177 research outputs found
Recommended from our members
Establishing and Monitoring SLAs in complex Service Based Systems
In modern service economies, service provisioning needs to be regulated by complex SLA hierarchies among providers of heterogeneous services, defined at the business, software, and infrastructure layers. Starting from the SLA Management framework defined in the SLA@SOI EU FP7 Integrated Project, we focus on the relationship between establishment and monitoring of such SLAs, showing how the two processes become tightly interleaved in order to provide meaningful mechanisms for SLA management. We first describe the process for SLA establishment adopted within the framework; then, we propose an architecture for monitoring established SLAs, which satisfies the two main requirements introduced by SLA establishment: the availability of historical data for evaluating SLA offers and the assessment of the capability to monitor the terms in a SLA offer
Feasibility and Predictive Performance of a Triage System for Patients with Cancer During the COVID-19 Pandemic
Background: Triage procedures have been implemented to limit hospital access and minimize infection risk among patients with cancer during the coronavirus disease (COVID-19) outbreak. In the absence of prospective evidence, we aimed to evaluate the predictive performance of a triage system in the oncological setting. Materials and Methods: This retrospective cohort study analyzes hospital admissions to the oncology and hematology department of Udine, Italy, during the COVID-19 pandemic (March 30 to April 30, 2020). A total of 3,923 triage procedures were performed, and data of 1,363 individual patients were reviewed. Results: A self-report triage questionnaire identified 6% of triage-positive procedures, with a sensitivity of 66.7% (95% confidence interval [CI], 43.0%â85.4%), a specificity of 94.3% (95% CI, 93.5%â95.0%), and a positive predictive value of 5.9% (95% CI, 4.3%â8.0%) for the identification of patients who were not admitted to the hospital after medical review. Patients with thoracic cancer (odds ratio [OR], 1.69; 95% CI, 1.13â2.53, p =.01), younger age (OR, 1.52; 95% CI, 1.15â2.01, p <.01), and body temperature at admission â„37°C (OR, 9.52; 95% CI, 5.44â16.6, p <.0001) had increased risk of positive triage. Direct hospital access was warranted to 93.5% of cases, a further 6% was accepted after medical evaluation, whereas 0.5% was refused at admission. Conclusion: A self-report questionnaire has a low positive predictive value to triage patients with cancer and suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptoms. Differential diagnosis with tumor- or treatment-related symptoms is always required to avoid unnecessary treatment delays. Body temperature measurement improves the triage process's overall sensitivity, and widespread SARS-CoV-2 testing should be implemented to identify asymptomatic carriers. Implications for Practice: This is the first study to provide data on the predictive performance of a triage system in the oncological setting during the coronavirus disease outbreak. A questionnaire-based triage has a low positive predictive value to triage patients with cancer and suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptoms, and a differential diagnosis with tumor- or treatment-related symptoms is mandatory to avoid unnecessary treatment delays. Consequently, adequate recourses should be reallocated for a triage implementation in the oncological setting. Of note, body temperature measurement improves the overall sensitivity of the triage process, and widespread testing for SARS-CoV-2 infection should be implemented to identify asymptomatic carriers
Regional lung recruitability during pneumoperitoneum depends on chest wall elastance - A mechanical and computed tomography analysis in rats
Laparoscopic surgery has been increasingly used as an alternative to open surgery for its well-known post-operative benefits. However, it is associated to intra-operative respiratory impairment (Valenza et al., 2010). Mechanical ventilation management is a challenge for the anesthetist in this scenario of intra-abdominal hypertension, because it is not clear how the modification of the ventilation parameters affects the different components of the respiratory system.
