Cost-efficient one-part alkali-activated mortars with low global warming potential for floor heating systems applications

Increasing building energy efficiency is one the most cost-effective ways to reduce emissions. The use of thermal insulation materials mitigates heat loss in buildings, therefore minimising heat energy needs. In recent years, several papers were published on the subject of foam alkali-activated cements with enhanced thermal conductivity. However, on those papers cost analysis was strangely avoided. This paper presents experimental results on one-part alkali-activated cements. It also includes global warming potential assessment and cost analysis. Foam one-part alkali-activated cements cost simulations considering two carbon dioxide social costs scenarios are also included. The results show that one-part alkali-activated cements mixtures based on 26%OPC + 58.3%FA + 8%CS + 7.7%CH and 3.5% hydrogen peroxide constitute a promising cost-efficient (67 euro/m3), thermal insulation solution for floor heating systems. This mixture presents a low global warming potential of 443 KgCO2eq/m3. The results confirm that in both carbon dioxide social cost scenarios the mixture 26 OPC + 58.3 FA + 8 CS + 7.7 CH with 3.5% hydrogen peroxide foaming agent is still the most cost efficient.

Cost efficiency and resistance to chemical attack of a fly ash geopolymeric mortar versus epoxy resin and acrylic paint coatings

This article presents results of an experimental investigation on the resistance to chemical attack (with sulphuric, hydrochloric and nitric acid) of several materials: OPC concrete, high-performance concrete, epoxy resin, acrylic painting and a fly ash-based geopolymeric mortar). Three types of acids with three high concentrations (10, 20 and 30%) were used to simulate long-term degradation. A cost analysis was also performed. The results show that the epoxy resin has the best resistance to chemical attack independently of the acid type and the acid concentration. However, the cost analysis shows that the epoxy resin-based solution is the least cost-efficient solution being 70% above the cost efficiency of the fly ash-based geopolymeric mortar.

Difference in the in-hospital mortality of unstable angina pectoris between men and women

PURPOSE: To assess differences in the in-hospital mortality (HM) rate between men and women with unstable angina pectoris (UA) according to age, depression of the ST segment, history of previous acute myocardial infarction (AMI), and risk factors for coronary heart disease. METHODS: From October 96 to March 98, 261 patients with UA were selected. Logistic regression models were developed to adjust the association between sex and HM for possible influence of covariables, such as hypertension, diabetes mellitus, dyslipidemia, sedentary lifestyle, smoking, and familial history of early coronary heart disease. RESULTS: HM due to UA was approximately three times higher in women (9.3%; 12/129) than in men (3.0%; 4/132) accounting for a relative risk of 3.07; 95% confidence interval (CI) =1.02-9.27. In logistic regression models, the association between sex and death was not significantly altered when the following parameters were considered: age, depression of the ST segment, history of previous AMI and risk factors for coronary heart disease. The nonadjusted and adjusted odds ratio (OR) for the distinct covariables were 3.28 (CI 95%=1.03-10.45) and 3.14 (CI = 95% = 0.88-11.20), respectively. CONCLUSION: Similarly to AMI, HM in UA is higher in women than in men. Age, risk factors for coronary heart disease, and depression of the ST segment in the electrocardiogram on patients' admission to the hospital did not significantly influence the association between sex and death.

Chest pain in the emergency room. Importance of a systematic approach

OBJECTIVE: To evaluate the efficiency of a systematic diagnostic approach in patients with chest pain in the emergency room in relation to the diagnosis of acute coronary syndrome (ACS) and the rate of hospitalization in high-cost units. METHODS: One thousand and three consecutive patients with chest pain were screened according to a pre-established process of diagnostic investigation based on the pre-test probability of ACS determinate by chest pain type and ECG changes. RESULTS: Of the 1003 patients, 224 were immediately discharged home because of no suspicion of ACS (route 5) and 119 were immediately transferred to the coronary care united because of ST elevation or left bundle-branch block (LBBB) (route 1) (74% of these had a final diagnosis of acute myocardial infarction [AMI]). Of the 660 patients that remained in the emergency room under observation, 77 (12%) had AMI without ST segment elevation and 202 (31%) had unstable angina (UA). In route 2 (high probability of ACS) 17% of patients had AMI and 43% had UA, whereas in route 3 (low probability) 2% had AMI and 7 % had UA. The admission ECG has been confirmed as a poor sensitivity test for the diagnosis of AMI ( 49%), with a positive predictive value considered only satisfactory (79%). CONCLUSION: A systematic diagnostic strategy, as used in this study, is essential in managing patients with chest pain in the emergency room in order to obtain high diagnostic accuracy, lower cost, and optimization of the use of coronary care unit beds.

Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

Background: High sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. Objective: To assess the correlation between serum hs-CRP levels (mg/L) in a peripheral vein in the left forearm (LFPV) with those in the coronary sinus (CS) of patients with coronary artery disease (CAD) and a diagnosis of stable angina (SA) or unstable angina (UA). Methods: This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Results: Forty patients with CAD (20 with SA and 20 with UA) were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001) and UA (r = 0.976, p < 0.001) and for the entire sample (r = 0.985, p < 0.001). Conclusion: Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA.

Development of a new method for the characterisation of bioreactors concerning heat and mass transfer

Since the specific heat transfer coefficient (UA) and the volumetric mass transfer coefficient (kLa) play an important role for the design of biotechnological processes, different techniques were developed in the past for the determination of these parameters. However, these approaches often use imprecise dynamic methods for the description of stationary processes and are limited towards scale and geometry of the bioreactor. Therefore, the aim of this thesis was to develop a new method, which overcomes these restrictions. This new approach is based on a permanent production of heat and oxygen by the constant decomposition of hydrogen peroxide in continuous mode. Since the degradation of H2O2 at standard conditions only takes place by the support of a catalyst, different candidates were investigated for their potential (regarding safety issues and reaction kinetic). Manganese-(IV)-oxide was found to be suitable. To compensate the inactivation of MnO2, a continuous process with repeated feeds of fresh MnO2 was established. Subsequently, a scale-up was successfully carried out from 100 mL to a 5 litre glass bioreactor (UniVessel®)To show the applicability of this new method for the characterisation of bioreactors, it was compared with common approaches. With the newly established technique as well as with a conventional procedure, which is based on an electrical heat source, specific heat transfer coefficients were measured in the range of 17.1 – 24.8 W/K for power inputs of about 50 – 70 W/L. However, a first proof of concept regarding the mass transfer showed no constant kLa for different dilution rates up to 0.04 h-1.Based on this, consecutive studies concerning the mass transfer should be made with higher volume flows, due to more even inflow rates. In addition, further experiments are advisable, to analyse the heat transfer in single-use bioreactors and in larger common systems.

Establishing an association between a peri-operative perfusion score system (PerfSCORE) and post-operative patient morbidity/mortality during CPB cardiac surgery.

BACKGROUND: To date, there is no quality assurance program that correlates patient outcome to perfusion service provided during cardiopulmonary bypass (CPB). A score was devised, incorporating objective parameters that would reflect the likelihood to influence patient outcome. The purpose was to create a new method for evaluating the quality of care the perfusionist provides during CPB procedures and to deduce whether it predicts patient morbidity and mortality. METHODS: We analysed 295 consecutive elective patients. We chose 10 parameters: fluid balance, blood transfused, Hct, ACT, PaO2, PaCO2, pH, BE, potassium and CPB time. Distribution analysis was performed using the Shapiro-Wilcoxon test. This made up the PerfSCORE and we tried to find a correlation to mortality rate, patient stay in the ICU and length of mechanical ventilation. Univariate analysis (UA) using linear regression was established for each parameter. Statistical significance was established when p < 0.05. Multivariate analysis (MA) was performed with the same parameters. RESULTS: The mean age was 63.8 +/- 12.6 years with 70% males. There were 180 CABG, 88 valves, and 27 combined CABG/valve procedures. The PerfSCORE of 6.6 +/- 2.4 (0-20), mortality of 2.7% (8/295), CPB time 100 +/- 41 min (19-313), ICU stay 52 +/- 62 hrs (7-564) and mechanical ventilation of 10.5 +/- 14.8 hrs (0-564) was calculated. CPB time, fluid balance, PaO2, PerfSCORE and blood transfused were significantly correlated to mortality (UA, p < 0.05). Also, CPB time, blood transfused and PaO2 were parameters predicting mortality (MA, p < 0.01). Only pH was significantly correlated for predicting ICU stay (UA). Ultrafiltration (UF) and CPB time were significantly correlated (UA, p < 0.01) while UF (p < 0.05) was the only parameter predicting mechanical ventilation duration (MA). CONCLUSIONS: CPB time, blood transfused and PaO2 are independent risk factors of mortality. Fluid balance, blood transfusion, PaO2, PerfSCORE and CPB time are independent parameters for predicting morbidity. PerfSCORE is a quality of perfusion measure that objectively quantifies perfusion performance.

