The Effectiveness of Various Reminder Systems on Appointment-Keeping Adherence in a University-Based Primary-Care Setting

Treatment nonadherence is a significant problem that can affect not only the healthcare industry, but also more importantly, a patient’s health. Appointment-keeping adherence is expected to supersede all other types of adherence in terms of its importance and sequence. Various interventions have been used to treat nonadherence including appointment-keeping nonadherence within medical practices. Some of these interventions include different types of reminders (phone, letter, cards, etc.) and different types of therapy (motivational interviewing (MI) and cognitive behavioral therapy). Both reminders and MI have been effective in the past in treating appointment-keeping nonadherence. Therefore, will an MI-formatted letter reminder improve appointment-keeping adherence better than a non-MI-formatted letter reminder, phone reminder, and no reminder? Archival data from a university-based primary-care practice that implemented a protocol using varying reminder systems were examined and analyzed for this study. One hundred ninety four patients were randomly selected. The data displayed that MI-formatted reminders (80%) were not significantly better (p = .239) than non-MI-formatted letter reminders (75%), phone reminders (82%), or no reminders (66%). However, reminders as a whole (MI, non-MI and phone combined) were significantly better than no reminders (p = .049). Age was also indicated as a significant predictor (r2 = .048, p = .002) for adherence, but gender was not. Therefore, one can conclude that adding MI to an existing intervention may not improve appointment-keeping adherence; however, the use of a letter format may have hindered its efficacy along with other issues inherent in the study. Overall, reminders are an effective means to improve appointment-keeping adherence

Contaminants standards

Contaminant and toxic hazards during manned space flight

AN AUTOMATED FRAMEWORK FOR ENSURING INFORMATION CONSISTENCY IN PRICE LIST TENDERING DOCUMENT

Effective cost estimation for tendering plays a critical role in the building construction process, enabling efficient investment management and ensuring successful execution of the construction phase. Traditional cost estimation procedure involves manual information processing to extract and match technical data from textual description construction resources. This activity requires practitioner deep experience and manual effort, often resulting in errors and, in the worst scenario, judicial disputes. In response to the increasing demand for structured information and automated processes, this study addresses the need for Public Administrations to achieve better control over the data contained in public tendering documents provided to practitioners. To fulfill this objective, a framework is proposed to automatically retrieve information from these documents, serving as a support tool to map items within the documents, highlight missing data, and critical semantic ambiguity. The designed framework aims to develop a tool for automatically identifying similarities between work items and their corresponding elementary resource items in Price List tendering documents. By leveraging the information retrieval NLP technique of cosine similarity through TF-IDF, a methodology was developed to support and facilitate practitioners' activities. Finally, the framework was tested on four case studies extracted from Lombardy Regional Italian price list documents showing that the resulting support tool is able to automate the analysis process and efficiently reveal inconsistency. The model successfully extracted and correctly matched the elementary resource to the corresponding work query in 75% of the cases where the elementary resource was present in the list. Additionally, the model proved to be a valuable tool in helping practitioners identify missing resources

Digital Transformation in the Construction Sector: From BIM to Digital Twin

In the next years, perhaps more than ever before, a technological revolution will transform the construction sector in all its aspects, greatly affecting services, production, and supplies. With BIM, and even more considering the Digital Twin topic, the innovation of tools has entailed a methodological innovation for the whole sector, owing to virtual reality simulations and actual dynamic real-time monitoring. This research, starting from an integrated analysis between the current research trends and some relevant national and European projects about the digitalization of construction sector, aims at providing a systematic analysis of some of the pillars that are guiding this phenomenon. In detail, the state of the art, activities, and trends of standardization and platform development in construction sector are considered and intersected to provide a clear background towards the future trends in the sector

Commissioning and operation of the Cherenkov detector for proton Flux Measurement of the UA9 Experiment

The UA9 Experiment at CERN-SPS investigates channeling processes in bent silicon crystals with the aim to manipulate hadron beams. Monitoring and characterization of channeled beams in the high energy accelerators environment ideally requires in-vacuum and radiation hard detectors. For this purpose the Cherenkov detector for proton Flux Measurement (CpFM) was designed and developed. It is based on thin fused silica bars in the beam pipe vacuum which intercept charged particles and generate Cherenkov light. The first version of the CpFM is installed since 2015 in the crystal-assisted collimation setup of the UA9 experiment. In this paper the procedures to make the detector operational and fully integrated in the UA9 setup are described. The most important standard operations of the detector are presented. They have been used to commission and characterize the detector, providing moreover the measurement of the integrated channeled beam profile and several functionality tests as the determination of the crystal bending angle. The calibration has been performed with Lead (Pb) and Xenon (Xe) beams and the results are applied to the flux measurement discussed here in detail.Comment: 25 pages, 14 figure

Can Baseline IL-6 Levels Predict Long COVID in Subjects Hospitalized for SARS-CoV-2 Disease?

