Fiber optic attenuator

A fiber optic attenuator of the invention is a mandrel structure through which a bundle of optical fibers is wrapped around in a complete circle. The mandrel structure includes a flexible cylindrical sheath through which the bundle passes. A set screw on the mandrel structure impacts one side of the sheath against two posts on the opposite side of the sheath. By rotating the screw, the sheath is deformed to extend partially between the two posts, bending the fiber optic bundle to a small radius controlled by rotating the set screw. Bending the fiber optic bundle to a small radius causes light in each optical fiber to be lost in the cladding, the amount depending upon the radius about which the bundle is bent

Zinc Transporter 8 Antibodies Complement GAD and IA-2 Antibodies in the Identification and Characterization of Adult-Onset Autoimmune Diabetes: Non Insulin Requiring Autoimmune Diabetes (NIRAD) 4

OBJECTIVE: Zinc transporter 8 (ZnT8) is an islet beta-cell secretory granule membrane protein recently identified as an autoantibody antigen in type 1 diabetes. The aim of this study was to determine the prevalence and role of antibodies to ZnT8 (ZnT8As) in adult-onset diabetes. RESEARCH DESIGN AND METHODS: ZnT8As were measured by a radioimmunoprecipitation assay using recombinant ZnT8 COOH-terminal or NH(2)-terminal proteins in 193 patients with adult-onset autoimmune diabetes having antibodies to either GAD (GADAs) or IA-2 (IA-2As) and in 1,056 antibody-negative patients with type 2 diabetes from the Non Insulin Requiring Autoimmune Diabetes (NIRAD) study. RESULTS: ZnT8As-COOH were detected in 18.6% patients with autoimmune diabetes and 1.4% with type 2 diabetes. ZnT8As-NH(2) were rare. ZnT8As were associated with younger age and a high GADA titer. The use of GADAs, IA-2As, and ZnT8As in combination allowed a stratification of clinical phenotype, with younger age of onset of diabetes and characteristics of more severe insulin deficiency (higher fasting glucose and A1C, lower BMI, total cholesterol, and triglycerides) in patients with all three markers, with progressive attenuation in patients with two, one, and no antibodies (all P(trend) < 0.001). Autoantibody titers, association with high-risk HLA genotypes, and prevalence of thyroid peroxidase antibodies followed the same trend (all P < 0.001). CONCLUSIONS: ZnT8As are detectable in a proportion of patients with adult-onset autoimmune diabetes and seem to be a valuable marker to differentiate clinical phenotypes

Order Orthoptera

Authors report an annotated checklist of Orthoptera of UAE, based on their collecting and bibliography

Assistenza infermieristica interculturale: analisi delle variazioni nella percezione delle problematiche relazionali con i pazienti stranieri

RIASSUNTOLa nostra societí  è fortemente soggetta al fenomeno immigrazione, ed è sempre più probabile anche in ambito sanitario intraprendere relazioni con persone con un background culturale differente. Scopo di questa indagine è analizzare la percezione che gli infermieri italiani hanno rispetto alle dinamiche relazionali con i pazienti stranieri, valutandone l'evoluzione nel tempo ed identificando le variabili che possono influire sulla qualití  della relazione. E' stato condotto studio quanti-qualitativo con finalití  descrittiva tramite questionario volto a rilevare: grado di preparazione teorico-pratico degli infermieri verso l'assistenza agli stranieri, impatto emotivo ed esperienziale della relazione, difficoltí  emerse e strategie di risoluzione. Campione costituito da 101 infermieri italiani operanti presso l'Ospedale San Raffaele di Milano in 6 specifiche Unití  Operative: 91 questionari compilati nel periodo maggio-giugno 2011. Analisi dei dati ottenuti attraverso strumenti statistici e confronto degli stessi con quelli rilevati in un'analoga indagine svolta nel 2004. L'esperienza relativa all'assistenza interculturale è giudicata complessivamente interessante e gratificante e la reazione emotiva registrata dagli infermieri intervistati è prevalentemente positiva. Vi sono difficoltí  legate soprattutto a problemi di comunicazione e/o lingua e, secondariamente, al maggior carico assistenziale derivato dalla presenza degli immigrati. Alle difficoltí  gli infermieri rispondono più con risorse attitudinali proprie dei singoli che con competenze specifiche e tendono a delegare il problema al servizio di Mediazione Culturale. L'impatto che i pazienti stranieri hanno sugli infermieri è molto intenso. Nel tempo le difficoltí  emerse non sono diminuite: poco o nulla è stato fatto in questi anni, a parte un miglioramento della formazione accademica; tuttavia è emerso che la buona preparazione teorica non sembra fornire soluzioni realmente fruibili all'atto pratico. Questo studio, pur avendo un valore statistico relativo ed un grado di approfondimento limitato, vuole attirare sull'argomento l'attenzione degli infermieri e, in special modo, di coloro che ricoprono ruoli dirigenziali, nella speranza di trovare soluzioni ai problemi messi in luce.Parole chiave: infermieristica interculturale, assistenza infermieristica, alterití  culturale, fenomeno migratorio.ABSTRACTToday's society is highly impacted by immigration, as well as healthcare system. It is becoming increasingly common and frequent to establish relationships with patients with different cultural backgrounds. The aim of this study is analyzing Italian nurses' perception of the relational dynamics with foreign patients, to determine its evolution, and to identify the variables which can affect the quality of care. The study is both qualitative and quantitative with descriptive aim, using a questionnaire that assesses the theoretical–practical level of preparation, both perceptive and effective, of nurses when assisting foreign patients. To evaluate the emotional and experiential impact of the relationship with foreign patients, the difficulties encountered while establishing such relationship, and the resolution strategies – both effective and potential. The sample, composed of 101 Italian nurses employed at SanRaffaele Hospital in 6 specific Operational Units, resulted in a total of 91 returned questionnaires during the period May-June 2011. The data was analyzed through statistical instruments and compared to the results of a similar study done in 2004. The experience of intercultural nursing is seen by the sample as interesting and rewarding. The vast majority of nurses have positive responses. The more frequent issues are those connected with communication with foreign patients, and those connected with the increase workload due the presence of foreign patients. Nurses responded to difficulties more with human skills than with specific abilities, and tend to delegate the problem to the Cultural Mediation service. This new issue has a very high impact on nurses. The emerged difficulties have not decreased over time, this due to the lack of a proper policy within health care facilities in recent years, with the exception of a little improvement on the academic education. However the current academic education does not provide solutions useful in the everyday routing. This study, despite the small sample and a rather narrow degree of analysis, likes to draw attention on the topic both of nurses and on health care facilities managerial team in order to develop a effective startegie to deal with the emerged issues.Keywords: intercultural nursing, nursing care, cultural otherness, migratio

