Search

Objective:Research findings regarding child-centered care and electronic patient reported outcome measures (e-PROMs) within pediatric palliative oncology care reveal an intricate field of study. This study aimed to map innovations in e-PROMs for the pediatric cancer population in palliative care and their impact on symptom management, and communication with healthcare professionals. Methods:A scoping review was designed following the Arksey and O’Malley framework. Literature searches were conducted in CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS, and Web of Science. Inclusion criteria targeted children aged 0–18 years with cancer, receiving palliative and/or end-of-life care, and using e-PROMs. Results:Twelve articles were included: 10 quantitative studies, one qualitative study, and one mixed-method study. A narrative synthesis approach was used to summarize the findings, categorized into three sections: (a) technological innovation of e-PROMs in pediatric palliative oncology care; (b) the impact of e-PROMs on symptom monitoring, management, and children's care; (c) the effects of e-PROMs on communication between children and healthcare professionals in pediatric palliative oncology care. Conclusion:e-PROMs have proven effective in empowering children to express their perspectives and actively engage in their end-of-life care. Due to flexible software and devices designed for various age groups, these tools fit seamlessly into children's daily routines and preferences, including the use of play-oriented applications. They facilitate a deeper understanding, and management of physical and emotional symptoms while ensuring care remains child-centered. This emphasizes the importance of preserving the essence of childhood and addressing the unique needs and experiences of young patients in pediatric palliative oncology care.

Quadruped robots are used for a wide variety of transportation and exploration tasks due to their high dexterity. Currently, many studies utilize soft robotic legs to replace rigid-link-based legs, with the aim to improve quadruped robots' adaptability to complex environments. However, the conventional soft legs still face the challenge of limited load-bearing capacity. To cope with this issue, we propose in this work a type of soft-rigid hybrid leg, which is synthesized by using a multistage topology optimization method. A simplified model is also created to describe the kinematics of the synthesized soft leg. Using the realized legs, we have developed a turtle-inspired quadruped robot called TurBot. By mimicking the walking pattern of a turtle, two motion gaits (straight-line walking and turning) are designed to realize the robotic locomotion. Experiments are also conducted to evaluate the walking performance of TurBot. Results show that the realized robot can achieve stable straight-line walking and turning motions. In addition, TurBot can carry up to 500 g extra weight while walking, which is 126% of its own body weight. Moreover, different locomotion tests have also successfully verified TurBot's ability to adapt to complex environments.

Arrays of single photon avalanche diodes (SPADs) fabricated in a 150 nm CMOS technology have been exposed to neutrons up to fluences of about $4.3 \times 10^{10}~1$ MeV neutron equivalent cm $^{-2}$ , with fluxes around $3 \times 10^{6}~1$ MeV neutron equivalent cm $^{-2}\text{s}^{-1}$ . Dark count rate (DCR) was monitored during irradiation and for some time, from 5 to 23 min, depending on the irradiation step, at the end of the irradiation interval to investigate the dynamics of defect formation and short-term annealing. Measurements were performed both on single- and on dual-layer devices, where SPAD arrays are face to face bonded and read out in coincidence. A range of different DCR behaviors were detected after single neutron interaction with the device substrate, including in particular partial performance recovery following a logarithmic relaxation process, but also damped oscillation phenomena, sudden step-shaped changes, and the emergence of RTS-like fluctuations, pointing to different defect reordering dynamics.

Although Kawasaki disease is commonly regarded as a single disease entity, variability in clinical manifestations and disease outcome has been recognised. We aimed to use a data-driven approach to identify clinical subgroups.

To describe a new technique based on a different deployment of the Endurant Stent-Graft System (Medtronic Cardiovascular, Santa Rosa, CA) during endovascular aortic aneurysm repair to guarantee a more precise deployment in presence of severe neck angulation (SNA).

