Potencial evocado auditivo de tronco encefálico em recém-nascido: influência do sexo e da relação peso e idade gestacional

OBJECTIVE:To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR) in preterm (PT) and term (T) newborns.METHODS:176 newborns were evaluated by ABR; 88 were preterm infants - 44 females (22 small and 22 appropriate for gestational age) and 44 males (22 small and 22 appropriate for gestational age). The preterm infants were compared to 88 term infants - 44 females (22 small and 22 appropriate for gestational age) and 44 males (22 small and 22 appropriate for gestational age). All newborns had bilateral presence of transient otoacoustic emissions and type A tympanometry.RESULTS:No interaural differences were found. ABR response did not differentiate newborns regarding weight/gestational age in males and females. Term newborn females showed statistically shorter absolute latencies (except on wave I) than males. This finding did not occur in preterm infants, who had longer latencies than term newborns, regardless of gender.CONCLUSIONS:Gender and gestational age influence term infants' ABR, with lower responses in females. The weight/gestational age ratio did not influence ABR response in either groups.OBJETIVO:Verificar las influencias del sexo y la relación peso/edad gestacional en las respuestas del Potencial Evocado Auditivo de Tronco Encefálico (PEATE) en recién nacidos pretérmino (PT) y a término (T).MÉTODOS:Se evaluaron a 176 recién nacidos por medio del PEATE, siendo 88 prematuros - 44 femeninos (22 pequeños y 22 adecuados para la edad gestacional) y 44 masculinos (22 pequeños y 22 adecuados para la edad gestacional). Se compararon los prematuros con 88 recién nacidos a término, 44 del sexo femenino (22 pequeños y 22 adecuados) y 44 del sexo masculino (22 pequeños y 22 adecuados). Todos los recién nacidos presentaron emisiones otoacústicas bilateralmente, por estímulo transiente y timpanometría tipo A.RESULTADOS:No se encontraron diferencias interaurales y en el desempeño de los recién nacidos en las respuestas del PEATE respecto a la clasificación peso/edad gestacional, en ambos sexos. Los recién nacidos a término del sexo femenino mostraron latencias absolutas estadísticamente más cortas (excepto onda I) que las del sexo masculino; lo mismo no pasó con los prematuros. Los neonatos pretérmino presentaron latencias más prolongadas que las de los recién nacidos a término, independiente del sexo.CONCLUSIONES:El sexo y la edad gestacional ejercen influencia relevante en el PEATE de recién nacidos a término, con respuestas menores en el sexo femenino, debiendo considerárselas en el análisis clínico. La relación peso/edad gestacional, en contrario, no interfiere en las respuestas de ese potencial.OBJETIVO:Verificar as influências do sexo e a relação peso/idade gestacional nas respostas do Potencial Evocado Auditivo de Tronco Encefálico (PEATE) em recém-nascidos pré-termo (PT) e a termo (T).MÉTODOS:Avaliaram-se 176 recém-nascidos por meio do PEATE, sendo 88 prematuros - 44 femininos (22 pequenos e 22 adequados para a idade gestacional) e 44 masculinos (22 pequenos e 22 adequados para a idade gestacional). Compararam-se os prematuros a 88 recém-nascidos a termo, 44 do sexo feminino (22 pequenos e 22 adequados) e 44 do sexo masculino (22 pequenos e 22 adequados). Todos os recém-nascidos apresentaram emissões otoacústicas bilateralmente, por estímulo transiente e timpanometria tipo A.RESULTADOS:Não se encontraram diferenças interaurais e no desempenho dos recém-nascidos nas respostas do PEATE quanto à classificação peso/idade gestacional, em ambos os sexos. Os recém-nascidos a termo do sexo feminino mostraram latências absolutas estatisticamente mais curtas (exceto onda I) do que os do masculino; o mesmo não ocorreu nos prematuros. Os neonatos pré-termo apresentaram latências mais prolongadas que as dos recém-nascidos a termo, independentemente do sexo.CONCLUSÕES O sexo e a idade gestacional exercem influência relevante no PEATE de recém-nascidos a termo, com respostas menores no sexo feminino. A relação peso/idade gestacional, ao contrário, não interfere nas respostas desse potencial.UNIFESP Hospital São PauloUniversidade de São Paulo Faculdade de MedicinaUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)UNIFESP, Hospital São PauloUNIFESP, EPMSciEL

