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Optimized Feedforward Control for the Co-Administration of Propofol and Remifentanil for Induction of Hypnosis in General Anesthesia
No full textGeneral anesthesia is a crucial component of invasive medical procedures. Our primary focus is the optimization of the simultaneous infusion of propofol and remifentanil during induction. In particular, we compute a feedforward infusion rate that minimizes the time for bringing the Bispectral Index (BIS) value below an assigned threshold, while ensuring that the BIS remains above an assigned minimum value. We consider a two-drug model, that takes into account the synergistic effect of the two drugs. Due to the expression of the Hill function, the constraint of maintaining the BIS in a given interval is non-convex. We propose a convex tightening to formulate the overall optimal control task as a convex optimization problem. Through simulation experiments, we show that this hybrid feedforward-feedback strategy quickly achieves the BIS target, while maintaining safe and clinically acceptable infusion rates
When Should Elective Neck Dissection Be Considered for Early-Stage Oral Cavity Tumors? Insights From a Multicenter Study of 1109 Patients and Development of a Multiparametric Predictive Model
No full textBackground: Nodal metastases significantly affect prognosis in oral cavity squamous cell carcinoma (OCSCC). In early-stage OCSCC (cT1–T2 cN0), management of the clinically negative neck (cN0) remains controversial. Depth of invasion (DOI) is a key determinant for END, but other histopathological parameters, such as grading, perineural invasion (PNI), lymphovascular invasion (LVI), and worst pattern of invasion (WPOI), are emerging prognostic factors. Methods: This multicenter retrospective study analyzed 1109 patients with cT1-T2 cN0 OCSCC treated at 30 Italian hospitals since 2017. Data on histopathological parameters, tumor characteristics, and patient outcomes were collected via the REDCap platform. Simple and multivariable logistic regression models were developed to assess predictors of occult nodal metastases. Results: A total of 585 patients were clinically classified as cT1 tumors (53%), 503 as cT2 (45%), and cTis (1.9%). Of the 1109 patients, 193 (28%) had occult nodal metastases, with DOI, LVI, PNI, WPOI, and grading emerging as significant predictors. A predictive model integrating these variables demonstrated superior accuracy compared to a DOI-only model (AUROC comparison, p < 0.01). Conclusion: This study highlights the importance of incorporating multiple histopathological parameters into risk models for occult nodal metastases, overcoming the fixed DOI as a cutoff. The proposed predictive model offers a more precise method for guiding END in early-stage OCSCC, allowing individualized risk estimation
Development of a Simplified Geriatric Score-4 (SGS-4) to Predict Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation in Patients Aged over 50
Get PDFI (possibili) limiti costituzionali alla riforma della giustizia nell'ordinamento italiano
No full textDopo aver affrontato il tema della rigidità della costituzione e dei limiti alle revisioni costituzionali, l'attenzione si concentra sulla proposta di revisione del Titolo IV, Parte II, della Costituzione, promossa nel corso della XIX Legislatura
Trends in Engineering Education on ISO GPS and GD&T: A Look at Today and Tomorrow
No full textConsidering the importance of the recent renewed interest in geometric specification management in industry and academia, along with the evolving landscape of educational models post-COVID-19, the authors aimed to investigate, through a literature review, the status of educational practices on these topics. In particular, the presence of educational initiatives dedicated to geometric and functional product specifications in mechanical or industrial engineering programs was investigated, with a specific focus on standards such as ISO GPS and ASME GD&T outside the Italian context. An analysis was then conducted to identify common teaching strategies and the development of specific tools to improve the understanding of these complex topics. The review of education and training experiences revealed significant trends and insights for future training efforts. In particular, the prevalence of active learning practices emerged, and detailed course descriptions demonstrate the effectiveness of hands-on approaches, often supplemented by specific tools, in facilitating student understanding. Leveraging these trends, educators can design more effective interventions to equip students with the knowledge and skills they need to succeed with geometric specifications
Brescia: la ridefinizione architettonica degli spazi del commercio dal XVI al XX secolo
No full textThe contribution intends to analyze specifìcally from urban and architectural standpoint the detailed plans designed and built - far Brescia and far the Piazza del Mercato in particular - by Ludovico Beretta, but a/so to focus attention on the connection, from the sixteenth century to today, between the trade regulations and changes to the urban and architectural framework of the historic center of Brescia and the market square. Consequently, the focus will be placed on the regulation of trade between the eighteenth, nineteenth and twentieth centuries, but a/so on the neoclassica/ and modern reforms of the square
Comment on Onisor et al. Reply to Stein, J.M. Comment on “Onisor et al. Effectiveness and Clinical Performance of Erythritol Air-Polishing in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials. Medicina 2022, 58, 866”
Get PDFMultiplicity-dependent inclusive J/ψ production at forward rapidity in pp collisions at s = 13 TeV
No full textThis paper presents a study of the inclusive forward J/ψ yield as a function of forward charged-particle multiplicity in pp collisions at s = 13 TeV using data collected by the ALICE experiment at the CERN LHC. The results are presented in terms of relative J/ψ yields and relative charged-particle multiplicities with respect to these quantities obtained in inelastic collisions having at least one charged particle in the pseudorapidity range |η| < 1. The J/ψ mesons are reconstructed via their decay into μ+μ− pairs in the forward rapidity region (2.5 < y < 4). The relative multiplicity is estimated in the forward pseudorapidity range which overlaps with the J/ψ rapidity region. The results show a steeper-than-linear increase of the J/ψ yields versus the multiplicity. They are compared with previous measurements and theoretical model calculations
Gli ecosistemi della conoscenza in sanità: il valore e l’attrattività generati dalla ricerca clinica. Il caso dell’Azienda Ospedaliero Universitaria Pisana (AOUP)
No full textA new parallel-batch scheduling problem with non-identical jobs, compatible families, and setup times
Get PDFThis paper addresses a new parallel-batch scheduling problem on a single batch-processing machine, inspired by an industrial heat treatment process. The goal is forming and sequencing batches with non-identical jobs belonging to compatible families while minimizing the makespan. The longest job in each batch determines the batch processing time, and setup times depend on the sequence of dominant families. We propose a mixed-integer linear programming (MILP) formulation for the problem and some valid inequalities. Computational experiments demonstrate the formulation’s effectiveness and compare the performance of Cplex and Gurobi solvers