Automated diagnosis of encephalitis in pediatric patients using EEG rhythms and slow biphasic complexes

Slow biphasic complexes (SBC) have been identified in the EEG of patients suffering for inflammatory brain diseases. Their amplitude, location and frequency of appearance were found to correlate with the severity of encephalitis. Other characteristics of SBCs and of EEG traces of patients could reflect the grade of pathology. Here, EEG rhythms are investigated together with SBCs for a better characterization of encephalitis. EEGs have been acquired from pediatric patients: ten controls and ten encephalitic patients. They were split by neurologists into five classes of different severity of the pathology. The relative power of EEG rhythms was found to change significantly in EEGs labeled with different severity scores. Moreover, a significant variation was found in the last seconds before the appearance of an SBC. This information and quantitative indexes characterizing the SBCs were used to build a binary classification decision tree able to identify the classes of severity. True classification rate of the best model was 76.1% (73.5% with leave-one-out test). Moreover, the classification errors were among classes with similar severity scores (precision higher than 80% was achieved considering three instead of five classes). Our classification method may be a promising supporting tool for clinicians to diagnose, assess and make the follow-up of patients with encephalitis

Study of tributary inflows in Lake Iseo with a rotating physical model

The influence of Coriolis force on the currents of large lakes is well acknowledged; very few contributions, however, investigate this aspect in medium-size lakes where its relevance could be questionable. In order to study the area of influence of the two major tributary rivers in Lake Iseo, a rotating vertically distorted physical model of the northern part of this lake was prepared and used, respecting both Froude and Rossby similarity. The model has a horizontal length scale factor of 8000 and a vertical scale factor of 500 and was used both in homogeneous and in thermally stratified conditions. We explored the pattern of water circulation in front of the entrance mouth for dif- ferent hydrologic scenarios at the beginning of spring and in summer. We neglected the influence of winds. The primary purposes of the model were twofold: i) to increase our level of knowledge of the hydrodynamics of Lake Iseo by verifying the occurrence of dynamical effects related to the Earth’s rotation on the plume of the two tributaries that enter the northern part of the lake and ii) to identify the areas of the lake that can be directly influenced by the tributaries’ waters, in order to provide guidance on water quality monitoring in zones of relevant environmental and touristic value. The results of the physical model confirm the relevant role played by the Coriolis force in the northern part of the lake. Under ordinary flow conditions, the model shows a systematic deflection of the inflowing waters towards the western shore of the lake. The inflow triggers a clockwise gyre within the Lovere bay, to the West of the inflow, and a slow counter-clockwise gyre, to the East of the inflow, that returns water towards the river mouth along the eastern shore. For discharges with higher return period, when only the contribution by Oglio River is relevant, the effect of the Earth’s rotation weakens in the entrance zone and the plume has a more rectilinear pattern, whilst in the far field the current driven by the inflows keeps moving along the western shore. On the basis of these results one could expect that the north-western part of the lake between Castro and Lovere, although not aligned with the tributaries’ axes, is more sensitive to accumulation effects related to river-borne pollution. The results obtained with the physical model are critically compared with data obtained from different sources: the trajectory of a lagrangian drogue; a map of reflectivity data from the lake floor; a map of water turbidity at the intrusion depth. The findings are also confirmed by the results of a 3D numerical model of the lake

Hydraulic hazard mapping in alpine dam break prone areas: the Cancano dam case

Dam-break hazard assessment is of great importance in the Italian Alps, where a large number of medium and large reservoirs are present in valleys that are characterized by widespread urbanized zones on alluvial fans and along valley floors. Accordingly, there is the need to identify specific operative approaches in order to quantify hydraulic hazard which in mountain regions inevitably differ from the ones typically used in flat flood-prone areas. These approaches take advantage of: 1) specific numerical algorithms to pre-process the massive topographic information generally needed to describe very irregular bathymetries; 2) an appropriate mathematical model coupled with a robust numerical method which can deal in an effective way with variable geometries like the ones typical of natural alpine rivers; 3) suitable criteria for the hydraulic hazard assessment; 4) representative test cases to verify the accuracy of the overall procedure. This contribution presents some preliminary results obtained in the development of this complex toolkit, showing its application to the test case of the Cancano dam-break, for which the results from a physical model are available. This case was studied in 1943 by De Marchi, who investigated the consequences of the potential collapse of the Cancano dam in Northern Italy as a possible war target during the World War II. Although dated, the resulting report (De Marchi, 1945) is very interesting, since it mixes in a synergistic way theoretical, experimental and numerical considerations. In particular, the laboratory data set concerning the dam-break wave propagation along the valley between the Cancano dam and the village of Cepina provides an useful benchmark for testing the predictive effectiveness of mathematical and numerical models in mountain applications. Here we suggest an overall approach based on the 1D shallow water equations that proved particularly effective for studying dam-break wave propagation in alpine valleys, although this kind of problems is naturally subject to "substantial uncertainties and unavoidable arbitrarinesses" (translation from De Marchi, 1945). The equations are solved by means of a shock-capturing finite volume method involving the Pavia Flux Predictor (PFP) scheme proposed by Braschi and Gallati (1992). The comparison between numerical results and experimental data confirms that the mathematical model adopted is capable of capturing the main engineering aspects of the phenomenon modeled by De Marchi

