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459 results on '"Milani G."'

1. Prediction of the optimal vulcanization of a fiber-reinforced elastomeric isolator made of natural rubber-ethylene propylene diene monomer blend

Author

Pianese, G., Milani, G., and Milani, F.

Subjects
Elastomers -- Chemical properties, Monomers -- Chemical properties, Engineering and manufacturing industries, Science and technology
Abstract

To seismically isolate a structure, it is possible to interpose a rubber device between the foundation and superstructure that increases the period of the superstructure, a feature that allows the structure to be 'transparent' to the seismic excitation. A package of several rubber pads typically constitutes a seismic isolator; they are 10-20 mm thick vertically interspersed with either steel laminas or fiber-reinforced polymer dry textiles suitably treated. So, the rubber has a primary role and must be vulcanized correctly to create the polymer cross-linking properly. All rubber mechanical properties are strongly affected by curing temperature and curing time. Under vulcanization is a typical production error that suppliers make in large-scale productions, especially when the size of the devices is considerable. It is common to deal with elastomeric isolators where rubber pads have been treated at a largely suboptimal temperature. This article proposes a numerical model for predicting the cross-linking degree of rubber pads used in seismic isolation and made by a natural rubber-ethylene propylene diene monomer rubber compound. The aim is to correctly define the optimal curing temperature and exposition time for producing a rubber quadruple shear test specimen and a fiber reinforced elastomeric isolator (FREI). The model is a kinetic one and takes into consideration the induction time. An experimental investigation has been conducted to validate the model with visible inspections and hardness measurements taken on the rubber pads (quadruple shear specimens) and the rubber devices. The results have shown the reliability of the new numerical model proposed, with a homogeneous mechanical properties distribution obtained within the rubber pads and the FREI. KEYWORDS induction, industrial process of elastomeric isolators FREIs, kinetic model, numerical modeling and experimental validation, rubber optimal vulcanization, thermal analyses, 1 | INTRODUCTION Elastomeric isolators are a popular and widely employed building seismic protection devices. They are typically composed of alternating layers of rubber and steel plates, with the steel [...]

Published
2023
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4. Atomic clock performance beyond the geodetic limit

Author

McGrew, W. F., Zhang, X., Fasano, R. J., Schäffer, S. A., Beloy, K., Nicolodi, D., Brown, R. C., Hinkley, N., Milani, G., Schioppo, M., Yoon, T. H., and Ludlow, A. D.

Subjects
Physics - Atomic Physics, Physics - Optics, Quantum Physics
Abstract

The passage of time is tracked by counting oscillations of a frequency reference, such as Earth's revolutions or swings of a pendulum. By referencing atomic transitions, frequency (and thus time) can be measured more precisely than any other physical quantity, with the current generation of optical atomic clocks reporting fractional performance below the $10^{-17}$ level. However, the theory of relativity prescribes that the passage of time is not absolute, but impacted by an observer's reference frame. Consequently, clock measurements exhibit sensitivity to relative velocity, acceleration and gravity potential. Here we demonstrate optical clock measurements surpassing the present-day ability to account for the gravitational distortion of space-time across the surface of Earth. In two independent ytterbium optical lattice clocks, we demonstrate unprecedented levels in three fundamental benchmarks of clock performance. In units of the clock frequency, we report systematic uncertainty of $1.4 \times 10^{-18}$, measurement instability of $3.2 \times 10^{-19}$ and reproducibility characterised by ten blinded frequency comparisons, yielding a frequency difference of $[-7 \pm (5)_{stat} \pm (8)_{sys}] \times 10^{-19}$. While differential sensitivity to gravity could degrade the performance of these optical clocks as terrestrial standards of time, this same sensitivity can be used as an exquisite probe of geopotential. Near the surface of Earth, clock comparisons at the $1 \times 10^{-18}$ level provide 1 cm resolution along gravity, outperforming state-of-the-art geodetic techniques. These optical clocks can further be used to explore geophysical phenomena, detect gravitational waves, test general relativity and search for dark matter., Comment: 32 pages, 5 figures

Published
2018
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8. Clinical and laboratory parameters associated with febrile seizure recurrence within the first 24 h: a ten-year cohort study

