bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid Optimization Techniques for Industrial Production Planning
Authors: Vasant Pandian
Published: April 2013

In this chapter, the main significant contributions of a new non-linear membership function using fuzzy approach to capture and describe vagueness in the technological coefficients of constraints in the industrial production planning problems are investigated thoroughly. This non-linear membership function is flexible and convenient to the decision makers in their decision making process. Secondly, a nonlinear objective function in the form of cubic function for fuzzy optimization problems is successfully solved by 15 hybrid and non-hybrid optimization techniques from the area of soft computing and classical approaches. Among the 15 techniques, three outstanding techniques are selected based on the percentage of quality solution. An intelligent performance analysis table is tabulated to the convenience of decision makers and implementers to select the niche optimization techniques to apply in real word problem solving approach particularly related to industrial engineering problems.
A Resource-Oriented Petri Net Approach to Scheduling and Control of Time-Constrained Cluster Tools in Semiconductor Fabrication
Authors: Wu NaiQi , Zhou MengChu
Published: April 2013

Because of residency time constraints and activity time variation for cluster tools, it is very challenging to schedule them. This chapter addresses their real-time scheduling issues and conducts their schedulability analysis in considering residency time constraints and bounded activity time variation. A Petri Net (PN) model, called Resource-Oriented PN (ROPN) is developed to model them. Such formal models describe not only the behavior of both initial transient and steady state processes of cluster tools but also determine the robot activity sequence with robot waits included. They are very compact, independent of wafer flow pattern, and useful for discrete-event control. It is due to the proposed models that scheduling cluster tools are converted into determining robot wait times. A two-level operational architecture is proposed to include an off-line periodic schedule and real-time controller. The former determines when a wafer should be placed into a process module for processing, while the latter regulates robot wait times on-line in order to reduce the effect of activity time variation on wafer sojourn times in process modules. Therefore, the system can adapt to random activity time variation. Based on the PN model, real-time operational architecture, and real-time control policy, it analyzes the effect of activity time variation on wafer sojourn time delay at a process module and presents its upper bounds. The upper bounds are given in an analytical form and can be easily evaluated. Then, it derives schedulability conditions that are in closed form expressions. If schedulable, an algorithm is developed to obtain an off-line periodic schedule. This schedule together with the real-time control policy forms a real-time schedule. It is optimal in terms of cycle time and can be analytically computed, which represents significant advance in this area. Several examples are used to show the applications of the proposed approach.
Feasible Dynamic Reconfigurations of Petri Nets
Authors: Zhang Jia Feng , Mosbahi Olfa , Khalgui Mohamed , Gharbi Atef
Published: April 2013

Reconfigurable systems have received much attention from academia and industry because they are efficient, agile, and reasonably priced, and they are the trend of all future systems. The chapter focuses on dynamic automatic reconfigurations of Control Systems to be classically modeled by Petri nets. Several modeling and verification methods for such systems are shown and compared before the introduction of the research work on feasible dynamic reconfigurations and the implementation of manufacturing systems based on Petri nets. Three different reconfiguration scenarios can be applied at run-time to such systems: Addition/Removal of places, Addition/Removal/Update of transitions, or finally, the simple modification of the initial marking. Three formal modules are defined accordingly, which allow the reconfigurations of the system’s Petri nets model: the first module to dynamically change places of the model, the second to dynamically reconfigure transitions within a given subset of places, and the third to modify the initial markings of places. To check the correct behavior of this architecture according to user requirements, the model checker SESA is applied for the verification of CTL-based properties of the proposed modules and also of the system. The contribution is applied to a real-world Benchmark Production System.
Design of Optimized Petri Net Supervisors for Flexible Manufacture Systems Based on Elementary Siphons
Authors: Yan Mingming
Published: April 2013

This chapter focuses on the deadlock prevention problems in Flexible Manufacturing Systems (FMS), and the major target is to design more excellent controllers that lead to a more permissive supervisor by adding a smaller number of monitors and arcs than the existing ones in the literature for the design of liveness-enforcing Petri net supervisors. The authors distinguish siphons in a Petri net model by elementary and dependent ones. For each elementary siphon, a monitor is added to the plant model such that it is invariant-controlled without generating emptiable control-induced siphons, and the controllability of a dependent siphon is ensured by changing the control depth variables of its related elementary siphons. Hence, a structurally simple Petri net supervisor is achieved. Based on the previous work, this chapter explores two optimized deadlock prevention approaches based on elementary siphons that can achieve the same control purpose and have more excellent performance.
Deadlock Control in Generalized Petri Nets
Authors: Zhao Mi , Hou Yifan
Published: April 2013

