Caring for children with brain tumors in an oncology ward: a phenomenologic-hermeneutic study

Brain tumors are the most common form of solid tumors in childhood and are characterized by an uncertain prognosis, often meaning tumor invasive surgical procedures in the first steps of the patient’s treatment. In a Pediatric Oncology Ward, children with brain tumors are considered a challenge for health professionals, due to the nature of the relationship between the child, the parents, and the health care providers in the initial phase of the patient’s illness. Here we present a phenomenologic-hermeneutic study, developed in the Oncology Ward of a Hospital in Southern Spain. All the caregivers of the Ward underwent interviews concerning their experience in caring for children with brain tumors. Interviews were recorded and transcribed with the consent of the participants and were analyzed by content themes. In the present paper, we focus on the experiences concerning the first meeting of the professionals with the children and their families and the principal critical issues related to the communication of the diagnosis

Integrated socio-hydrogeological approach to tackle nitrate contamination in groundwater resources. The case of Grombalia Basin (Tunisia)

Nitrate contamination still remains one of the main groundwater quality issues in several aquifers worldwide, despite the perduring efforts of the international scientific community to effectively tackle this problem. The classical hydrogeological and isotopic investigations are obviously of paramount importance for the characterization of contaminant sources, but are clearly not sufficient for the correct and long-term protection of groundwater resources. This paper aims at demonstrating the effectiveness of the socio-hydrogeological approach as the best tool to tackle groundwater quality issues, while contributing bridging the gap between science and society. An integrated survey, including land use, hydrochemical (physicochemical parameters and major ions) and isotopic (delta N-15(No3) and delta O-18(No3)) analyses, coupled to capacity building and participatory activities was carried out to correctly attribute the nitrate origin in groundwater from the Grombalia Basin (North Tunisia), a region where only synthetic fertilizers have been generally identified as the main source of such pollution. Results demonstrates that the basin is characterized by high nitrate concentrations, often exceeding the statutory limits for drinking water, in both the shallow and deep aquifers, whereas sources are associated to both agricultural and urban activities

La conducibilit\ue0 elettrica come strumento per stimare lo sviluppo del reticolo ipogeo

Una delle principali sfide nella ricerca speleologica \ue8 quella di stimare in modo il pi\uf9 possibile accurato l\u2019entit\ue0 (dimensione, estensione e sviluppo) e la localizzazione del reticolo ipogeo presente in un\u2019area carsica. Quando l\u2019attivit\ue0 esplorativa classica non risolve tutte le problematiche si utilizzano tecniche indirette quali per esempio la geofisica o le analisi idrogeologiche. In quest\u2019ottica nel 2015 \ue8 partita una proficua collaborazione tra gli speleologi del Gruppo Speleologico Monfalconese \u201cAmici del Fante\u201d, speleologi del Gruppo Speleologico \u201cTalpe del Carso\u201d - Jamarski Klub \u201cKraski Krti\u201d, studiosi indipendenti e ricercatori del dipartimento di Matematica e Geoscienze volta alla comprensione dei deflussi sotterranei e delle modalit\ue0 di ricarica/esaurimento del settore occidentale del Carso Classico. In questi ultimi 3 anni \ue8 stata sviluppata una metodologia che attraverso l\u2019analisi della conducibilit\ue0 elettrica delle acque superficiali e sotterranee presenti nell\u2019area di studio permette di individuare l\u2019origine e la provenienza delle diverse tipologie di acque presenti. La scelta del parametro conducibilit\ue0 elettrica non deriva solo dalla sua significativit\ue0, ma anche dal fatto che essa rappresenta un parametro di facile acquisizione e che non necessita di complesse e costose metodologie di analisi. Dato che la ricarica dell\u2019acquifero \ue8 dovuta principalmente a tre componenti quali le perdite dell\u2019Isonzo, l\u2019infiltrazione efficace e il contributo del sistema Reka-Timavo, da giugno 2015 ai primi mesi del 2018 sono state effettuate quasi 100 uscite sul terreno che hanno permesso di acquisire dati di conducibilit\ue0 elettrica e temperatura presso l\u2019Isonzo, il Reka, i laghi di Doberd\uf2 e Pietrarossa, le sorgenti di Sablici di Moschenizze, di Sardos e del Timavo. Nel contempo sono state installate due sonde multiparametriche sul fondo dell\u2019Abisso Samar di Riky (cat. FVG n.4709) e della Grotta del Proteo (cat. FVG n.1191) presso Sagrado (GO), che ogni 30 minuti acquisiscono informazioni sulla conducibilit\ue0 elettrica, la temperatura e il livello delle acque. L\u2019analisi dei dati ha permesso di individuare i valori caratteristici delle tre componenti principali di ricarica dell\u2019acquifero: l\u2019Isonzo con un valore di 240 uS/cm, le acque carsiche dovute al contributo delle precipitazioni con 470 uS/cm e il Reka con 310 uS/cm. Utilizzando questi valori \ue8 stato possibile quantificare il contributo delle diverse componenti sia in corrispondenza delle sorgenti che dei laghi carsici nei diversi regimi idrogeologici. Nel contempo l\u2019analisi dei dati in continuo ha permesso di stimare le modalit\ue0 di ricarica ed esaurimento del sistema ipogeo. Il lavoro che si presenta \ue8 stato realizzato grazie anche al contributo della Federazione Speleologica Isontina, dell\u2019Universit\ue0 degli Studi di Trieste e della Fondazione Carigo di Gorizia

Changes Induced by Exposure of the Human Lung to Glass Fiber–Reinforced Plastic

The inhalation of glass dusts mixed in resin, generally known as glass fiber–reinforced plastic (GRP), represents a little-studied occupational hazard. The few studies performed have highlighted nonspecific lung disorders in animals and in humans. In the present study we evaluated the alteration of the respiratory system and the pathogenic mechanisms causing the changes in a group of working men employed in different GRP processing operations and exposed to production dusts. The study was conducted on a sample of 29 male subjects whose mean age was 37 years and mean length of service 11 years. All of the subjects were submitted to a clinical check-up, basic tests, and bronchoalveolar lavage (BAL); microscopic studies and biochemical analysis were performed on the BAL fluid. Tests of respiratory function showed a large number of obstructive syndromes; scanning electron microscopy highlighted qualitative and quantitative alterations of the alveolar macrophages; and transmission electron microscopy revealed the presence of electron-dense cytoplasmatic inclusions indicating intense and active phlogosis (external inflammation). Biochemical analyses highlighted an increase in protein content associated with alterations of the lung oxidant/antioxidant homeostasis. Inhalation of GRP, independent of environmental concentration, causes alterations of the cellular and humoral components of pulmonary interstitium; these alterations are identified microscopically as acute alveolitis

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

\u201cProfessional educators and burnout\u201d

In recent years the risk of developing a burnout syndrome among workers in the helping professions has been clearly stated. Although burnout syndrome, in fact, is threatening different professional activities, incidence was reported higher in sanitary and social professions. In this work the risk of developing a Burnout syndrome was evidenced to occur in Educators working in the socio-sanitary area. Causal relationships where indicated not only in the working context and in the peculiar characteristic of the patients, but also in the precarious, from the juridical point of view, working conditions