Evaluation of Chloride Diffusion and Corrosion Resistance in Reinforced Concrete Using Internal Curing and Shrinkage Reducing Admixtures

The properties of high-performance concretes obtained by the internal curing technique were studied in the fresh and hardened states. In some of the concrete mixtures, fine normal weight aggregates were replaced with lightweight aggregates (LWA) at 20 % vol. and ordinary portland cement was replaced by pulverized class F fly ash at 20 % by mass. Additionally, some mixtures were prepared including a shrinkage-reducing admixture, either as part of the mixing water or pre-soaked into the lightweight fine aggregates. The prepared concretes were subjected to degradation tests, such as accelerated carbonation and chloride ion deterioration. In addition, the reinforced concretes were analyzed through electrochemical corrosion tests with the linear polarization resistance technique. It was found that the internally cured concretes presented a mechanical resistance similar to those reported for the reference concretes (conventional concretes), but provided a higher resistance to carbonation, rapid penetration of chloride ions, and a lower chloride ion diffusion coefficient. The reinforcing steel structure in the internally cured concretes showed lower corrosion currents (Icorr) and corrosion potentials (Ecorr) in comparison to the reference concretes. Therefore, the use of the internal curing technique in concretes with pre-soaking in either water or a solution of shrinkage-reducing admixture can be considered as a viable alternative to extend the service life of concrete structures in contact with harmful environments

Cáncer de pulmón no microcítico: quimioterapia y otros tratamientos sistémicos

Lung cancer is the most frequent neoplasia in industrialized countries and the leading cause of cancer death worldwide. Non-small cell lung cancer (NSCLC) accounts for 75-80% of lung carcinomas. Approximately one-third of these patients are diagnosed of locally advanced disease (Stage III of TNM staging system). Although surgery is the optimal treatment strategy, even in patients with stage I disease, approximately one third of them will die within 5 years, due to relapses and distant metastases. Several studies have explored the impact of neo-adyuvant chemotherapy in free disease survival and overall survival and adjuvant chemotherapy trials have been conducted to eliminate occult micrometastases and improve overall survival. In advanced disease, primary goals of therapy are palliation of symptoms as well as improvements in quality of life without high treatment-related toxicity

Nonferrous waste foundry sand and milling fly ash as alternative low mechanical strength materials for construction industry: effect on mortars at early ages

An alternative solution to reduce environmental pollution using aluminum waste foundry sand (AWFS) and fly ash (FA) to produce sustainable construction materials was studied. New mortars were prepared by partially replacing ordinary Portland cement with fly ash at 5, 10 and 15 % mass. and a total replace of Ottawa sand (OS) with AWFS. The specimens were cured at 25°C with a 100% relative humidity. The mechanical behavior was evaluated by compression test at the ages of 7, 14 and 28 days. The microstructural characteristics were analyzed by scanning electron microscopy (SEM). The results indicate that the addition of milling fly ash in AWFS mortars increases the mechanical resistance, mostly at 5% mass reaching the maximum value of 10 MPa at 28 days of age. Microstructurally, it was found a porous cement matrix with some cracking caused by the reaction of portland cement with the metallic aluminum remaining in the waste sand, which is correlated to the low mechanical resistance obtained. The final mechanical characteristic makes this new product a serious candidate to be used as a sustainable building material working at low load

Novel potential predictive markers of sunitinib outcomes in long-term responders versus primary refractory patients with metastatic clear-cell renal cell carcinoma