Author

Castellazzi, M, La Vecchia, A, Scali, M, Agostoni, C, Di Pietro, G, Milani, G, Castellazzi, Massimo Luca, La Vecchia, Adriano, Scali, Martina, Agostoni, Carlo, Di Pietro, Giada, Milani, Gregorio Paolo, Castellazzi, M, La Vecchia, A, Scali, M, Agostoni, C, Di Pietro, G, Milani, G, Castellazzi, Massimo Luca, La Vecchia, Adriano, Scali, Martina, Agostoni, Carlo, Di Pietro, Giada, and Milani, Gregorio Paolo

Abstract

Introduction: We assessed clinical and laboratory parameters associated with early recurrence of febrile seizure in patients presenting at the Emergency Department with a first episode. Methods: Case series of patients admitted to the emergency department with the first episode of febrile seizure for ten consecutive years. Exclusion criteria were focal features and prolonged duration (>15 min). Results: We included 693 patients, 284 (41%) female. Median age of 20 (IQR 15–27) months. Fifty-two (8%) patients had a recurrence within 24 h. At univariate analysis, patients with recurrent seizures had higher use of antipyretics (88% vs. 74%, P = 0.03, OR 2.6, 95% CI: 1.1–7.7), higher median maximal body temperature (39.3 °C, IQR 38.9–39.9, vs. 38.9, IQR 38.4–39.3, P < 0.001, OR 2.3, 95% CI: 1.5–2.6) and presented with a lower proportion of respiratory tract infections (54% vs. 70%, P = 0.02) compared to patients without recurrence. A maximal body temperature equal to or higher than 39 °C was associated with a higher recurrence (11% vs. 4%, P < 0.001, OR 2.9, 95% CI: 1.6–5.6). Hyponatremia was not associated with a risk of recurrence. The multivariate analysis confirmed a direct association with body temperature (OR 2.3, 95% CI: 1.5–3.7, P < 0.001), and an inverse association with respiratory tract infections (OR 0.4, 95% CI: 0.2–0.9, P = 0.01), while antipyretic use was not correlated (OR 1.9, 95% CI: 0.8–5.2, P = 0.2). Conclusions: High body temperature and respiratory tract infections were (directly and inversely) associated with recurrences. Consideration of these conditions might help for anticipating the probability of recurrence.

Published
2024

10. Hyperpolarizability and operational magic wavelength in an optical lattice clock

Author

Brown, R. C., Phillips, N. B., Beloy, K., McGrew, W. F., Schioppo, M., Fasano, R. J., Milani, G., Zhang, X., Hinkley, N., Leopardi, H., Yoon, T. H., Nicolodi, D., Fortier, T. M., and Ludlow, A. D.

Subjects
Physics - Atomic Physics, Quantum Physics
Abstract

Optical clocks benefit from tight atomic confinement enabling extended interrogation times as well as Doppler- and recoil-free operation. However, these benefits come at the cost of frequency shifts that, if not properly controlled, may degrade clock accuracy. Numerous theoretical studies have predicted optical lattice clock frequency shifts that scale nonlinearly with trap depth. To experimentally observe and constrain these shifts in an $^{171}$Yb optical lattice clock, we construct a lattice enhancement cavity that exaggerates the light shifts. We observe an atomic temperature that is proportional to the optical trap depth, fundamentally altering the scaling of trap-induced light shifts and simplifying their parametrization. We identify an "operational" magic wavelength where frequency shifts are insensitive to changes in trap depth. These measurements and scaling analysis constitute an essential systematic characterization for clock operation at the $10^{-18}$ level and beyond., Comment: 5 + 2 pages, 3 figures, added supplemental

Published
2017
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13. Ultra-stable optical clock with two cold-atom ensembles

Author

Schioppo, M., Brown, R. C., McGrew, W. F., Hinkley, N., Fasano, R. J., Beloy, K., Yoon, T. H., Milani, G., Nicolodi, D., Sherman, J. A., Phillips, N. B., Oates, C. W., and Ludlow, A. D.

