An outbreak of Streptococcus pneumoniae in an Italian nursing home

Streptococcus pneumoniae is the main cause of community-acquired pneumonia worldwide; pneumonia occurs sporadically in most cases, but rare outbreaks have been reported. We  describe an outbreak occurred in a 21-guests nursing home for elders in Aosta (Italy); outbreak occurred in april 2014 over a 2 weeks period, resulting in 12 out 20 guests affected (all with high fever and respiratory symptoms), two deaths (at home), nine patients referred  to Hospital Emergency Room, and eight admissions. Urinary streptococcus antigen was positive in seven out of eight patient tested. None of the nursing home guests were vaccinated against Streptococcus pneumoniae The Hospital Medical Direction and Public Health Service gave support and adopted strategies to contain the outbreak spread. We underline the need for pneumococcal vaccination in nursing homes/ Long-term care facilities; accurate check of hygiene behaviours in those setting is also mandatory. &nbsp

Ultralow loading electroless deposition of IrOx on nickel foam for efficient and stable water oxidation catalysis

Abstract Photocatalysis and electrolysis are crucial processes for the development of a sustainable, clean energy system, since they enable solar fuel production, such as hydrogen by water splitting, as well as CO2 reduction. In these processes efficient and robust catalysts for water oxidation are required and the reduction of employed amount of noble metals is crucial to reduce costs and increase the sustainability of the technology. To obtain extremely low iridium loading on nickel foam electrodes we have employed electroless deposition by spontaneous galvanic displacement as a simple, low cost, highly scalable technique. After deposition the Ir oxidation has been achieved by annealing in air at 250 °C. By varying the deposition parameters, an optimal condition has been achieved, with an overpotential for water oxidation of 360 mV at 10 mA cm−2 in 1.0 M KOH solution. The Ni foam coverage with Ir oxide has also a positive impact on the electrode stability, strongly decreasing the degradation rate, compared to the case of bare Ni foam. The average amount of noble metal in the best performing electrode is only 35 μg cm−2 for a 1.6 mm thick Ni foam electrode. The proposed approach is highly promising for gas diffusion electrodes, and can be implemented in electrolytic cells, as well as in fuel cells

Correlating electron trapping and structural defects in Al2O3 thin films deposited by plasma enhanced atomic layer deposition

In this article, electron trapping in aluminum oxide (Al2O3) thin films grown by plasma enhanced atomic layer deposition on AlGaN/GaN heterostructures has been studied and a correlation with the presence of oxygen defects in the film has been provided. Capacitance–voltage measurements revealed the occurrence of a negative charge trapping effect upon bias stress, able to fill an amount of charge traps in the bulk Al2O3 in the order of 5 × 1012 cm−2. A structural analysis based on electron energy-loss spectroscopy demonstrated the presence of low-coordinated Al cations in the Al2O3 film, which is an indication of oxygen vacancies, and can explain the electrical behavior of the film. These charge trapping effects were used for achieving thermally stable (up to 100 °C) enhancement mode operation in AlGaN/GaN transistors, by controlling the two-dimensional electron gas depletion

An Agent Based Model of Air Traffic Management

The WP-E ELSA project aims at developing an empirically grounded agent based model that describes some of the stylized facts observed in the Air Traffic Management of the European airspace. The model itself has two main parts: (i) The strategic layer, focused on the interaction between the Network Manager and the Airline Operators and (ii) the tactical layer, focused on aircraft and controllers behaviour in Air Traffic Control (ATC) sectors. The preliminary results for the strategic layer show that when we have a mixing of re-routing and shifting companies, the overall satisfaction can even increase together with the number of flights, which is an effect not observed when only one type of companies is present. The preliminary results for the tactical layer indicate that when shocks in the system are confined in small areas, the interplay between the re-routing and change of flight level strategies may even lead to trajectory modifications that give smaller average delays as long as the number of shocks increases

Nanoscale electro-structural characterisation of ohmic contacts formed on p-type implanted 4H-SiC

This work reports a nanoscale electro-structural characterisation of Ti/Al ohmic contacts formed on p-type Al-implanted silicon carbide (4H-SiC). The morphological and the electrical properties of the Al-implanted layer, annealed at 1700°C with or without a protective capping layer, and of the ohmic contacts were studied using atomic force microscopy [AFM], transmission line model measurements and local current measurements performed with conductive AFM

L’impatto farmacoeconomico del trattamento della schizofrenia con antipsicotici tipici ed atipici: l’esperienza di un DSM della Regione Sicilia

Il presente lavoro è stato realizzato con il patrocinio del Dipartimento Ispettorato Regionale Sanitario dell.Assessorato per la Sanità della Regione Sicilia, nella persona del Dirigente Generale Dott. Saverio Ciriminna BACKGROUND: The comparatively high acquisition costs of the new antipsychotic drugs have induced the mental health community to look closely at their potential benefits. OBJECTIVE: To compare the clinical and economic outcomes associated with olanzapine, risperidone and typical neuroleptics treatment for schizophrenia. METHODS:Amulticenter, observational, two-years long, retrospective and prospective study was conducted with 229 psychotic patients (in charge by psychiatric Centers of Regione Sicilia - Italy). Clinical outcomes were assessed using changes in CGI (Clinical Global Impression) and PANSS (Positive and Negative Syndrome Scale) scores. The economic data collection included pharmacological and non-pharmacological resources consumption (hospitalizations, medical/nurse visits, etc.). The economic evaluation was conducted in the perspective of the Local Psychiatric Services. RESULTS: The results in terms of clinical performance indicated an advantage (statistically significant) in the olanzapine group of patients. The pharmacological costs were significantly lower (p0,05). Treatment with olanzapine was associated with a lower non-pharmacological resources consumption and showed a general reduction (

Causes of death in women with breast cancer: a risks and rates study on a population-based cohort

IntroductionThe increasing survival of patients with breast cancer has prompted the assessment of mortality due to all causes of death in these patients. We estimated the absolute risks of death from different causes, useful for health-care planning and clinical prediction, as well as cause-specific hazards, useful for hypothesis generation on etiology and risk factors.Materials and methodsUsing data from population-based cancer registries we performed a retrospective study on a cohort of women diagnosed with primary breast cancer. We carried out a competing-cause analysis computing cumulative incidence functions (CIFs) and cause-specific hazards (CSHs) in the whole cohort, separately by age, stage and registry area.ResultsThe study cohort comprised 12,742 women followed up for six years. Breast cancer showed the highest CIF, 13.71%, and cardiovascular disease was the second leading cause of death with a CIF of 3.60%. The contribution of breast cancer deaths to the CIF for all causes varied widely by age class: 89.25% in women diagnosed at age <50 years, 72.94% in women diagnosed at age 50–69 and 48.25% in women diagnosed at age ≥70. Greater CIF variations were observed according to stage: the contribution of causes other than breast cancer to CIF for all causes was 73.4% in women with stage I disease, 42.9% in stage II–III and only 13.2% in stage IV. CSH computation revealed temporal variations: in women diagnosed at age ≥70 the CSH for breast cancer was equaled by that for cardiovascular disease and “other diseases” in the sixth year following diagnosis, and an early peak for breast cancer was identified in the first year following diagnosis. Among women aged 50–69 we identified an early peak for breast cancer followed by a further peak near the second year of follow-up. Comparison by geographic area highlighted conspicuous variations: the highest CIF for cardiovascular disease was more than 70% higher than the lowest, while for breast cancer the highest CIF doubled the lowest.ConclusionThe integrated interpretation of absolute risks and hazards suggests the need for multidisciplinary surveillance and prevention using community-based, holistic and well-coordinated survivorship care models

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat