Applied Research of the Hygrothermal Behaviour of an Internally Insulated Historic Wall without Vapour Barrier: In Situ Measurements and Dynamic Simulations

The hygrothermal behaviour of an internally insulated historic wall is still hard to predict, mainly because the physical characteristics of the materials composing the historic wall are unknown. In this study, the hygrothermal assessment of an internally thermal insulated masonry wall of an historic palace located in Ferrara, in Italy, is shown. In situ non-destructive monitoring method is combined with a hygrothermal simulation tool, aiming to better analyse and discuss future refurbishment scenarios. In this context, the original U-value of the wall (not refurbished) is decreased from 1.44 W/m2K to 0.26 W/m2K (10 cm stone wool). Under the site specific conditions of this wall, not reached by the sun or rain, it was verified that even in the absence of vapour barrier, no frost damage is likely to occur and the condensation risk is very limited. Authors proposed further discussion based on simulation. The results showed that the introduction of a second gypsum board to the studied technology compensated such absence, while the reduction of the insulation material thickness provides a reduction of RH peaks in the interstitial area by 1%; this second solution proved to be more efficient, providing a 3% RH reduction and the avoidance of further thermal losses

Applied Research of the Hygrothermal Behaviour of an Internally Insulated Historic Wall without Vapour Barrier: In Situ Measurements and Dynamic Simulations

The hygrothermal behaviour of an internally insulated historic wall is still hard to predict, mainly because the physical characteristics of the materials composing the historic wall are unknown. In this study, the hygrothermal assessment of an internally thermal insulated masonry wall of an historic palace located in Ferrara, in Italy, is shown. In situ non-destructive monitoring method is combined with a hygrothermal simulation tool, aiming to better analyse and discuss future refurbishment scenarios. In this context, the original U-value of the wall (not refurbished) is decreased from 1.44 W/m2K to 0.26 W/m2K (10 cm stone wool). Under the site specific conditions of this wall, not reached by the sun or rain, it was verified that even in the absence of vapour barrier, no frost damage is likely to occur and the condensation risk is very limited. Authors proposed further discussion based on simulation. The results showed that the introduction of a second gypsum board to the studied technology compensated such absence, while the reduction of the insulation material thickness provides a reduction of RH peaks in the interstitial area by 1%; this second solution proved to be more efficient, providing a 3% RH reduction and the avoidance of further thermal losses

Providing a nurse-led complex nursing INtervention FOcused on quality of life assessment on advanced cancer patients: The INFO-QoL pilot trial.

PURPOSE Unmet needs for advanced-disease cancer patients are fatigue, pain, and emotional support. Little information is available about the feasibility of interventions focused on patient-reported outcome measurement developed according to the Medical Research Council (MRC) Framework in advanced-disease cancer patients. We aimed to pilot a nurse-led complex intervention focused on QoL assessment in advanced-disease cancer patients. METHODS The INFO-QoL study was based on an exploratory, nonequivalent comparison group, pre-test-post-test design. Study sites received either the INFO-QoL intervention or usual care. Adult advanced-disease cancer patients admitted to hospice inpatient units that gave their informed consent were included in the study. Subjects were 187 patients and their families and 19 healthcare professionals. We evaluated feasibility, acceptability, and patients' outcomes using the Integrated Palliative Care Outcome Scale. RESULTS Nineteen healthcare professionals were included. The mean competence score increased significantly over time (p < 0.001) and the mean usefulness score was high 8.63 (±1.36). In the post-test phase, 54 patients were allocated to the experimental unit and 36 in the comparison unit. Compared to the comparison unit, in the experimental unit anxiety (R2 = 0.07; 95% CI = -0.06; 0.19), family anxiety (R2 = 0.22; 95% CI = -0.03; 0.41), depression (R2 = 0.31; 95% CI = -0.05; 0.56) and sharing feelings (R2 = 0.09; 95% CI = -0.05; 0.23), were improved between pre-test and post-test phase. CONCLUSIONS The INFO-QoL was feasible and potentially improved psychological outcomes. Despite the high attrition rate, the INFO-QoL improved the quality and safety culture for patients in palliative care settings

Bistability of Mitochondrial Respiration Underlies Paradoxical Reactive Oxygen Species Generation Induced by Anoxia

