On Relaxing Metric Information in Linear Temporal Logic

Metric LTL formulas rely on the next operator to encode time distances, whereas qualitative LTL formulas use only the until operator. This paper shows how to transform any metric LTL formula M into a qualitative formula Q, such that Q is satisfiable if and only if M is satisfiable over words with variability bounded with respect to the largest distances used in M (i.e., occurrences of next), but the size of Q is independent of such distances. Besides the theoretical interest, this result can help simplify the verification of systems with time-granularity heterogeneity, where large distances are required to express the coarse-grain dynamics in terms of fine-grain time units.Comment: Minor change

Living with stable angina: patients' pathway and needs in angina.

AIMS: There is evidence that stable angina patients may suffer from emotional disorders that further impair their quality of life. However, the emotional experience of living with stable angina from the patient's perspective still has to be explored. Thus, the main aim of this study was to explore patients' emotional experience of having stable angina and their reported needs during the pathway from the first symptoms, through the process of diagnosis, to management and related lifestyle changes. METHODS: A survey was conducted in 75 chronic ischemic heart disease patients with angina (Brazil, China, Romania, Russia, and Turkey) using a 75-min, face-to-face in-depth interview. RESULTS AND CONCLUSION: Patients' responses highlighted the need to increase individuals' awareness on the first signs and symptoms of the disease. The survey also showed that chronic stable angina patients need constant emotional support to overcome stress, anxiety, and depression. Finally, this study suggests the need to offer greater space for dialogue with healthcare professionals to get more comprehensive and 'patient-friendly' information

Physiopathological rationale of using high-flow nasal therapy in the acute and chronic setting: A narrative review

Chronic lung disease and admissions due to acute respiratory failure (ARF) are becoming increasingly common. Consequently, there is a growing focus on optimizing respiratory support, particularly non-invasive respiratory support, to manage these conditions. High flow nasal therapy (HFNT) is a noninvasive technique where humidified and heated gas is delivered through the nose to the airways via small dedicated nasal prongs at flows that are higher than the rates usually applied during conventional oxygen therapy. HFNT enables to deliver different inspired oxygen fractions ranging from 0.21 to 1. Despite having only recently become available, the use of HFNT in the adult population is quite widespread in several clinical settings. The respiratory effects of HNFT in patients with respiratory failure may be particularly relevant for clinicians. In this narrative review, we discuss the main pathophysiological mechanism and rationale for using HFNT in the acute and chronic setting

Economic Analysis and Technical Issues of Low Temperature PCM Thermal Storage Combined with a Condensing Micro-CHP

Abstract This study is focused on showing technical and economic issues related to the use of low temperature PCM (Phase Change Material) storage system coupled to a condensing micro CHP. That one is a single cylinder engine of rated power and thermal outputs equal to 5 kW and 13.1 kW respectively, equipped with a three-way catalyst to meet the regulations on pollutants emission. Two different system layouts were built and economical-environmental performance was evaluated. Specifically, a traditional water tank and a PCMs array were analysed. A two-family house characterized by a normalized primary energy need equal to 50.523 kWh/m2 y was assumed as the end user. That energy need is referred to the climatic conditions typical of Middle region in Italy. Finally, the LCOE (Levelised Cost of Electricity), calculated over a system lifespan of 15 years, has been chosen as the main indicator to compare the different options optimizing the CHP switching-on strategies

Heart rate and blood pressure monitoring in heart failure.

It has been long known that incessant tachycardia and severe hypertension can cause heart failure (HF). In recent years, it has also been recognized that more modest elevations in either heart rate (HR) or blood pressure (BP), if sustained, can be a risk factor both for the development of HF and for mortality in patients with established HF. Heart rate and BP are thus both modifiable risk factors in the setting of HF. What is less clear is the question whether routine systematic monitoring of these simple physiological parameters to a target value can offer clinical benefits. Measuring these parameters clinically during patient review is recommended in HF management in most HF guidelines, both in the acute and chronic phases of the disease. More sophisticated systems now allow long-term automatic or remote monitoring of HR and BP and whether this more detailed patient information can improve clinical outcomes will require prospective RCTs to evaluate. In addition, analysis of patterns of both HR and BP variability can give insights into autonomic function, which is also frequently abnormal in HF. This window into autonomic dysfunction in our HF patients can also provide further independent prognostic information and may in itself be target for future interventional therapies. This article, developed during a consensus meeting of the Heart Failure Association of the ESC concerning the role of physiological monitoring in the complex multi-morbid HF patient, highlights the importance of repeated assessment of HR and BP in HF, and reviews gaps in our knowledge and potential future directions

Physiological monitoring in the complex multimorbid heart failure patient - Conclusions.

Comorbidities are increasingly recognized as crucial components of the heart failure syndrome. Main specific challenges are polypharmacy, poor adherence to treatments, psychological aspects, and the need of monitoring after discharge. The chronic multimorbid patient therefore represents a specific heart failure phenotype that needs an appropriate and continuous management over time. This supplement issue covers the key points of a series of meeting coordinated by the Heart Failure Association of the European Society of Cardiology (ESC), that have discussed the issues surrounding the effective monitoring of our ever more complex and multimorbid heart failure patients. Here, we present an overview of the complex issues from a healthcare delivery perspective

Short-term physiological plasticity.Trade-off between drought and recovery responses in three Mediterranean cistus species

Short-term physiological plasticity allows plants to thrive in highly variable environments such as the Mediterranean ecosystems. In such context, plants that maximize physiological performance under favorable conditions, such as Cistus spp., are generally reported to have a great cost in terms of plasticity (i.e., a high short-term physiological plasticity) due to the severe reduction of physiological performance when stress factors occur. However, Cistus spp. also show a noticeable resilience ability in response to stress factors. We hypothesized that in Cistus species the short-term physiological response to stress and that to subsequent recovery can show a positive trade-off to offset the costs of the photosynthetic decline under drought. Gas exchange, chlorophyll fluorescence, and water relations were measured in C. salvifolius, C. monspeliensis, and C. creticus subsp. eriocephalus during an imposed experimental drought and subsequent recovery. Plants were grown outdoor in common garden conditions from seeds of different provenances. The short-term physiological response to stress and that to recovery were quantified via phenotypic plasticity index (PIstress and PIrecovery, respectively). A linear regression analysis was used to identify the hypothesized trade-off PIstress-PIrecovery. Accordingly, we found a positive trade-off between PIstress and PIrecovery, which was consistent across species and provenances. This result contributes in explaining the profit, more than the cost, of a higher physiological plasticity in response to short-term stress imposition for Cistus spp because the costs of a higher PIstress are payed back by an as much higher PIrecovery. The absence of leaf shedding during short-term drought supports this view. The trade-off well described the relative variations of gas exchange and water relation parameters. Moreover, the results were in accordance with the ecology of this species and provide the first evidence of a consistent trade-off between the short-term physiological responses to drought and recovery phases in Mediterranean species

Renal function, electrolytes, and congestion monitoring in heart failure.

Congestion, renal function, and electrolyte imbalance (particularly potassium) are common problems in the management of the complex multi-morbid patient with heart failure (HF). Poor control of these fundamental clinical features is associated with adverse outcomes. Close monitoring of serum potassium and renal function is recommended by most current guidelines during the management of an episode of acute decompensated HF, yet the recommendations remain poorly implemented. Physicians are advised to treat a state of euvolaemia after an admission with decompensated HF and residual congestion is a marker of worse outcome, yet control of congestion is poorly assessed and managed in real-world practice. This document reflects the key points discussed by a panel of experts during a Heart Failure Association meeting on physiological monitoring of the complex multi-morbid HF patient, and here, we present to aspects related to renal function, electrolyte, and congestion monitoring