178 research outputs found

    Use of coal mining waste as pozzolanic material in new blended cement matrixes

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    Research and eco-innovation geared to obtain alternative sources of raw materials from waste constitute pathways for enhancing the competitiveness of resource-intensive industries. Cement and concrete manufacture calls for new sources of new, highly pozzolanic products to improve the mechanical properties and durability of the resulting matrices, while at the same time reducing production costs and environmental impact. Spanish coal mining wastes generated in the extraction and washing steps from a mine in the Castilla-León region were investigated. Mineralogically, these wastes are composed by kaolinite (20-30%), illite (45-70%) and quartz (5-15). This composition is very interesting in order to activate, by controlled thermal activation, the present kaolinite that generates metakaolin, a highly pozzolanic product. Morphological, textural and microstructural changes affect the activity and reactivity of activated wastes. These first studies open up a new research line, practically unknown to the international research community, and stand out the important economic and environmental benefits associated with the recycling of these wastes as supplementary cementing materials for future commercial blended cements.Peer ReviewedPostprint (published version

    Miradas colectivas del departamento de Cundinamarca, Bogotá y municipio de Soacha

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    En este documento se hace una síntesis de las diversas problemáticas a intervenir en las diferentes familias y comunidades seleccionadas por el grupo. Se tratan temas relacionados con la violencia familiar, la falta de comunicación, la violación de derechos e incluso la falta de conciencia de vivir en comunidad.This document expose a summaries about various issues to be addressed in the different families and communities selected by the group. Topics related to family violence, no communication, violation of rights and even lack of awareness of living in community

    COVID-19 vaccine effectiveness against hospitalization due to SARS-CoV-2: A test-negative design study based on Severe Acute Respiratory Infection (SARI) sentinel surveillance in Spain

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    Background: With the emergence of SARS-CoV-2, influenza surveillance systems in Spain were transformed into a new syndromic sentinel surveillance system. The Acute Respiratory Infection Surveillance System (SiVIRA in Spanish) is based on a sentinel network for acute respiratory infection (ARI) surveillance in primary care and a network of sentinel hospitals for severe ARI (SARI) surveillance in hospitals. Methods: Using a test-negative design and data from SARI admissions notified to SiVIRA between January 1 and October 3, 2021, we estimated COVID-19 vaccine effectiveness (VE) against hospitalization, by age group, vaccine type, time since vaccination, and SARS-CoV-2 variant. Results: VE was 89% (95% CI: 83-93) against COVID-19 hospitalization overall in persons aged 20 years and older. VE was higher for mRNA vaccines, and lower for those aged 80 years and older, with a decrease in protection beyond 3 months of completing vaccination, and a further decrease after 5 months. We found no differences between periods with circulation of Alpha or Delta SARS-CoV-2 variants, although variant-specific VE was slightly higher against Alpha. Conclusions: The SiVIRA sentinel hospital surveillance network in Spain was able to describe clinical and epidemiological characteristics of SARI hospitalizations and provide estimates of COVID-19 VE in the population under surveillance. Our estimates add to evidence of high effectiveness of mRNA vaccines against severe COVID-19 and waning of protection with time since vaccination in those aged 80 or older. No substantial differences were observed between SARS-CoV-2 variants (Alpha vs. Delta).The data of the study was originally collectedas part of the following projects run by the European Centre for Disease Prevention and Control:“Establishing Severe Acute Respiratory Infections (SARI) surveillance and performing hospital-based COVID-19 transmission studies”, “Developing an infrastructure and performing vaccine effectiveness studies for COVID-19 vaccines in the EU/EEA”, and the “Vaccine Effectiveness, Burden and Impact Studies(VEBIS) of COVID-19 and Influenza".S

    Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

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    Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

    Long-Term Real-World Effectiveness and Safety of Ustekinumab in Crohn’s Disease Patients: The SUSTAIN Study

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    Background Large real-world-evidence studies are required to confirm the durability of response, effectiveness, and safety of ustekinumab in Crohn’s disease (CD) patients in real-world clinical practice. Methods A retrospective, multicentre study was conducted in Spain in patients with active CD who had received ≥1 intravenous dose of ustekinumab for ≥6 months. Primary outcome was ustekinumab retention rate; secondary outcomes were to identify predictive factors for drug retention, short-term remission (week 16), loss of response and predictive factors for short-term efficacy and loss of response, and ustekinumab safety. Results A total of 463 patients were included. Mean baseline Harvey-Bradshaw Index was 8.4. A total of 447 (96.5%) patients had received prior biologic therapy, 141 (30.5%) of whom had received ≥3 agents. In addition, 35.2% received concomitant immunosuppressants, and 47.1% had ≥1 abdominal surgery. At week 16, 56% had remission, 70% had response, and 26.1% required dose escalation or intensification; of these, 24.8% did not subsequently reduce dose. After a median follow-up of 15 months, 356 (77%) patients continued treatment. The incidence rate of ustekinumab discontinuation was 18% per patient-year of follow-up. Previous intestinal surgery and concomitant steroid treatment were associated with higher risk of ustekinumab discontinuation, while a maintenance schedule every 12 weeks had a lower risk; neither concomitant immunosuppressants nor the number of previous biologics were associated with ustekinumab discontinuation risk. Fifty adverse events were reported in 39 (8.4%) patients; 4 of them were severe (2 infections, 1 malignancy, and 1 fever). Conclusions Ustekinumab is effective and safe as short- and long-term treatment in a refractory cohort of CD patients in real-world clinical practice

