Analysis of the Mechanical Properties of a Stabilized Subgrade Type Soil under a Sustainable Approach for Construction.

This article presents an experimental study to analyze the mechanical properties of a soil stabilized with ordinary Portland cement (OPC) under a sustainable approach consisting of a significant substitution of OPC for sugarcane bagasse ash (SCBA) to reduce the quantity of cement used in the stabilization, reaching the necessary mechanical requirements for its use as a subgrade layer. Soil specimens were elaborated with 3%, 5%, and 7% OPC as a stabilizing agent by weight of the soil. These mixtures were then partially substituted with 25%, 50%, and 75% SCBA, with these percentages being by weight of the stabilizer (OPC). Compaction, compressive strength, and California bearing ratio (CBR) tests were performed to evaluate the mechanical properties of the specimens. The results indicate that a 25% substitution of OPC by SCBA shows a similar performance to the mixture with only Portland cement, so a reduction in OPC use can be made. Further, with a substitution of 100% OPC by SCBA, the CBR of natural soil without stabilizers is improved.

Evaluating pollution-related damage and restoration success in urban forests with participatory monitoring and digital tools.

Peri-urban forest monitoring requires indicators of vegetation damage. An example is the sacred fir (Abies religiosa) forests surrounding Mexico City, which have been heavily exposed to tropospheric ozone, a harmful pollutant, for over 4 decades. We developed a participatory monitoring system with which local community members and scientists generated data on ozone tree damage. Santa Rosa Xochiac rangers (13) used the digital tool KoboToolBox to record ozone damage to trees, tree height, tree ages, tree condition, tree position, and whether the tree had been planted. Thirty-five percent of the trees (n = 1765) had ozone damage. Younger trees had a lower percentage of foliage damaged by ozone than older trees (p < 0.0001), and asymptomatic trees tended to be younger (p < 0.0001). Symptomatic trees were taller than asymptomatic trees of the same age (R2 c  = 0.43, R2 m  = 0.27). Involving local communities facilitated forest monitoring and using digital technology improved data quality. This participatory system can be used to monitor forest condition change over time and thus aids restoration efforts driven by government or local communities' interests, facilitating local decision-making.

Evaluación del daño relacionado a la contaminación y del éxito de la restauración de los bosques urbanos con un monitoreo participativo y herramientas digitales Resumen El monitoreo de los bosques periurbanos requiere indicadores de daños en la vegetación. Un ejemplo son los bosques de abeto (Abies religiosa) que rodean la Ciudad de México, pues desde hace más de 4 décadas han estado expuestos al ozono troposférico, un contaminante nocivo. Desarrollamos un sistema de monitoreo participativo con el que miembros de la comunidad local y científicos generaron datos sobre los daños causados por el ozono en los árboles. Los guardabosques de Santa Rosa Xochiac (133) utilizaron la herramienta digital KoboToolBox para registrar los daños causados por el ozono en los árboles, su altura, edad, estado, posición y si eran árboles plantados. El 35% de los árboles (n = 1,765) presentó daños por ozono. Los árboles más jóvenes tenían un menor porcentaje de follaje dañado por el ozono que los árboles más viejos (p<0.0001), y los árboles asintomáticos tendían a ser más jóvenes (p<0.0001). Los árboles sintomáticos eran más altos que los asintomáticos de la misma edad (R2 c = 0.43, R2 m = 0.27). La participación de las comunidades locales facilitó el monitoreo forestal y el uso de tecnología digital mejoró la calidad de los datos. Este sistema participativo puede utilizarse para monitorear los cambios en el estado de los bosques a lo largo del tiempo y contribuir a los esfuerzos de restauración impulsados por el gobierno o las comunidades locales, facilitando la toma de decisiones a nivel local.

Corrosion Behavior of Steel-Reinforced Green Concrete Containing Recycled Coarse Aggregate Additions in Sulfate Media.

