Spontaneous Dural Carotid-Cavernous Fistula Treated with Microcoil Insertion

This report includes a case of a 65-year-old woman presenting with a spontaneous dural carotid-cavernous fistula. Biomicroscopic examination of the anterior segment showed significant conjunctival chemosis, dilatation of the episcleral vessels, narrow anterior chamber, and a proptosis of the right eye, whereas the fellow eye was unremarkable. Retinal examination revealed an impaired arteriovenous ratio (A/V) from 1-4 to 1-2 and two extensive cotton exudates. An ultrasound scan (US) demonstrated congestion of the upper ophthalmic vein. Selective brain angiography through right femoral catheterization revealed a dural fistula of the wall of the cavernous right sinus. The patient underwent surgery on the superior ophthalmic vein and insertion of a micro-catheter in the cavernous sinus under CT guidance. Furthermore, a trans-femoral catheter was placed in the carotid artery on the same side as the fistula to allow arteriographic controls after micro coil positioning and embolization. Angiographic follow-up immediately after positioning the coils showed the occluded fistula and a regular flow circulation between the internal and the external carotid arteries. After treatment, the patient presented a complete resolution of symptoms. Conservative management is effective and safe in treating patients with carotid-cavernous fistula and mild clinical features because of a good chance of spontaneous or secondary thrombosis after arteriographic occlusion

Retrospective analyses of psychological distress and defense style among cancer patients

Objective: Psychological distress is common in cancer patients during the diagnostic phase. Research demonstrated that anxiety, depression and defense mechanisms may influence physical and psychological well-being in patients with malignant tumors. The present retrospective study investigated the associations between clinical and psychological characteristics of cancer patients waiting for the diagnosis, focusing on metastatic cancer (MC) and breast cancer (BC). Methods: Patients with a new diagnosis of cancer referring to a Clinical Oncology Unit in Central Italy were interviewed during the 2017 for psychological assessment. Double-blind information about anxiety, depression, sleep disorders, defense style, and cancer diagnosis were available for the 567 patients included in this study. T-test, chi-squared and regression analyses were performed to detect associations between psychological variables and the presence of metastasis (MC) in the whole sample and in the subgroup of breast cancer (BC) patients. Results: Female gender and younger age were associated with anxiety, depres-sion, and maladaptive defense style. A significant positive relationship was found between presence of metastasis and symptoms of anxiety. Depression resulted significantly more frequent in BC, while there was a trend close to statistical significance in MC. Immature defense style was widely used by BC women, with a score close to statistical significance. Conclusions: This retrospective study provided empirical evidence of the relationship between psychological functioning and clinical characteristics of cancer. In line with previous research, our findings confirmed the peculiar psychological functioning of BC patients. Further investigations are needed to understand how the diagnosis of cancer may influence the individual psychological functioning and vice versa

An Energy Blockchain, a Use Case on Tendermint

The recent advances in distributed energy systems require new models for exchanging energy among prosumers in microgrids. The blockchain technology promises to solve the digital issues related to distributed systems without a trusted authority and to allow quick and secure energy transactions, which are verified and cryptographically protected. Transactions are approved and subsequently recorded on all the machines participating in the blockchain. This work demonstrates how users, which are nodes of the energy and digital networks, exchange energy supported by a customized blockchain based on Tendermint. We focus on the procedures for generating blocks and defining data structures for storing energy transactions

Review of potential and actual penetration of solar power in Vietnam

With the average solar radiation reaching up to 5 kWh/m2, Vietnam is considered as a country showing an excellent potential for solar power production. Since the year 2000, there have been a lot of studies about the potential of this source in Vietnam. So far, many applications of solar power have been implemented on small, medium, and large scales. In fact, the total capacity of current grid-connected solar power plants has exceeded the planned capacity by 2020 nearly 6 times. However, the studies of solar potential in Vietnam are still incomplete. The policies and mechanisms for developing solar power projects have received attention from the authorities but have not been really satisfactory. The infrastructure is still poor and the power system does not keep up with the development of modern grids. This paper reviewed the potential and actual implementation stage of photovoltaic projects in Vietnam. Moreover, the barriers and challenges of institution, technique, economy, and finance have been considered explicitly for the future development of solar energy in Vietnam

