Management of Hypnotics in Patients with Insomnia and Heart Failure during Hospitalization: A Systematic Review

Background: Heart failure is a chronic, progressive syndrome of signs and symptoms, which has been associated to a range of comorbidities including insomnia. Acute decompensation of heart failure frequently leads to hospital admission. During hospital admission, long-term pharmacological treatments such as hypnotics can be modified or stopped. Aim: To synthesize the scientific evidence available about the effect of withdrawing hypnotic drugs during hospital admission in patients with decompensated heart failure and insomnia. Method: A systematic review of the literature following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines was carried out in the following scientific databases: PubMed, Scopus, Dialnet and Cochrane. Inclusion criteria: studies including a population of adults with heart failure and sleep disorders in treatment with hypnotics and admitted to hospital, studies written in English or Spanish and published until June 2020. Exclusion criteria: studies involving children, patients admitted to intensive care and patients diagnosed with sleep apnea. Results: We identified a total of 265 documents; only nine papers met the selection criteria. The most frequently used drugs for the treatment of insomnia in patients with heart failure were benzodiazepines and benzodiazepine agonists; their secondary effects can alter perceived quality of life and increase the risk of adverse effects. Withdrawal of these drugs during hospital admission could increase the risk of delirium. Future research in this area should evaluate the management of hypnotics during hospital admission in patients with decompensated heart failure. In addition, safe and efficient non-pharmacological alternatives for the treatment of insomnia in this population should be tested and implemented

Go/rGo as reinforcing nanofiller in carbon fiber/epoxy resin composite systems

Interfacial interactions between matrix and reinforcement of composites influences greatly in final properties of the material. Carbon Fibers are characterized for to have low interactions with resins when forming a composite material. In the present study, 0.3 wt% of GO/rGO were incorporated in three systems of epoxy resin/carbon fiber as reinforcing fillers, trying to profit the chemical affinity between aromatics structures of GO/rGO and polar interactions with epoxy resin. GO/rGO were characterized by XPS, TGA was performed on carbon fiber, epoxy resins and composites obtained and SEM was utilized to observe composite samples in detail once mechanical tests were conducted. Composites experienced noticeable enhancements by employing Bisphenol Epoxy (BP) cured with methyl cyclohexane-1,2-dicarboxylic anhydride (MCHDA) as matrix and carbon fiber of 300 g/cm2 as reinforcement; Youngs modulus, rupture stress and elongation to fail- ure increased almost twofold compared to non-modified composites by adding GO in the system and even superior boosts can be appreciated with rGO, which additionally improves the flexural stress from 14.6 to 30.1 GPa.Postprint (published version

Redshift distributions of galaxies in the Dark Energy Survey Science Verification shear catalogue and implications for weak lensing

We present photometric redshift estimates for galaxies used in the weak lensing analysis of the Dark Energy Survey Science Verification (DES SV) data. Four model- or machine learning-based photometric redshift methods—ANNZ2, BPZ calibrated against BCC-Ufig simulations, SKYNET, and TPZ—are analyzed. For training, calibration, and testing of these methods, we construct a catalogue of spectroscopically confirmed galaxies matched against DES SV data. The performance of the methods is evaluated against the matched spectroscopic catalogue, focusing on metrics relevant for weak lensing analyses, with additional validation against COSMOS photo-z’s. From the galaxies in the DES SV shear catalogue, which have mean redshift 0.72 0.01 over the range 0.3 < z < 1.3, we construct three tomographic bins with means of z ¼ f0.45; 0.67; 1.00g. These bins each have systematic uncertainties δz ≲ 0.05 in the mean of the fiducial SKYNET photo-z nðzÞ. We propagate the errors in the redshift distributions through to their impact on cosmological parameters estimated with cosmic shear, and find that they cause shifts in the value of σ8 of approximately 3%. This shift is within the one sigma statistical errors on σ8 for the DES SV shear catalogue. We further study the potential impact of systematic differences on the critical surface density, Σcrit, finding levels of bias safely less than the statistical power of DES SV data. We recommend a final Gaussian prior for the photo-z bias in the mean of nðzÞ of width 0.05 for each of the three tomographic bins, and show that this is a sufficient bias model for the corresponding cosmology analysis

Proposal for the design and implementation of a mixture of concrete and recycled aggregates to improve the bearing capacity of sandy soils in the Puente Piedra district in Zapallal, Lima

