A case-crossover study of sleep, fatigue, and other transient exposures at workplace and the risk of non-fatal occupational injuries among the employees of an Italian academic hospital

Objectives: Transient exposure with acute effect has been shown to affect the risk of occupational injuries in various industrial settings and at the healthcare workplace. The objective of this study has been to identify transient exposures related to occupational injury risk in an Italian teaching hospital. Material and Methods: A case-crossover study was conducted among the employees of the University Hospital of Udine who reported an occupational injury, commuting accident, or incident involving biological risk in a 15-month period in the years 2013 and 2014. The matched-pair interval approach was used to assess the role of acute sleep deprivation whereas the usual frequency approach was used for other 13 transient exposures. Results: Sleep hours were not associated with the risk of injuries whereas a significant risk increase was associated with fatigue, rush, distraction, emergency situations, teaching to or being taught by someone, non-compliant patients, bloody operative/work field, excess noise, complex procedures, and anger. Conclusions: We identified transient exposures that increased the risk of occupational injuries in an Italian teaching hospital, providing indications for interventions to increase workers' safety at the healthcare workplace. Int J Occup Med Environ Health 2016;29(6):1001–100

an ecological study on the association between characteristics of hospital units and the risk of occupational injuries and adverse events on the example of an italian teaching hospital

OBJECTIVES: We explored the association of workplace characteristics with occupational injuries and adverse events in an Italian teaching hospital. MATERIAL AND METHODS: This ecological study was conducted using data routinely collected in the University Hospital of Udine, Northeastern Italy. Poisson regression models were used to investigate, at the hospital unit level, the association between 5 outcomes, including: occupational injuries, patient falls, medication errors, other adverse events and near-misses, and various characteristics of the units. RESULTS: The proportion of female workers in a unit, the average number of sick-leave days and of overtime hours, the number of medical examinations requested by employees, and being a surgical unit were significantly associated with some of the outcomes. CONCLUSIONS: Despite ecological nature of the study, which does not allow for inferences to be drawn at the individual level, the results of our study provide useful clues to support strategies and interventions directed towards healthier work environments and better patient care in hospitals. Language: e

Raffaels Madonna dell'Impannata

Die vorliegende Abschlussarbeit befasst sich mit dem Gemälde Madonna dell’Impannata von Raffael. Der Fokus liegt auf dem Entstehungsprozess des Werkes, der sich als sehr komplex erweist. Die Arbeit hat das Ziel, eine Entstehungsdatierung vorzuschlagen. Nach einer kurzen Einführung in die Geschichte des Werkes und dessen Rezeption richtet sich der Fokus auf die Analyse der Vorzeichnungen der Madonna dell’Impannata, welche mit Skizzen für parallele Aufträge verglichen werden. Dananch wird die malerische Entwicklung des Themas „Madonna mit Kind“ im Oeuvre Raffaels tiefgehend analysiert. Anschließend werden Werke analysiert, die zur gleichen Zeit wie die Madonna dell’Impannata entstanden sind, um stilistische Ähnlichkeiten festzustellen. Da die Ikonografie des Gemäldes einen weiteren Schwerpunkt bildet, wird auch dieser Aspekt untersucht, zusammen mit der Figur des Auftraggebers Bindo Altoviti, der wahrscheinlich ebenso eine wichtige Rolle für den Entstehungsprozess des Werkes und dessen Ikonografie gespielt hat.This MA thesis deals with the painting Madonna dell'Impannata by Raphael. The focus is on the creation process of the work, which turns out to be a very complex one. The aim of the thesis is to propose a date of origin. After a brief introduction to the history of the work and its reception, the emphasis is on the analysis of the preparatory drawings of the Madonna dell'Impannata, which are compared with preparatory drawings for parallel commissions. In the following, the motif development of the theme "Madonna with Child" in Raphael's oeuvre will be analysed in depth. Subsequently, works created at the same time as the Madonna dell'Impannata will be analysed to identify stylistic similarities. The iconography of the painting is a further focal point, so this aspect will also be examined, together with the figure of Bindo Altoviti. The patron of the painting played probably an equally important role in the creation process of the work and its iconography

Risposte delle papille gustative a stimoli sensoriali multipli: analisi mediante la metodica del calcium imaging.

RIASSUNTO Il senso del gusto origina dall’interazione con le cellule sensoriali gustative, presenti per lo più sulla superficie della lingua, ma anche nel palato, nella faringe e nella laringe, di molecole, presenti nel cibo o nelle bevande. Insieme all’olfatto, il gusto gioca un ruolo primario nella regolazione dell’introduzione del cibo. Le varie centinaia di sapori che è possibile percepire sono generate da stimoli chimici, che a livello gustativo si possono raggruppare in base a sei gusti principali: DOLCE, SALATO, ACIDO, AMARO, UMAMI (GUSTO DEL GLUTAMMATO), GUSTO DEL GRASSO (Lindemann, 1996). Lo scopo di questa tesi è stato quello di valutare la risposta delle cellule gustative a stimoli complessi, rappresentati dalla miscela di più molecole chimiche, che includevano un dolcificante sintetico, il preparato commerciale myDietor. In particolare sono state analizzate le risposte indotte in seguito alla somministrazione a cellule gustative presenti nelle gemme gustative intatte, identificate in sezioni di lingua di topo, delle seguenti molecole: myDietor, myDietor+Fruttosio, myDietor+Na-glutammato. L’approccio utilizzato in questa tesi, rispetto a quello convenzionale basato sull’analisi delle risposte evocate dall’applicazione di una singola molecola, può risultare utile per valutare la risposta delle gemme gustative intatte a stimoli più vicini a quelli a cui sono realmente esposte nella vita reale e in tal modo ampliare le conoscenze sulle complesse relazioni che intervengono tra cellule gustative e stimoli organici. La valutazione delle risposte agli stimoli gustativi, condotta mediante misure delle variazioni del Ca2+ intracellulare, un elemento chiave del sistema di trasduzione gustativa, è resa complessa dai suoi valori compresi nell’ambito nano-micromolare. Lo studio è stato pertanto condotto mediante metodiche di time-lapse fluorescence imaging, basate sull’uso del fluorocromo (Fluo-4) nella versione acetometossiestere perché capace di penetrare la membrana plasmatica e diventare fluorescente dopo rimozione del gruppo acetometossi da parte delle esterasi cellulari. Per la rilevazione della fluorescenza è stato utilizzato un microscopio ottico invertito (Leica DMI 4000B) e il software Leica Application Suite Advanced Fluorescence (Leica Microsystems LAS AF). Lo studio ha permesso di: 1) mettere a punto una metodologia da utilizzare per le misurazioni delle variazioni di fluorescenza in risposta alla variazione del calcio intracellulare in cellule gustative; 2) individuare un approccio alternativo per risolvere il problema dell’autofluorescenza delle papille gustative di tipo filiformi; 3) valutare le risposte a stimoli complessi. I risultati ottenuti mostrano come la risposta delle cellule gustative alla saccarina, quando presentata in associazione ad altri stimoli gustativi, non sia interpretabile sulla base dei modelli presenti in letteratura, elaborati a partire dalle risposte alla saccarina singola. In particolare vengono rivelate significative interazioni tra stimoli in grado di agire su siti diversi dello stesso recettore, alterando completamente la risposta alla saccarina. Capire il meccanismo dell’interazione della saccarina con altre molecole gustative ha importanti risvolti, considerando il suo largo utilizzo non solo nell’industria alimentare, ma anche in ambito farmaceutico per migliorare la palatabilità di formulati da assumere per via orale. Questi studi potranno inoltre contribuire ad una più profonda comprensione dei meccanismi fisiologici del sistema gustativo e, considerato il ruolo dei recettori gustativi in sede gastro-intestinale, anche in meccanismi di regolazione di tipo endocrina evocati dai nutrienti derivati dalla digestione degli alimenti

Bioengineered in vitro models of human tissues and drug design and development.

Bioengineered in vitro models of human tissues and drug design and development This work is developed around two macro-themes, with a common purpose: the development of new drugs to fight inflammatory states that affect the retina and cardiovascular system. The dysregulation of metalloproteinases enzymatic activity is a major feature in many severe pathologies. The creation of an in vitro model of the sub-retinal space, the study of the metalloproteinase families’ regulation and their proteolytic activity, can provide key tools and insights for the design of suitable inhibitors of metalloproteinases, capable of counteracting the dysregulation of these enzymes involved in the progression of inflammatory diseases. The two topics pursued are: 1. Fabrication and characterization of a biotechnological Bruch’s membrane(BM) for an in vitro model of the Human Outer Blood-Retinal Barrier (oBRB). The aim of this work is to fabricate a biotechnological in vitro model BM to test the permeability and safety of novel drug candidates and to study their impact on retinal cells in physiological and AMD conditions. The results have proven that electrospun mats are capable to reproduce the in vivo properties of BM, indicating that these membranes can be used as a substrate for retinal cells cultivation. 2. Investigation of versicanase activity of ADAMTS (A Disintegrin And Metalloproteinase with Thrombospondin motifs) proteases. This project aimed to set-up and optimize a western blot-based versicanase assay that can be used to screen novel glycosylated compounds identifying ADAMTS variant-specific inhibitors. The study of new selective exosite ADAMTS-4 and -5 inhibitors showed good preliminary results, encouraging further studies on glycoconjugate compounds, as potential therapeutic agents for inflammatory processes

