Es el reimplante valvular mejor que el bentall biológico modificado para tratar aneurismas de la raíz asociados a insuficiencia?

Es el reimplante valvular mejor que el Bentall Biológico Modificado para tratar aneurismas de la raíz asociados a insuficiencia? Obando CE; Gutiérrez HF; Santamaría G, Bresciani R; Camacho J; Sandoval N; Umaña J. Departamento de Cirugía Cardiovascular, Fundación Cardio Infantil, Bogotá, Colombia. Objetivo: comparar resultados funcionales, morbilidad y sobrevida a corto y mediano plazo, tras la realización de Bentall modificado con prótesis Freestyle vs reimplante valvular de Tirone David, en insuficiencia aortica secundaria a aneurisma de la raíz. Diseño: revisión de registros institucionales de 88 pacientes tratados entre enero de 2003 y agosto de 2009 con insuficiencia aortica secundaria a aneurisma de la raíz sin daño valvular, distribuidos en dos cohortes: Grupo 1 (Bentall modificado) y Grupo 2 (reimplante valvular). Se evaluaron complicaciones perioperatorias, transfusiones, estancias hospitalarias y en el seguimiento a mediano plazo insuficiencia valvular, clase funcional, función ventricular y sobrevida. Solidez de los resultados verificada mediante análisis de propensidad con balanceo de grupos. Resultados: Grupo (1) 51(57.9%) pacientes y grupo (2) 37(42.1%). Aunque el grupo 2 es mas joven, patrones similares de coomorbilidad, anatomía de la raíz, función y diámetros ventriculares hacen comparables los dos grupos. Seguimiento de 3.3 años (IQR 2.0-4.4). Mortalidad temprana 2(3.8%) vs 0 p =0.2 y tardía de 2(4.1%) vs 0 p=0.33. El análisis estratificado de covariables en bloques de distribución tampoco identifica diferencias en mortalidad. El análisis de sobrevida de mortalidad y sobrevida libre de eventos identifica desenlaces similares entre los grupos (Log-Rank chi2=0.9, p=0.3); incluyendo Insuficiencia aortica = II temprana (3.8% vs 0, p=0.2) y tardía (3.8%vs 0, p=0.1), transfusiones perioperatorias, reintervenciones por sangrado (2.3% vs 3.4%, p=0.4), arritmias (25.5% vs 13.5%, p=0.2) y disfunción neurológica (5.7% vs 2.9%, p=0.9). Finalmente la hospitalización total (6.5 {1-35} vs 4{3-16} p=0.001) y estancia en Cuidado intensivo (2.5 {1-21} vs 1{1-16} p=0.001) es superior en el grupo1. Conclusiones: el tratamiento de los aneurismas de la raíz aortica asociados a insuficiencia valvular sin daño estructural, mediante reimplante valvular o Bentall biológico modificado ofrece resultados similares a corto y mediano plazo. La preservación valvular se asocia a estancias mas cortas, pero no hay diferencia en complicaciones postoperatorias, estatus funcional, insuficiencia valvular, función ventricular, mortalidad y sobrevida libre de eventos adversos.

Modified radical mastectomy: A pilot clinical trial comparing the use of conventional electric scalpel and harmonic scalpel

Background: The aim of this study was to compare the rates of local postoperative complications among women undergoing modified radical mastectomy with an electric scalpel (ES) or a harmonic scalpel (HS). It is thought that HS use has less postoperative complications, mainly seroma formation. Methods: This study was a prospective non-randomised clinical trial (NCT01391988) among consecutive patients, performed in parallel. Patients underwent modified radical mastectomy using an HS or ES. We analysed the following operative variables: time, blood loss and seroma volume drainage. Postoperative complications, including seroma, flap necrosis, haematoma and infection were evaluated on the 7th and 14th days. Results: Forty-six patients underwent a MRM with ES and 49 with HS; no differences were observed between the groups. The rate of local complications was 29% in the HS group and 52% in the ES group (p=0.024). The rates of seroma (16.3% versus 28.3%; p=0.161), necrosis (4.1% vs. 21.7%; p=0.013; OR=0.15), haematoma (2.0% vs. 8.7%; p=0.195) and infection (2.0% vs. 6.5%; p=0.351) were lower in the HS group. Adding the findings of all comparative studies using HSs in MRM to the seroma rates in the current study, the seroma rate, expressed as a categorical variable, did not decrease with HS. Seroma was present in 60/219 cases using an HS and in 69/239 cases utilising an ES (p=0.72). Based on a multivariate analysis, HS decreased the risk of skin necrosis (p=0.015). Conclusions: HSs do not decrease the seroma rate. However, this method may be useful in skin sparing mastectomy because it decreases skin flap necrosis. © 2013 Surgical Associates Ltd.

