Fast glycorrhachia and cerebrospinal fluid protein as predictors of sensory block in anesthesia with subarachnoid Ropivacaine

BACKGROUND: Identify if glycorrhachia and cerebrospinal fluid protein could influence the time of sensory block to T10, the duration and the metameric block's level, after a standard dose of Ropivacaine. METHODS: 80 patients, ASA I - III undergoing to transurethral prostate resection with spinal anesthesia in a prospected open study were recruited. A 0.2 ml liquor's sample was taken; glycorrhachia, by glycemic stix and CSF protein, by urinary stix, were got, before Ropivacaine 0.5% 15 mg injection (0.10 - 0.15 mlsec). After anti-trendelemburg, with 30 ° tilting for 15 min, the onset of sensory block to T10, the maximum metameric level to 15' and the time of sensory block were reported. The data collection were analyzed using the software language R. RESULTS: A significant correlation liquor specific weigh preoperative glycemia (0.749), liquoral specific weigh glycorrhachia (rho = 0.751; R2 = 0.564; P 0.05) and specific weigh CSF protein (rho = 0.684; R2 = 0.468; P 0.05) were reported. Inverse relation CSF weightsensory block level (rho -0.789, P 0.05, R2 0.621) was evidenced. Inverse relation onset time to T10 glycorrhachia (84%) and cephalic block glycorrhachia (76%) were found. Inverse correlation onset time to T 10 CSF protein and cephalic block proteinorrachia was respectively 84% and 67%. A rho of 0.712 with R2 of 51% BMI onset to T10 and rho of 0.681 with R2 of 51% BMI maximum cephalic block with P 0.05 were reported. CONCLUSIONS: The predictability of a iso-hypobaric local anesthetic could reduce the risk of procedure failure and adverse events by further cephalic spread

A penny-shaped crack in a filament reinforced matrix. 1: The filament model

The electrostatic problem of a penny-shaped crack in an elastic matrix which reinforced by filaments or fibers perpendicular to the plane of the crack was studied. The elastic filament model was developed for application to evaluation studies of the stress intensity factor along the periphery of the crack, the stresses in the filaments or fibers, and the interface shear between the matrix and the filaments or fibers. The requirements expected of the model are a sufficiently accurate representation of the filament and applicability to the interaction problems involving a cracked elastic continuum with multi-filament reinforcements. The technique for developing the model and numerical examples of it are shown

A penny shaped crack in a filament-reinforced matrix. 2: The crack problem

The elastostatic interaction problem between a penny-shaped crack and a slender inclusion or filament in an elastic matrix was formulated. For a single filament as well as multiple identical filaments located symmetrically around the crack the problem is shown to reduce to a singular integral equation. The solution of the problem is obtained for various geometries and filament-to-matrix stiffness ratios, and the results relating to the angular variation of the stress intensity factor and the maximum filament stress are presented

L∞-norm and energy quantization for the planar Lane–Emden problem with large exponent

For any smooth bounded domain (Formula presented.), we consider positive solutions to (Formula presented.)which satisfy the uniform energy bound (Formula presented.)for (Formula presented.). We prove convergence to (Formula presented.) as (Formula presented.) of the (Formula presented.)-norm of any solution. We further deduce quantization of the energy to multiples of (Formula presented.), thus completing the analysis performed in De Marchis et al. (J Fixed Point Theory Appl 19:889–916, 2017)

Intravitreal injection of Ozurdex(®) implant in patients with persistent diabetic macular edema, with six-month follow-up

AIM: To evaluate the efficacy of intravitreal dexamethasone injections in diabetic macular edema (DME). METHODS: A 700 μg slow-release intravitreal dexamethasone implant (Ozurdex®) was placed in the vitreal cavity of 17 patients (19 eyes) affected with persistent DME. Best corrected visual acuity (BCVA) was assessed through Early Treatment Diabetic Retinopathy Study (ETDRS). Central macular thickness (CMT) was measured by spectral-domain optical coherence tomography. BCVA and CMT examinations were carried out at baseline (T0) and repeated after three days, one month (T1), three months (T3), four months (T4), and six months (T6) post injection. RESULTS: Dexamethasone implant induced an improvement in ETDRS at T1, T3, T4, and T6 post injection. CMT was reduced at T1, T3, and T4, while at T6, CMT values were not statistically different from baseline. No complications were observed during the follow-up. CONCLUSION: Our data suggest that dexamethasone implant is effective in reducing DME symptoms within a six-month frame

Sectional symmetry of solutions of elliptic systems in cylindrical domains

In this paper we prove a kind of rotational symmetry for solutions of semilinear elliptic systems in some bounded cylindrical domains. The symmetry theorems obtained hold for low-Morse index solutions whenever the nonlinearities satisfy some convexity assumptions. These results extend and improve those obtained in [6, 9, 16, 18]

