60 research outputs found
Effects of Spatial Food Distribution on Search Behavior in Rats (Rattus norvegicus)
To analyze how search strategies are adapted according to the geometric distribution of food sources, the authors submitted rats to a search task in which they had to explore 9 food trays in an open field and avoid visiting already-depleted trays. Trays were spatially arranged in 4 independent configurations: a cross, a 3 × 3 matrix, 3 clusters of 3 trays each, and a random configuration. Rats exhibited differential search efficiency as a specific effect of the susceptibility of the configurations to being explored in a principled way: Crosses were first, matrices or clusters were in the middle, and random configurations were last. Although no exhaustive searches or highly principled patterns were observed in any of the configurations, performances improved as the sessions went by. Thus, structural affordances of the environment influence the construction not only of search strategies but also of information linked to where the reward is. © 2007 American Psychological Association
Postpartum hemorrhage management, the importance of timing.
Postpartum hemorrhage is defined as a blood loss equal to or greater than 500 ml, which can occur from 24 hours to six weeks after delivery. It is a critical event with a rapid and devastating evolution, which can quickly lead to maternal shock and death.
Many efforts have been made to create international and multisectoral guidelines that allow to face an event that represents the cause of about one quarter of maternal deaths. It is crucial to create a team able to act promptly in accordance with shared protocols. The availability of shared guidelines and protocols and the organization of periodic simulations and teamwork training are part of the fundamental initiatives that can promote the safety of perinatal care.
The purpose of this document is to give clinicians the tools to minimize the risks associated with inadequate management of hemorrhagic emergency, avoiding the risk of “too little or too late” and giving patients maximum safety
The Three Hundred Project: Mapping The Matter Distribution in Galaxy Clusters Via Deep Learning from Multiview Simulated Observations
A galaxy cluster as the most massive gravitationally-bound object in the
Universe, is dominated by Dark Matter, which unfortunately can only be
investigated through its interaction with the luminous baryons with some
simplified assumptions that introduce an un-preferred bias. In this work, we,
{\it for the first time}, propose a deep learning method based on the U-Net
architecture, to directly infer the projected total mass density map from
idealised observations of simulated galaxy clusters at multi-wavelengths. The
model is trained with a large dataset of simulated images from clusters of {\sc
The Three Hundred Project}. Although Machine Learning (ML) models do not depend
on the assumptions of the dynamics of the intra-cluster medium, our whole
method relies on the choice of the physics implemented in the hydrodynamic
simulations, which is a limitation of the method. Through different metrics to
assess the fidelity of the inferred density map, we show that the predicted
total mass distribution is in very good agreement with the true simulated
cluster. Therefore, it is not surprising to see the integrated halo mass is
almost unbiased, around 1 per cent for the best result from multiview, and the
scatter is also very small, basically within 3 per cent. This result suggests
that this ML method provides an alternative and more accessible approach to
reconstructing the overall matter distribution in galaxy clusters, which can
complement the lensing method.Comment: 15 pages, 13 figures, published in MNRA
Generating galaxy clusters mass density maps from mock multiview images via deep learning
Galaxy clusters are composed of dark matter, gas and stars. Their dark matter component, which amounts to around 80% of the total mass, cannot be directly observed but traced by the distribution of diffused gas and galaxy members. In this work, we aim to infer the cluster’s projected total mass distribution from mock observational data, i.e. stars, Sunyaev-Zeldovich, and X-ray, by training deep learning models. To this end, we have created a multiview images dataset from The Three Hundred simulation that is optimal for training Machine Learning models. We further study deep learning architectures based on the U-Net to account for single-input and multi-input models. We show that the predicted mass distribution agrees well with the true one
IL WAGNER DI ADORNO TRA FANTASMAGORIA E REGRESSIONE
La relazione ha presentato alcuni aspetti teorici dell'interpretazione adorniana di Wagner alla luce della influenze di Lukacs, Horkheimer e Benjamin
Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy
IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical
attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced
colorectal cancers at diagnosis.
OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced
oncologic stage and change in clinical presentation for patients with colorectal cancer.
DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all
17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December
31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period),
in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was
30 days from surgery.
EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery,
palliative procedures, and atypical or segmental resections.
MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer
at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as
cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding,
lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery,
and palliative surgery. The independent association between the pandemic period and the outcomes
was assessed using multivariate random-effects logistic regression, with hospital as the cluster
variable.
RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years)
underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142
(56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was
significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR],
1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic
lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03).
CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the
SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients
undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for
these patients
Coronary microvascular resistance: methods for its quantification in humans
Coronary microvascular dysfunction is a topic that has recently gained considerable interest in the medical community owing to the growing awareness that microvascular dysfunction occurs in a number of myocardial disease states and has important prognostic implications. With this growing awareness, comes the desire to accurately assess the functional capacity of the coronary microcirculation for diagnostic purposes as well as to monitor the effects of therapeutic interventions that are targeted at reversing the extent of coronary microvascular dysfunction. Measurements of coronary microvascular resistance play a pivotal role in achieving that goal and several invasive and noninvasive methods have been developed for its quantification. This review is intended to provide an update pertaining to the methodology of these different imaging techniques, including the discussion of their strengths and weaknesses
Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease
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