The respiratory system is composed of two elastic elements in series: the lung and the chest wall. The latter, in turn, is made up of two parallel components: the rib cage and the diaphragm, which is also part of the abdominal wall. Disregarding airflow resistances, the positive pressure applied to the respiratory system during mechanical ventilation distends all these elements. How the applied pressure is distributed within the respiratory system depends on the compliance of each single element (Cortes-Puentes et al., 2015) and its distribution within the lungs depends on the compliance of the lung zones, i.e., regional compliance (Mutoh et al., 1991; Lowhagen et al., 2010)
Recommended from our members
Aligning Monitoring and Compliance Requirements in Evolving Business Networks
Dynamic business networks (BNs) are intrinsically characterised by change. Compliance requirements management, in this context, may become particularly challenging. Partners in the network may join and leave the collaboration dynamically and tasks over which compliance requirements are specified may be consequently delegated to new partners or backsourced by network participants. This paper considers the issue of aligning the compliance requirements in a BN with the monitoring requirements they induce on the BN participants when change (or evolution) occurs. We first provide a conceptual model of BNs and their compliance requirements, introducing the concept of monitoring capabilities induced by compliance requirements. Then, we present a set of mechanisms to ensure consistency between the monitoring and compliance requirements when BNs evolve, e.g. tasks are delegated or backsourced in-house. Eventually, we discuss a prototype implementation of our framework, which also implements a set of metrics to check the status of a BN in respect of compliance monitorability
Using Relational Verification for Program Slicing
Program slicing is the process of removing statements from a program such that defined aspects of its behavior are retained. For producing precise slices, i.e., slices that are minimal in size, the program\u27s semantics must be considered. Existing approaches that go beyond a syntactical analysis and do take the semantics into account are not fully automatic and require auxiliary specifications from the user. In this paper, we adapt relational verification to check whether a slice candidate obtained by removing some instructions from a program is indeed a valid slice. Based on this, we propose a framework for precise and automatic program slicing. As part of this framework, we present three strategies for the generation of slice candidates, and we show how dynamic slicing approaches - that interweave generating and checking slice candidates - can be used for this purpose. The framework can easily be extended with other strategies for generating slice candidates. We discuss the strengths and weaknesses of slicing approaches that use our framework
Low temperature method for the production of calcium phosphate fillers
BACKGROUND: Calcium phosphate manufactured samples, prepared with hydroxyapatite, are used as either spacers or fillers in orthopedic surgery, but these implants have never been used under conditions of mechanical stress. Similar conditions also apply with cements. Many authors have postulated that cements are a useful substitute material when implanted in vivo. The aim of this research is to develop a low cristalline material similar to bone in porosity and cristallinity. METHODS: Commercial hydroxyapatite (HAp) and monetite (M) powders are mixed with water and compacted to produce cylindrical samples. The material is processed at a temperature of 37â120 degrees C in saturated steam to obtain samples that are osteoconductive. The samples are studied by X-ray powder diffraction (XRD), Vickers hardness test (HV), scanning electron microscopy (SEM), and porosity evaluation. RESULTS: The X-ray diffractions of powders from the samples show patterns typical of HAp and M powders. After thermal treatment, no new crystal phase is formed and no increase of the relative intensity of the peaks is obtained. Vicker hardness data do not show any relationship with treatment temperature. The total porosity decreases by 50â60% according to the specific thermal treatment. Scanning electron microscopy of the surfaces of the samples with either HAp 80%-M 20% (c) or Hap 50%-M 50% (f), show cohesion of the powder grains. CONCLUSIONS: The dissolution-reprecipitation process is more intesive in manufactured samples (c) and (f), according to Vickers hardness data. The process occurs in a steam saturated environment between 37 degrees and 120 degrees C. (c) (f) manufactured samples show pore dimension distributions useful to cellular repopulation in living tissues
Androgen regulation of the androgen receptor coregulators
This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens
5-Phenyl-dipyrromethane and 5-(4-pyridyl)-dipyrromethane as modular building blocks for bio-inspired conductive molecularly imprinted polymer (cMIP). An electrochemical and piezoelectric investigation
5-Phenyl-dipyrromethane (5-ph-DP) and 5-(4-pyridyl)dipyrromethane (5-py-DP) are proposed, for the first time, as electroactive building blocks for the preparation of sensors based on molecularly imprinted conductive polymers (cMIP). This paper reports the electrochemical and gravimetric investigation on 5-phenyl-dipyrromethane and 5-(4-pyridyl)dipyrromethane and it demonstrates their ability to form both conductive homo-polymers (cMIP) and co-polymers (co-cMIP). The template salicylic acid (SA) was reversibly and selectively incorporated in the obtained synthetic pockets as proved by both voltammetric and piezoelectric investigation. Moreover, the sensitivity of co-cMIP was higher compared to the two homopolymers. The analytical performances confirm that dipyrromethanes, properly functionalized, can be used as electroactive amino acid-like monomers, to prepare bio-inspired imprinted polymers. \ua9 The Royal Society of Chemistry 2015
- âŠ