Smart technologies: useful tools to assess the exposure to solar ultraviolet radiation for general population and outdoor workers

Beside some documented benefits attributed to ultraviolet solar radiation (solar UVR), a lot of adverse effects are a consequence of a chronic exposure, including the occurrence of photo-induced skin cancer. Improvement in risks perception, due to UVR overexposure, in the case of occupational or recreational exposure, is of great importance for public health. The amount of exposure to UVR has to be assessed as accurately as possible, with the aim to characterize different exposure conditions and, by their appropriate management, to prevent adverse health effects attributed to prolonged exposure to solar radiation (SR). The available technology allows to acquire such information, either using miniaturized and wearable sensors, or through devices who exploit radiative transfer models by integrating satellite-based radiometric data with meteorological data. We proceeded to an intercomparison to evaluate the performance of different devices in three commonly exposure conditions. Applications using satellite data, developed for preventing sunburn during recreational exposure, are adeguate for that purpose, while for a more accurate exposure assessment, only those which evaluate the irradiance in near real-time provide acceptable results. Unlike earlier, the low-cost devices that use wearable sensors showed inadequate performance for our purpose

Effect of temperature and strain rate on the compressive behaviour of supramolecular polyurethane

Supramolecular polyurethanes (SPUs) possess thermoresponsive and thermoreversible properties, and those characteristics are highly desirable in both bulk commodity and value-added applications such as adhesives, shape-memory materials, healable coatings and lightweight, impact-resistant structures (e.g. protection for mobile electronics). A better understanding of the mechanical properties, especially the rate and temperature sensitivity, of these materials are required to assess their suitability for different applications. In this paper, a newly developed SPU with tuneable thermal properties was studied, and the response of this SPU to compressive loading over strain rates from 10−3 to 104 s−1 was presented. Furthermore, the effect of temperature on the mechanical response was also demonstrated. The sample was tested using an Instron mechanical testing machine for quasi-static loading, a home-made hydraulic system for moderate rates and a traditional split Hopkinson pressure bars (SHPBs) for high strain rates. Results showed that the compression stress-strain behaviour was affected significantly by the thermoresponsive nature of SPU, but that, as expected for polymeric materials, the general trends of the temperature and the rate dependence mirror each other. However, this behaviour is more complicated than observed for many other polymeric materials, as a result of the richer range of transitions that influence the behaviour over the range of temperatures and strain rates tested

Developing an algorithm to assess the UV erythemal dose for outdoor workers Validation through direct measures

An algorithm has been developed to determine the annual dose of UV solar radiation for outdoor workers. The dose is indirectly assessed basing on satellite data, mean global irradiance values, workers' data obtained by means of a questionnaire and corrective coefficients provided by a mathematical model. The values obtained by the use of the algorithm are compared with those obtained by measurement records in different environments. Results demonstrated that the algorithm estimates the mean daily erythemal dose with good approximation

Quasi-static magnetohydrodynamic turbulence at high Reynolds number

We analyse the anisotropy of homogeneous turbulence in an electrically conducting fluid submitted to a uniform magnetic field, for low magnetic Reynolds number, in the quasi- static approximation. We interpret disagreeing previous predictions between linearized theory and simulations: in the linear limit, the kinetic energy of transverse velocity components, normal to the magnetic field, decays faster than the kinetic energy of the axial component, along the magnetic field (Moffatt (1967)); whereas many numerical studies predict a final state characterised by dominant energy of transverse velocity components. We investigate the corresponding nonlinear phenomenon using Direct Numerical Simulations of freely-decaying turbulence, and a two-point statistical spectral closure based on the Eddy Damped Quasi-Normal Markovian model. The transition from the three-dimensional turbulent flow to a "two-and-a-half-dimensional" flow (Montgomery & Turner (1982)) is a result of the combined effects of short-time linear Joule dissipation and longer time nonlinear creation of polarisation anisotropy. It is this combination of linear and nonlinear effects which explains the disagreement between predictions from linearized theory and results from numerical simulations. The transition is characterized by the elongation of turbulent structures along the applied magnetic field, and by the strong anisotropy of directional two-point correlation spectra, in agreement with experimental evidence. Inertial equatorial transfers in both DNS and the model are presented to describe in detail the most important equilibrium dynamics. Spectral scalings are maintained in high Reynolds number turbulence attainable only with the EDQNM model, which also provides simplified modelling of the asymptotic state of quasi-static MHD turbulence.Comment: Journal of Fluid Mechanics, 201

Visceral leishmaniasis in the State of Maranhão, Brazil: evolution of an epidemic

The authors provide a brief report on the historical evolution of visceral leishmaniasis in the State of Maranhão, Brazil, evaluating possible factors for growth of the disease in the State and control measures by the Brazilian Ministry of Health to integrate health services finto the maintenance of control programs.Os autores fazem um breve relato da evolução histórica da leishmaniose visceral no Estado do Maranhão, Brasil, avaliando as possíveis causas da expansão da referida doença no Estado, assim como as medidas de controle adotadas pelo Ministério da Saúde objetivando a diminuição da incidência da mesma.Universidade Federal do Maranhão Faculdade de Medicina Departamento de PatologiaEscola Paulista de MedicinaUNIFESP, EPMSciEL

Angiogenesis genotyping in the selection of first-line treatment with either sunitinib or pazopanib for advanced renal cell carcinoma

Recent data from the COMPARZ study seem to suggest a noninferiority of pazopanib confronted with sunitinib in PFS and OS. We previously reported how VEGF and VEGFR polymorphisms might have a predictive role in patients treated with first-line sunitinib. Aim of our study was to investigate whether tumour angiogenesis genotyping could influence clinical outcome in RCC patients treated with either sunitinib or pazopanib, in order to help clinicians select the appropriate treatment for each patient. Results: 19 patients were treated with pazopanib while 78 received sunitinib. VEGF A rs833061 resulted significant in PFS in sunitinib vs pazopanib patients (CC+CT > TT in sunitinib, TT > CC+CT in pazopanib; p CC in sunitinib, CC > GG+CG in pazopanib; p CC in sunitinib, CC > AA+AC in pazopanib; p < 0,0001). OS showed no statistically significant difference. Conclusions: In our analysis patients with opposite polymorphisms of rs833061, rs2010963, rs699947 of VEGF A seems to have a better PFS if treated with either sunitinib or pazopanib. Our data seem to suggest that biology could have a role choosing first line treatment for mRCC patients. Methods: A retrospective analysis on 97 histologic samples of mRCC patients was conducted for VEGF-A, VEGF-C and VEGFR-1,2,3 single nucleotide polymorphisms (SNPs

Effectiveness and acceptability of psycho-education group intervention for people hospitalized in psychiatric wards and nurses

Objective: To assess effectiveness and acceptability of a Psycho-education Group Intervention (PGI) on a sample of patients admitted to a Psychiatric Inpatient Unit (PIU) and on ward nurses. Methods: Case-control study. PGI was delivered according to the model of Vendittelli and colleagues (2008). Male and female patients aged 18-70 were eligible. Cases attended the PGI, while controls did not. A 5-item ad hoc Likert-scale was used to record ward atmosphere. The Italian version of the Simple Feedback Question Form for people attending Cognitive Behaviour Therapy Group (SFQF-CBTG) was administered to each patient before discharge. The primary outcome was readmission rate after 6 months from discharge, secondary outcomes were ratings of ward atmosphere by nurses and feed-back from people hospitalized. All Statistics were performed with STATA 13.1. Results: Fifty-two patients were enrolled, 17 cases and 35 controls. No significant differences emerged in the primary outcome, though compulsory readmissions were noticeable only among controls. Ratings of ward atmosphere in relation to group activities did not differ. Seventeen SFQF-CBTG were filled in. Most cases reported at discharge to have found the group "helpful", stating that "they would attend it in the future again", and "group topics were not difficult". Conclusions: No evidence emerged in favour or against effectiveness of the PGI for patients and ward nurses, though the intervention was rated as acceptable and feasible

Laparoscopic peritoneal lavage: A definitive treatment for diverticular peritonitis or a &quot;bridge&quot; to elective laparoscopic sigmoidectomy?

