BDP/formoterol MART asthma exacerbation benefit increases with blood eosinophil level

A number of studies have evaluated the effectiveness of a “Maintenance And Reliever Therapy” (MART) regimen combining in a single inhaler the rapid-acting, long-acting β2-agonist (LABA) formoterol fumarate (FF) with an inhaled corticosteroid (ICS) in asthma. Such a regimen is now established for the treatment of moderate-to-severe asthma in adolescents and adults in many guidelines. Furthermore, rescue short-acting β2-agonists (SABAs) are no longer recommended as sole therapy even for patients with mild asthma, and an ICS/FF combination used as needed is the preferred reliever therapy

Fairness in ambulance routing for post disaster management

Disaster management generally includes the post-disaster stage, which consists of the actions taken in response to the disaster damages. These actions include the employment of emergency plans and assigned resources to (i) rescue affected people immediately, (ii) deliver personnel, medical care and equipment to the disaster area, and (iii) aid to prevent the infrastructural and environmental losses. In the response phase, humanitarian logistics directly influence the efficiency of the relief operation. Ambulances routing problem is defined as employing the optimisation tools to manage the flow of ambulances for finding the best ambulance tours to transport the injured to hospitals. Researchers pointed out the importance of equity and fairness in humanitarian relief services: managing the operations of ambulances in the immediate aftermath of a disaster must be done impartially and efficiently to rescue affected people with different priority in accordance with the restrictions. Our research aim is to find the best ambulance tours to transport the patients during a disaster in relief operations while considering fairness and equity to deliver services to patients in balance. The problem is formulated as a new variant of the team orienteering problem with hierarchical objectives to address also the efficiency issue. Due to the limitation of solving the proposed model using a general-purpose solver, we propose a new hybrid algorithm based on a machine learning and neighbourhood search. Based on a new set of realistic benchmark instances, our quantitative analysis proves that our algorithm is capable to largely reduce the solution running time especially when the complexity of the problem increases. Further, a comparison between the fair solution and the system optimum solution is also provided

Doped Polysiloxane Scintillators for Thermal Neutrons Detection

Boron doped polysiloxane scintillators have been produced with different concentrations of boron and their scintillation yields have been studied as a function of the boron content under α, γ and fast and thermal neutrons irradiation. Their response has been compared with standard commercial plastic scintillators, namely EJ-212 as plastic scintillator and EJ-254 as boron doped scintillator. The produced samples exhibited a scintillation yield similar to EJ-212. The effect of boron on the energy transfer mechanism and on the polymer radiation hardness has been investigated by means of fluorescence and ion beam induced luminescence (IBIL) measurements. Detection efficiencies for thermal neutrons higher than commercial plastic scintillators have been attained with boron doped samples

Combining Process Mining and Optimization: A Scheduling Application in Healthcare

Optimizing the scheduling of operating rooms is quite a challenging task, as different aspects, some of which the medical personnel is not completely aware of, may have a strong impact on the scheduling and need to be taken into account. This work aims at addressing such a problem by proposing a framework that combines process analysis and operations research. Process mining techniques are used for analysing interventional radiology data collected from the information system of a hospital and identifying delays and lagging cases, as well as the causes of these delays. Leveraging the knowledge acquired by looking at data (e.g., the procedures that are more often delayed), an optimization model able to take into account these aspects is designed. This paper describes the preliminary results of a proof-of-concept based on 3 months real-life data. The results show that, taking into account the information discovered from data, allows for obtaining a more accurate scheduling

Radiological contrast media in the breastfeeding woman: A position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy

Objectives Breastfeeding is a well-recognised investment in the health of the mother-infant dyad. Nevertheless, many professionals still advise breastfeeding mothers to temporarily discontinue breastfeeding after contrast media imaging. Therefore, we performed this review to provide health professionals with basic knowledge and skills for appropriate use of contrast media. Methods A joint working group of the Italian Society of Radiology (SIRM), Italian Society of Paediatrics (SIP), Italian Society of Neonatology (SIN) and Task Force on Breastfeeding, Ministry of Health, Italy prepared a review of the relevant medical literature on the safety profile of contrast media for the nursing infant/child. Results Breastfeeding is safe for the nursing infant of any post-conceptional age after administration of the majority of radiological contrast media to the mother; only gadoliniumbased agents considered at high risk of nephrogenic systemic fibrosis (gadopentetate dimeglumine, gadodiamide, gadoversetamide) should be avoided in the breastfeeding woman as a precaution; there is no need to temporarily discontinue breastfeeding or to express and discard breast milk following the administration of contrast media assessed as compatible with breastfeeding