1,339 research outputs found
Social Media’s impact on Intellectual Property Rights
This is a draft chapter. The final version is available in Handbook of Research on Counterfeiting and Illicit Trade, edited by Peggy E. Chaudhry, published in 2017 by Edward Elgar Publishing Ltd, https://doi.org/10.4337/9781785366451. This material is for private use only, and cannot be used for any other purpose without further permission of the publisher.Peer reviewe
Heart Institute Telemedicine and Telehealth Initiatives and Perspectives
This is a brief report of the telemedicine and telehealth initiatives developed at the Heart Institute (InCor HC FMUSP) since 2009. The challenges to develop, implement and make the service operational are described. Support was received from the Telemedicine University Network of the Ministry of Science, Technology and Innovation, the National Health Fund of Ministry of Health and a private donor to establish this Telemedicine and Telehealth Centre, making it possible for our students, professors and professionals to participate in activities at a distance, such as videoconferences, transmission of surgical procedures, web conferences and online courses. The Centre is also responsible for coordinating all local audio-visual resources available in our classrooms and amphitheatre, as well as producing videos. Although the main focus of the Centre is education, the Centre provides support for the management of tele-ecg contracts, second opinion services and other opportunities for innovation in the field of telemedicine and telehealth. The current infrastructure has extended integration with other Services of the Institute, leading the acquisition of skills by health professionals, but the challenge remains of raising the awareness of collaborative work at a distance, implementing innovative healthcare services for remote monitoring of our patients with chronic conditions, and assessing their impact. It is mandatory to acquire and use new technologies to add value to patient care and, at the same time, get good return on investment
Online and offline integration in marketing communication. Delving into the business perspective
Literature about Integrated Marketing Communication (IMC) is still evolving, but lacks
a systematic focus on online and offline integration approaches. This research aims to
identify the key managerial issues related to online and offline integration within IMC
and explore the existence of clusters of firms with consistent conducts and results. We
carried out a survey with 124 large firms operating in Italy, running first exploratory
factor analyses and then a non-hierarchical cluster analysis. The former highlight the
nature of the implementation modalities of online and offline integration in IMC, the
main types of advantages, and the different categories of barriers to such
implementation. The latter results in two clusters of firms. Academic and managerial
implications are presented along with future research directions
Light intensity affects the mixotrophic carbon exploitation in Chlorella protothecoides: consequences on microalgae-bacteria based wastewater treatment.
Abstract
Microalgal-bacteria consortia application on wastewater treatment has been widely studied, but a deeper comprehension of consortium interactions is still lacking. In particular, mixotrophic exploitation of organic compounds by microalgae affects gas (CO2 and O2) exchange between microalgae and bacteria, but it is not clear how environmental conditions may regulate algal metabolism. Using a respirometric-based protocol, we evaluated the combined effect of organic carbon and light intensity on oxygen production and consumption by C. protothecoides, and found that the chemical oxygen demand (COD) was not consumed when incident light increased. Batch experiments under different incident lights, with C. protothecoides alone and in consortium with activated sludge bacteria, confirmed the results obtained by respirometry. Continuous system experiments testing the combined effects of light intensity and residence time confirmed that, under limiting light, mixotrophy is preferred by C. protothecoides, and the nutrient (COD, N, P) removal capability of the consortium is enhanced
Ultrasonographic Assessment for Tenosynovitis in Juvenile Idiopathic Arthritis with Ankle Involvement: Diagnostic and Therapeutic Significance
Background: The role of musculoskeletal ultrasound in JIA is still controversial, although there is growing evidence on its utility, especially in the diagnosis of tenosynovitis. Methods: We presented a retrospective cross-sectional study of a group of patients with JIA with ankle swelling followed in a Pediatric Rheumatology Service of a tertiary-level pediatric hospital in Northern Italy during the follow-up period between January 1st 2003 and December 31st 2019. Preliminary results have been presented at the EULAR Congress 2021. We enrolled only patients who underwent msk-US, and we identified those with a clinical and sonographic diagnosis of tenosynovitis. For each patient, we collected data on demographics, clinical characteristics, and therapeutic strategies during the follow-up. Results: On December 31st 2019, 56 swollen ankles of 48 patients were assessed with msk-US. Twenty-two ankles showed sonographic signs of joint synovitis, sixteen ankles presented signs of both joint synovitis and tenosynovitis, and fourteen ankles presented sonographic signs of tenosynovitis only. Overall, tenosynovitis was detected on 27 (56%) out of 48 children with at least a swollen ankle. In 13 patients out of 27 with tenosynovitis (48%), there was no joint synovitis of ankle or foot. Twenty-five patients with tenosynovitis (92%) achieved clinical and radiological remission: seven patients achieved remission of tenosynovitis with methotrexate only, and fifteen patients with biological drugs alone or in combination therapy. Conclusions: We observed that more than half of the patients with ankle swelling presented a tenosynovitis, and about 50% of them did not show sonographic signs of an active joint synovitis. Among patients with tenosynovitis, biological therapy alone or in association with DMARDs showed effectiveness in inducing disease remission
Fever tree revisited: From malaria to autoinflammatory diseases