Subjects
Physics - Atomic Physics, Physics - Optics
Abstract

Atomic clocks based on optical transitions are the most stable, and therefore precise, timekeepers available. These clocks operate by alternating intervals of atomic interrogation with dead time required for quantum state preparation and readout. This non-continuous interrogation of the atom system results in the Dick effect, an aliasing of frequency noise of the laser interrogating the atomic transition. Despite recent advances in optical clock stability achieved by improving laser coherence, the Dick effect has continually limited optical clock performance. Here we implement a robust solution to overcome this limitation: a zero-dead-time optical clock based on the interleaved interrogation of two cold-atom ensembles. This clock exhibits vanishingly small Dick noise, thereby achieving an unprecedented fractional frequency instability of $6 \times 10^{-17} / \sqrt{\tau}$ for an averaging time $\tau$ in seconds. We also consider alternate dual-atom-ensemble schemes to extend laser coherence and reduce the standard quantum limit of clock stability, achieving a spectroscopy line quality factor $Q> 4 \times 10^{15}$.

Published
2016
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30. Genome engineering of Stx1-and Stx2-converting bacteriophages unveils the virulence of the dairy isolate Escherichia coli O174:H2 strain UC4224

Author

Milani, Giovanni, Belloso Daza, Mireya Viviana, Cortimiglia, Claudia, Bassi, Daniela, Cocconcelli, Pier Sandro, Milani G., Belloso Daza M. V., Cortimiglia C. (ORCID:0000-0001-6884-091X), Bassi D. (ORCID:0000-0001-9020-3853), Cocconcelli P. S. (ORCID:0000-0003-2212-7611), Milani, Giovanni, Belloso Daza, Mireya Viviana, Cortimiglia, Claudia, Bassi, Daniela, Cocconcelli, Pier Sandro, Milani G., Belloso Daza M. V., Cortimiglia C. (ORCID:0000-0001-6884-091X), Bassi D. (ORCID:0000-0001-9020-3853), and Cocconcelli P. S. (ORCID:0000-0003-2212-7611)

Abstract

The past decade witnessed the emergence in Shiga toxin-producing Escherichia coli (STEC) infections linked to the consumption of unpasteurized milk and raw milk cheese. The virulence of STEC is primarily attributed to the presence of Shiga toxin genes (stx1 and stx2) carried by Stx-converting bacteriophages, along with the intimin gene eae. Most of the available information pertains to the "Top 7" serotypes associated with STEC infections. The objectives of this study were to characterize and investigate the pathogenicity potential of E. coli UC4224, a STEC O174:H2 strain isolated from semi-hard raw milk cheese and to develop surrogate strains with reduced virulence for use in food-related studies. Complete genome sequence analysis of E. coli UC4224 unveiled the presence of a Stx1a bacteriophage, a Stx2a bacteriophage, the Locus of Adhesion and Autoaggregation (LAA) pathogenicity island, plasmid-encoded virulence genes, and other colonization facilitators. In the Galleria mellonella animal model, E. coli UC4224 demonstrated high pathogenicity potential with an LD50 of 6 CFU/10 & mu;L. Upon engineering E. coli UC4224 to generate single and double mutant derivatives by inactivating stx1a and/or stx2a genes, the LD50 increased by approximately 1 Log-dose in the single mutants and 2 Log-doses in the double mutants. However, infectivity was not completely abolished, suggesting the involvement of other virulence factors contributing to the pathogenicity of STEC O174:H2. Considering the possibility of raw milk cheese serving as a reservoir for STEC, cheesemaking model was developed to evaluate the survival of UC4224 and the adequacy of the respective mutants as reduced-virulence surrogates. All tested strains exhibited the ability to survive the curd cooking step at 48 & DEG;C and multiplied (3.4 Log CFU) in cheese within the subsequent 24 h. These findings indicate that genomic engineering did not exert any unintended effect on the double stx1-stx2 mutant behaviou

Published
2023

32. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study

Author

Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., Bellettato M., Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.

Abstract

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques.What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting.What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic

Published
2022

35. A review of numerical models for masonry structures

Author

D’Altri, A.M., primary, Sarhosis, V., additional, Milani, G., additional, Rots, J., additional, Cattari, S., additional, Lagomarsino, S., additional, Sacco, E., additional, Tralli, A., additional, Castellazzi, G., additional, and de Miranda, S., additional

Published
2019
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39. INVESTIGATING THE SEISMIC RESPONSE OF URM WALLS WITH IRREGULAR OPENING LAYOUT THROUGH DIFFERENT MODELING APPROACHES

Author

Parisse, F., primary, Buonocunto, V., additional, Cantagallo, C., additional, Di Primio, A., additional, Di Domenico, E., additional, Lo Presti, N., additional, Acconcia, E., additional, Cannizzaro, F., additional, Castellazzi, G., additional, D'Altri, A. M., additional, Liseni, S., additional, Manzini, C. F., additional, Marques, R., additional, Occhipinti, G., additional, Pacella, G., additional, Petracca, M., additional, Silva, L. C., additional, Brandonisio, G., additional, Calderoni, B., additional, Caliò, I., additional, Camata, G., additional, Lourenço, P. B., additional, Milani, G., additional, de Miranda, S., additional, Parisi, F., additional, Magenes, G., additional, and Cattari, S., additional

Published
2023
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46. Avaliação da presença de resíduos de piretróides em amostras de água, sedimento e pescado na Bacia Hidrográfica do Rio Tramandaí (Rio Grande do Sul)

Author

Milani, G. B and Et Al

Abstract

R E S U M O Atualmente, o Brasil está entre os maiores consumidores de agrotóxicos do mundo e os corpos hídricos estão constantemente sendo contaminados. Os piretróides surgiram no início da década de 1980 como alternativa aos de maior potencial tóxico uma vez que apresentavam baixa toxicidade aguda em mamíferos, não se acumulavam nos tecidos adiposos e não seriam persistentes no meio ambiente, mas quando misturados a outro agrotóxico, potencializam sua ação e permanência no ambiente. O objetivo deste trabalho foi avaliar a presença de até 17 contaminantes em amostras de água, sedimento e peixes coletados na Bacia Hidrográfica do Rio Tramandaí (BHRT). Os resíduos de piretróides foram determinados usando espectrômetro de massa e cromatografia gasosa, o método HF-LPME foi usado para determinação em água, e QuEChERS modificado em sedimentos e peixes. Foram coletadas 225 amostras (109 de água, 98 de sedimento e 18 de peixes). Foram obtidas 24 amostras com resíduos de piretróides (14 de água, 6 de sedimento e 4 de peixe) acima do limite de detecção dos métodos, com 19 amostras acima do limite de quantificação (13 de água, 2 de sedimento e 4 de peixe). Maiores concentrações foram observadas nas amostras de peixes, como esperado devido às características físico-químicas desses compostos. Embora a frequência de detecção tenha sido baixa, esses resultados indicam que há potencial para o transporte de piretróides utilizados na BHRT e seus afluentes atingindo os corpos d’água. Palavras-Chaves: Piretróide, Água, Sedimento, Peixe, Bacia Hidrográfica do Rio Tramandaí.

Published
2022
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47. High Damping Rubber Isolators for Low-Rise Masonry Buildings

Author

Pianese, G., Milani, G., Formisano, A., Pianese, G., Milani, G., and Formisano, A.

Subjects
regenerated EPDM, fibre-reinforced elastomeric isolator (FREI), non-linear dynamic analysis, seismic isolation, non-linear dynamic analysi, high damping rubber
Abstract

Many developing countries are located in earthquake-prone areas where buildings are often of poor design and not sufficiently protected against earthquakes. This causes damage or total collapse of buildings and heavy casualties whenever an earthquake occurs. Elastomeric isolators are special devices for the seismic isolation of structures. Typically, they consist of alternate layers of steel or fiber-reinforced laminas and rubber. They are positioned between the ground and the foundation to increase the structure's natural period and reduce the inertia forces applied in case of an earthquake. This study proposes a detailed 3D Finite Element (FE) modelling of elastomeric isolators for low-rise masonry buildings in developing countries, developed with the FE software code Abaqus. The isolator consists of an energy dissipation core made of relatively High Damping Rubber and an external Ethylene Propylene Diene Monomer (EPDM) ring. In addition, it presents unbonded boundary conditions to reduce production costs and allow its applicability in developing countries. The upper and lower edges do not exhibit any bond with the supports. The main feature of such a device is the large deformability thanks to the roll-over deformation and the favourably lower lateral stiffness compared to the bonded isolator.

Published
2022

48. Distance learning, technological devices, lifestyle and behavior of children and their family during the COVID-19 lockdown in Lombardy: a survey

Author

Picca, M, Manzoni, P, Milani, G, Mantovani, S, Cravid, C, Mariani, D, Mezzopane, A, Marinello, R, Bove, C, Ferri, P, Macchi, M, Agostoni, C, Picca M., Manzoni P., Milani G. P., Mantovani S., Cravid C., Mariani D., Mezzopane A., Marinello R., Bove C, Ferri P., Macchi M., Agostoni C., Picca, M, Manzoni, P, Milani, G, Mantovani, S, Cravid, C, Mariani, D, Mezzopane, A, Marinello, R, Bove, C, Ferri, P, Macchi, M, Agostoni, C, Picca M., Manzoni P., Milani G. P., Mantovani S., Cravid C., Mariani D., Mezzopane A., Marinello R., Bove C, Ferri P., Macchi M., and Agostoni C.

Abstract

Background: The COVID-19 pandemic and the subsequent national lockdowns, school closures and distance learning may have had both negative and positive effects on physical and mental health of children. Methods: A cross-sectional study was conducted on a large group of children between 1 and 10 years old in Lombardy, Italy (n = 3392). Their parents filled in a survey answering single or multiple-choice questions about their offspring’s behavior changes (including sleep, dietary habits, emotional disturbances), relationship with siblings, parents and peers, the use of digital technologies, and distance learning experience during the lockdown. Results: Parents reported lifestyles and emotional alterations during the lockdown. The modifications of family relationships, parents’ remote working, and screen time were associated with sleep, emotional and behavioral modifications. Distance learning was overall considered adequate. Conclusions: This study reported the most updated data on the effects of COVID-19 pandemic lockdown on children between 1 and 10 years of age in a large sample of Italian schoolchildren. The results of this study point out that pediatricians and authorities should support relationships within families during the COVID-19 pandemic. Parents’ remote working might play an important role for this purpose.

Published
2021

49. Aspiration Risk Factors, Microbiology, and Empiric Antibiotics for Patients Hospitalized With Community-Acquired Pneumonia