This chapter proposes a number of deadlock prevention polices for a class of generalized Petri nets, namely G-systems, which is usually considered to be the most generalized Petri nets that can model Flexible Manufacturing Systems (FMSs) with machining, assembly, and disassembly operations. First, a deadlock prevention policy based on elementary siphons theory is presented, which indicates that structural complexity and behavioral permissiveness can be improved effectively. In order to reduce the computational complexity, a Mixed Integer Programming (MIP)-based deadlock detection approach is proposed, then two deadlock control polices combined with MIP method are introduced. Finally, comparison among deadlock prevention policies reported in this chapter is done in terms of structural complexity, behavioral permissiveness, and computational complexity of the resulting supervisor through a typical case study. Importantly, future research directions related to this area are presented at the end of this chapter.
Deadlock Prevention for Automated Manufacturing Systems with Uncontrollable and Unobservable Transitions
Authors: Qin Meng
Published: April 2013

Many deadlock prevention policies on the basis of Petri nets dealing with deadlock problems in flexible manufacturing systems exist. However, most of them do not consider uncontrollable and unobservable transitions. This chapter solves deadlock problems in Petri nets with uncontrollable and unobservable transitions. A sufficient condition is developed to decide whether an existing deadlock prevention policy is still applicable in a Petri net with uncontrollable and unobservable transitions, when the policy itself is developed under the assumption that all the transitions are controllable and observable. Moreover, the author develops a deadlock prevention policy to design liveness-enforcing supervisors for a class of Petri nets with partial observability and controllability of transitions. Furthermore, a sufficient condition to decide the existence of a monitor to enforce a liveness constraint is developed.
Solving Siphons with the Minimal Cardinality for Deadlock Control
Authors: Li Shaoyong
Published: April 2013

By modifying the objective function and adding new constraints to a Mixed Integer Programming (MIP) method proposed by Park and Reveliotis, this chapter presents a Revised MIP (RMIP) method to directly solve siphons, called smart siphons, with the minimal cardinality as well as the minimal number of resource places. Accordingly, a proper Control Place (CP) is added for each smart siphon in order to achieve the desired control. Both efficiency and practicality of this method are proved through a theoretical proof and several examples.
Academic Community in Transition
Authors: Jandric Petar
Published: April 2013

Based on critical transdisciplinary research methodology, this chapter develops a Freirean model of the role of academic community in the network society. The developed model consists of four steps: individual conscientization, building attitudes, interaction with people and broad approach which encompasses the whole society. Those steps are constantly repeated in a never-ending circle, where each iteration provides deeper understanding of people’s current circumstances and background for active participation in the society. The model reflects the fact that the role of academic community in the network society is directly associated with the question what kind of world we would like to live in. On such basis, it calls for active personal development and wide social engagement. In this way, this chapter replaces pessimism contained in contemporary critiques of global education with moderately optimistic critical liberatory praxis.
Effects of a Home-Based Monitoring Device on Innovation in Healthcare Delivery
Authors: Acheampong Faustina , Vimarlund Vivian
Published: April 2013

Information technology has been suggested to improve patient health outcomes and reduce the burden of care. In this study, we explored the effects of collaborative innovation between caregivers and patients on healthcare delivery as a consequence of the use of an IT-based device by patients with atrial fibrillation. Two cardiologists and two nurses were interviewed while questionnaires were mailed to 75 patients querying them about the use of a home-based ECG for remote monitoring. Findings indicated that the caregivers considered the device to enhance the quality of clinical decision-making. Patients found the device to be useful and felt more involved in their own care. However, the introduction of the device presented work overload for the caregivers. Thus, the facilitation of timely diagnostics and decision-making were not realized. IT is an enabler through which innovation in healthcare delivery can be realized, but it must be integrated into work practices to realize potential benefits.
Emissions Trading Schemes in the Transportation Sector
Authors: Maragkogianni Alexandra , Papaefthimiou Spiros , Zopounidis Constantin
Published: April 2013

The transportation sector is a constantly growing source of greenhouse gas emissions, and its inclusion in the European Union Emissions Trading Scheme (EU-ETS) has become inevitable, aiming to mitigate climate change effects. This chapter summarises the operation of the scheme, the accompanying legal framework, the induced implications, and the necessary requirements for the inclusion of transportation sub-sectors in the scheme. The implementation of the EU-ETS in aviation, shipping, and road transport is described, while details on the emissions trading and allowances allocation are provided. The processes of monitoring, reporting, and verification of emissions are reported along with the energy challenges, environmental, and financial impacts of the anticipated market based measures.
The Impact of Climate Change in the Modern Enterprise
Authors: Danos Anastasios , Boulouta Konstantina
Published: April 2013

This article analyses the profound and rapid climate changes that have taken place worldwide in the past two decades and their effects on modern enterprise. Reducing greenhouse gas emissions and developing strategies to adapt to and counterbalance future impacts of climate change sustainably are among the most pressing needs of the world today. Global temperatures are predicted to continue rising, bringing changes in weather patterns, rising sea levels, and increased frequency and intensity of extreme weather events. Such climatic events can have a major impact on households, businesses, critical infrastructure and vulnerable sections of society, as well as having a major economic impact. Therefore, society must prepare to cope with living in a changing climate. The effects of a changing climate have considerable impacts on modern enterprises. In some parts of the world, these impacts are increasingly becoming evident.
Green Computing
Authors: Jena Rabindra Ku , Dey D. G.
Published: April 2013