Increased production of reactive oxygen species (ROS) in mitochondria underlies major systemic diseases, and this clinical problem stimulates a great scientific interest in the mechanism of ROS generation. However, the mechanism of hypoxia-induced change in ROS production is not fully understood. To mathematically analyze this mechanism in details, taking into consideration all the possible redox states formed in the process of electron transport, even for respiratory complex III, a system of hundreds of differential equations must be constructed. Aimed to facilitate such tasks, we developed a new methodology of modeling, which resides in the automated construction of large sets of differential equations. The detailed modeling of electron transport in mitochondria allowed for the identification of two steady state modes of operation (bistability) of respiratory complex III at the same microenvironmental conditions. Various perturbations could induce the transition of respiratory chain from one steady state to another. While normally complex III is in a low ROS producing mode, temporal anoxia could switch it to a high ROS producing state, which persists after the return to normal oxygen supply. This prediction, which we qualitatively validated experimentally, explains the mechanism of anoxia-induced cell damage. Recognition of bistability of complex III operation may enable novel therapeutic strategies for oxidative stress and our method of modeling could be widely used in systems biology studies

Differential diagnosis of neurodegenerative dementias with the explainable MRI based machine learning algorithm MUQUBIA

Biomarker-based differential diagnosis of the most common forms of dementia is becoming increasingly important. Machine learning (ML) may be able to address this challenge. The aim of this study was to develop and interpret a ML algorithm capable of differentiating Alzheimer's dementia, frontotemporal dementia, dementia with Lewy bodies and cognitively normal control subjects based on sociodemographic, clinical, and magnetic resonance imaging (MRI) variables. 506 subjects from 5 databases were included. MRI images were processed with FreeSurfer, LPA, and TRACULA to obtain brain volumes and thicknesses, white matter lesions and diffusion metrics. MRI metrics were used in conjunction with clinical and demographic data to perform differential diagnosis based on a Support Vector Machine model called MUQUBIA (Multimodal Quantification of Brain whIte matter biomArkers). Age, gender, Clinical Dementia Rating (CDR) Dementia Staging Instrument, and 19 imaging features formed the best set of discriminative features. The predictive model performed with an overall Area Under the Curve of 98%, high overall precision (88%), recall (88%), and F1 scores (88%) in the test group, and good Label Ranking Average Precision score (0.95) in a subset of neuropathologically assessed patients. The results of MUQUBIA were explained by the SHapley Additive exPlanations (SHAP) method. The MUQUBIA algorithm successfully classified various dementias with good performance using cost-effective clinical and MRI information, and with independent validation, has the potential to assist physicians in their clinical diagnosis

Equatorial Atlantic Ocean dynamics in a coupled ocean–atmosphere model simulation

The ocean temperatures and zonal currents at the equatorial Atlantic simulated by an improved version of the Brazilian earth system model (BESM), with changes in the cloud cover scheme and optical properties of the atmospheric component, are analyzed and compared to those obtained from a previous version of BESM and also from other seven selected CMIP5 models. It is shown that this updated version of BESM, despite some persistent biases, more accurately represents the surface temperature variation at the Equator and the equatorial thermocline east–west slope. These improvements are associated to a more realistic seasonal cycle achieved for the Atlantic equatorial undercurrent, as well as sea surface temperatures and zonal wind stress. The better simulation of the equatorial undercurrent is, in its turn, credited to a more realistic representation of the surface wind position and strength at the tropical Atlantic by the coupled model. With many of the systematic errors noticed in the previous version of the model alleviated, this version of BESM can be considered as a useful tool for modelers involved in Atlantic variability studies

Impaired aquaporins expression in the gastrointestinal tract of rat after mercury exposure

The main route of exposure to mercury in humans is through the diet. Consequently, the gastrointestinal mucosa is exposed to the mercurial forms, where they cause intestinal fluid accumulation, mucosal injuries and diarrhea. The relationship between inorganic mercury (HgCl2 ) and methylmercury (CH3 HgCl) exposure and water movement in the gastrointestinal tract is still unexplored. The leading role of aquaporins (AQPs) in the rapid bidirectional movement of fluid in the gastrointestinal tract of mammals is well established. The present study evaluates the effect of HgCl2 and CH3 HgCl exposure on AQP expression in different portions of the gastrointestinal tract of rats treated by gavage (5 mg kg(-1) of mercury species, single dose, 4 days). The results show that mercury species reduce mRNA and protein levels of AQPs in different parts of the gastrointestinal tract. In the stomach, treated rats show a significant reduction of expression of AQP3 (80-90% for mRNA and 50% for protein) and AQP4 (95-99% for mRNA and 20-40% for protein). In the small and large intestine, treated rats experience a significant reduction of AQP3 and AQP7 expression. Protein contents of both AQPs are reduced in similar proportions in jejunum (AQP3: 40-50%; AQP7: 45-50%) and colon (AQP3: 35-40%; AQP7: 45-60%), regardless of the treatment. Our results indicate that some AQPs are downregulated in the rat gastrointestinal tract by mercury exposure, suggesting a possible role of AQPs in the development of mercury gastrointestinal symptoms

