Redesigning doctor-patient relationship in the private health care during COVID-19 pandemic: Retrospective cohort study

AbstractSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is experiencing pandemic diffusion. The experience of an Italian private health care structure was reviewed.We retrospectively collected data about services provided in a single medium complexity private health care structure. Furthermore, we classified specialties within 4 categories, based on the performance of urgent non-deferrable services and possible provision of services without a necessary contact with the patient.The structure canceled/postponed almost every deferrable service, providing only 3% of services that could be performed without direct contact with patients. Regarding non-deferrable services requiring the presence of the patient, about 42% of booked services have been autonomously canceled/postponed by patients for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) fear. The administrative services have been remotely performed by smart working as far as possible.Private health care structures may safely continue to provide non-deferrable services while respecting the restrictive measures imposed by the government, encouraging telehealth and smart working modalities

A modified model for the Lobula Giant Movement Detector and its FPGA implementation

The Lobula Giant Movement Detector (LGMD) is a wide-field visual neuron located in the Lobula layer of the Locust nervous system. The LGMD increases its firing rate in response to both the velocity of an approaching object and the proximity of this object. It has been found that it can respond to looming stimuli very quickly and trigger avoidance reactions. It has been successfully applied in visual collision avoidance systems for vehicles and robots. This paper introduces a modified neural model for LGMD that provides additional depth direction information for the movement. The proposed model retains the simplicity of the previous model by adding only a few new cells. It has been simplified and implemented on a Field Programmable Gate Array (FPGA), taking advantage of the inherent parallelism exhibited by the LGMD, and tested on real-time video streams. Experimental results demonstrate the effectiveness as a fast motion detector

Building a Prediction Model for Vacuum-Assisted Operative Vaginal Delivery Risk

Aim: The objective of this study was to evaluate the risk factors for operative vaginal delivery and to propose a new nomogram for predicting the risk. Methods: We retrospectively analyzed the data of 1,955 pregnancies that occurred in our clinic between the years 2007 and 2008. Included were singleton pregnancies with labor diagnosis after the 36th gestational week in which spontaneous or operative vaginal deliveries occurred. In this study, the operative delivery was carried out exclusively by vacuum extraction. Results: After univariate analysis and multivariate logistic regression stepwise model selection, maternal age, nulliparity, medically assisted procreation, gestational age at birth, male fetus, epidural analgesia and medical induction of labor were found to be the most predictive variables for operative vaginal delivery. Considering these factors we propose a new nomogram for an objectified determination of the risk of operative vaginal delivery. Conclusions: The new nomogram we propose could be an important tool for an objectified determination of the risk of operative vaginal delivery by vacuum extraction in individualized patient counseling

Scaling dependence on the fluid viscosity ratio in the selective withdrawal transition

In the selective withdrawal experiment fluid is withdrawn through a tube with its tip suspended a distance S above a two-fluid interface. At sufficiently low withdrawal rates, Q, the interface forms a steady state hump and only the upper fluid is withdrawn. When Q is increased (or S decreased), the interface undergoes a transition so that the lower fluid is entrained with the upper one, forming a thin steady-state spout. Near this transition the hump curvature becomes very large and displays power-law scaling behavior. This scaling allows for steady-state hump profiles at different flow rates and tube heights to be scaled onto a single similarity profile. I show that the scaling behavior is independent of the viscosity ratio.Comment: 33 Pages, 61 figures, 1 tabl

Systemic mastocytosis and essential thrombocythemia: Case report and literature overview

Case report of a patient with essential thrombocythemia and mastocytosis and overview of the literatur

Analysis of cancellation in two-dimensional magnetohydrodynamic turbulence

A signed measure analysis of two-dimensional intermittent magnetohydrodynamic turbulence is presented. This kind of analysis is performed to characterize the scaling behavior of the sign-oscillating flow structures, and their geometrical properties. In particular, it is observed that cancellations between positive and negative contributions of the field inside structures, are inhibited for scales smaller than the Taylor microscale, and stop near the dissipative scale. Moreover, from a simple geometrical argument, the relationship between the cancellation exponent and the typical fractal dimension of the structures in the flow is obtained.Comment: 21 pages, 5 figures (3 .jpg not included in the latex file

