Emergências psiquiátricas: manejo de agitação psicomotora e avaliação de risco suicida

The objective of this article is to present guidelines and assessment protocols of frequently observed conditions in the context of psychiatric emergencies, namely, management of agitation and evaluation of suicide risk. The peculiarities of the interaction between psychiatric emergency and mental health services and the differential diagnosis of first-episode psychosis are briefly presented. Based on scientific evidence associated with our clinical experience, we discuss the skills and competencies needed for the management of emergencies in psychiatry, with emphasis on psychiatric interview techniques, attitudinal/ behavioral approach and pharmacological interventionsO objetivo deste artigo é a apresentação de diretrizes e protocolos de avaliação de condições frequentemente observadas em contexto de emergências psiquiátricas, a saber; manejo de agitação psicomotora e avaliação de risco suicida. As peculiaridades da interação entre serviços de emergências psiquiá- tricas e rede de saúde mental e do diagnóstico diferencial de primeiro episódio psicótico também são brevemente discutidas. Com base em evidências científicas associadas à experiência clínica dos autores, são apresentadas as habilidades e competências necessárias para o manejo de emergências em psiquiatria, com ênfase em técnicas de entrevista psiquiátrica, abordagem atitudinal/comportamental e intervenções farmacológica

Preliminary Simulation Study and Heat Integration of a Highly Intensified and Flexible Process for Bio-DME and Electricity Production

We present the preliminary process modelling study and heat integration optimization for a novel highly intensified and flexible process for the co-production of bio-DME and electricity from biomass. The process combines two “sorption-enhanced” reactors: one holds a flexible sorption enhanced gasification process whilst the other undergoes a novel sorption enhanced DME synthesis. The novel system is being developed in the framework of the H2020 EU project FLEDGED. The preliminary process simulation is based on simplified (first-principle) models of the main process units while the heat integration optimization is performed with a systematic energy targeting methodology. The DME off-gas can be used in a gas turbine or in an internal combustion engine with minor differences in efficiency while the process waste heat can be efficiently recovered by a multiple-pressure-level heat recovery steam cycle. According to the results, the plant can achieve a biomass-to-DME conversion efficiency of 31.14 % (LHV basis) and a biomass-to-electricity conversion efficiency of 19.3 %

Preliminary Simulation Study and Heat Integration of a Highly Intensified and Flexible Process for Bio-DME and Electricity Production

We present the preliminary process modelling study and heat integration optimization for a novel highly intensified and flexible process for the co-production of bio-DME and electricity from biomass. The process combines two “sorption-enhanced” reactors: one holds a flexible sorption enhanced gasification process whilst the other undergoes a novel sorption enhanced DME synthesis. The novel system is being developed in the framework of the H2020 EU project FLEDGED. The preliminary process simulation is based on simplified (first-principle) models of the main process units while the heat integration optimization is performed with a systematic energy targeting methodology. The DME off-gas can be used in a gas turbine or in an internal combustion engine with minor differences in efficiency while the process waste heat can be efficiently recovered by a multiple-pressure-level heat recovery steam cycle. According to the results, the plant can achieve a biomass-to-DME conversion efficiency of 31.14 % (LHV basis) and a biomass-to-electricity conversion efficiency of 19.3 %

Time Of Flight Detectors: From phototubes to SiPM

A sample of Silicon Photomultipliers was tested because they looked promising for future space missions: low consumption, low weight, resistance to radiation damage and insensitivity to magnetic fields. They have been studied in laboratory by means of the same characterization methods adopted to calibrate the fine mesh photomultipliers used by the Time Of Flight of the AMS-02 experiment. A detailed simulation was made to reproduce the SiPM response to the various experimental conditions. A possible counter design has been studied with front end electronics card equipped with SiPMs and Peltier cell for thermoregulation. A proper simulation based on COMSOL Multiphysics package reproduces quite well the Peltier cell nominal cooling capability

Geoarchaelogical documentation of a series of destructive events at Montegibbio Roman villa site