[Intercultural nursing: analysis of changes in the perception of relational problems with foreign patients].

Today's society is highly impacted by immigration, as well as healthcare system. It is becoming increasingly common and frequent to establish relationships with patients with different cultural backgrounds. The aim of this study is analyzing Italian nurses' perception of the relational dynamics with foreign patients, to determine its evolution, and to identify the variables which can affect the quality of care. The study is both qualitative and quantitative with descriptive aim, using a questionnaire that assesses the theoretical-practical level of preparation, both perceptive and effective, of nurses when assisting foreign patients. To evaluate the emotional and experiential impact of the relationship with foreign patients, the difficulties encountered while establishing such relationship, and the resolution strategies - both effective and potential. The sample, composed of 101 Italian nurses employed at SanRaffaele Hospital in 6 specific Operational Units, resulted in a total of 91 returned questionnaires during the period May-June 2011. The data was analyzed through statistical instruments and compared to the results of a similar study done in 2004. The experience of intercultural nursing is seen by the sample as interesting and rewarding. The vast majority of nurses have positive responses. The more frequent issues are those connected with communication with foreign patients, and those connected with the increase workload due the presence of foreign patients. Nurses responded to difficulties more with human skills than with specific abilities, and tend to delegate the problem to the Cultural Mediation service. This new issue has a very high impact on nurses. The emerged difficulties have not decreased over time, this due to the lack of a proper policy within health care facilities in recent years, with the exception of a little improvement on the academic education. However the current academic education does not provide solutions useful in the everyday routing. This study, despite the small sample and a rather narrow degree of analysis, likes to draw attention on the topic both of nurses and on health care facilities managerial team in order to develop a effective startegie to deal with the emerged issues

Dietary Fat, Sugar Consumption, and Cardiorespiratory Fitness in Patients With Heart Failure With Preserved Ejection Fraction

Heart failure with preserved ejection fraction (HFpEF) is associated with obesity and, indirectly, with unhealthy diet. The role of dietary components in HFpEF is, however, largely unknown. In this study, the authors showed that in obese HFpEF patients, consumption of unsaturated fatty acids (UFA), was associated with better cardiorespiratory fitness, and UFA consumption correlated with better diastolic function and with greater fat-free mass. Similarly, mice fed with a high-fat diet rich in UFA and low in sugars had preserved myocardial function and reduced weight gain. Randomized clinical trials increasing dietary UFA consumption and reducing sugar consumption are warranted to confirm and expand our findings

Labile plasma iron and echocardiographic parameters are associated to cardiac events in beta-thalassemic patients

