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A pesar de los grandes avances en la cardiología en el siglo XX y XXI, la insuficiencia cardiaca sigue suponiendo la principal causa de hospitalización en las personas ancianas y presentando un pronóstico ominoso. Además, a pesar de los múltiples estudios sobre nuevas dianas farmacológicas, apenas hemos avanzado en el campo del tratamiento, tal vez porque aún existen lagunas en su fisiopatología. No debemos olvidar que la insuficiencia cardiaca es un compendio de signos y síntomas que engloban múltiples órganos y sistemas. Mucho se está investigando sobre la relación entre riñón y corazón en forma de síndrome cardiorrenal. Algo cada vez más en boga es el papel del abdomen en la disfunción orgánica de la insuficiencia cardiaca. En ese sentido, el sistema venoso contiene el 70% del volumen sanguíneo, siendo almacenado en su mayor parte dentro de las vísceras abdominales. Un aumento del tono simpático supone aumento intenso del retorno venoso tan importante como para aumentar las presiones de llenado y justificar una descompensación cardiaca. La congestión sistémica determina un aumento en la presión intraabdominal que está correlacionada con la disfunción renal en la insuficiencia cardiaca avanzada. La hipoperfusión tisular intestinal supone microtraslocación bacteriana promoviendo el status proinflamatorio típico de este síndrome. La visión holística e integrada de la insuficiencia cardiaca puede suponer un avance tanto en la estratificación del riesgo como en las estrategias terapéuticas. Grandes pasos se están dando en este sentido con estudios sobre la ultrafiltración, paracentesis, diálisis peritoneal, suero hipertónico o fármacos adsorbentes del sodio.

The interaction of surfactants with liposomes eventually leads to the rupture of such structures and the solubilization of the phospholipid components. In this paper, solubilization is regarded as a decrease in light scattering of liposome suspensions. To this end, in accordance with the nomenclature, adopted by Lichtenberg, three parameters were considered as corresponding to the effective surfactant/lipid molar ratios (Re) at which light scattering starts to decrease, Re; reaches 50% of the original value, Re; and shows no further decrease, Re. These parameters corresponded to the Re at which the surfactant (i) saturated the liposomes, (ii) resulted in a 50% solubilization of vesicles and (iii) led to a total solubilization of liposomes. The surfactants tested were the nonionic surfactant octylphenol ethoxylated with 10 units of ethylene oxide or Triton X-100 (OP-10EO), two anionic surfactants, sodium dodecyl sulfate and sodium dodecyl ether sulfate, and an amphoteric surfactant dodecyl betaine (D-Bet). Unilamellar liposomes formed by egg phosphatidylcholine containing increasing amounts of phosphatidic acid were used. The Re parameters were the lowest for D-Bet, followed by OP-10EO, whereas the anionic surfactants always showed the highest values regardless of the electrical charge of the lipid bilayers. These parameters seem also to be inversely related to the critical micelle concentration (CMC) of the surfactant, except for OP-10EO. Moreover, the CMC values of the surfactant/lipid systems at 0.5 mM lipid concentration corresponded in all cases to the surfactant concentration at which liposomes were saturated by surfactants. As a consequence, this ratio can be regarded as an interesting parameter associated with the mixed micelle formation in liposome solubilization. [ABSTRACT FROM AUTHOR]

The coincidence of a study on different ecocements to environmental exposition in Madrid (Spain) with the airborne dust from the Sahara desert in the same location, during the year 2022, facilitated the knowledge of the ecocement permeability to different sources of contamination. In general, mortars with a siliceous composition are more compact and less permeable to environmental particles compared to those with a calcareous composition. Binary mortars with glass have an intermediate response to pollutants and the most favorable for the incidence of contamination are ternary sulfoaluminate cements. The analysis of the ions penetration in the different cements studied has been followed by XRF, XRD-Rietveld and SEM/EDX analyses., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Construction and demolition waste (CDW) currently constitutes a waste stream with growing potential use as a secondary raw material in the manufacture of eco-cements that offer smaller carbon footprints and less clinker content than conventional cements. This study analyzes the physical and mechanical properties of two different cement types, ordinary Portland cement (OPC) and calcium sulfoaluminate (CSA) cement, and the synergy between them. These cements are manufactured with different types of CDW (fine fractions of concrete, glass and gypsum) and are intended for new technological applications in the construction sector. This paper addresses the chemical, physical, and mineralogical characterization of the starting materials, as well as the physical (water demand, setting time, soundness, water absorption by capillary action, heat of hydration, and microporosity) and mechanical behavior of the 11 cements selected, including the two reference cements (OPC and commercial CSA). From the analyses obtained, it should be noted that the addition of CDW to the cement matrix does not modify the amount of water by capillarity with respect to OPC cement, except for Labo CSA cement which increases by 15.7%, the calorimetric behavior of the mortars is different depending on the type of ternary and hybrid cement, and the mechanical resistance of the analysed mortars decreases. The results obtained show the favorable behavior of the ternary and hybrid cements made with this CDW. Despite the variations observed in the different types of cement, they all comply with the current standards applicable to commercial cements and open up a new opportunity to improve sustainability in the construction sector.

Background: Breast reconstruction is frequently offered to cancer patients who undergo mastectomy. Older women tend to have lower rates of reconstruction mostly due to an age-based discretion. We aimed to assess the safety of this surgery in this population., Methods: We conducted a single-center retrospective analysis of patients who underwent breast reconstruction following mastectomy between 2015 and 2020 at "Complejo Hospitalario Universitario de Albacete." Patients were classified according to age when the reconstruction process began (group A: < 65 years-group B: > 65 years). Differences in demographics and clinical data were analyzed using Student's t test and Chi-square test. Multivariable logistic regression models were used to estimate odds ratio (OR) and confidence intervals (CIs) for surgical complications according to age group. Propensity-score matching was used as a sensitivity analysis to test consistency among results., Results: We included 304 women (266: group A-38: group B). Complete reconstruction was achieved in 48.1% of patients in group A vs 10.5% in group B (P < 0.001). After adjusting for potential confounders, age was not associated with an increased risk of surgical complications, neither overall (OR 0.88, 95%CI 0.40-1.95), early (OR 1.35, 95%CI 0.58-3.13) nor late (OR 1.05, 95%CI 0.40-2.81). Radiotherapy and smoking history were significant predictors for complications in every setting., Conclusions: In our cohort, age at breast reconstruction is not associated with a higher risk of surgical complications, in contrast to radiotherapy and smoking history. Therefore, age should not be a limiting factor when considering breast reconstruction., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

In recent years, the development of ternary cements has become a priority research line for obtaining cements with a lower carbon footprint, with the goal to contribute to achieve climate neutrality by 2050. This study compared ordinary Portland cement (OPC) durability to the performance of ternary cements bearing OPC plus 7% of a 2:1 binary blend of either calcareous (Hc) or siliceous (Hs) concrete waste fines and shatterproof glass. Durability was measured further to the existing legislation for testing concrete water absorption, effective porosity, pressurized water absorption and resistance to chlorides and CO 2 . The experimental findings showed that the 7% blended mortars performed better than the reference cement in terms of total and effective porosity, but they absorbed more pressurized water. They also exhibited lower CO 2 resistance, particularly in the calcareous blend, likely due to its higher porosity. Including the binary blend of CDW enhanced chloride resistance with diffusion coefficients of 2.9 × 10 -11 m 2 s -1 (calcareous fines-glass, 7%Hc-G) and 1.5 × 10 -11 m 2 s -1 (siliceous fines-glass, 7%Hs-G) compared to the reference cement's 4.3 × 10 -11 m 2 s -1 . The siliceous fines-glass blend out-performed the calcareous blend in all the durability tests. As the mortars with and without CDW (construction and demolition waste) performed to similar standards overall, the former were deemed viable for the manufacture of future eco-efficient cements.

Concrete mixing can lead to mechanical degradation of aggregates, particularly when dealing with recycled concrete aggregates. In this work, the attrition of such materials during mixing is studied by means of experiments and simulations. The effect of the presence of fines, water addition, flow configuration of the mixer (co- or counter-current) and impeller frequency is discussed. Experiments were performed in a laboratory Eirich mixer. Discrete element numerical simulations (DEM) were performed on the same geometry by mimicking the behaviour of the material and, in particular, the cohesion induced by water and the cement paste using either Hertz-Mindlin or Hertz-Mindlin with Johnson-Kendall-Roberts (JKR) contact laws. The combination of the collision energy spectra extracted from the DEM simulations and an attrition model allowed the prediction of the mass loss due to attrition in 1-min experiments. Semi-quantitative agreement was observed between experiments and simulations, with a mean relative error of 26.4%. These showed that higher mass losses resulted from operation at the highest impeller speeds, co-current operation, and also with the wet aggregate. Mixing of the agglomerate in the concrete mix resulted in a significant reduction in attrition when compared to mixing aggregates alone. With further validation, the proposed simulation approach can become a valuable tool in the optimization of mixing by allowing the effects of material, machine and process variables to be studied on the mass loss due to attrition.

This work analyses the influence of fine concrete fractions (<5 mm) of different natures -calcareous (HcG) and siliceous (HsT)-obtained from construction and demolition waste (C&DW) on the behaviour of blended cement pastes with partial replacements between 5 and 10%. The two C&DW fractions were characterised by different instrumental techniques. Subsequently, their lime-fixing capacity and the physico-mechanical properties of the blended cement pastes were analysed. Lastly, the environmental benefits of reusing these fine wastes in the manufacture of future eco-efficient cement pastes were examined. The results show that HsT and HcG exhibit weak pozzolanic activity, owing to their low reactive silica and alumina content. Despite this, the new cement pastes meet the physical and mechanical requirements of the existing regulations for common cements. It should be highlighted that the blended cement pastes initially showed a coarser pore network, but then they underwent a refinement process between 2 and 28 days, along with a gain in compressive strength, possibly due to the double pozzolanic and filler effect of the wastes. The environmental viability of the blended cements was evaluated in a Life Cycle Assessment (LCA) concluding that the overall environmental impact could be reduced in the same proportion of the replacement rate. This is in line with the Circular Economy goals and the 2030 Agenda for Sustainable Development.

Animal and human anatomy is among the most complex systems known, and suitable teaching methods have been of great importance in the progress of knowledge. Examining the human body is part of the process by which medical students come to understand living forms. However, the need to preserve cadavers has led to the development of various techniques to manufacture models for teaching purposes. A variety of materials, such as wax, wood, papier-mache, or glass, have long been used to construct animal and plant models. In the case of the human body, the most innovative, yet controversial, method of preservation has been plastination, invented by the German physician Gunther von Hagens, by which actual human bodies are preserved as odourless and aesthetic models for teaching and exhibitions. We point out in our study that the 'hands-on' approach that some anatomical models allow, namely, the (clastic) disassembly and reassembly of the parts of complex systems and their models, is not only a crucial tool for learning, but is far superior to the simple passive observation that rigid, single-piece models allow. And what is valid for the learning of anatomy can be generalized to the acquisition of knowledge of other complex physical systems.