Use of clay from a local source for calcination and subsequent preparation of the mixed cement

This paper deals with the use of calcinated clay and micronized limestone as supplementary cementitious materials (SMCs) for preparation of blended Portland cement CEM II/B-M (Q-LL). Clay used in this study was calcinated at 700°C and pozzolanic activity after calcination was assessed using accelerated R3 pozzolanic test and modified Chapelle test. The influence of calcinated clay and limestone addition on mechanical properties and hydration process was investigated and an optimal ratio for 35% clinker replacement was found. Initial decrease of mechanical strength at early ages, caused by SCM addition, was almost compensated during maturation of the binder.

Regulation of cell quiescence-proliferation balance by Ca2+-CaMKK-Akt signaling

Compared with our extensive understanding of the cell cycle, we have limited knowledge of how the cell quiescence-proliferation decision is regulated. Using a zebrafish epithelial model, we report a novel signaling mechanism governing the cell quiescence-proliferation decision. Zebrafish Ca2+-transporting epithelial cells or ionocytes maintain high cytoplasmic Ca2+ levels ([Ca2+]c) due to the expression of Trpv6. Genetic deletion, pharmacological inhibition of Trpv6 or reducing external Ca2+ lowered the [Ca2+]c and reactivated these cells. The ionocyte reactivation was attenuated by chelating intracellular Ca2+ and inhibiting calmodulin (CaM), suggesting a Ca2+/CaM-dependent mechanism at work. Ling-term imaging studies showed that after an initial decrease, [Ca2+]c gradually returned to the basal levels. There was a concomitant decease in ER Ca2+ levels. Lowering the ER Ca2+ store content or inhibiting ryanodine receptors impaired ionocyte reactivation. Further analyses suggest that CaMKK is a key molecular link between Ca2+ and Akt signaling. Genetic deletion or inhibition of CaMKK abolished and expression of a constitutively active Akt rescued cell reactivation. These results suggest that the quiescence-proliferation decision in zebrafish ionocytes is regulated by Trpv6-mediated Ca2+ and CaMKK-Akt signaling.

Clinical and laboratory signs and risk factors for nephrotoxicity, associated with antiangiogenic drugs

Background. Anti-angiogenic anticancer drugs that block the vascular endothelial growth factor signaling pathway can cause renal damage. Assessment of the risk of nephrotoxicity allows developing optimal treatment approaches and ensuring the relative safety of therapy. Aim. To assess early clinical and laboratory manifestations and risk factors for nephrotoxicity of antiangiogenic drugs. Materials and methods. The study included 50 patients who received antiangiogenic drugs in different regimens of chemotherapy. Demographic factors, body mass index, blood pressure levels, type of antiangiogenic drug, and concomitant therapy were assessed. Before treatment and over a period of 8 weeks, the levels of hemoglobin, number of platelets and schistocytes, D-dimer levels, serum lactate dehydrogenase (LDH) levels, as well as daily proteinuria and serum creatinine and eGFRCKD-EPI were assessed. Linear regression analysis was performed to assess risk factors for nephrotoxicity and arterial hypertension (AH). Results. The median age of patients was 46 [3457] years, 22 (44%) men and 28 (56%) women. AH developed in 52%, a decrease in eGFR in 42%, along with a decrease in hemoglobin levels and an increase in LDH levels at 2 weeks of therapy. The numbers of schistocytes and platelets significantly decreased by 8 weeks of therapy. Risk factors for impaired renal function during treatment with antiangiogenic drugs were an initial decrease in GFR less than 80 ml/min/1.73 m2, an increase in D-dimer levels, and a decrease in hemoglobin levels by 8 weeks of treatment. The risk factors for AH during therapy were the initial decrease in eGFR less than 80 ml/min/1.73 m2 and no prophylactic anticoagulant therapy. Conclusion. Early signs of nephrotoxicity of antiangiogenic anticancer drugs were a decrease in eGFR and AH. The independent risk factors for nephrotoxicity were the initial decrease in eGFR, an increase in D-dimer levels, and a decrease in hemoglobin levels at 8 weeks of treatment, while the prophylactic use of anticoagulant therapy reduced this risk in our study.

MO413EFFECTS OF CHRONIC, LONG-TERM ACE-INHIBITOR TREATMENT ON CYTOKINE STORM AND RENAL FUNCTION AFTER CARDIO-PULMONARY BYPASS: A PROSPECTIVE OBSERVATIONAL STUDY

Background and Aims Cardiopulmonary bypass (CPB) may trigger organs damage, including kidney injury, due to a massive cytokine release. In this observational, prospective study, we have analyzed the possible impact of chronic treatment with ACE-Inhibitors (ACE-I) on the inflammatory response and renal function after CPB. Method Sixty-nine patients undergoing major cardiac surgery with CPB were enrolled. Patients were stratified according to long-term (>6 mo.) ACE-I use (n=38) or not (n=31). The primary endpoint was to analyze the changes in their IL-1 alpha, IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, TNF alpha, EGF and VEGF plasma levels. Secondary (renal) endpoints were: postoperative acute kidney injury (AKI), recovery of baseline GFR values and the absolute changes in renal function indexes. Results After CPB, IL-1alpha, IL-1beta, IL-4 and TNF-alpha remained stable overtime, while a significant decrease in IL-2 plasma levels was noticed in the ACE-I group (p=0.01). IL-6 and IL-8 plasma levels increased after surgery and tended to decrease after 48h. IL-10 plasma levels showed a similar variation, but both their rise and decrease were more pronounced in patients under ACE-I treatment (p=0.007). Finally, VEGF and EGF showed a marked initial decrease with a tendency to normalization 10 days after surgery (p for trend ranging from 0.01 to 0.001) (Figure 1-2). The occurrence of AKI within 2 days after surgery, the rate of GFR recovery and the absolute changes in renal function indexes were not statistically different between groups (Figure 3). Conclusion Chronic, long-term ACE-I treatment may influence the inflammatory response following CPB. On the other hand, this drug class apparently has neutral impact on perioperative renal outcomes.

505 A Single Center Cohort Observational Study to Assess The Surgical Admissions During COVID-19 And Recommendations For Redeployment Of The Surgical Workforce

Introduction The redeployment of the surgical workforce to support other frontline specialties was an integral part of the nationwide response to the COVID-19 pandemic. The R number is gradually increasing in different parts of the UK suggesting a second wave is imminent. Aimed to analyze the surgical emergency workload and provide recommendations for future redeployments. Method Three separate cohorts of adult emergency admissions; emergency admissions prior to lockdown (23rd of February to 22nd of March), 1 month after (23rd of March to 22nd of April) and 2 months after (23rd of April to 22nd of May). Data was collected regarding patient characteristics, duration of symptoms prior to presentation, clinical outcomes and compared between these groups. Results Notable initial decrease in admission per day (4.3 to 2.5) and interventional management (30%) during the 1st month of lockdown. A marked increase in 24-hour discharge rate (50%). These parameters begun to normalize by the 2nd month. The rate of overall conservative management gradually increased from 36.7% pre-lockdown to 60.9% at the 2nd month. Conclusions Providing elective work is cancelled, surgical teams could safely tolerate working with 30%-40% of original staffing level, which will need to be gradually increased to 50%-70% after 1 month.

Effect of Polymer Viscosity and Polymerization Kinetics on the Electrical Response of Carbon Nanotube Yarn/Vinyl Ester Monofilament Composites

The effect of polymerization kinetics and resin viscosity on the electrical response of a single carbon nanotube yarn (CNTY) embedded in a vinyl ester resin (VER) during polymerization was investigated. To analyze the effect of the polymerization kinetics, the concentration of initiator (methyl ethyl ketone peroxide) was varied at three levels, 0.6, 0.9, and 1.2 wt.%. Styrene monomer was added to VER, to reduce the polymer viscosity and to determine its effect on the electrical response of the CNTY upon resin wetting and infiltration. Upon wetting and wicking of the CNTY by VER, a transient decrease in the CNTY electrical resistance (ca. −8%) was observed for all initiator concentrations. For longer times, this initial decrease in electrical resistance may become a monotonic decrease (up to ca. −17%) or change its trend, depending on the initiator concentration. A higher concentration of initiator showed faster and more negative electrical resistance changes, which correlate with faster gel times and higher build-up of residual stresses. An increase in styrene monomer concentration (reduced viscosity) resulted in an upward shift of the electrical resistance to less negative values. Several mechanisms, including wetting, wicking, infiltration, electronic transfer, and shrinkage, are attributed to the complex electrical response of the CNTY upon resin wetting and infiltration.