Background: Placebo response appears to be increasing in antidepressant, antipsychotic and various internal medicine trials. A similar trend has been reported for OCD during 1989-1999. Placebo response is generally considered as the extent to which placebo treatment is associated with core symptom improvement. In this analysis, we used Joinpoint regression to assess the time trend of both placebo response and placebo responder rates according to the year of publication with no time restriction in OCD drug trials. Methods: We included drug and/or psychotherapy trials vs. placebo from PubMed, Embase, CINAHL, and PsycINFO retrieved through the search (placebo OR sham) AND (obsessive* OR OCD). We included studies through investigator consensus. We then performed on data of included studies log-linear joinpoint segmented regression models using a p<0.05 cutoff. Results: We included 113 studies from 112 published papers. Placebo mean annual response rates in OCD studies significantly increased from 1991 to 2017 with an annual percent change (APC) of 0.66%, while placebo mean annual responder rates also significantly increased from 2010 to 2017, with an APC of 5.45%. Drug mean annual response rates in OCD studies significantly increased from 1987 to 2012 with an APC of 0.72%, while the corresponding responder rates did not show statistically significant APC changes between 1984 and 2017. Conclusion: We observed a tendency for placebo to increase both measures of response in OCD clinical drug trials through the years that tend to approximate the responses shown by drugs. Changes in the type of study (moving from classical head to head comparisons to add-on studies in treatmentresistant populations) and countries involved in experimentation may partially account for some portion of these results. It appears that placebo effects are becoming more elusive and out of control.

In scintillation and dosimetry applications, the increasing interest on the use of colloidal quantum dots (QDs) in comparison with organic fluorophores is mainly due to their easier chemical processability, narrower photoluminescence (PL) emission, and higher cross-section for ionizing radiation. The development of scintillators and dosimeter based on QDs, however, relies on a deep understanding of the effects of ionizing radiation on QD structures. In this paper, we present the optical characterization of colloidal cadmium-free InGaP/ZnS core–shell QDs embedded in polydimethylsiloxane (PDMS) and irradiated with 2 MeV protons (H+) in the fluence range of 1014to 1015H+cm–2. Steady-state PL measurements of the irradiated samples show a decrease of the average QD PL intensity, indicating the introduction of PL quenching centers. Time-resolved PL measurements, acquired with a time-correlated single photon counting system, provide a way to probe the radiation-induced change in the carrier recombination dynamics of the QDs. A detailed analysis of the time-resolved PL curves demonstrates the presence of PL quenching defects localized both at the inner (core) and at the outer (shell) structure of the nanocrystal. The radiation-induced change in the QD optical properties, coupled with a suitable radiation hardness of the PDMS in these irradiation conditions, open the way for possible future applications related to dosimetry systems based on QDs as nanostructured sensing elements.

The rapid development of digitization and 3D printing is creating an ever-increasing demand for methods for the automated generation of 3D models from real components. Thanks to the progress and widespread use of computer vision, it is now possible to merge classical engineering tasks with image processing techniques. Computer-aided design can therefore be automated using information from image data. In this study, we present a novel method for automated digitization of 3D structures using AprilTag fiducial system and Solid Geometry Library. The proposed design process is implemented in matlab. AprilTags are used to realize 3D coordinate measurements to digitally capture the 3D dimensions of real components. Based on these data, 3D replica models are generated with the Solid Geometry Library toolbox, which enables the automated design of 3D surface models in matlab. The mathematical background of this procedure is described. The capability of the proposed method is demonstrated on 3D structures composed of components with fixed cross sections and fundamental 3D structures such as prisms, cylinders, and spheres. Further improvements in the coordinate measurement process using AprilTag and further implementation in matlab can extend the functionality for the digitization of more complex 3D structures.

