1,013 research outputs found

    IN1 BUDGETARY IMPACT OF PNEUMOCOCCAL CONJUGATE VACCINATION OF NEWBORNS IN THE PERSPECTIVE OF THE REGIONAL HEALTH CARE SYSTEM OF LOMBARDY

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    Water vapour permeability of clay bricks

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    The water vapour permeability of clay bricks has been experimentally measured in order to draw a representative outline of industrial products without pore-forming additives. The correlations between water vapour permeability and the main compositional and microstructural parameters of both bricks and clay bodies have been investigated. A statistical model was set up in order to predict with reasonable precision and reliability, the water vapour permeability on the basis of open porosity, bulk density, mean pore size and pore specific surface values of bricks, and the finer particle size of clay bodies

    Detection of activity and position of speakers by using deep neural networks and acoustic data augmentation

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    The task of Speaker LOCalization (SLOC) has been the focus of numerous works in the research field, where SLOC is performed on pure speech data, requiring the presence of an Oracle Voice Activity Detection (VAD) algorithm. Nevertheless, this perfect working condition is not satisfied in a real world scenario, where employed VADs do commit errors. This work addresses this issue with an extensive analysis focusing on the relationship between several data-driven VAD and SLOC models, finally proposing a reliable framework for VAD and SLOC. The effectiveness of the approach here discussed is assessed against a multi-room scenario, which is close to a real-world environment. Furthermore, up to the authors’ best knowledge, only one contribution proposes a unique framework for VAD and SLOC acting in this addressed scenario; however, this solution does not rely on data-driven approaches. This work comes as an extension of the authors’ previous research addressing the VAD and SLOC tasks, by proposing numerous advancements to the original neural network architectures. In details, four different models based on convolutional neural networks (CNNs) are here tested, in order to easily highlight the advantages of the introduced novelties. In addition, two different CNN models go under study for SLOC. Furthermore, training of data-driven models is here improved through a specific data augmentation technique. During this procedure, the room impulse responses (RIRs) of two virtual rooms are generated from the knowledge of the room size, reverberation time and microphones and sources placement. Finally, the only other framework for simultaneous detection and localization in a multi-room scenario is here taken into account to fairly compare the proposed method. As result, the proposed method is more accurate than the baseline framework, and remarkable improvements are specially observed when the data augmentation techniques are applied for both the VAD and SLOC tasks

    Thermal conductivity of clay bricks

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    In the present work the thermal conductivity of 29 samples of clay bricks was measured and the correlations of the thermal performance with the compositional, physical, and microstructural features of products were investigated. The results obtained directed our attention toward a better understanding of the role played by some parameters (i.e., mineralogical components and pore size distribution), other than bulk density, in improving or depressing the insulating properties of bricks. Among them, the unfavorable role of quartz, Ca-rich silicates, and amorphous phase came out, while the role of pore size and specific surface should be more accurately evaluated in the structural design of materials

    Radiolarian biostratigraphic evidence for a Late Jurassic age of the El Tambor Group ophiolites (Guatemala)

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    We present a radiolarian biostratigraphic study of the metacherts of the El Tambor Group ophiolites (South Motagua Unit), Guatemala. The ophiolite sequence comprises MOR pillow metabasalts, massive metabasalts, metacherts and micaschists. The age of the studied metacherts is referable to the Late Jurassic (Oxfordian - Kimmeridgian). The radiolarian assemblage described in this paper is the first Jurassic finding in the ophiolitic MOR succession of the Motagua zone and represents a valuable tool to constrain the geodynamic evolution of the Caribbean area. A review of the ages of Jurassic rocks associated with the ophiolites from the Caribbean area is also reported

    The cost of inflammatory bowel disease management matches with clinical course: A single outpatient centre analysis

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    Inflammatory bowel diseases (IBD) have a large economic burden on health systems. Our single-centre observational retrospective study aimed to assess an economic evaluation in two IBD outpatient cohorts (biological and conventional therapy) in relation to disease activity within a three-year follow-up. Four hundred and seventeen consecutive IBD patients referred to our tertiary gastroenterology unit (Bari-Puglia-Southern Italy) on January 2014–December 2016 were included. For each group (conventional/biological), we assessed direct/indirect costs and clinical/endoscopic activity within the first year and along the three-year follow-up. Statistical analyses: Wilcoxon signed-rank test (continuous variables), chi-square and Fisher’s test (categorical variables), Spearman ranks (single outcome) and ANOVA (detection time, clinical/endoscopic scores) were used. Continuous variables were expressed as mean ± standard deviation and range and/or median, interquartile range and range; categorical variables were expressed as proportions with 95% confidence interval. Direct and indirect cost items of 2014 and 2014–2016 were higher in patients treated with biological than conventional therapy. Subjects on biological therapy were younger and showed clinical and endoscopic moderate-to-severe disease activity. After three years, they reached a significant improvement from baseline. Conversely, disease activity was mild when conventional treatment had a beneficial effect. In conclusion, overall IBD management cost matches with clinical course and needs long-term evaluation in critical patients

    Intestinal tuberculosis in a child living in a country with a low incidence of tuberculosis: a case report

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    Background: Relatively common in adults, intestinal tuberculosis is considered rare in children and adolescents. The protean manifestations of intestinal tuberculosis mean that the diagnosis is often delayed (sometimes even for years), thus leading to increased mortality and unnecessary surgery. The main diagnostic dilemma is to differentiate intestinal tuberculosis and Crohn’s disease because a misdiagnosis can have dramatic consequences. Case presentation: A 13-year-old Caucasian, Italian female adolescent attended the Emergency Department complaining of abdominal pain, a fever of up to 38°C, night sweats, diarrhea with blood in stool, and a weight loss of about three kilograms over the previous two months. Physical examination revealed a marked skin pallor and considerable abdominal distension with relevant discomfort in all the abdominal quadrant. Laboratory tests revealed a decreased white blood cell count with anemia and increased C-reactive protein levels. The Mantoux tuberculin skin test was negative. A chest X-ray and an abdominal ultrasonography did not reveal any significant findings. The patient underwent colonoscopy that showed diffuse mucosal congestion and significant blood loss, and laparatomy showed small bowel and colon loops with a whitish appearance. A biopsy of the ileal mucosa revealed inflammation with noncaseating granulomas possibly due to bacterial infection. Given the suspicion of an opportunistic bacterial infection in a child with chronic inflammatory bowel disease (possibly Crohn’s disease), treatment with a third-generation cephalosporin was started. However, the abdominal pain, fever and poor general condition persisted and so, after 11 days, the patient underwent total body computed tomography and magnetic resonance imaging of the brain. On the basis of the radiological findings, miliary tuberculosis was suspected and bronchoscopy was performed and resulted positive for Mycobacterium tuberculosis. Miliary tuberculosis was confirmed and an effective treatment with four drugs was started. Conclusion: This case shows that the manifestations of intestinal tuberculosis can be very difficult to diagnose and mimic those of Chron’s disease. Total body computed tomography and laparotomy with an intestinal biopsy for the detection of Mycobacterium tuberculosis are the means of avoid the risks of a misdiagnosis in children with unexplained chronic abdominal problems

    Vaccines in children with inflammatory bowel disease: Brief review

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    Incidence of inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), is increasing worldwide. Children with IBDs have a dysfunctional immune system and they are frequently treated with immunomodulating drugs and biological therapy, which significantly impair immune system functions and lead to an increased risk of infections. Vaccines are essential to prevent at least part of these infections and this explains why strict compliance to the immunization guidelines specifically prepared for IBD patients is strongly recommended. However, several factors might lead to insufficient immunization. In this paper, present knowledge on the use of vaccines in children with IBDs is discussed. Literature review showed that despite a lack of detailed quantification of the risk of infections in children with IBDs, these children might have infections more frequently than age-matched healthy subjects, and at least in some cases, these infections might be even more severe. Fortunately, most of these infections could be prevented when recommended schedules of immunization are carefully followed. Vaccines given to children with IBDs generally have adequate immunogenicity and safety. Attention must be paid to live attenuated vaccines that can be administered only to children without or with mild immune system function impairment. Vaccination of their caregivers is also recommended. Unfortunately, compliance to these recommendations is generally low and multidisciplinary educational programs to improve vaccination coverage must be planned, in order to protect children with IBD from vaccine-preventable diseases

    Pleistocene slope, shallow-marine and continental deposits of eastern central Italy wedge-top basin: a record of sea-level changes and mountain building.

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    This guidebook to Pleistocene sediments exposed in eastern central Italy has been prepared for the PRE-3 geological field trip accompanying the XXI INQUA Congress held in Rome, Italy, in July 2023. It is designed to provide an overview of the sedimentological features, stratigraphic architecture and basin evolutionary steps during the Pleistocene of the central portion of the Periadriatic basin (Central Periadriatic Basin), a N-S oriented foreland basin system associated to the Central Apennine Outer Orogenic Wedge. The Central Periadriatic Basin stretches along the Marche and Abruzzo regions and is an excellent example of an evolving mountain chain and associated deep-marine to fluvial-alluvial foredeep and wedge-top basin system. By integrating surface and subsurface datasets, this field trip affords a fine west to east transect through the Pleistocene basin-fill in southern Marche, where exposures allow a close examination of sedimentary facies and architecture of depositional systems. The basinfill succession includes coarse-grained submarine canyon-fills encased in slope mudstones, mixed beachface-shoreface conglomerates and sandstones, and alternating conglomerate and mudstone bodies interpreted as fluvial-channel and floodplain deposits, respectively. The analysis of facies architecture and discontinuity surfaces will allow the attendees to understand the relative role of sea-level changes, sediment supply, and thrust front propagation inside the foreland basins system as several factors controlling the stratigraphic record
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