Background: several potential predictive markers of efficacy of targeted agents in patients with metastatic renal cell carcinoma (mRCC) have been identified. Interindividual heterogeneity warrants further investigation. Patients and methods: multicenter, observational, retrospective study in patients with clear-cell mRCC treated with sunitinib. Patients were classified in two groups: long-term responders (LR) (progression-free survival (PFS)≥22 months and at least stable disease), and primary refractory (PR) (progressive disease within 3-months of sunitinib onset). Objectives were to compare baseline clinical factors in both populations and to correlate tumor expression of selected signaling pathways components with sunitinib PFS. Results: 123 patients were analyzed (97 LR, 26 PR). In the LR cohort, overall response rate was 79% and median duration of best response was 30 months. Median PFS and overall survival were 43.2 (95% confidence intervals[CI]:37.2-49.3) and 63.5 months (95%CI:55.1-71.9), respectively. At baseline PR patients had a significantly lower proportion of nephrectomies, higher lactate dehydrogenase and platelets levels, lower hemoglobin, shorter time to and higher presence of metastases, and increased Fuhrman grade. Higher levels of HEYL, HEY and HES1 were observed in LR, although only HEYL discriminated populations significantly (AUC[ROC]=0.704; cut-off=34.85). Increased levels of hsa-miR-27b, hsa-miR-23b and hsa-miR-628-5p were also associated with prolonged survival. No statistical significant associations between hsa-miR-23b or hsa-miR-27b and the expression of c-Met were found. Conclusions: certain mRCC patients treated with sunitinib achieve extremely long-term responses. Favorable baseline hematology values and longer time to metastasis may predict longer PFS. HEYL, hsa-miR-27b, hsa-miR-23b and hsa-miR-628-5p could be potentially used as biomarkers of sunitinib response

Novel potential predictive markers of sunitinib outcomes in long-term responders versus primary refractory patients with metastatic clear-cell renal cell carcinoma

Background: Several potential predictive markers of efficacy of targeted agents in patients with metastatic renal cell carcinoma (mRCC) have been identified. Interindividual heterogeneity warrants further investigation. Patients and methods: Multicenter, observational, retrospective study in patients with clear-cell mRCC treated with sunitinib. Patients were classified in two groups: long-term responders (LR) (progression-free survival (PFS)=22 months and at least stable disease), and primary refractory (PR) (progressive disease within 3-months of sunitinib onset). Objectives were to compare baseline clinical factors in both populations and to correlate tumor expression of selected signaling pathways components with sunitinib PFS. Results: 123 patients were analyzed (97 LR, 26 PR). In the LR cohort, overall response rate was 79% and median duration of best response was 30 months. Median PFS and overall survival were 43.2 (95% confidence intervals[CI]:37.2-49.3) and 63.5 months (95%CI:55.1-71.9), respectively. At baseline PR patients had a significantly lower proportion of nephrectomies, higher lactate dehydrogenase and platelets levels, lower hemoglobin, shorter time to and higher presence of metastases, and increased Fuhrman grade. Higher levels of HEYL, HEY and HES1 were observed in LR, although only HEYL discriminated populations significantly (AUC[ROC]=0.704; cut-off=34.85). Increased levels of hsa-miR-27b, hsa-miR-23b and hsa-miR-628-5p were also associated with prolonged survival. No statistical significant associations between hsa-miR-23b or hsa-miR-27b and the expression of c-Met were found. Conclusions: Certain mRCC patients treated with sunitinib achieve extremely long-term responses. Favorable baseline hematology values and longer time to metastasis may predict longer PFS. HEYL, hsa-miR-27b, hsa-miR-23b and hsa-miR- 628-5p could be potentially used as biomarkers of sunitinib response

A correlative biomarker study and integrative prognostic model in chemotherapy-naïve metastatic castration-resistant prostate cancer treated with enzalutamide

There is a considerable need to incorporate biomarkers of resistance to new antiandrogen agents in the management of castration-resistant prostate cancer (CRPC). We conducted a phase II trial of enzalutamide in first-line chemo-naïve asymptomatic or minimally symptomatic mCRPC and analyzed the prognostic value of TMPRSS2-ERG and other biomarkers, including circulating tumor cells (CTCs), androgen receptor splice variant (AR-V7) in CTCs and plasma Androgen Receptor copy number gain (AR-gain). These biomarkers were correlated with treatment response and survival outcomes and developed a clinical-molecular prognostic model using penalized cox-proportional hazard model. This model was validated in an independent cohort. Ninety-eight patients were included. TMPRSS2-ERG fusion gene was detected in 32 patients with no differences observed in efficacy outcomes. CTC detection was associated with worse outcome and AR-V7 in CTCs was associated with increased rate of progression as best response. Plasma AR gain was strongly associated with an adverse outcome, with worse median prostate specific antigen (PSA)-PFS (4.2 vs. 14.7 m; p < 0.0001), rad-PFS (4.5 vs. 27.6 m; p < 0.0001), and OS (12.7 vs. 38.1 m; p < 0.0001). The clinical prognostic model developed in PREVAIL was validated (C-Index 0.70) and the addition of plasma AR (C-Index 0.79; p < 0.001) increased its prognostic ability. We generated a parsimonious model including alkaline phosphatase (ALP); PSA and AR gain (C-index 0.78) that was validated in an independent cohort. TMPRSS2-ERG detection did not correlate with differential activity of enzalutamide in first-line mCRPC. However, we observed that CTCs and plasma AR gain were the most relevant biomarkers

