507 research outputs found
De Sitter Thermodynamics from Diamonds's Temperature
The thermal time hypothesis proposed by Rovelli [1] regards the physical
basis for the flow of time as thermodynamical and provides a definition of the
temperature for some special cases. We verify this hypothesis in the case of de
Sitter spacetime by relating the uniformly accelerated observer in de Sitter
spacetime to the diamond in Minkowski spacetime. Then, as an application of it,
we investigate the thermal effect for the uniformly accelerated observer with a
finite lifetime in dS spacetime, which generalizes the corresponding result for
the case of Minkowski spacetime [2].
Furthermore, noticing that a uniformly accelerated dS observer with a finite
lifetime corresponds to a Rindler observer with a finite lifetime in the
embedding Minkowski spacetime, we show that the
global-embedding-Minkowski-spacetime (GEMS) picture of spacetime thermodynamics
is valid in this case. This is a rather nontrivial and unexpected
generalization of the GEMS picture, as well as a further verification of both
the thermal time hypothesis and the GEMS picture.Comment: 10 pages, 3 figures, LaTeX; v2: reorganized with a new section added
concerning a generalization of the GEMS picture from our result; v3: version
with minor corrections, to appear in JHE
mycosis fungoides in childhood description and study of two siblings
Primary cutaneous T-cell lymphomas are exceedingly rare in children and adolescents. However, mycosis fungoides (MF) is the most frequent primary cutaneous lymphoma diagnosed in childhood. Two cases of MF in siblings (a 14-year-old boy and his 10-year-old sister) are reported. On the basis of clinical features (histopathological and immunophenotypical findings) a diagnosis of MF patch lesions was made in both siblings. Since recent data in the literature have underlined a high frequency of the HLA-DQB1*03 allele in patients with familial MF (including child patients), the HLA profile of the patients was analysed, indicating the presence of a haplotype (HLA-DQB1*03,*03 in the girl, HLA-DQB1*02,*03 in the boy) corresponding with that described in recent literature. Two rare and exceptional cases of MF in siblings are reported, highlighting the presence of a peculiar haplotype
La concimazione del rosmarino
Nell\u2019accertare le asportazioni di azoto, fosforo e potassio, si osserva che la concimazione influenzerebbe la qualit\ue0 dell\u2019olio essenziale
An algebraic Birkhoff decomposition for the continuous renormalization group
This paper aims at presenting the first steps towards a formulation of the
Exact Renormalization Group Equation in the Hopf algebra setting of Connes and
Kreimer. It mostly deals with some algebraic preliminaries allowing to
formulate perturbative renormalization within the theory of differential
equations. The relation between renormalization, formulated as a change of
boundary condition for a differential equation, and an algebraic Birkhoff
decomposition for rooted trees is explicited
Case mix at the European Institute of Oncology: first report of the Tumour Registry, 2000–2002
Introduction: An institutional and centralized hospital-based tumour registry (TR) is the ideal supporting tool for the organization and management of clinical data in a comprehensive cancer centre. The purpose of this paper is to describe the development of the TR at the European Institute of Oncology (IEO) in Milan, Italy, from its origin to its current applications. Material and methods: After a series of meetings with members of administrative, clinical, research and informatics departments, the TR was activated in March 2006 with the aim to collect data on all the individuals referring to the Institute, with or at risk of developing a tumour. It was implemented on an Oracle\u2122-based interface. A minimum data set of variables was defined and data collection was divided into four forms, which together gather all the relevant data on patients, tumours, treatments and subsequent events. Results: After a 6-month pilot period, which involved the training of the tumour registrars, adjustments to the structure of the registry, development of data quality control procedure and finalization of the operative protocol, from September 2006 the data collection has been fully operative. Five registrars have been chronologically entering data of all individuals who visited the IEO for the first time since 1st January 2000. As of March 2009, data on 69,637 individuals and 43,567 tumours has been reviewed, recoded and registered in the TR. Twenty-two percent of the tumours (n=9,578) were first invasive primaries, diagnosed and treated in IEO; the most common sites were breast (n=4,972), lung (n=627), intestines (n=479) and prostate (n=376). Conclusion: The IEO TR has been proven functional and reliable in monitoring the activity of the Hospital, allowing extraction of data from any subpopulation with characteristics of interest. The structured and centralized TR represents an important tool for our research-oriented Institution