Author

Marin-Corral, J, Pascual-Guardia, S, Amati, F, Aliberti, S, Masclans, J, Soni, N, Rodriguez, A, Sibila, O, Sanz, F, Sotgiu, G, Anzueto, A, Dimakou, K, Petrino, R, van de Garde, E, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Adrian Ceccato, V, Chertcoff, J, Lascar, F, Di Tulio, F, Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Bashi, J, Dodo, R, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Pefura Yone, E, Mbatchou Ngahane, B, Shen, N, Xu, J, Bustamante Rico, C, Buitrago, R, Pereira Paternina, F, Kayembe Ntumba, J, Carevic, V, Jakopovic, M, Jankovic, M, Matkovic, Z, Mitrecic, I, Bouchy Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, Baunbaek-knudsen, G, Petersen, P, Andersen, S, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, de Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Spielmanns, M, Creutz, P, Suttorp, N, Siaw-Lartey, B, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Martin-Loeches, I, Maor, Y, Strahilevitz, J, Faverio, P, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Del Prato, B, De Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Menzella, F, Milani, G, Nava, S, Palmiero, G, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, San Luca, O, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Adefuye Bolanle Olufunlola, O, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ferrao, C, Neves, J, Abel, S, Ravara, S, Brocovschii, V, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Ali Bukhary, Z, Edathodu, J, Fathy, A, Abdulaziz Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, S, Milenkovic, B, Pesut, D, Borderias, L, Bordon Garcia, N, Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Interna, M, Gallego, M, Gaspar-GarcIa, I, Gonzalez del Castillo, J, Victoria, P, Martinez, E, Malo de Molina, R, Marcos, P, Menendez, R, Pando-Sandoval, A, Aymerich, C, Lacoma de la Torre, A, Garcia-Olive, I, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Arnauld Attannon Fiogbe, I, Yangui, F, Bilaceroglu, S, Levent Dalar, I, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Hancock, C, Villafuerte, D, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Ricardo, A, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Reyes, L, Angel, L, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Wunderink, R, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, Labra, L, Marin-Corral J., Pascual-Guardia S., Amati F., Aliberti S., Masclans J. R., Soni N., Rodriguez A., Sibila O., Sanz F., Sotgiu G., Anzueto A., Dimakou K., Petrino R., van de Garde E., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Adrian Ceccato V. H. D. C. A., Chertcoff J., Lascar F., Di Tulio F., Diaz A. C., de Vedia L., Ganaha M. C., Lambert S., Lopardo G., Luna C. M., Malberti A. G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P. G., Stagnaro J. P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Bashi J., Dodo R., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A. D., Pefura Yone E. W., Mbatchou Ngahane B. H., Shen N., Xu J. -F., Bustamante Rico C. A., Buitrago R., Pereira Paternina F. J., Kayembe Ntumba J. -M., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M. -L., Christensen A. B., Heitmann Bodtger U. C., Meyer C. N., Jensen A. V., Baunbaek-knudsen G., Petersen P. T., Andersen S., El-Said Abd El-Wahhab I., Morsy N. E., Shafiek H., Sobh E., Abdulsemed K. A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P. A., Mahesh P. A., Jayaraj B. S., Narayan K. V., Udnur H. B., Krishnamurthy S. B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Faverio P., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., San Luca O., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., Mihsra D. R., Shrestha P., Ridgeon E., Awokola B. I., Adefuye Bolanle Olufunlola O. N. O., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Abel Salazar, Ravara S. B., Brocovschii V., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z. A., Edathodu J., Fathy A., Abdulaziz Enani A. M., Mohamed N. E., Memon J. U., Bella A., Bogdanovic S. N., Milenkovic B., Pesut D., Borderias L., Bordon Garcia N. M., Alarcon H. C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Interna M., Gallego M., Gaspar-GarcIa I., Gonzalez del Castillo J., Victoria P. J., Martinez E. L., Malo de Molina R., Marcos P. J., Menendez R., Pando-Sandoval A., Aymerich C. P., Lacoma de la Torre A., Garcia-Olive I., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F., Torra E. V., Pujol J. A., Feldman C., Yum H. K., Arnauld Attannon Fiogbe I. U., Yangui F., Bilaceroglu S., Levent Dalar I. D., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Feneley A., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Hancock C., Villafuerte D., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Ricardo A. Franco-Sadud C. J., Meier G., Gaga M., Holland T. L., Bergin S. P., Kheir F., Landmeier M., Lois M., Nair G. B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Noda J., Hinojosa C. I., Levine S. M., Reyes L. F., Angel L. F., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Wunderink R. G., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., Labra L., Marin-Corral, J, Pascual-Guardia, S, Amati, F, Aliberti, S, Masclans, J, Soni, N, Rodriguez, A, Sibila, O, Sanz, F, Sotgiu, G, Anzueto, A, Dimakou, K, Petrino, R, van de Garde, E, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Adrian Ceccato, V, Chertcoff, J, Lascar, F, Di Tulio, F, Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Bashi, J, Dodo, R, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Pefura Yone, E, Mbatchou Ngahane, B, Shen, N, Xu, J, Bustamante Rico, C, Buitrago, R, Pereira Paternina, F, Kayembe