Adopting a High-Polyphenolic Diet Is Associated with an Improved Glucose Profile: Prospective Analysis within the PREDIMED-Plus Trial

Previous studies suggested that dietary polyphenols could reduce the incidence and complications of type-2 diabetes (T2D); although the evidence is still limited and inconsistent. This work analyzes whether changing to a diet with a higher polyphenolic content is associated with an improved glucose profile. At baseline, and at 1 year of follow-up visits, 5921 participants (mean age 65.0 ± 4.9, 48.2% women) who had overweight/obesity and metabolic syndrome filled out a validated 143-item semi-quantitative food frequency questionnaire (FFQ), from which polyphenol intakes were calculated. Energy-adjusted total polyphenols and subclasses were categorized in tertiles of changes. Linear mixed-effect models with random intercepts (the recruitment centers) were used to assess associations between changes in polyphenol subclasses intake and 1-year plasma glucose or glycosylated hemoglobin (HbA1c) levels. Increments in total polyphenol intake and some classes were inversely associated with better glucose levels and HbA1c after one year of follow-up. These associations were modified when the analyses were run considering diabetes status separately. To our knowledge, this is the first study to assess the relationship between changes in the intake of all polyphenolic groups and T2D-related parameters in a senior population with T2D or at high-risk of developing T2

Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours : results from the COPPADIS cohort

The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose

Educación Superior y Pandemia. Aprendizajes y buenas prácticas en Iberoamérica

La aportación actual no entra en analizar aspectos generales de la pandemia (naturaleza, origen, extensión general y en el país, etc.) o de otras situaciones que se derivan del confinamiento, por considerar que son suficientemente conocidos. Tampoco pretende realizar una recensión de informes sobre la temática elaborados por organismos como la UNESCO-IESALC, el Banco Mundial, el BID o la CRUE y revisar las aportaciones de investigadores de la temática. Más bien trata de aportar concreciones y dimensiones prácticas de la Educación Superior de cada país que puedan ayudar en los aspectos de organización y gestión de estas instituciones. En este sentido considera aspectos referidos a: (1) Desarrollo de las enseñanzas: alteraciones en la duración y estructura de los títulos; modificaciones de objetivos, metodologías y sistemas de evaluación; atención a colectivos vulnerables; etc.(2) Organización institucional: atención a las personas (gestión del alumnado, profesorado y personal de administración y servicios, rol de los directivos, etc.); infraestructuras; desarrollo de procesos (matriculación, gestión administrativa y económica, etc.); y resultados (académicos como tasa de aprobados, nivel de abandono u otros; y no académicos). (3) Vinculación con el entorno: actuaciones de y con la comunidad o colaboraciones significativas. Incluye el escrito de cada país con referencias y reflexiones sobre los anteriores aspectos, así como algunas experiencias de interés y, por último, reflexiones, valoraciones y retos sobre la gestión en los momentos de confinamiento y reapertura, con la idea de identificar aprendizajes significativos y orientaciones de cara a la actuación en la situación actual y similares que se puedan producir en el futuro. Las diferentes aportaciones se centran en la enseñanza universitaria, incluyendo los estudios superiores, que en muchos países tienen gran importancia y desarrollo, y tratan de proporcionar una visión general de los diferentes países sin obviar descender a las particularidades concretas que exigen el identificar buenas prácticas o medidas específicas de organización y desarrollo de la formación. Hablamos del trabajo de 41 especialistas de 13países iberoamericanos que permiten conocer y analizar las actuaciones por países, pero también realizar un estudio de las iniciativas que se han tomado en todos los países considerando algunos de los tópicos que considera el Informe. En todo caso, cabe destacar la actualidad y trascendencia del tema y la rapidez por trasladar a la sociedad un Informe detallado sobre las actuaciones universitarias existentes y sus resultados

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection