Continuous time-interaction processes for population size estimation, with an application to drug dealing in Italy

We introduce a time-interaction point process where the occurrence of an event can increase (self-excitement) or reduce (self-correction) the probability of future events. Self-excitement and self-correction are allowed to be triggered by the same event, at different timescales; other effects such as those of covariates, unobserved heterogeneity, and temporal dependence are also allowed in the model. We focus on capture-recapture data, as our work is motivated by an original example about the estimation of the total number of drug dealers in Italy. To do so, we derive a conditional likelihood formulation where only subjects with at least one capture are involved in the inference process. The result is a novel and flexible continuous-time population size estimator. A simulation study and the analysis of our motivating example illustrate the validity of our approach in several scenarios

Benefits and biosafety of use of buckypaper for surgical applications. A pilot study in a rabbit clinical trial model

Background: One of the main problems related to prosthetic abdominal surgery is mesh fixation. Suture line tension, mesh separation, displacement, or improper application of stitches are the leading causes of complications, including seroma, postoperative pain, and recurrence. A surface able to adhere firmly to living tissue represents an effective alternative to conventional perforating fixations. As a bio-adhesive tape, we report experimental evidence on the potential applicability of the BuckyPaper (BP), a felt composed of entangled multi-walled carbon nanotubes. Matherial and methods: BP is implanted to assess its biosafety and effectiveness as an adhesive prosthetic device. Results: During 35 days we observed no rabbit behavioral alteration, BP stability in the implantation site, good adhesion, and integration of the device with the surrounding tissue, and no adverse reactions. Conclusions: BP could be used as an adhesive to secure the prostheses to tissues in abdominal wall prosthetic surgery, but large-size animal studies are needed

Comparison of Centella with flavonoids for treatment of symptoms in hemorrhoidal disease and after surgical intervention: A randomized clinical trial

Gli effetti dei flebotonici sono stati valutati per il tempo di arresto del sanguinamento e il tempo di scomparsa dell'irritazione anale in 130 pazienti affetti da malattia emorroidaria, tempo di arresto del sanguinamento e tempo di scomparsa del dolore dopo intervento [emorroidectomia (in 31 pazienti) oppure incisione e drenaggio di trombosi emorroidaria (in 34 pazienti)]. Queste valutazioni sono state fatte nel breve periodo di tempo 0-42 gg. Sessanta pazienti randomizzati hanno ricevuto la procedura di routine (sia conservativa che chirurgica) (gruppo di controllo C). Il gruppo dei pazienti che hanno ricevuto il trattamento con flebotonici (sia conservativo che chirurgico) è stato suddiviso in due sottogruppi: quello trattato con flavonoidi (Gruppo A, n = 73) e quello trattato con Centella (Gruppo B, n = 66). Il tempo di scomparsa del sanguinamento è stato verificato dal Giorno 0 fino al Giorno 42. La guarigione è stata stimata con il metodo Kaplan-Meier, il test Kruskal-Wallis è stato utilizzato per valutare le variazioni del punteggio VAS per studiare il dolore (dopo intervento per emorroidectomia oppure incisione e drenaggio di trombosi emorroidaria), oppure irritazione anale nei pazienti trattati conservativamente. Il tempo medio di emorragia è stato di 2 settimane per i gruppi A e B; 3 settimane per il gruppo C. Il confronto dei punteggi VAS tra i gruppi (irritazione): A vs C, p = 0,007; B vs C, p = 0,041; e A vs B, rispettivamente p = 0,782. Per quanto riguarda gli operati con emorroidectomia, il tempo di arresto del sanguinamento è stato rispettivamente di 3 e 4 settimane nei gruppi A e B, 5 settimane nel gruppo C. L'istopatologia ha mostrato un'associazione tra flavonoidi e fibrosi emorroidaria (p = 0,008). I flebotonici hanno mostrato significativi effetti benefici sia negli operati che nei pazienti trattati conservativamente. Tra i flebotonici, i flavonoidi sono stati più efficaci contro il sanguinamento e l'irritazione anale.Phlebotonics' effects were evaluated to reduce time-to-stop bleeding and anal irritation in 130 patients who complained of hemorrhoidal disease (HD); bleeding and pain after hemorrhoidectomy (31 patients) and hemorrhoidal thrombosis (34 patients) in the short time. Sixty patients were randomized to receive the routine treatment (both conservative and surgical) (control Group C). The treated group (both conservative and surgical) was divided into two subgroups: one treated with flavonoids (Group A, n = 73), the other with Centella (Group B, n = 66). Time-to-stop bleeding was checked at baseline and checkups (0 up to day 42). Healing was estimated with Kaplan-Meier method, the Kruskal-Wallis test estimated changes in the VAS scores. The HD median time-to-stop bleeding was 2 weeks for Groups A and B; 3 weeks for Group C. VAS scores comparison among Groups (irritation): A vs C, p = 0.007; B vs C, p = 0.041; and A vs B, p = 0.782 resulted respectively. As for operated hemorrhoids, the time-to-stop bleeding was 3 and 4 weeks in Groups A and B and 5 in Group C. Histopathology showed an association between flavonoids and piles' fibrosis (p = 0.008). Phlebotonics in HD, as well as after surgery, showed significant beneficial effects. Flavonoids are the most effective phlebotonics against bleeding and anal irritation

May Bradykinesia Features Aid in Distinguishing Parkinson's Disease, Essential Tremor, And Healthy Elderly Individuals?

