Identification of Post-Intensive Care Syndrome (PICS) in Primary Care

Abstract Background: Post-intensive care syndrome (PICS) occurs in approximately 50% of ICU survivors and increases risk of mortality and hospital readmission while decreasing quality of life. There were no national guidelines for diagnosis or treatment of PICS at the time of the completion of this project. Purpose: The purpose of this project was to increase identification of PICS in the primary care setting by providers. This was accomplished by implementing an educational toolkit and algorithm to better identify patients with PICS and to evaluate the incidence of PICS. Methods: An educational presentation and a survey were presented to the providers at a primary care office in Maryland. An algorithm was applied to each patient seen in the office from October 2020 to February 2021; if the patients were identified by the algorithm to be at risk for PICS, the PICSq was administered in the office by the medical assistants. Results: The data concerning the effect of the education material imply a positive correlation on provider confidence in the diagnosis of PICS. The mean pre-education was 0 on a self-rated scale of 0-5 (SD=0) and the mean pre-education was 3 on a scale of 0-5 (SD=1.155). In the five months of observation and data collection, thirteen patients were identified to be at risk for PICS requiring screening using the PICSq. Conclusion: Provider education about PICS in the primary care setting can increase the rate of identification of PICS. Tools such as the algorithm and the PICSq, in conjunction with increased provider awareness within the primary care setting, promoted a more positive transition following an acute care stay

TARJETA POSTAL ROMÁNTICA. MARIE LAFARGUE [Material gráfico]

MILÁN (ITALIA)Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte, 201

Exploring the multifaceted circumstellar environment of the luminous blue variable HR Carinae

Indexación: Web of Science; Scopus.We present a multiwavelength study of the Galactic luminous blue variable HR Carinae, based on new high-resolution mid-infrared (IR) and radio images obtained with the Very Large Telescope (VLT) and the Australia Telescope Compact Array (ATCA), which have been complemented by far-infrared Herschel-Photodetector Array Camera and Spectrometer (PACS) observations and ATCA archive data. The Herschel images reveal the large-scale distribution of the dusty emitting nebula, which extends mainly to the north-east direction, up to 70 arcsec from the central star, and is oriented along the direction of the space motion of the star. In the mid-infrared images, the brightness distribution is characterized by two arcshaped structures, tracing an inner envelope surrounding the central star more closely. At radio wavelengths, the ionized gas emission lies on the opposite side of the cold dust with respect to the position of the star, as if the ionized front were confined by the surrounding medium in the north-south direction. Comparison with previous data indicates significant changes in the radio nebula morphology and in the mass-loss rate from the central star, which has increased from 6.1 × 10-6M⊙ yr-1 in 1994-1995 to 1.17 × 10-5M⊙ yr-1 in 2014. We investigate possible scenarios that could have generated the complex circumstellar environment revealed by our multiwavelength data.https://academic.oup.com/mnras/article-lookup/doi/10.1093/mnras/stw307

Educational cosmic ray experiments with Geiger counters

Experiments concerning the physics of cosmic rays offer to high-school teachers and students a relatively easy approach to the field of research in high energy physics. The detection of cosmic rays does not necessarily require the use of sophisticated equipment, and various properties of the cosmic radiation can be observed and analysed even by the use of a single Geiger counter. Nevertheless, the variety of such kind of experiments and the results obtained are limited because of the inclusive nature of these measurements. A significant improvement may be obtained when two or more Geiger counters are operated in coincidence. In this paper we discuss the potential of performing educational cosmic ray experiments with Geiger counters. In order to show also the educational value of coincidence techniques, preliminary results of cosmic ray experiments carried out by the use of a simple coincidence circuit are briefly discussed

The polarization mode of the auroral radio emission from the early-type star HD142301

We report the detection of the auroral radio emission from the early-type magnetic star HD142301. New VLA observations of HD142301 detected highly polarized amplified emission occurring at fixed stellar orientations. The coherent emission mechanism responsible for the stellar auroral radio emission amplifies the radiation within a narrow beam, making the star where this phenomenon occurs similar to a radio lighthouse. The elementary emission process responsible for the auroral radiation mainly amplifies one of the two magneto-ionic modes of the electromagnetic wave. This explains why the auroral pulses are highly circularly polarized. The auroral radio emission of HD142301 is characterized by a reversal of the sense of polarization as the star rotates. The effective magnetic field curve of HD142301 is also available making it possible to correlate the transition from the left to the right-hand circular polarization sense (and vice-versa) of the auroral pulses with the known orientation of the stellar magnetic field. The results presented in this letter have implications for the estimation of the dominant magneto-ionic mode amplified within the HD142301 magnetosphere.Comment: 5 pages, 4 figures; accepted to MNRAS Letter

The MEV project: design and testing of a new high-resolution telescope for Muography of Etna Volcano

The MEV project aims at developing a muon telescope expressly designed for the muography of Etna Volcano. In particular, one of the active craters in the summit area of the volcano would be a suitable target for this experiment. A muon tracking telescope with high imaging resolution was built and tested during 2017. The telescope is a tracker based on extruded scintillating bars with WLS fibres and featuring an innovative read-out architecture. It is composed of three XY planes with a sensitive area of \SI{1}{m^2}; the angular resolution does not exceeds \SI{0.4}{\milli\steradian} and the total angular aperture is about $\pm$\SI{45}{\degree}. A special effort concerned the design of mechanics and electronics in order to meet the requirements of a detector capable to work in a hostile environment such as the top of a tall volcano, at a far distance from any facility. The test phase started in January 2017 and ended successfully at the end of July 2017. An extinct volcanic crater (the Monti Rossi, in the village of Nicolosi, about 15km from Catania) is the target of the measurement. The detector acquired data for about 120 days and the preliminary results are reported in this work

Piezoelectric Rainfall Energy Harvester Performance by Advanced Arduino based Measuring System

This paper presents the performances of rainfall energy harvesting through the use of a piezoelectric transducer and an Arduino-based measuring system. Different studies agree on the possibility of generating electricity from rainfall, but to date, a study on measuring the quantity of energy produced during rainfall is still missing. The present study begins with results obtained from laboratory researchers using piezoelectric transducers and oscilloscopes, finalized to measure the energy produced from a single raindrop, and concludes with an ad hoc Arduino-based measuring system, aimed to measure the actual amount of electrical energy produced by a piezoelectric transducer that is exposed to rainfall of variable durations

SCORPIO-II: Spectral indices of weak Galactic radio sources

In the next few years the classification of radio sources observed by the large surveys will be a challenging problem, and spectral index is a powerful tool for addressing it. Here we present an algorithm to estimate the spectral index of sources from multiwavelength radio images. We have applied our algorithm to SCORPIO (Umana et al. 2015), a Galactic Plane survey centred around 2.1 GHz carried out with ATCA, and found we can measure reliable spectral indices only for sources stronger than 40 times the rms noise. Above a threshold of 1 mJy, the source density in SCORPIO is 20 percent greater than in a typical extra-galactic field, like ATLAS (Norris et al. 2006), because of the presence of Galactic sources. Among this excess population, 16 sources per square degree have a spectral index of about zero, suggesting optically thin thermal emission such as Hii regions and planetary nebulae, while 12 per square degree present a rising spectrum, suggesting optically thick thermal emission such as stars and UCHii regions.Comment: 12 pages, 11 figures, accepted by MNRA

Synovial sarcoma: when epigenetic changes dictate tumour development.

Synovial sarcoma is a highly aggressive soft tissue malignancy that often affects adolescents and young adults. It is associated with a unique chromosomal translocation that results in the formation and expression of the fusion gene SS18-SSX, which underlies its pathogenesis. Although SS18-SSX provides a potentially unique therapeutic target, all attempts to neutralise it have been unsuccessful thus far. When complete surgical removal of the tumour fails, therapy is limited to largely ineffective cytotoxic drug regimens. Nevertheless, recent discoveries about the mechanisms of SS18-SSX protein function have provided insight into potential alternative therapeutic strategies. SS18-SSX displays oncogenic activity through protein-protein interactions and participation in chromatin remodelling complexes. This review summarises our current understanding of the function of SS18-SSX and the mechanisms by which it alters the epigenetic landscape of permissive cells to induce transformation and the subsequent development of synovial sarcoma

Soft tissue sarcomas: introduction to the Virchows Archiv review issue

Molecular tumour pathology - and tumour genetic