The role of weighing-bathing sequence and postmenstrual age in eliciting adaptive/maladaptive responses in very low birth weight preterm infants

Purpose: In the neonatal intensive care unit, preterm infants are exposed to several stressful stimuli. Inappropriate stimulation led to high risk for short- and long-term neurocognitive disabilities. This study aimed to evaluate whether the sequence of execution of weighing/bathing nursing procedures and postmenstrual age (PMA) have any effect on preterm infants' stress responses. Design and Methods: Prospective cross-sectional study on a sample of 21 preterm infants. Responses to the procedures were assessed using an observational sheet based on Als's Synactive Theory of Development. Autonomic and motor responses were scored according to five-point Likert scales. The order of execution of weighing/bathing nursing procedures and PMA were documented. Effects of weighing/bathing execution sequence and PMA on autonomic and motor response scores were analyzed by linear multiple regression analysis. Results: The sequence of execution had a significant effect on the autonomic score during weighing (p =.035), evidencing more stress when weighing was executed first. A higher level of stress response on the autonomic score during both weighing (p =.015) and bathing (p =.018) procedure was independently associated with a lower infant PMA. Conclusions and Practice Implications: The real-time recognition of adaptive/maladaptive responses allows nurses to personalize their approach to preterm infants, taking into account PMA and adjusting the appropriate sequence of execution of weighing/bathing nursing procedures

Influence of different types of solvent on the effectiveness of nanolime treatments on highly porous mortar substrates

Historic calcareous structures suffer from weathering processes that result in the loss of some of their original properties. Nanolime products represent an attractive choice for the consolidation of these substrates containing calcite due to their high chemical compatibility with the original structure. The effectiveness of nanolime products has been widely proven for superficial consolidation treatments (e.g. plasters and wall-paintings). However, its consolidation mechanism in highly porous substrates (e.g. limestones or lime mortars) still needs to be fully understood. The aim of this paper is to study the influence of different types of solvent on the effectiveness of nanolime treatments on highly porous lime-mortars. The consolidation effectiveness is investigated by evaluating changes on superficial cohesion, porosity, drilling resistance, water absorption by capillarity, drying rate and aesthetic properties. Results showed that nanolime dispersed in a mixture of isopropanol (50%) and water (50%) yielded slightly better consolidation properties in terms of reduction in porosity, increase in strength and penetration within coarse lime-mortars than nanolime dispersed in other solvents

New Materials and Technologies for Durability and Conservation of Building Heritage

The increase in concrete structures’ durability is a milestone to improve the sustainability of buildings and infrastructures. In order to ensure a prolonged service life, it is necessary to detect the deterioration of materials by means of monitoring systems aimed at evaluating not only the penetration of aggressive substances into concrete but also the corrosion of carbon-steel reinforcement. Therefore, proper data collection makes it possible to plan suitable restoration works which can be carried out with traditional or innovative techniques and materials. This work focuses on building heritage and it highlights the most recent findings for the conservation and restoration of reinforced concrete structures and masonry buildings

Cystatin C and Cardiovascular Risk

Patients with chronic kidney disease (CKD) are at high risk for developing cardiovascular disease (CVD) and cardiovascular events. Cystatin C, a protease inhibitor synthesized in all nucleated cells, has been proposed as a replacement for serum creatinine for the assessment of renal function, particularly to detect small reductions in glomerular filtration rate. CONTENT: This report presents a review of the role of cystatin C as a predictor of cardiovascular risk. SUMMARY: Patients with higher circulating cystatin C concentrations appear to have an increased cardiovascular risk profile, i.e., they are older and have a higher prevalence of systemic hypertension, dyslipidemia, documented CVD, increased body mass index, and increased concentrations of C-reactive protein. Prospective studies have shown, in various clinical scenarios, that patients with increased cystatin C are at a higher risk of developing both CVD and CKD. Importantly, cystatin C appears to be a useful marker for identifying individuals at a higher risk for cardiovascular events among patients belonging to a relatively low-risk category as assessed by both creatinine and estimated glomerular filtration rate values. Of interest, elastolytic proteases and their inhibitors, in particular cystatin C, have been shown to be directly involved in the atherosclerotic process. Increased concentrations of cystatin C appear to be indicative of preclinical kidney disease associated with adverse outcomes. Clinical studies involving direct glomerular filtration rate measurements are required to ascertain both the true role of this promising marker in renal disease and whether atherogenic factors like inflammation can account for increases in cystatin C concentrations, thus explaining its predictive value in CV

