349 research outputs found
Adjoint Appell-Euler and First Kind Appell-Bernoulli Polynomials
The adjunction property, recently introduced for Sheffer polynomial sets, is considered in the case of Appell polynomials. The particular case of adjoint Appell-Euler and Appell-Bernoulli polynomials of the first kind is analyzed
A nonlinear model for marble sulphation including surface rugosity: Theoretical and numerical results
We consider an evolution system describing the phenomenon of marble sulphation of a monument, accounting of the surface rugosity. We first prove a local in time well posedness result. Then, stronger assumptions on the data allow us to establish the existence of a global in time solution. Finally, we perform some numerical simulations that illustrate the main feature of the proposed model
Flow Index: a novel, non-invasive, continuous, quantitative method to evaluate patient inspiratory effort during pressure support ventilation
Background: The evaluation of patient effort is pivotal during pressure support ventilation, but a non-invasive, continuous, quantitative method to assess patient inspiratory effort is still lacking. We hypothesized that the concavity of the inspiratory flow-time waveform could be useful to estimate patient’s inspiratory effort. The purpose of this study was to assess whether the shape of the inspiratory flow, as quantified by a numeric indicator, could be associated with inspiratory effort during pressure support ventilation. Methods: Twenty-four patients in pressure support ventilation were enrolled. A mathematical relationship describing the decay pattern of the inspiratory flow profile was developed. The parameter hypothesized to estimate effort was named Flow Index. Esophageal pressure, airway pressure, airflow, and volume waveforms were recorded at three support levels (maximum, minimum and baseline). The association between Flow Index and reference measures of patient effort (pressure time product and pressure generated by respiratory muscles) was evaluated using linear mixed effects models adjusted for tidal volume, respiratory rate and respiratory rate/tidal volume. Results: Flow Index was different at the three pressure support levels and all group comparisons were statistically significant. In all tested models, Flow Index was independently associated with patient effort (p < 0.001). Flow Index prediction of inspiratory effort agreed with esophageal pressure-based methods. Conclusions: Flow Index is associated with patient inspiratory effort during pressure support ventilation, and may provide potentially useful information for setting inspiratory support and monitoring patient-ventilator interactions
Surgical site infection after caesarean section. Space for post-discharge surveillance improvements and reliable comparisons
Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive
Prediction of arterial pressure increase after fluid challenge
<p>Abstract</p> <p>Background</p> <p>Mean arterial pressure above 65 mmHg is recommended for critically ill hypotensive patients whereas they do not benefit from supranormal cardiac output values. In this study we investigated if the increase of mean arterial pressure after volume expansion could be predicted by cardiovascular and renal variables. This is a relevant topic because unnecessary positive fluid balance increases mortality, organ dysfunction and Intensive Care Unit length of stay.</p> <p>Methods</p> <p>Thirty-six hypotensive patients (mean arterial pressure < 65 mmH) received a fluid challenge with hydroxyethyl starch. Patients were excluded if they had active bleeding and/or required changes in vasoactive agents infusion rate in the previous 30 minutes. Responders were defined by the increase of mean arterial pressure value to over 65 mmHg or by more than 20% with respect to the value recorded before fluid challenge. Measurements were performed before and at one hour after the end of fluid challenge.</p> <p>Results</p> <p>Twenty-two patients (61%) increased arterial pressure after volume expansion. Baseline heart rate, arterial pressure, central venous pressure, central venous saturation, central venous to arterial PCO<sub>2 </sub>difference, lactate, urinary output, fractional excretion of sodium and urinary sodium/potassium ratio were similar between responder and non-responder. Only 7 out of 36 patients had valuable dynamic indices and then we excluded them from analysis. When the variables were tested as predictors of responders, they showed values of areas under the ROC curve ranging between 0.502 and 0.604. Logistic regression did not reveal any association between variables and responder definition.</p> <p>Conclusions</p> <p>Fluid challenge did not improve arterial pressure in about one third of hypotensive critically ill patients. Cardiovascular and renal variables did not enable us to predict the individual response to volume administration.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00721604">NCT00721604</a>.</p