Ntumba, J, Carevic, V, Jakopovic, M, Jankovic, M, Matkovic, Z, Mitrecic, I, Bouchy Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, Baunbaek-knudsen, G, Petersen, P, Andersen, S, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, de Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Spielmanns, M, Creutz, P, Suttorp, N, Siaw-Lartey, B, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Martin-Loeches, I, Maor, Y, Strahilevitz, J, Faverio, P, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Del Prato, B, De Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Menzella, F, Milani, G, Nava, S, Palmiero, G, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, San Luca, O, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Adefuye Bolanle Olufunlola, O, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ferrao, C, Neves, J, Abel, S, Ravara, S, Brocovschii, V, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Ali Bukhary, Z, Edathodu, J, Fathy, A, Abdulaziz Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, S, Milenkovic, B, Pesut, D, Borderias, L, Bordon Garcia, N, Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Interna, M, Gallego, M, Gaspar-GarcIa, I, Gonzalez del Castillo, J, Victoria, P, Martinez, E, Malo de Molina, R, Marcos, P, Menendez, R, Pando-Sandoval, A, Aymerich, C, Lacoma de la Torre, A, Garcia-Olive, I, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Arnauld Attannon Fiogbe, I, Yangui, F, Bilaceroglu, S, Levent Dalar, I, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Hancock, C, Villafuerte, D, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Ricardo, A, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Reyes, L, Angel, L, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Wunderink, R, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, Labra, L, Marin-Corral J., Pascual-Guardia S., Amati F., Aliberti S., Masclans J. R., Soni N., Rodriguez A., Sibila O., Sanz F., Sotgiu G., Anzueto A., Dimakou K., Petrino R., van de Garde E., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Adrian Ceccato V. H. D. C. A., Chertcoff J., Lascar F., Di Tulio F., Diaz A. C., de Vedia L., Ganaha M. C., Lambert S., Lopardo G., Luna C. M., Malberti A. G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P. G., Stagnaro J. P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Bashi J., Dodo R., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A. D., Pefura Yone E. W., Mbatchou Ngahane B. H., Shen N., Xu J. -F., Bustamante Rico C. A., Buitrago R., Pereira Paternina F. J., Kayembe Ntumba J. -M., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M. -L., Christensen A. B., Heitmann Bodtger U. C., Meyer C. N., Jensen A. V., Baunbaek-knudsen G., Petersen P. T., Andersen S., El-Said Abd El-Wahhab I., Morsy N. E., Shafiek H., Sobh E., Abdulsemed K. A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P. A., Mahesh P. A., Jayaraj B. S., Narayan K. V., Udnur H. B., Krishnamurthy S. B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Faverio P., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., San Luca O., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., Mihsra D. R., Shrestha P., Ridgeon E., Awokola B. I., Adefuye Bolanle Olufunlola O. N. O., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Abel Salazar, Ravara S. B., Brocovschii V., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z. A., Edathodu J., Fathy A., Abdulaziz Enani A. M., Mohamed N. E., Memon J. U., Bella A., Bogdanovic S. N., Milenkovic B., Pesut D., Borderias L., Bordon Garcia N. M., Alarcon H. C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Interna M., Gallego M., Gaspar-GarcIa I., Gonzalez del Castillo J., Victoria P. J., Martinez E. L., Malo de Molina R., Marcos P. J., Menendez R., Pando-Sandoval A., Aymerich C. P., Lacoma de la Torre A., Garcia-Olive I., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F., Torra E. V., Pujol J. A., Feldman C., Yum H. K., Arnauld Attannon Fiogbe I. U., Yangui F., Bilaceroglu S., Levent Dalar I. D., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Feneley A., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Hancock C., Villafuerte D., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Ricardo A. Franco-Sadud C. J., Meier G., Gaga M., Holland T. L., Bergin S. P., Kheir F., Landmeier M., Lois M., Nair G. B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Noda J., Hinojosa C. I., Levine S. M., Reyes L. F., Angel L. F., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Wunderink R. G., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., and Labra L.

Abstract

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study Design and Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidities, microbiological results, and anti-anaerobic antibiotics were analyzed in all groups. Patients were further stratified in severe and nonsevere CAP groups. Results: We enrolled 2,606 patients with CAP, of which 193 (7.4%) had ACAP. Risk factors independently associated with ACAP were male, bedridden, underweight, a nursing home resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding. Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-, CAP/AspRF+ and ACAP (0.0% vs 1.03% vs 1.64%). Patients with severe ACAP had higher rates of total gram-negative bacteria (64.3% vs 44.3% vs 33.3%, P =.021) and lower rates of total gram-positive bacteria (7.1% vs 38.1% vs 50.0%, P <.001) when compared with patients with severe CAP/AspRF+ and severe CAP/AspRF-, respectively. Most patients (>50% in all groups) independent of AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics. Interpretation: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar

Published
2021

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