Over the centuries the idea of recurrent fevers has mainly been associated with malaria, but many other fevers, such as typhoid and diphtheria were cause for concern. It is only in recent times, with the more severe forms of fever from infectious origin becoming less frequent or a cause for worry that we started noticing recurrent fevers without any clear infectious cause, being described as having a pathogenesis of autoinflammatory nature. The use of molecular examinations in many cases can allow a diagnosis where the cause is monogenic. In other cases, however the pathogenesis is likely to be multifactorial and the diagnostic-therapeutic approach is strictly clinical. The old fever tree paradigm developed to describe fevers caused by malaria has been revisited here to describe today's periodic fevers from the periodic fever adenitis pharyngitis aphthae syndrome to the more rare autoinflammatory diseases. This model may allow us to place cases that are yet to be identified which are likely to be of multifactorial origin
T-Wave alternans: desempeño clÃnico, limitaciones, metodologÃas de análisis
Reconhecer com precisão indivÃduos com maior risco imediato de morte súbita cardÃaca (MSC) ainda é uma questão em aberto. A natureza fortuita dos eventos cardiovasculares agudos não parece se adequar ao conhecido modelo de indução de taquicardia/fibrilação ventricular por um gatilho em sincronia a um substrato arritmogênico estático. Quanto ao mecanismo da MSC, uma instabilidade elétrica dinâmica explicaria melhor a raridade da associação simultânea de um gatilho certo a um substrato cardÃaco apropriado. Diversos estudos tentaram medir essa instabilidade elétrica cardÃaca (ou um equivalente válido) em uma sequência de batimentos cardÃacos no ECG. Dentre os mecanismos possÃveis podemos citar o prolongamento do QT, dispersão do QT, potenciais tardios, alternância de onda T ou T-wave alternans (TWA), e turbulência da frequência cardÃaca. Este artigo se atém em particular ao papel da TWA no panorama atual da estratificação de risco cardÃaco. Os achados sobre TWA ainda são heterogêneos, variando de um desempenho prognóstico muito bom até um quase nulo, dependendo da população clÃnica observada e protocolo clÃnico usado. Para preencher as atuais lacunas no conhecimento sobre TWA, profissionais médicos e pesquisadores devem explorar melhor as caracterÃsticas técnicas das diversas tecnologias disponÃveis para a avaliação de TWA e atentar ao fato de que os valores de TWA respondem a diversos outros fatores, além de medicamentos. Informações sobre mecanismos celulares e subcelulares da TWA estão fora do escopo deste artigo, mas são referenciados alguns dos principais trabalhos sobre este tópico, com o intuito de auxiliar no entendimento dos conceitos e fatos cobertos neste artigo. ______________________________________________________________________________________ ABSTRACTAccurate recognition of individuals at higher immediate risk of sudden cardiac death (SCD) is still an open question. The fortuitous nature of acute cardiovascular events just does not seem to fit the well-known model of ventricular tachycardia/fibrillation induction in a static arrhythmogenic substrate by a synchronous trigger. On the mechanism of SCD, a dynamical electrical instability would better explain the rarity of the simultaneous association of a correct trigger and an appropriate cardiac substrate. Several studies have been conducted trying to measure this cardiac electrical instability (or any valid surrogate) in an ECG beat stream. Among the current possible candidates we can number QT prolongation, QT dispersion, late potentials, T-wave alternans (TWA), and heart rate turbulence. This article reviews the particular role of TWA in the current cardiac risk stratification scenario. TWA findings are still heterogeneous, ranging from very good to nearly null prognostic performance depending on the clinical population observed and clinical protocol in use. To fill the current gaps in the TWA base of knowledge, practitioners, and researchers should better explore the technical features of the several technologies available for TWA evaluation and pay greater attention to the fact that TWA values are responsive to several factors other than medications. Information about the cellular and subcellular mechanisms of TWA is outside the scope of this article, but the reader is referred to some of the good papers available on this topic whenever this extra information could help the understanding of the concepts and facts covered herein. ______________________________________________________________________________________ RESUMENReconocer con precisión individuos con mayor riesgo inmediato de muerte súbita cardÃaca (MSC) aun es una cuestión en abierto. La naturaleza fortuita de los eventos cardiovasculares agudos no parece adecuarse al conocido modelo de inducción de taquicardia/fibrilación ventricular por un gatillo en sincronÃa con un substrato arritmogénico estático. En cuanto al mecanismo de la MSC, una inestabilidad eléctrica dinámica explicarÃa mejor la rareza de la asociación simultánea de un gatillo correcto a un substrato cardÃaco apropiado. Diversos estudios trataron de medir esa inestabilidad eléctrica cardÃaca (o un equivalente válido) en una secuencia de latidos cardÃacos en el ECG. Entre los mecanismos posibles podemos citar la prolongación del QT, dispersión del QT, potenciales tardÃos, alternancia de onda T o T-wave alternans (TWA), y turbulencia de la frecuencia cardÃaca. Este artÃculo se atiene en particular al papel de la TWA en el panorama actual de la estratificación de riesgo cardÃaco. Los hallazgos sobre TWA aun son heterogéneos, variando de un desempeño pronóstico muy bueno hasta uno casi nulo, dependiendo de la población clÃnica observada y protocolo clÃnico usado. Para llenar las actuales lagunas en el conocimiento sobre TWA, profesionales médicos e investigadores deben explotar mejor las caracterÃsticas técnicas de las diversas tecnologÃas disponibles para la evaluación de TWA y estar atento al hecho de que los valores de TWA responden a otros diversos factores, además de medicamentos. Informaciones sobre mecanismos celulares y subcelulares de la TWA están fuera del objetivo de este artÃculo, pero son referenciados algunos de los principales trabajos sobre este tópico, con el propósito de auxiliar en la comprensión de los conceptos y hechos cubiertos en este artÃculo
Chronic recurrent multifocal osteomyelitis: experience from a single pediatric rheumatology center over the past ten years
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