524 research outputs found

    A Neumann eigenvalue problem for fully nonlinear operators

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    In this paper we study the asymptotic behavior of the principal eigenvalues associated to the Pucci operator in bounded domain Ω\Omega with Neumann/Robin boundary condition i.e. ∂nu=αu\partial_n u=\alpha u when α\alpha tends to infinity. This study requires Lipschitz estimates up to the boundary that are interesting in their own rights.Comment: 19 page

    Clinical Governance Should Be a Priority When Care Delivery Systems Are Disrupted

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    Urinary ethylenethiourea as biomarkers of exposure to ethylenebisdithiocarbamates in floriculture workers in Ecuador

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    Floriculture represents one of the major sources of income in Ecuador that is one of the greatest worldwide producers of ornamental flowers. Floriculture can be carried out both in open fields and in greenhouses with an extensive use of pesticides, among which, ethylenbisdithiocarbamate fungicides (EBDTCs). Aim of this study was to assess EBDTCs exposure in Ecuadorian floricultural workers by the determination of the urinary excretion of the major metabolite of these compounds, ethylenethiourea (ETU). Thirty-six floriculture workers and 34 unexposed healthy subjects (controls) from an Andean region entered the study. Workers were exposed to EBDTCs while applying plant protection products, and during re-entry activities or crop maintenance in one open field and two greenhouse farms. They provided morning pre-exposure (n=31) and afternoon post-exposure (n=24) urine spot samples. Controls provided one urine spot sample collected in the morning. In agricultural workers median ETU in pre- and after-exposure samples was 3.2 (<0.5-34.5) and 6.2 (1.5-26.5) \ub5g/g creatinine. Although ETU increased after the workshift the difference was not significant. ETU was higher in workers then in controls (0.7, <0.5-7.1 \ub5g/g creatinine, p < 0.01). When subjects were divided according to job titles, applicators showed the highest ETU (17.0, 1.5-34.5 \ub5g/g creatinine) whereas growing, post-harvesting and maintenance workers showed similar levels (4.3, <0.5-26.5; 2.8, <0.5-11.1; 4.8, 3.2-6.5 \ub5g/g creatinine, respectively). Higher ETU was observed in greenhouse compared to open field workers (p < 0.01). This study suggests that Ecuadorian floricultures are exposed to EBDTCs at levels approaching those observed in Italian vineyard workers. The lack of difference between ETU in pre- vs. post-exposure samples is attributable to previous day exposure, in fact the kinetic of excretion is such that in prior to next shift urine significant amount of ETU is still present

    Impact of total automation consolidating first-line laboratory tests on diagnostic blood loss

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    Background: Blood loss for laboratory testing may contribute to hospital-acquired anemia. When implementing the core laboratory (core-lab) section, we consolidated first-line tests decreasing the number of tubes previously dispatched to different sites. Here, hypothesized benefits of the amount of blood volume drawn were explored. Methods: We retrieved, using a laboratory information system (LIS), the number of tubes received by laboratories interested in the change from all clinical wards in a year-based period, i.e. 2013 for pre-core-lab and 2015 for core-lab system, respectively. Data were expressed as the overall number of tubes sent to laboratories, the corresponding blood volume, and the number of laboratory tests performed, normalized for the number of inpatients. Results: After consolidation, the average number of blood tubes per inpatient significantly decreased (12.6 vs. 10.7, p\u2009&lt;\u20090.001). However, intensive care units (ICUs) did not reduce the number of tubes per patient, according to the needs of daily monitoring of their clinical status. The average blood volume sent to laboratories did not vary significantly because serum tubes for core-lab required higher volumes for testing up to 55 analytes in the same transaction. Finally, the number of requested tests per patient during the new osystem slightly decreased ( 122.6%). Conclusions: Total laboratory automation does not automatically mean reducing iatrogenic blood loss. The new system affected the procedure of blood drawing in clinical wards by significantly reducing the number of handled tubes, producing a benefit in terms of costs, labor and time consumption. Except in ICUs, this also slightly promoted some blood saving. ICUs which engage in phlebotomizing patients daily, did not take advantage from the test consolidation

    Performance of Diagram immunoturbidimetric assay for serum albumin on Abbott Architect c16000 platform

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    Roc de Combe est l’un des sites de référence pour étudier les modalités de passage Paléolithique moyen récent – Paléolithique supérieur initial (Châtelperronien) et Paléolithique supérieur ancien (Aurignacien ancien) dans le Sud-Ouest de la France. Fouillé par F. Bordes en 1966 et longtemps réputé pour une « interstratification » – désormais rejetée – servant la thèse de l’acculturation, il a fait l’objet d’une étude des niveaux attribués au Châtelperronien et à l’Aurignacien, mais les séries du Moustérien demeuraient jusqu’à ce jour identifiées, cependant non étudiées. Un récent travail universitaire mené par l’une d’entre nous (M.L.M.) permet désormais de disposer d’un bilan techno-économique et typologique confirmant l’attribution de cette série au Moustérien de débitage Discoïde à denticulés, techno-complexe qui clôt dans le Sud-Ouest de la France nombre d’archéo-séquences. La présente étude donne les premières données numériques relatives à cette série inédite, la positionne dans un cadre chrono-culturel et son contexte régional, en insistant sur un statut pétrographique relativement original propre à la Bouriane, région faisant la liaison entre Périgord et Quercy.Roc de Combe (Lot, France) is one of the key sites concerning the Late Middle to Upper Palaeolithic transition in southwestern France. 1966’ excavation, led by François Bordes, has yielded some Mousterian, Chatelperronian, Aurignacian and Gravettian rich assemblages. Here we present the analysis of the unpublished Mousterian lithic assemblages, studied by one of us during a Master degree. From this study, the belonging of this industry to a Denticulate-Discoid Mousterian has been confirmed, a technocomplex usually classically attributed to the final stage of the Mousterian. Several radiocarbon dates confirm this attribution. Finally, our analysis shows an original lithic raw material procurement strategy, due to the site location, peculiar to the Bouriane between Perigord and Quercy

    A historical vertebrate collection from the Middle Miocene of the Peruvian Amazon

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    The Miocene aquatic and terrestrial fossil record from western Amazonia constitute a clear evidence of the palaeoenvironmental diversity that prevailed in the area, prior to the establishment of the Amazon River drainage. During the Miocene, the region was characterized by a freshwater megawetland basin, influenced by episodic shallow-marine incursions. A fossil vertebrate collection from the middle Miocene strata of the Pebas Formation is here studied and described. This historical collection was recovered in 1912 along the banks of the Itaya River (Iquitos, Peru), during a scientific expedition led by two scientists of the University of Zurich, Hans Bluntschli and Bernhard Peyer. Our findings include a total of 34 taxa, including stingrays, bony fishes, turtles, snakes, crocodylians, and lizards. Fishes are the most abundant group in the assemblage (~ 23 taxa), including the first fossil record of the freshwater serrasalmids Serrasalmus, and Mylossoma, and the hemiodontid Hemiodus for the Pebas system, with the latter representing the first fossil be discovered for the entire Hemiodontidae. The presence of a representative of Colubroidea in the middle Miocene of Iquitos supports the hypothesis of arrival and dispersal of these snakes into South America earlier than previously expected. This fossil assemblage sheds light on the palaeoenvironments, and the geographical/temporal range of several aquatic/terrestrial lineages inhabiting the Amazonian region

    Laparoscopic splenectomy as a definitive management option for high-grade traumatic splenic injury when non operative management is not feasible or failed: a 5-year experience from a level one trauma center with minimally invasive surgery expertise

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    Technique, indications and outcomes of laparoscopic splenectomy in stable trauma patients have not been well described yet. All hemodynamically non-compromised abdominal trauma patients who underwent splenectomy from 1/2013 to 12/2017 at our Level 1 trauma center were included. Demographic and clinical data were collected and analysed with per-protocol and an intention-to-treat comparison between open vs laparoscopic groups. 49 splenectomies were performed (16 laparoscopic, 33 open). Among the laparoscopic group, 81% were successfully completed laparoscopically. Laparoscopy was associated with a higher incidence of concomitant surgical procedures (p 0.016), longer operative times, but a significantly faster return of bowel function and oral diet without reoperations. No significant differences were demonstrated in morbidity, mortality, length of stay, or long-term complications, although laparoscopic had lower surgical site infection (0 vs 21%).The isolated splenic injury sub-analysis included 25 splenectomies,76% (19) open and 24% (6) laparoscopic and confirmed reduction in post-operative morbidity (40 vs 57%), blood transfusion (0 vs 48%), ICU admission (20 vs 57%) and overall LOS (7 vs 9 days) in the laparoscopic group. Laparoscopic splenectomy is a safe and effective technique for hemodynamically stable patients with splenic trauma and may represent an advantageous alternative to open splenectomy in terms of post-operative recovery and morbidit
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