NEUROHORMONES IN MITRAL STENOSIS BEFORE AND AFTER PERCUTANEOUS BALLOON MITRAL VALVOTOMY

BACKGROUND AND AIM OF THE STUDY: The hormonal response to percutaneous balloon mitral valvotomy (PBMV) has been described in patients in sinus rhythm (SR) and with atrial fibrillation (AF). The study aim was to evaluate the effect of hemodynamic parameters and PBMV on atrial natriuretic factor (ANF) secretion and plasma renin activity (PRA) in mitral stenosis in SR and AF. METHODS: Thirty-one patients (26 females, five males; mean age 50.5+/-14 years) with pure rheumatic mitral stenosis underwent PBMV. Fourteen patients had AF, and 17 were in SR. PRA and ANF were measured 24 h before, and at 30 and 60 min, 24 h and one month after PBMV, after resting in a supine position for > or =2 h. Digitalis and diuretics were withdrawn 48 h before sampling; neither had patients received ACE inhibitors or beta-blockers during the previous month. RESULTS: PBMV was successful in all cases, without complication. Mitral valve area was increased and wedge pressure decreased in both groups after PBMV. In AF patients, neither PRA nor ANF were significantly affected before and after PBMV; in SR patients, ANF was decreased and PRA increased significantly, notably 24 h after PBMV. The cardiac index was increased in both groups, but was distinctly lower in AF patients both before and after PBMV. CONCLUSION: Despite similar hemodynamic results, reversal of the hormonal pattern after PBMV occurred only in SR patients, most likely because in AF patients a low cardiac index elicits a hormonal response similar to heart failure. This abnormal hormonal pattern may limit functional recovery after PBMV; hence, PBMV is best attempted while patients are still in SR

Age-related macular degeneration: Current knowledge of zinc metalloproteinases involvement

Background: Advanced age-related macular degeneration (AMD) is the leading cause of blindness in the elderly with limited therapeutic options. The disease is characterized by photoreceptor loss in the macula and reduced retinal pigment epithelium (RPE) function, associated with matrix degradation, cell proliferation, neovascularization and inflammation. Matrix metalloproteinases (MMPs), a disintegrin and metalloproteinases (ADAMs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTSs) play a critical role in the physiology of extracellular matrix (ECM) turnover and, in turn, in ECM pathologies, such as AMD. A balance between the activities of MMPs and Tissue inhibitors of metalloproteinase (TIMPs) is crucial for the integrity of the ECM components; indeed, a dysregulation in the ratio of these factors produces profound changes in the ECM, including thickening and deposit formation, which eventually might lead to AMD development. Objective: This article reviews the relevance and impact of zinc metalloproteinases on the development of AMD and their roles as biomarkers and/or therapeutic targets. We illustrate some studies on several inhibitors of MMPs currently used to dissect physiological properties of MMPs. Moreover, all molecules or technologies used to control MMP and ADAM activity in AMD are analyzed. Conclusion: This study underlines the changes in the activity of MMPs expressed by RPE cells, highlights the functions of already used MMP inhibitors and consequently suggests their application as therapeutic agents for the treatment of AMD

Digital Modernism Heritage Lexicon

The book investigates the theme of Modernism (1920-1960 and its epigones) as an integral part of tangible and intangible cultural heritage which contains the result of a whole range of disciplines whose aim is to identify, document and preserve the memory of the past and the value of the future. Including several chapters, it contains research results relating to cultural heritage, more specifically Modernism, and current digital technologies. This makes it possible to record and evaluate the changes that both undergo: the first one, from a material point of view, the second one from the research point of view, which integrates the traditional approach with an innovative one. The purpose of the publication is to show the most recent studies on the modernist lexicon 100 years after its birth, moving through different fields of cultural heritage: from different forms of art to architecture, from design to engineering, from literature to history, representation and restoration. The book appeals to scholars and professionals who are involved in the process of understanding, reading and comprehension the transformation that the places have undergone within the period under examination. It will certainly foster the international exchange of knowledge that characterized Modernism