Physicochemical and mechanical properties of zirconium oxide and niobium oxide modified Portland cement-based experimental endodontic sealers

Aim: To evaluate the physicochemical and mechanical properties of Portland cement-based experimental sealers (ES) with different radiopacifying agents (zirconium oxide and niobium oxide micro- and nanoparticles) in comparison with the following conventional sealers: AH Plus, MTA Fillapex and Sealapex. Methodology: The materials were tested for setting time, compressive strength, flow, film thickness, radiopacity, solubility, dimensional stability and formaldehyde release. Data were subjected to anova and Tukey tests (P < 0.05). Results: MTA Fillapex had the shortest setting time and lowest compressive strength values (P < 0.05) compared with the other materials. The ES had flow values similar to the conventional materials, but higher film thickness (P < 0.05) and lower radiopacity (P < 0.05). Similarly to AH Plus, the ES were associated with dimensional expansion (P > 0.05) and lower solubility when compared with MTA Fillapex and Sealapex (P < 0.05). None of the endodontic sealers evaluated released formaldehyde after mixing. Conclusion: With the exception of radiopacity, the Portland cement-based experimental endodontic sealers presented physicochemical properties according to the specifications no 57 ANSI/ADA (ADA Professional Product Review, 2008) and ISO 6876 (Dentistry - Root Canal Sealing Materials, 2012, British Standards Institution, London, UK). The sealers had setting times and flow ability that was adequate for clinical use, satisfactory compressive strength and low solubility. Additional studies should be carried out with the purpose of decreasing the film thickness and to determine the ideal ratio of radiopacifying agents in Portland cement-based root canal sealers. © 2013 International Endodontic Journal.

Carbon paste electrode modified with ascorbic acid and carbon nanotubes for determination copper in sugar cane spirit

This work has been carried out in order to determine the copper content in sugar cane spirit samples from the south of Minas Gerais, using a carbon paste electrode modified with ascorbic acid and carbon nanotubes using the square wave voltammetry technique. The following parameters were studied: Ed (deposit potencial). Td (deposit time), f (frequency), A (amplitude) and ΔEs (increment scanning). The analytical curve was built in an interval from 0.5 to 12 mg L-1 and a coefficient of linear correlation of 0.997 Three sugar cane spirit samples were analysed, which presented copper content ranging from 0.29 to 1.59 mg L-1.

Designed functional defects in colloidal photonic crystals: switching, biomonitoring and modified photoluminescence

Es werden zwei komplementäre "bottom-up" Methoden präsentiert, die den kontrollierten Einbau von "intelligenten" planaren Defekten in selbstorganisierte kolloidale photonische Kristalle (KPKs) ermöglichen. Die Defektschicht basiert auf einem funktionellen, nanometer-skalierten dünnen Film, der entweder durch schichtweise ("layer-by-layer") Selbstorganisation und Mikrokontakttransferübertragung oder durch Aufschleudern und einer KPK-Opferfüllung hergestellt wird. Die entwickelten Techniken gestatten die Integration von maßgeschneiderten dünnen Defektfilmen bestehend aus einer enorm großen Vielfalt an Materialien; sie sind kostengünstig und können im größeren Maßstab angewendet werden. Optische Untersuchungen zeigen einen engen, durch den Defekt hervorgerufenen Transmissionszustand in der photonischen Bandlücke. Die Defektwellenlänge hängt von der optischen Dicke der Defektschicht ab. Aktives Schalten der Defektwellenlänge wird erreicht, indem Defektschichten aus Makromolekülen hergestellt werden, die über externe Erreger wie Licht, Temperatur, Redoxzyklen und mechanischen Druck adressiert werden können. Die Ergebnisse der Untersuchungen sind im Einklang mit separat durchgeführten Ellipsometrie-Messungen und theoretischen "scalar wave approximation"-Berechnungen. Darüber hinaus werden KPKs mit funktionellen biomolekularen Defekten vorgestellt. Über Verschiebungen der Defektmode können DNA-Konformationsänderungen, die enantioselektive Einlagerung eines chiralen Antitumormedikaments sowie Enzymaktivitäten optisch beobachtet werden. Die Einlagerung von fluoreszierenden Farbstoffen und Quantenpunkten in Defekt-KPKs führt zu einer eindeutigen, durch die photonische Bandlücke und den Defektzustand hervorgerufenen Modifizierung der Photolumineszenz (PL)-Spektren. Schaltbare PL-Modifizierungen werden detektiert, wenn adressierbare Defekt-KPKs verwendet werden.

Analysis of the modified optical properties and band structure of GaAs12xSbx-capped InAs/GaAs quantum dots

The origin of the modified optical properties of InAs/GaAs quantum dots (QD) capped with a thin GaAs1−xSbx layer is analyzed in terms of the band structure. To do so, the size, shape, and composition of the QDs and capping layer are determined through cross-sectional scanning tunnelling microscopy and used as input parameters in an 8 × 8 k·p model. As the Sb content is increased, there are two competing effects determining carrier confinement and the oscillator strength: the increased QD height and reduced strain on one side and the reduced QD-capping layer valence band offset on the other. Nevertheless, the observed evolution of the photoluminescence (PL) intensity with Sb cannot be explained in terms of the oscillator strength between ground states, which decreases dramatically for Sb > 16%, where the band alignment becomes type II with the hole wavefunction localized outside the QD in the capping layer. Contrary to this behaviour, the PL intensity in the type II QDs is similar (at 15 K) or even larger (at room temperature) than in the type I Sb-free reference QDs. This indicates that the PL efficiency is dominated by carrier dynamics, which is altered by the presence of the GaAsSb capping layer. In particular, the presence of Sb leads to an enhanced PL thermal stability. From the comparison between the activation energies for thermal quenching of the PL and the modelled band structure, the main carrier escape mechanisms are suggested. In standard GaAs-capped QDs, escape of both electrons and holes to the GaAs barrier is the main PL quenching mechanism. For small-moderate Sb (<16%) for which the type I band alignment is kept, electrons escape to the GaAs barrier and holes escape to the GaAsSb capping layer, where redistribution and retraping processes can take place. For Sb contents above 16% (type-II region), holes remain in the GaAsSb layer and the escape of electrons from the QD to the GaAs barrier is most likely the dominant PL quenching mechanism. This means that electrons and holes behave dynamically as uncorrelated pairs in both the type-I and type-II structures.

A second order in time modified Lagrange-Galerkin finite element method for the incompressible Navier-Stokes equations

We introduce a second order in time modified Lagrange--Galerkin (MLG) method for the time dependent incompressible Navier--Stokes equations. The main ingredient of the new method is the scheme proposed to calculate in a more efficient manner the Galerkin projection of the functions transported along the characteristic curves of the transport operator. We present error estimates for velocity and pressure in the framework of mixed finite elements when either the mini-element or the $P2/P1$ Taylor--Hood element are used.

Super resolution using a modified Spherical Geodesic Waveguide suitable for manufacturing

The previous publications (Miñano et al, 2011) have shown that using a Spherical Geodesic Waveguide (SGW), it can be achieved the super-resolution up to ? /500 close to a set of discrete frequencies. These frequencies are directly connected with the well-known Schumann resonance frequencies of spherical symmetric systems. However, the Spherical Geodesic Waveguide (SGW) has been presented as an ideal system, in which the technological obstacles or manufacturing feasibility and their influence on final results were not taken into account. In order to prove the concept of superresolution experimentally, the Spherical Geodesic Waveguide is modified according to the manufacturing requirements and technological limitations. Each manufacturing process imposes some imperfections which can affect the experimental results. Here, we analyze the influence of the manufacturing limitations on the super-resolution properties of the SGW. Beside the theoretical work, herein, there has been presented the experimental results, as well.

