Expression and immunohistochemical localization of leptin in human periapical granulomas

Background: Leptin, initially described as an adipocyte-derived hormone to regulate weight control, is expressed in normal and inflamed human dental pulp, being up-regulated during pulp experimental inflammation. Leptin receptor (LER) has been identified in human periapical granulomas. The aim of this study was to analyze and characterize the expression of leptin in human periapical granulomas. Material and Methods: Fifteen periapical inflammatory lesions were obtained from extracted human teeth and teeth which underwent periapical surgery. After their morphological categorization as periapical granulomas and gradation of the inflammatory infiltrate, they were examined by immunohistochemistry using human leptin policlonal antibodies. Leptin mRNA expression was also determined by quantitative real-time PCR (qRT-PCR) and the amount of leptin protein was analyzed by immunoblot. Results: All periapical lesions exhibited the characteristic of chronic granulomatous inflammatory process with inflammatory infiltrate grade III. Leptin+ cells were detected in 13 periapical granulomas (86.6%). The median number of Leptin+ cells in periapical granulomas was 1.70 (0.00-7.4). Amongst the inflammatory cells in the periapical granulomas, only macrophages were reactive to leptin antibodies. Western blot analysis revealed the presence in all samples of a protein with apparent molecular weight of approximately 16 kDa, corresponding to the estimated molecular weights of leptin. The expression of leptin mRNA was confirmed by qRT-PCR analysis and the size of the amplified fragment (296 bp for leptin and 194 bp for cyclophilin) was assessed by agarose gel electrophoresis. Conclusions: For the first time, it has been demonstrated that human periapical granuloma expresses the adipokine leptin

Mecanizado por arranque de viruta asistido por electropulsos

Este artículo trata sobre una nueva técnica de mecanizado: el proceso de torneado asistido in situ con corriente eléctrica, a través de la influencia de electropulsos. Un generador ha sido fabricado para inducir intensidades de corriente de 90 A, duraciones de pulso entre los 50 y 200 μs y frecuencias de descarga de 100 a 300 Hz. Se ha estudiado para acero 1045, la influencia de las diferentes configuraciones eléctricas que asisten el proceso de mecanizado respecto a las propiedades superficiales y el consumo de potencia eléctrica. Los resultados muestran que el proceso asistido mejora la mecanibilidad reduciéndose el consumo de potencia en 104 W y la energía especifica corte en un 22%. También modifica las propiedades superficiales, reduciendo la rugosidad media en un rango del 7 al 22% comparado con el proceso de torneado convencional

Predictive model for polishing times in mould finishing

El pulido, proceso final utilizado en la producción de piezas, es a menudo lento y se aplica manualmente. Normalmente define la rugosidad superficial y la precisión de la pieza. Se lleva a cabo utilizando partículas duras para producir la abrasión de la superficie de la pieza a pulir. En este documento se propone un modelo para predecir el progreso del frente de pulido. El modelo tiene en cuenta la topografía resultante antes de la mecanización a través de su curva de Abbott - Firestone, la velocidad relativa del material abrasivo, la fuerza aplicada, el material de la pieza y el tamaño de los granos abrasivos. Separa las aportaciones realizadas por el material de la pieza y el tipo abrasivo de la topografía previa. También muestra los valores recomendados para los diferentes parámetros de proceso a ser utilizados en la predicción de la evolución del frente de pulido en algunos materiales. Además se estima el tiempo de pulido necesario para eliminar completamente la topografía resultante del fresado utilizando una estrategia de perforación transversal. Por último, se muestra la predicción del modelo del frente de pulido, lo que confirma que el mecanismo de abrasión caracteriza dicho proceso.Polishing, the final process used in the production of parts, is often slow and often applied manually. It normally defines the surface roughness and part accuracy. It is performed using hard particles to produce abrasion of the workpiece surface to be polished. In this paper a model for predicting the progress of the polishing face is proposed. The model considers the topography resulting from prior mechanizing through its Abbott-Firestone curve, the relative speed of the abrasive material, the applied force, the workpiece material and the size of the abrasive grains. It separates the contributions made by the workpiece material and the abrasive type from the prior topography. It also shows recommended values for different process parameters to be used in predicting the evolution of the polishing front in some materials. Additionally, the polishing time required to completely remove the topography that results from ball milling using a cross drilling strategy is estimated. Finally, the model's correct prediction of the polished front is shown, confirming that the abrasion mechanism characterizes the sandpaper polishing process.Peer Reviewe

Influence of the regime of electropulsing-assisted machining on the plastic deformation of the layer being cut