Background: Athanasios Koukopoulos proposed the primacy of mania hypothesis (PoM) in a 2006 book chapter and later, in two peer-reviewed papers with Nassir Ghaemi and other collaborators. This hypothesis supports that in bipolar disorder, mania leads to depression, while depression does not lead to mania. Objective: To identify evidence in literature that supports or falsifies this hypothesis. Method: We searched the medical literature (PubMed, Embase, PsycINFO, and the Cochrane Library) for peer-reviewed papers on the primacy of mania, the default mode function of the brain in normal people and in bipolar disorder patients, and on illusion superiority until 6 June, 2016. Papers resulting from searches were considered for appropriateness to our objective. We adopted the PRISMA method for our review. The search for consistency with PoM was filtered through the neurobiological results of superiority illusion studies. Results: Out of a grand total of 139 records, 59 were included in our analysis. Of these, 36 were of uncertain value as to the primacy of mania hypothesis, 22 favoured it, and 1 was contrary, but the latter pooled patients in their manic and depressive phases, so to invalidate possible conclusions about its consistency with regard to PoM. All considered studies were not focused on PoM or superiority illusion, hence most of their results were, as expected, unrelated to the circuitry involved in superiority illusion. A considerable amount of evidence is consistent with the hypothesis, although indirectly so. Limitations. Only few studies compared manic with depressive phases, with the majority including patients in euthymia. Conclusion: It is possible that humans have a natural tendency for elation/optimism and positive selfconsideration, that are more akin to mania; the depressive state could be a consequence of frustrated or unsustainable mania. This would be consistent with PoM.

On-chip direct coupling of dielectric waveguides to Si substrate-integrated photodetectors has been realized within a top-down approach. A first-run 44% external quantum efficiency at 850 nm is shown for an oxynitride photonic integrated circuit at room temperature.

AbstractIntroductionThe role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives.MethodsAn ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010.ResultsDuring the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population.ConclusionsDespite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a “learning organization” and improve both efficacy and safety of first aid care.

Bruno Touschek’s life as a physicist spanned the period from World War II to the 1970s. He was a key figure in the developments of electron–positron colliders and storage rings, and made important contributions to theoretical high energy physics. Storage rings, initially developed for high energy physics, are being widely used in many countries as synchrotron radiation sources and are a tool for research in physics, chemistry, biology, environmental sciences and cultural heritage studies. We describe Touschek’s life in Austria, where he was born, in Germany, where he participated in the construction of a betatron during WWII, and in Italy, where he proposed and led to completion the first electron–positron storage ring in 1960, in Frascati. We highlight how his central European culture influenced his lifestyle and work, and his main contributions to physics, such as the discovery of the Touschek effectand beam instabilities in the larger storage ring ADONE.

Kawasaki disease, the most common cause of acquired heart disease in developed countries, is a self-limited vasculitis that is treated with high doses of intravenous immunoglobulin. Resistance to intravenous immunoglobulin in Kawasaki disease increases the risk of coronary artery aneurysms. We assessed whether the addition of infliximab to standard therapy (intravenous immunoglobulin and aspirin) in acute Kawasaki disease reduces the rate of treatment resistance.

The doctor of philosophy (PhD) degree in nursing science prepares nurses to be scientists through a rigorous program of scholarship and research. Nurses who complete this degree are recognized globally as researchers who are expected to pursue a career of intellectual inquiry. Today, the internationally small cohort of PhD-prepared nurses contributes empirically to the generation and development of nursing science. There is currently a shortage of doctorally prepared nurses to meet the increased demands for researchers and educators in schools of nursing and experts in patient care. The Institute of Medicine has recommended doubling the number of doctorally prepared nurses by 2020 and has emphasized that nurses achieve higher levels of education and training through an improved educational system that promotes seamless academic progression. However, in the United States, the overall PhD completion rate is only 57%. This article reports on the process undertaken by a collegial support group of students in a PhD in nursing science program who encouraged each other’s progress through the dissertation process within a calendar year.2013;44(7):309–312.J Contin Educ Nurs2013;44(7):309–312.

L’osteoporosi è una malattia dello scheletro caratterizzata da bassa densità minerale ossea, scarsa qualità dell’osso e aumentato rischio di fratture. Le recenti conoscenze fisiopatologiche sui meccanismi cellulari e molecolari dell’osteoporosi hanno spostato l’attenzione dello sviluppo farmaceutico dal classico bersaglio degli osteoclasti, agli osteoblasti e agli osteociti. In questa review analizzeremo brevemente i farmaci approvati o in fase di studio per tale patologia.

Abstract: This article gives a brief outline of the life and works of the Austrian physicist Bruno Touschek, who conceived and, 50 years ago, brought to completion the construction of AdA, the first electron-positron storage ring. The events which led to the approval of the AdA project and the Franco-Italian collaboration which confirmed the feasibility of electron-positron storage rings will be recalled. We shall illustrate Bruno Touschek’s formation both as a theoretical physicist and as an expert in particle accelerators during the period between the time he had to leave the Vienna Staatgymnasium in 1938, because of his Jewish origin from the maternal side, until he arrived in Italy in the early 1950s and, in 1960, proposed to build AdA, in Frascati. The events which led to Touschek’s collaboration with Rolf Widerøe in the construction of the first European betatron will be described. The article will make use of a number of unpublished as well as previously unknown documents, which include an early correspondence with Arnold Sommerfeld and Bruno Touschek’s letters to his family in Vienna from Italy, Germany and Great Britain. The impact of Touschek’s work on students and collaborators from University of Rome will be illustrated through his work on QED infrared radiative corrections to high energy e + e − experiments and the book Meccanica Statistica.

Areas covered in this review:We focus our attention on data on the efficacy of currently available and emerging drugs for the management of cancer treatment induced bone loss (CTIBL) found in a PubMed research from 1997 till today.Importance of the field:One of the most common and severe safety issues of the antihormonal therapy in both sexes is the CTIBL and the related fragility fractures. In postmenopausal women with estrogenic receptor positive breast cancer, the third-generation aromatase inhibitors (AIs) are the standard therapy. Observational retrospective studies have found that AIs treated patients had a high rate of bone loss and fracture risk (RR 1.3). Also in men with prostate cancer receiving androgen deprivation therapy, the increase in bone turnover and the consequent bone loss are very rapid and sustained significantly increasing the fracture risk.What the reader will gain:The aim of our review is to provide the current evidences for the management of bone loss and fracture risk in this subpopulation.Take home message:The very high rate of bone loss and the high incidence of fractures indicate that cancer patients at risk of CTIBL need to be carefully monitored and stratified for fracture risk. Although there is a strong evidence of efficacy in prevention of bone loss and reduction of fracture risk for many drugs approved for postmenopausal osteoporosis (PMO) and male osteoporosis, for CTIBL there are actually no drugs approved for this indication.

Despite the widespread recognition of pyuria in acute Kawasaki disease (KD) patients and its inclusion in the American Heart Association list of supporting laboratory data for KD diagnosis, no systematic study of pyuria and the origin of these cells in KD patients have been reported. We used automated urinalysis with flow cytometry to characterize urine samples from 135 acute KD subjects and 87 febrile control (FC) subjects without urinary tract infection. Pyuria defined as ≥12 (for males) or 20 (for females) cells/μL was present in 79.8% of KD and 54.0% of FC subjects (P< 0.0001). The median number of white blood cells (WBC) in the urine was 42 WBC/μL in KD and 12 WBC/μL in FC (P< 0.0001). No significant difference between the groups was seen for urine red blood cell (RBC) count, protein, or specific gravity. Comparison of voided versus catheter-collected urine samples indicated an origin of the cells from the bladder or upper urinary tract in both patient groups. Pyuria in KD subjects was not correlated with age or day of illness. Overall, the presence of pyuria was neither specific nor sensitive as a marker for KD, but the magnitude of pyuria was significantly higher in KD patients compared with the FC group.

This paper reports on a novel range camera employing Single Photon Avalanche Diodes for Time-of-Flight imaging applications. The architecture of an active pixel containing a single photon detector and the relative read-out channel is presented together with experimental results of a 64-pixel linear array. The sensor array, fabricated with a standard high-voltage 0.8-µm CMOS technology, exhibits a range accuracy of better than ± 3cm in the range interval 2m to 5m, without any external averaging operation.