Validating an alternative method to predict thermoelectric generator performance

When designing a system that utilises TEG (Thermoelectric generator) technology, it is required to know what will be the performance of the TEGs under the expected operating conditions. To do this, equations that model the performance of the TEG must be used. There are existing equations which predict the effi- ciency and power output of the TEGs but in this paper, alternative equations are derived which are far simpler than the existing equations to use. These derived equations predict the efficiency and maximum power output as a function of temperature difference. Parameters which describe the characteristics of the TEG such as the gradient of the current - voltage curve, gradient of the open circuit voltage - temperature difference curve and the thermal resistance are required to be able to use these equations. Testing was undertaken to find these parameters and to validate the output of these equations to the experimental results. It was found that the equations derived are valid but should not be used at very high temperature differences

Improvement of Cesanese d'Affile wine expression: The addition of solid carbon dioxide for the valorization of an autochthonous vine

This study involved the region of DOCG Cesanese del Piglio (Lazio), an area renowned for the cultivation of Cesanese d'Affile, which is an autochtonous variety of grape. To evaluate the effect induced by the addition of a cryogen (C02iS) on the extraction of phenolic compounds, Cesanese d'Affile grapes coming from the same vineyard were transformed utilising the same winemaking technology, differing only for the stage of grape maceration. Main chemical parameters of the wines and their sensory profiles were analysed during winemaking and after 8 months of aging in oak barrels to observe the impact of cryomaceration on overall wine quality. It can be stated that the addition of a cryogen to the crushed grapes can be a viable choice to improve the expression of the main features of a native grape such as Cesanese d'Affile, preserving its nutraceutical features and giving to the product a more complex sensory profile

Green approach for an eco-compatible consolidation of the Agrigento biocalcarenites surface

In this paper, we investigate a conservation treatment on different kinds of Agrigento's biocalcarenites, introducing a new non-commercial aqueous nanolime suspension for compatible and eco-friendly extensive applications. This nanolime, here tested for the first time, can be considered a green treatment for both the environment and the health of the conservator. Petrographic, chemico-physical and mechanical investigations of the different biocalcarenites were carried out before and after treatment application. This new nanolime yielded a very promising consolidation effectiveness for all the biocalcarenites, increasing the superficial cohesion and the drilling resistance without significantly altering the stone porosity or the aesthetical features

Transcatheter aortic valve implantation with a self-expanding nitinol bioprosthesis: prediction of the need for permanent pacemaker using simple baseline and procedural characteristics.

To ascertain incidence and predictors of new permanent pacemaker (PPM) following transcatheter aortic valve implantation (TAVI) with the self-expanding aortic bioprosthesis. BACKGROUND: TAVI with the Medtronic Corevalve (MCV) Revalving System (Medtronic, Minneapolis, MN) has been associated with important post-procedural conduction abnormalities and frequent need for PPM. METHODS: Overall, 73 consecutive patients with severe symptomatic AS underwent TAVI with the MCV at two institutions; 10 patients with previous pacemaker and 3 patients with previous aortic valve replacement were excluded for this analysis. Clinical, echocardiographic, and procedural data were collected prospectively in a dedicated database. A standard 12-lead ECG was recorded in all patients at baseline, after the procedure and predischarge. Decision to implant PPM was taken according to current guidelines. Logistic multivariable modeling was applied to identify independent predictors of PPM at discharge. RESULTS: Patients exhibited high-risk features as evidenced by advanced age (mean = 82.1 \ub1 6.2 years) and high surgical scores (logistic EuroSCORE 23.0 \ub1 12.8%, STS score 9.4 \ub1 6.9%). The incidence of new PPM was 28.3%. Interventricular septum thickness and logistic Euroscore were the baseline independent predictors of PPM. When procedural variables were included, the independent predictors of PPM were interventricular septum thickness (OR 0.52; 95% CI 0.32-0.85) and the distance between noncoronary cusp and the distal edge of the prosthesis (OR 1.37; 95% CI 1.03-1.83). CONCLUSIONS: Conduction abnormalities are frequently observed after TAVI with self-expandable bioprosthesis and definitive pacing is required in about a third of the patients, with a clear association with depth of implant and small interventricular septum thickness