ERDF/FEDER SAF2013-49663-EXP, by the Comunidad de Madrid (S2017/BMD-3867 RENIM-CM) and cofunded with European structural and investment funds. This study forms part of a Master Research Agreement between the CNIC and Philips Healthcare. This research program is part of an institutional agreement between FIIS Fundacion Jimenez Diaz and the CNIC. The CNIC is supported by the Ministry of Science, Innovation and Universities MICIU the Instituto de Salud Carlos III (ISCiii), and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (award SEV-2015-0505). X.R. has received support from the DYSEC-CNIC CARDIOJOVEN fellowship program. R.F.-J. is a recipient of funding from the European Union Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie (Agreement No. 707642).S

    Summary report of MINSIS workshop in Madrid

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    Recent developments on tau detection technologies and the construction of high intensity neutrino beams open the possibility of a high precision search for non-standard {\mu} - {\tau} flavour transition with neutrinos at short distances. The MINSIS - Main Injector Non-Standard Interaction Search- is a proposal under discussion to realize such precision measurement. This document contains the proceedings of the workshop which took place on 10-11 December 2009 in Madrid to discuss both the physics reach as well as the experimental requirements for this proposal.Comment: Proceedings of the MINSIS Workshop, Dec 10-11, 2009 in Madrid. 15 pages late

    Knowledge, attitudes and preventive practices of primary health care professionals towards alcohol use: A national, cross-sectional study.

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    Introduction Primary care (PC) professionals' knowledge about alcohol use has been identified as one of the barriers PC providers face in their clinic. Both PC professionals’ level of training and attitude are crucial in the clinical practice regarding alcohol use. Objective To evaluate the knowledge, attitude, and preventive practices of Spanish PC physicians and nurses towards alcohol use. Design An observational, descriptive, cross-sectional, multi-center study. Methodology Location: PC centers of the Spanish National Health System (NHS). Participants: PC physicians and nurses selected randomly from health care centers, and by sending an e-mail to semFYC and SEMERGEN members. Healthcare providers completed an online survey on knowledge, attitude, and follow-up recommendations for reducing alcohol intake. A descriptive, bivariate, and multivariate statistical analysis was conducted (p<0.05). Results Participants: 1,760 healthcare providers completed the survey (75.6% [95% CI 73.5–77.6] family physicians; 11.4% [95% CI 9.9–12.9] medical residents; and 12.5% [95% CI 10.9–14.1] nurses), with a mean age of 44.7 (SD 11.24, range: 26–64, 95% CI: 47.2–48.2). Knowledge was higher in family physicians (p<0.001), older professionals (Spearman's r = 0.11, p<0.001), and resident trainers (p<0.001). The PC professional most likely to provide advice for reducing alcohol use was: a nurse (p <0.001), female (p = 0.010), between 46 and 55 years old (p <0.001). Conclusions PC providers’ knowledge and preventive practices regarding alcohol use are scarce, hence specific training strategies to increase their knowledge and improve their attitude and skills with regard to this health problem should be considered a healthcare policy priority.post-print507 K

    The Molecular Tumor Board Portal supports clinical decisions and automated reporting for precision oncology

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    Cancer; Cancer geneticsCáncer; Genética del cáncerCàncer; Genètica del càncerThere is a growing need for systems that efficiently support the work of medical teams at the precision-oncology point of care. Here, we present the implementation of the Molecular Tumor Board Portal (MTBP), an academic clinical decision support system developed under the umbrella of Cancer Core Europe that creates a unified legal, scientific and technological platform to share and harness next-generation sequencing data. Automating the interpretation and reporting of sequencing results decrease the need for time-consuming manual procedures that are prone to errors. The adoption of an expert-agreed process to systematically link tumor molecular profiles with clinical actions promotes consistent decision-making and structured data capture across the connected centers. The use of information-rich patient reports with interactive content facilitates collaborative discussion of complex cases during virtual molecular tumor board meetings. Overall, streamlined digital systems like the MTBP are crucial to better address the challenges brought by precision oncology and accelerate the use of emerging biomarkers.Open access funding provided by Karolinska Institut