Novel green concrete (GC) admixtures containing 50% and 100% recycled coarse aggregate (RCA) were manufactured according to the ACI 211.1 standard. The GC samples were reinforced with AISI 1080 carbon steel and AISI 304 stainless steel. Concrete samples were exposed to 3.5 wt.% Na2SO4 and control (DI-water) solutions. Electrochemical testing was assessed by corrosion potential (Ecorr) according to the ASTM C-876-15 standard and a linear polarization resistance (LPR) technique following ASTM G59-14. The compressive strength of the fully substituted GC decreased 51.5% compared to the control sample. Improved corrosion behavior was found for the specimens reinforced with AISI 304 SS; the corrosion current density (icorr) values of the fully substituted GC were found to be 0.01894 µA/cm2 after Day 364, a value associated with negligible corrosion. The 50% RCA specimen shows good corrosion behavior as well as a reduction in environmental impact. Although having lower mechanical properties, a less dense concrete matrix and high permeability, RCA green concrete presents an improved corrosion behavior thus being a promising approach to the higher pollutant conventional aggregates.

Linfoma no Hodgkin tipo MALT de la glándula parótida. Presentación de un caso / MALT non-Hodgkin Lymphoma of the Parotid Gland. Presentation of a Case

Resumen Los linfomas de las glándulas salivales son una entidad e incidencia rara. La localización más frecuente es la glándula parótida, seguida de las glándulas submandibular y sublingual. La mayoría de los linfomas parótidos son linfomas no Hodgkin y se consideran derivados de tejido linfoide asociado a la mucosa (MALT). De manera poco frecuente, estos casos se han notificado y con frecuencia se diagnostican de manera inadecuada, ya que su presentación es relativamente benigna, comportamiento localizado, crecimiento lento y varios años de evolución.

Abstract Lymphomas of the salivary glands are a rare entity with a rare incidence. They are more commonly found on the parotid gland, followed by the submandibular and sublingual glands. The majority of parotid lymphomas are non-Hodgkin's lymphomas and are considered to be derived from mucosal-associated lymphoid tissue (MALT). Reports of these cases are scarce and often misdiagnosed since: their manifestation is relatively benign, they have a localized behavior, a slow growth and the evolution takes several years.

Corrosion Behavior of AISI 304 Stainless Steel Reinforcements in SCBA-SF Ternary Ecological Concrete Exposed to MgSO4.

In this study, ternary ecological concrete (TEC) mixtures were produced with partial substitution of the ordinary Portland cement (OPC) by 10%, 20%, and 30% of sugar cane bagasse ash (SCBA) and silica fume (SF); a control mixture (100% OPC) was prepared according to ACI 211.1 standard. The studied TEC specimens were reinforced with AISI 304 stainless steel and AISI 1018 carbon steel rebars. TEC reinforced specimens were immersed in two different electrolytes, a control (DI-water) and 3.5 wt.% MgSO4 solution, for 180 days. The electrochemical corrosion was monitored by corrosion potential (Ecorr) according to ASTM C-876-15 standard, and the linear polarization resistance (LPR) technique using ASTM G59 standard. The Ecorr and current density icorr results show that AISI 304 stainless steel rebars have a high corrosion resistance, with icorr values below 0.1 µA/cm2, which is interpreted as a level of negligible corrosion. The best corrosion performance was found for the TEC mixture made with a 20% addition of blend of sugar cane bagasse ash-silica fume (SCBA-SF) to the OPC.

Infusión de furosemida intravenosa domiciliaria, continua y prolongada en insuficiencia cardiaca refractaria por pericarditis constrictive / Long-term home-administered continuous intravenous furosemide infusion in refractory heart failure from constrictive pericarditis

Presentamos dos casos clínicos de pacientes con pericarditis constrictiva en insuficiencia cardiaca refractaria a tratamiento diurético combinado y dosis elevadas de furosemida, con disnea de pequeños-mínimos esfuerzos y grandes dificultades para abandonar el hospital por dependencia al tratamiento parenteral. Fueron tratados con infusión continua intravenosa de furosemida mediante infusores elastoméricos. La técnica se mantuvo a largo plazo en domicilio de forma eficaz, con muy buena tolerancia y sin efectos secundarios reseñables

We present two clinical cases about constrictive pericarditis in advanced heart failure refractory to combined diuretic therapy and high dose of furosemide. Patients had small-minimum efforts dyspnea and difficulties to be discharged because of parenteral treatment dependency. They were treated with intravenous continuous furosemide infusion administered by elastomeric pumps. Long-term use at home was effective, well-tolerated and without remarkable secondary effect