Mather invariants in groups of piecewise-linear homeomorphisms

We describe the relation between two characterizations of conjugacy in groups of piecewise-linear homeomorphisms, discovered by Brin and Squier in [2] and Kassabov and Matucci in [5]. Thanks to the interplay between the techniques, we produce a simplified point of view of conjugacy that allows ua to easily recover centralizers and lends itself to generalization.

Outcome of patients with acute coronary syndrome in hospitals of different sizes. A report from the AMIS Plus Registry.

To assess the impact of admission to different hospital types on early and 1-year outcomes in patients with acute coronary syndrome (ACS). Between 1997 and 2009, 31 010 ACS patients from 76 Swiss hospitals were enrolled in the AMIS Plus registry. Large tertiary institutions with continuous (24 hour/7 day) cardiac catheterisation facilities were classified as type A hospitals, and all others as type B. For 1-year outcomes, a subgroup of patients admitted after 2005 were studied. Eleven type A hospitals admitted 15987 (52%) patients and 65 type B hospitals 15023 (48%) patients. Patients admitted into B hospitals were older, more frequently female, diabetic, hypertensive, had more severe comorbidities and more frequent non-ST segment elevation (NSTE)-ACS/unstable angina (UA). STE-ACS patients admitted into B hospitals received more thrombolysis, but less percutaneous coronary intervention (PCI). Crude in-hospital mortality and major adverse cardiac events (MACE) were higher in patients from B hospitals. Crude 1-year mortality of 3747 ACS patients followed up was higher in patients admitted into B hospitals, but no differences were found for MACE. After adjustment for age, risk factors, type of ACS and comorbidities, hospital type was not an independent predictor of in-hospital mortality, in-hospital MACE, 1-year MACE or mortality. Admission indicated a crude outcome in favour of hospitalisation during duty-hours while 1-year outcome could not document a significant effect. ACS patients admitted to smaller regional Swiss hospitals were older, had more severe comorbidities, more NSTE-ACS and received less intensive treatment compared with the patients initially admitted to large tertiary institutions. However, hospital type was not an independent predictor of early and mid-term outcomes in these patients. Furthermore, our data suggest that Swiss hospitals have been functioning as an efficient network for the past 12 years.

Notch1 control of oligodendrocyte differentiation in the spinal cord.

We have selectively inhibited Notch1 signaling in oligodendrocyte precursors (OPCs) using the Cre/loxP system in transgenic mice to investigate the role of Notch1 in oligodendrocyte (OL) development and differentiation. Early development of OPCs appeared normal in the spinal cord. However, at embryonic day 17.5, premature OL differentiation was observed and ectopic immature OLs were present in the gray matter. At birth, OL apoptosis was strongly increased in Notch1 mutant animals. Premature OL differentiation was also observed in the cerebrum, indicating that Notch1 is required for the correct spatial and temporal regulation of OL differentiation in various regions of the central nervous system. These findings establish a widespread function of Notch1 in the late steps of mammalian OPC development in vivo.

Wilhelm Ziely ("Olwier und Artus", "Valentin und Orsus", 1521) und das Fiktionsproblem des frühneuhochdeutschen Prosaromans

Wilhelm Zielys ca. 1511-21 in Bern entstandene Prosaromane ‛Olwier und Artus' und ‛Valentin und Orsus' nach französischer Vorlage sind bisher kaum erschlossen. Lediglich ihre Paratexte werden seit jeher registriert: Zielys Vorrede zum 1521 als Doppelausgabe erschienenen Erstdruck beider Romane sowie ein erläuterndes Schlusskapitel zu ‛Olwier und Artus' gelten als innovative Lösungsversuche des im 16. Jahrhundert virulenten Wahrheitsproblems der Literatur und als frühe Zeugnisse für die Entwicklung modernen Fiktionsbewusstseins. Der Beitrag analysiert zunächst in systematischem Zugriff Verbindungspunkte zur neuzeitlichen Literaturästhetik und zeigt auf, daß diese Verbindungen nicht historisch sein können. In einem zweiten, historischen Zugriff untersucht er Zielys Modell im Kontext seines Gesamtwerks und stellt es in den kulturgeschichtlichen Zusammenhang der Jahre um 1520 in der alten Eidgenossenschaft. Er arbeitet die enge Anbindung der poetologischen Positionierung Zielys an den glaubensgeschichtlichen Diskurs am Vorabend der Berner Reformation heraus und wirft neue Fragen zur Auseinandersetzung mit dem Fiktionsproblem im Prosaroman, zugleich auch nach dem literaturwissenschaftlichen Zugang zu vormoderner Fiktionalität, auf.

