In situ hydration imaging study of a ye'elimite paste by ptychographic x-ray computed tomography

Eco-cements are a desirable alternative to ordinary Portland cements because of their lower CO2 footprints. For instance, the manufacture of Calcium SulfoAluminate (CSA) cements is more environmentally friendly than that of Portland cements as their production may decrease CO2 footprint by up to 40%. CSA cements contain ye'elimite, Ca4Al6O12SO4, as main phase. The hydration of ye'elimite leads to hydrated compounds such as crystalline ettringite (AFt), crystalline monosulfoaluminate (AFm) and amorphous aluminum hydroxide gel, Al(OH)3·nH2O. Here, we report the results of a ptychographic X-ray computed tomography (PXCT) study on the in situ hydration of ye'elimite with gypsum at different early ages. PXCT is a nondestructive X-ray imaging technique which provides 3D electron density and attenuation coefficient distributions of cement pastes with an isotropic resolution close to 100 nm allowing distinguishing between component phases with very similar contrast in more conventional absorption-based X-ray tomography. The sample was prepared by hydrating ye'elimite with gypsum. Four datasets were recorded at 48, 53, 58 and 63 hours of hydration. The main aim of this imaging study was to quantify the microstructure evolution, within this time interval, with submicrometer spatial resolution. The different component phases were identified and their mass densities determined. Furthermore, the tomograms were segmented and the volume percentage of each component were determined and compared at the four hydrating ages. The overall porosity content (air and pore solution) decreased from 11.5 to 8.8 vol% and the anhydrous material content (ye'elimite and gypsum) decreased from 14.7 to 7.5 vol% in the studied time interval. Correspondingly, the hydrated content (crystalline ettringite and aluminum hydroxide gel) increased from 73.7 to 83.7 vol%. The time evolution of several anhydrous particles was analyzed to determine the dissolution rate of the ye'elimite particles. Similarly, the pore filling process has also been investigated by quantifying their time evolution. These rates are reported and some insights about the mechanisms of these processes are discussed.This work has been supported by MINECO through BIA2014−57658-C2-1-R and BIA2014-57658-C2-2-R, which is cofunded by FEDER, research grants. We thank SLS for providing beamtime at the cSAXS beamline. We also thank the Swiss National Science Foundation SNF for the support to the work of J.C.d.S. (Grant 137772). Instrumentation development was supported by SNF (R’EQUIP, No. 145056,“OMNY”) and the Competence Centre for Materials Science and Technology (CCMX) of the ETH-Board, Switzerland. In addition, the authors would like to thank Dr. Manuel Guizar-Sicairos for his valuable assistance with the ptychography and PXCT data analysis

A practice-based randomized controlled trial to improve medication adherence among Latinos with hypertension: study protocol for a randomized controlled trial

BACKGROUND: Latinos experience disproportionately higher rates of uncontrolled hypertension as compared to Blacks and Whites. While poor adherence is a major contributor to disparities in blood pressure control, data in Latino patients are scant. More importantly, translation of interventions to improve medication adherence in community-based primary care practices, where the majority of Latino patients receive their care is non-existent. METHODS: Using a randomized controlled design, this study evaluates the effectiveness of a culturally tailored, practice-based intervention compared to usual care on medication adherence, among 148 Latino patients with uncontrolled hypertension who are non-adherent to their antihypertensive medications. Bilingual medical assistants trained as Health Coaches deliver the intervention using an electronic medical record system-embedded adherence script. Patients randomized to the intervention group receive patient-centered counseling with a Health Coach to develop individualized self-monitoring strategies to overcome barriers and improve adherence behaviors. Health Coach sessions are held biweekly for the first 3 months (6 sessions total) and then monthly for the remaining 3 months (3 sessions total). Patients randomized to the usual care group receive standard hypertension treatment recommendations as determined by their primary care providers. The primary outcome is the rate of medication adherence at 6 months. The secondary outcome is reduction in systolic and diastolic blood pressure at 6 months. DISCUSSION: If successful, findings from this study will provide salient information on the translation of culturally tailored, evidence-based interventions targeted at medication adherence and blood pressure control into practice-based settings for this high-risk population. TRIAL REGISTRATION: NCT01643473 on 16 July 2012