Perfusión de furosemida subcutánea como tratamiento paliativo en insuficiencia cardiaca refractaria / Subcutaneous furosemide infusion as palliative treatment in refractory end-stage heart failure

Resumen En la insuficiencia cardiaca terminal los síntomas predominantes habitualmente están relacionados con la congestión; sin embargo, la resistencia a diuréticos vía oral es frecuente y necesita tratamiento parenteral para paliar los síntomas. La administración intravenosa de furosemida requiere hospitalización o asistencia hospitalaria, lo que supone un deterioro significativo de la calidad de vida de pacientes en fases avanzadas de la enfermedad. La administración subcutánea continua de furosemida mediante infusor elastomérico es una técnica eficaz con baja tasa de complicaciones graves que permite la administración de diurético parenteral en el ámbito domiciliario, y evita la necesidad de hospitalizar. A pesar de que esta modalidad de tratamiento no está aceptada en ficha técnica y requiere más estudios que precisen su indicación, puede suponer un recurso adecuado para pacientes seleccionados. Se presenta el caso de una paciente con insuficiencia cardiaca avanzada, síntomas congestivos y ausencia de respuesta a tratamiento deplectivo vía oral, tratada con perfusión continua subcutánea domiciliaria de furosemida mediante infusor elastomérico de forma prolongada.

Abstract In end-stage heart failure the predominant symptoms are usually associated with congestion. However, the resistance to oral diuretics is common and requires parenteral treatment to alleviate the symptoms. The intravenous administration of furosemide requires hospital admission or hospital care. This leads to a significant decrease in the quality of life of patients in advance stages of the disease. The continuous subcutaneous infusion of furosemide using an elastomeric pump is an effective technique, with a low rate of serious complications that allows a parenteral diuretic to be administered in the home environment and thus avoiding the need for hospital admission. Despite this mode of treatment not being indicated in the drug data sheet, and requires more studies that specify its indication, it may be a suitable recourse for selected patients. It is presented a case of a patient with advanced heart failure, congestive symptoms, and a lack of response to oral diuretics treatment, and then treated with a continuous and prolonged subcutaneous infusion of furosemide at home using an elastomeric infusion pump.

Effect of Silica Fume and Fly Ash Admixtures on the Corrosion Behavior of AISI 304 Embedded in Concrete Exposed in 3.5% NaCl Solution.

The use of supplementary cementitious materials such as fly ash, slag, and silica fume improve reinforced concrete corrosion performance, while decreasing cost and reducing environmental impact compared to ordinary Portland cement. In this study, the corrosion behavior of AISI 1018 carbon steel (CS) and AISI 304 stainless steel (SS) reinforcements was studied for 365 days. Three different concrete mixtures were tested: 100% CPC (composite Portland cement), 80% CPC and 20% silica fume (SF), and 80% CPC and 20% fly ash (FA). The concrete mixtures were designed according to the ACI 211.1 standard. The reinforced concrete specimens were immersed in a 3.5 wt.% NaCl test solution to simulate a marine environment. Corrosion monitoring was evaluated using the corrosion potential (Ecorr) according to ASTM C876 and the linear polarization resistance (LPR) according to ASTM G59. The results show that AISI 304 SS reinforcements yielded the best corrosion behavior, with Ecorr values mainly pertaining to the region of 10% probability of corrosion, and corrosion current density (icorr) values indicating passivity after 105 days of experimentation and low probability of corrosion for the remainder of the test period.

Tolerabilidad y efectividad de levetiracetam y midazolam en infusión continua subcutánea: caso clínico / Tolerability and effectiveness of levetiracetam and midazolam in subcutaneous continuous infusion: case report

La enfermedad de Parkinson es un trastorno neurológico crónico caracterizado por síntomas motores y no motores. Su asociación con epilepsia ha sido objeto de estudio desde hace mucho tiempo. En fases avanzadas es frecuente el deterioro cognitivo y la pérdida de la deglución, lo que obliga a la administración parenteral de medicamentos. Levetiracetam ha sido utilizado en infusión subcutánea con buenos resultados y sin efectos secundarios relevantes, aunque la posibilidad de infusión combinada junto a otros medicamentos de uso frecuente en Cuidados Paliativos es poco conocida. Presentamos el caso de una paciente con enfermedad de Parkinson en fase terminal y crisis comiciales en la que, al perder la vía oral y los accesos venosos para su tratamiento, se utilizó levetiracetam en infusión continua subcutánea combinada con midazolam. Esta mantuvo el control de síntomas alcanzado previamente por vía venosa, sin efectos adversos locales. La administración conjunta con midazolam no alteró la estabilidad ni la efectividad del anticonvulsivante

Parkinson's disease is a chronic neurological disorder characterized by motor and non-motor symptoms. Its association with epilepsy has been studied for a long time. In advanced stages, cognitive deterioration and loss of swallowing are common. This requires the parenteral administration of medicines. Levetiracetam has been used in subcutaneous infusion with good results and without relevant side effects, although the possibility of combined infusion together with other medications frequently used in palliative care is not well known. We report the case of a patient with Parkinson’s disease in the terminal phase and seizures in which, after losing the oral route and venous access for treatment, levetiracetam was used in continuous subcutaneous infusion combined with midazolam. Symptom control remained the same as previously achieved using the venous route, without local adverse effects. Coadministration with midazolam did not alter the stability or effectiveness of the anticonvulsant

Respuesta a: "Insuficiencia cardiaca terminal, ¿es posible morir bien?" / Answer to: "End-stage heart failure: is there a good way to die?"

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Sedación paliativa en hemorragia digestiva alta masiva (hematemesis) / Palliative sedation in massive upper gastrointestinal bleeding (haematemesis)

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Commissioning of the Controlled and Automatized Testing Facility for Human Behavior and Control (CASITA).

Human behavior is one of the most challenging aspects in the understanding of building physics. The need to evaluate it requires controlled environments and facilities in which researchers can test their methods. In this paper, we present the commissioning of the Controlled and Automatized Testing Facility for Human Behavior (CASITA). This is a controlled space emulation of an office or flat, with more than 20 environmental sensors, 5 electrical meters, and 10 actuators. Our contribution shown in this paper is the development of an infrastructure-Artificial Intelligence (AI) model pair that is perfectly integrated for the study of a variety of human energy use aspects. This facility will help to perform studies about human behavior in a controlled space. To verify this, we have tested this emulation for 60 days, in which equipment was turned on and off, the settings of the conditioning system were modified remotely, and lighting operation was similar to that in real behaviors. This period of commissioning generated 74.4 GB of raw data including high-frequency measurements. This work has shown that CASITA performs beyond expectations and that sensors and actuators could enable research on a variety of disciplines related to building physics and human behavior. Also, we have tested the PROPHET software, which was previously used in other disciplines and found that it could be an excellent complement to CASITA for experiments that require the prediction of several pertinent variables in a given study. Our contribution has also been to proof that this package is an ideal "soft" addition to the infrastructure. A case study forecasting energy consumption has been performed, concluding that the facility and the software PROPHET have a great potential for research and an outstanding accuracy.

¿Es necesario proteger la infusión continua de morfina de la luz? / Is it necessary to protect continuous morphine infusion from light?

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Supervivencia, según la Palliative Performance Scale, de pacientes oncológicos trasladados a unidades de cuidados paliativos de media estancia por un equipo de soporte hospitalario / Survival of cancer patients discharged to intermediate stay palliative care units according to the Palliative Performance Scale