Abstract: In this note, we summarize and compare various model predictions forpp total cross-section σ tot pp , giving an estimate of the range of predictions for the total cross-section, σ tot pp expected at the LHC. We concentrate on the results for σ tot pp obtained in a particular QCD based model of the energy dependence of the total cross-section, including the effect of soft gluon radiation. We obtain the range of predictions in this model by exploring the allowed range of model parameters. We further give a handy parametrisation of these results which incidentally spans the range of various other available predictions at the LHC as well

Neurologic soft signs (NSS) are considered a somatic feature associated with schizophrenia (DSM-IV) that are present in neuroleptic-treated, as well as untreated or first-episode patients. The aim of this study was to determine the incidence and severity of NSS in groups of schizophrenic patients treated with either a conventional neuroleptic medication, haloperidol (n = 37), or atypical antipsychotic medications, risperidone (n = 19), clozapine (n = 34), and olanzapine (n = 18). NSS were assessed with the Neurological Evaluation Scale (NES), whereas extrapyramidal symptoms (EPS), which occur more commonly with conventional neuroleptic treatment, were evaluated using the Simpson-Angus Scale. NES scores were not significantly different between groups. Slight differences were found for 2 items only. The haloperidol group showed higher scores for the "Romberg test," whereas the clozapine group showed higher scores for "short-term memory." There were significant correlations between EPS and NES total score in the haloperidol and risperidone groups. These results demonstrate an overall overlapping of NSS among the groups, confirming their substantial independence from neurologic implications of neuroleptic treatment.

The electrical injection in porous silicon fabricated with heavily doped p-type silicon is very sensitive to NO2. The known effect is an injection increase associated to NO2. We show experimentally a strong correlation between two structural properties and the sensitivity of electrical injection to NO2. The first property is the microstructure, i.e. the pore morphology at nm scale. A structure with straight, elongated pores shows large sensitivity, as opposed to a branching structure. The second property is the layer thickness, which determines the sign of the effect of NO2. If the thickness is sufficiently low – of the order of few µm – the injection in presence of NO2 decreases, instead of increasing. (© 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

Some studies in animal models showed that several neurotrophins may be implicated in the regulation of light-dependent suprachiasmatic pacemaker and in other functions implicated in long-term memory acquisition during sleep. However, no data are known about the role played by NGF in ultradian regulation in humans. The aim of this study was to investigate whether or not there is a natural diurnal fluctuation during daytime in healthy and schizophrenic subjects with a normal light/dark cycle. In a sample of 33 subjects (10 male schizophrenics and 23 healthy subjects) an ELISA assay was used to study the ultradian NGF cycle in blood samples at 9.00, 13.00 and 20.00 hours. The study showed an ultradian rhythm of NGF in healthy subjects with a “V” trend: higher at 9:00 and 20:00 and lower at 13:00. We also show significant differences between male and female controls. No NGF ultradian rhythm among schizophrenic patients compared to healthy subjects was found. The results of this study lead to a rhythmic NGF regulation that appears altered in schizophrenics, where higher levels in the morning and lower levels in the evening were observed, compared to the controls, and support the hypothesis of a role played by NGF in schizophrenia.

A survey on the 6-month prevalence of depression in the Italian community was performed using the modified-Mini-International Neuropsychiatric Interview (MINI) administered with a computer-prompted interview to a panel of 5566 individuals, which aimed to validate the results of a previous similar survey and evaluate the socio-economic consequences of the illness. Prevalence of major depression and minor depression accounted for 10.8 and 3.3 of the cases, respectively, thus confirming the previous results (8.0 and 2.9, respectively). Major depression was 1.4-fold more prevalent in females compared to males, while minor depression was 2.6-fold more prevalent in males, thus confirming the previous results (1.3 and 1.6, respectively). The majority of subjects of all MINI depression categories, including major depression (62.7 versus 83.9 of the minor depression and 82.3 of the depressive symptoms subjects), did not consult any healthcare professional with respect to their symptoms. Among the major depression subjects undergoing medical consultation, 34.2 of were not prescribed any therapy or intervention, while only 36.8 reportedly started a drug therapy (22.3 with an antidepressant). More than twice as many major depression subjects had at least three physician visits and drug therapies and more than three-fold as many had at least four instrumental examinations in the preceding 6 months compared to no depression subjects. Loss of work or global activity longer than 1 week was reported by approximately four-fold as many major depression subjects compared to no depression subjects. These results provide evidence for a higher frequency of under-recognition of depression as a medical illness in Italy compared to other European countries, while confirming the evidence from other countries on the small proportion of subjects with disabling symptoms who receive treatment, particularly specific treatment with antidepressants, and on the direct relationship between the impairment induced by the depressive symptoms and global healthcare resources use, as well as of work and activity days lost.