Local and Global Well-Posedness for Aggregation Equations and Patlak-Keller-Segel Models with Degenerate Diffusion

Recently, there has been a wide interest in the study of aggregation equations and Patlak-Keller-Segel (PKS) models for chemotaxis with degenerate diffusion. The focus of this paper is the unification and generalization of the well-posedness theory of these models. We prove local well-posedness on bounded domains for dimensions $d\geq 2$ and in all of space for $d\geq 3$, the uniqueness being a result previously not known for PKS with degenerate diffusion. We generalize the notion of criticality for PKS and show that subcritical problems are globally well-posed. For a fairly general class of problems, we prove the existence of a critical mass which sharply divides the possibility of finite time blow up and global existence. Moreover, we compute the critical mass for fully general problems and show that solutions with smaller mass exists globally. For a class of supercritical problems we prove finite time blow up is possible for initial data of arbitrary mass.Comment: 31 page

Risk-Reducing Breast and Gynecological Surgery for BRCA Mutation Carriers: A Narrative Review

This narrative review aims to clarify the role of breast and gynecological risk-reduction surgery in BRCA mutation carriers. We examine the indications, contraindications, complications, technical aspects, timing, economic impact, ethical issues, and prognostic benefits of the most common prophylactic surgical options from the perspectives of a breast surgeon and a gynecologist. A comprehensive literature review was conducted using the PubMed/Medline, Scopus, and EMBASE databases. The databases were explored from their inceptions to August 2022. Three independent reviewers screened the items and selected those most relevant to this review’s scope. BRCA1/2 mutation carriers are significantly more likely to develop breast, ovarian, and serous endometrial cancer. Because of the Angelina effect, there has been a significant increase in bilateral risk-reducing mastectomy (BRRM) since 2013. BRRM and risk-reducing salpingo-oophorectomy (RRSO) significantly reduce the risk of developing breast and ovarian cancer. RRSO has significant side effects, including an impact on fertility and early menopause (i.e., vasomotor symptoms, cardiovascular disease, osteoporosis, cognitive impairment, and sexual dysfunction). Hormonal therapy can help with these symptoms. Because of the lower risk of developing breast cancer in the residual mammary gland tissue after BRRM, estrogen-only treatments have an advantage over an estrogen/progesterone combined treatment. Risk-reducing hysterectomy allows for estrogen-only treatments and lowers the risk of endometrial cancer. Although prophylactic surgery reduces the cancer risk, it has disadvantages associated with early menopause. A multidisciplinary team must carefully inform the woman who chooses this path of the broad spectrum of implications, from cancer risk reduction to hormonal therapies

Thin film evolution equations from (evaporating) dewetting liquid layers to epitaxial growth

In the present contribution we review basic mathematical results for three physical systems involving self-organising solid or liquid films at solid surfaces. The films may undergo a structuring process by dewetting, evaporation/condensation or epitaxial growth, respectively. We highlight similarities and differences of the three systems based on the observation that in certain limits all of them may be described using models of similar form, i.e., time evolution equations for the film thickness profile. Those equations represent gradient dynamics characterized by mobility functions and an underlying energy functional. Two basic steps of mathematical analysis are used to compare the different system. First, we discuss the linear stability of homogeneous steady states, i.e., flat films; and second the systematics of non-trivial steady states, i.e., drop/hole states for dewetting films and quantum dot states in epitaxial growth, respectively. Our aim is to illustrate that the underlying solution structure might be very complex as in the case of epitaxial growth but can be better understood when comparing to the much simpler results for the dewetting liquid film. We furthermore show that the numerical continuation techniques employed can shed some light on this structure in a more convenient way than time-stepping methods. Finally we discuss that the usage of the employed general formulation does not only relate seemingly not related physical systems mathematically, but does as well allow to discuss model extensions in a more unified way