To this day, the treatment of generalized peritonitis secondary to diverticular perforation is still controversial. Recently, in patients with acute sigmoid diverticulitis, laparoscopic lavage and drainage has gained a wide interest as an alternative to resection. Based on this backdrop, we decided to perform a systematic review of the literature to evaluate the safety, feasibility, and efficacy of peritoneal lavage in perforated diverticular disease. A bibliographic search was performed in PubMed for case series and comparative studies published between January 1992 and February 2014 describing laparoscopic peritoneal lavage in patients with perforated diverticulitis. A total of 19 articles consisting of 10 cohort studies, 8 case series, and 1 controlled clinical trial met the inclusion criteria and were reviewed. In total these studies analyzed data from 871 patients. The mean follow-up time ranged from 1.5 to 96 months when reported. In 11 studies, the success rate of laparoscopic peritoneal lavage, defined as patients alive without surgical treatment for a recurrent episode of diverticulitis, was 24.3%. In patients with Hinchey stage III diverticulitis, the incidence of laparotomy conversion was 1%, whereas in patients with stage IV it was 45%. The 30-day postoperative mortality rate was 2.9%. The 30-day postoperative reintervention rate was 4.9%, whereas 2% of patients required a percutaneous drainage. Readmission rate after the first hospitalization for recurrent diverticulitis was 6%. Most patients who were readmitted (69%) required redo surgery. A 2-stage laparoscopic intervention was performed in 18.3% of patients. Laparoscopic peritoneal lavage should be considered an effective and safe option for the treatment of patients with sigmoid diverticulitis with Hinchey stage III peritonitis; it can also be consider as a “bridge” surgical step combined with a delayed and elective laparoscopic sigmoidectomy in order to avoid a Hartmann procedure. This minimally invasive staged approach should be considered for patients without systemic toxicity and in centers experienced in minimally invasive surgery techniques. Further evidence is needed, and the ongoing RCTs will better define the role of the laparoscopic peritoneal lavage/drainage in the treatment of patients with complicated diverticulitis

Performance and characteristics of the Newborn Hearing Screening Program in Campania region (Italy) between 2013 and 2019

Purpose: Universal newborn hearing screening (UNHS) in the first month of life is crucial for facilitating both early hearing detection and intervention (EHDI) of significant permanent hearing impairment (PHI). In Campania region, UNHS has been introduced in 2003 by the Regional Council Resolution and started on January 2007. The aim of this paper is to update a previous article describing the performance of the program since its implementation in the period between 2013 and 2019. Methods: A longitudinal retrospective study was carried at the Regional Reference Center III on 350,178 babies born in the analysis period. The paper reports the main results of overall coverage, referral rate, lost-to-follow-up rate,yield for PHI and shall determine various risk factor associations with hearing impairment Results: In Campania region, 318,878 newborns were enrolled at I level, with a coverage rate of 91.06%, 301,818 (86.18%) Well Infant Nurseries (WIN) and 17,060 (5.35%) Neonatal Intensive Care Unit (NICU) babies. PHI was identified in 413 children, 288 (69.73%) bilaterally and 125 (30.26%) unilaterally. The overall cumulative incidence rate of PHI was 1.29 per 1000 live-born infants (95% CI 1.17–1.42) with a quite steady tendency during the whole study period. Conclusions: This study confirms the feasibility and effectiveness of UNHS in Campania region also in a setting with major socioeconomic and health organization restrictions.The program meets quality benchmarks to evaluate the progress of UNHS. Nowadays, it is possible to achieve an early diagnosis of all types of HL avoiding the consequences of hearing deprivation

Advanced repeated structuring and learning procedure to detect acute myocardial ischemia in serial 12-lead ECGs

Objectives. Acute myocardial ischemia in the setting of acute coronary syndrome (ACS) may lead to myocardial infarction. Therefore, timely decisions, already in the pre-hospital phase, are crucial to preserving cardiac function as much as possible. Serial electrocardiography, a comparison of the acute electrocardiogram with a previously recorded (reference) ECG of the same patient, aids in identifying ischemia-induced electrocardiographic changes by correcting for interindividual ECG variability. Recently, the combination of deep learning and serial electrocardiography provided promising results in detecting emerging cardiac diseases; thus, the aim of our current study is the application of our novel Advanced Repeated Structuring and Learning Procedure (AdvRS&LP), specifically designed for acute myocardial ischemia detection in the pre-hospital phase by using serial ECG features. Approach. Data belong to the SUBTRACT study, which includes 1425 ECG pairs, 194 (14%) ACS patients, and 1035 (73%) controls. Each ECG pair was characterized by 28 serial features that, with sex and age, constituted the inputs of the AdvRS&LP, an automatic constructive procedure for creating supervised neural networks (NN). We created 100 NNs to compensate for statistical fluctuations due to random data divisions of a limited dataset. We compared the performance of the obtained NNs to a logistic regression (LR) procedure and the Glasgow program (Uni-G) in terms of area-under-the-curve (AUC) of the receiver-operating-characteristic curve, sensitivity (SE), and specificity (SP). Main Results. NNs (median AUC = 83%, median SE = 77%, and median SP = 89%) presented a statistically (P value lower than 0.05) higher testing performance than those presented by LR (median AUC = 80%, median SE = 67%, and median SP = 81%) and by the Uni-G algorithm (median SE = 72% and median SP = 82%). Significance. In conclusion, the positive results underscore the value of serial ECG comparison in ischemia detection, and NNs created by AdvRS&LP seem to be reliable tools in terms of generalization and clinical applicability.Cardiolog