High-resolution imaging of basin-bounding normal faults in the Southern Apennines seismic belt (Italy) by traveltime and frequency-domain full-waveform tomography

We apply a two-step seismic imaging flow by combined first-arrival traveltime and frequency-domain waveform tomographies to dense wide aperture data collected in the Val d’Agri basin (southern Italy). A large wavelength Vp model determined by first-arrival traveltime tomography is used as a starting model for waveform tomography. The multiscale waveform tomography consisting of successive inversion of increasing frequencies allows to progressively reconstruct the short wavelengths of the velocity model, providing valuable information on the Quaternary basin and on range-bounding normal-faulting systems

New insights into crustal structure, Cenozoic magmatism, CO2 degassing and seismogenesis in the southern Apennines and Irpinia region from local earthquake tomography

We present high-resolution Vp and Vp/Vs models of the southern Apennines (Italy) computed using local earthquakes recorded from 2006 to 2011 with a graded inversion scheme that progressively resolves the crustal structure, from the large scale of the Apennines belt to the local scale of the normal-fault system. High-Vp bodies defined in the upper and mid crust under the external Apennines are interpreted as extensive mafic intrusions revealing anorogenic magmatism episodes that broadened on the Adriatic domain during Paleogene. Under the mountain belt, a low-Vp region, annular to the Neapolitan volcanic district, indicates the existence of a thermal/fluid anomaly in the mid crust, coinciding with a shallow Moho and diffuse degassing of deeply derived CO2. In the belt axial zone, low Vp/Vs gas-pressurized rock volumes under the Apulian carbonates correlate to high heat flow, strong CO2-dominated gas emissions of mantle origin and shallow carbonate reservoirs with pressurized CO2 gas caps. We hypothesize that the pressurized fluid volumes located at the base of the active fault system influence the rupture process of large normal-faulting earthquakes, like the 1980 Mw6.9 Irpinia event, and that major asperities are confined within the high-Vp Apulian carbonates. This study confirms once more that pre-existing structures of the Pliocene Apulian belt controlled the rupture propagation during the Irpinia earthquake. The main shock broke a 30 km long, NE-dipping seismogenic structure, whereas delayed ruptures (both the 20 s and the 40 s sub-events) developed on antithetic faults, reactivating thrust faults located at the eastern edge of the Apulian belt

DMAIC Approach for the Reduction of Healthcare-Associated Infections in the Neonatal Intensive Care Unit of the University Hospital of Naples ‘Federico II’

Improvements in the obstetrical and neonatal management have allowed children to survive. These enhancements have showed, anyway, a general increased incidence of healthcare-associated infections, one of the most influent causes of morbidity and mortality in neonatal intensive care units. The aim of this paper is to suggest corrective measures to reduce sentinel germs colonization and identify the relationships between bacteria colonization with the number of procedures and the length of hospital stay. The Lean Six Sigma methodology was used to tackle this issue using a tailored Define, Measure, Analyze, Improve, and Control problem-solving strategy. An increased number of procedures and an extended length of hospital stay demonstrated a statistically significant influence on newborns’ possibility to be infected by sentinel germs. These findings could guide the clinical staff to improve the management of neonates in neonatal intensive care units reducing the number of infected patients, their length of hospital stay and the costs for the hospital. © 2021, Springer Nature Switzerland AG

From 3D to 4D passive seismic tomography: The sub-surface structure imaging of the Val d’Agri region, southern Italy

Local earthquakes (passive seismic) tomography (LET) is a well established tool for the imaging of the sub-surface structure. Alternative to active seismics, the main advantages of using natural sources are the better sounding in deeper portions of the upper crust, the relatively low cost, and the direct availability of S-waves. The main drawback is the achievable model resolution, which is limited by the density of the seismic network and the distribution of elastic sources, rather than the elastic wave frequency. Recently, 4D variations (in space and time) of velocity anomalies have been recognized in active volcanoes (Patanè et al., 2006) and normal faulting systems and ascribed to the medium response to transient geological processes, like dyke intrusions or fluid pressure increase on fault planes. In this paper we show how LET contributes to the imaging of the upper crust in a very attractive region like the Val d’Agri in southern Italy, which hosts both significant oil fields and seismogenic structures. We show that LET allows to improve the definition of the crust structure, at depths larger than those sampled by conventional seismic profiles, and detect the space-time dependency of elastic properties in response to local variations of fluid pressur

An Augmented Reality-Based Solution for Monitoring Patients Vitals in Surgical Procedures

In this work, an augmented reality (AR) system is proposed to monitor in real time the patient's vital parameters during surgical procedures. This system is characterised metrologically in terms of transmission error rates and latency. These specifications are relevant for ensuring real-time response. The proposed system automatically collects data from the equipment in the operating room (OR), and displays them in AR. The system was designed, implemented and validated through experimental tests carried out using a set of Epson Moverio BT-350 AR glasses to monitor the output of a respiratory ventilator and a patient monitor in the OR

Computing the absorption and emission spectra of 5-methylcytidine in different solvents: a test-case for different solvation models

