37 research outputs found

    Dean Emeritus Patrick J. Rohan

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    (Excerpt) Patrick J. Rohan’s connection to St. John’s reaches back more than half a century. He graduated from St. John’s University in 1954 and from the School of Law in 1956. Two years later, he joined the Law School faculty, where he served for fifty-two years until his retirement in June 2009. He died just a few months later, on November 26, 2009. The School of Law community mourns the passing of this man of St. John’s—Dean Emeritus, Professor of Law, alumnus, supporter, and friend

    Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period

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    No data on antibiotic resistance in bloodstream infection (BSI) in people living with HIV (PLWH) exist. The objective of this study was to describe BSI epidemiology in PLWH focusing on multidrug resistant (MDR) organisms. A retrospective, single-center, observational study was conducted including all positive blood isolates in PLWH from 2004 to 2017. Univariable and multivariable GEE models using binomial distribution family were created to evaluate the association between MDR and mortality risk. In total, 263 episodes (299 isolates) from 164 patients were analyzed; 126 (48%) BSI were community-acquired, 137 (52%) hospital-acquired. At diagnosis, 34.7% of the patients had virological failure, median CD4 count was 207/μL. Thirty- and 90-day mortality rates were 24.2% and 32.4%, respectively. Thirty- and 90-day mortality rates for MDR isolates were 33.3% and 46.9%, respectively (p < 0.05). Enterobacteriaceae were the most prevalent microorganisms (29.8%), followed by Coagulase-negative staphylococci (21.4%), and S. aureus (12.7%). In BSI due to MDR organisms, carbapenem-resistant K. pneumoniae and methicillin-resistant S. aureus were associated with mortality after adjustment for age, although this correlation was not confirmed after further adjustment for CD4 < 200/μL. In conclusion, BSI in PLWH is still a major problem in the combination antiretroviral treatment era and it is related to a poor viro-immunological status, posing the question of whether it should be considered as an AIDS-defining event

    Is it really advantageous to operate proximal femoral fractures within 48 h from diagnosis? – A multicentric retrospective study exploiting COVID pandemic-related delays in time to surgery

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    Objectives: Hip fractures in the elderly are common injuries that need timely surgical management. Since the beginning of the pandemic, patients with a proximal femoral fracture (PFF) experienced a delay in time to surgery. The primary aim of this study was to evaluate a possible variation in mortality in patients with PFF when comparing COVID-19 negative versus positive. Methods: This is a multicentric and retrospective study including 3232 patients with PFF who underwent surgical management. The variables taken into account were age, gender, the time elapsed between arrival at the emergency room and intervention, pre-operative American Society of Anesthesiology score, pre-operative cardiovascular and respiratory disease, and 10-day/1-month/6-month mortality. For 2020, we had an additional column, “COVID-19 swab positivity.” Results: COVID-19 infection represents an independent mortality risk factor in patients with PFFs. Despite the delay in time-to-surgery occurring in 2020, no statistically significant variation in terms of mortality was detected. Within our sample, a statistically significant difference was not detected in terms of mortality at 6 months, in patients operated within and beyond 48 h, as well as no difference between those operated within or after 12/24/72 h. The mortality rate among subjects with PFF who tested positive for COVID-19 was statistically significantly higher than in patients with PFF who tested. COVID-19 positivity resulted in an independent factor for mortality after PFF. Conclusion: Despite the most recent literature recommending operating PFF patients as soon as possible, no significant difference in mortality was found among patients operated before or after 48 h from diagnosis

    Prospective validation of the CLIP score: a new prognostic system for patient with cirrhosis and hepatocellular carcinoma

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    Prognosis of patients with cirrhosis and hepatocellular carcinoma (HCC) depends on both residual liver function and tumor extension. The CLIP score includes Child-Pugh stage, tumor morphology and extension, serum alfa-fetoprotein (AFP) levels, and portal vein thrombosis. We externally validated the CLIP score and compared its discriminatory ability and predictive power with that of the Okuda staging system in 196 patients with cirrhosis and HCC prospectively enrolled in a randomized trial. No significant associations were found between the CLIP score and the age, sex, and pattern of viral infection. There was a strong correlation between the CLIP score and the Okuda stage, As of June 1999, 150 patients (76.5%) had died. Median survival time was 11 months, overall, and it was 36, 22, 9, 7, and 3 months for CLIP categories 0, 1, 2, 3, and 4 to 6, respectively. In multivariate analysis, the CLIP score had additional explanatory power above that of the Okuda stage. This was true for both patients treated with locoregional therapy or not. A quantitative estimation of 2-year survival predictive power showed that the CLIP score explained 37% of survival variability, compared with 21% explained by Okuda stage. In conclusion, the CLIP score, compared with the Okuda staging system, gives more accurate prognostic information, is statistically more efficient, and has a greater survival predictive power. It could be useful in treatment planning by improving baseline prognostic evaluation of patients with RCC, and could be used in prospective therapeutic trials as a stratification variable, reducing the variability of results owing to patient selection