Hydration studies of ye’elimite by using Ptychographic X-ray nano-tomography

CSA (Calcium SulfoAluminate) cements may have variable compositions but all of them contain ye’elimite(Ca4Al6O12SO4). The manufacture of CSA cements is more environmentally friendly than that of ordinary Portland cements as their production releases up to 40% less CO2. The hydration of ye’elimite leads to crystalline ettringite (AFt) and amorphous aluminum hydroxide (AH3•nH2O). Ptychographic X-ray computed nanotomography (PXCT) has been used here to study the hydration of ye’elimite-containing samples. PXCT is an X-ray imaging technique having demonstrated an isotropic 3D resolution better than 20 nm[1]. PXCT, which nondestructively provides 3D images of the sample complex-valued X-ray refractive index, has been recently applied for hydration studies of Portland cement samples[2]. Samples for this study were measured in cSAXS beamline (Swiss Light Source). The main goal of this study has been the quantification of the electron and mass densities of the phases present in these samples. These mass densities were compared with the theoretical values in order to identify the phases and matched well the expected values. For instance, the hydration of pure ye’elimite with gypsum sample was studied. This sample should show a large amount of AFt due to the presence of gypsum in the hydration medium. This is precisely what it was observed from the analysis of the histogram. Figure 1 shows the tomogram of one slice obtained for this sample. The most relevant results for CSA cement hydration will be discussed. A volume of interest (VOI) histogram has been studied in order to identify all the phases. Figure 2 shows a comparison between the histogram obtained in this study and a previous one performed by Gastaldi et al. (2012) at TOMCAT Beamline (Swiss Light Source). As it can be observed, TOMCAT data cannot properly distinguish between AFt and ye'elimite phase. Conversely, PXCT technique can resolve the peaks for all the phases present in CSA cements. All reconstructions have been successful and now we are analyzing the data (segmentation, etc.) to characterize the porosities and the shape and size of the different phase, chiefly ettringite.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone

AbstractThe aim of this study was to assess changes in antibiotic resistance, epidemiology and outcome among patients with Enterococcus faecalis infective endocarditis (EFIE) and to compare the efficacy and safety of the combination of ampicillin and gentamicin (A+G) with that of ampicillin plus ceftriaxone (A+C). The study was a retrospective analysis of a prospective cohort of EFIE patients treated in our centre from 1997 to 2011. Thirty patients were initially treated with A+G (ampicillin 2 g/4 h and gentamicin 3 mg/kg/day) and 39 with A+C (ampicillin 2 g/4 h and ceftriaxone 2 g/12 h) for 4–6 weeks. Increased rates of high-level aminoglycoside resistance (HLAR; gentamicin MIC ≥512 mg/L, streptomycin MIC ≥1024 mg/L or both) were observed in recent years (24% in 1997–2006 and 49% in 2007–2011; p 0.03). The use of A+C increased over time: 1997–2001, 4/18 (22%); 2002–2006, 5/16 (31%); 2007–2011, 30/35 (86%) (p <0.001). Renal failure developed in 65% of the A+G group and in 34% of the A+C group (p 0.014). Thirteen patients (43%) in the A+G group had to discontinue treatment, whereas only one patient (3%) treated with A+C had to discontinue treatment (p <0.001). Only development of heart failure and previous chronic renal failure were independently associated with 1-year mortality, while the individual antibiotic regimen (A+C vs. A+G) did not affect outcome (OR, 0.7; 95% CI, 0.2–2.2; p 0.549). Our study shows that the prevalence of HLAR EFIE has increased significantly in recent years and that alternative treatment with A+C is safer than A+G, with similar clinical outcomes, although the sample size is too small to draw firm conclusions. Randomized controlled studies are needed to confirm these results

Strong magnetoelastic effect in CeCo1-xFexSi as Néel order is suppressed

A very strong magnetoelastic effect in the CeCo1-xFexSi alloys is reported. The strength of the magnetostrictive effect can be tuned upon changing x. The moderate low-temperature linear magnetostriction observed at low Fe concentrations becomes very large (ΔLL16T,2K=3×10-3) around the critical concentration xc≈0.23 at which the long-range antiferromagnetic order vanishes. Upon increasing doping through the nonmagnetic region (x>xc), the magnetostriction strength gradually weakens again. The interplay between magnetic order and the Kondo screening appears to cause an enhanced valence susceptibility slightly changing the Ce ions valence, ultimately triggering the large magnetostriction observed around the critical concentration. Previous studies of the evolution of the lattice parameters with x as well as magnetization and x-ray absorption spectroscopy measurements support this hypothesis.Fil: Correa, Víctor Félix. Comisión Nacional de Energía Atómica. Gerencia del Area de Investigación y Aplicaciones No Nucleares. Gerencia de Física (Centro Atómico Bariloche). División Bajas Temperaturas; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Villagrán Asiares, Alberto Gaston. Comisión Nacional de Energía Atómica. Gerencia del Area de Investigación y Aplicaciones No Nucleares. Gerencia de Física (Centro Atómico Bariloche). División Bajas Temperaturas; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; ArgentinaFil: Betancourth Giraldo, Diana Maria. Comisión Nacional de Energía Atómica. Gerencia del Area de Investigación y Aplicaciones No Nucleares. Gerencia de Física (Centro Atómico Bariloche). División Bajas Temperaturas; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Encina, Sergio. Comisión Nacional de Energía Atómica. Gerencia del Area de Investigación y Aplicaciones No Nucleares. Gerencia de Física (Centro Atómico Bariloche). División Bajas Temperaturas; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Pedrazzini, Pablo. Comisión Nacional de Energía Atómica. Gerencia del Area de Investigación y Aplicaciones No Nucleares. Gerencia de Física (Centro Atómico Bariloche). División Bajas Temperaturas; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Cornaglia de la Cruz, Pablo Sebastian. Comisión Nacional de Energía Atómica. Gerencia del Área Investigaciones y Aplicaciones No Nucleares. Gerencia de Física (CAB). Grupo de Teoría de Sólidos; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Garcia, Daniel Julio. Comisión Nacional de Energía Atómica. Gerencia del Área Investigaciones y Aplicaciones No Nucleares. Gerencia de Física (CAB). Grupo de Teoría de Sólidos; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Sereni, Julian Gustavo Renzo. Comisión Nacional de Energía Atómica. Gerencia del Area de Investigación y Aplicaciones No Nucleares. Gerencia de Física (Centro Atómico Bariloche). División Bajas Temperaturas; Argentina. Comisión Nacional de Energía Atómica. Gerencia del Área de Energía Nuclear. Instituto Balseiro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Maiorov, B.. Los Alamos National High Magnetic Field Laboratory; Estados UnidosFil: Caroca Canales, N.. Max planck institut Fur Chemische Physik Fester Stoffe; AlemaniaFil: Geibel, C.. Max planck institut Fur Chemische Physik Fester Stoffe; Alemani

Nanoinformatics: developing new computing applications for nanomedicine

Nanoinformatics has recently emerged to address the need of computing applications at the nano level. In this regard, the authors have participated in various initiatives to identify its concepts, foundations and challenges. While nanomaterials open up the possibility for developing new devices in many industrial and scientific areas, they also offer breakthrough perspectives for the prevention, diagnosis and treatment of diseases. In this paper, we analyze the different aspects of nanoinformatics and suggest five research topics to help catalyze new research and development in the area, particularly focused on nanomedicine. We also encompass the use of informatics to further the biological and clinical applications of basic research in nanoscience and nanotechnology, and the related concept of an extended ?nanotype? to coalesce information related to nanoparticles. We suggest how nanoinformatics could accelerate developments in nanomedicine, similarly to what happened with the Human Genome and other -omics projects, on issues like exchanging modeling and simulation methods and tools, linking toxicity information to clinical and personal databases or developing new approaches for scientific ontologies, among many others

