1,721,040 research outputs found
Diagnosis of polymyalgia rheumatica in primary health care: favoring and confounding factors - a cohort study.
Full text linkObjectives: To evaluate in a primary care setting the favoring and confounding factors for the diagnosis of polymyalgia rheumatica (PMR). Material and methods: Among 303 patients consecutively referred by their general practitioners (GPs) to our rheumatologic outpatient clinic, we identified three groups: group A - patients with confirmed diagnosis of PMR, group B - patients with unconfirmed diagnosis, group C - patients with unrecognized PMR. All the diagnostic confounding and favoring factors were discussed with GPs using an e-mail questionnaire. Participation in rheumatology training courses represented the final question. The collected data were statistically assessed in a blind way. In Fisher's exact test and ANOVA test, a p-value was significant if < 0.05. The study was carried out in compliance with the Helsinki Declaration and approved by the Ethics Committee of Mariano Lauro Hospital. Every patient signed an informed consent form at the time of the first visit. Results: All patients were Caucasian; 24.1% were male; mean age was 72.3 ±8.6 years (min. - 51, max. - 94). There were 41 patients in group A, 93 in group B and 169 in group C. The percentage of misdiagnoses was very high (87.1%): among 134 patients diagnosed with PMR by their GPs (group A + group B) confirmation was made in 41, and in 169 unrecognized PMR was found. Participation in training courses was very significant compared to the diagnostic accuracy (p < 0.0001 in χ2 test) and to the diagnosis timing (24.3 days ±12.5 vs. 42.9 ±15.5 with p-value < 0.05 in the ANOVA test). When the percentages were assessed according to participation, an inadequate evaluation of some clinical manifestations favored over-diagnosis among the trained GPs. Conclusions: The level of diagnostic accuracy for PMR must be improved in primary care. Participation in rheumatology training courses can be an important step
Choline alphoscerate (alpha-glyceryl-phosphoryl-choline) an old choline- containing phospholipid with a still interesting profile as cognition enhancing agent.
No full textCholinergic precursors have represented the first approach to counter cognitive impairment occurring in adultonset dementia disorders. These compounds were early leaved because their clinical efficacy was not clearly demonstrated. This is probably not true for some choline-containing phospholipids including choline alphoscerate. Choline alphoscerate increases the release of acetylcholine in rat hippocampus, facilitates learning and memory in experimental animals, improves brain transduction mechanisms and decreases age-dependent structural changes occurring in rat brain areas involved in learning and memory. The compound exerts neuroprotective effects in models of altered cholinergic neurotransmission and of brain vascular injury. In clinical studies choline alphoscerate improved memory and attention impairment, as well as affective and somatic symptoms in dementia disorders. An ongoing trial indicates that association between the acetylcholinesterase inhibitor donepezil and choline alphoscerate is accompanied by an improvement in several cognitive tests superior to that induced by donepezil alone. It is suggested that this association may represent a therapeutic option to prolong beneficial effects of cholinergic therapies in Alzheimer's disease patients with concomitant ischemic cerebrovascular disorders. In summary, choline alphoscerate has significant effects on cognitive function with a good safety profile and tolerability. Although limited both in terms of size of the samples investigated and of the length of treatment, preclinical and clinical results presented suggest that cognitive enhancing capabilities of choline alphoscerate merit of being further investigated in appropriate trials
Tool condition monitoring framework for predictive maintenance: a case study on milling process
No full textn metal cutting processes, tool condition monitoring has a great importance to prevent surface damage and maintaining the quality of surface finishing. With the development of digitalisation and connection of industrial machines, it has become possible to collect real-time data from various types of sensors (e.g. vibration, acoustic or emission) during the process execution. However, information fusion from multiple sensor signals and tool health prediction still present a big challenge. The aim of this paper is to present a data-driven framework to estimate the tool wear status and predict its remaining useful life by using machine learning techniques. The first part of the framework is dedicated to sensor data preprocessing and feature engineering, while the second part deals with the development of prediction models. Different types of machine learning algorithms are used and compared to find the best result. A case study in a milling process is presented to illustrate the potentialities of the proposed framework for tool condition monitoring
”The use the Harmonic Scalpel versus conventional knot tyng for thyroidectomy: results of a case-control study”
No full textBackground: The Harmonic Scalpel (HS) coagulates and simultaneously
cuts tissues using mechanical energy with ultrasonic
frequency. Its role in minimally invasive thyroid surgery is well
defined. Despite its routine use has been criticized by some, HS has
been recently proposed also for conventional thyroidectomy (CT) in
small series of patients. The aim of this comparative study is to verify
in a large series of patients the efficiency and safety of HS for CT.
