Respiratory function in power plant workers exposed to nitrogen dioxide.

BACKGROUND: Power plant workers are potentially exposed to nitrogen dioxide (NO2) and may therefore be at higher risk of pulmonary diseases than the general population. AIMS: To assess the association of NO2 exposure with spirometric abnormalities in power plant workers. METHODS: Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and forced expiratory ratio (FER = FEV1/FVC) were correlated with demographic characteristics, smoking history and environmental exposure to NO2 in power plant workers exposed to environmental NO2 at work and in a control group of administrative employees. Twenty-four hour environmental NO2 concentrations were measured at each workplace. RESULTS: The concentrations of environmental NO2 ranged from 1.21 to 7.82mg m(-3) with a mean value of 3.91 + 1.51mg m(-3). The results showed that FEV1 and FVC were significantly lower in 347 power plant workers than in the 349 controls (P < 0.001). The FER was significantly correlated with age, environmental NO2 concentration, smoking and height. CONCLUSIONS: Occupational exposure to NO2 emissions in power plants is significantly associated with lung function abnormalities as assessed by spirometry. Spirometric measurements in power plant workers exposed to NO2 emissions may be an effective means of detecting early signs of impaired respiratory health in this group of workers

Hybrid Video/Optical See-Through HMD

An old but still ongoing subject of debate among augmented reality (AR) experts is about which see-through paradigm is best in wearable AR displays. Video see-through (VST) and optical see-through (OST) paradigms have both their own strengths and shortcomings with respect to technological and human-factor aspects. The major difference between these see-through paradigms is in providing an aided (VST) or unaided (OST) view of the real world. In this work, we present a novel approach for the development of AR stereoscopic head-mounted displays (HMDs) that can provide both the see-through mechanisms. Our idea is to dynamically modify the transparency of the display through a liquid crystal (LC)-based electro-optical shutter applied on the top of a standard OST device opportunely modified for housing a pair of external cameras. A plane-induced homography transformation is used for consistently warping the video images, hence reducing the parallax between cameras and displays. An externally applied drive voltage is used for smoothly controlling the light transmittance of the LC shutters so as to allow an easy transition between the unaided and the camera-mediated view of the real scene. Our tests have proven the efficacy of the proposed solution under worst-case lighting conditions

I HSE Symposium – Health Safety Environment Symposium: Napoli, 12-13 ottobre 2018

[English]:"Health, Safety and Environment Symposium" is an event of national importance dedicated to the theme of safety and prevention. The Department of Public Health of the University of Naples "Federico II" and the Associazione Europea per la Prevenzione (European Prevention Association) organized this event on October 12th and 13th 2018, in Naples. Exponents of the academic, institutional and entrepreneurial world have compared their own experiences and had the opportunity to debate topics concerning health, environment and safety. Objective is to pursue unique targets in prevention theme and to find common aspects and convergence points beyond different approaches of each 'actor': whatever is his intellectual work, according to their skills, prerogatives and objectives. Intent is to lay the foundations for a permanent and shared comparison, on an annual basis; to set up a meeting between the multi-faceted areas in which are organized the activities in the areas of prevention and safety; to institutionalize a training and social initiative, comprehensive and nonfragmentary, as many previous attempts to create similar occasions have been. Debate is not an end in itself, but a comparison that, over the years, can start an effective growth of the health and safety sectors, in particular in prevention: a meeting that can contribute to innovation. During the event, exponents of the University and institutional fields, representatives of public bodies and business managers and industry professionals, have presented twenty-six unique and original projects. There publications will act as both a portal and an archive for the first one and for the next editions of the national HSE Symposium. In this way it will be possible to create a useful tool for non-professionals, who can find an updated and scientifically valid point of reference for health and safety issues. Graduates and undergraduates, in addition to presenting their project, can get opportunities to improve their skills by comparing with industry professionals and safety supervisors: a very useful way to get started in the world of work with more knowledge and awareness. The design of a "wide-ranging" safety conference, with the participation of all the professionals involved in the sector, was born from the exchange of experiences between professor Umberto Carbone (Department of Public Health of the University of Naples " Federico II "), and the engineer Vincenzo Fuccillo (president of the Associazione Europea per la Prevenzione - European Prevention Association), who also oversaw the realization of this book./[Italiano]: “Health, Safety and Environment Symposium” è stato, oltre che un importante evento di rilevanza nazionale per i temi trattati, un momento unico di confronto tra gli addetti ai lavori nei settori Salute, Sicurezza sul Lavoro e Ambiente. Il nobile scopo del Simposio ideato e organizzato dal Dipartimento di Sanità Pubblica dell’Università degli Studi di Napoli “Federico II” e dall’Associazione Europea per la Prevenzione è quello di diventare un vero e proprio punto di riferimento sul tema, un appuntamento fisso, con cadenza autunnale, per dare a ciascuno dei protagonisti uno spazio di partecipazione al dibattito e un aggiornamento sullo stato dell’arte. Il Simposio rappresenta un’occasione irrinunciabile per l’individuazione di strategie e soluzioni comuni e condivise alle principali problematiche, fornendo un contributo irrinunciabile in termini di innovazione

