1,428 research outputs found

    Altitude Control System for Indoor Airship

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    The indoor airship is designed to estimate direction and altitude using dead reckoning techniques. Sensors such as gyroscopes and accelerometers provide measurements affected by biases and additive noise. Degradation of accuracy produced by these errors is corrected using independent measurements from ultrasonic range finder, barometer and magnetometer that are supplied to the Kalman filter. A real-time fuzzy logic controller uses the statistical best estimate to perform a feedback control loop. As result the airship is capable of maintaining the altitude in a range of 5cm from the set point

    The Management of Psoriatic Arthritis in Italy: Organizational Impact Analysis of Optimized Pathways

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    BACKGROUND: The management of psoriatic arthritis requires competencies in the fields of both rheumatology and dermatology, and a multidisciplinary approach.AIM: To propose an effective pathway for the diagnosis, monitoring and treatment of psoriatic arthritis in the Italian context, and to assess its organizational impact on the Regional Health Service of Lombardy Region.METHODS: The analysis was performed through interviews conducted with two key opinion leaders in the areas of dermatology and rheumatology. The current pathway of patients who present symptoms that might be related to psoriatic arthritis was defined and an optimized pathway was then proposed on the basis of the clinical practice, considering the implementation of a dermatology and rheumatology shared outpatient service. The organizational impact of the optimized pathway was then assessed from both the hospital and that of the Regional Health Service of Lombardy Region perspectives.RESULTS: The implementation of the service would have a positive impact on patients' experience, improving the quality of the service provided, thanks to the multidisciplinary approach adopted, limiting the patients' resources needed for the diagnosis, reducing the number of visits and time loss. The optimized pathway, therefore, would have a limited impact on the marketing mix, while potentially improving patients satisfaction, increasing the possibility of patients' retention. To successfully implement the dermatological and rheumatologic multidisciplinary service, a precise communication strategy is mandatory.CONCLUSIONS: The optimized pathway for the diagnosis and management of psoriatic arthritis proposed would have a limited organizational impact at both hospital and Regional Health Service levels, while leading to theoretical benefits in terms of a prompt diagnosis of the pathology

    Effect of oxide nanoparticles on thermal and mechanical properties of electrospun separators for lithium-ion batteries

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    This study reports the fabrication and characterization of poly(ethylene oxide) (PEO) and poly(vinylidenefluoride-co-chlorotrifluoroethylene) (PVDF-CTFE) nanofibrous separators for lithium-ion batteries loaded with different amounts of fumed-silica and tin oxide nanoparticles. Membrane morphological characterization (SEM, TEM) showed the presence of good-quality nanofibres containing nanoparticles. Thermal degradation and membrane mechanical properties were also investigated, and a remarkable effect of nanoparticle addition on membrane mechanical properties was found. In particular, PEO membranes were strengthened by the addition of metal oxide, whereas PVDF-CTFE membranes acquired ductility

    Budget impact analysis of the use of daclatasvir in Italy for the treatment of Hepatitis C Virus (HCV) genotype 3 patients

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    BACKGROUND: Hepatitis C Virus (HCV) infection represents a global health problem, leading to chronic cirrhosis, hepatocellular carcinoma (HCC), hepatic decompensation and liver transplant. The aim of the study was the evaluation of the impact on the budget of the Italian National Health Service (INHS) of the use of Daclatasvir (DCV) for the treatment of HCV genotype 3 in patients with advanced fibrosis.METHODS: An analytical decision model with a five year time horizon was implemented. Two scenarios were considered: a. 100% of market share for Interferon (INF-α)+Ribavirin (RBV)+Sofosbuvir (SOF) for 12 weeks; b. SOF+DCV+RBV for 24 weeks with annual market shares of 50% in 2015 and 2016, 55% in 2017 and 2018, 60% in 2019, and INF-α+RBV+SOF for 12 weeks with the remaining market shares. Every annual cycle a percentage of patients equal to the effectiveness of the antiviral treatment reach a sustained virologic response and during the first year of treatment patients may experience treatment related adverse events. The costs considered (2015) are those of the antiviral therapy, and direct medical costs for health state and adverse events management. Univariate and multivariate sensitivity analyses were performed.RESULTS: DCV would lead to an increase of the costs for the INHS (year 1 +21.31 millions, year 2 +21.35 millions, year 3 + 23.37 millions, year 4 + 23.26 millions and year 5 +16.37 millions). The sensitivity analysis confirmed the robustness of the results.CONCLUSIONS: The use of DCV is likely to have a short term impact on the INHS budget increasing resources use compared to the sole use of INF-α+RBV+SOF. However, a trend of reduction of the costs increase is observed due to the management of health states and adverse events which may lead to the possibility to reduce costs in the long term

    Nine ideas to improve the clinical management of HIV infected patients during the COVID-19 pandemic