A methodology for assessing the impact of salinity gradient power generation in urban contexts

The paper proposes a methodology to assess the potential impact of salinity gradient power technology in urban contexts. The idea to employ such energy source in urban contexts derives from the observation that, among the energy districts outputs, low-salinity treated wastewater can be used to produce electricity if a suitable source of high salinity feed (seawater of a salt-works) is also available. The methodology uses the HOMER software for assessing the district’s electric energy production, consumption and exchange with the main grid. Then, starting from the total gross surface and the number of inhabitants of the district, some possible realistic scenarios characterized by different wastewater flow rate are defined. Finally, for each scenario the size and the yearly energy production of the salinity gradient power system are calculated thanks to a simulator carried out by the same authors. An application example, considering three different scenarios, shows that urban density plays a crucial role in the process and that the most promising realistic scenarios are those including treated wastewater and brine and unlimited seawater and brine. The economic feasibility of the salinity gradient power technology is evaluated by a comparison with classical renewable technologies such as photovoltaic and wind systems

H^s versus C^0-weighted minimizers

We study a class of semi-linear problems involving the fractional Laplacian under subcritical or critical growth assumptions. We prove that, for the corresponding functional, local minimizers with respect to a C^0-topology weighted with a suitable power of the distance from the boundary are actually local minimizers in the natural H^s-topology.Comment: 15 page

Critical Assessments of the Potential for Integrating Renewable Energy into Isolated Grids on Vietnamese Islands: The Case of the An-Binh Grid

Renewable electricity for off-grid areas is widely seen as one of the top choices in supporting local economic development in most countries, and so is Vietnam. Over the years, many isolated networks using renewable energy sources have been deployed for off-grid areas in Vietnam. However, the use of these energy sources in Vietnam’s isolated networks is still facing many challenges due to its infancy here. The issues of reliability and vulnerability of these networks are not given the expected attention. Another challenge is that the issues of the operational security of these systems could also be negatively affected by the variable nature of renewable sources, including static and dynamic security. For this reason, this study aims to contribute to a better understanding of integrating renewable energy into isolated networks, and in this case, using solar power for the An-Binh Island grid in Vietnam. The findings from this study suggest that choosing the right structure of the power mix could contribute to improving the operational security of isolated networks. Moreover, several solutions to enhance the reliability of this grid are also proposed. The NEPLAN environment was selected for simulation and analysis for all the scenarios in this study

Clinical care conditions and needs of palliative care patients from five italian regions: Preliminary data of the demetra project

In order to plan the right palliative care for patients and their families, it is essential to have detailed information about patients’ needs. To gain insight into these needs, we analyzed five Italian local palliative care networks and assessed the clinical care conditions of patients facing the complexities of advanced and chronic disease. A longitudinal, observational, noninterventional study was carried out in five Italian regions from May 2017 to November 2018. Patients who accessed the palliative care networks were monitored for 12 months. Sociodemographic, clinical, and symptom information was collected with several tools, including the Necesidades Paliativas CCOMS-ICO (NECPAL) tool, the Edmonton Symptom Assessment System (ESAS), and interRAI Palliative Care (interRAI-PC). There were 1013 patients in the study. The majority (51.7%) were recruited at home palliative care units. Cancer was the most frequent diagnosis (85.4%), and most patients had at least one comorbidity (58.8%). Cancer patients reported emotional stress with severe symptoms (38.7% vs. 24.3% in noncancer patients; p = 0.001) and were less likely to have clinical frailty (13.3% vs. 43.9%; p < 0.001). Our study confirms that many patients face the last few months of life with comorbidities or extreme frailty. This study contributes to increasing the general knowledge on palliative care needs in a high-income country