Information technology (IT) is playing an increasingly important role in both business and individuals’ private lives. It is also consuming ever greater amounts of energy; therefore, it is a significant source of CO2 emissions. Thus, environmental and energy conservation issues have gained attention in recent years. The reality of rising energy costs and their impact on international affairs coupled with the increased concern over the global warming climate crisis and other environmental issues have shifted the social and economic consciousness of modern society. This paper discusses different aspects of green computing and its impact in India.
Availability Estimation of Demand Buses as Human Transportation System, Using Self-Organizing Map
Authors: Watanabe Toyohide , Uesugi Kentaro
Published: April 2013

The demand bus is a new transportation means, which is timely planned and runs order by order in accordance with independent requests of individual customers. Demand buses are alternative transportation vehicles, replacing traditional routing-oriented buses. In this paper, the authors address the characteristic issues, attend to the practical operations, and estimate and evaluate the trade-off strategies between usage convenience and cost management. The main idea, which is established from the features among parameters interpretatively, is to make use of visualization techniques and apply a self-organizing map (SOM) to this visualization. The authors display the co-related classification results computed individually from several selected parameters to keep their meaningful correspondence.
Students’ Questioning and Creativity
Authors: Almeida Patrícia Albergaria , Teixeira-Dias José Joaquim , Medina Jorge
Published: April 2013

University students must develop several higher-order skills along their higher education route. One of these fundamental skills is creativity. The practice of questioning is one of the modes to enhance creativity. In this paper, the authors illustrate how students’ approaches to creativity can be linked to the types of questions they ask in Higher Education. Several teaching and learning strategies were implemented in a geology course and a chemistry course, at the University of Aveiro, Portugal, as a way of promoting students’ questioning competence. The relationship between the kinds of questions asked and the students’ approaches to creativity is analysed and discussed.
Exploring the Effects of a Mindfulness Program for Students of Secondary School
Authors: Franco Clemente , Mañas Israel , Cangas Adolfo J. , Gallego José
Published: April 2013

This study analyzes the effects of a mindfulness program on a group of students in the first year of Compulsory Secondary Education from three public schools. A total of 61 students participated. A group comparison design (randomized controlled trial) with pretest-posttest measurement was used on an experimental and a control group. The statistical analyses show a significant improvement of academic performance, as well as an increase in all self-concept dimensions and a significant decrease in anxiety states and traits. These results are in agreement with other studies that have found mindfulness programmes to be effective in the educative system. The importance of mindfulness techniques in the educative system is also discussed.
Delivering Educational Games to Mobile Devices
Authors: Minovic Miroslav , Milovanovic Miloš , Starcevic Dušan
Published: April 2013

A new generation of students is accustomed to daily use of mobile devices, and educating them in the proper way is a complicated task. Video games are an ideal tool for communicating with students, and finding the right combination of using mobile devices with educational games is important for educating them. This paper describes a novel approach to educational game defining and interpretation. Application of a model-driven approach to educational game interpretation enables the use of the same game on different devices and platforms. The authors enable the interpretation of an educational game on any mobile device. These games take learning outside the classroom and provide a fun and interesting way of learning anytime, anywhere. The authors use an adventure game as an example using this methodology.
CbSSDF
Authors: Du Xiaofeng , Munro Malcolm , Song William
Published: April 2013

Web services as a new distributed system technology have been widely adopted by industries in the areas, such as enterprise application integration (EAI), business process management (BPM), and virtual organization (VO). However, lack of semantics in the current Web service standards has become a major barrier in service discovery and composition. To tackle the semantic issues of Web services, this paper proposes a comprehensive semantic service description framework – CbSSDF and a two-step service discovery mechanism based on CbSSDF—to help service users to easily locate their required services. The authors give a detailed explanation of CbSSDF, and then evaluate the framework by comparing it with OWL-S to examine how the proposed framework can improve the efficiency and effectiveness of service discovery and composition. The evaluation is carried out by analysing the different proposed solutions based on these two frameworks for achieving a series of tasks in a scenario.
Bridging the Inequality Gap to Accessing Medicare and Medicaid Information Online
Authors: Schmeida Mary , McNeal Ramona
Published: April 2013

Historic inequalities in U.S. Internet usage associated with demographic factors have left the underserved, primarily the poor and rural, with fewer information and options to public health insurance online. Government initiatives to overcome the Internet infrastructure barriers are opening access to Medicare and Medicaid websites for these vulnerable groups. Using multivariate regression analysis and individual level data from the Internet and American Life Project, we explore demographic factors asking: “how successful have government efforts been to bring underserved Americans online to Medicare and Medicaid public health insurance information?” The authors find some historic inequalities are narrowing as individuals with lower income are more likely to search for insurance information online with geographic differences not playing a major role. The authors’ findings also suggest that age and gender are important factors in determining which individuals search for insurance information online.
Homeostatic Proliferation of Naive CD4+ T Cells in Mesenteric Lymph Nodes Generates Gut-Tropic Th17 Cells
Authors: Kawabe Takeshi , Sun Shu-lan , Fujita Tsuyoshi , Yamaki Satoshi , Asao Atsuko , Takahashi Takeshi , So Takanori , Ishii Naoto
Published: April 2013