Nutrient delivery efficiency of a combined sewer along a lake challenged by incipient eutrophication

Although sewage diversion outside of a lake's watershed is now ordinary practice in the restoration of eutrophic lakes, often the observed recovery is slower than expected and the internal load from the lake anoxic sediments is identified as a possible reason. However, in the case of combined sewer, the quantification of the residual nutrient load discharged from sewer spillways must also be questioned. In this paper, the diversion efficiency of the sewer system along the east coast of Lake Iseo, a prealpine Italian lake where eutrophication effects are still severe, is investigated. To this purpose, a representative part of the sewer system was modelled by PCSWMM and calibrated by using an extensive series of discharge measurements. Water quality monitoring during wet weather periods reveals that the first flush is common in tributary sewers, whereas it is absent along the main collector. Moreover, flow discharges are strongly affected by infiltration waters, which are controlled by the lake water level. The calibrated model, including infiltration modeling, was used to assess the annual overflow volumes and the nutrient load through a continuous 10-year simulation. Simulations were conducted both with regard to the current conditions and to a climate change scenario. Results show that the discharged residual load is at least 7 times larger than the design value, with the water infiltration contributing to 17% to the overflow volume and that non-structural practices could considerably reduce the overall impact of the sewer. This research thus provides important insight into the potential impact of combined sewer overflows on lacustrine environments and addresses effective mitigation measures in similar contexts

A case of labial fusion and urinary pseudo-incontinence in an elderly woman. A surgical treatment and a review

Labial fusion is defined as either partial or complete adherence of the labia minora (1), and also called vulvar fusion, adhesions of the labia minor or conglutination of the labia minora and sinechia of the vulva. The complete and severe labial fusion is a rare pathology with a small number of cases reported in the literature in adults. We present a case report of a postmenopausal woman who presented with voiding difficulty and incontinence and was treated by surgical division of the adhesions and immediate resolution of the urinary incontinence confirmed by multichannel urodynamic test postoperatively

Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery

OBJECTIVE: The aim of this retrospective study was to evaluate the role of surgical setting (urgent vs. elective) and approach (open vs. laparoscopic) in affecting postoperative pulmonary complications (PPCs) prevalence in patients undergoing abdominal surgery. PATIENTS AND METHODS: After local Ethical Committee approval, 409 patients who had undergone abdominal surgery between January and December 2014 were included in the final analysis. PPCs were defined as the development of one of the following new findings: respiratory failure, pulmonary infection, aspiration pneumonia, pleural effusion, pneumothorax, atelectasis on chest X-ray, bronchospasm or un-planned urgent re-intubation. RESULTS: PPCs prevalence was greater in urgent (33%) vs. elective setting (7%) (chi(2) with Yates correction: 44; p=0.0001) and in open (6%) vs. laparoscopic approach (1.9%) (chi(2) with Yates correction: 12; p=0.0006). PPCs occurrence was positively correlated with in-hospital mortality (Biserial Correlation r=0.37; p=0.0001). Logistic regression showed that urgent setting (p=0.000), Ariscat (Assess Respiratory Risk in Surgical Patients in Catalonia) score (p=0.004), and age (p=0.01) were predictors of PPCs. A cutoff of 23 for Ariscat score was also identified as determining factor for PPCs occurrence with 94% sensitivity and 29% specificity. CONCLUSIONS: Patients undergoing abdominal surgery in an urgent setting were exposed to a higher risk of PPCs compared to patients scheduled for elective procedures. Ariscat score fitted with PPCs prevalence and older patients were exposed to a higher risk of PPCs. Prospective studies are needed to confirm these result

Distribution of G-concurrence of random pure states

Average entanglement of random pure states of an N x N composite system is analyzed. We compute the average value of the determinant D of the reduced state, which forms an entanglement monotone. Calculating higher moments of the determinant we characterize the probability distribution P(D). Similar results are obtained for the rescaled N-th root of the determinant, called G-concurrence. We show that in the limit $N\to\infty$ this quantity becomes concentrated at a single point G=1/e. The position of the concentration point changes if one consider an arbitrary N x K bipartite system, in the joint limit $N,K\to\infty$, K/N fixed.Comment: RevTeX4, 11 pages, 4 Encapsuled PostScript figures - Introduced new results, Section II and V have been significantly improved - To appear on PR

Two independent photon pairs versus four-photon entangled states in parametric down conversion

We study the physics of four-photon states generated in spontaneous parametric down-conversion with a pulsed pump field. In the limit where the coherence time of the photons t_c is much shorter than the duration of the pump pulse Delta t, the four photons can be described as two independent pairs. In the opposite limit, the four photons are in a four-particle entangled state. Any intermediate case can be characterized by a single parameter chi, which is a function of t_c/Delta t. We present a direct measurement of chi through a simple experimental setup. The full theoretical analysis is also provided.Comment: 10 pages, 3 figures, submitte

Direct measurement of superluminal group velocity and of signal velocity in an optical fiber

We present an easy way of observing superluminal group velocities using a birefringent optical fiber and other standard devices. In the theoretical analysis, we show that the optical properties of the setup can be described using the notion of "weak value". The experiment shows that the group velocity can indeed exceed c in the fiber; and we report the first direct observation of the so-called "signal velocity", the speed at which information propagates and that cannot exceed c.Comment: 5 pages, 5 figure