The regression of isothermal thermogravimetric data to evaluate degradation Ea values of polymers: A comparison with literature methods and an evaluation of lifetime predictions reliability. Part II

The kinetics of the isothermal degradation in static air atmosphere of four well known polymers, polyethylene (PE), polystyrene (PS), polycarbonate (PC) and poly(methyl methacrylate) (PMMA) was studied by both a long-term (more than three years) experiment at relatively low temperature (423 K) and a set of short-term experiments at higher temperatures. The activation energy (E-a) values of degradation were determined by both the MacCallum and Wilkinson literature methods, and were compared with those obtained through a new very simple method we set up, based on the direct regression of TG mass loss data. About two years ago we published the results concerning PE and PS because their mass losses during long-term experiments were sufficiently high. The long-term degradation experiments were continued until now and in this second part we report the results concerning PC and PMMA. The degradation E-a values calculated from short-term experimental data through the three different methods were in good agreement with each other for both PC and PMMA, thus confirming the general applicability of our simple method for the determination of E-a. The experimental data at lower temperature of PC were not in agreement with those at higher temperatures, thus confirming the low reliability of the kinetic parameters (and then of lifetime predictions) at low temperature determined by experiments at higher temperatures. Partially disagreeing results were obtained for PMMA, which were discussed and interpreted. (C) 2013 Elsevier Ltd. All rights reserved.The kinetics of the isothermal degradation in static air atmosphere of four well known polymers, polyethylene (PE), polystyrene (PS), polycarbonate (PC) and poly(methyl methacrylate) (PMMA) was studied by both a long-term (more than three years) experiment at relatively low temperature (423 K) and a set of short-term experiments at higher temperatures. The activation energy (Ea) values of degradation were determined by both the MacCallum and Wilkinson literature methods, and were compared with those obtained through a new very simple method we set up, based on the direct regression of TG mass loss data. About two years ago we published the results concerning PE and PS because their mass losses during long-term experiments were sufficiently high. The long-term degradation experiments were continued until now and in this second part we report the results concerning PC and PMMA. The degradation Ea values calculated from short-term experimental data through the three different methods wer

A phase 2 quasi-experimental trial evaluating the feasibility, acceptability, and potential effectiveness of complex nursing intervention focused on QoL assessment on advanced cancer patients with palliative care needs: study protocol

Abstract Background Palliative care (PC) is an approach that improves the quality of life (QoL) of patients and their families facing the problem associated with incurable terminal disease. A number of QoL assessment tools have been validated in PC and their use described for research purposes, to support clinical practice, and as part of the quality improvement programs. There is a paucity of evidence on the implementation of a nursing intervention focused on QoL assessment in PC practice. The aim of this study is to model and determine the feasibility of a nursing complex intervention focused on QoL assessment in PC practice. Methods The intervention will be evaluated through a quasi-experimental non-equivalent comparison group before-after study design. This project can be classified as phases 1–2, according to the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. The study setting will take place in two inpatient hospice units in Italy. The study sample will be constituted of 39 multidisciplinary healthcare professionals and a sample of 46 advanced cancer patients admitted to hospices during the implementation of the intervention. Discussion This study will generate information to address the implementation of QoL measurement in palliative care practice. Findings of this study will be used to inform a phase 3 trial according to the MRC framework. Trial registration ISRCTN41201864 retrospectively registered

Assessment of the Exposure of Turkey Farmers to Antimicrobial Resistance Associated with Working Practices

The objective of the present study was the identification of farming practices in the production of turkeys for human consumption, and their ranking in terms of the occupational probability of exposure to antimicrobial resistant (AMR) bacteria, for farm workers. We gathered evidence and data from scientific literature, on risk factors for AMR in farmers, and on the prevalence of those hazards across farming phases. We administered semi-structured interviews to public and private veterinarians in Northern Italy, to obtain detailed information on turkey farming phases, and on working practices. Data were then integrated into a semi-quantitative Failure Modes and Effect Analysis (FMEA). Those working practices, which are characterized by direct contact with numerous animals, and which are carried out frequently, with rare use of personal protection devices resulted as associated with the greatest probability of exposure to AMR. For methicillin resistant Staphylococcus aureus (MRSA), these included vaccination and administration of any individual therapy, and removal and milling of litter, given the exposure of farmers to high dust level. Indeed, levels of occupational exposure to MRSA are enhanced by its transmission routes, which include direct contact with animal, as well as airborne transmission. Level of exposure to extended spectrum beta lactamase (ESBL) is more strictly associated with direct contact and the oral-fecal route. Consequently, exposure to ESBL resulted and associated with the routinely tipping over of poults turned on their back, and with the individual administration of therapies