Acute febrile illness is associated with Rickettsia spp infection in dogs

BACKGROUND: Rickettsia conorii is transmitted by Rhipicephalus sanguineus ticks and causes Mediterranean Spotted Fever (MSF) in humans. Although dogs are considered the natural host of the vector, the clinical and epidemiological significance of R. conorii infection in dogs remains unclear. The aim of this prospective study was to investigate whether Rickettsia infection causes febrile illness in dogs living in areas endemic for human MSF. METHODS: Dogs from southern Italy with acute fever (n = 99) were compared with case–control dogs with normal body temperatures (n = 72). Serology and real-time PCR were performed for Rickettsia spp., Ehrlichia canis, Anaplasma phagocytophilum/A. platys and Leishmania infantum. Conventional PCR was performed for Babesia spp. and Hepatozoon spp. Acute and convalescent antibodies to R. conorii, E. canis and A. phagocytophilum were determined. RESULTS: The seroprevalence rates at first visit for R. conorii, E. canis, A. phagocytophilum and L. infantum were 44.8%, 48.5%, 37.8% and 17.6%, respectively. The seroconversion rates for R. conorii, E. canis and A. phagocytophilum were 20.7%, 14.3% and 8.8%, respectively. The molecular positive rates at first visit for Rickettsia spp., E. canis, A. phagocytophilum, A. platys, L. infantum, Babesia spp. and Hepatozoon spp. were 1.8%, 4.1%, 0%, 2.3%, 11.1%, 2.3% and 0.6%, respectively. Positive PCR for E. canis (7%), Rickettsia spp. (3%), Babesia spp. (4.0%) and Hepatozoon spp. (1.0%) were found only in febrile dogs. The DNA sequences obtained from Rickettsia and Babesia PCRs positive samples were 100% identical to the R. conorii and Babesia vogeli sequences in GenBank®, respectively. Febrile illness was statistically associated with acute and convalescent positive R. conorii antibodies, seroconversion to R. conorii, E. canis positive PCR, and positivity to any tick pathogen PCRs. Fourteen febrile dogs (31.8%) were diagnosed with Rickettsia spp. infection based on seroconversion and/or PCR while only six afebrile dogs (12.5%) seroconverted (P = 0.0248). The most common clinical findings of dogs with Rickettsia infection diagnosed by seroconversion and/or PCR were fever, myalgia, lameness, elevation of C-reactive protein, thrombocytopenia and hypoalbuminemia. CONCLUSIONS: This study demonstrates acute febrile illness associated with Rickettsia infection in dogs living in endemic areas of human MSF based on seroconversion alone or in combination with PCR

A Precision Treatment Model for Internet-Delivered Cognitive Behavioral Therapy for Anxiety and Depression among University Students:A Secondary Analysis of a Randomized Clinical Trial