In this article, the influence of electropulsing on the machinability of steel S235 and aluminium 6060 has been studied during conventional and electropulsing-assisted turning processes. The machinability indices such as chip compression ratio ¿, shear plane angle f and specific cutting energy (SCE) are investigated by using different cutting parameters such as cutting speed, cutting feed and depth of cut during electrically-assisted turning process. The results and analysis of this work indicated that the electrically-assisted turning process improves the machinability of steel S235, whereas the machinability of aluminium 6060 gets worse. Finally, due to electropluses (EPs), the chip compression ratio ¿ increases with the increase in cutting speed during turning of aluminium 6060 and the SCE decreases during turning of steel S235.Peer ReviewedPostprint (published version

Electropulsing effects on mechanical and metallurgical behavior of AISI-SAE 4140 steel

The electroplasticity phenomenon (EP) produces changes in the mechanical properties of a metal, due to the simultaneous application of mechanical stresses of compression, bending, etc., and high instantaneous current pulses. The changes produced on the plastic deformation rate by the EP are due to thermal effects (such as Joule effect) and other effects associated to the electric and magnetic fields. There are only a few studies that consider, as this paper does, the effects of electropulsing effect on tensile test processes in which the electron flow is esteemed as the main reason. In this paper, the results of a research on tensile test on specimen of AISI-SAE 4140, assisted by high-current-density electric pulses are presented. The aim is to evaluate the effect of these pulses on the microstructure and mechanical properties of metallic materials. The phase transformations and microstructural changes in the metallic specimens exposed to EP were analysed using Scanning Electron Microscopy (SEM), Diffraction Ray X (DRX) and Differential Scanning Calorimetry (DSC). Preliminary results show there are some differences in the material behaviour, between the specimens tensile tested with and without EP, such as: decreases values of yield and ultimate strength and XRD analyses attests to a slight displacement and intensity reduction of diffraction. Moreover, the application of current density in the order of 2.18 A/mm² is enough to produce changes in mechanical and metallographic properties of AISI/SAE 4140.Peer ReviewedPostprint (published version

Analysis of the Part Distortions for Inconel 718 SLM: A Case Study on the NIST Test Artifact

The present paper evaluates the misalignment and geometry distortion of the standard National Institute of Standards and Technology (NIST) test artifact in Inconel 718 alloy, when several layers with and without supports are employed to manufacture it by the Selective Laser Melting (SLM) process. To this end, a coordinate-measuring machine (CMM) is used to measure the geometrical distortion in each manufacturing configuration, following the same measurement protocol. The results show that the laser path strategy favors a thermal gradient which, consequently, induces geometrical distortions in the part. To prove this hypothesis, a numerical simulation is performed to determine the thermal gradient and the pattern of the residual stresses. It was found that the geometrical distortion certainly depends on the position of the feature position and laser strategy, where thermal cycles and residual thermal stresses had an impact in the end-part geometry, especially if a high strength-to-weight ratio commonly used in aeronautics is present.This work is supported by the Serra Húnter program (Generalitat de Catalunya) reference number [UPC-LE-304 (2018)] and by the Aeronautics Advanced Manufacturing Center (CFAA) in the JANO—Joint action toward digital transformation project framework. Diego Celentano acknowledges Pontificia Universidad Católica de Chile (PUC), Wallonie-Bruxelles International (WBI) and National Council for Scientific and Technological Research CONICYT (FONDECYT Projects No. 3180006 and 1180591) for the financial supports provided for this work

Reduction of Die Wear and Structural Defects of Railway Screw Spike Heads Estimated by FEM

Railway spike screws are manufactured by hot forging on a massive scale, due to each kilometer of railway track needing 8600 spike screws. These components have a low market value, so the head must be formed in a single die stroke. The service life of the dies is directly related to the amount of energy required to form a single screw. The existing standard for spike screws specifies only the required tolerances for the head dimensions, particularly the angle of the hub faces and the radius of agreement of the hub with the cap. Both geometrical variables of the head and process conditions (as-received material diameter and flash thickness) are critical parameters in spike production. This work focuses on minimizing the energy required for forming the head of a railway spike screw by computational simulation. The variables with the highest degree of incidence on the energy, forging load, and filling of the die are ordered statistically. The results show that flash thickness is the variable with the most significant influence on forming energy and forming load, as well as on die filling. Specifically, the minimum forming energy was obtained for combining of a hub wall angle of 1.3° an as-received material diameter of 23.54 mm and a flash thickness of 2.25 mm. Flash thickness generates a lack of filling at the top vertices of the hub, although this defect does not affect the functionality of the part or its serviceability. Finally, the wear is mainly concentrated on the die splice radii, where the highest contact pressure is concentrated according to the computational simulation results.This work is supported by the Serra Húnter program (Generalitat de Catalunya) reference number (UPC-LE-304 (2018)) and by the Aeronautics Advanced Manufacturing Center (CFAA). Thanks also are given to special agreement INTI-Faculty of engineering of Bilbao and to university group grant IT 1337-19

