ABSTRACT
Spaceborne-based monitoring for environmental purposes has become a well-established practice. The recent progress of synthetic aperture radar (SAR) sensors, including through the European Space Agency's (ESA) Sentinel-1 constellation, has enabled the scientific community to identify and monitor several geohazards, including subsidence ground deformations. A case study in the Tuscany Region, Italy, highlights the effectiveness of interferometric synthetic aperture radar (InSAR) in detecting abrupt increases in ground deformation rates in an industrial area of Montemurlo municipality. In this case, InSAR data enabled prompt identification of the phenomenon, supporting the authorities in charge of environmental management to thoroughly investigate the situation. First, an on-site validation was performed via field surveys confirming the presence of cracks and fissures on some edifices. Further analysis, including water pumping rates, settlement gauge and topographic levelling, corroborated the InSAR data's findings regarding vertical deformation. Integration of collected data allowed for spatial identification and assessment of the subsidence bowl and its source depth recognized by the remote sensing data. The Montemurlo case offers a procedural guideline for managing abrupt accelerations, identified by InSAR data in subsidence-prone areas due to fluid overexploitation. In fact, these data proved useful in helping local authorities responsible for hydrogeomorphological risk management. With the exacerbation of deformation issues in subsidence-prone regions due to climate change, early detection and monitoring of such phenomena are increasingly crucial, with InSAR data playing a central role in achieving this goal.
ABSTRACT
This theoretical and reflexive study analyzed the risks related to the maintenance of patency of the Peripherally Inserted Central Catheter with the use of saline solution in comparison with saline-filled syringes, through the application of the Healthcare Failure Mode and Effect Analysis - HFMEA. The process was mapped, detailing the failure modes of each step. For the calculation of the Risk Priority Number, the severity and probability of the failure modes were analyzed. This analysis gave rise to the severity and probability matrix. Finally, actions to reduce the failure modes in the maintenance of patency were proposed, considering the use of saline-filled syringes in comparison to the use of saline ampoules. It was verified that the use of saline ampoules is associated with a greater risk, since it requires four stages more than saline-filled syringe does not, increasing the risk of contamination and the level of three different risks, which would result in additional hospital costs. The use of the saline-filled syringe would avoid risks that could negatively affect the patient's health, the nursing professional and the health institution.
Subject(s)
Catheterization, Peripheral/instrumentation , Central Venous Catheters , Healthcare Failure Mode and Effect Analysis , Saline Solution/administration & dosage , Humans , Risk Assessment/methods , SyringesABSTRACT
ABSTRACT This theoretical and reflexive study analyzed the risks related to the maintenance of patency of the Peripherally Inserted Central Catheter with the use of saline solution in comparison with saline-filled syringes, through the application of the Healthcare Failure Mode and Effect Analysis - HFMEA. The process was mapped, detailing the failure modes of each step. For the calculation of the Risk Priority Number, the severity and probability of the failure modes were analyzed. This analysis gave rise to the severity and probability matrix. Finally, actions to reduce the failure modes in the maintenance of patency were proposed, considering the use of saline-filled syringes in comparison to the use of saline ampoules. It was verified that the use of saline ampoules is associated with a greater risk, since it requires four stages more than saline-filled syringe does not, increasing the risk of contamination and the level of three different risks, which would result in additional hospital costs. The use of the saline-filled syringe would avoid risks that could negatively affect the patient's health, the nursing professional and the health institution.
RESUMEN Este estudio teórico reflexivo analizó los riesgos relacionados con el proceso de mantenimiento de la permeabilidad del Catéter Central de Inserción Periférica, con el empleo de solución salina en comparación con jeringa rellena de solución salina, mediante la aplicación de la herramienta Healthcare Failure Mode and Effect Analysis - HFMEA. El proceso fue mapeado detallándose los modos de falla de cada etapa. Para el cómputo del Risk Priority Number, se analizaron los modos de falla en cuanto a la severidad y la probabilidad. Mediante dicho análisis, se confeccionó la matriz de severidad y probabilidad. Por fin, se evidenciaron las propuestas de acciones para la reducción de los modos de fallas en el proceso de mantenimiento de la permeabilidad en el caso de utilizarse la jeringa en comparación con la utilización de ampollas de solución salina. Se verificó que el uso de ampollas de solución salina representa mayor riesgo para el paciente, visto que demanda cuatro etapas más que el mantenimiento con jeringa rellena, aumentando el riesgo de contaminación y la criticidad de tres peligros, lo que resultaría en costos hospitalarios adicionales. El uso de la jeringa rellena evitaría riesgos mayores, los que podrían repercutir desfavorablemente en la salud del paciente, en el profesional enfermero y el centro sanitario.