Thermal behaviour of bitumen modified by sulphur addition

The most frequent use of bitumen is as binder for pavement applications. The effect of sulphur addition on the properties of the bitumen has been extensively studied several decades ago. Recently, there is a renewed interest in researching the behaviour of sulphur-bitumen combination, because off 1.The future availability of bitumen may be limited and 2. The beneficial consumption of great amounts of sulphur compounds from petroleum refining is advisable. The addition of sulphur to bitumen provokes the beginning of chemical reactions depending on the sulphur content and heating temperature. At heating temperatures T< 140 ºC liquid sulphur reacts with naphthenic-aromatic fraction forming polysulphides. At temperatures above 150 ºC dehydrogenization reactions with emission of hydrogen sulfide take place and naphthenic-aromatic molecules are transformed into asphaltenes. Therefore, the addition of sulphur to bitumen provokes changes in the chemical structure of the bitumen. The objective of this work is to analyze, the thermal behaviour of sulphur-bitumen mixtures of different composition (0-35 %wt sulphur content) prepared at 130 and 140 ºC, by means of differential scanning calorimetry (DSC). Besides, the volatile emissions of the mixtures at high temperature have been estimated from loss weight measurements as a function of stored time

Improvement of compatibility and stability on polyethylene-modified bitumen by use of an aromatic extra as compatibilizer.

Bitumen modification by polyethylene addition usually improves the mechanical properties of the binder and, therefore, the behavior in service of the bituminous mix: thermal susceptibility and rutting can be diminished, whilst the resistance to low temperature cracking may increase. To achieve this improvement it is necessary a good compatibility between the base bitumen and the polyethylene. Low compatibility between bitumen and polyethylene can lead to phase separation: the polymer- asphalt incompatibility translates into a deterioration of ultimate properties. The object of this research project was to determine if these problems can be diminished by using certain compatibilizer agents, e.g. an aromatic extract from the oil refinery. Compatibility and stability of the polyethylene modified bitumen were studied using conventional test methods and dynamic shear reometer (DSR). Blends of bitumen and polyethylene were prepared with neat bitumen (PMB) or bitumen with compatibilizer as component of the binder (PMBC) and then compared. The experimental results show that “colloid instability index”(IC) is a parameter that can be used to control the compatibility between bitumen and polyethylene. From polyethylene point of view, one of the parameters that govern is the “melt flow index” (MFI). Experimental results show that PMBC formulated with low IC bitumen and hi gh MFI lineal polyethylene can be considered as stable binder.

Storage stability of SBS/sulfur modified bitumens at high temperature: influence of bitumen composition and structure

Polymer modified bitumens, PMBs, are usually prepared at high temperature and subsequently stored for a period of time, also at high temperature. The stability of PMBs, in these conditions, has a decisive influence in order to obtain the adequate performances for practical applications. In this article the attention is focused in the analysis of the factors that determine the stability of styrene–butadiene–styrene copolymer (SBS)/sulfur modified bitumens when the mixtures are maintained at high temperature. Bitumens from different crude oil sources were used to prepare SBS/sulfur modified bitumens. Changes in the values of viscosity, softening point, as well as in the morphology of PMB samples, stored at 160 °C, were related to the bitumen chemical composition and to the amount of asphaltene micelles present in the neat bitumen used in their preparation El trabajo se centra en el estudio de la influencia de la estructura /composición del betún sobre la compatibilidad del sistema betún/SBS. Cuatro betunes provenientes de dos crudos distintos se seleccionaron y sus mezclas se utilizaron para preparar betunes modificados con contenidos de SBS del 3% en peso

Inorganic Nanoparticle-Modified Poly(Phenylene Sulphide)/ Carbon Fiber Laminates: Thermomechanical Behaviour