Homeostatic proliferation of naive T cells in the spleen and cutaneous lymph nodes supplies memory–phenotype T cells. The “systemic” proliferative responses divide distinctly into fast or slow cell division rates. The fast proliferation is critical for generation of effector memory T cells. Because effector memory T cells are abundant in the lamina propria of the intestinal tissue, “gut-specific” homeostatic proliferation of naive T cells may be important for generation of intestinal effector memory T cells. However, such organ-specific homeostatic proliferation of naive T cells has not yet been addressed. In this study, we examined the gut-specific homeostatic proliferation by transferring CFSE-labeled naive CD4+ T cells into sublethally irradiated mice and separately evaluating donor cell division and differentiation in the intestine, mesenteric lymph nodes (MLNs), and other lymphoid organs. We found that the fast-proliferating cell population in the intestine and MLNs had a gut-tropic α4β7+ Th17 phenotype and that their production was dependent on the presence of commensal bacteria and OX40 costimulation. Mesenteric lymphadenectomy significantly reduced the Th17 cell population in the host intestine. Furthermore, FTY720 treatment induced the accumulation of α4β7+IL-17A+ fast-dividing cells in MLNs and eliminated donor cells in the intestine, suggesting that MLNs rather than intestinal tissues are essential for generating intestinal Th17 cells. These results reveal that MLNs play a central role in inducing gut-tropic Th17 cells and in maintaining CD4+ T cell homeostasis in the small intestine.
Local Administration of TLR Ligands Rescues the Function of Tumor-Infiltrating CD8 T Cells and Enhances the Antitumor Effect of Lentivector Immunization
Authors: Xiao Haiyan , Peng Yibing , Hong Yuan , Huang Lei , Guo Z. Sheng , Bartlett David L. , Fu Ning , Munn David H. , Mellor Andrew , He Yukai
Published: April 2013

Cancer vaccines, to date, have shown limited effect to control the growth of established tumors due largely to effector failure of the antitumor immune responses. Tumor lesion is characterized as chronic indolent inflammation in which the effector function of tumor-infiltrating lymphocytes (TILs) is severely impaired. In this study, we investigated whether the effector function of CD8 TILs could be rescued by converting the chronic inflammation milieu to acute inflammation within tumors. We found that injection of TLR3/9 ligands (polyI:C/CpG) into a tumor during the effector phase of lentivector (lv) immunization effectively rescued the function of lv-activated CD8 TILs and decreased the percentage of T regulatory within the tumor, resulting in a marked improvement in the antitumor efficacy of lv immunization. Mechanistically, rescue of the effector function of CD8 TILs by TLR3/9 ligands is most likely dependent on production, within a tumor, of type-1 IFN that can mature and activate tumor-infiltrating dendritic cells. The effector function of CD8 TILs could not be rescued in mice lacking intact type I IFN signaling. These findings have important implications for tumor immunotherapy, suggesting that type I IFN-mediated activation of tumor-infiltrating dendritic cells within a tumor will most likely restore/enhance the effector function of CD8 TILs and thus improve the antitumor efficacy of current cancer vaccines.
Management of critical limb ischemia: proposal for a multidisciplinary operating network in Tuscany
Authors: Landini Giancarlo , Panigada Grazia , Meini Simone , Melillo Elio , Cappelli (FADOI Toscana) Roberto , Bellandi (SICVE Toscana) Guido
Published: April 2013

Introduction: Critical limb ischemia (CLI) is a clinical entity that is not well known to patients or the mass media, and it often receives inadequate attention by medical specialists as well. In most cases, patients with CLI already have advanced disease when they are first seen by physicians, and they frequently arrive on internal medicine wards without having received appropriate treatment. The numerous comorbidities that characterize these cases really require multidisciplinary management. Materials and methods: We sent multiple-choice questionnaires to 26 internal medicine units in hospitals located in the Tuscany region of Italy to learn more about the true incidence and impact of CLI. Results: As expected, in most wards, there is no specific, structured clinical protocols for effective management of CLI patients.Discussion: We analyze the current situation and propose a multidisciplinary network for structured, integrated management of CLI. The network would operate throughout the region and be composed of internist-angiologists and vascular surgeons with greater awareness of CLI and experience in its management. This initiative, if effectively implemented, will help increase awareness of this condition and the fact that CLI patients are suffering from what is unacceptably an ‘‘orphan’’ illness.
Rare splenic complications and specific serology: decisive diagnostic tools in two cases of visceral leishmaniasis
Authors: Celestini Andrea , Paglia Federica , Dell’ Unto Orlando , Guarisco Riccardo , Puoti Claudio
Published: April 2013

Introduction: Visceral leishmaniasis (VL) is a major endemic vector-borne disease in Southern Europe. We present two cases of VL, both characterized by splenic complications. Methods and results: Case 1: A 47-year-old female presented with effort angina, hepatosplenomegaly and pancytopenia. The clinical course was complicated by splenic infarction. Although bone marrow biopsy failed to show amastigotes, diagnosis was performed by a fast agglutinating screening test (FAST) and confirmed by a direct agglutinating test (DAT). The patient was treated successfully with AmBisome. Case 2: A 22-year-old male who had undergone a splenectomy to treat splenic rupture related to a minor trauma four months earlier presented with fever, nocturnal sweats and weight loss. The lack of pancytopenia was due to the absence of the spleen. The first biopsy did not identify parasites, but because the FAST had been positive, another bone marrow biopsy was performed, which demonstrated leishmaniasis. This patient was treated with the same schedule of AmBisome infusion. Discussion: 1) The clinical presentation of VL can be atypical, 2) splenic complications can characterize this disease, and 3) specific serology may be an important tool to reach a diagnosis.
Farmacologia di genere
Authors: Politi Cecilia
Published: April 2013

Not available
In-hospital delirium risk assessment, diagnosis and management; medications to avoid
Authors: Clegg Andrew , Young John
Published: April 2013

Background: Delirium is a common, but potentially preventable complication of acute illness that is associated with important adverse outcomes including increased length of hospital admission, risk of dementia and admission to long-term care. In-hospital risk assessment and diagnosis: Age over 65, severe illness, current hip fracture and presence of cognitive impairment or dementia are important risk factors for delirium. Assess people with any of these risk factors for recent changes or fluctuations in behaviour that might indicate delirium. If any indicators are present, complete a full cognitive assessment to confirm the diagnosis of delirium. In-hospital risk management: Multicomponent delirium prevention interventions can reduce the incidence of delirium in hospital by around one third and should be provided to people with any of the important risk factors that do not have delirium at admission. A medication review that considers both the number and type of prescribed medications is an important part of the multicomponent delirium prevention intervention. Which medications to avoid in people at risk of delirium: For people at risk of delirium, avoid new prescriptions of benzodiazepines or consider reducing or stopping these medications where possible. Opioids should be prescribed with caution in people at risk of delirium but this should be tempered by the observation that untreated severe pain can itself trigger delirium. Caution is also required when prescribing dihydropyridines and antihistamine H1 antagonists for people at risk of delirium and considered individual patient assessment is advocated. Conclusion: Delirium is common, distressing to patients, relatives and carers and is associated with important adverse outcomes. Multicomponent delirium prevention interventions can reduce the incidence of delirium by approximately one third and usually incorporate a medication review. Identification of which medications to avoid in people at risk of delirium will help guide evidence-based decision making.
The Medicine in the court and the involvement of the society
Authors: D’Amore Francesco
Published: April 2013

Not available
Triazolam, obesity and non cardiac pulmonary edema
Authors: Di Stefano Fabio , Nicolai Salvatore , Salvati Filippo
Published: April 2013

Introduction Triazolam belongs to the group of benzodiazepines and may have side effects on the respiratory system which include not only respiratory depression, but also transient benign non cardiac pulmonary edema.Case report A 52 year old obese woman developed pulmonary edema after she was taking triazolam for almost two weeks without any other medications. All possible cardiogenic and non cardiogenic causes were excluded. The condition was severe enough to require non invasive ventilation.Discussion This case differs from the other report of triazolam associated non cardiac pulmonary edema for its severity requiring non invasive ventilation. The pathogenetic mechanism is unknown. Despite the lack of objective evidence to explain pulmonary venous hypertensive changes in our case, we want to advice that triazolam should be used with caution in obese patients, as obesity might aggravate this described drug adverse reaction.
Bilateral ovarian teratoma presenting with a clinical picture of acute abdomen
Authors: Rocchietti March Massimiliano
Published: April 2013

We describe the case of a 30-year-old patient with bilateral mature cystic teratoma (MCT) of the ovaries. The patient had been complaining of mild abdominal pain for several months that had suddenly become severe. Early diagnosis at the emergency room was acute appendicitis, but definitive diagnosis was bilateral ovarian teratoma. We therefore recommend considering ovarian teratomas in the differential diagnosis of acute abdomen in young women in an emergency care setting.
Caring for health-care workers. Experience with a psychological support program for nurses working in Internal Medicine
Authors: Albertazzi Elena , Campanini Mauro , Ferrotti Giuseppina , Bobbio Flavio , Ziliotto Giuliana
Published: April 2013

