179 research outputs found
Induction machine stator fault on-line diagnosis based on LabVIEW environment
No full textThe benefits of machine condition monitoring have been widely recognized as superior with respect to other alternative maintenance approaches. As matter of fact, condition monitoring is an operational strategy for machine integrity assessment, fault identification and life extension. The cost-benefit ratio will be reduced in progress owing to the commercial diagnostic environment availability. This paper presents the implementation of a diagnostic procedure to detect induction machine stator faults based on LabVIEW environment. The diagnosis is performed by using a suitable neural network, trained by faulted machine simulator, that has, as input variables, the negative sequence current component and the variation of the positive sequence current component between actual and healthy machine conditions. The statement of a trigger threshold that discerns between true faults and intrinsic disymmetry of the machine is discussed as well
Induction machine stator faults on-line diagnosis based on LabVIEW environment
No full textBari, Italia
Prostate-specific membrane antigen (PSMA) radioguided surgery in prostate cancer: An overview of current application and future perspectives
No full textRadical prostatectomy (RP) with or without pelvic lymph node dissection (PLND) is the most frequent approach to treat men affected by prostate cancer (PCa), together with primary radiotherapy. Generally, patients performed computed tomography (CT) and bone scintigraphy to stage the disease prior to surgery. However, specific inhibitors directed to the prostate-specific membrane antigen (PSMA) have been recently proposed as radiopharmaceutical for positron emission tomography (PET) imaging. PSMA-PET proved higher diagnostic accuracy to stage high-risk PCa compared to conventional imaging, even if its impact on overall survival is yet to be confirmed. One of the main limitations for PSMA-PET in staging PCa is represented by the low sensitivity in identifying metastatic lymph node, namely in case of nodes smaller than 4–5 mm. Radioguided surgery (RGS) is based on the intraoperative detection of radiation emitted by the specific radiopharmaceutical. Recently, the possibility of performing RGS using cancer-specific radiotracer with high diagnostic accuracy (e.g. PSMA inhibitors) gained attention. In this review, we aimed to explore the value of PSMA-RGS in PCa, aimed at improving the surgery accuracy to remove nodal metastasis. Furthermore, we evaluated different radiation detectors (gamma rays probes vs. beta positron probes) and the diagnostic accuracy of these probes compared to PSMA-PET. A comprehensive literature review was performed in December 2022 with a non-systematic approach. After the first literature screening, a total of 16 studies have been selected and a comprehensive qualitative narrative synthesis of the articles has been performed. First studies showed promising results for PSMA-RGS, and prospective trials demonstrated good concordance of in vivo PSMA-positive detected nodes with histopathology analysis of the specimens. High sensitivity and specificity of the RGS approach were found. Whilst gamma probes have been more broadly explored, the clinical use of beta probes has been tested in feasibility studies only. Finally, Cerenkov luminescence imaging, micro-image guidance and augmented reality/virtual reality approaches in surgery are currently rising attention and are generating future perspectives for PSMA-guided surgery in PCa
Anticholinergic Drug Use and Negative Outcomes Among the Frail Elderly Population Living in a Nursing Hom
No full textAIM:
Increasing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older nursing home residents.
METHODS:
We used data from the database of the U.L.I.S.S.E project (Un Link Informatico sui Servizi Sanitari Esistenti per l'Anziani), a prospective multicenter observational study. Patients from 31 facilities in Italy were assessed at baseline and at 6 and 12 months by trained personnel, using the Minimum Data Set for Nursing Home (MDS-NH). The only exclusion criterion was age younger than 65 years. The Anticholinergic Risk Scale (ARS), a list of commonly prescribed drugs with potential anticholinergic effects, was used to calculate the anticholinergic load.
RESULTS:
A total population of 1490 patients was analyzed; almost half of the sample (48%) was using drugs with anticholinergic properties. The population of patients with ARS 1 or higher had a higher comorbidity index (P < .003) and greater cognitive impairment (CPS 5-6) (P < .007). They were more likely to suffer from heart failure, Parkinson disease, depression, anxiety, and schizophrenia. In multivariate analysis, a higher score in the ARS scale was associated with a greater likelihood of functional decline (described as the loss of ≥1 ADL point) (odds ratio [OR] 1.13; confidence interval [CI] 1.03-1.23), to a higher rate of falls (OR 1.26; CI 1.13-1.41), and to a higher incidence of delirium (OR 1.16; CI 1.02-1.32) during a 1-year follow-up.