    The association between insight and depressive symptoms in schizophrenia: Undirected and Bayesian network analyses

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    Background. Greater levels of insight may be linked with depressive symptoms among patients with schizophrenia, however, it would be useful to characterize this association at symptom-level, in order to inform research on interventions. Methods. Data on depressive symptoms (Calgary Depression Scale for Schizophrenia) and insight (G12 item from the Positive and Negative Syndrome Scale) were obtained from 921 community-dwelling, clinically-stable individuals with a DSM-IV diagnosis of schizophrenia, recruited in a nationwide multicenter study. Network analysis was used to explore the most relevant connections between insight and depressive symptoms, including potential confounders in the model (neurocognitive and social-cognitive functioning, positive, negative and disorganization symptoms, extrapyramidal symptoms, hostility, internalized stigma, and perceived discrimination). Bayesian network analysis was used to estimate a directed acyclic graph (DAG) while investigating the most likely direction of the putative causal association between insight and depression. Results. After adjusting for confounders, better levels of insight were associated with greater self-depreciation, pathological guilt, morning depression and suicidal ideation. No difference in global network structure was detected for socioeconomic status, service engagement or illness severity. The DAG confirmed the presence of an association between greater insight and self-depreciation, suggesting the more probable causal direction was from insight to depressive symptoms. Conclusions. In schizophrenia, better levels of insight may cause self-depreciation and, possibly, other depressive symptoms. Person-centered and narrative psychotherapeutic approaches may be particularly fit to improve patient insight without dampening self-esteem

    Finishing the euchromatic sequence of the human genome

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    The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

    A distributed backbone-based framework for live video sharing in VANETs

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    Vehicular Ad-Hoc Networks (VANETs) have been expanding their portfolio to support a large variety of services, ranging from safety to on-road multimedia applications. The distribution of real-time videos in a Vehicle-to-Vehicle (V2V) fashion allows drivers, passengers, paramedics, and first responder teams to capture, share, and watch video sequences from accidents and disasters that happened kilometers away. In this context, the transmission of live video streams in V2V scenarios must be done with Quality of Experience (QoE) criteria. This paper introduces the DBD (Distributed Beaconless Dissemination) protocol that improves the delivery of real-time video ows on multimedia highway VANETs, where it is important to maintain backbone-based routes for video dissemination in multi-path opportunistic V2V environments. The proposed solution improves the IEEE 802.11p MAC layer to solve the Spurious Forwarding problem, while increasing the packet delivery ratio and reducing the forwarding delay, especially in heavy vehicular traffic conditions caused by accidents, that we recreated from empirical data. Performance evaluation results show the benefits of DBD compared to existing works in forwarding video sequences in V2V VANET scenarios, on the basis of objective and subjective QoE measurements. Copyright © 2014 ACM

    A distributed beaconless routing protocol for real-time video dissemination in multimedia VANETs

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    Vehicular Ad-Hoc Networks (VANETs) will play an important role in Smart Cities and will support the development of not only safety applications, but also car smart video surveillance services. Recent improvements in multimedia over VANETs allow drivers, passengers, and rescue teams to capture, share, and access on-road multimedia services. Vehicles can cooperate with each other to transmit live flows of traffic accidents or disasters and provide drivers, passengers, and rescue teams rich visual information about a monitored area. Since humans will watch the videos, their distribution must be done by considering the provided Quality of Experience (QoE) even in multi-hop, multi-path, and dynamic environments. This article introduces an application framework to handle this kind of services and a routing protocol, the DBD (Distributed Beaconless Dissemination), that enhances the dissemination of live video flows on multimedia highway VANETs. DBD uses a backbone-based approach to create and maintain persistent and high quality routes during the video delivery in opportunistic Vehicle to Vehicle (V2V) scenarios. It also improves the performance of the IEEE 802.11p MAC layer, by solving the Spurious Forwarding (SF) problem, while increasing the packet delivery ratio and reducing the forwarding delay. Performance evaluation results show the benefits of DBD compared to existing works in forwarding videos over VANETs, where main objective and subjective QoE results are measured

    What is mesotherapy? Recommendations from an international consensus

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    The Italian society of mesotherapy, after a national consensus, carried out an international web-based consensus by the Delphi method. Our objective was to clarify the role of mesotherapy, its advantages, limitations, and correct use in clinical practice with multidisciplinary experts. All the experts approved the final recommendations and mesotherapy has been redefined as a minimally invasive technique that consists of the introduction of small amounts of pharmaceutical substances with micro deposits in the surface layer of the skin. The slowly injected compounds diffuse into the underlying tissues and produce a drug-sparing effect compared to the parenteral route. Used properly, this technique can be useful in some clinical indications
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