Three-axial Fiber Bragg Grating Strain Sensor for Volcano Monitoring

Fiber optic and FBGs sensors have attained a large diffusion in the last years as cost-effective monitoring and diagnostic devices in civil engineering. However, in spite of their potential impact, these instruments have found very limited application in geophysics. In order to study earthquakes and volcanoes, the measurement of crustal deformation is of crucial importance. Stress and strain behaviour is among the best indicators of changes in the activity of volcanoes .. Deep bore-hole dilatometers and strainmeters have been employed for volcano monitoring. These instruments are very sensitive and reliable, but are not cost-effective and their installation requires a large effort. Fiber optic based devices offer low cost, small size, wide frequency band, easier deployment and even the possibility of creating a local network with several sensors linked in an array. We present the realization, installation and first results of a shallow-borehole (8,5 meters depth) three-axial Fiber Bragg Grating (FBG) strain sensor prototype. This sensor has been developed in the framework of the MED-SUV project and installed on Etna volcano, in the facilities of the Serra La Nave astrophysical observatory. The installation siteis about 7 Km South-West of the summit craters, at an elevation of about 1740 m. The main goal of our work is the realization of a three-axial device having a high resolution and accuracy in static and dynamic strain measurements, with special attention to the trade-off among resolution, cost and power consumption. The sensor structure and its read-out system are innovative and offer practical advantages in comparison with traditional strain meters. Here we present data collected during the first five months of operation. In particular, the very clear signals recorded in the occurrence of the Central Italy seismic event of October 30th demonstrate the performances of our device.PublishedWien7TM. Sviluppo e Trasferimento Tecnologic

Primary Biliary Cholangitis : advances in management and treatment of the disease

Primary Biliary Cholangitis, previously known as Primary Biliary Cirrhosis, is a rare disease, which mainly affects women in their fifth to seventh decades of life. It is a chronic autoimmune disease characterized by a progressive damage of interlobular bile ducts leading to ductopenia, chronic cholestasis and bile acids retention. Even if the disease usually presents a long asymptomatic phase and a slow progression, in many patients it may progress faster toward cirrhosis and its complications. The 10\uc2\ua0year mortality is greater than in diseases such as human immunodeficiency virus/Hepatitis C Virus coinfection and breast cancer. Ursodeoxycholic acid is the only treatment available today, but even if effective in counteracting the disease progression for the majority of patients, in approximately 40% is not able to decrease effectively the alkaline phosphatase, a surrogate marker of disease activity. Recently, obeticholic acid received the European Medicines Agency conditional approval, as add on treatment in patients non responders or intolerant to ursodeoxycholic acid. The present paper illustrates the opinion of a working group, composed by clinical pharmacologists, gastroenterologists/hepatologists with specific expertise on Primary Biliary Cholangitis and patient associations, on the state of the art and future perspectives of the disease management. The agreement on the document was reached through an Expert Meeting

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p &lt; 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P &lt; 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p &lt; 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription