Survey Report: Audio Branding Support Systems

Existing tools for use in audio branding are surveyed and typical core work steps are defined. Particular attention is paid to professional metaphors in use and intuitive usability which support audio branding communication, workflows, automation, monitoring and maintenance. Furthermore design of UIs which give representation support are examined in detail. Results are arranged into concrete requirements and recommendations for the project's tool developments.EC/H2020/688122/EU/Artist-to-Business-to-Business-to-Consumer Audio Branding System/ABC D

Insulin degludec/insulin aspart combination for the treatment of type 1 and type 2 diabetes

Glycemic control remains the major therapeutic objective to prevent or delay the onset and progression of complications related to diabetes mellitus. Insulin therapy represents a cornerstone in the treatment of diabetes and has been used widely for achieving glycemic goals. Nevertheless, a large portion of the population with diabetes does not meet the internationally agreed glycemic targets. Moreover, insulin treatment, especially if intensive, may be associated with emergency room visits and hospitalization due to hypoglycemic events. Therefore, fear of hypoglycemia or hypoglycemic events represents the main barriers to the attainment of glycemic targets. The burden associated with multiple daily injections also remains a significant obstacle to initiating and maintaining insulin therapy. The most attractive insulin treatment approach should meet the patients' preference, rather than demanding patients to change or adapt their lifestyle. Insulin degludec/insulin aspart (IDegAsp) is a new combination, formulated with ultra-long-acting insulin degludec and rapid-acting insulin aspart, with peculiar pharmacological features, clinical efficacy, safety, and tolerability. IDegAsp provides similar, noninferior glycemic control to a standard basal-bolus regimen in patients with type 1 diabetes mellitus, with additional benefits of significantly lower episodes of hypoglycemia (particularly nocturnal) and fewer daily insulin injections. Moreover, although treatment strategy and patients' viewpoint are different in type 1 and type 2 diabetes, trial results suggest that IDegAsp may be an appropriate and reasonable option for initiating insulin therapy in patients with type 2 diabetes inadequately controlled on maximal doses of conventional oral agents. This paper will discuss the role of IDegAsp combination as a novel treatment option in diabetic patients. © 2014 Dardano et al

Was there a COVID-19 harvesting effect in Northern Italy?

We investigate the possibility of a harvesting effect, i.e. a temporary forward shift in mortality, associated with the COVID-19 pandemic by looking at the excess mortality trends of an area that registered one of the highest death tolls in the world during the first wave, Northern Italy. We do not find any evidence of a sizable COVID-19 harvesting effect, neither in the summer months after the slowdown of the first wave nor at the beginning of the second wave. According to our estimates, only a minor share of the total excess deaths detected in Northern Italian municipalities over the entire period under scrutiny (February - November 2020) can be attributed to an anticipatory role of COVID-19. A slightly higher share is detected for the most severely affected areas (the provinces of Bergamo and Brescia, in particular), but even in these territories, the harvesting effect can only account for less than 20% of excess deaths. Furthermore, the lower mortality rates observed in these areas at the beginning of the second wave may be due to several factors other than a harvesting effect, including behavioral change and some degree of temporary herd immunity. The very limited presence of short-run mortality displacement restates the case for containment policies aimed at minimizing the health impacts of the pandemic

Optimal therapy of type 2 diabetes: a controversial challenge

Type 2 diabetes mellitus (T2DM) is one of the most common chronic disorders in older adults and the number of elderly diabetic subjects is growing worldwide. Nonetheless, the diagnosis of T2DM in elderly population is often missed or delayed until an acute metabolic emergency occurs. Accumulating evidence suggests that both aging and environmental factors contribute to the high prevalence of diabetes in the elderly. Clinical management of T2DM in elderly subjects presents unique challenges because of the multifaceted geriatric scenario. Diabetes significantly lowers the chances of "successful" aging, notably it increases functional limitations and impairs quality of life. In this regard, older diabetic patients have a high burden of comorbidities, diabetes-related complications, physical disability, cognitive impairment and malnutrition, and they are more susceptible to the complications of dysglycemia and polypharmacy. Several national and international organizations have delivered guidelines to implement optimal therapy in older diabetic patients based on individualized treatment goals. This means appreciation of the heterogeneity of the disease as generated by life expectancy, functional reserve, social support, as well as personal preference. This paper will review current treatments for achieving glycemic targets in elderly diabetic patients, and discuss the potential role of emerging treatments in this patient population

Adverse events during longterm low-dose glucocorticoid treatment of polymyalgia rheumatica: a retrospective study

To assess the occurrence of adverse events in a cohort of patients with polymyalgia rheumatica (PMR), treated with low-dose glucocorticoids (GC). METHODS: This was a retrospective study by review of medical records. RESULTS: We identified 222 patients who had a mean duration of followup of 60 ± 22 months and a mean duration of GC therapy of 46 ± 22 months. We found that 95 patients (43%) had at least 1 adverse event after a mean duration of GC therapy of 31 ± 22 months and a mean cumulative dose of 3.4 ± 2.4 g. In particular, 55 developed osteoporosis, 31 had fragility fractures; 27 developed arterial hypertension; 11 diabetes mellitus; 9 acute myocardial infarction; 3 stroke; and 2 peripheral arterial disease. Univariate analysis showed that the duration of GC treatment was significantly associated with osteoporosis (p < 0.0001), fragility fractures (p < 0.0001), arterial hypertension (p < 0.005), and acute myocardial infarction (p < 0.05). Cumulative GC dose was significantly associated with osteoporosis (p < 0.0001), fragility fractures (p < 0.0001), and arterial hypertension (p < 0.01). The adverse events occurred more frequently after 2 years of treatment. Multivariate analysis showed that GC duration was significantly associated with osteoporosis (adjusted OR 1.02, 95% CI 1.02-1.05) and arterial hypertension (adjusted OR 1.03, 95% CI 1.01-1.06); GC cumulative dose was significantly associated with fragility fractures (adjusted OR 1.4, 95% CI 1.03-1.8). CONCLUSION: Longterm, low-dose GC treatment of PMR is associated with serious adverse events such as osteoporosis, fractures, and arterial hypertension; these adverse events occur mostly after 2 years of treatment

Spatially explicit effective reproduction numbers from incidence and mobility data

Current methods for near real-time estimation of effective reproduction numbers from surveillance data overlook mobility fluxes of infectors and susceptible individuals within a spatially connected network (the metapopulation). Exchanges of infections among different communities may thus be misrepresented unless explicitly measured and accounted for in the renewal equations. Here, we first derive the equations that include spatially explicit effective reproduction numbers, ℛk(t), in an arbitrary community k. These equations embed a suitable connection matrix blending mobility among connected communities and mobility-related containment measures. Then, we propose a tool to estimate, in a Bayesian framework involving particle filtering, the values of ℛk(t) maximizing a suitable likelihood function reproducing observed patterns of infections in space and time. We validate our tools against synthetic data and apply them to real COVID-19 epidemiological records in a severely affected and carefully monitored Italian region. Differences arising between connected and disconnected reproduction numbers (the latter being calculated with existing methods, to which our formulation reduces by setting mobility to zero) suggest that current standards may be improved in their estimation of disease transmission over time

Gear tooth root fatigue test monitoring with continuous acoustic emission: Advanced signal processing techniques for detection of incipient failure

The phenomenon of fatigue in gears at the tooth root can be a cause of catastrophic failure if not detected in time. Where traditional low-frequency vibration may help in detecting a well-developed crack or a completely failed tooth, a system for early detection of the nucleation and initial propagation of a fatigue crack can be of great use in condition monitoring. Acoustic emission is a potentially suitable technique, as it is sensitive to the higher frequencies generated by crack propagation and is not affected by low-frequency noise. In this article, a static gear pair is tested where a crack was initiated at a tooth root. Continuous acoustic emission was periodically recorded throughout the test. Data were processed in multiple ways to support the early detection of crack initiation. Initially, traditional feature–based acoustic emission was employed. This showed qualitative results indicating fracture initiation around 8000 cycles. A rolling cross-correlation was then employed to compare two given system states, showing a sensitivity to large changes towards the final phases of crack propagation. A banded fast Fourier transform approach showed that the 110- to 120-kHz band was sensitive to the observed crack initiation at 8000 cycles, and to the later larger propagation events at 22,000 cycles. Two advanced data processing techniques were then used to further support these observations. First, a technique based on Chebyshev polynomial decomposition was used to reduce each wavestream data to a vector of 25 descriptors; these were used to track the system deviation from a baseline state and confirmed the previously observed deviations with a higher sensitivity. Further confirmation came from the analysis of wavestream entropy content, providing support from multiple data analysis techniques on the feasibility of system state tracking using continuous acoustic emission

Bedside wireless lung ultrasound for the evaluation of COVID-19 lung injury in senior nursing home residents.

Lung Ultrasound (LUS) is regarded to be potentially useful to diagnose lung injury in older adults living in nursing homes with suspected COVID-19 pneumonia. We aimed at evaluating presence lung injury among senior nursing home residents by LUS performed with portable wireless scanner echography. The study population consisted of 150 residents with a mean age of 88 years (85% female) residing in 12 nursing homes in Northern Italy. Subjects had to have a history of recent onset of symptoms compatible with COVID-19 pneumonia or have been exposed to the contagion of patients carrying the disease. COVID-19 testing was performed with SARS-CoV-2 nasal-pharyngeal (NP) swabs. Positive subjects to LUS scanning were considered those with non-coascelent B-lines in >3 zones, coalescent B-lines in >3 zones and with iperdensed patchy non-consolidated lungs. Sixty-three percent had positive NP testing and 65% had LUS signs of pulmonary injury. LUS had a sensitivity of 79% in predicting positive NP testing. Sixteen percent of residents tested negative for SARSCoV-2 carried the signs of COVID-19 lung injury at LUS. There were 92 patients (61%) with current or recent symptoms.Positivity to LUS scanning was reported in 73% of residents with symptoms, while it was 53% in those without (P=0.016). A positive NP testing was observed in 66% of residents with symptoms and in 57% of those without (P=0.27). We conclude that assessment of LUS by portable wireless scanner echography can be profitability utilized to diagnose lung injury among senior nursing home residents with or without symptoms compatible with COVID-19 pneumonia