4,073 research outputs found
Experimental determination of pressure drop and flow characteristics of dilute gas-solid suspensions
Loading ratio, glass particle size, and air Reynolds number effects on pressure drop and flow characteristics of air-solid suspension in turbulent pipe flo
An agent-based approach to assess drivers’ interaction with pre-trip information systems.
This article reports on the practical use of a multi-agent microsimulation framework to address the issue of assessing drivers’
responses to pretrip information systems. The population of drivers is represented as a community of autonomous agents,
and travel demand results from the decision-making deliberation performed by each individual of the population as regards
route and departure time. A simple simulation scenario was devised, where pretrip information was made available to users
on an individual basis so that its effects at the aggregate level could be observed. The simulation results show that the
overall performance of the system is very likely affected by exogenous information, and these results are ascribed to demand
formation and network topology. The expressiveness offered by cognitive approaches based on predicate logics, such as the
one used in this research, appears to be a promising approximation to fostering more complex behavior modelling, allowing
us to represent many of the mental aspects involved in the deliberation process
Torsion free groups with indecomposable holonomy group I
We study the torsion free generalized crystallographic groups with the
indecomposable holonomy group which is isomorphic to either a cyclic group of
order or a direct product of two cyclic groups of order .Comment: 22 pages, AMS-Te
Recurrence of status epilepticus: Prognostic role and outcome predictors.
OBJECTIVE: Predictors of morbidity and mortality after status epilepticus (SE) have been studied extensively in hospital- and population-based cohorts. However, little attention has been directed toward SE recurrence after an incident episode. We investigated clinical and demographic characteristics of patients presenting SE recurrence and its specific prognostic role.
METHODS: In this observational cohort study, we screened our prospective registry of consecutive adults with SE between April 2006 and February 2014. Demographic and clinical data were compared between incident and recurrent SE episodes; risk of SE recurrence was assessed through survival analysis, and the prognostic role of SE recurrence with multivariable logistic regressions.
RESULTS: Of the incident cohort (509 patients), 68 (13%) experienced recurrent SE. The cumulative recurrence rate over 4 years was 32%. Recurrence risk was significantly reduced after an acute SE etiology (hazard ratio [HR] 0.5, 95% confidence interval [CI] 0.31-0.82; p = 0.005), and was borderline increased in women (HR 1.59, 95% CI 0.97-2.65; p = 0.06). Although recurrent SE episodes showed lower morbidity and mortality, prognosis was independently related to Status Epilepticus Severity Score (STESS) and potentially fatal etiology, but not to SE recurrence.
SIGNIFICANCE: This study provides class III evidence that SE recurrence involves a significant proportion of patients, and that recurrence risk is independently associated with chronic etiology and to a lesser extent with female gender. However, contrary to underlying cause and SE severity, SE recurrence per se does not independently correlate with outcome. Early identification of patients at higher risk of SE recurrence may influence their management during follow-up
A new formulation of oral viscous budesonide in treating of paediatric eosinophilic oesophagitis: a pilot study
OBJECTIVES:
Oral viscous budesonide is a recent therapeutic option for eosinophilic oesophagitis (EoE) compared with dietary restriction and inhaled steroids. This single-centre, open-label, not blinded study aims to evaluate the efficacy and safety of a new, preprepared oral viscous budesonide suspension (PVB) in children and adolescents with EoE.
METHODS:
We treated 36 children with PVB (29 boys; median age 12 years) with EoE diagnosed according to European Society for Paediatric Gastroenterology Hepatology and Nutrition guidelines. Patients <150 and >150 cm height received 2 and 4 mg PVB daily, respectively, for 12 weeks. Upper gastrointestinal endoscopy was performed at baseline, after 12 weeks of therapy and 24 weeks after the end of therapy. Baseline and post-treatment scores were calculated for symptoms, endoscopy, and histology. Serum cortisol was performed at baseline, 12, and 36 weeks.
RESULTS:
At the end of PVB trial, endoscopy showed macroscopic remission in 32 patients (88.9%), whereas at histology median pre- and post-treatment peak eosinophil count/high power field (HPF) markedly decreased from 42.2 (range: 15-100) to 2.9 (range: 0-30); moreover, mean symptom and histology scores impressively improved compared with baseline (P < 0.01). At 24 weeks after the end of PVB therapy, endoscopy showed oesophageal relapse in 21 patients (58.3%), whereas 15 (41.7%) were still in remission. Seven children (19.4%) with positive multichannel intraluminal impedance-pH were treated also with proton pump inhibitors. No significant difference between pre-/post-treatment morning cortisol levels occurred.
CONCLUSIONS:
The new PVB suspension presented in the present study is effective and safe for treating children with proven EoE. Larger placebo-controlled clinical trials would provide more information about dosing, efficacy, and long-term safety of this formulation, specifically designed for the oesophagus
EEG reactivity to pain in comatose patients: Importance of the stimulus type.
INTRODUCTION: Electroencephalogram (EEG) background reactivity is a potentially interesting outcome predictor in comatose patients, especially after cardiac arrest, but recent studies report only fair interrater reliability. Furthermore, there are no definite guidelines for its testing. We therefore investigated the EEG effect of standardized noxious stimuli in comatose patients not reactive to auditory stimuli.
METHODS: In this prospective study we applied a protocol using three different painful stimuli (bilateral nipple pinching, pinprick at the nose base, finger-nail compression on each side), grouped in three distinct clusters with an alternated sequence, during EEG recordings in comatose patients. We only analyzed recordings showing any reactivity to pain. Fisher and χ2 tests were used as needed to assess contingency tables.
RESULTS: Of 42 studies, 12 did not show any background reactivity, 2 presented SIRPIDs, and 2 had massive artefacts; we thus analyzed 26 EEGs recorded in 17 patients (4 women, 24%). Nipple pinching more frequently induced a change in EEG background activity (p<0.001), with a sensitivity of 97.4% for reactivity. Neither the order of the stimuli in the cluster (p=0.723), nor the cluster order (p=0.901) influenced the results.
CONCLUSION: In this pilot study, bilateral, synchronous nipple pinching seems to be the most efficient method to test nociceptive EEG reactivity in comatose patients. This approach may enhance interrater reliability, but deserves confirmation in larger cohorts
Yield of Outpatient Sleep EEG for Epileptiform Alterations' Detection in Children.
PURPOSE: Ambulatory EEGs in children are frequently ordered as sleep studies. However, the yield according to different clinical situations has received little attention to date. The authors aimed to quantify the added value in terms of detection of epileptiform features of an EEG containing sleep, as compared with only wakefulness, according to the referral diagnoses.
METHODS: The authors retrospectively selected consecutive outpatients' EEG recordings of patients between 6 months to 16 years old, performed between January 2014 and February 2015. The authors excluded those lacking at least 10 minutes of waking and/or at least 5 minutes of behavioral sleep. Interictal epileptiform activity (IEA) in wakefulness and sleep was compared among referral suspected diagnoses. Additional yield of sleep was considered if at least one of the following was observed: appearance of interictal epileptiform activity or increase by >50%; interictal epileptiform activity change in localization or morphology, seizure occurrence.
RESULTS: A total of 425 recordings (mean age 6.9 ± 4.7 years) were analyzed. Of them, 194 (45.6%) presented an additional yield during sleep, which was dependent on the occurrence of IEA during wakefulness: 77/251 (30.7%) in those without versus 117/174 (67.2%) in those with wakefulness IEA (P < 0.001, χ). The yield was markedly lower in studies performed for nonepileptic referral diagnoses (7% vs. 43% to 100%; P < 0.001, Fisher).
CONCLUSIONS: When wakefulness EEG lacks epileptiform features, the yield of sleep EEG in our pediatric population appeared modest, especially in patients without a suspected epileptic syndrome. This information may be used to optimize the request of sleep EEG in children
Interpretations of Individualistic and Collectivistic Drinking Messages in Beer Commercials by Teenagers from Five European Countries
The study is a qualitative investigation into European teenagers’ meaning-making of beer commercials with individualistic and collectivistic drinking messages. The subjects were teenagers (aged 13–16) from Finland, Germany, Italy, the Netherlands and Poland. Eight (8) focus group interviews were conducted in each country, with a total of 267 participants. Beer commercials acted as stimuli for the group discussions. The adolescents’ speech in these discussions was analysed for the perceived positive outcomes of drinking alcohol and for perceptions of competence attached to drinking. The speech of the participants is juxtaposed to a semiotic reading of the commercials and differences between the groups are explained by cultural differences. Key words: Drinking cultures; Teenagers; Beer commercials; RAGI; Collectivistic and individualistic culturesResumé: L'étude est une enquête qualitative sur la signification perçue par les adolescents européens vis-à-vis des publicités de bière avec des messages individualistes et collectivistes. Les sujets d’étude étaient des adolescents (âgés de 13-16) de la Finlande, de l'Allemagne, de l'Italie, des Pays-Bas et de la Pologne. Huit (8) groupes d’entretien ont été menés dans chaque pays, avec un total de 267 participants. Les publicités de bière ont été utilisées comme des stimuli pour activer les discussions de groupe. Les discours des adolescents dans ces discussions ont été analysés pour les résultats positifs perçus de la consommation d'alcool et la perception des compétences associées à l'alcoolisme. Les discours des participants sont juxtaposés à une lecture sémiotique des publicités et les différences entre les groupes sont expliquées par les différences culturelles.Mots-clés: cultures de vin; adolescents; publicités de bière; RAGI; culture collectiviste et individualist
Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C.
Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C.
In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5).
We analyzed 61 patients. The presence of two or more predictors out of, unreactive electroencephalogram (EEG) background, epileptiform EEG, absent pupillary and/or corneal reflex, early myoclonus, bilaterally absent cortical somatosensory evoked potentials, and serum NSE >75 μg/l, had a high specificity for predicting mortality (positive predictive value [PPV] = 1.00, 95% CI 0.87-1.00) and poor outcome (PPV = 1.00, 95% CI 0.80-1.00). Reactive EEG background was highly sensitive for predicting good outcome (0.95, 95% CI 0.74-0.99).
Prediction of outcome after CA and TTM targeting 36 °C seems valid in adults using the same features tested at 33 °C. A reactive EEG under TTM appears highly sensitive for good outcome
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