The immune response to infection plays a crucial role in the pathogenesis of COVID-19, but several patients develop a wide range of persistent symptoms, which is becoming a major global health and economic burden. However, reliable indicators are not yet available to predict the persistence of symptoms typical of the so-called long COVID. Our study aims to explore an eventual role of IL-6 levels as a marker of long COVID. Altogether, 184 patients admitted to the COVID Medicine Unit of the University Hospital in Palermo, Italy, from the 1st of September 2020, were analyzed. Patients were divided into two groups according to the IL-6 serum levels (normal or elevated), considering the serum IL-6 levels measured during the first four days of hospitalization. In our study, higher serum IL-6 levels were associated with a doubled higher risk of long COVID (OR = 2.05; 95% CI: 1.04–4.50) and, in particular, they were associated with a higher incidence of mobility decline (OR = 2.55; 95% CI: 1.08–9.40) and PTSD (OR = 2.38; 95% CI: 1.06–8.61). The analysis of our case series confirmed the prominent role of IL-6 levels in response to SARS-CoV-2 infection, as predictors not only of COVID-19 disease severity and unfavorable outcomes, but also long COVID development trends

Vitamin d3 enriches ceramide content in exosomes released by embryonic hippocampal cells

The release of exosomes can lead to cell\u2013cell communication. Nutrients such as vitamin D3 and sphingolipids have important roles in many cellular functions, including proliferation, dif-ferentiation, senescence, and cancer. However, the specific composition of sphingolipids in exo-somes and their changes induced by vitamin D3 treatment have not been elucidated. Here, we ini-tially observed neutral sphingomyelinase and vitamin D receptors in exosomes released from HN9.10 embryonic hippocampal cells. Using ultrafast liquid chromatography tandem mass spec-trometry, we showed that exosomes are rich in sphingomyelin species compared to whole cells. To interrogate the possible functions of vitamin D3, we established the optimal conditions of cell treatment and we analyzed exosome composition. Vitamin D3 was identified as responsible for the vitamin D receptor loss, for the increase in neutral sphingomyelinase content and sphingomyelin changes. As a consequence, the generation of ceramide upon vitamin D3 treatment was evident. Incubation of the cells with neutral sphingomyelinase, or the same concentration of ceramide pro-duced in exosomes was necessary and sufficient to stimulate embryonic hippocampal cell differen-tiation, as vitamin D3. This is the first time that exosome ceramide is interrogated for mediate the effect of vitamin D3 in inducing cell differentiation

Improved aperture measurements at the LHC and results from their application in 2015

A good knowledge of the available aperture in the LHC is essential for a safe operation due to the risk of magnet quenches or even damage in case of uncontrolled beam losses. Experimental validations of the available aperture are therefore crucial and were in the past carried out by either a collimator scan combined with beam excitations or through the use of local orbit bumps. In this paper, we show a first comparison of these methods in the same machine configuration, as well as a new very fast method based on a beam-based collimator alignment and a new faster variant of the collimator scan method. The methods are applied to the LHC operational configuration for 2015 at injection and with squeezed beams and the measured apertures are presented.peer-reviewe

Ceramide releases exosomes with a specific miRNA signature for cell differentiation

Exosomes are well established effectors of cell–cell communication. Their role on maturation of embryonic cells located in hippocampus, seat of memory, is unknown. Here we show that ceramide facilitates release of exosomes from HN9.10e cells extending information for cell differentiation to neighboring cells. We found only 38 miRNAs differentially expressed in exosomes derived from ceramide-treated cells in comparison with control cells (including 10 up-regulated and 28 down-regulated). Some overexpressed miRNAs (mmu-let-7f-1-3p, mmu-let-7a-1-3p, mmu-let-7b-3p, mmu-let-7b-5p, mmu-miR-330-3p) regulate genes encoding for protein involved in biological, homeostatic, biosynthetic and small molecule metabolic processes, embryo development and cell differentiation, all phenomena relevant for HN9.10e cell differentiation. Notably, the overexpressed mmu-let-7b-5p miRNA appears to be important for our study based on its ability to regulate thirty-five gene targets involved in many processes including sphingolipid metabolism, sphingolipid-related stimulation of cellular functions and neuronal development. Furthermore, we showed that by incubating embryonic cells with exosomes released under ceramide treatment, some cells acquired an astrocytic phenotype and others a neuronal phenotype. We anticipate our study to be a start point for innovative therapeutic strategies to regulate the release of exosomes useful to stimulate delayed brain development in the newborn and to improve the cognitive decline in neurodegenerative disorders