Carbon fiber (CF)-reinforced high-temperature thermoplastics such as poly(phenylene sulphide) (PPS) are widely used in structural composites for aerospace and automotive applications. The porosity of CF-reinforced polymers is a very important topic for practical applications since there is a direct correlation between void content and mechanical properties. In this study, inorganic fullerene-like tungsten disulphide (IF-WS2) lubricant nanoparticles were used to manufacture PPS/IF-WS2/CF laminates via melt-blending and hot-press processing, and the effect of IF-WS2 loading on the quality, thermal and mechanical behaviour of the hybrid composites was investigated. The addition of IF-WS2 improved fiber impregnation, resulting in lower degree of porosity and increased delamination resistance, compression and flexural properties; their reinforcement effect was greater at temperatures above the glass transition (Tg). IF-WS2 contents higher than 0.5 wt % increased Tg and the heat deflection temperature while reduced the coefficient of thermal expansion. The multiscale laminates exhibited higher ignition point and notably reduced peak heat release rate compared to PPS/CF. The coexistence of micro- and nano-scale fillers resulted in synergistic effects that enhanced the stiffness, strength, thermal conductivity and flame retardancy of the matrix. The results presented herein demonstrate that the IF-WS2 are very promising nanofillers to improve the thermomechanical properties of conventional thermoplastic/CF composites.

Study of the effect of four warm mix asphalt additives on bitumen modified with 15% crumb rubber

Due to a growing concern over global warming, the bituminous mixture industry is making a constant effort to diminish its emissions by reducing manufacturing and installation temperatures without compromising the mechanical properties of the bituminous mixtures. The use of mixtures with tyre rubber has demonstrated that these mixtures can be economical and ecological and that they improve the behaviour of the pavements. However, bituminous mixtures with a high rubber content present one major drawback: they require higher mixing and installation temperatures due to the elevated viscosity caused by the high rubber content and thus they produce larger amounts of greenhouse gas emissions than conventional bituminous mixtures. This article presents a study of the effect of four viscosity-reducing additives (Sasobit®, Asphaltan A®, Asphaltan B® and Licomont BS 100®) on a bitumen modified with 15% rubber. The results of this study indicate that these additives successfully reduce viscosity, increase the softening temperature and reduce penetration. However, they do not have a clear effect on the test for elastic recovery and ductility at 25 °C.

Modified Gutenberg-Richter coefficient for damage evaluation in reinforced concrete structures subjected to seismic simulations on a shaking table

This paper presents analysis and discussion of the b- and ib-values calculated from the acoustic emission (AE) signals recorded during dynamic shake-table tests conducted on a reinforced concrete (RC) frame subjected to several uniaxial seismic simulations of increasing intensity until collapse. The intensity of shaking was controlled by the peak acceleration applied to the shake-table in each seismic simulation, and it ranged from 0.08 to 0.47 times the acceleration of gravity. The numerous spurious signals not related to concrete damage that inevitably contaminate AE measurements obtained from complex dynamic shake-table tests were properly filtered with an RMS filter and the use of guard sensors. Comparing the b- and ib-values calculated through the tests with the actual level of macro-cracking and damage observed during testing, it was concluded that the limit value of 0.05 proposed in previous research to determine the onset of macro-cracks should be revised in the case of earthquake-type dynamic loading. Finally, the b- and ibvalues were compared with the damage endured by the RC frame evaluated both visually and quantitatively in terms of the inter-story drift index.

A modified DEA model to estimate the importance of objectives with an application to agricultural economics

This paper demonstrates a connection between data envelopment analysis (DEA) and a non-interactive elicitation method to estimate the weights of objectives for decision-makers in a multiple attribute approach. This connection gives rise to a modified DEA model that allows us to estimate not only efficiency measures but also preference weights by radially projecting each unit onto a linear combination of the elements of the payoff matrix (which is obtained by standard multicriteria methods). For users of multiple attribute decision analysis the basic contribution of this paper is a new interpretation in terms of efficiency of the non-interactive methodology employed to estimate weights in a multicriteria approach. We also propose a modified procedure to calculate an efficient payoff matrix and a procedure to estimate weights through a radial projection rather than a distance minimization. For DEA users, we provide a modified DEA procedure to calculate preference weights and efficiency measures that does not depend on any observations in the dataset. This methodology has been applied to an agricultural case study in Spain.