On the Use of FOPID Controllers for Maintenance Phase of General Anesthesia

This paper investigates the performance achievable with a fractional-order PID regulator controlling the Depth of Hypnosis (measured via the Bispectral Index Scale) through the administration of propofol during the maintenance phase of total intravenous anesthesia. In particular, two different methodologies were applied to tune the controller: in the first case, genetic algorithms (GAs) were used to minimize the integrated absolute error, while in the second case, the isodamping approach-a method that targets phase margin invariance with respect to the process dc gain-was employed. In both cases, the performance was extensively analyzed and compared with that of a standard PID controller by simulating multiple patients through a Monte Carlo method. The results demonstrate that a fractional-order PID controller can be effectively used to control the Depth of Hypnosis, but the improvement with respect to a standard PID controller is marginal

Uso Da Zona De Amortecimento De Uma Unidade De Conservação De Cerrado Por Mamíferos

Habitat loss and degradation is threatening mammals worldwide. Therefore, Protected Areas (PA) are of utmost importance to preserve biodiversity. Their effectiveness, however, depends on some management strategies such as buffer zones, which prevent/mitigate the impact of external threats and might increase the amount of available habitat for wildlife existing within reserves. Nevertheless, how intensively terrestrial mammals use buffer zones remains little studied, particularly in the Neotropical region. Aiming to analyse the use of a buffer zone (5 km wide) by medium and large-sized mammals, we modelled the occupancy probabilities of five species of conservation concern including local (interior and buffer zone) as a site covariate, simultaneously controlling for imperfect detection. Data collection was made with camera traps from April to September 2013 in a 9000 ha Cerrado PA (“interior”) and in its surrounding area (39721.41 ha; “buffer zone”). This PA (Jataí Ecological Station) is immersed in a landscape where sugarcane plantations predominate in the northeastern of the state of São Paulo. We also conducted an inventory to compare the number and composition of species between interior and buffer zone. A total of 31 mammal species (26 natives) was recorded via camera traps and active search for sightings, vocalizations, tracks and signs. Occupancy estimates for Myrmecophaga tridactyla, Leopardus pardalis and Pecari tajacu were numerically higher in interior. On the other hand, Chrysocyon brachyurus had the highest occupancy in buffer zone, while the largest predator, Puma concolor, used both areas similarly. However, as the confidence intervals (95%) overlapped, the differences in occupancy probabilities between interior and buffer were weak for all these species. Additionally, regarding only the species recorded by cameras, the observed and estimated richness were similar between interior and buffer zone of the PA. Our data demonstrated that the buffer zone is indeed used by medium and large-sized mammals, including conservation-dependent ones. The lack of enforcement of current legislation regarding buffer zones is therefore a real threat for mammals, even when protection is guaranteed in the interior of protected areas. © Universidade Estadual de Campinas UNICAMP. All rights reserved.16

INTERACTION BETWEEN NANOFILLED COMPOSITES AND POLYWAVE MULTILED CURING LAMPS: AN IN VITRO STUDY

8nonenoneBattaglia V; Bergantin E; Paolino D; Coero Borga FA; Cadenaro M; Breschi L; Berutti E; Scotti N.Battaglia, V; Bergantin, E; Paolino, D; Coero Borga, Fa; Cadenaro, Milena; Breschi, Lorenzo; Berutti, E; Scotti, Nicol

Ictal epileptic headache: When terminology is not a moot question

open7noThe relationship between headache and epilepsy is complex and despite the nature of this association is not yet clear. In the last few years, it has been progressively introduced the concept of the “ictal epileptic headache” that was included in the recently revised International Classification of Headaches Disorders 3rd edition (ICHD-3-revised). The diagnostic criteria for ictal epileptic headache (IEH) suggested in 2012 were quite restrictive thus leading to the underestimation of this phenomenon. However, these criteria have not yet been included into the ICHD-3 revision published in 2018, thus creating confusion among both, physicians and experts in this field. Here, we highlight the importance to strictly apply the original IEH criteria explaining the reasons through the analysis of the clinical, historical, epidemiological and pathophysiological characteristics of the IEH itself. In addition, we discuss the issues related to the neurophysiopathological link between headache and epilepsy as well as to the classification of these epileptic events as “autonomic seizure”.openParisi P.; Paolino M.C.; Raucci U.; Vecchia N.D.; Belcastro V.; Villa M.P.; Striano P.Parisi, P.; Paolino, M. C.; Raucci, U.; Vecchia, N. D.; Belcastro, V.; Villa, M. P.; Striano, P

Management of childhood headache in the emergency department. Review of the literature

Headache is the third cause of visits to pediatric emergency departments (ED). According to a systematic review, headaches in children evaluated in the ED are primarily due to benign conditions that tend to be self-limiting or resolve with appropriate pharmacological treatment. The more frequent causes of non-traumatic headache in the ED include primitive headaches (21.8-66.3%) and benign secondary headaches (35.4-63.2%), whereas potentially life-threatening (LT) secondary headaches are less frequent (2-15.3%). Worrying conditions include brain tumors, central nervous system infections, dysfunction of ventriculo-peritoneal shunts, hydrocephalus, idiopathic intracranial hypertension, and intracranial hemorrhage. In the emergency setting, the main goal is to intercept potentially LT conditions that require immediate medical attention. The initial assessment begins with an in-depth, appropriate history followed by a complete, oriented physical and neurological examination. The literature describes the following red flags requiring further investigation (for example neuroimaging) for recognition of LT conditions: abnormal neurological examination; atypical presentation of headaches: subjective vertigo, intractable vomiting or headaches that wake the child from sleep; recent and progressive severe headache (< 6 months); age of the child < 6 years; no family history for migraine or primary headache; occipital headache; change of headache; new headache in an immunocompromised child; first or worst headache; symptoms and signs of systemic disease; headaches associated with changes in mental status or focal neurological disorders. In evaluating a child or adolescent who is being treated for headache, physicians should consider using appropriate diagnostic tests. Diagnostic tests are varied, and include routine laboratory analysis, cerebral spinal fluid examination, electroencephalography, and computerized tomography or magnetic resonance neuroimaging. The management of headache in the ED depends on the patient's general conditions and the presumable cause of the headache. There are few randomized, controlled trials on pharmacological treatment of headache in the pediatric population. Only ibuprofen and sumatriptan are significantly more effective than placebo in determining headache relief

Cannabidiol treatment for refractory epilepsies in pediatrics

Cannabis extracts in oil are becoming increasingly available, and, during the last years, there has been growing public and scientific interest about therapeutic properties of these compounds for the treatment of several neurologic diseases, not just epilepsy. The discovered role of the endocannabinoid system in epileptogenesis has provided the basis to investigate the pharmacological use of exogenously produced cannabinoids, to treat epilepsy. Although, physicians show reluctance to recommend Cannabis extracts given the lack of high-quality safety available data, from literature data cannabidiol (CBD) results to be a promising and safe anticonvulsant drug with low side-effect. In particular, according to early studies, CBD can reduce the frequency of seizures and lead to improvements in quality of life in children affected by refractory epilepsy. So, for these reasons, the detailed study of the interactions between CBD and anticonvulsant drugs (AEDs) administered simultaneously in polytherapy, is arousing increasing interest, to clarify and to assess the incidence of adverse effects and the relation between dose escalation and quality of life measures. To date, in pediatric age, CBD efficacy and safety is not supported by well-designed trials and strong scientific evidence are not available. These studies are either retrospective or small-scale observational and only during the last years Class I evidence data for a pure form of CBD have been available, as demonstrated in placebo-controlled RCTs for patients affected by Lennox-Gastaut syndrome and Dravet syndrome. It is necessary to investigate CBD safety, pharmacokinetics and interaction with other AEDs alongside performing double-blinded placebo-controlled trials to obtain conclusive data on its efficacy and safety in the most frequent epilepsies in children, not just in the epileptic encephalopathy. This review was aimed to revise the available data to describe the scientific evidence for CBD in Pediatric Epilepsies