High concordance between trained nurses and gastroenterologists in evaluating recordings of small bowel video capsule endoscopy (VCE)

Background & Aims: The video capsule endoscopy (VCE) is an accurate and validated tool to investigate the entire small bowel mucosa, but VCE recordings interpretation by the gastroenterologist is time-consuming. A pre-reading of VCE recordings by an expert nurse could be accurate and cost saving. We assessed the concordance between nurses and gastroenterologists in detecting lesions on VCE examinations. Methods: This was a prospective study enrolling consecutive patients who had undergone VCE in clinical practice. Two trained nurses and two expert gastroenterologists participated in the study. At VCE pre-reading the nurses selected any abnormalities, saved them as “thumbnails” and classified the detected lesions as a vascular abnormality, ulcerative lesion, polyp, tumor mass, and unclassified lesion. Then, the gastroenterologist evaluated and interpreted the selected lesions and, successively, reviewed the entire video for potential missed lesions. The time for VCE evaluation was recorded. Results: A total of 95 VCE procedures performed on consecutive patients (M/F: 47/48; mean age: 63 ± 12 years, range: 27−86 years) were evaluated. Overall, the nurses detected at least one lesion in 54 (56.8%) patients. There was total agreement between nurses and gastroenterologists, no missing lesions being discovered at a second look of the entire VCE recording by the physician. The pre-reading procedure by nurse allowed a time reduction of medical evaluation from 49 (33-69) to 10 (8-16) minutes (difference:-79.6%). Conclusions: Our data suggest that trained nurses can accurately identify and select relevant lesions in thumbnails that subsequently were faster reviewed by the gastroenterologist for a final diagnosis. This could significantly reduce the cost of VCE procedure

A minimum-time obstacle-avoidance path planning algorithm for unmanned aerial vehicles

In this article, we present a new strategy to determine an unmanned aerial vehicle trajectory that minimizes its flight time in presence of avoidance areas and obstacles. The method combines classical results from optimal control theory, i.e. the Euler-Lagrange Theorem and the Pontryagin Minimum Principle, with a continuation technique that dynamically adapts the solution curve to the presence of obstacles. We initially consider the two-dimensional path planning problem and then move to the three-dimensional one, and include numerical illustrations for both cases to show the efficiency of our approach

Gli interventi educativi per i pazienti con scompenso cardiaco: una sintesi della letteratura

Patient education is recognized as a central component of heart failure care and reduces hospital readmissions. Nurses have an important role in providing patient education and modifying self-care behaviors. The aim of this article is to examine characteristics of educational interventions for heart failure patients, their measured outcomes and the role of nurses in providing education. We conducted a literature review of the last 10 years and considered 30 articles. Multisession motivational interventions, repeated over time and with different follow-up interventions seem to produce the best results. However, some aspects remain controversial

Monitoring of masonry historical constructions: 10 years of static monitoring of the world's largest oval dome

This paper presents the analyses conducted on the data acquired by the monitoring system of the “Regina Montis Regalis” Basilica of Vicoforte (Italy) in the decade 2004–2014. The Basilica is a building of great historical, architectural, and structural significance, owing its fame to its impressive masonry oval dome, the world's largest of this shape (internal axes of 37.23 by 24.89 m). The dome-drum system of the Basilica has suffered over the years of significant structural problems, partly due to the settlements of the building induced progressively by newly built masses and also to the sliding of the underground. In 1983, concerns over the severe settlements and cracking phenomena affecting the structure prompted the decision to undertake strengthening interventions. A special hooping system, consisting of 56 tie bars, placed around the oval perimeter of the dome, was thus conceived to limit the crack opening. The monitoring system of the Basilica installed in the early 1980s underwent several renovations, and in 2004, its acquisition procedure was automatized. One hundred twelve instruments, consisting of temperature sensors, crackmeters, load cells, pressure cells, wire gauges, hygrometer, piezometers, and hydrometer, are currently installed on the Basilica. This study is primarily focused on data acquired by the crackmeters, the extensometers along the main axes of dome, and the load cells placed at the ends of the tie bars. The main aim of the reported analysis is to evaluate the possible progression of the cracks on the Basilica, and the structural performance of the strengthening interventions put in place in 1985–1987

Passive ocean acoustic tomography: theory and experiment

In this paper the Passive Ocean Acoustic Tomography (P-OAT) methodology is presented. This technique, avoiding the use of a dedicated active sound source, estimates the sea water temperature spatial distribution from the received noise emitted from ships of opportunity. The feasibility of the proposed methodology has been confirmed both by test-runs on semi-synthetic data and by the use of real acoustic and environmental data collected during INTIMATE00 experiment performed on October 2000 in the Atlantic Ocean off the Portuguese coasts