Background and aim: Notwithstanding the improvement in therapies, patients affected by thalassemia major (TM) and intermedia (TI) are still at high risk of cardiac complications. This study aimed at evaluating the incidence and predictive factors for developing cardiac events in adult β-TM and TI patients. Population andmethods: Data on diagnosis and clinical historywere collected retrospectively; prospective data on new-onset cardiac failure and arrhythmias, echocardiographic parameters, biochemical variables including non-transferrin-bound iron (NTBI) and labile plasma iron (LPI), magnetic resonance imaging (MRI) T2* measurement of hepatic and cardiac iron deposits, and iron chelation therapy were recorded during a 6 year follow-up. Results: Thirty-seven patients, 29 TM and 8 TI, were included. At baseline, 8 TM patients and 1 TI patient had previously experienced a cardiac event (mainly heart failure). All patients were on chelation therapy and only 3 TM patients had mild-to-severe cardiac siderosis. During follow-up, 11 patients (29.7%) experienced a new cardiac event. The occurrence of cardiac events was correlated to high LPI levels (OR 12.0, 95% CI 1.56-92.3, p 0.017), low mean pre-transfusion hemoglobin (OR 0.21, 95% C.I. 0.051-0.761, p 0.21), and echocardiographic parameters suggestive of myocardial hypertrophy. Multivariate analysis disclosed high LPI and left ventricle mass index (LVMI) as independent variables significantly associated with cardiac events. Cardiac iron deposits measured by MRI T2* failed to predict cardiac events. Conclusion: LPI, Hb levels, and echocardiographic parameters assessing cardiac remodeling are associated to cardiac events in adult TM and TI patients. LPI might represent both a prognostic marker and a potential target for novel treatment strategies. Further studies are warranted to confirm our findings on larger population

Effects of the COVID-19 lockdown on glycaemic control in subjects with type 2 diabetes: the glycalock study

Aim: To assess the effect of the coronavirus disease 2019 (COVID-19) lockdown on glycaemic control in subjects with type 2 diabetes (T2D). Materials and Methods: In this observational, multicentre, retrospective study conducted in the Lazio region, Italy, we compared the differences in the HbA1c levels of 141 subjects with T2D exposed to lockdown with 123 matched controls with T2D who attended the study centres 1 year before. Basal data were collected from 9 December to 9 March and follow-up data from 3 June to 10 July in 2020 for the lockdown group, and during the same timeframes in 2019 for the control groups. Changes in HbA1c (ΔHbA1c) and body mass index (ΔBMI) during lockdown were compared among patients with different psychological well-being, as evaluated by tertiles of the Psychological General Well-Being Index (PGWBS). Results: No difference in ΔHbA1c was found between the lockdown and control groups (lockdown group −0.1% [−0.5%−0.3%] vs. control group −0.1% [−0.4%−0.2%]; p =.482). Also, no difference was found in ΔBMI (p =.316) or ΔGlucose (p =.538). In the lockdown group, subjects with worse PGWBS showed a worsening of HbA1c (p =.041 for the trend among PGWBS tertiles) and BMI (p =.022). Conclusions: The COVID-19 lockdown did not significantly impact glycaemic control in people with T2D. People with poor psychological well-being may experience a worsening a glycaemic control because of restrictions resulting from lockdown. These findings may aid healthcare providers in diabetes management once the second wave of COVID-19 has ended

Clinical features of patients with type 2 diabetes with and without Covid-19: a case control study (CoViDiab I)

Aims: To evaluate whether subjects with diabetes hospitalized for Coronavirus disease-19 (Covid-19) represent a subgroup of patients with high-risk clinical features compared to patients with diabetes without Covid-19. Methods: In this case-control study 79 patients with type 2 diabetes out of 354 adults hospitalized for Covid-19 and 158 controls with type 2 diabetes but without Covid-19, matched for age and gender, were enrolled. Medical history and concomitant therapies were retrieved from medical charts and compared between cases and controls, controlling for confounders. Results: Fully-adjusted multivariate logistic regression model showed that previous CVD history did not differ between patients with and without Covid-19 (odds ratio 1.40, 95% confidence interval [CI]: 0.59–3.32, p = 0.45). A higher prevalence of chronic obstructive pulmonary disease (COPD) (OR 3.72, 95%CI: 1.42–9.72, p = 0.007) and of chronic kidney disease (CKD) (OR 3.08, 95%CI: 1.18–8.06, p = 0.022) and a lower prevalence of ever smokers (OR 0.30, 95%CI: 0.13–0.67, p = 0.003), of users of lipid lowering agents (OR 0.26, 95%CI: 0.12–0.54, p &lt; 0.001), and of anti-hypertensive drugs (OR 0.39, 95%CI: 0.16–0.93, p = 0.033) were found among cases. Conclusions: CVD prevalence does not differ between people with diabetes with and without Covid-19 requiring hospitalization. An increased prevalence of COPD and of CKD in Covid-19 patients with type 2 diabetes is suggested. These findings aid to clarify the relationship between underlying conditions and SARS-CoV-2 infection in the high-risk group of patients with diabetes