RESUMO Este estudo teórico-reflexivo analisou os riscos relacionados ao processo de manutenção da permeabilidade do Cateter Central de Inserção Periférica, com o uso de solução salina em comparação com seringa preenchida com solução salina, por meio da aplicação da ferramenta Healthcare Failure Mode and Effect Analysis - HFMEA. O processo foi mapeado detalhando-se os modos de falha de cada etapa. Para o cálculo do Risk Priority Number, analisaram-se os modos de falha quanto à severidade e à probabilidade. A partir dessa análise, elaborou-se a matriz de severidade e probabilidade. Por fim, evidenciaram-se propostas de ações para redução dos modos de falhas no processo de manutenção da permeabilidade caso fosse utilizada a seringa preenchida em comparação com a utilização de ampolas de solução salina. Verificou-se que o uso de ampolas de solução salina representa maior risco para o paciente, visto que demanda quatro etapas a mais que do que a manutenção com seringa preenchida, aumentando o risco de contaminação e a criticidade de três perigos, o que resultaria em custos hospitalares adicionais. O uso da seringa preenchida evitaria riscos maiores, os quais poderiam repercutir, desfavoravelmente, na saúde do paciente, no profissional de enfermagem e na instituição de saúde.
Subject(s)
Patient Safety , Vascular Access Devices , Central Venous Catheters , Nursing Care , Quality of Health Care , Cost Control , Saline SolutionABSTRACT
We present the continuous monitoring of ground deformation at regional scale using ESA (European Space Agency) Sentinel-1constellation of satellites. We discuss this operational monitoring service through the case study of the Tuscany Region (Central Italy), selected due to its peculiar geological setting prone to ground instability phenomena. We set up a systematic processing chain of Sentinel-1 acquisitions to create continuously updated ground deformation data to mark the transition from static satellite analysis, based on the analysis of archive images, to dynamic monitoring of ground displacement. Displacement time series, systematically updated with the most recent available Sentinel-1 acquisition, are analysed to identify anomalous points (i.e., points where a change in the dynamic of motion is occurring). The presence of a cluster of persistent anomalies affecting elements at risk determines a significant level of risk, with the necessity of further analysis. Here, we show that the Sentinel-1 constellation can be used for continuous and systematic tracking of ground deformation phenomena at the regional scale. Our results demonstrate how satellite data, acquired with short revisiting times and promptly processed, can contribute to the detection of changes in ground deformation patterns and can act as a key information layer for risk mitigation.
ABSTRACT
There is evidence demonstrating that sexual complaints represent the most specific symptoms associated with late onset hypogonadism, while central obesity is the most specific sign. In obese men, hypogonadism can further worsen the metabolic profile and increase abdominal fat. In addition, although hypogonadism can exacerbate obesity-associated erectile dysfunction (ED), recent data suggest that a direct contribution of fat-derived factors could be hypothesized. In particular, an animal model recently documented that fat accumulation induces several hepatic pro-inflammatory genes closely linked to corpora cavernosa endothelial dysfunction. Lifestyle modifications and weight loss are the first steps in the treatment of ED patients with obesity or metabolic diseases. In symptomatic hypogonadal men with metabolic impairment and obesity, combining the effect of testosterone substitution with lifestyle modifications could result in better outcomes.
