An exploratory investigation of the facility maintenance program at Sterling Regional High School

The purpose of the study was to a) determine the effectiveness of the current maintenance program at Sterling High School and to b) make changes in the program to promote staff satisfaction, safety of the environment, and fiscal matters. Administrators and staff members were interviewed regarding the program. A random sample of 100 work orders was analyzed to determine repair time, cost per repair, and percentage of return repairs for each of six maintenance categories, including electrical, plumbing, heating/ventilation/air conditioning (HVAC), fire alarms, other mechanical, and interior. It was determined that the HVAC system required the most repair time, most return repairs, and was the most costly. Changes were made in the computerized documentation systems and work responsibility systems within the maintenance department. Administrators discussed other implications of adopting a similar facility maintenance plan and preventative maintenance program. Continued study is required to determine the cost effectiveness of a preventative maintenance program

Muon calibration of the ASTRI-Horn telescope: preliminary results

Astri-Horn is a Small-Sized Telescope (SST) for very-high energy gamma-ray astronomy installed in Italy at the INAF "M.C. Fracastoro" observing station (Mt. Etna, Sicily). The ASTRI-Horn telescope is characterized by a dual-mirror optical system and a curved focal surface covered by SiPM sensors managed by a innovative fast front-end electronics. Dedicated studies were performed to verify the feasibility of the calibration through muons on the relatively small size of the primary mirror (~4 m diameter), as in the case of larger Cherenkov telescopes. A number of tests were performed using simulations of the atmospheric showers with the CORSIKA package and of the telescope response with a dedicated simulator. In this contribution we present a preliminary analysis of muon events detected by ASTRI-Horn during the regular scientific data taking performed in December 2018 and March 2019. These muon events validate the results obtained with the simulations and definitively confirm the feasibility of calibrating the ASTRI-Horn SST telescope with muons.Comment: Proceedings of the 36th International Cosmic Ray Conference, Madison, Wisconsin, USA, 24 July-1 August 201

Maintaining good practice in breast cancer management and reducing the carbon footprint of care: study protocol and preliminary results

Objective: Health care accounts for up to 8-10% of greenhouse emission yearly in the US and surgical room contributes an estimated 25-30% of hospital waste. Despite the major role of greenhouse emissions because of surgery, little has been done by surgeons to reduce their impact. In this paper, we present a multicentric retrospective analysis to evaluate the carbon footprint of the most common breast surgical treatment and a preliminary analysis of our results. Patients and Methods: Retrospective analysis with processed-based life cycle assessment (LCA) has been obtained to determine carbon footprint of different surgical procedures. In our preliminary study, we enrolled all consecutive patients undergoing breast conserving procedure (BCP) between 9th March 2019 and 9th March 2021 to underline the reduction in fuel consumption with postoperative telehealth application (pre-COVID-19 vs. COVID-19). A propensity score matching was implemented to optimize comparability. Results: From 276 BCP patients, PSM included 69 pre-COVID-19 and 69 COVID-19 groups, respectively. No statistically significant difference was found in the tumor stage, marital status, and distance from the hospital. A total of 466 postoperative visits was performed and a statistically significant difference in telehealth visit rate was found between groups (1.75% vs. 51.68%; p<0.001). A reduction of 4312.38 km in travel to the hospital was found in the COVID-19 group. No difference was found in postoperative complications. Conclusions: Health systems worldwide are implementing zero-carbon programs to reduce their carbon footprint. Breast surgeons should consider the consequences of their actions and embrace the pillars of the circular economy. Our data could promote further action in order to raise awareness regarding carbon footprint of breast surgery

N-acetylcysteine lacks universal inhibitory activity against influenza A viruses

N-acetylcysteine (NAC) has been recently proposed as an adjuvant therapeutic drug for influenza pneumonia in humans. This proposal is based on its ability to restrict influenza virus replication in vitro and to attenuate the severity of the disease in mouse models. Although available studies were made with different viruses (human and avian), published information related to the anti-influenza spectrum of NAC is scarce. In this study, we show that NAC is unable to alter the course of a fatal influenza pneumonia caused by inoculation of a murinized swine H1N1 influenza virus. NAC was indeed able to inhibit the swine virus in vitro but far less than reported for other strains. Therefore, susceptibility of influenza viruses to NAC appears to be strain-dependent, suggesting that it cannot be considered as a universal treatment for influenza pneumonia

Post-mortem findings in vaccine-induced thrombotic thombocytopenia

Greinacher et al.1 and Schultz et al.2 were the first to independently report the main clinical and laboratory features of 11 and five respective patients from Germany, Austria and Norway who developed life-threatening thrombohemorrhagic complications 5 to 16 days after the administration of the first dose of the chimpanzee adenoviral vector vaccine ChAdOx1nCoV-19 against SARS-CoV-2 and COVID-19. Subsequently Scully et al.3 reported similar findings in 23 patients treated with the same vaccine in the United Kingdom. More recently, See et al.4 reported a case series of 12 patients from the USA with cerebral venous sinus thrombosis following the vaccination with Ad26.CoV2.S employing a human adenoviral vector. The main post-vaccination features common to the case series were the occurrence of venous thromboembolism mainly in unusual sites (cerebral and abdominal veins) and the concomitant presence of bleeding symptoms associated with severe thrombocytopenia, often accompanied by laboratory signs of consumption coagulopathy with low plasma fibrinogen and hugely increased levels of D-dimer. The majority of reported patients reacted positively for serum immunoglobulin G (IgG) antibodies to the platelet factor 4 PF4/heparin complex. 1-4 Another common feature was the high mortality rate. The mechanism of this very rare thrombohemorrhagic syndrome was postulated to be a vaccine-triggered autoimmune reaction, with the development of antibodies against a still ill-defined PF4/polyanion complex that causes platelet activation as in heparin-induced thrombocytopenia (HIT),1-4 notwithstanding the fact that no cases were exposed to heparin before the onset of thrombosis and thrombocytopenia. We report herewith the detailed post-mortem macroscopic and microscopic findings in two similar cases that occurred in the Italian region of Sicily