Importance: Guided internet-delivered cognitive behavioral therapy (i-CBT) is a low-cost way to address high unmet need for anxiety and depression treatment. Scalability could be increased if some patients were helped as much by self-guided i-CBT as guided i-CBT. Objective: To develop an individualized treatment rule using machine learning methods for guided i-CBT vs self-guided i-CBT based on a rich set of baseline predictors. Design, Setting, and Participants: This prespecified secondary analysis of an assessor-blinded, multisite randomized clinical trial of guided i-CBT, self-guided i-CBT, and treatment as usual included students in Colombia and Mexico who were seeking treatment for anxiety (defined as a 7-item Generalized Anxiety Disorder [GAD-7] score of ≥10) and/or depression (defined as a 9-item Patient Health Questionnaire [PHQ-9] score of ≥10). Study recruitment was from March 1 to October 26, 2021. Initial data analysis was conducted from May 23 to October 26, 2022. Interventions: Participants were randomized to a culturally adapted transdiagnostic i-CBT that was guided (n = 445), self-guided (n = 439), or treatment as usual (n = 435). Main Outcomes and Measures: Remission of anxiety (GAD-7 scores of ≤4) and depression (PHQ-9 scores of ≤4) 3 months after baseline. Results: The study included 1319 participants (mean [SD] age, 21.4 [3.2] years; 1038 women [78.7%]; 725 participants [55.0%] came from Mexico). A total of 1210 participants (91.7%) had significantly higher mean (SE) probabilities of joint remission of anxiety and depression with guided i-CBT (51.8% [3.0%]) than with self-guided i-CBT (37.8% [3.0%]; P =.003) or treatment as usual (40.0% [2.7%]; P =.001). The remaining 109 participants (8.3%) had low mean (SE) probabilities of joint remission of anxiety and depression across all groups (guided i-CBT: 24.5% [9.1%]; P =.007; self-guided i-CBT: 25.4% [8.8%]; P =.004; treatment as usual: 31.0% [9.4%]; P =.001). All participants with baseline anxiety had nonsignificantly higher mean (SE) probabilities of anxiety remission with guided i-CBT (62.7% [5.9%]) than the other 2 groups (self-guided i-CBT: 50.2% [6.2%]; P =.14; treatment as usual: 53.0% [6.0%]; P =.25). A total of 841 of 1177 participants (71.5%) with baseline depression had significantly higher mean (SE) probabilities of depression remission with guided i-CBT (61.5% [3.6%]) than the other 2 groups (self-guided i-CBT: 44.3% [3.7%]; P =.001; treatment as usual: 41.8% [3.2%]; P &lt;.001). The other 336 participants (28.5%) with baseline depression had nonsignificantly higher mean (SE) probabilities of depression remission with self-guided i-CBT (54.4% [6.0%]) than guided i-CBT (39.8% [5.4%]; P =.07). Conclusions and Relevance: Guided i-CBT yielded the highest probabilities of remission of anxiety and depression for most participants; however, these differences were nonsignificant for anxiety. Some participants had the highest probabilities of remission of depression with self-guided i-CBT. Information about this variation could be used to optimize allocation of guided and self-guided i-CBT in resource-constrained settings. Trial Registration: ClinicalTrials.gov Identifier: NCT04780542.</p

Complications and outcomes of tubeless versus nephrostomy tube in percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized clinical trials

We aimed to perform a systematic review of randomized trials to summarize the evidence on the safety and stone-free rate after Tubeless percutaneous nephrolithotomy (PCNL) (ureteral stent/catheter, no nephrostomy) compared to Standard PCNL (nephrostomy, with/without ureteral stent/catheter) to evaluate if the tubeless approach is better. The inverse variance of the mean difference with a random effect, 95% Confidence Interval (CI), and p values was used for continuous variables. Categorical variables were assessed using Cochran-Mantel-Haenszel method with the random effect model, and reported as Risk Ratio (RR), 95% CI, and p values. Statistical significance was set at p < 0.05 and a 95% CI. 26 studies were included. Mean operative time was significantly shorter in the Tubeless group (MD-5.18 min, 95% CI - 6.56, - 3.80, p < 0.00001). Mean postoperative length of stay was also significantly shorter in the Tubeless group (MD-1.10 day, 95% CI - 1.48, - 0.71, p < 0.00001). Incidence of blood transfusion, angioembolization for bleeding control, pain score at the first postoperative day, the number of patients requiring postoperative pain medication, fever, urinary infections, sepsis, perirenal fluid collection, pleural breach, hospital readmission, and SFR did not differ between the two groups. Incidence of postoperative urinary fistula was significantly lower in the Tubeless group (RR 0.18, 95% CI 0.07, 0.47, p = 0.0005). This systematic review shows that tubeless PCNL can be safely performed and the standout benefits are shorter operative time and hospital stay, and a lower rate of postoperative urinary fistula.Universita Politecnica delle Marche within the CRUI-CARE Agreemen