Subject(s)
Diabetes Mellitus, Type 2/complications , Erectile Dysfunction/etiology , Hypogonadism/etiology , Metabolic Syndrome/complications , Obesity, Abdominal/complications , Penile Erection , Abdominal Fat/physiopathology , Adiposity , Adult , Aged , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/physiopathology , Diabetes Mellitus, Type 2/therapy , Erectile Dysfunction/diagnosis , Erectile Dysfunction/physiopathology , Erectile Dysfunction/prevention & control , Hormone Replacement Therapy , Humans , Hypogonadism/diagnosis , Hypogonadism/physiopathology , Hypogonadism/therapy , Male , Metabolic Syndrome/diagnosis , Metabolic Syndrome/physiopathology , Metabolic Syndrome/therapy , Middle Aged , Obesity, Abdominal/diagnosis , Obesity, Abdominal/physiopathology , Obesity, Abdominal/therapy , Risk Factors , Risk Reduction Behavior , Testosterone/deficiency , Testosterone/therapeutic use , Treatment Outcome , Weight LossABSTRACT
Buildings are sensitive to movements caused by ground deformation. The mapping both of spatial and temporal distribution, and of the degree of building damages represents a useful tool in order to understand the landslide evolution, magnitude and stress distribution. The high spatial resolution of space-borne SAR interferometry can be used to monitor displacements related to building deformations. In particular, PSInSAR technique is used to map and monitor ground deformation with millimeter accuracy. The usefulness of the above mentioned methods was evaluated in San Fratello municipality (Sicily, Italy), which was historically affected by landslides: the most recent one occurred on 14th February 2010. PSInSAR data collected by ERS 1/2, ENVISAT, RADARSAT-1 were used to study the building deformation velocities before the 2010 landslide. The X-band sensors COSMO-SkyMed and TerraSAR-X were used in order to monitor the building deformation after this event. During 2013, after accurate field inspection on buildings and structures, damage assessment map of San Fratello were created and then compared to the building deformation velocity maps. The most interesting results were obtained by the comparison between the building deformation velocity map obtained through COSMO-SkyMed and the damage assessment map. This approach can be profitably used by local and Civil Protection Authorities to manage the post-event phase and evaluate the residual risks.
ABSTRACT
BACKGROUND: Acute phase proteins (APPs) are promising markers of inflammation in dogs, because they are more sensitive than WBC counts in detecting clinical and subclinical inflammation. Endogenous corticosteroids can mask an acute phase response and make it more difficult to identify underlying inflammatory disease. OBJECTIVE: The purpose of this study was to evaluate the acute phase protein response in dogs with spontaneous hyperadrenocorticism (HAC) with and without concurrent inflammatory conditions. METHODS: Serum concentrations of C-reactive protein (CRP), haptoglobin (Hp), fibrinogen, and albumin were measured in 44 healthy adult dogs and 39 dogs with HAC; the HAC group was further divided into dogs with and without concurrent infection/inflammation. A fourth group of dogs with severe sepsis and without HAC was compared with the dogs with HAC and severe sepsis. RESULTS: Dogs with uncomplicated HAC had significantly higher Hp and fibrinogen concentrations compared with healthy control dogs (P<.001). Dogs with HAC and severe inflammatory disease also had significantly higher CRP and lower albumin concentrations than control dogs and dogs with HAC without concurrent inflammation. Dogs with sepsis but without HAC had significantly higher CRP concentrations than dogs with HAC and sepsis. CONCLUSIONS: Dogs with HAC had increases in the moderate APPs (Hp and fibrinogen), and no significant changes in CRP and albumin compared with healthy dogs. Although concurrent HAC appeared to blunt the CRP response in dogs with sepsis, increased serum CRP concentration in dogs with HAC is likely indicative of severe concurrent inflammation.
Subject(s)
Acute-Phase Proteins/metabolism , Adrenocortical Hyperfunction/veterinary , Dog Diseases/blood , Inflammation/veterinary , Adrenocortical Hyperfunction/blood , Adrenocortical Hyperfunction/complications , Animals , Dogs , Female , Inflammation/blood , Inflammation/complications , MaleABSTRACT
Gastrinomas of the stomach are extremely rare endocrine tumors producing Zollinger-Ellison syndrome. We report here the case of a patient with gastrinoma of the stomach who presented regional and hepatic metastases at the time of diagnosis. The endocrine tumor was discovered incidentally 8 yr after the onset of symptoms related to peptic ulcer, which responded to medical treatment with a proton pump inhibitor. Surgery did not cure the patient, as demonstrated by provocative tests showing serum gastrin responses indicative of residual disease. A long-term treatment with the somatostatin analog lanreotide induced a biochemical response and was associated with a substantially stable disease.