INTRODUCCIÓN: La capacidad para pronosticar la supervivencia de pacientes con enfermedad terminal de la «Palliative Performance Scale» (PPS) es ampliamente reconocida. Esta escala se ha utilizado también en la planificación de cuidados y en la gestión de recursos asistenciales paliativos. OBJETIVO: Estimar la supervivencia en el centro de destino de los pacientes oncológicos que se trasladan a unidades de cuidados paliativos de media estancia (UCPME) desde un hospital de agudos según la puntuación en la escala PPS en el momento del traslado. Evaluar la asociación entre dicha puntuación y la supervivencia. MÉTODO: Estudio retrospectivo sobre pacientes oncológicos atendidos por el equipo de soporte hospitalario de cuidados paliativos del Hospital Ramón y Cajal de Madrid que fueron trasladados a una UCPME, en el período 01/07/08-31/12/09. Se estimaron las funciones de supervivencia mediante el método de Kaplan-Meier para el grupo de pacientes con puntuación en la escala PPS ≤ 20% y PPS > 20% y se compararon mediante la prueba de log-rank. Para estimar las probabilidades de supervivencia a distintos tiempos en función del valor de PPS al alta se ajustó un modelo de Cox. RESULTADOS: Fueron incluidos 77 pacientes (edad media 77 [9,6] años; 42,9% mujeres). El tumor más frecuente fue el de pulmón (14,3%). Los valores medios y desviación estándar de PPS en el momento del traslado fueron 40,9 (12,6%). En el grupo PPS ≤ 20%, la mediana de supervivencia fue de 4 IC 95% (0-9) días, y en el de PPS > 20% de 33 IC 95% (19-47) días (p = 0,006). Se obtuvo un 4% más de riesgo de mortalidad por unidad de descenso de PPS (HR = 1,04, IC 95% 1,02-1,06). CONCLUSIONES: La supervivencia de los pacientes en los centros de destino fue significativamente diferente según la puntuación de la escala PPS en el momento del traslado. A partir de los resultados se elaboró una tabla de probabilidades de fallecimiento en función de la puntuación PPS en el momento del traslado y los días transcurridos tras este

INTRODUCTION: The value of "Palliative Performance Scale" (PPS) to estimate survival of patients with terminal illness is widely recognized. This scale has also been used in care planning and resource management in palliative care. AIMS: To estimate survival in the host institution for cancer patients who move to intermediatestay palliative care units (UCPME) from an acute care hospital according to the PPS value at time of transfer. To evaluate the association between this score and survival. Method: Retrospective study of cancer patients treated by a palliative care support team and transferred to an UCPME in the period 01/07/2008 to 31/12/2009. We estimated survival by Kaplan-Meier function for the group of patients with PPS score < 20% and PPS> 20% and compared by log-rank test. A Cox model was adjusted to estimate the probability of survival at different times depending on the value of PPS at the time of discharge. RESULTS: Seventy seven patients were included (mean age 77 (9.6) years; 42.9% women). Lung cancer was the most frequent neoplasm (14.3%). The mean PPS at the time of transfer was 40.9% (12.6). Median survival was 4 days (95% CI; 0-9) in the PPS ≤ 20% group, and 33 days (95% CI; 19-47) in the PPS > 20% group (P = .006). There was a 4% increased risk of mortality per unit decrease in PPS (HR = 1.04, 95% CI 1.02-1.06). CONCLUSIONS: Patients survival in the UCPME was significantly different depending on the PPS at the time of discharge. A death probabilities table according to the PPS at the time of transfer and the days afterwards was created from the results

Sedación paliativa / Palliative sedation

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Lesiones descamativas en palmas y plantas: caso clínico / Squamous lesions on palms and plantar areas: clinical case

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Dynamic function of the alkyl spacer of acetogenins as potent inhibitors of mitochondrial complex I. A molecular dynamics simulation approach.

Acetogenins are among the most potent of the known inhibitors of complex I (NADH-ubiquinone oxidoreductase) in mitochondrial electron transfer system. Elucidation of the dynamic function of the alkyl spacer linking the two toxophores (i.e., the hydroxylated tetrahydrofuran and the γ-lactone rings) is critical for fully understanding their inhibition mechanism. To this end, using molecular dynamics simulations a structure-activity relationship study of a series of acetogenins was performed for the first time using this approach. Our results clearly indicated that both, the length and the molecular flexibility of the spacer, were crucial for taking an active conformation. A partially folded conformation with an optimal length (bis-tetrahydrofuran rings and 13 carbon atoms) of about 16 Šwith a high molecular flexibility might depict an active form of the spacer. In addition, we demonstrated that the bis-tetrahydrofuran derivatives are able to overcome the shortage of the length of the spacer more efficiently than the mono-tetrahydrofuran derivatives with the help of the additional tetrahydrofuran, which acts as a pseudospacer. Our results obtained from molecular dynamics calculations supported the use of a combined decane/water system as a good solvent model to simulate the biological environment of acetogenins acting as inhibitor of complex I.