Guanosine-mediated anxiolytic-like effect: Interplay with adenosine a1 and a2a receptors

Acute or chronic administration of guanosine (GUO) induces anxiolytic-like effects, for which the adenosine (ADO) system involvement has been postulated yet without a direct experimental evidence. Thus, we aimed to investigate whether adenosine receptors (ARs) are involved in the GUO-mediated anxiolytic-like effect, evaluated by three anxiety-related paradigms in rats. First, we confirmed that acute treatment with GUO exerts an anxiolytic-like effect. Subsequently, we investigated the effects of pretreatment with ADO or A1R (CPA, CCPA) or A2AR (CGS21680) agonists 10 min prior to GUO on a GUO-induced anxiolytic-like effect. All the combined treatments blocked the GUO anxiolytic-like effect, whereas when administered alone, each compound was ineffective as compared to the control group. Interestingly, the pretreatment with nonselective antagonist caffeine or selective A1R (DPCPX) or A2AR (ZM241385) antagonists did not modify the GUO-induced anxiolytic-like effect. Finally, binding assay performed in hippocampal membranes showed that [3H]GUO binding became saturable at 100–300 nM, suggesting the existence of a putative GUO binding site. In competition experiments, ADO showed a potency order similar to GUO in displacing [3H]GUO binding, whereas AR selective agonists, CPA and CGS21680, partially displaced [3H]GUO binding, but the sum of the two effects was able to displace [3H]GUO binding to the same extent of ADO alone. Overall, our results strengthen previous data supporting GUO-mediated anxiolytic-like effects, add new evidence that these effects are blocked by A1R and A2AR agonists and pave, although they do not elucidate the mechanism of GUO and ADO receptor interaction, for a better characterization of GUO binding sites in ARs

A new enhanced PSPICE implementation of the equivalent circuit model of SiPM detectors

The present work proposes an improved PSPICE implementation of the equivalent electrical model of silicon photomultipliers (SiPMs) to simulate and predict their transient re-sponse to avalanche trigger events. In particular, the developed model provides a detailed investigation of magnitude and timing of the read-out signals and can therefore be exploited to perform reliable circuit-level simulations. The modeling approach used is strictly related to the physics of each basic microcell constituting the SiPM device, and allows the avalanche timing as well as the photodiode current and voltage to be accurately simulated. Predictive capabilities of the proposed model are demonstrated by means of experimental measurements on a real detector. Versatility of the proposed model is also confirmed

Breast cancer rehabilitation and reconditioning

Breast Cancer (BC), a prominent oncological disease, has become an increasing concern for countless women across the globe. The rising incidences underscore the urgent need for a comprehensive post-treatment rehabilitation strategy to address the challenges posed by intensive treatments. This rehabilitation is not merely about physical recovery but requires a holistic lens, considering disability as an overarching loss of functional integrity. Embracing this perspective enables healthcare professionals to devise strategies that focus on the entirety of a patient's well-being. Central to this approach is the Individual Rehabilitation Project (IRP), a tailored program designed to elevate the post-treatment quality of life. It stresses the importance of early interventions, particularly after surgery, to mitigate potential complications and functional deficits. Physical activities, curated and executed under professional guidance, form a cornerstone of the rehabilitation process. Depending on each patient's specific condition and stage of recovery, a range of exercises is recommended. Beyond the immediate post-surgical phase, patients are introduced to adaptive physical endeavors like fencing and dragon boating. Such activities are not merely for physical recovery but also play a significant role in enhancing self-esteem, self-perception, and overall mental resilience. Once acute and post-acute care has been completed, and a clinical functional stability is reached, BC patients, now better defined as person with BC disability (PwBC). As the narrative unfolds, it becomes clear that BC rehabilitation is an intricate dance between physical recovery and psychological well-being, necessitating an individualized, patient-centric approach. Furthermore, this opinion paper highlights the urgency for rigorous research, especially randomized trials, to refine and validate the efficacy of these rehabilitation procedures, ensuring that patients not only survive but thrive post-treatment

Lipopolysaccharide from Gut-Associated Lymphoid-Tissue-Resident Alcaligenes faecalis: Complete Structure Determination and Chemical Synthesis of Its Lipid A

Alcaligenes faecalis is the predominant Gram-negative bacterium inhabiting gut-associated lymphoid tissues, Peyer's patches. We previously reported that an A. faecalis lipopolysaccharide (LPS) acted as a weak agonist for Toll-like receptor 4 (TLR4)/myeloid differentiation factor-2 (MD-2) receptor as well as a potent inducer of IgA without excessive inflammation, thus suggesting that A. faecalis LPS might be used as a safe adjuvant. In this study, we characterized the structure of both the lipooligosaccharide (LOS) and LPS from A. faecalis. We synthesized three lipid A molecules with different degrees of acylation by an efficient route involving the simultaneous introduction of 1- and 4′-phosphates. Hexaacylated A. faecalis lipid A showed moderate agonistic activity towards TLR4-mediated signaling and the ability to elicit a discrete interleukin-6 release in human cell lines and mice. It was thus found to be the active principle of the LOS/LPS and a promising vaccine adjuvant candidate