Homeostatic sleep regulation in the absence of the circadian sleep‐regulating component: effect of short light–dark cycles on sleep–wake stages and slow waves

Background Aside from the homeostatic and circadian components, light has itself an important, direct as well as indirect role in sleep regulation. Light exerts indirect sleep effect by modulating the circadian rhythms. Exposure to short light-dark cycle (LD 1:1, 1:1 h light - dark) eliminates the circadian sleep regulatory component but direct sleep effect of light could prevail. The aim of the present study was to examine the interaction between the light and the homeostatic influences regarding sleep regulation in a rat model. Methods Spontaneous sleep–wake and homeostatic sleep regulation by sleep deprivation (SD) and analysis of slow waves (SW) were examined in Wistar rats exposed to LD1:1 condition using LD12:12 regime as control. Results Slow wave sleep (SWS) and REM sleep were both enhanced, while wakefulness (W) was attenuated in LD1:1. SWS recovery after 6-h total SD was more intense in LD1:1 compared to LD12:12 and SWS compensation was augmented in the bright hours. Delta power increment during recovery was caused by the increase of SW number in both cases. More SW was seen during baseline in the second half of the day in LD1:1 and after SD compared to the LD12:12. Increase of SW number was greater in the bright hours compared to the dark ones after SD in LD1:1. Lights ON evoked immediate increase in W and decrease in both SWS and REM sleep during baseline LD1:1 condition, while these changes ceased after SD. Moreover, the initial decrease seen in SWS after lights ON, turned to an increase in the next 6-min bin and this increase was stronger after SD. These alterations were caused by the change of the epoch number in W, but not in case of SWS or REM sleep. Lights OFF did not alter sleep–wake times immediately, except W, which was increased by lights OFF after SD. Conclusions Present results show the complex interaction between light and homeostatic sleep regulation in the absence of the circadian component and indicate the decoupling of SW from the homeostatic sleep drive in LD1:1 lighting condition.

Evaluation of the Efficiency of Treatment with Rituximab for Systemic Scleroderma (A Case Report)

The article describes a clinical case of a progressive form of systemic scleroderma in a 39-year-old man. The patient has an acute course and rapid progression of the disease with a significant initial decrease in the forced vital capacity of the lungs, with signs of an unfavorable prognosis, such as a diffuse form, a high skin count (> 14), male sex, and high positivity for antibodies to Scl-70. In connection with the ineffectiveness of standard therapy with glucocorticoids and immunosuppressants at an early stage of the disease, the option of treatment with genetically engineered drugs (rituximab) was considered. As a result of the therapy, a positive trend was noted.

Results of extended phenotyping of von Willebrand disease in the remote diagnostic program in children

In the course of our earlier data obtained in remote diagnosis of von Willebrand disease (vWD) program, 16 samples were identified for extended laboratory work up in order to clarify a specific subtype of vWD. Purpose of the study: extended phenotyping of blood samples with suspected type 2 vWD. This study is supported by the Independent Ethics Committee and approved by the Academic Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. Using 16 aliquoted frozen samples, collagen-binding (vWF:CB) and fVIII-binding activity of vWF (vWF:FVIIIB) tests were performed, as well as multimeric analysis of vWF. Isolated fVIII deficiency with no laboratory signs of 2N vWD subtype were detected in 7 (44%) of 16 patients with an initial decrease in the ratio of fVIII activity to vWF antigen. In the remaining 9 patients, vWF:CB was assessed, which showed a decrease in association with collagen in 6 patients, which allows one to suspect type 2A or 2B. In the remaining 3 with normal vWF:CB patients, type 2M was suspected. MA helped to further identify patients with suspected type 2B vWD. The use of remote diagnostics technologies allows phenotyping most forms of vWD even in patients living in regions with limited laboratory capabilities.