Lung response to prone positioning in mechanically-ventilated patients with COVID-19
Background: Prone positioning improves survival in moderate-to-severe acute respiratory distress syndrome (ARDS) unrelated to the novel coronavirus disease (COVID-19). This benefit is probably mediated by a decrease in alveolar collapse and hyperinflation and a more homogeneous distribution of lung aeration, with fewer harms from mechanical ventilation. In this preliminary physiological study we aimed to verify whether prone positioning causes analogue changes in lung aeration in COVID-19. A positive result would support prone positioning even in this other population. Methods: Fifteen mechanically-ventilated patients with COVID-19 underwent a lung computed tomography in the supine and prone position with a constant positive end-expiratory pressure (PEEP) within three days of endotracheal intubation. Using quantitative analysis, we measured the volume of the non-aerated, poorly-aerated, well-aerated, and over-aerated compartments and the gas-to-tissue ratio of the ten vertical levels of the lung. In addition, we expressed the heterogeneity of lung aeration with the standardized median absolute deviation of the ten vertical gas-to-tissue ratios, with lower values indicating less heterogeneity. Results: By the time of the study, PEEP was 12 (10–14) cmH2O and the PaO2:FiO2 107 (84–173) mmHg in the supine position. With prone positioning, the volume of the non-aerated compartment decreased by 82 (26–147) ml, of the poorly-aerated compartment increased by 82 (53–174) ml, of the normally-aerated compartment did not significantly change, and of the over-aerated compartment decreased by 28 (11–186) ml. In eight (53%) patients, the volume of the over-aerated compartment decreased more than the volume of the non-aerated compartment. The gas-to-tissue ratio of the ten vertical levels of the lung decreased by 0.34 (0.25–0.49) ml/g per level in the supine position and by 0.03 (− 0.11 to 0.14) ml/g in the prone position (p < 0.001). The standardized median absolute deviation of the gas-to-tissue ratios of those ten levels decreased in all patients, from 0.55 (0.50–0.71) to 0.20 (0.14–0.27) (p < 0.001). Conclusions: In fifteen patients with COVID-19, prone positioning decreased alveolar collapse, hyperinflation, and homogenized lung aeration. A similar response has been observed in other ARDS, where prone positioning improves outcome. Therefore, our data provide a pathophysiological rationale to support prone positioning even in COVID-19
Stressors in the ICU: different perceptions of patients, relatives and staff members
Introduction The high-risk critically ill are exposed to signifi cant
stressors, along with diffi culties in communicating them to relatives
and members of the staff . The aim of this study was to compare the
perception of stressors as reported by patients (P), relatives (R) and ICU
staff members (S).
Methods A validated questionnaire [1] was used to quantitatively
assess discomforts related to the ICU stay. Items were clustered into categories; higher scores refer to a higher stressfulness. The median
(IQR) was calculated for each category. Twenty-eight high-risk critically
ill at discharge, 55 relatives 48 hours after admission of their next of kin,
and a total of 125 staff members (55 attending physicians, 40 nurses
and 30 medical students/specialist trainees) were interviewed. Fifty-six
of the staff members were used to keep patients consciously sedated
as for local guidelines; the remaining used deeper levels of sedation.
Nonparametric tests were used as needed.
Results All stressor categories were diff erently reported by the three
groups analysed: environmental (S = 17 (15 to 19), R = 15 (13 to 18),
P = 10 (8 to 11), P <0.01), relationships (S = 23 (21 to 25), R = 20.5 (17 to
24.5), P = 14 (11 to 17), P <0.01), emotional (S = 25.5 (23 to 28), R = 24
(20 to 26), P = 18 (15 to 22), P <0.01), and physical (S = 35 (31 to 38),
R = 33 (26.5 to 37), P = 27 (21 to 30), P <0.01). Among the staff members,
nurses overestimated more than attending physicians, while trainees
are closer to relatives\u2019 perception (P = 0.03). Staff members used to
conscious sedation overestimate less the impact of environmental
stressors (P = 0.03). Years of experience (r = 0.24, P = 0.03) and age
(r = 0.27, P = 0.01) are related to stressor overestimation among staff
members.
Conclusion Members of the staff should reconsider their beliefs on
patients\u2019 perception of stressors. We argue that such an overestimation
may bring inappropriate administration of analgesic and sedative
drugs, particularly for nurses and older members of staff . Relatives
might be useful intermediaries to have a better insight of patients\u2019
perception
- …