Investment Decisions in Retirement: The Role of Subjective Expectations

Working Paper: WP 2012-274The rapid transition from defined benefit (DB) pension plans to defined contribution (DC) plans has a potential benefit of offering pension holders greater control over how their pension accumulations are invested. If pension holders are willing to take some risk, investments in the stock market could increase their economic preparation for retirement, and, indeed, economic theory as well as the typical advice of financial advisors calls for stock market investments. Yet, the rate of stock holding is much below what theory suggests it should be, undoing any benefit associated with the greater control coming from DC plans. The leading explanations for this under-investing include excessive risk aversion, costs of entry, and misperceptions about possible returns in the stock market. We show that excessive risk aversion is not able to account for the low fraction of stock holding. However, a model with heterogeneous subjective expectations about stock market returns is able to account for low stock market participation, and tracks the share of risky assets conditional on participation reasonably well. Based on the model with subjective expectations, we estimate a welfare loss of up to 12% compared to investment under rational expectations, if actual returns follow the same distribution as in the past 50 years. The policy implication is that there is considerable scope for welfare improvement as a result of consumer education regarding stock market returns. However, the welfare loss is much smaller if individuals are not very risk averse or if actual returns follow the same distribution as in the past 10 years.Social Security Administrationhttp://deepblue.lib.umich.edu/bitstream/2027.42/94534/1/wp274.pd

a new digital signal processing method for spectrum interference monitoring

Frequency spectrum is a limited shared resource, nowadays interested by an ever growing number of different applications. Generally, the companies providing such services pay to the governments the right of using a limited portion of the spectrum, consequently they would be assured that the licensed radio spectrum resource is not interested by significant external interferences. At the same time, they have to guarantee that their devices make an efficient use of the spectrum and meet the electromagnetic compatibility regulations. Therefore the competent authorities are called to control the access to the spectrum adopting suitable management and monitoring policies, as well as the manufacturers have to periodically verify the correct working of their apparatuses. Several measurement solutions are present on the market. They generally refer to real-time spectrum analyzers and measurement receivers. Both of them are characterized by good metrological accuracies but show costs, dimensions and weights that make no possible a use "on the field". The paper presents a first step in realizing a digital signal processing based measurement instrument able to suitably accomplish for the above mentioned needs. In particular the attention has been given to the DSP based measurement section of the instrument. To these aims an innovative measurement method for spectrum monitoring and management is proposed in this paper. It performs an efficient sequential analysis based on a sample by sample digital processing. Three main issues are in particular pursued: (i) measurement performance comparable to that exhibited by other methods proposed in literature; (ii) fast measurement time, (iii) easy implementation on cost-effective measurement hardware

Search and study for meteorites analogous to Didymos

The Hera mission will arrive at the Didymos system to study the efficiency of momentum transfer and to further investigate the binary system in great detail after the Double Asteroid Redirection Test (DART) mission impact. We took advantage of two online data bases of meteorites spectra and of recent Didymos spectra taken before and after the DART impact. We performed the first selection based on the comparison of the band centre values of the silicate absorption bands (localized at 1 and 2 μm) between Didymos and the meteorites. The second selection was made defining a four-dimensional space parameter whose dimensions were the band depth and the slope of the two bands, normalized to Didymos values. We introduced a distance measure to find the closest meteorites to Didymos in this space. Finally, we made the last selection based on other criteria, such as the presence of different spectra of the same meteorite, the presence of different spectra from different data bases, and the comparison with the literature. The result of this work is a list of six meteorites that are the most analogous to Didymos system. We also found out that Didymos is most probably mainly composed of L/LL ordinary chondrites, with a preference for the LL sub-type. From our list of meteorites, we were able to estimate the normalized abundance of olivine and pyroxene of Didymos. Finally, a match between Didymos and OC meteorites was also found in the Mid-InfraRed (MIR) range

