29 research outputs found

    Influence of the thermal processing and doping on LaMnO3 and La0.8A0.2MnO3 (A = Ca, Sr, Ba) perovskites prepared by auto-combustion for removal of VOCs

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    Single-phase oxygen stoichiometric LaMnO3 and doped La0.8A0.2MnO3 (A = Ca, Sr, Ba) perovskites have been prepared by a simple one-step auto-combustion method. Cation-deficient LaMnO3+őī and La0.8A0.2MnO3+őī were obtained by calcination of the former samples in air at 750 ‚ó¶C. The samples were characterized by X-ray powder diffraction, X-ray photoelectron spectroscopy, temperature-programmed reduction, temperature-programmed oxygen desorption, and N2 ph ysisorption in order to apply them as catalysts in the complete catalytic oxidation of acetone as a model volatile organic compound. The studied phases show the expected orthorhombic and rhombohedral perovskite crystal structures. Catalytic experiments performed with all the samples show measurable activity already at 100 ‚ó¶C. At 200 ‚ó¶C, doped La0.8A0.2MnO3 samples show higher activity than undoped LaMnO3, with increasing conversion with larger A-cation size. Calcined samples also show higher activity than as-prepared ones making La0.8Ba0.2MnO3+őī the best catalyst at this temperature. All doped samples show >95% acetone conversion at T ‚Č• 250 ‚ó¶C with a weak dependence on the sample processing or A cation doping. The collected evidence confirms that the most important factors for the catalytic activity of these oxides are the Mn4+/Mn3+ molar ratio on the surface of the samples and the cation-deficiency of the bulk perovskite structure. In addition, increasing the symmetry of the bulk crystal structure appears to have an additional favourable effect. Despite the observation of the presence of surface carbonates, we show that it is possible to use the as-prepared samples without further thermal treatment with good results in the oxidation of acetone

    Methodology of a Large Multicenter Observational Study of Patients with COVID-19 in Spanish Intensive Care Units.

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    The COVID-19 pandemic created tremendous challenges for health-care systems. Intensive care units (ICU) were hit with a large volume of patients requiring ICU admission, mechanical ventilation, and other organ support with very high mortality. The Centro de Investigación Biomédica en Red-Enfermedades Respiratorias (CIBERES), a network of Spanish researchers to investigate in respiratory disease, commissioned the current proposal in response to the Instituto de Salud Carlos III (ISCIII) call. CIBERESUCICOVID is a multicenter, observational, prospective/retrospective cohort study of patients with COVID-19 admitted to Spanish ICUs. Several work packages were created, including study population and ICU data collection, follow-up, biomarkers and miRNAs, data management and quality. This study included 6102 consecutive patients admitted to 55 ICUs homogeneously distributed throughout Spain and the collection of blood samples from more than 1000 patients. We enrolled a large population of COVID-19 ICU-admitted patients including baseline characteristics, ICU and MV data, treatments complications, and outcomes. The in-hospital mortality was 31%, and 76% of patients required invasive mechanical ventilation. A 3-6 month and 1 year follow-up was performed. Few deaths after 1 year discharge were registered. Low anti-SARS-CoV-2 S antibody levels predict mortality in critical COVID-19. These antibodies contribute to prevent systemic dissemination of SARS-CoV-2. The severity of COVID-19 impacts the circulating miRNA profile. Plasma miRNA profiling emerges as a useful tool for risk-based patient stratification in critically ill COVID-19 patients. We present the methodology used in a large multicenter study sponsored by ISCIII to determine the short- and long-term outcomes in patients with COVID-19 admitted to more than 50 Spanish ICUs

    Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

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    The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

    Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

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    To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2 +/- 20.6% vs 93.6 +/- 20.6%, P < 0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4 +/- 5.2 mm vs 19.9 +/- 6.7 mm, P < 0.001), higher incidence of pericardial effusion (30% vs 5.2%, P < 0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P < 0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairment

    Investigación, desarrollo tecnológico e innovación en ingeniería y administración

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    El objetivo del libro es divulgar resultados de investigaci√≥n producto de los proyectos de Investigaci√≥n, desarrollo e innovaci√≥n en las √°reas de ingenier√≠as y administraci√≥n, ejecutados en las instituciones que hacen parte de la Red de Conocimiento en el sector de la Ingenier√≠a‚ÄďRECSI e instituciones aliadas nacionales e internacionales, y que han sido presentados en el marco del Encuentro Internacional en ciencias aplicadas e ingenier√≠as EISI, entre los a√Īos 2018 y 2022. La obra consolida el trabajo de la red y de sus instituciones aliadas, en la generaci√≥n y apropiaci√≥n social del conocimiento en diferentes regiones tanto nacionales como internacionales. Se presenta en tres secciones; ‚ÄúGesti√≥n, desarrollo y competitividad‚ÄĚ, ‚ÄúIngenier√≠as y administraci√≥n‚ÄĚ y ‚ÄúFormaci√≥n en ingenier√≠as‚ÄĚ.Creaci√≥n del SENA versus archivos conservados -- En ‚ÄúRescate y organizaci√≥n de los fondos documentales acumulados‚ÄĚ: Testimonio de las Tablas de Valoraci√≥n Documental TVD -- Primer soporte tecnol√≥gico para conservaci√≥n documental y apoyo a eliminaci√≥n del soporte papel: microfilmaci√≥n -- Incidencia de la Ley General de Archivos, junio de 2000 en la gesti√≥n documental y administraci√≥n de archivos del SENA -- La identificaci√≥n archiv√≠stica como l√≠nea de acci√≥n institucional - Experiencia en la elaboraci√≥n de tablas de retenci√≥n documental -- Incidencia de la Ley del Archivista en el Servicio Nacional de Aprendizaje SENA -- Segunda versi√≥n de instrumento archiv√≠stico: tabla de retenci√≥n documental TRD -- Primer instrumento archiv√≠stico en el registro √ļnico de series y subseries documentales de la naci√≥n -- ON BASE - Primer Sistema de gesti√≥n documental SGD -- Plan de Mejoramiento Archiv√≠stico: Un reto para superar -- Diagn√≥sticos Archiv√≠sticos: Base para la Planeaci√≥n Estrat√©gica de la Entidad -- Instrumentos Archiv√≠sticos: Herramientas claves para el desarrollo documental -- Adquisici√≥n e implementaci√≥n del sistema de gesti√≥n de documentos electr√≥nicos de archivo SGDEA - Para la conformaci√≥n del archivo electr√≥nico SENA - AESna243 p√°gina

    Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study

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    Background The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae. Methods Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months. Findings Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01). Interpretation Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd

    Influence of the Thermal Processing and Doping on LaMnO3 and La0.8A0.2MnO3 (A = Ca, Sr, Ba) Perovskites Prepared by Auto-Combustion for Removal of VOCs

    No full text
    Single-phase oxygen stoichiometric LaMnO3 and doped La0.8A0.2MnO3 (A = Ca, Sr, Ba) perovskites have been prepared by a simple one-step auto-combustion method. Cation-deficient LaMnO3+&delta; and La0.8A0.2MnO3+&delta; were obtained by calcination of the former samples in air at 750 &deg;C. The samples were characterized by X-ray powder diffraction, X-ray photoelectron spectroscopy, temperature-programmed reduction, temperature-programmed oxygen desorption, and N2 physisorption in order to apply them as catalysts in the complete catalytic oxidation of acetone as a model volatile organic compound. The studied phases show the expected orthorhombic and rhombohedral perovskite crystal structures. Catalytic experiments performed with all the samples show measurable activity already at 100 &deg;C. At 200 &deg;C, doped La0.8A0.2MnO3 samples show higher activity than undoped LaMnO3, with increasing conversion with larger A-cation size. Calcined samples also show higher activity than as-prepared ones making La0.8Ba0.2MnO3+&delta; the best catalyst at this temperature. All doped samples show &gt;95% acetone conversion at T &ge; 250 &deg;C with a weak dependence on the sample processing or A cation doping. The collected evidence confirms that the most important factors for the catalytic activity of these oxides are the Mn4+/Mn3+ molar ratio on the surface of the samples and the cation-deficiency of the bulk perovskite structure. In addition, increasing the symmetry of the bulk crystal structure appears to have an additional favourable effect. Despite the observation of the presence of surface carbonates, we show that it is possible to use the as-prepared samples without further thermal treatment with good results in the oxidation of acetone

    Major candidate variables to guide personalised treatment with steroids in critically ill patients with COVID-19: CIBERESUCICOVID study.

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    Although there is evidence supporting the benefits of corticosteroids in patients affected with severe coronavirus disease 2019 (COVID-19), there is little information related to their potential benefits or harm in some subgroups of patients admitted to the intensive care unit (ICU) with COVID-19. We aim to investigate to find candidate variables to guide personalized treatment with steroids in critically ill patients with COVID-19. Multicentre, observational cohort study including consecutive COVID-19 patients admitted to 55 Spanish ICUs. The primary outcome was 90-day mortality. Subsequent analyses in clinically relevant subgroups by age, ICU baseline illness severity, organ damage, laboratory findings and mechanical ventilation were performed. High doses of corticosteroids (‚Č•‚ÄČ12¬†mg/day equivalent dexamethasone dose), early administration of corticosteroid treatment ( Between February 2020 and October 2021, 4226 patients were included. Of these, 3592 (85%) patients had received systemic corticosteroids during hospitalisation. In the propensity-adjusted multivariable analysis, the use of corticosteroids was protective for 90-day mortality in the overall population (HR 0.77 [0.65-0.92], p‚ÄČ=‚ÄČ0.003) and in-hospital mortality (SHR 0.70 [0.58-0.84], p‚ÄČ Corticosteroid in ICU-admitted patients with COVID-19 may be administered based on age, severity, baseline inflammation, and invasive mechanical ventilation. Early administration since symptom onset may prove harmful

    Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

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    To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2‚ÄȬĪ‚ÄČ20.6% vs 93.6‚ÄȬĪ‚ÄČ20.6%, P‚ÄČ&lt;‚ÄČ0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4‚ÄȬĪ‚ÄČ5.2¬†mm vs 19.9‚ÄȬĪ‚ÄČ6.7¬†mm, P‚ÄČ&lt;‚ÄČ0.001), higher incidence of pericardial effusion (30% vs 5.2%, P‚ÄČ&lt;‚ÄČ0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P‚ÄČ&lt;‚ÄČ0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairment

    Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

    Get PDF
    To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2 ¬Ī 20.6% vs 93.6 ¬Ī 20.6%, P < 0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4 ¬Ī 5.2 mm vs 19.9 ¬Ī 6.7 mm, P < 0.001), higher incidence of pericardial effusion (30% vs 5.2%, P < 0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P < 0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairmen
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