IntroductionNurses working in an Internal Medicine ward must have very specific training and aptitude. Dealing with different types of patients with widely varying ages and different medical issues requires flexibility in managing emergencies and in choosing between various professional interventions, as well as strong communication skills. Because of this variety, the workload is perceived as being particularly heavy.Materials and methodsThe article describes the intervention of a psychologist in support of the nursing staff of an Internal Medicine ward. The intervention was prompted by findings of high staff turnover. The work began with an analysis of the group dynamics in the nursing team, and the psychologist's action was based on a group approach. In this way, specific problems of the group were solved through the instrument of the group itself, which became the true promoter of change.ResultsNurses worked to recognize their professional identity and to strengthen their self-esteem, and this changed their perception of their workload. The team also became more aware of its individual and group resources. These changes decreased staff turnover and reduced arguments between the nurses themselves and between the nurses and patients’ relatives.DiscussionThe nursing team become more solid and better organized. It dealt with emotional problems and has become more receptive to changes in the way the work is organized.
Good end-of-life care: a feasible and necessary goal
Authors: Costantini Massimo , Valenti Danila , Civardi Giuseppe , Nardi Roberto
Published: April 2013

Not available
Acute respiratory failure following ovarian hyperstimulation syndrome
Authors: Nicolini Antonello , Perazzo Alessandro , Gatto Piergiorgio , Santo Mario , Bonfiglio Monica
Published: April 2013

Ovarian hyperstimulation syndrome is a serious and potentially life-threatening physiological complication that may be encountered in patients who undergo controlled ovarian hyperstimulation cycles. The syndrome is typically associated with regimes of exogenous gonadotropins, but it can be seen, albeit rarely, when clomiphene is administered during the induction phase. Although this syndrome is widely described in scientific literature and is well known by obstetricians, the knowledge of this pathological and potentially life-threatening condition is generally less than satisfactory among physicians. The dramatic increase in therapeutic strategies to treat infertility has pushed this condition into the realm of acute care therapy. The potential complications of this syndrome, including pulmonary involvement, should be considered and identified so as to allow a more appropriate diagnosis and management. We describe a case of a woman with an extremely severe (Stage 6) ovarian hyperstimulation syndrome who presented ascites, bilateral pleural effusion and severe respiratory failure treated with non-invasive ventilation. The patient was admitted to the intensive care unit because of severe respiratory failure, ascites, and bilateral pleural effusion due to ovarian hyperstimulation syndrome. Treatment included non-invasive ventilation and three thoracentesis procedures, plus the administration of albumin, colloid solutions and high-dose furosemid. Severe form of ovarian hyperstimulation syndrome is observed in 0.5-5% of the women treated, and intensive care may be required for management of thromboembolic complications, renal failure and severe respiratory failure. Pulmonary intensive care may involve thoracentesis, oxygen supplementation and, in more severe cases, assisted ventilation. To our knowledge, there have been only two studies in English language medical literature that describe severe respiratory failure treated with non-invasive ventilation.
Multi-professional audit supports clinical governance in projecting and implementing a new stroke care area
Authors: Masina Marco , Malservisi Simona , Domenichini Elisabetta , Censoni Pio Francesco , Mingolini Nadia
Published: April 2013

Patients with acute stroke have better outcomes in terms of survival or regaining independence if they receive organized inpatient care in a specific setting (Stroke Unit, SU) where a coordinated multidisciplinary team can ensure the best level of care. The clinical governance of an SU requires a systematic monitoring of diagnostic, clinical and therapeutic processes through a structured audit. The entire project and set up of a new SU in Bentivoglio, Italy, were based on a model that focused on multidisciplinary teamwork and clinical governance. An audit based on the Benjamin audit cycle followed every step of the set up of the new SU. Markers from national and international guidelines and from the Italian Regional Audit, together with a specific database were used. The audit showed a high level of care and a significant improvement in the majority of clinical, diagnostic and therapeutic parameters. Only a few markers (i.e. waiting times for ultrasound tomography and prescription of oral anticoagulation therapy) required specific projects in order to improve the results. Our experience confirmed that a structured audit can support clinical governance of an SU by monitoring clinical processes and quality of care. Such an audit involves the whole professional team and shows the effects of any single actions. It also helps integration and co-operation among staff. Furthermore, a structured audit is a useful instrument for professional accountability for both qualitative and quantitative aspects of care.
Hypertension and emergency medicine: an update
Authors: Meschi Michele , Detrenis Simona , Bianchi Laura , Saccò Marcella , Bertorelli Marcello , Pioli Sarah , Boffetti Francesca , Spagnoli Francesca , Fiaccadori Enrico , Caiazza Alberto
Published: April 2013

The objective of this paper is to evaluate the correct management of hypertension in emergency departments. Studies were identified searching PubMed up to April 30, 2012, combining the terms ‘HYPERTENSIVE EMERGENCY’ and ‘HYPERTENSIVE URGENCY’. The search strategy was limited to English and Italian language papers on adult and pediatric patients. Hypertensive crises are commonly found in emergency departments. A range of pharmacological options are available in this setting, but each physician should tailor theoretical principles to the individual patient according to his or her clinical parameters.
Misoprostol for prevention and treatment of postpartum haemorrhage: A systematic review
Authors: Olefile Kabelo M. , Khondowe Oswell , M’Rithaa Doreen
Published: April 2013