CONCLUSIONS:
The use of medications with anticholinergic properties is common among older nursing home residents. Our results suggest that among older nursing home residents the use of anticholinergic drugs is associated with important negative outcomes, such as functional decline, falls, and delirium
Nutritional Strategies Against Sarcopenia of Aging: Current Evidence and Future Directions
No full textSarcopenia is the loss of skeletal muscle mass and function that occurs with aging. This condition is associated with increased risk for several adverse health outcomes, including frailty, disability, falls, loss of independent living, and mortality. As yet, no pharmacological treatment exists to halt the progression of sarcopenia; similarly, no pharmacological remedies are available to prevent its onset. The combination of nutritional interventions and physical exercise is currently considered to be the most effective strategy for the management of sarcopenia. In this chapter, the role of nutrition as a countermeasure for sarcopenia is discussed. The chapter is organized into three main sections: established dietary recommendations, novel nutritional candidates, and possible dietary strategies. We conclude with presenting issues related to inappropriate prescription of nutritional supplements, and the prospect of adopting cutting-edge technologies to design targeted dietary interventions
Sarcopenia in heart failure: Mechanisms and therapeutic strategies
No full textChronic heart failure (CHF) is a highly prevalent condition among the elderly and is associated with considerable morbidity, institutionalization and mortality. In its advanced stages, CHF is often accompanied by the loss of muscle mass and strength. Sarcopenia is a geriatric syndrome that has been actively studied in recent years due to its association with a wide range of adverse health outcomes. The goal of this review is to discuss the relationship between CHF and sarcopenia, with a focus on shared pathophysiological pathways and treatments. Malnutrition, systemic inflammation, endocrine imbalances, and oxidative stress appear to connect sarcopenia and CHF. At the muscular level, alterations of the ubiquitin proteasome system, myostatin signaling, and apoptosis have been described in both sarcopenia and CHF and could play a role in the loss of muscle mass and function. Possible therapeutic strategies to impede the progression of muscle wasting in CHF patients include protein and vitamin D supplementation, structured physical exercise, and the administration of angiotensin-converting enzyme inhibitors and β-blockers. Hormonal supplementation with growth hormone, testosterone, and ghrelin is also discussed as a potential treatment
Una herencia mitica: el caso de los Vikingos en Norte América
No full textIn alcune zone degli Stati Uniti persiste tuttora una tradizione di origine ottocentesca: quella di una presunta eredità "vichinga", che dall'epoca dei viaggi dei norreni in Nord America si sarebbe trasmessa fino agli americani di oggi. Alla base di questa tradizione vi sono i racconti medievali sui viaggi di Leifr Eiríksson e di altri norreni nel Vínland (la "Terra del vino"), forse uno dei capitoli più affascinanti della storia delle esplorazioni, la cui storicità è stata però a lungo oggetto di dibattito e discussione tra gli studiosi. Inizialmente considerata con scetticismo, tra Otto e Novecento essa ha ricevuto nuova linfa dalla cosiddetta "archeologia popolare", condotta cioè da amatori non professionisti, prima di venire definitivamente confermata negli anni Sessanta del XX secolo dagli scavi condotti a L'Anse aux Meadows, sull'isola di Terranova (Canada): qui, infatti, furono portati alla luce i resti di un insediamento scandinavo datato attorno all'anno 1000, l'unico insediamento europeo nelle Americhe precedente all'arrivo di Cristoforo Colombo.
Se l'autenticità del sito di L'Anse aux Meadows è fuor di dubbio, nell'arco di circa due secoli sono state invece numerose le segnalazioni di presunti reperti e resti "vichinghi" negli Stati Uniti orientali (Rhode Island e Massachusetts) e nel Midwest (Wisconsin e soprattutto Minnesota) rivelatisi poi falsi o contraffazioni moderne. L'esempio certamente più eclatante è rappresentato dalla pietra runica di Kensington, rinvenuta nel 1898 da un immigrato svedese, attorno alla quale un altro scandinavo-americano, Hjalmar Holand, creò una vera e propria narrazione storica avente come protagonisti degli scandinavi crudelmente massacrati dai nativi americani. Nello Stato del Minnesota, in particolare, la storia dei "norvegesi di Kensington", alimentata da fattori ideologici e dal grande fascino insito nel "mito vichingo", è diventata una sorta di religione civica finalizzata alla legittimazione della conquista bianca della frontiera, nonché un business regionale incentrato su una vera e propria eredità o identità "vichinga" (si pensi per esempio alla squadra di football dei Minnesota Vikings di Minneapolis).
