169 research outputs found
Surrogate modeling of the aeroacoustics of an NM80 wind turbine
Wind turbines play a major role in the European Green Deal for clean energy transition.
Noise is a critical aspect among open technological issues, as it determines the possibility of onshore
installations near inhabited places and the possible detrimental effects on wildlife when offshore. This
paper assesses the accuracy of different approaches to predicting the sound pressure level (SPL) of a
wind turbine. The 2.75 MW Neg Micon NM80 horizontal axis wind turbine (HWAT) was simulated
in OpenFOAM, modeling the turbine with the actuator line method (ALM) implemented in the
turbinesFoam library. Two different inflow conditions were considered: a stationary inflow with a
typical atmospheric boundary layer profile and a time-dependent inflow derived from a precursor
channel with fully turbulent conditions. The surrogate model for noise prediction used for this work
is based on the synthetic/surrogate acoustics models (SAMs) of Amiet and Brooks-Pope-Marcolini
(BPM). This approach allows for blade motion modeling and the prediction of the SPL of the URANS
postprocessing results. The SPL spectrum obtained was then compared to the results from the other
aeroacoustic solvers of IEA Task 39 participants, showing the best performance in the fully turbulent
case. The results demonstrate that coupling between the ALM and surrogate acoustics provides more
accurate results than the blade element momentum (BEM) approach
Intensive insulin therapy increases glutathione synthesis rate in surgical ICU patients with stress hyperglycemia
OBJECTIVE:
The glutathione system plays an essential role in antioxidant defense after surgery. We assessed the effects of intensive insulin treatment (IIT) on glutathione synthesis rate and redox balance in cancer patients, who had developed stress hyperglycemia after major surgery.
METHODS:
We evaluated 10 non-diabetic cancer patients the day after radical abdominal surgery combined with intra-operative radiation therapy. In each patient, a 24-hr period of IIT, aimed at tight euglycemic control, was preceded, or followed, by a 24-hr period of conventional insulin treatment (CIT) (control regimen). Insulin was administered for 24 hours, during total parenteral nutrition, at a dosage to maintain a moderate hyperglycemia in CIT, and normoglycemic blood glucose levels in IIT (9.3\ub10.5 vs 6.5\ub10.3 mmol/L respectively, P<0.001; coefficient of variation, 9.7\ub11.4 and 10.5\ub11.1%, P = 0.43). No hypoglycemia (i.e., blood glucose < 3.9 mmol/L) was observed in any of the patients. Insulin treatments were performed on the first and second day after surgery, in randomized order, according to a crossover experimental design. Plasma concentrations of thiobarbituric acid reactive substances (TBARS) and erythrocyte glutathione synthesis rates (EGSR), measured by primed-constant infusion of L-[2H2]cysteine, were assessed at the end of each 24-hr period of either IIT or CIT.
RESULTS:
Compared to CIT, IIT was associated with higher EGSR (2.70\ub10.51 versus 1.18\ub10.29 mmol/L/day, p = 0.01) and lower (p = 0.04) plasma TBARS concentrations (2.2\ub10.2 versus 2.9\ub10.4 nmol/L).
CONCLUSIONS:
In patients developing stress hyperglycemia after major surgery, IIT, in absence of hypoglycemia, stimulates erythrocyte glutathione synthesis, while decreasing oxidative stress
Development of a New Tool for 3D Modeling for Regenerative Medicine
The effectiveness of therapeutic treatment based on regenerative medicine for degenerative diseases (i.e., neurodegenerative or cardiac diseases) requires tools allowing the visualization and analysis of the three-dimensional (3D) distribution of target drugs within the tissue. Here, we present a new computational procedure able to overcome the limitations of visual analysis emerging by the examination of a molecular signal within images of serial tissue/organ sections by using the conventional techniques. Together with the 3D anatomical reconstitution of the tissue/organ, our framework allows the detection of signals of different origins (e.g., marked generic molecules, colorimetric, or fluorimetric substrates for enzymes; microRNA; recombinant protein). Remarkably, the application does not require the employment of specific tracking reagents for the imaging analysis. We report two different representative applications: the first shows the reconstruction of a 3D model of mouse brain with the analysis of the distribution of the β-Galactosidase, the second shows the reconstruction of a 3D mouse heart with the measurement of the cardiac volume
Higher protein intake is associated with improved muscle strength in elite senior athletes
OBJECTIVE:
The optimal protein intake for elderly individuals who exercise regularly has not yet been clearly defined. The aim of this study was to test the hypothesis that protein intake level is associated with muscle strength in elderly elite athletes.
METHODS:
We evaluated 50 elite senior athletes (38 men and 12 women) participating in the European Master Games 2011 in an observational cross-sectional study. Participants were divided into two groups-lower (LPI) or higher (HPI) protein intake-according to the median value of their ratio of urinary urea nitrogen to urinary creatinine (i.e., 8.8 g/L), as a marker of protein intake. A dietary interview confirmed differences in protein consumption between the LPI and HPI groups. We also evaluated body composition (bioimpedance), muscle strength, and hematochemical indices.