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    Globally, in 2019, HIV infection was still responsible for 1.7 million new infections 2.2 and for 690,000 deaths in the same year. Tailored and new antiretroviral therapy (ART) regimens, individualised follow-up and new technologies to support data-sharing between health—care professional caring for people living with HIV (PLHIV) and to deliver ART to patients are desperately needed to reach the 90-90-90-90 ambitious goals. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, responsible for the Coronavirus-19 (COVID-19) pandemic that spread globally in 2020, posed a huge challenge for PLHIV and HIV physicians worldwide in terms of continuum of care.In this paper we encourage “up-to-date patient-centred HIV medicine” and we give nine ideas to improve HIV management in clinical practice during the COVID-19 pandemic

    Influence of Magnesium as a Major Contributor of Water Hardness on Some Cardiac Disease Risk Factors

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    Various ecological studies report a reduction in cardiovascular disease mortality risk with increasing magnesium levels in drinking water. Most of the studies done in this field were epidemiologic studies.The aim of the present study was to examine whether magnesium addition to drinking water can affect risks of cardiac disease. The study included five groups of male albino rats. The rats received either tap water or water containing 5, 10, 20 g of magnesium sulfate per liter. During the whole experiment, all the groups received hypercholesterolemic diet except for the normal control which received normal basal diet. At the end of the experiment, blood was drawn for the determination of plasma magnesium, lipid profile and liver function. In addition, the extent of obesity was determined using the body mass index (BMI). In all groups magnesium addition was associated with higher levels of plasma magnesium. The blood analysis showed a significant decrease in serum total cholesterol, triglycerides, LDL- cholesterol and VLDL- cholesterol, while there was a significant increase in HDL- cholesterol in groups received magnesium sulfate in drinking water, compared with the hypercholesterolemic group received tap water. GOT, GPT and ALP followed the same trend. The addition of MgSO4 to the drinking water results in significant decrease in BMI of the magnesium treated groups relative to the hypercholesterolemic control. These results showed that high magnesium concentration in drinking water is capable of decreasing some cardiac disease risk factors in male albino rats. Keywords: Cardiac disease, hypercholesterolemia, Magnesium, Risk factors, Water

    Benchmarking of health technologies distribution models: an investigation of Lombardy’s local health authorities

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    Purpose – The purpose of this paper is to develop a benchmarking framework for assessing the performance of the distribution models adopted by the local branches of National Health Services (NHSs) for delivering health technologies to patients at a local level, and to derive prescriptions for enhancing design and optimal management of the distribution models. Design/methodology/approach – The authors focussed the study on the distribution of absorbent devices for incontinence, adopting the analytic hierarchy process as a tool for developing the benchmarking framework. The authors applied the framework to the context of the Italian NHS with respect to the Lombard Local Health Authorities, assessing their performance in terms of operational efficiency and service quality. Findings – The developed framework constitutes a novel contribution, and it allows for generating prescriptions. Through its application to the context studied the authors found that a “one-size-fits-all” distribution model cannot be proposed, as regards both efficiency and effectiveness, since process standardization does not provide benefits or savings in all contexts. Rather, a total landed cost approach in the evaluation of the distribution practices must be adopted. Practical implications – This paper offers to managers and decision makers an innovative approach to the design of distribution models for health technologies. It provides policy makers with prescriptions to develop regulations fostering a comprehensive view of the factors for an optimal health technologies distribution at a local level. Originality/value – Given the dearth of scientific publications focussed on the distribution at the local level of health technologies, this paper significantly contributes to the existing body of knowledge and it offers an innovative framework which can be proficiently replicated in manifold contexts

    Different Effects of Angiotensin Converting Enzyme Inhibitors on Endothelin-1 and Nitric Oxide Balance in Human Vascular Endothelial Cells: Evidence of an Oxidant-Sensitive Pathway

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    Angiotensin converting enzyme inhibitors (ACE-I) are able to reduce the formation of the potent vasoconstrictor endothelin-1 and increase nitric oxide bioavailability in human vascular endothelial cells (HUVECs). We tested the effects of two sulfhydryl-containing ACE-I, zofenoprilat, and captopril, and two nonsulfhydryl containing ACE-I, enalaprilat and lisinopril, on endothelin-1/nitric oxide balance and oxidative stress in HUVECs. All the four tested ACE-I reduced endothelin-1 secretion and increased nitric oxide metabolite production by HUVECs. However, zofenoprilat (−42% after 8 hours of incubation) was more effective (P < .05) than enalaprilat (−25%), lisinopril (−21%), and captopril (−30%) in reducing endothelin-1 secretion. Similarly, zofenoprilat (+110% after 8 hours of incubation) was more effective (P < .05) than enalaprilat (+64%), lisinopril (+63%), and captopril (+65%) in increasing nitric oxide metabolite production. The effect of ACE-I on endothelin-1 and nitric oxide metabolite production is mediated by the activation of bradykinin B2 receptor being counteracted, at least in part, by a specific antagonist. Zofenoprilat and, to a lesser extent, captopril also reduced oxidative stress in HUVECs. In conclusion, among the four tested ACE-I, zofenoprilat was more effective in improving endothelin-1/nitric oxide balance in HUVECs likely because of its greater antioxidant properties
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