Frecuencia del trastorno por déficit de atención en una escuela primaria / Frequency of the attention-deficit disorder in a primary school

Se realizó un estudio descriptivo, prospectivo, de intervención comunitaria, desde un enfoque o paradigma cuantitativo en la escuela de nivel primario José Martí del municipio Guines, Provincia La Habana, durante el período comprendido entre septiembre del 2006 a enero del 2007 con el objetivo de determinar la frecuencia del Trastorno por Déficit de Atención e Hiperactividad, así como evaluar el nivel de conocimientos que sobre el trastorno objeto de estudio tienen los profesores del centro estudiantil, antes y después de un Programa de Intervención. Se seleccionó una muestra de 60 niños a los cuales se les realizaron pruebas psicológicas y psicométricas, además de una encuesta a los profesores para medir sus conocimientos sobre los elementos esenciales de la entidad clínica. Se evidenció en un alto porciento la presencia del síndrome patológico, reflejándose el mayor número de casos en el sexo masculino y en edades comprendidas entre los 6 y 7 años. El subtipo clínico que predominó en la investigación fue el trastorno por déficit de atención tipo combinado, así como se demostró la presencia de alta comorbilidad en los niños estudiados. Se comprobó escasos conocimientos por parte del personal docente de la institución antes del programa de capacitación instrumentado, así como mejoría en dichos conocimientos posterior a la etapa de intervención(AU)

Conocimientos que tienen las madres sobre la fiebre y el manejo del niño febril / Knowledge that possess mothers about fever and the handling of the febrile child

Se realizó un estudio descriptivo, analítico y de corte transversal entre el 1ro de octubre y el 31 de diciembre del 2006 en 100 madres de niños menores de cinco años que correspondian a la totalidad con esa edad en seis consultorios del área urbana del Policlínico Universitario “Santiago Rafael Echezarreta Mulkay” de San José de las Lajas, provincia de La Habana con el objetivo de conocer la magnitud de sus preocupaciones, criterios erróneos e insuficiencias con respecto a la fiebre y al manejo del niño febril. Se les aplicó una encuesta con 19 preguntas cerradas y 21 aspectos. Se abordaron tres problemas fundamentales: Conocimientos Generales sobre la fiebre, mitos y errores, Utilización de Antitérmicos y Medidas generales en el control de la fiebre. Se evaluaron las respuestas en cuatro categorias: excelentes, buenos, aceptables e insuficientes. La información obtenida se procesó estadísticamente y se aplicaron medidas para análisis de variables cualitativas como la relación, la proporción y el porciento. Se concluye que las madres tienen insuficientes conocimientos con respecto a la fiebre y el manejo del niño febril. Consideran que la fiebre no puede ser beneficiosa para su hijo y la relacionan con la posibilidad de desencadenar convulsiones y daño del sistema nervioso central. Se identifican como mitos y errores: la relación de la fiebre con el brote de los dientes, que la dipirona produce ascenso inicial de la temperatura corporal y que es fundamental dar un baño previo al niño para su administración. El conocimiento sobre la utilización de los medicamentos antitérmicos fue el aspecto que más errores mostró. Un gran número de las encuestadas no conocen o no utilizan como antitermicos el paracetamol y el ibuprofeno (AU)

A descriptive, analytical, and transversal study was carried out between October 1st and December 31st 2006 in 100 mothers of children less than five years of age than corresponded to the totality with that age in six doctor's offices of the urban area of the "Santiago Rafael Echezarreta Mulkay" Policlinical University of San José de las Lajas, Havana Province with the objective of knowing the magnitude of their preoccupations, erroneous criteria and insufficiencies with respect to fever and the handling of the febrile child. A survey was applied to them with 19 closed questions and 21 aspects. Three fundamental problems were approached: General knowledge on fever, myths and errors, use of antithermics and general measures in the control of fever. The answers were evaluated in four cathegories: excellent, good, acceptable and insufficient. The obtained data was statistically processed, and measures for the analysis of qualitative variables like relation, proportion and percent were applied. It was concluded that mothers possess an insufficient knowledge with respect to fever and the handling of the febrile child. They consider that fever cannot be beneficial for their children and relate it to the possibility of unleashing convulsions and damage to the central nervous system. As myths and errors were identified: the relation of fever with the tooth bud, that dipirona produces initial ascent of the corporal temperature and that it is fundamental to give a previous bath to the child for its administration. The knowledge on the use of antithermal medication was the aspect that showed more errors. A great number of the surveyed mothers do not know or do not use antithermics such as paracetamol and ibuprofen(AU)