RESULTS:
LPI and HPI groups were homogeneous for age (72 [68-74] and 71 [68-74] y, respectively), fat-free mass index (18.4 [17-19.4] and 18.2 [17-19.1] kg/m2), body fat (18.3% [12.3-20.7%] and 16.6% [13.6-21.2%]), and glomerular filtration rate (57.7 [53.8-64.9] and 62.7 [56.1-69.3] mL/min/1.73 m2). The HPI group showed greater leg and trunk muscle strength (N) compared with the LPI group (left leg extension, 339 [238-369] versus 454 [273-561], respectively, P < 0.05; right leg extension, 319 [249-417] versus 432 [334-635], P 64 0.05; trunk extension, 435 [370-467] versus 464 [390-568], P 64 0.05).
CONCLUSIONS:
Higher protein intake in elite senior athletes is associated with a greater muscle strength
A multicenter randomized phase 4 trial comparing sodium picosulphate plus magnesium citrate vs. polyethylene glycol plus ascorbic acid for bowel preparation before colonoscopy. The PRECOL trial
Background: Adequate bowel preparation before colonoscopy is crucial.
Unfortunately, 25% of colonoscopies have inadequate bowel cleansing. From
a patient perspective, bowel preparation is the main obstacle to colonoscopy.
Several low-volume bowel preparations have been formulated to provide
more tolerable purgative solutions without loss of efficacy.
Objectives: Investigate efficacy, safety, and tolerability of Sodium
Picosulphate plus Magnesium Citrate (SPMC) vs. Polyethylene Glycol
plus Ascorbic Acid (PEG-ASC) solutions in patients undergoing
diagnostic colonoscopy.
Materials and methods: In this phase 4, randomized, multicenter, twoarm trial, adult outpatients received either SPMC or PEG-ASC for bowel
preparation before colonoscopy. The primary aims were quality of bowel
cleansing (primary endpoint scored according to Boston Bowel Preparation
Scale) and patient acceptance (measured with six visual analogue scales). The
study was open for treatment assignment and blinded for primary endpoint
assessment. This was done independently with videotaped colonoscopies
reviewed by two endoscopists unaware of study arms. A sample size of 525
patients was calculated to recognize a difference of 10% in the proportion of
successes between the arms with a two-sided alpha error of 0.05 and 90%
statistical power.
Results: Overall 550 subjects (279 assigned to PEG-ASC and 271 assigned
to SPMC) represented the analysis population. There was no statistically
significant difference in success rate according to BBPS: 94.4% with
PEG-ASC and 95.7% with SPMC (P = 0.49). Acceptance and willing to
repeat colonoscopy were significantly better for SPMC with all the scales.
Compliance was less than full in 6.6 and 9.9% of cases with PEG-ASC and
SPMC, respectively (P = 0.17). Nausea and meteorism were significantly more
bothersome with PEG-ASC than SPMC. There were no serious adverse events
in either group.
Conclusion: SPMC and PEG-ASC are not different in terms of efficacy, but
SPMC is better tolerated than PEG-ASC. SPMC could be an alternative to lowvolume PEG based purgative solutions for bowel preparation
Covid-19 and the role of smoking: the protocol of the multicentric prospective study COSMO-IT (COvid19 and SMOking in ITaly).
The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for -COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality
Optimizing the “Time to pregnancy” in women with multiple sclerosis: the OPTIMUS Delphi survey
BackgroundThe debate on how to manage women affected by multiple sclerosis (MS) during reproductive age is still open, as is the issue of fertility in such patients. Main issue regard the identification of the optimal window for pregnancy and how to deal with medical therapy before and during conception. The aim of this Delphi consensus was to collect the opinions of a multidisciplinary group, involving reproductive medicine specialists and neurologists with experience in the management of multiple sclerosis women with reproductive desire.MethodsFour experts plus scientific coordinators developed a questionnaire distributed online to 10 neurologists and later discussed the responses and amended a list of statements. The statements were then distributed via an online survey to 23 neurologists (comprising the first 10), who voted on their level of agreement/disagreement with each statement. Consensus was achieved if agreement or disagreement with a statement exceeded 66%.ResultsTwenty-one statements reached consensus after two rounds of voting, leading to the following main recommendations: (1) Fertility evaluation should be suggested to wMS, in case of the need to shorten time to pregnancy and before treatment switch in women on DMTs contraindicated in pregnancy, particularly in case of highly active disease and age > 35 years. (2) ART should not be discouraged in wMS, but the use of DMTs until pregnancy confirmation should be suggested; ART may be considered in order to reduce time to pregnancy in MS women with a reduced ovarian reserve and/or age > 35 years, but in case of an expected poor ART prognosis and the need for more than one ART cycle, a switch to a high-efficacy DMD before ART should be offered. (3) Oocyte cryopreservation may be considered in women with reduced ovarian reserve, with unpredictable time to complete diagnostic workup and achieve disease control; a risk/cost–benefit analysis must be performed in women >35 years, considering the diminished ovarian reserve.ConclusionThis consensus will help MS neurologists to support family planning in wMS, respecting MS therapeutic needs while also taking into account the safety and impact of advancing age on fertility
Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy
IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical
attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced
colorectal cancers at diagnosis.
OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced
oncologic stage and change in clinical presentation for patients with colorectal cancer.
DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all
17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December
31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period),
in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was
30 days from surgery.
EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery,
palliative procedures, and atypical or segmental resections.
MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer
at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as
cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding,
lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery,
and palliative surgery. The independent association between the pandemic period and the outcomes
was assessed using multivariate random-effects logistic regression, with hospital as the cluster
variable.
RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years)
underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142
(56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was
significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR],
1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic
lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03).
CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the
SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients
undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for
these patients
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