Existence, nonexistence and uniqueness for Lane-Emden type fully nonlinear systems

We study existence, nonexistence, and uniqueness of positive radial solutions for a class of nonlinear systems driven by Pucci extremal operators under a Lane-Emden coupling configuration. Our results are based on the analysis of the associated quadratic dynamical system and energy methods. For both regular and exterior domain radial solutions we obtain new regions of existence and nonexistence. Besides, we show an exclusion principle for regular solutions, either in RN or in a ball, by exploiting the uniqueness of trajectories produced by the flow. In particular, for the standard Lane-Emden system involving the Laplacian operator, we prove that the critical hyperbola of regular radial positive solutions is also the threshold for existence and nonexistence of radial exterior domain solutions with Neumann boundary condition. As a byproduct, singular solutions with fast decay at infinity are also found

Traumi oculari al pronto soccorso oculistico. Ricerca condotta presso la Clinica Oculistica del Policlinico Umberto I di Roma su 81.825 casi in 10 anni. La prevenzione è sempre fondamentale per evitare danni oculari.

Abstract Obiettivo Determinare gli esiti funzionali a distanza dei traumi oculari gravi contusivi e perforanti che hanno necessitato di intervento chirurgico. Metodi Studio retrospettivo, effettuato tra gennaio 2003 e marzo 2013, di 672 pazienti con macrotraumi oculari, giunti al Pronto Soccorso (PS) della Clinica Oculistica, Dipartimento di Oftalmologia del Policlinico Umberto I di Roma. In particolare abbiamo focalizzato l’attenzione sui pazienti con traumi oculari contusivi o “a bulbo chiuso” e perforanti (ferite, corpo estraneo intraoculare – CEIO –, scoppio del bulbo) o “a bulbo aperto”. Risultati Il numero degli accessi per trauma è stato di 81.825 in 10 anni, di cui 672 (0,82%) con un macrotrauma che ha necessitato di intervento medico e chirurgico. Più frequenti (445; 66,18%) i traumi contusivi rispetto ai perforanti (227; 33,82%). Dei perforanti, 105 (46,3%) hanno avuto uno scoppio del bulbo che, assieme ai CEIO (67; 29,7%), sono le principali cause di prognosi infausta per l’occhio traumatizzato. Tra le complicanze più frequenti ci sono state, in ordine, quelle corneali (abrasioni ecc.) (94,2%), l’ipoema (86,3%) e la commotio retinae (edema di Berlin, 85,8%). Gli esiti funzionali a 6 mesi sono variati da visus normale (≤10/10 e >6/10) in 441 pazienti (65,7%), fino a cecità assoluta (MM, PL, NPL) in 57 pazienti (8,3%). L’OTS (ocular trauma score) e la tempestività d’intervento sono risultati essere un indice prognostico importante. Conclusioni Gli esiti funzionali (acuità visiva finale)dei traumi oculari contusivi e perforanti sono incrementabili con l’adeguatezza e la tempestività dell’intervento chirurgico del trauma in sé e delle complicanze che possono presentarsi contemporaneamente o successivamente. I traumi costituiscono una delle principali cause di ipovisione o cecità monoculare nei soggetti giovani adulti

A Review of Production Planning Models: Emerging features and limitations compared to practical implementation

In the last few decades, thanks to the interest of industry and academia, production planning (PP) models have shown significant growth. Several structured literature reviews highlighted the evolution of PP and guided the work of scholars providing in-depth reviews of optimization models. Building on these works, the contribution of this paper is an update and detailed analysis of PP optimization models. The present review allows to analyze the development of PP models by considering: i) problem type, ii) modeling approach, iii) development tools, iv) industry-specific solutions. Specifically, to this last point, a proposed industrial solution is compared to emerging features and limitations, which shows a practical evolution of such a system

Cyber-physical systems (CPS) in supply chain management: From foundations to practical implementation

Since 2015 developments such as Industry 4.0 and cyber-physical production systems on the technology side, and approaches such as flexible and smart manufacturing systems hold great potential. These in turn give rise to special requirements that the production planning, control and monitoring, among others, needing a paradigm shift to exploit the full potential of these methods and techniques. Starting from foundations in Cyber Physical Systems (CPS), building upon definitions and findings reported by literature, a practical example of innovative Cyber Physical Supply Chain Planning System (CPS2) is provided. The paper clarifies the advantages of cyber-physical systems in the production planning, controlling and monitoring perspective with respect to manufacturing, logistics and related planning practices. A set of basic features of CPS2 systems are discussed and addressed by contextualizing service orientation architecture and microservices components with respect to supply chain management collaboration and cooperation practices. The identification of specific technologies behind those functions, within the developed research, provides some practical insight if the interesting CPS2 potential