Patients and methods: Between April 2004 and April 2005, 267
consecutive patients were prospectively selected to undergo total
thyroidectomy (TT) with the use of HS (HS-Group). Exclusion
criteria were: previous neck surgery, minimally invasive and/or
video-assisted procedures, lymph node dissection or other associated
procedures. A case-control study including 267 patients who
underwent TT with a conventional haemostasis technique (knot
tying) (KT-group) between January 2003 and March 2004 was
performed. The controls were matched for age and sex. The
following parameters were registered: preoperative diagnosis, operative
time (from incision to skin closure), total operative room
occupation time (from induction to the end of the anaesthesia),
number of drains, total drainage fluid volume, complications, final
histology, postoperative stay, postoperative pain, patients satisfaction
with the cosmetic result and postoperative outcome. Patients of the
HS-Group were compared with those of the KT-Group.
Results: The two groups were well matched for age and sex (P =
NS). No significant difference was found concerning preoperative
diagnosis, final histology, postoperative pain, postoperative stay and
complications rate (P = NS). One postoperative bleeding requiring reoperation
was observed in the HS-Group; no other bleeding episodes
were observed. Three transient recurrent nerve palsies were observed
in each group, no permanent palsy was observed. Transient
hypocalcemia was observed in 95 patients in HS-Group and in 94
in KT-Group; one patients in the KT-Group experienced permanent
hypoparathyroidism (P = NS). Operative time was significantly
shorter in the HS-Group (66.4 ± 17.3 vs 72.3 ± 23.6 minutes,
P < 0.005), as well as the total operative room occupation time
(95.0 ± 22.9 vs 103.9 ± 24.8 minutes, P < 0.001). The mean number
of drains was significantly lower in the HS-Group (1.0 ± 0.4 vs
1.3 ± 0.5 minutes, P < 0.001). No significant difference was found
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concerning drainage fluid volume in patients with drains. Patients of
the HS-Group were more satisfied with the cosmetic result and the
postoperative outcome (P < 0.001 and P < 0.005).
Conclusion: HS is a safe and efficacious alternative to KT also for
CT, allowing for a significant reduction of operative time (about
10 %) and drain utilization without increasing the complication
rate. The higher patients satisfaction with the cosmetic result and
the postoperative outcome could be explained by the possibility
HS offers to perform TT through smaller skin incisions
Design and Simulation of a Battery Swapping System for Electric Vehicles
No full textElectric vehicles show a significant potential both to reduce carbon emissions due to an energy storage system which can be recharged using renewable energy sources. The long time it takes to recharge the batteries of an electric car can be a limit to its spread and reach a "massive adoption". This work aims at evaluating the feasibility of using an automated battery swapping system for vehicles in the city of Turin in Italy. The battery swapping station was designed by using real data from a leading company in warehouse handling. (GAP nu) Various configurations were proposed by varying the number of stations operating in the city, the number of cars served simultaneously in each station and the number of automatic guided vehicles that replace the battery in the stations. The analysis was conducted by using a discrete event simulation model. The customer service, the infrastructure costs and the battery life cycle preservation were considered as performance indicators. The obtained results showed that the project is feasible both from an infrastructural point of view and an energetic point of view
Cholinergic precursors in the treatment of cognitive impairment of vascular origin: ineffective approaches or need for re-evaluation?