Design of a modular Autonomous Underwater Vehicle for archaeological investigations
MARTA (MARine Tool for Archaeology) is a modular AUV (Autonomous Underwater Vehicle) designed and developed by the University of Florence in the framework of the ARROWS (ARchaeological RObot systems for the World's Seas) FP7 European project. The ARROWS project challenge is to provide the underwater archaeologists with technological tools for cost affordable campaigns: i.e. ARROWS adapts and develops low cost AUV technologies to significantly reduce the cost of archaeological operations, covering the full extent of an archaeological campaign (underwater mapping, diagnosis and cleaning tasks). The tools and methodologies developed within ARROWS comply with the "Annex" of the 2001 UNESCO Convention for the protection of Underwater Cultural Heritage (UCH). The system effectiveness and MARTA performance will be demonstrated in two scenarios, different as regards the environment and the historical context, the Mediterranean Sea (Egadi Islands) and the Baltic Sea
The relationship between S. aureus and branched-chain amino acids content in composite cow milk
The early diagnosis of mastitis is an essential factor for the prompt detection of the
animal for further actions. In fact, if not culled, infected cows must be segregated from the milking
herd and milked last, or milked with separate milking units. Besides microbiological analysis, the
somatic cell count (SCC) commonly used as predictor of intramammary infection, frequently lead
to a misclassification of milk samples. To overcome these limitations, more specific biomarkers
are continuously evaluated. The total amino acid content increases significantly in mastitic milk
compared to normal milk. S. aureus requires branched-chain amino acids (BCAAs—isoleucine,
leucine, and valine) for protein synthesis, branched-chain fatty acids synthesis, and environmental
adaptation by responding to their availability via transcriptional regulators. The increase of BCAAs
in composite milk has been postulated to be linked to mammary infection by S. aureus. The aim
of this work is to demonstrate, by a direct ion-pairing reversed-phase method, based on the use of
the evaporative light-scattering detector (IP-RP-HPLC-ELSD), applied to 65 composite cow milk
samples, a correlation between the concentration of isoleucine and leucine, and S. aureus load. The
correlation coe cient, r, was found to be 0.102 for SCC (p = 0.096), 0.622 for isoleucine (p < 0.0001),
0.586 for leucine (p < 0.0001), 0.013 for valine (p = 0.381), and 0.07 for tyrosine (p = 0.034), standing for
a positive correlation between S. aureus and isoleucine and leucine concentration. The link between
the content of BCAAs, isoleucine and leucine, and udder infection by S. aureus demonstrated with
our study has an important clinical value for the rapid diagnosis of S. aureus mastitis in cows.http://www.mdpi.com/journal/animalsam2020Paraclinical Science
Guillain-Barré syndrome and COVID-19: an observational multicentre study from two Italian hotspot regions
Objective: Single cases and small series of Guillain-Barré syndrome (GBS) have been reported during the SARS-CoV-2 outbreak worldwide. We evaluated incidence and clinical features of GBS in a cohort of patients from two regions of northern Italy with the highest number of patients with COVID-19. Methods: GBS cases diagnosed in 12 referral hospitals from Lombardy and Veneto in March and April 2020 were retrospectively collected. As a control population, GBS diagnosed in March and April 2019 in the same hospitals were considered. Results: Incidence of GBS in March and April 2020 was 0.202/100 000/month (estimated rate 2.43/100 000/year) vs 0.077/100 000/month (estimated rate 0.93/100 000/year) in the same months of 2019 with a 2.6-fold increase. Estimated incidence of GBS in COVID-19-positive patients was 47.9/100 000 and in the COVID-19-positive hospitalised patients was 236/100 000. COVID-19-positive patients with GBS, when compared with COVID-19-negative subjects, showed lower MRC sum score (26.3±18.3 vs 41.4±14.8, p=0.006), higher frequency of demyelinating subtype (76.6% vs 35.3%, p=0.011), more frequent low blood pressure (50% vs 11.8%, p=0.017) and higher rate of admission to intensive care unit (66.6% vs 17.6%, p=0.002). Conclusions: This study shows an increased incidence of GBS during the COVID-19 outbreak in northern Italy, supporting a pathogenic link. COVID-19-associated GBS is predominantly demyelinating and seems to be more severe than non-COVID-19 GBS, although it is likely that in some patients the systemic impairment due to COVID-19 might have contributed to the severity of the whole clinical picture
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