International audience; The optical spectra of 5-methylcytidine in three different solvents (tetrahydrofuran, acetonitrile, and water) is measured, showing that both the absorption and the emission maximum in water are significantly blue-shifted (0.08 eV). The absorption spectra are simulated based on CAM-B3LYP/TD-DFT calculations but including solvent effects with three different approaches: (i) a hybrid implicit/explicit full quantum mechanical approach, (ii) a mixed QM/MM static approach, and (iii) a QM/MM method exploiting the structures issuing from molecular dynamics classical simulations. Ab-initio Molecular dynamics simulations based on CAM-B3LYP functionals have also been performed. The adopted approaches all reproduce the main features of the experimental spectra, giving insights on the chemical−physical effects responsible for the solvent shifts in the spectra of 5-methylcytidine and providing the basis for discussing advantages and limitations of the adopted solvation models

A Fuzzy Inference System for the Assessment of Indoor Air Quality in an Operating Room to Prevent Surgical Site Infection

Indoor air quality in hospital operating rooms is of great concern for the prevention of surgical site infections (SSI). A wide range of relevant medical and engineering literature has shown that the reduction in air contamination can be achieved by introducing a more efficient set of controls of HVAC systems and exploiting alarms and monitoring systems that allow having a clear report of the internal air status level. In this paper, an operating room air quality monitoring system based on a fuzzy decision support system has been proposed in order to help hospital staff responsible to guarantee a safe environment. The goal of the work is to reduce the airborne contamination in order to optimize the surgical environment, thus preventing the occurrence of SSI and reducing the related mortality rate. The advantage of FIS is that the evaluation of the air quality is based on easy-to-find input data established on the best combination of parameters and level of alert. Compared to other literature works, the proposed approach based on the FIS has been designed to take into account also the movement of clinicians in the operating room in order to monitor unauthorized paths. The test of the proposed strategy has been executed by exploiting data collected by ad-hoc sensors placed inside a real operating block during the experimental activities of the “Bacterial Infections Post Surgery” Project (BIPS). Results show that the system is capable to return risk values with extreme precision

Management of the Diabetic Patient in the Diagnostic Care Pathway

Diabetes is a complex pathology both for the affected patients and for the medical specialists who follow them. Furthermore, since diabetes is a pathology with a high prevalence and incidence, it is essential to intervene effectively in therapeutic actions through the application of common guidelines. Therefore, in order to improve the management of the diabetic patient, the aim of the work is to define a Diagnostic Therapeutic Assistance Pathway (PDTA). A questionnaire-based approach is adopted for data collection from 136 patients at the Clinical Dermatology Unit of the University Hospital “Federico II”. In most cases (64%) the diagnosis was made by the General Practitioner, 15% of patients obtained the diagnosis at the ASL and 12% at the Polyclinic of Naples AOU “Federico II” and the remaining part from the diabetologist specialist. The second access is generally carried out at the “Federico II” AOU (66%), followed by the ASL (17%), by a doctor specialized in diabetology (12%) while no patient has turned to the General Practitioner for the treatment of diabetes. The final visit is carried out at the “Federico II” AOU in almost cases. The data obtained follow the Italian guidelines: the patients get the diagnosis from the Family Doctor and then they are addressed either to ASL or to diabetologists specialists. For the subsequent visits, most of them prefer to turn to the “Federico II” AOU, especially when they have complications associated with the diseases as they are followed in a more careful and satisfying manner

Regression Models to Study the Total LOS Related to Valvuloplasty

Background: Valvular heart diseases are diseases that affect the valves by altering the normal circulation of blood within the heart. In recent years, the use of valvuloplasty has become recurrent due to the increase in calcific valve disease, which usually occurs in the elderly, and mitral valve regurgitation. For this reason, it is critical to be able to best manage the patient undergoing this surgery. To accomplish this, the length of stay (LOS) is used as a quality indicator. Methods: A multiple linear regression model and four other regression algorithms were used to study the total LOS function of a set of independent variables related to the clinical and demographic characteristics of patients. The study was conducted at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona” of Salerno (Italy) in the years 2010–2020. Results: Overall, the MLR model proved to be the best, with an R2 value of 0.720. Among the independent variables, age, pre-operative LOS, congestive heart failure, and peripheral vascular disease were those that mainly influenced the output value. Conclusions: LOS proves, once again, to be a strategic indicator for hospital resource management, and simple linear regression models have shown excellent results to analyze it

Comparing Two Approaches for Thyroidectomy: A Health Technology Assessment through DMAIC Cycle

Total thyroidectomy is very common in endocrine surgery and the haemostasis can be obtained in different ways across surgery; recently, some devices have been developed to support this surgical phase. In this paper, a health technology assessment is conducted through the define, measure, analyse, improve, and control cycle of the Six Sigma methodology to compare traditional total thyroidectomy with the surgical operation performed through a new device in an overall population of 104 patients. Length of hospital stay, drain output, and time for surgery were considered the critical to qualities in order to compare the surgical approaches which can be considered equal regarding the organizational, ethical, and security impact. Statistical tests (Kolmogorov–Smirnov, t test, ANOVA, Mann–Whitney, and Kruskal–Wallis tests) and visual management diagrams were employed to compare the approaches, but no statistically significant difference was found between them. Considering these results, this study shows that the introduction of the device to perform total thyroidectomy does not guarantee appreciable clinical advantages. A cost analysis to quantify the economic impact of the device into the practice could be a future development. Healthy policy leaders and clinicians who are requested to make decisions regarding the supply of biomedical technologies could benefit from this research