En la ciudad de Lima, el incremento de las obras de construcción ha generado gran cantidad de restos provenientes de la construcción y demolición de edificaciones. Como consecuencia, un aumento de escombros debido a la inadecuada gestión y la falta del cumplimiento del reglamento de manejo de residuos sólidos de las construcciones y demoliciones. La presente investigación titulada “Propuesta de diseño e implementación de mezcla de concreto y agregados reciclados para la mejora de la capacidad portante de suelos arenosos en el distrito de Puente Piedra en Zapallal, Lima” tiene un enfoque exploratorio y experimental; cuyo objetivo es utilizar los residuos de construcción y demolición de edificaciones como un agregado reciclado para el mejoramiento de propiedades mecánicas de suelos arenosos. Para ello, se propone una nueva mezcla de concreto reciclado y suelo natural arenoso que logre cumplir con los requerimientos que exige la norma técnica CE 010 pavimentos urbanos. Dicha norma requiere una Relación de Soporte de California (CBR) mayor al 30% y un grado de compactación de 95% para la capa base de estructuras de baja transitabilidad. En consecuencia, esta nueva combinación sería una buena alternativa para mejorar la resistencia a la penetración y al esfuerzo cortante de suelos arenosos. Esta combinación será útil como base para diferentes construcciones de pavimentos urbanos menores, entre ellas veredas o aceras y pasajes peatonales y otras estructuras de tránsito con baja demanda de carga. Además, con la implementación de la propuesta se lograría reducir el exceso de residuos de concreto arrojados en las vías públicas, playas, ríos, acantilados, etc. Ya que pasarían a una planta de transferencia y formarían parte del ciclo de reúso.In the city of Lima, the increase in construction works has generated a large amount of remains from the construction and demolition of buildings. Consequently, an increase in debris due to inadequate management and lack of compliance with the regulations for the management of solid waste from construction and demolition. The present research titled “Proposal for the design and implementation of a mixture of concrete and recycled aggregates to improve the bearing capacity of sandy soils in the Puente Piedra district in Zapallal, Lima” has an exploratory and experimental approach; whose objective is to use construction and demolition waste from buildings as a recycled aggregate to improve the mechanical properties of sandy soils. To do this, a new mixture of recycled concrete and natural sandy soil is proposed that meets the requirements of the technical standard CE 010 for urban pavements. This standard requires a California Bearing Ratio (CBR) greater than 30% and a degree of compaction of 95% for the base layer of low- trafficability structures. Consequently, this new combination would be a good alternative to improve the resistance to penetration and shear stress of sandy soils. This combination will be useful as a base for different constructions of minor urban pavements, including sidewalks, bicycle lanes, pedestrian passages, sports slabs, and other traffic structures with low load demand. Furthermore, with the implementation of the proposal it would be possible to reduce the excess of concrete waste dumped on public roads, beaches, rivers, cliffs, etc. Since they would go to a transfer plant and be part of the reuse cycle.Trabajo de Suficiencia Profesiona

Sleep quality in patients with heart failure in the spanish population: A cross-sectional study

Background: Heart failure is a major problem in western societies. Sleep Disorders maintain a bidirectional relationship with heart failure, as shown by studies conducted in other countries. This study aims to describe the quality of sleep in Spanish patients with heart failure. Materials and methods: We carried out a cross-sectional study to analyze the quality of sleep in a sample of 203 patients with a diagnosis of heart failure admitted to an Internal Medicine Service. The Pittsburg Sleep Quality Index (PSQI) was used to evaluate sleep quality in our sample over a one-month period. Results: 75% of the sample presented sleep disorders. The most common problems included the interruption of sleep (73.5% nocturia and 30% breathing difficulties); 35% had poor sleep efficiency; 33% showed a decrease in daytime performance; 84% had used hypnotics at some point to induce sleep and 35% used them regularly. Conclusions: This is the first study to report on the perceived sleep quality of patients with heart failure in Spain. Self-perception of sleep quality differed from that estimated by the PSQI. The prevalence of the use of sleep-inducing medication was very high. The diurnal dysfunction generated by sleep disorders in a heart failure environment can contribute to the development of self-care and cognitive deterioration problems

Go/rGo as reinforcing nanofiller in carbon fiber/epoxy resin composite systems

Interfacial interactions between matrix and reinforcement of composites influences greatly in final properties of the material. Carbon Fibers are characterized for to have low interactions with resins when forming a composite material. In the present study, 0.3 wt% of GO/rGO were incorporated in three systems of epoxy resin/carbon fiber as reinforcing fillers, trying to profit the chemical affinity between aromatics structures of GO/rGO and polar interactions with epoxy resin. GO/rGO were characterized by XPS, TGA was performed on carbon fiber, epoxy resins and composites obtained and SEM was utilized to observe composite samples in detail once mechanical tests were conducted. Composites experienced noticeable enhancements by employing Bisphenol Epoxy (BP) cured with methyl cyclohexane-1,2-dicarboxylic anhydride (MCHDA) as matrix and carbon fiber of 300 g/cm2 as reinforcement; Youngs modulus, rupture stress and elongation to fail- ure increased almost twofold compared to non-modified composites by adding GO in the system and even superior boosts can be appreciated with rGO, which additionally improves the flexural stress from 14.6 to 30.1 GPa