Attraverso un attento esame di diversi, presunti reperti "vichinghi" e di altri oggetti ugualmente collegati alla storia delle esplorazioni norrene in America, come il penny del Maine e la controversa mappa di Vínland, l'articolo ripercorre la storia di questa tradizione, per risalire alle ragioni politiche, ideologiche e sociali che hanno portato a forgiare una simile visione del passato americano, ancora oggi molto radicata e popolare
Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence
No full textThe use of medication with anticholinergic properties is widespread among older subjects. Many drugs of common use such as antispasmodics, bronchodilators, antiarrhythmics, antihistamines, anti-hypertensive drugs, antiparkinson agents, skeletal muscle relaxants, and psychotropic drugs have been demonstrated to have an anticholinergic activity. The most frequent adverse effects are dry mouth, nausea, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment such as confusion, agitation and coma. A growing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment in the elderly population. However, the morbidity and management issues associated with unwanted anticholinergic activity are underestimated and frequently overlooked. Moreover, their possible relation with specific negative outcome in the elderly population is still not firmly established. The aim of the present review was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older persons. We searched PubMed and Cochrane combining the search terms "anticholinergic", "delirium", "cognitive impairment", "falls", "mortality" and "discontinuation". Medicines with anticholinergic properties may increase the risks of functional and cognitive decline, morbidity, institutionalization and mortality in older people. However, such evidences are still not conclusive probably due to possible confounding factors. In particular, more studies are needed to investigate the effects of discontinuation of drug with anticholinergic properties. Overall, minimizing anticholinergic burden should always be encouraged in clinical practice to improve short-term memory, confusion and delirium, quality of life and daily functioning
Experimental validation of an innovative approach in biokinetics study for personalised dosimetry of molecular radiation therapy treatments
No full text: One of today's main challenges in molecular radiation therapy is to assess an individual dosimetry that allows treatment to be tailored to the specific patient, in accordance with the current paradigm of 'personalized medicine'. The evaluation of the absorbed doses for tumor and organs at risk in molecular radiotherapy is typically based on MIRD schema acquiring few experimental points for the assessement of biokinetic parameters. WIDMApp, the wearable individual dose monitoring apparatus, is an innovative approach for internal dosimetry based on a wearable radiation detecting system for individual biokinetics sampling, a Monte Carlo simulation for particle interaction, and an unfolding algorithm for data analysis and integrated activity determination at organ level. A prototype of a WIDMApp detector element was used to record the photon emissions in a body phantom containing 3 spheres with liquid sources (18F,64Cu and99mTc) to simulate organs having different washout. Modelling the phantom geometry on the basis of a CT scan imaging, the Monte Carlo simulation computed the contribution of each emitting sphere to the signal detected in 3 positions on the phantoms surface. Combining the simulated results with the data acquired for 120 h, the unfolding algorithm deconvolved the detected signal and assessed the decay half-life (T1/2) and initial activity values (A(0)) that best reproduces the observed exponential decays. A 3%-18% level of agreement is found between the actualA(0) andT1/2values and those obtained by means of the minimization procedure based on the Monte Carlo simulation. That resulted in an estimation of the cumulated activity <15%. Moreover, WIDMApp data redundancy has been used to mitigate some experimental occurrences that happened during data taking. A first experimental test of the WIDMApp approach to internal radiation dosimetry is presented. Studies with patients are foreseen to validate the technique in a real environment
Technical note: a wearable radiation measurement system for collection of patient-specific time-activity data in radiopharmaceutical therapy: system design and Monte Carlo simulation results
No full textPurpose: A high level of personalization in Molecular Radiotherapy (MRT) could bring advantages in terms of treatment effectiveness and toxicity reduction. Individual organ-level dosimetry is crucial to describe the radiopharmaceutical biodistribution expressed by the patient, to estimate absorbed doses to normal organs and target tissue(s). This paper presents a proof-of-concept Monte Carlo simulation study of “WIDMApp” (Wearable Individual Dose Monitoring Apparatus), a multi-channel radiation detector and data processing system for in vivo patient measurement and collection of radiopharmaceutical biokinetic data (i.e., time-activity data). Potentially, such a system can increase the amount of such data that can be collected while reducing the need to derive it via nuclear medicine imaging. Methods: a male anthropomorphic MIRD phantom was used to simulate photons (i.e., gamma-rays) propagation in a patient undergoing a (Formula presented.) I thyroid treatment. The administered activity was set to the amount usually administered for the treatment of differentiated carcinoma while its initial distribution in different organs was assigned following the ICRP indications for the (Formula presented.) I biokinetics. Using this information, the simulation computes the Time-dependent Counts Curves (TCCs) that would have been measured by seven WIDMApp-like sensors placed and oriented to face each one of five emitting organs plus two thyroid lobes. A deconvolution algorithm was then applied on this simulated data set to reconstruct the Time-Activity Curve (TAC) of each organ. Deviations of the reconstructed TACs parameters from values used to generate them were studied as a function of the deconvolution algorithm initialization parameters and assuming non-Poisson fluctuation of the TCCs data points. Results: This study demonstrates that it is possible, at least in the simple simulated scenario, to reconstruct the organ cumulated activity by measuring the time dependence of counts recorded by several detectors placed at selected positions on the patient's body. The ability to perform in vivo sampling more frequently than conventional biokinetic studies increases the number of time points and therefore the accuracy in TAC estimates. In this study, an accuracy on cumulated activity of 5% is obtained even with a 20% error on the TCC data points and a 50% error on the initial guess on the parameters of the deconvolution algorithm. Conclusions: the WIDMApp approach could provide an effective tool to characterize more accurately the radiopharmaceutical biokinetics in MRT patients, reducing the need of resources of nuclear medicine departments, such as technologist and scanner time, to perform individualized biokinetics studies. The relatively simple hardware for the approach proposed would allow its application to large numbers of patients. The results obtained justify development of an actual prototype system to characterize this technique under realistic conditions
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