L'effectivité des Conventions anti-corruption internationales : vers une Cour pénale internationale en criminalité économique pour punir le vol d'Etat

This doctoral thesis proposes an International Criminal Court Specialized in Economic Crime (ICC/EC) as a solution to the main obstacles to the effectiveness of international anti-corruption conventions studied. In fact, the dispute settlement systems of the international anti-corruption Conventions do not provide sufficient guarantees of effectiveness, and offenses and crimes of corruption are not under the jurisdiction of the International Criminal Court (ICC) derived from the Rome Statute of 2000. In a first part, this work analyzes seven international anti-corruption Conventions adopted between 1996 and 2003, respectively, by the Organization of American States (OAS), the Organization for Economic Cooperation and Development (OECD), the European Union (EU), the Council of Europe (CoE), the African Union (AU) and the United Nations (UN). In a second part, this study highlights a deficit of rationalization and optimization of offenses included in the conventions: an incomplete criminalization of legal persons for corruption, an equally insufficient criminalization for corruption of political leaders benefiting both from criminal and civil immunities, as well as the limited outcome of international asset recovery de-rived from corruption. Finally, given the previous analysis made, this thesis concludes with a pro-posal for an independent ICC/EC specific to economic crimes in order to overcome the major obstacles highlighted and which strongly affect the effectiveness of the international anti-corruption conventions. - Cet ouvrage de thèse doctorale propose, comme solution principale aux obstacles à l'effectivité des Conventions anti-corruption internationales étudiées, une Cour Pénale Internationale Spécialisée en Criminalité Economique (CPI/CE). En effet, les systèmes de règlement des différends des Conven¬tions anti-corruption internationales n'offrent pas suffisamment de gage d'effectivité et les délits et crimes de corruption transnationale ne sont pas de la compétence de la Cour Pénale Internationale (CPI) issue du statut de Rome de 2000. Dans un premier temps, le présent ouvrage analyse sept Conventions anti-corruption internationales adoptées entre 1996 et 2003, respectivement, par l'Organisation des Etats Américains (OEA), l'Organisation de Coopération et de Développement Economiques (OCDE), l'Union européenne (UE), le Conseil de l'Europe (CoE), l'Union Africaine (UA) et l'Organisation des Nations Unies (ONU). Dans un deuxième temps, l'ouvrage met en lumière un déficit de rationalisation et d'optimisation des incriminations que contiennent les Conventions, dont notamment : une incrimination lacunaire des personnes morales pour corruption, une incrimination tout aussi insuffisante pour corruption des dirigeants politiques au bénéfice d'immunités pénale et civile et une restitu¬tion internationale des avoirs issus de la corruption à portée limitée. Finalement, c'est au vu de l'analyse effectuée que le présent ouvrage conclut avec la proposition d'une CPI/CE indépendante et spécifique aux crimes économiques afin de pallier au mieux les obstacles majeurs mis en exergue et qui nuisent fortement à l'effectivité des Conventions anti-corruption internationales.

Usefulness of Clinical Scores for Patient Risk Stratification in Non-ST Elevation Acute Coronary Syndrome: Any Role for Serum Markers of Inflammation?

Risk stratification of patients with unstable angina or non ST-segment elevation myocardial infarction (UA/NSTEMI) is problematic given the heterogeneous presentation of the condition and clinical characteristics of patients. We sought to compare, in acute coronary syndrome patients, the prognostic value of two frequently used risk scores (RS): the Thrombolysis in Myocardial Infarction (TIMI) and the physician’s risk assessment (PRA). We also assessed whether serum biomarkers can increase the prognostic accuracy of clinical RS.