Quality of life of COVID-19 critically ill survivors after ICU discharge : 90 days follow-up

Purpose The onset of the coronavirus disease 19 (COVID-19) pandemic in Italy induced a dramatic increase in the need for intensive care unit (ICU) beds for a large proportion of patients affected by COVID-19-related acute respiratory distress syndrome (ARDS). The aim of the present study was to describe the health-related quality of life (HRQoL) at 90 days after ICU discharge in a cohort of COVID-19 patients undergoing invasive mechanical ventilation and to compare it with an age and sex-matched sample from the general Italian and Finnish populations. Moreover, the possible associations between clinical, demographic, social factors, and HRQoL were investigated. Methods COVID-19 ARDS survivors from 16 participating ICUs were followed up until 90 days after ICU discharge and the HRQoL was evaluated with the 15D instrument. A parallel cohort of age and sex-matched Italian population from the same geographic areas was interviewed and a third group of matched Finnish population was extracted from the Finnish 2011 National Health survey. A linear regression analysis was performed to evaluate potential associations between the evaluated factors and HRQoL. Results 205 patients answered to the questionnaire. HRQoL of the COVID-19 ARDS patients was significantly lower than the matched populations in both physical and mental dimensions. Age, sex, number of comorbidities, ARDS class, duration of invasive mechanical ventilation, and occupational status were found to be significant determinants of the 90 days HRQoL. Clinical severity at ICU admission was poorly correlated to HRQoL. Conclusion COVID-19-related ARDS survivors at 90 days after ICU discharge present a significant reduction both on physical and psychological dimensions of HRQoL measured with the 15D instrument. Trial Registration: NCT04411459.Peer reviewe

Resuscitative endovascular balloon occlusion of the aorta in out-of-hospital cardiac arrest - A Delphi consensus study for uniform data collection.

BACKGROUND Evolving research on resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct treatment for out-of-hospital cardiac arrest mandates uniform recording and reporting of data. A consensus on which variables need to be collected may enable comparing and merging data from different studies. We aimed to establish a standard set of variables to be collected and reported in future REBOA studies in out-of-hospital cardiac arrest. METHODS A four-round stepwise Delphi consensus process first asked experts to propose without restraint variables for future REBOA research in out-of-hospital cardiac arrest. The experts then reviewed the variables on a 5-point Likert scale and ≥75% agreement was defined as consensus. First authors of published papers on REBOA in out-of-hospital cardiac arrest over the last five years were invited to join the expert panel. RESULTS The data were collected between May 2022 and December 2022. A total of 28 experts out of 34 primarily invited completed the Delphi process, which developed a set of 31 variables that might be considered as a supplement to the Utstein style reporting of research in out-of-hospital cardiac arrest. CONCLUSIONS This Delphi consensus process suggested 31 variables that enable future uniform reporting of REBOA in out-of-hospital cardiac arrest

QCD corrections to the production of a heavy quark pair plus a hard photon in e+e−e^+ e^- annihilation

We present complete results for the $O(\alpha_s)$ corrections to the production of a heavy quark pair plus a hard photon, in $e^+ e^-$ annihilation, including both photon and $Z$ intermediate states. Virtual corrections are calculated analytically in $4 - 2 \epsilon$ dimensions, together with the soft approximation to the real emission diagrams. After cancellation of infrared divergences, real and virtual contributions are combined numerically to obtain the cross section for the production of two heavy quark jets plus a hard photon in next-to-leading order. The resulting fully differential cross section can be used to construct arbitrary distributions with the desired experimental cuts.Comment: 12 pages, 5 figures, LaTe

I.S.Mu.L.T. Achilles Tendon Ruptures Guidelines

This work provides easily accessible guidelines for the diagnosis, treatment and rehabilitation of Achilles tendon ruptures. These guidelines could be considered as recommendations for good clinical practice developed through a process of systematic review of the literature and expert opinion, to improve the quality of care for the individual patient and rationalize the use of resources. This work is divided into two sessions: 1) questions about hot topics; 2) answers to the questions following Evidence Based Medicine principles. Despite the frequency of the pathology andthe high level of satisfaction achieved in treatment of Achilles tendon ruptures, a global consensus is lacking. In fact, there is not a uniform treatment and rehabilitation protocol used for Achilles tendon ruptures

Externalities and the nucleolus

In most economic applications, externalities prevail: the worth of a coalition depends on how the other players are organized. We show that there is a unique natural way of extending the nucleolus from (coalitional) games without externalities to games with externalities. This is in contrast to the Shapley value and the core for which many different extensions have been proposed

ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

The FASER Detector

FASER, the ForwArd Search ExpeRiment, is an experiment dedicated to searching for light, extremely weakly-interacting particles at CERN's Large Hadron Collider (LHC). Such particles may be produced in the very forward direction of the LHC's high-energy collisions and then decay to visible particles inside the FASER detector, which is placed 480 m downstream of the ATLAS interaction point, aligned with the beam collisions axis. FASER also includes a sub-detector, FASER$\nu$, designed to detect neutrinos produced in the LHC collisions and to study their properties. In this paper, each component of the FASER detector is described in detail, as well as the installation of the experiment system and its commissioning using cosmic-rays collected in September 2021 and during the LHC pilot beam test carried out in October 2021. FASER will start taking LHC collision data in 2022, and will run throughout LHC Run 3

Effetti del diametro sul profilo aromatico di salami fermentati impiegando due diverse colture starter

Molti fattori contribuiscono alla formazione delle caratteristiche "tipiche" dei salami e tra questi l’impiego di colture starter e il diametro del budello svolgono un ruolo rilevante. Infatti il tipo di microrganismi presenti e la dimensione del prodotto influenzano importanti eventi che avvengono durante la maturazione (calo peso, attività proteoliche e lipolitiche) e che portano alla formazione di composti volatili. Recentemente, è stata studiata l’influenza del diametro sulle caratteristiche chimico-fisiche e aromatiche di salami a fine maturazione ma questi prodotti provenivano da materie prime differenti ed erano prodotti attraverso processi diversi. A seguito di questo lavoro preliminare, è stato effettuato un lavoro più ampio mirato alla valutazione dell'effetto del diametro e di due diverse colture starter sulla popolazione microbica e sulle caratteristiche chimico-fisiche in salami prodotti industrialmente. I prodotti sono stati periodicamente analizzati e nel corso del mio elaborato abbiamo studiato l’impatto delle variabili considerate (diametro e starter) sul profilo in molecole volatili e sulle caratteristiche organolettiche dei salami ottenuti. Dai risultati è emerso che l’aroma si differenziava principalmente in relazione al diametro e ciò può essere attribuito sia alle diverse tempistiche richieste per arrivare al prodotto finito, sia alla minore disponibilità di ossigeno nei campioni a diametro maggiore. L’influenza dello starter impiegato era invece inferiore. Questo potrebbe essere dovuto al fatto che per tutti i campioni sono state adottate condizioni industriali di fermentazione e maturazione non specifiche e quindi non adatte ad esaltare le peculiarità fisiologiche dei ceppi impiegati. Ciò sottolinea la necessità di ulteriori studi per ottimizzare le prestazioni degli starter in relazione al processo al fine di massimizzare le peculiarità dei prodotti, difendendone la differenziazione come un valore, oltre che economico, anche culturale

Sacred places, territorial economy and cultural identity in northern Epirus (Chaonia)

The only sacred place in Chaonia whose material, spatial, and cultic features are sufficiently known is the Sanctuary of Asklepios in Butrint. However, only its middle-to-late Hellenistic and Roman stages have been extensively investigated, focusing on the role of the Asklepieion as a political and self-identity point of reference for the koinon of the Prasaiboi first, and then on the modifications of the complex from the foundation of the Augustan colony onwards. The origins of the cult and the earliest stages of the sanctuary, instead, are much more uncertain. Their traditional dating to the late 4th or early 3rd century BC relied mostly on the alleged chronology of the ceramics found by L. M. Ugolini, in 1929, in a votive deposit and to the role of Corcyra in the transmission of the cult during the late Classical early Hellenistic period. If this latter relationship is certainly plausible, the paper focuses instead on this deposit, in order to give the most accurate dating of its earliest phase and try to understand its link to the origin of the worship. The new dating to the 2nd century B.C. and no more to the early Hellenistic period (late 4th-3rd century B.C.), then provide new food for thoughts on the earliest phases of both the cult and the sanctuary. The main contribute of the paper is then to have definitely isolated these materials from the assumed dating of the early phase of the sanctuary. This dating is based on the dedicatory inscription of the theatre (dated by P.Cabanes between 232 and 168 B.C.) and to the assumption that, for its irregular arrangement, the theatre would be later to the sacellum. In the absence of stratigraphic data, the idea of an early Hellenistic phase of the sacellum has traditionally been linked to the supposed contemporary chronology of the votive deposit as well has to the role of Corcyra. These new data then show that the reading of the sanctuary and in particular its early phases are more complex and certainly need further investigations. Moreover, these materials have not only been study by a chronological point of view, but their reassessment as lead to important considerations about their role in the specific worship of Asklepios, as well as about the impact of the presence of the sanctuary in the regional material culture, stressing the differences between objects from this sacred context and those for other urban regional contexts, suggesting the well known phenomenon of a production dedicated to the sanctuaries