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

    Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

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    Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

    Orientaciones específicas para la incorporación de tecnología en procesos de formación de profesores de Ciencias Naturales, Lenguaje y Comunicación, y Matemáticas en contextos de diversidad para el diseño de secuencias de enseñanza aprendizaje

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    Las Tecnologías de la Información y de la Comunicación (TIC) se han transformado en un elemento de innovación dentro del conocimiento humano. Aplicadas directamente a la disciplina académica, las TIC se han ganado un espacio debido al creciente interés de este tipo de herramientas por parte de los docentes. No obstante, al día de hoy, en Latinoamérica el uso de TIC no es masivo. Su implementación aún está en una etapa inicial, y esto es debido a diversos factores. Algunos tienen que ver con el poco seguimiento que se realiza al implementar este tipo de tecnologías en las instituciones educativas; la limitada formación es una debilidad. En una escuela, el profesor que no ha sido preparado adecuadamente en el uso de TIC difícilmente logrará utilizarlas adecuadamente, y sus metodologías de aula serán, probablemente, idénticas a las que existían previas a su implementación. Existe una gran diferencia entre conocer una herramienta y dominarla; el dominio se logra, por ejemplo, al conocer las ventajas y desventajas que posee una herramienta determinada en conexión directa con los contenidos y las necesidades de los estudiantes. El dominio de las TIC otorga al docente de aula la posibilidad de tomar decisiones que tiendan a la efectividad del proceso educativo, puesto que las TIC no son solo un conjunto de herramientas, sino que, además, son orientables hacia un área u otra dependiendo de factores variables propios del proceso. Teniendo en cuenta el contexto anterior, este documento contiene algunas orientaciones para el uso del material desarrollado en el área de Ciencias Naturales, Lenguaje y Comunicación, y Matemáticas del Proyecto ALTER-NATIVA, el cual va dirigido a la formación de profesores que atienden poblaciones en contexto de diversidad con incorporación de las TIC. Es importante anotar que las actividades que se proponen son una posibilidad distinta de asumir la enseñanza de las ciencias naturales, lo cual a su vez implica reflexión y evaluación constante de la práctica de los docentes de esta área; que los compromete también con los desarrollos tecnológicos actuales, lo cual conlleva analizar y canalizar sus esfuerzos para diseñar y gestionar mecanismos que permitan la incorporación de las TIC en sus prácticas, pues se considera que estas posibilitan colaborar en la construcción de mundos posibles cercanos a los ideales de participación, igualdad y equidad (Alter -nativa , 2012). Estas orientaciones específicas tienen un doble propósito: primero, cobijan algunas recomendaciones, las cuales son una propuesta de uso para aprovechar al máximo el material que se propone en el estudio de las Ciencias Naturales, Lenguaje y Comunicación, y Matemáticas, para las poblaciones objeto de estudio. Para el desarrollo de las actividades planteadas es necesario que los estudiantes para profesor y profesores de escuelas, colegios y universidades de las áreas de Ciencias Naturales, Lenguaje y Comunicación, y Matemáticas, como posibles usuarios de este material, las perciban como un recurso que tiene un potencial y que, para su desarrollo, se hace necesario tener presente el diseño y estructura didáctica, los objetivos temáticos, la infraestructura, los recursos tecnológicos, las necesidades y características de las poblaciones con quien se vaya a utilizar, entre otros aspectos. Y segundo, estas orientaciones tienen como propósito ofrecer elementos para la formación de profesores de Ciencias Naturales, Lenguaje y Comunicación, y Matemáticas en su acción pedagógica y didáctica; se involucran las prácticas profesionales de diseño y elaboración de objetos didácticos y de los objetos virtuales de aprendizaje (OVA) como casos específicos de estos. Tomando como referencia lo anterior, se plantea como objetivos central de este texto el presentar algunas orientaciones que es necesario tener en cuenta a la hora incorporar TIC en la formación de profesores de Ciencias Naturales, Lenguaje y Comunicación, y Matemáticas. De igual forma, unos objetivos específicos serían los siguientes: a) Establecer unas orientaciones que sean consideradas a la hora de usar los recursos virtuales como los Objetos Virtuales de aprendizaje (OVA) que fueron diseñados como parte del proyecto ALTER-NATIVA en el área de ciencias naturales, lenguaje y matemáticas. b) Favorecer el aprendizaje de las ciencias naturales, lenguaje y matemáticas en las poblaciones objeto de estudio a través del uso de las TIC. c) Resaltar la importancia que tiene el uso de las TIC para concebir el aprendizaje como un sistema de interacción y no como transmisión de información solamente. d) Aportar a la reflexión y formación de docentes con una cultura tecnológica que les permita afrontar su labor pedagógica y didáctica en ámbitos de diversidad. e) Proporcionar unos elementos teóricos y de uso de las TIC que les admita la planeación, el diseño, desarrollo, uso y evaluación de objetos virtuales u OVA dentro de un ambiente virtual de aprendizaje
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