Background: Postpartum haemorrhage (PPH) is a leading cause of maternal mortality especially in the developing world. Misoprostol, a highly effective drug is highly effective in inducing uterine contractions and has been proposed as a low-cost, easy-to-use intervention for PPH.Objective: This study assessed evidence of the effectiveness of misoprostol for the prevention and treatment of PPH.Method: Databases searched included MEDLINE, PUBMED, CINHAL, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE. Reference lists and conference proceedings were also searched for more studies. Three studies included in the meta-analysis were limited to randomised controlled trials (RCT). Two reviewers independently screened all articles for methodological quality using a standardised instrument adapted from the Cochrane Collaboration website. Data were entered in Review Manager 5.1 software for analysis.Results: Three trials (n = 2346) compared misoprostol to a placebo. Misoprostol was shown not to be effective in reducing PPH (risk ratios [RR] 0.65; 95% confidence interval [CI] 0.40–1.06). Only one trial reported on the need for a blood transfusion (RR 0.14; 95% CI 0.02–1.15). Shivering (RR 2.75; 95% CI 2.26–3.34) and pyrexia (RR 5.34; 95% CI 2.86–9.96) were significantly more common with misoprostol than with a placebo.Conclusion: The use of misoprostol was not associated with any significant reduction in the incidence of PPH. Therefore, in order to verify the efficacious use of misoprostol in the treatment of PPH, specialised investigations of its dose and routes of administration for clinically significant effects and acceptable side effects are warranted.
Sharp weak type estimates for weights in the class $A_{p_1, p_2}$
Authors: Reznikov Alexander
Published: April 2013

We get sharp estimates for the distribution function of nonnegative weights that satisfy the so-called

A_{p_1, p_2}

condition. For particular choices of parameters

p_1

,

p_2

this condition becomes an

A_p

-condition or reverse Hölder condition. We also get maximizers for these sharp estimates. We use the Bellman technique and try to carefully present and motivate our tactics. As an illustration of how these results can be used, we deduce the following result: if a weight

w

is in

A_2

then it self-improves to a weight that satisfies a reverse Hölder condition.
Paraproducts via $H^{\infty}$-functional calculus
Authors: Frey Dorothee
Published: April 2013

Let

X

be a space of homogeneous type and let

L

be a sectorial operator with bounded holomorphic functional calculus on

L^2(X)

. We assume that the semigroup

\{e^{-tL}\}_{t>0}

satisfies the Davies–Gaffney estimates. In this paper, we introduce a new type of paraproduct operators that is constructed via certain approximations of the identity associated with

L

. We show various boundedness properties on

L^p(X)

and the recently developed Hardy and BMO spaces

H^p_L(X)

and

{\rm BMO}_L(X)

. Generalizing standard paraproducts constructed via convolution operators, we show

L^2(X)

off-diagonal estimates as a substitute for Calderón–Zygmund kernel estimates. As an application, we study differentiability properties of paraproducts in terms of fractional powers of the operator

L

.

The results of this paper are fundamental for the proof of a

T(1)

-Theorem for operators that are beyond the reach of Calderón–Zygmund theory, which is the subject of a forthcoming paper.
On isoperimetric inequalities with respect to infinite measures
Authors: Brock Friedemann , Mercaldo Anna , Posteraro Maria Rosaria
Published: April 2013

We study isoperimetric problems with respect to infinite measures on

\mathbb{R} ^n

. In the case of the measure

\mu

defined by

d\mu = e^{c|x|^2 }\, dx

,

c\geq 0

, we prove that, among all sets with given

\mu

-measure, the ball centered at the origin has the smallest (weighted)

\mu

-perimeter. Our results are then applied to obtain Pólya–Szegö-type inequalities, Sobolev embedding theorems, and a comparison result for elliptic boundary value problems.
Isoperimetric profile and random walks on locally compact solvable groups
Authors: Tessera Romain
Published: April 2013

We study the large-scale geometry of a large class of amenable locally compact groups comprising all solvable algebraic groups over a local field and their discrete subgroups. We show that the isoperimetric profile of these groups is in some sense optimal among amenable groups. We use this fact to compute the probability of return of symmetric random walks, and to derive various other geometric properties.
Benthic‐pelagic coupling in a temperate inner continental shelf fish assemblage
Authors: Woodland Ryan J. , Secor David H.
Published: April 2013