Labor Force Transitions at Older Ages: The Roles of Work Environment and Personality

Besides compensation and financial incentives, several other work-related factors may affect individual retirement decisions. Specifically, job characteristics such as autonomy, skill variety, task significance and difficulty, stress and physical demands, peer pressure and relations with co-workers, play a crucial role in determining psychological commitment to work at older ages. While financial preparedness for retirement and health shocks are often cited as main predictors of the choice to exit the labor force, there exists relatively little research documenting the extent to which the work environment itself and its interaction with economic variables influence retirement decisions. We document that job characteristics are associated with labor force transitions at older ages, in particular transitions to retirement and part-time employment. Additionally, we show that while personality traits do not directly drive labor force transitions, the effect of job characteristics on labor supply outcomes varies with the “intensity” of personality traits. We also document that job characteristics themselves are strongly related to personality traits. This suggests that, depending on their personality, individuals may select into specific jobs, whose characteristics ultimately shape their retirement paths.Social Security Administrationhttp://deepblue.lib.umich.edu/bitstream/2027.42/102270/1/wp295.pd

Adjuvant modern radiotherapy in resected pN2 NSCLC patients: results from a multicentre retrospective analysis on acute and late toxicity on behalf of AIRO thoracic oncology study group: the RAC-TAC study

Background: Recently, the PORT-C and LUNG-ART trials, which evaluated the role of postoperative radiation therapy (PORT), have significantly altered the treatment landscape for NSCLC pN2 patients who previously underwent surgery. In response, the Italian Association of Radiotherapy and Oncology Thoracic Oncology study group has initiated an observational multicenter trial to assess both acute and late toxicities of PORT in pN2 NSCLC patients treated with modern techniques. Methods: Data on NSCLC patients submitted to PORT after radical surgery treated between 2015 and 2020 in six Italian Centers were collected. Heart, lung, and esophageal acute and late toxicities have been retrospectively analyzed and related to radiation therapy dosimetric parameters. Furthermore, loco-regional control, distant metastasis and overall survival have been analyzed. Results: A total of 212 patients with a median age of 68 years from six different centers were included in this analysis (142 males and 70 females). Prior to undergoing PORT, 96 patients (45.8%) had a history of heart disease, 110 patients (51.9%) had hypertension, and 51 patients (24%) had COPD. Acute toxicity was observed in 147 patients (69.3%), with lung toxicity occurring in 93 patients (G1 in 70 patients, G2 in 17 patients, and G3 in 4 patients), esophageal toxicity in 114 patients (G1 in 89 patients, G2 in 23 patients, and G3 in 1 patient), and cardiac toxicity in 4 patients (G1 in 2 patients and G3 in 2 patients). Late side effects were found in 60 patients (28.3%), predominantly involving the lungs (51 patients: 32 G1, 11 G2, and 1 G3) and the esophagus (11 patients: 8 G1 and 3 G2), with no reported late cardiac side effects. Various clinical and dosimetric parameters were found to correlate with both acute and chronic toxicities. Over a median follow-up period of 54 months, 48 patients (22.6%) showed locoregional disease relapse, 106 patients (50%) developed distant metastases, and 66 patients (31.1%) died. Conclusions: RAC-TAC retrospective multicentric study showed the low toxicity of PORT when advanced technology is used. At the same time, it’s noteworthy to underline that 50% of the patients develop distant recurrences in the follow up

Laparoscopic adjustable gastric band in an obese unrelated living donor prior to kidney transplantation: a case report

Introduction. Obese living donors who undergo donor nephrectomy have higher rates of intra-operative and post-operative complications. Many centres exclude obese donors from living donor transplant programs. Diet, exercise and medication are often ineffective weight loss interventions for donors, hence bariatric surgery should be considered. Case presentation. We report the case of a 53-year-old Caucasian woman who underwent laparoscopically adjustable gastric banding. The procedure enabled her to lose sufficient weight to gain eligibility for kidney donation. After losing weight, she had an uncomplicated laparoscopic donor nephrectomy surgery, and the recipient underwent successful kidney transplantation. Conclusion. Laparoscopically adjustable gastric banding should be considered for obese potential living kidney donors whenever transplantation units restrict access to donor nephrectomy based on the increased surgical risk for donors

Pre-emptive TIPS in high-risk acute variceal bleeding. An updated and revised individual patient data meta-analysis

Background and aims: A previous individual patient data meta-analysis (IPD-MA) showed that compared with drugs+endoscopy, the placement of transjugular portosystemic shunt within 72 hours of admission (pre-emptive transjugular intrahepatic portosystemic shunt: p-TIPS) increases the survival of high-risk patients (Child-Pugh B+ active bleeding and Child-Pugh C<14 points) with cirrhosis and acute variceal bleeding. However, the previous IPD-MA was not a two-stage meta-analysis, did not consider the potential risk of selection bias of observational studies, and did not include the most recent randomized clinical trial. We performed an updated and revised IPD-MA to reassess the efficacy of p-TIPS, addressing all previous issues. Approach and results: We included all studies from the previous IPD-MA and searched for other possible eligible publications until September 2022. We performed a two-stage IPD-MA of data from 8 studies (4 randomized clinical trials and 4 observational). In addition, we performed a sensitivity analysis excluding those patients dying up to the first 72 hours after admission in the Drugs+Endoscopy arms of the 4 observational studies. The primary end point was the effects of p-TIPS versus Drugs+Endoscopy on 1-year survival.We identified 1389 patients (342 p-TIPS and 1047 Drugs+Endoscopy). The two-stage IPD-MA showed that p-TIPS significantly reduced the mortality in the overall population (HR=0·43, 95% CI: 0.32-0.60, p <0.001. This effect was observed in both subgroups of patients with Child-Pugh. The sensitivity analysis confirmed the survival benefit of p-TIPS. Conclusions: The updated two-stage IPD-MA confirms the significant survival advantage of p-TIPS in high-risk patients with cirrhosis and acute variceal bleeding. As a result, we recommend p-TIPS as the preferred first-choice treatment for these patients

Axial forces and bending moments in the loaded rabbit tibia in vivo

<p>Abstract</p> <p>Background</p> <p>Different animal models are used as fracture models in orthopaedic research prior to implant use in humans, although biomechanical forces can differ to a great extend between species due to variable anatomic conditions, particularly with regard to the gait. The rabbit is an often used fracture model, but biomechanical data are very rare. The objective of the present study was to measure axial forces, bending moments, and bending axis directly in the rabbit tibia <it>in vivo</it>. The following hypothesis was tested: Axial forces and bending moments in the mid-diaphysis of rabbit tibia differ from other experimental animals or indirectly calculated data.</p> <p>Methods</p> <p>A minifixateur system with 4 force sensors was developed and attached to rabbit tibia (<it>n </it>= 4), which were subsequently ostectomised. Axial forces, bending moments and bending angles were calculated telemetrically during weight bearing in motion between 6 and 42 days post operation.</p> <p>Results</p> <p>Highest single values were 201% body weight [% bw] for axial forces and 409% bw cm for bending moments. Whereas there was a continous decrease in axial forces over time after day 10 (<it>P </it>= 0.03 on day 15), a decrease in bending moments was inconsistent (<it>P </it>= 0.03 on day 27). High values for bending moments were frequently, but not consistently, associated with high values for axial forces.</p> <p>Conclusion</p> <p>Axial forces in rabbit tibia exceeded axial forces in sheep, and differed from indirectly calculated data. The rabbit is an appropriate fracture model because axial loads and bending moments in rabbit tibia were more closely to human conditions than in sheep tibia as an animal model.</p