Objective: Obstetric complications may be an etiologically important factor in the development of schizophrenia. The aim of this study was to evaluate whether the risk for developing schizophrenia in adult life is increased in individuals with more severe obstetric complications at birth. Methods: To this end, mothers were interviewed to gather data about obstetric complications. The 'midwife protocol' of Parnas and colleagues was used to quantify the presence and entity of obstetric complications. We studied the frequency distribution and the severity of obstetric complications in 64 male DSM IV schizophrenic patients. The genetic load was reduced by using 81 brothers who were not psychiatric patients as controls. Odds ratios for the effects of obstetric complications, maternal age, birth order and birth weight were calculated using conditional logistic regression. Results: The only factor found to have a significant effect on the risk of schizophrenia was the overall measure of obstetric complications at birth. The history of obstetric complications was higher in schizophrenic patients than in their siblings. Conclusion: The results seem to confirm the hypothesis that obstetric complications may contribute to increased vulnerability to the disease, in addition to genetic risk factors.

We have fabricated a multiparametric gas sensor based on porous silicon. The sensing parameters are the electrical conductivity of a single porous Si layer and the resonance wavelength of a porous silicon microcavity, both fabricated on the same substrate. The electrical conductivity allows detection of 50 ppb of nitrogen dioxide in dry air. Although relative humidity also affects the electrical conductivity, the contributions due to nitrogen dioxide and to humidity can be distinguished by simultaneously monitoring the cavity resonance wavelength and the current. We also demonstrate a three-contact configuration which further increases the sensitivity of the electrical response of the sensor.

Abstract.: The complementarity between chiral perturbation theory and the linear sigma model is exploited to study production in radiative decays, where the effects of the f 0 (980) scalar resonance, and those of its more controversial partner, should become manifest via the decay chain. The recently reported data on coming from the VEPP-2M e + e - collider in Novosibirsk and the DANE -factory in Frascati can be reasonably described in our approach, which we propose as a promising first step towards more detailed analyses. The f 0 (980) contribution, which appears as a moderately narrow peak at the high part of the dipion mass spectrum, can be interpreted as the isoscalar member of the scalar nonet with a large coupling and an coupling suppressed by almost ideal -f0 mixing. Indeed, the mixing angle in the flavor basis is found to be , if the f0 propagator is approximated by a simple Breit-Wigner expression, or , if an improved two-channel analysis is performed. The resonance, which is then strongly coupled to pion pairs, yields a tiny contribution because, in our approach, its coupling to kaon pairs is proportional to and thus quite small.

AbstractBackground:Cannabis is a possible risk factor for the onset of schizophrenia and can induce neurocognitive, behavioural and motor co-ordination alterations. The aim of this study was to evaluate the role of cannabis in the occurrence of neurological soft signs (NSS) and, considering that this drug has been related to positive symptoms, whereas NSS have been linked to negative symptoms, we also examined the role of clinical features. Methods:The study investigated NSS in 25 male cannabis-consuming and 25 male non-consuming schizophrenic patients, using the Neurological Evaluation Scale. Clinical features were studied using SANS and SAPS. Results:Significant differences emerged after comparison analysis, with more NSS in non-consuming patients. The SANS subscales Alogia and Anhedonia-asociality were also statistically significant in this group of patients. Discussion:If non-consuming patients show a higher incidence of both NSS and negative symptoms, which, according to the literature, seem to be associated, then these findings suggest that NSS are relatively independent from cannabis, but not from clinical features.Copyright © 2002 S. Karger AG, Basel