Go/rGo as reinforcing nanofiller in carbon fiber/epoxy resin composite systems

Interfacial interactions between matrix and reinforcement of composites influences greatly in final properties of the material. Carbon Fibers are characterized for to have low interactions with resins when forming a composite material. In the present study, 0.3 wt% of GO/rGO were incorporated in three systems of epoxy resin/carbon fiber as reinforcing fillers, trying to profit the chemical affinity between aromatics structures of GO/rGO and polar interactions with epoxy resin. GO/rGO were characterized by XPS, TGA was performed on carbon fiber, epoxy resins and composites obtained and SEM was utilized to observe composite samples in detail once mechanical tests were conducted. Composites experienced noticeable enhancements by employing Bisphenol Epoxy (BP) cured with methyl cyclohexane-1,2-dicarboxylic anhydride (MCHDA) as matrix and carbon fiber of 300 g/cm2 as reinforcement; Youngs modulus, rupture stress and elongation to fail- ure increased almost twofold compared to non-modified composites by adding GO in the system and even superior boosts can be appreciated with rGO, which additionally improves the flexural stress from 14.6 to 30.1 GPa

The PANDEMYC Score. An Easily Applicable and Interpretable Model for Predicting Mortality Associated With COVID-19.

This study aimed to build an easily applicable prognostic model based on routine clinical, radiological, and laboratory data available at admission, to predict mortality in coronavirus 19 disease (COVID-19) hospitalized patients. We retrospectively collected clinical information from 1968 patients admitted to a hospital. We built a predictive score based on a logistic regression model in which explicative variables were discretized using classification trees that facilitated the identification of the optimal sections in order to predict inpatient mortality in patients admitted with COVID-19. These sections were translated into a score indicating the probability of a patient's death, thus making the results easy to interpret. Median age was 67 years, 1104 patients (56.4%) were male, and 325 (16.5%) died during hospitalization. Our final model identified nine key features: age, oxygen saturation, smoking, serum creatinine, lymphocytes, hemoglobin, platelets, C-reactive protein, and sodium at admission. The discrimination of the model was excellent in the training, validation, and test samples (AUC: 0.865, 0.808, and 0.883, respectively). We constructed a prognostic scale to determine the probability of death associated with each score. We designed an easily applicable predictive model for early identification of patients at high risk of death due to COVID-19 during hospitalization.S

Characteristics, complications and outcomes among 1549 patients hospitalised with COVID-19 in a secondary hospital in Madrid, Spain: a retrospective case series study

Objectives To describe demographic, clinical, radiological and laboratory characteristics, as well as outcomes, of patients admitted for COVID-19 in a secondary hospital.Design and setting Retrospective case series of sequentially hospitalised patients with confirmed SARS-CoV-2, at Infanta Leonor University Hospital (ILUH) in Madrid, Spain.Participants All patients attended at ILUH testing positive to reverse transcriptase-PCR on nasopharyngeal swabs and diagnosed with COVID-19 between 1 March 2020 and 28 May 2020.Results A total of 1549 COVID-19 cases were included (median age 69 years (IQR 55.0–81.0), 57.5% men). 78.2% had at least one underlying comorbidity, the most frequent was hypertension (55.8%). Most frequent symptoms at presentation were fever (75.3%), cough (65.7%) and dyspnoea (58.1%). 81 (5.8%) patients were admitted to the intensive care unit (ICU) (median age 62 years (IQR 51–71); 74.1% men; median length of stay 9 days (IQR 5–19)) 82.7% of them needed invasive ventilation support. 1393 patients had an outcome at the end of the study period (case fatality ratio: 21.2% (296/1393)). The independent factors associated with fatality (OR; 95% CI): age (1.07; 1.06 to 1.09), male sex (2.86; 1.85 to 4.50), neurological disease (1.93; 1.19 to 3.13), chronic kidney disease (2.83; 1.40 to 5.71) and neoplasia (4.29; 2.40 to 7.67). The percentage of hospital beds occupied with COVID-19 almost doubled (702/361), with the number of patients in ICU quadrupling its capacity (32/8). Median length of stay was 9 days (IQR 6–14).Conclusions This study provides clinical characteristics, complications and outcomes of patients with COVID-19 admitted to a European secondary hospital. Fatal outcomes were similar to those reported by hospitals with a higher level of complexity