Background: Bradykinesia is the hallmark feature of Parkinson's disease (PD); however, it can manifest in other conditions, including essential tremor (ET), and in healthy elderly individuals. Objective: Here we assessed whether bradykinesia features aid in distinguishing PD, ET, and healthy elderly individuals. Methods: We conducted simultaneous video and kinematic recordings of finger tapping in 44 PD patients, 69 ET patients, and 77 healthy elderly individuals. Videos were evaluated blindly by expert neurologists. Kinematic recordings were blindly analyzed. We calculated the inter-raters agreement and compared data among groups. Density plots assessed the overlapping in the distribution of kinematic data. Regression analyses and receiver operating characteristic curves determined how the kinematics influenced the likelihood of belonging to a clinical score category and diagnostic group. Results: The inter-rater agreement was fair (Fleiss K = 0.32). Rater found the highest clinical scores in PD, and higher scores in ET than healthy elderly individuals (p < 0.001). In regard to kinematic analysis, the groups showed variations in movement velocity, with PD presenting the slowest values and ET displaying less velocity than healthy elderly individuals (all ps < 0.001). Additionally, PD patients showed irregular rhythm and sequence effect. However, kinematic data significantly overlapped. Regression analyses showed that kinematic analysis had high specificity in differentiating between PD and healthy elderly individuals. Nonetheless, accuracy decreased when evaluating subjects with intermediate kinematic values, i.e., ET patients. Conclusion: Despite a considerable degree of overlap, bradykinesia features vary to some extent in PD, ET, and healthy elderly individuals. Our findings have implications for defining bradykinesia and categorizing patients

Evaluation of vestibular function in patients affected by obstructive sleep apnea performing functional head impulse test (fHIT)

Purpose: Obstructive sleep apnoea (OSA) is a common disease with significantly related complications. Since a connection between the vestibular nucleus and sleep regulator pathways has been demonstrated, vestibular evaluation in OSA patients was partially studied and none used functional head impulse test (fHIT) for this purpose. This paper aimed at evaluating the vestibular function in patients affected by OSA using fHIT, selecting patients who did not present any other related to cardiovascular, neurological, or metabolic diseases. Patients and Methods: Patients enrolled had a diagnosis of OSA by polysomnography type III and were cataloged according to American Association of Sleep Medicine criteria. Each patient underwent fHIT. Statistical significance was set at 0.05. Results: A total of 85 patients were enrolled in the study of which 50 had a diagnosis of OSA and were included in the case group, while 35 belonged to the control group. In 88.6% of subjects of the case group was evidenced a vestibular impairment with a substantial difference between the two study groups (p<0.05). Conclusion: The results show that the incidence of vestibular lesions in patients with obstructive sleep apnoea is underestimated and that fHIT can identify these lesions early

The efficacy of interprofessional simulation in improving collaborative attitude between nursing students and residents in medicine. A study protocol for a randomised controlled trial

Background: Effective collaboration among health professionals is an essential component to ensure quality of care. Many adverse events experienced by patients are attributed to misunderstanding or poor communication among members of the interprofessional team. Interprofessional simulation is a learning strategy used to improve collaboration and facilitate communication between medical and nursing students. Aim of the work: To determine the efficacy of educational program based on high-fidelity interprofessional simulation aimed at improving collaborative attitude. Method: For this purpose, a protocol for a planned single-center, non-blinded and Randomized Controlled Trial (RCT) was chosen. The present has been approved by the Ethics Committee of Area Vasta Emilia Nord (Italy) (n° 479/2018). All students attending the second and third year of nursing and all resident physicians in anesthesia, reanimation, intensive care and pain management of University of Modena and Reggio Emilia, will be recruited and randomly assigned to two groups. The Experimental Group (EG) will receive an educational intervention based on high-fidelity simulation and the Control Group (CG) will attend a traditional classroom lesson. Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC) and Readiness for Interprofessional Learning Scale (RIPLS) will be administered before and after the educational program in both the EG and CG. Conclusion: Expected outcomes is that, at the end of the study, nursing students and resident physicians who participated in the interprofessional simulation show significantly higher levels of interprofessional collaboration compared to the CG, evaluated through the JSAPNC

Health Management in Italian Prisons during {COVID}-19 Outbreak: A Focus on the Second and Third Wave

The SARS-CoV-2 spread is a threatening and challenging issue for correctional systems worldwide because of many factors, particularly overcrowding and of the intrinsic characteristics of the population. The prevention measures adopted by the Italian Government were aimed to protect and preserve both inmates’ and prison workers’ health. The present study aimed to evaluate the efficacy of the adopted strategies. Methods: Data regarding Italian prisons’ occupation and prisoners’ population from January 2019 to June 2021, as well as the cumulative weekly increase of confirmed cases and the number of doses of vaccine administered among the population of inmates, the prison workers, and Italian population from November 2020 to the end of June 2021, were collected. Results: Prisons’ occupation dropped from 120% to 106% after the beginning of the pandemics. The confirmed cases between inmates were consistently lower than among the Italian population and prison workers. A time-series chart showed a time lag of one week between the peaks of the different population. Conclusions: The containing strategies adopted by the Italian correctional system have proved their effectiveness in terms of the prevention and protection of both inmate and staff health