Differential diagnosis between Parkinson's disease and essential tremor using the smartphone's accelerometer

Background: The differential diagnosis between patients with essential tremor (ET) and those with Parkinson's disease (PD) whose main manifestation is tremor may be difficult unless using complex neuroimaging techniques such as 123I-FP-CIT SPECT. We considered that using smartphone's accelerometer to stablish a diagnostic test based on time-frequency differences between PD an ET could support the clinical diagnosis. Methods: The study was carried out in 17 patients with PD, 16 patients with ET, 12 healthy volunteers and 7 patients with tremor of undecided diagnosis (TUD), who were re-evaluated one year after the first visit to reach the definite diagnosis. The smartphone was placed over the hand dorsum to record epochs of 30 s at rest and 30 s during arm stretching. We generated frequency power spectra and calculated receiver operating characteristics curves (ROC) curves of total spectral power, to establish a threshold to separate subjects with and without tremor. In patients with PD and ET, we found that the ROC curve of relative energy was the feature discriminating better between the two groups. This threshold was then used to classify the TUD patients. Results: We could correctly classify 49 out of 52 subjects in the category with/without tremor (97.96% sensitivity and 83.3% specificity) and 27 out of 32 patients in the category PD/ET (84.38% discrimination accuracy). Among TUD patients, 2 of 2 PD and 2 of 4 ET were correctly classified, and one patient having PD plus ET was classified as PD. Conclusions: Based on the analysis of smartphone accelerometer recordings, we found several kinematic features in the analysis of tremor that distinguished first between healthy subjects and patients and, ultimately, between PD and ET patients. The proposed method can give immediate results for the clinician to gain valuable information for the diagnosis of tremor. This can be useful in environments where more sophisticated diagnostic techniques are unavailable

Clinical consensus recommendations regarding non-invasive respiratory support in the adult patient with acute respiratory failure secondary to SARS-CoV-2 infection

La enfermedad por coronavirus 2019 (COVID-19) es una infección del tracto respiratorio causada por un nuevo coronavirus emergente que se reconoció por primera vez en Wuhan, China, en diciembre de 2019. Actualmente la Organización Mundial de la Salud (OMS) ha definido la infección como pandemia y existe una situación de emergencia sanitaria y social para el manejo de esta nueva infección. Mientras que la mayoría de las personas con COVID-19 desarrollan solo una enfermedad leve o no complicada, aproximadamente el 14% desarrollan una enfermedad grave que requiere hospitalización y oxígeno, y el 5% pueden requerir ingreso en una unidad de cuidados intensivos. En casos severos, COVID-19 puede complicarse por el síndrome de dificultad respiratoria aguda (SDRA), sepsis y shock séptico y fracaso multiorgánico. Este documento de consenso se ha preparado sobre directrices basadas en evidencia desarrolladas por un panel multidisciplinario de profesionales médicos de cuatro sociedades científicas españolas (Sociedad Española de Medicina Intensiva y Unidades Coronarias [SEMICYUC], Sociedad Española de Neumología y Cirugía Torácica [SEPAR], Sociedad Española de Urgencias y Emergencias [SEMES], Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor [SEDAR]) con experiencia en el manejo clínico de pacientes con COVID-19 y otras infecciones virales, incluido el SARS, así como en sepsis y SDRA. El documento proporciona recomendaciones clínicas para el soporte respiratorio no invasivo (ventilación no invasiva, oxigenoterapia de alto flujo con cánula nasal) en cualquier paciente con presentación sospechada o confirmada de COVID-19 con insuficiencia respiratoria aguda. Esta guía de consenso debe servir como base para una atención optimizada y garantizar la mejor posibilidad de supervivencia, así como permitir una comparación fiable de las futuras intervenciones terapéuticas de investigación que formen parte de futuros estudios observacionales o de ensayos clínicos.Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the management of this new infection. While most people with COVID-19 develop only mild or uncomplicated illness, approximately 14% develop severe disease that requires hospitalization and oxygen support, and 5% require admission to an intensive care unit. In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure. This consensus document has been prepared on evidence-informed guidelines developed by a multidisciplinary panel of health care providers from four Spanish scientific societies (Spanish Society of Intensive Care Medicine [SEMICYUC], Spanish Society of Pulmonologists [SEPAR], Spanish Society of Emergency [SEMES], Spanish Society of Anesthesiology, Reanimation, and Pain [SEDAR]) with experience in the clinical management of patients with COVID-19 and other viral infections, including SARS, as well as sepsis and ARDS. The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. This consensus guidance should serve as a foundation for optimized supportive care to ensure the best possible chance for survival and to allow for reliable comparison of investigational therapeutic interventions as part of randomized controlled trials

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group