No full textNimodipine and its use in cerebrovascular disease: evidence from recent preclinical and controlled clinical studies
No full textNimodipine is a 1,4-dihydropyridine-derivative Ca(2+)-channel blocker developed approximately 30 years ago. It is highly lipophilic, crosses the blood-brain barrier, and reaches brain and cerebrospinal fluid. Early treatment with nimodipine reduces the severity of neurological deficits resulting from vasospasm in subarachnoid haemorrhage (SAH) patients. In SAH, nimodipine reduced spasm-related deficits of all severities, but no spasm-unrelated deficits. This paper has reviewed preclinical studies on the influence of nimodipine in various animal models of cerebral ischemia, with particular attention toward investigations published in the last 10 years. These studies further support the main indication of nimodipine, by clarifying some mechanisms of the anti-ischemic activity of the compound. Papers reporting a possible role of nimodipine in epileptogenesis were also examined. Clinical studies on nimodipine were grouped into subarachnoid hemorrhage, acute ischemic stroke, cerebral ischemia without stroke, dementia disorders, and migraine. Clinical investigations have shown that the drug improves neurological outcome by reducing the incidence and severity of ischemic deficits in patients with SAH from ruptured intracranial berry aneurysms regardless of their post-ictus neurological condition. No relevant effects of treatment with nimodipine were reported for acute ischemic stroke, cerebral ischemia without stroke, and migraine, except than for cluster headache. The less pronounced cardiovascular effects of nimodipine compared to other dihydropyridine-type Ca(2+)-channel blockers probably accounts for its use out of label for treating patients affected by chronic cerebral ischemia and vascular cognitive impairment. However, the blood pressure-lowering effects of nimodipine should not be minimized, as clinical studies have documented lowering blood pressure in small groups of patients, including cases of withdrawn due to pronounced hypotension induced by nimodipine administration. In the area of vascular cognitive impairment, short-term benefits of nimodipine do not justify its use as a long-term anti-dementia drug, and benefits obtained in elderly patients affected by subcortical vascular dementia require to be confirmed by other groups and in larger scale trials. In conclusion, nimodipine is a safe drug with an important place in pharmacotherapy and with the main documentation for reduction in the severity of neurological deficits resulting from vasospasm in SAH patients
Open-Source IoT Lab for Fully Remote Teaching
No full textIn the era of Industry 4.0, the concept of IoT has pervaded every sector of manufacturing, promoting hyperconnectivity as an enabling status for effective communication between company departments, as well as real-time monitoring of the status of manufacturing resources. The Coronavirus pandemic, due to the SARS-CoV-2 virus (COVID-19), confirmed the advantages provided by an IoT ecosystem in the worldwide economy. The role of universities in the development and use of this technology is twofold: on the one hand, the research activity supports the digital transformation of enterprises, and on the other hand the teaching activity trains the new managers of the future. Therefore, this work proposes a didactical activity in which students are guided to the creation of an IoT system that has several advantages: it is easy to develop, it uses only open-source components, and it includes all the necessary modules for the development of a real Industrial IoT (IIoT) system. Thanks to this experience, the students acquire different skills: (1) they operate on the hardware part of the system using sensors and actuators connected to a Raspberry Pi; (2) they develop and connect PostgreSQL database; (3) they generate an automation algorithm with for intelligent data management; finally, (4) they design a Human-Machine Interface using dashboards and social chat. The scope of this lab is not focused to university teams only. It is also accessible to high school students thanks to drag and drop programming (Node-Red) and tools (Telegram) close to the students everyday life. A further contribution of this project is to provide a method of managing a course that can be conducted entirely remotely as demonstrated during the current pandemic period
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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