[Primary care and natriuretic peptides: design of a care process as a pathway to improve the diagnosis of heart failure]. / Atención primaria y péptidos natriuréticos: diseño de un proceso asistencial para la mejora en el diagnóstico de la insuficiencia cardiaca.

INTRODUCTION: There are few data about the optimal use of natriuretic peptides (NP) in the Primary Care (PC) setting. The aim to assess how, through a common coordinated PC-hospital care pathway, the use of NPs in patients with suspected heart failure (HF) is improved. MATERIAL AND METHODS: Analytical, experimental, prospective, non-randomized study. An intervention group composed of 22 PC physicians from 2 health centers is provided with face-to-face training and a consensual protocol is attached with a cut-off point of NT-proBNP> 300 pg/mL as pathological. The control group is made up of the rest of PC physicians in the healthcare area. The aim is to compare the use and results of PN in both groups. Propensity analysis is performed so thar the patient populations with requested PN are comparable. RESULTS: From June 2021 to March 2022, NP was requested in 103 and 105 patients in the intervention/control groups. Both populations were similar, with equal HF risk. Symptomatology was present in 100% of intervention vs 41% of asymptomatic patients in the control group (p <0.001). ECG was performed in 100% vs 33.3%, p <0.001. Optimal NP indication in 76.7% vs 29.5%, p <0.001. In the intervention group more patients with NT-proBNP> 300 pg/mL are referred to cardiology consultations (76.6% vs 27.2%, p 0.001). CONCLUSION: The optimal indication for NP and its interpretation as a diagnostic tool for HF, in the PC setting seems not to be appropriate, but improvable with a coordinated and multidisciplinary intervention approach.

Use of plastic scrap in asphalt mixtures added by dry method as a partial substitute for bitumen.

In recent decades, the generation of plastic waste has increased substantially worldwide, with the result that more of such waste is introduced into the environment. Currently, most polymers (polyethylene terephthalate, polyethylene, polyvinyl chloride, and others) are recycled. However, some are rejected for recycling in the primary separation processes due to their physical condition, contamination, or size. These materials are called plastic scrap. In this research, the use of plastic scrap added by dry method was evaluated as a replacement for bitumen in asphalt mixtures. Two sizes of plastic scrap, coarse and fine, were considered. An AC16S semi-dense mixture was designed for this purpose, with a 10% reduction in binder, and 10% and 20% of plastic scrap binder was added in coarse and fine sizes. The results obtained in the Marshall stability and flow test showed reduced moisture damage, greater indirect tensile strength, higher air void content, and a 2% decrease in the conserved tensile strength ratio while the same usage field as the conventional mixture was maintained. Meanwhile, significant decreases in plastic deformations, as compared to traditional values, were obtained from resilient modulus and rutting tests.

Use of bottom ash from olive pomace combustion in the production of eco-friendly fired clay bricks.

Olive pomace bottom ash was used to replace different amounts (10-50wt%) of clay in brick manufacturing. The aim of this study is both studying bricks properties and showing a new way of olive pomace bottom ash recycling. Properties of waste bricks were compared to conventional products following standard procedures in order to determine the maximum waste percentage. The amount of olive pomace bottom ash is limited to 20wt%, obtaining bricks with superior engineering properties when 10wt% of waste is added. Adding higher amount of waste (30-50wt%) resulted in bricks with water absorption and compressive strength values on the edge of meeting those established by standards. Therefore, the addition of 10 and 20wt% of olive pomace bottom ash produced bricks with a bulk density of 1635 and 1527kg/m(3) and a compressive strength of 33.9MPa and 14.2MPa, respectively. Fired bricks fulfil standards requirements for clay masonry units, offering, at the same time, better thermal insulation of buildings due to a reduction in thermal conductivity of 14.4% and 16.8% respectively, compared to control bricks (only clay).

Recycling of ash from biomass incinerator in clay matrix to produce ceramic bricks.

The objective of this study is to investigate the effect of incorporation of ash from biomass incinerator as raw material on the production of ceramic bricks for their application in construction. So, for the fabrication of bricks, compositions were prepared with addition of increasing amounts of waste ash (0%, 10%, 20%, 30%, 40% and 50% in wt.) in the clay body. The mixed samples were sintered using conventional powder processing based on powder compaction at 54.5 MPa and firing them at 950 °C without the addition of additives. Effect on apparent density, water absorption and mechanical properties were investigated. The results showed that water absorption increased and apparent density and compressive strength decreased with higher amounts of ash. Bricks with an ash content up to 20% meet the UNE standards compressive strength. As a result, since interesting performances were observed, the potential use of ashes from biomass incinerator up to 20 wt.% in ceramic formulations of industrial interest was confirmed. In this sense, incorporating ashes into clay body reduces environmental problems and total cost of raw material disposition.

Sludge valorization from wastewater treatment plant to its application on the ceramic industry.

The main aim of this study is to assess the effect of incorporating waste sludge on the properties and microstructure of clay used for bricks manufacturing. Wastewater treatment plants produce annually a great volume of sludge. Replacing clay in a ceramic body with different proportions of sludge can reduce the cost due to the utilization of waste and, at the same time, it can help to solve an environmental problem. Compositions were prepared with additions of 1%, 2.5%, 5%, 7.5%, 10% and 15% wt% waste sludge in body clay. In order to determine the technological properties, such as bulk density, linear shrinkage, water suction, water absorption and compressive strength, press-moulded bodies were fired at 950 °C for coherently bonding particles in order to enhance the strength and the other engineering properties of the compacted particles. Thermal heating destroys organic remainder and stabilizes inorganic materials and metals by incorporating oxides from the elemental constituent into a ceramic-like material. Results have shown that incorporating up to 5 wt% of sludge is beneficial for clay bricks. By contrast, the incorporation of sludge amounts over 5 wt% causes deterioration on the mechanical properties, therefore producing low-quality bricks.

Interactions of mycobacterial glycopeptidolipids with membranes: influence of carbohydrate on induced alterations.

Glycopeptidolipids (GPLs) are specific constituents of mycobacteria known as opportunistic pathogens. The influence of the carbohydrate moiety on GPL-induced membrane alterations was examined with GPLs bearing 1-5 sugar residues (GPL-1 to GPL-5) and a sulfated GPL (S-GPL-2). GPLs decreased the ADP/O ratio and increased controlled respiration of isolated mitochondria. The more polar GPLs were the less active, with the following order of efficiency: GPL-1 > GPL-2 > S-GPL-2 = GPL-3 = GPL-5. GPL-1 and GPL-2 increased passive permeability of liposomes to carboxyfluorescein (GPL-1 > GPL-2), while GPL-3 and GPL-5 were inactive. GPL-2 and GPL-3 decreased the transmembrane electrical potential (delta psi) in isolated mitochondria (GPL-2 > GPL-3). These results suggest that GPLs uncouple oxidative phosphorylation by increasing the passive permeability of the mitochondrial membrane to protons. Compression isotherms of GPL-2 monolayers showed that, at low surface pressure, the area per GPL-2 molecule was about 5 times that of an acyl chain: it is likely that the peptide moiety was at the air/water interface. With an increase in the surface pressure, its area decreased, down to that of a tightly packed acyl chain. It is postulated that the glycopeptidic moiety can be either at in the interface or dipping into the water.(ABSTRACT TRUNCATED AT 250 WORDS)

Principales causas de abandono de los tratamientos de ortodoncia

Se realizó un estudio para determinar las causas más frecuentes del abandono del tratamiento de ortodoncia. Se utilizó una muestra de 176 historias clínicas en pasivo del servicio de ortodoncia de la Clínica Estomatológica Docente Provincial de Sancti Spíritus comprendidos en los años 1981-1986. Mediante el modelo de encuesta confeccionado al efecto, se determinó que las principales causas de abandono fueron las molestias causadas por la aparatología, el dolor y la dificultadcon la fonación. Los resultados obtenidos permiten realizar estudios y extraer conclusiones a fin de tener medidas que permitan rescatar estos abandonos. (AU)

Principales causas de abandono de los tratamientos de ortodoncia

Se realizó un estudio para determinar las causas más frecuentes del abandono del tratamiento de ortodoncia. Se utilizó una muestra de 176 historias clínicas en pasivo del servicio de ortodoncia de la Clínica Estomatológica Docente Provincial de Sancti Spíritus comprendidos en los años 1981-1986. Mediante el modelo de encuesta confeccionado al efecto, se determinó que las principales causas de abandono fueron las molestias causadas por la aparatología, el dolor y la dificultad con la fonación. Los resultados obtenidos permiten realizar estudios y extraer conclusiones a fin de tener medidas que permitan rescatar estos abandonos.(AU)

A test of the adams-creamer decay hypothesis for the timing of motor responses.

The Adams-Creamer hypothesis states that S uses the decay of proprioceptive feedback from an early portion of a movement to cue a timed response at some later time. This hypothesis was tested by creating passive left-arm movement in one group and withholding it from another, and having Ss make a right-hand response when exactly 2.0 sec. had elapsed since the end of the movement Ss with left-arm feedback had less absolute and algebraic error, and greater within-S consistency than did the no-movement control Ss and, when KR was withdrawn, Ss with left-arm movement regressed less than did Ss without the left-arm movement, which provided 2 lines of support for the decay hypothesis.