Does timing of initiation influence acceptance and adherence to NIV in patients with ALS

Background: The role of nocturnal non invasive ventilation (NIV) to prolong tracheostomy-free survival, is still controversial in amyotrophic lateral sclerosis (ALS) patients and the best timing to initiate NIV is unclear. Objective: As NIV acceptance and adherence can be influenced by many factors, we aimed to compare immediate acceptance and short-term NIV adherence between NIV initiated very early and NIV initiated later. Methods: This is a post hoc analysis of our previous cohort retrospective study of 88 ALS patients: 53 under later NIV (late group – LG) (forced vital capacity [FVC] 80%). We compared hours of NIV use as immediate acceptance of NIV (use ≥4 h/night) and dherence at 4 months post-initiation (defined as use ≥4 h/night or 120 h/month). Results: No differences were found between VEG and LG in use of NIV (>5 h/night in both groups), immediate acceptance (85.7% vs. 85.0%, p = 0.927) and short-term adherence (81.3% vs. 87.2%, p = 0.469); 39.7% of patients increased their NIV use (35% by >60 min/night). A decline in adherence was observed in 12.5% of patients irrespective of group affiliation. Conclusions: In ALS patients, initiation of very early NIV does not reduce its immediate acceptance or the short-term adherence. However, at least 1 in 10 patients may be at risk of reducing their adherence irrespective of early or late NIV prescription. As still under debate and not conclusive, further literature on early NIV benefit is welcomed. Keywords: Home mechanical ventilation, ALS, Motoneuron disease, NI

Relaxation Techniques for People with Chronic Obstructive Pulmonary Disease: A Systematic Review and a Meta-Analysis

Chronic Obstructive Pulmonary Disease (COPD) people suffer from severe physical impairments, which often elicit significant psychological distress and impact their quality of life. This meta-analysis aimed to assess evidence from the scientific literature on the effects of relaxation techniques. Methods. We investigated 9 databases to select 25 RCTs. Studies included both inpatients and outpatients with COPD. Both respiratory and psychological outcomes were considered

Sudakov resummation of multiparton QCD cross sections

We present the general expressions for the resummation, up to next-to-leading logarithmic accuracy, of Sudakov-type logarithms in processes with an arbirtrary number of hard-scattering partons. These results document the formulae used by the authors in several previous phenomenological studies. The resummation formulae presented here, which are valid for phase-space factorizable observables, determine the resummation correction in a process-independent fashion. All process dependence is encoded in the colour and flavour structure of the leading order and virtual one-loop amplitudes, and in Sudakov weights associated to the cross section kinematics. We explicitly illustrate the application to the case of Drell--Yan and prompt-photon production.Comment: 13 pages, LaTe

Clinical Psychology and Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis is a fatal and progressive disease, characterized by progressive muscles weakness, with consequent loss of physical capacities. Psychologists can play an important role in ALS care, by providing clinical activities in every step of the disease, including support and counseling activities directed to patients, their caregivers and to physicians

Matching NLO QCD computations with PYTHIA using MC@NLO

We present the matching between a next-to-leading order computation in QCD and the PYTHIA parton shower Monte Carlo, according to the MC@NLO formalism. We study the case of initial-state radiation, and consider in particular single vector boson hadroproduction.Comment: 16 pages, 10 figures. Several comments and two figures have been adde

Extraction of antibacterial active compounds from dry leaves of African plants of the Combretaceae family

The dry leaves of two African plants of the Combretaceae family, furnished by the botanist of the St. Jean de Dieu hospital of Tangueita (Benin, central Africa),were extracted with a sequence of 5 solvents with increasing polarity (from cyclohexane to water).The raw materials, obtained from these extractions following solvent evaporations, were tested for antibiotic activity against gram negative and gram positive bacterial strains. According to the results of a modified Kirby-Bauer test, no promising effect was obtained against Gram negative bacteria while interesting dose-effect activities were observed against Gram positive strains. In particular, from G. senegalensis active compounds were found in the low polarity extract (dichloromethane) which, at a concentration of 800 μg/disk (13 mm diameter disk), resulted in a grow inhibition crown of 4.7 mm and 2.6 mm on Enterococcus faecalis and Staphylococcus aureus MSSA, respectively. An higher amount of the aqueous extract (4760 μg/disk) also produced a good result as 5.7 mm and 5.0 mm crowns were observed. The extracts from C. micranthum showed an inhibiting effect in the more polar extracts (i.e. from ethanol and water) which gave 1 mm of grow inhibition crown on both strains at a concentration of 1000 μg/disk. The most promising extract from each plant was partially purified and then tested on some clinical relevant bacterial strains: S. aureus MRSA, Clostridium difficile, Streptococcus pyogenes, Streptococcus pneumoniae, Corynebacterium striatum, Neisseria gonorrhoeae, Haemophylus influenzae, Escherichia coli, obtaining a good killing effects on the Gram positive bacteria of the panel

Water filling in carbon nanotubes with different wettability and implications on nanotube/water heat transfer via atomistic simulations

The peculiar heat and mass transfer properties of Carbon Nanotubes (CNTs) envision promising applications in nanoengineering and nanofluidic devices, such as heat sinks and desalination membranes. However, a comprehensive understanding of the intertwined effects of mass transfer (entrance and exit of liquid molecules inside CNTs) and heat transfer mechanisms (thermal exchange at the CNT/solvent interface) as a function of the properties of CNT surface is currently incomplete. In this work, we use molecular dynamics simulations to study heat and mass transfer in single wall CNTs with (5,5) and (10,10) chirality immersed in water. We present a sensitivity analysis where, starting from different choices of interaction potentials between CNTs and water molecules, we deduce the corresponding CNT/water wetting parameters, we model fill-in and fill-out water dynamics and arrangement of water molecules at the equilibrium. Spontaneous water entrance into CNTs is examined and a single energy parameter to model water filling is introduced. Secondly, we compute the CNT/water thermal boundary resistance for the different wetting properties. In perspective, this work supports a more rational design of CNT-based devices operating in nanothermal and nanobiological environments

Acceptance and adherence to non-invasive positive pressure ventilation in people with chronic obstructive pulmonary disease: a grounded theory study

IntroductionNon-Invasive Positive Pressure Ventilation (NPPV) is an established treatment for people with Chronic Obstructive Pulmonary Disease (COPD), but it is often improperly used or rejected. The patterns of acceptance and adherence to NPPV, conceiving constraints, and strengths related to its adaptation have not been explored from a qualitative perspective yet.ObjectivesThis study aims to qualitatively explore patterns of adaptation to NPPV in people affected by COPD and to identify the core characteristics and the specific adaptive challenges during the adaptation process.MethodsForty-two people with moderate or severe COPD were recruited and 336 unstructured interviews were conducted. A Constructivist Grounded Theory was used to gather and analyze data: the transcriptions were mutually gathered in open, selective, and theoretical phases, with open, selective, and theoretical coding, respectively.ResultsThe analysis resulted in a non-linear and dynamic process, characterized by three phases: deciding, trying NPPV, and using NPPV. The patterns revealed that positive and negative NPPV experiences, together with beliefs, emotions, stressful mental states, and behaviors result in different acceptance and adherence rates.DiscussionsThese findings may be helpful to implement new care strategies to promote acceptance and adherence to NPPV

Mandibular torus as a new index of success for mandibular advancement devices

Background: In obstructive sleep apnoea (OSA), treatment with mandibular advancement devices (MADs) reduces patients' Apnoea-Hypopnoea index (AHI) scores and improves their sleepiness and quality of life. MADs are non-invasive alternatives for patients who cannot tolerate traditional continuous positive airway pressure (CPAP) therapy. The variability of responses to these devices makes it necessary to search for predictors of success. The aim of our study was to evaluate the presence of mandibular torus as a predictor of MAD efficacy in OSA and to identify other potential cephalometric factors that could influence the response to treatment. Methods: This was a retrospective cohort study. The study included 103 patients diagnosed of OSA who met the criteria for initiation of treatment with MAD. Structural variables were collected (cephalometric and the presence or absence of mandibular torus). Statistical analysis was performed to evaluate the existence of predictive factors for the efficacy of MADs. Results: A total of 103 patients who were consecutively referred for treatment with MAD were included (89.3% men); the mean age of the participants was 46.3 years, and the mean AHI before MAD was 31.4 (SD 16.2) and post- MAD 11.3 (SD 9.2). Thirty-three percent of patients had mandibular torus. Torus was associated with a better response (odds ratio (OR) = 2.854 (p = 0.035)) after adjustment for sex, age, body mass index (BMI; kg/m2), the angle formed by the occlusal plane to the sella?nasion plane (OCC plane to SN), overinjection, and smoking. No cephalometric predictors of efficacy were found that were predictive of MAD treatment success. Conclusions: The presence of a mandibular torus practically triples the probability of MAD success. This is the simplest examination with the greatest benefits in terms of the efficacy of MAD treatment for OSA

COVIDIAGNOSTIX : health technology assessment of serological tests for SARS-CoV-2 infection.

Abstract Objective In vitro diagnostic tests for SARS-COV-2, also known as serological tests, have rapidly spread. However, to date, mostly single-center technical and diagnostic performance's assessments have been carried out without an intralaboratory validation process and a health technology assessment (HTA) systematic approach. Therefore, the rapid HTA for evaluating antibody tests for SARS-COV-2 was applied. Methods The use of rapid HTA is an opportunity to test innovative technology. Unlike traditional HTA (which evaluates the benefits of new technologies after being tested in clinical trials or have been applied in practice for some time), the rapid HTA is performed during the early stages of developing new technology. A multidisciplinary team conducted the rapid HTA following the HTA Core Model® (version 3.0) developed by the European Network for Health Technology Assessment. Results The three methodological and analytical steps used in the HTA applied to the evaluation of antibody tests for SARS-COV-2 are reported: the selection of the tests to be evaluated; the research and collection of information to support the adoption and appropriateness of the technology; and the preparation of the final reports and their dissemination. Finally, the rapid HTA of serological tests for SARS-CoV-2 is summarized in a report that allows its dissemination and communication. Conclusions The rapid-HTA evaluation method, in addition to highlighting the characteristics that differentiate the tests from each other, guarantees a timely and appropriate evaluation, becoming a tool to create a direct link between science and health management