The hypothesis that demersal finfish production dependence on pelagic food webs decreased with seabed habitat affinity and fish size was tested using stable isotope and stomach contents data from 17 finfish species collected during summer months from the inner continental shelf of the U.S. mid‐Atlantic coast. Trophic dependence on pelagic prey was generally lower among species with higher affinities for bottom habitats, but even species morphologically adapted for bottom feeding benefited from pelagic production via diel vertical migration of prey. There was a consistent pattern of declining reliance on pelagic food webs with increasing fish size, although the relationship between size and trophic sources varied among functional groups within the fish community. Overall, pelagic primary production during the summer was an important basal energy source for the demersal finfish community in this coastal ocean habitat (d 20 m depth), particularly during juvenile life phases. These results suggest that these fish communities are sensitive to climate‐related changes in contemporaneous pelagic primary production in addition to the timing and magnitude of spring phytoplankton blooms.
Coccolithophore surface distributions in the North Atlantic and their modulation of the air-sea flux of CO2 from 10 years of satellite Earth observation data
Authors: Shutler J. D. , Land P. E. , Brown C. W. , Findlay H. S. , Donlon C. J. , Medland M. , Snooke R. , Blackford J. C.
Published: April 2013

Abstract. Coccolithophores are the primary oceanic phytoplankton responsible for the production of calcium carbonate (CaCO3). These climatically important plankton play a key role in the oceanic carbon cycle as a major contributor of carbon to the open ocean carbonate pump (~50%) and their calcification can affect the atmosphere-to-ocean (air-sea) uptake of carbon dioxide (CO2) through increasing the seawater partial pressure of CO2 (pCO2). Here we document variations in the areal extent of surface blooms of the globally important coccolithophore, Emiliania huxleyi, in the North Atlantic over a 10-year period (1998–2007), using Earth observation data from the Sea-viewing Wide Field-of-view Sensor (SeaWiFS). We calculate the annual mean sea surface areal coverage of E. huxleyi in the North Atlantic to be 474 000 ± 104 000 km2, which results in a net CaCO3 carbon (CaCO3-C) production of 0.14–1.71 Tg CaCO3-C per year. However, this surface coverage (and, thus, net production) can fluctuate inter-annually by −54/+8% about the mean value and is strongly correlated with the El Niño/Southern Oscillation (ENSO) climate oscillation index (r=0.75, p<0.02). Our analysis evaluates the spatial extent over which the E. huxleyi blooms in the North Atlantic can increase the pCO2 and, thus, decrease the localised air-sea flux of atmospheric CO2. In regions where the blooms are prevalent, the average reduction in the monthly air-sea CO2 flux can reach 55%. The maximum reduction of the monthly air-sea CO2 flux in the time series is 155%. This work suggests that the high variability, frequency and distribution of these calcifying plankton and their impact on pCO2 should be considered if we are to fully understand the variability of the North Atlantic air-to-sea flux of CO2. We estimate that these blooms can reduce the annual N. Atlantic net sink atmospheric CO2 by between 3–28%.
Inverse modeling of hydrologic parameters using surface flux and runoff observations in the Community Land Model
Authors: Sun Y. , Hou Z. , Huang M. , Tian F. , Leung L. R.
Published: April 2013

Abstract. This study demonstrates the possibility of inverting hydrologic parameters using surface flux and runoff observations in version 4 of the Community Land Model (CLM4). Previous studies showed that surface flux and runoff calculations are sensitive to major hydrologic parameters in CLM4 over different watersheds, and illustrated the necessity and possibility of parameter calibration. Two inversion strategies, the deterministic least-square fitting and stochastic Markov-Chain Monte-Carlo (MCMC) Bayesian inversion approaches, are evaluated by applying them to CLM4 at selected sites. The unknowns to be estimated include surface and subsurface runoff generation parameters and vadose zone soil water parameters. We find that using model parameters calibrated by the least-square fitting provides little improvements in the model simulations but the sampling-based stochastic inversion approaches are consistent – as more information comes in, the predictive intervals of the calibrated parameters become narrower and the misfits between the calculated and observed responses decrease. In general, parameters that are identified to be significant through sensitivity analyses and statistical tests are better calibrated than those with weak or nonlinear impacts on flux or runoff observations. Temporal resolution of observations has larger impacts on the results of inverse modeling using heat flux data than runoff data. Soil and vegetation cover have important impacts on parameter sensitivities, leading to different patterns of posterior distributions of parameters at different sites. Overall, the MCMC-Bayesian inversion approach effectively and reliably improves the simulation of CLM under different climates and environmental conditions. Bayesian model averaging of the posterior estimates with different reference acceptance probabilities can smooth the posterior distribution and provide more reliable parameter estimates, but at the expense of wider uncertainty bounds.
On kinematics of very steep waves
Authors: Shemer L.
Published: April 2013

Abstract. Experiments on extremely steep waves generated in a large wave tank by focusing of a broad-banded wave train serve as a motivation for the theoretical analysis of the conditions leading to wave breaking. Particular attention is given to the crest of the steepest wave where both the horizontal velocity and the vertical acceleration attain their maxima. Analysis is carried out up to the 3rd order in wave steepness. The apparent, Eulerian and Lagrangian accelerations are computed for wave parameters observed in experiments. It is demonstrated that for a wave group with a wide spectrum, the crest propagation velocity differs significantly from both the phase and the group velocities of the peak wave. Conclusions are drawn regarding the applicability of various criteria for wave breaking.