The Italian territory is rich in archaeological heritage, located in hilly, plain or coastal areas. Frequently, it is possible to \ufb01nd only the remains of ancient cultures, villages and sparse houses dating back many centuries. Therefore, no other documentation but the remains themselves can give information about both the existence and the events that eventually determined the end of historical sites, caused either by abandonment or destruction. The causes that can determine the abandonment or the destruction can be various, and may be due to anthropic and/or natural causes, and only in very few cases documents or pictures of these events are preserved. Anthropic causes can be diverse: wrong design and/or building schemes of the structure or of the foundation, wars etc. Natural causes could be variuos as well, and can be related to the environmental context of the site. For example, in mountainous areas the main causes can be landslides, snow avalanches, soil creep affecting the foundations. In plain areas \ufb02oods are the main process leading to the disruption of hamlets. Along the coast tsunamis are to be considered. Other natural causes could be earthquakes or climate changes. In the Emilian Apennines, near Sassuolo (Modena, Italy), a Roman villa dated from the I century B.C. to the VI century A.D. has been excavated along a gentle slope. The villa can be divided in four different buildings from successive periods. During the \ufb01rst period of life of the villa (I century B.C.-I century A.D.) a destructive event caused the abandonment of this building, whose walls and mosaic \ufb02oors have been destroyed in a odd way. Which was the cause of this destruction? An earthquake, a human error in construction or a landslide? What makes this question even more interesting is the probable relation of this event with an ancient source (Pliny the Older, Naturalis Historia II, 199) who remembers how in the Modena area a \u201cportentum terrarum\u201d (earthquake) and the collision of two mountains destroyed buildings and properties. Historically, the Sassuolo hills are identi\ufb01ed as the location of this event, where similar destructive events have been attested also later on, also in correlation with the presence of mud volcanoes nearby the area. The research is aimed at de\ufb01ning the causes that determined the destruction of the Roman villa located along the Montegibbio slope. The study was carried out with a multidisciplinary approach, integrating several experts, including archaeologists, geologists and engineers. At present, no document or picture referring the causes of the destruction have been found. Therefore, in order to draw some hypotheses on the nature of the events, the analysis of the deformation of the remains, of the foundation of the buildings and the reconstruction of the slope evolution have been carried out. The results obtained so far highlight the fact that integration of geological records and archaeological evidence is the key point to unravel the evolution of this historical site

Effects of sex hormonal levels and phases of the menstrual cycle in the processing of emotional faces

Several neuropsychiatry disorders have shown a sexual dimorphism in their incidence, symptom profile and therapeutic response. A better understanding of the impact of sex hormones in emotional processing sexual dimorphism could bring tight to this important clinical finding. Some studies have provided evidence of sex differences in the identification of emotional faces, however, results are inconsistent and such inconsistency could be related to the lack of experimental control of the sex hormone status of participants. More recently, a few studies evaluated the modulation of facial emotion recognition by the phase of the menstrual cycle and sex hormones, however, none of them directly compared these results with a group of men. We evaluated the accuracy of facial emotion recognition in 40 healthy volunteers. Eleven women were assigned to early follicular group, nine women to the ovulatory group and 10 women to luteal group, depending on the phase of menstrual cycle, and a group of 10 men were also evaluated. Estrogen, progesterone and testosterone levels were assessed. The performance of the groups in the identification of emotional faces varied depending on the emotion. Early follicular group were more accurate to perceive angry faces than all other groups. Sadness was more accurately recognized by early follicular group than by luteal group and regarding the recognition of fearful faces a trend to a better performance and a significantly higher accuracy was observed, respectively, in the early follicular group and in the ovulatory group, in comparison to men. In women, estrogen negatively correlated to the accuracy in perception of angry mate faces. Our results indicate sex hormones to be implicated in a sexual dimorphism in facial emotion recognition, and highlight the importance of estrogen specifically in the recognition of negative emotions such as sadness, anger and fear. (C) 2009 Elsevier Ltd. All rights reserved

Malnutrition and nutrition impact symptoms (NIS) in surgical patients with cancer.

Background and aimNutrition impact symptoms (NIS) are common in cancer patients and the negative impacts on nutritional status indicate the need for research, diagnosis and nutritional intervention in order to reduce the risk of malnutrition. We aimed to verify the presence of malnutrition, the need for nutritional intervention, NIS and their influence on the nutritional status of surgical patients with cancer.MethodsThis cross-sectional study was carried out in a public tertiary hospital, from March 2017 to October 2019. Nutritional status, the need for nutritional intervention and NIS were assessed through the Patient-Generated Subjective Global Assessment (PG-SGA) in the first 48 hours of hospital admission.ResultsAmong the 135 patients evaluated, 55.6% were elderly and 51.1% were male; patients had a median age of 62 years and a predominance of cancer located in the lower gastrointestinal tract (35.6%). Malnutrition and the need for nutritional intervention were identified in 60.0% and 90.4% of cases, respectively. The presence of three or more NIS was reported by 51.9% of patients. Significant differences in NIS were observed according to sex, PG-SGA classification and PG-SGA score. After logistic regression analysis, it was determined that the symptoms that increased the chances of malnutrition were anorexia, constipation, strange taste, mouth sores and others (depression, dental or financial problems).ConclusionMalnutrition, the need for nutritional intervention and the presence of three or more NIS were elevated in the patients evaluated. Malnutrition was associated with the presence of NIS, indicating the need for attention and care in antineoplastic treatment