    Trends in primary total hip arthroplasty in Spain from 2001 to 2008: Evaluating changes in demographics, comorbidity, incidence rates, length of stay, costs and mortality

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    <p>Abstract</p> <p>Background</p> <p>Hip arthroplasties is one of the most frequent surgical procedures in Spain and are conducted mainly in elderly subjects. We aim to analyze changes in incidence, co-morbidity profile, length of hospital stay (LOHS), costs and in-hospital mortality (IHM) of patients undergoing primary total hip arthroplasty (THA) over an 8-year study period in Spain.</p> <p>Methods</p> <p>We selected all surgical admissions in individuals aged ≥40 years who had received a primary THA (ICD-9-CM procedure code 81.51) between 2001 and 2008 from the National Hospital Discharge Database. Age- and sex-specific incidence rates, LOHS, costs and IHM were estimated for each year. Co-morbidity was assessed using the Charlson comorbidity index.</p> <p>Multivariate analysis of time trends was conducted using Poisson regression. Logistic regression models were conducted to analyze IHM.</p> <p>Results</p> <p>We identified a total of 161,791 discharges of patients having undergone THA from 2001 to 2008. Overall crude incidence had increased from 99 to 105 THA per 100.000 inhabitants from 2001 to 2008 (p < 0.001). In 2001, 81% of patients had a Charlson Index of 0, 18.4% of 1-2, and 0.6% > 2 and in 2008, the prevalence of 1-2 or >2 had increased to 20.4% and 1.1% respectively (p < 0.001). The mean LOHS was 13 days in 2001 and decreased to 10.45 days in 2008 (p < 0.001). During the period studied, the mean cost per patient increased from 6,634 to 9,474 Euros. Multivariate analysis shows that from 2001 to 2008 the incidence of THA hospitalizations has significantly increased for both sexes and only men showed a significant reduction in IHM after THA.</p> <p>Conclusions</p> <p>The current study provides clear and valid data indicating increased incidence of primary THA in Spain from 2001 to 2008 with concomitant reductions in LOHS, slight reduction IHM, but a significant increase in cost per patient. The health profile of the patient undergoing a THA seems to be worsening in Spain.</p

    Standardized Classification of Aortic Arch Branching Patterns (SCAABP)

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    Objectives. To review current anatomical classifications for the aortic branching patterns and propose a method for standardized classification of Aortic Arch Branching Patterns (SCAABP). Methods. Through a three-stage Delphi method, expert vascular anatomists in morphology design SCAABP to report trunks, branches, and laterality of aortic arch branching patterns. Results. SCAABP is a classification that includes 7 parameters (Number of branches, and 6 types of branches [braquiocephalic trunk, common trunk, common carotid, subclavian artery, vertebral artery, and ectopic arteries]). It can integrate all reported branching patterns and allows the classification of new or unreported patterns. The classification allows standardization for future comparison of results, and improvement of evidence-based anatomy. Conclusions. SCAABP is a standardized method for classifying anatomical variants of the aortic arch. It is simple, clear, and contemplates new variants. All reported classifications can be integrated

    Trends in the Management of Non-Vestibular Skull Base and Intracranial Schwannomas

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    The aim of this review is to analyze the latest trends in the management of nonvestibular skull base and intracranial schwannomas in order to optimize tumor control and quality of life. Non-vestibular cranial nerve schwannomas are rare lesions, representing 5-10% of cranial nerve schwannomas. Management decisions should be individualized depending on tumor size, location and associated functional deficits. Generally, large sized schwannomas exerting significant mass effect with increased intracranial pressure are treated surgically. In some cases, even after optimal skull base resection, it is not possible to achieve a gross total resection because tumor location and extent and/or to reduce morbidity. Thus, subtotal resection followed by stereotactic radiosurgery or fractioned radiotherapy offers an alternative approach. In certain cases, stereotactic radiosurgery or radiotherapy alone achieves good tumor control rates and less morbidity to gross total resection. Finally, given the slow growth rate of most of these tumors, observation with periodic radiographic follow-up approach is also a reasonable alternative for small tumors with few, if any, symptoms.Peer reviewe
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