Noninvasive Ventilation and Droplet dispersion. Health professional protocols. Nurse perspective. in: Noninvasive Ventilation in High-Risk Infections and Mass Casualty Events,

The past few decades have seen major impacts of different pandemics and mass casualty events on health resource use in terms of rising health cost and increased mortality.

Development and optimisation of protocols for surface cleaning of cultural heritage metals

The conservation and valorisation of cultural heritage is of fundamental importance for our society, since it is witness to the legacies of human societies. In the case of metallic artefacts, because corrosion is a never-ending problem, the correct strategies for their cleaning and preservation must be chosen. Thus, the aim of this project was the development of protocols for cleaning archaeological copper artefacts by laser and plasma cleaning, since they allow the treatment of artefacts in a controlled and selective manner. Additionally, electrochemical characterisation of the artificial patinas was performed in order to obtain information on the protective properties of the corrosion layers. Reference copper samples with different artificial corrosion layers were used to evaluate the tested parameters. Laser cleaning tests resulted in partial removal of the corrosion products, but the lasermaterial interactions resulted in melting of the desired corrosion layers. The main obstacle for this process is that the materials that must be preserved show lower ablation thresholds than the undesired layers, which makes the proper elimination of dangerous corrosion products very difficult without damaging the artefacts. Different protocols should be developed for different patinas, and real artefacts should be characterised previous to any treatment to determine the best course of action. Low pressure hydrogen plasma cleaning treatments were performed on two kinds of patinas. In both cases the corrosion layers were partially removed. The total removal of the undesired corrosion products can probably be achieved by increasing the treatment time or applied power, or increasing the hydrogen pressure. Since the process is non-invasive and does not modify the bulk material, modifying the cleaning parameters is easy. EIS measurements show that, for the artificial patinas, the impedance increases while the patina is growing on the surface and then drops, probably due to diffusion reactions and a slow dissolution of copper. It appears from these results that the dissolution of copper is heavily influenced by diffusion phenomena and the corrosion product film porosity. Both techniques show good results for cleaning, as long as the proper parameters are used. These depend on the nature of the artefact and the corrosion layers that are found on its surface.

Effect of the FSH dose in superovulatory protocols on ovulatory follicle dynamics in ewes.

The objective of this study, was to evaluate the exogenous FSH dose effect on gonadotrophic treatment over ewes ovulatory follicle dynamics.

Performance comparison of C-V2X and WAVE protocols for vehicular to infrastructure communications: simulation of the highway use case

The objective of this thesis is the analysis and the study of the various access techniques for vehicular communications, in particular of the C-V2X and WAVE protocols. The simulator used to study the performance of the two protocols is called LTEV2Vsim and was developed by the CNI IEIIT for the study of V2V (Vehicle-to-Vehicle) communications. The changes I made allowed me to study the I2V (Infrastructure-to-Vehicle) scenario in highway areas and, with the results obtained, I made a comparison between the two protocols in the case of high vehicular density and low vehicular density, putting in relation to the PRR (packet reception ratio) and the cell size (RAW, awareness range). The final comparison allows to fully understand the possible performances of the two protocols and highlights the need for a protocol that allows to reach the minimum necessary requirements.

Development of functional MRI protocols in the study of neurodegenerative diseases: MRI study in patients with REM sleep behavior disorder, idiopathic Parkinson's disease and multisystem atrophy

In the central nervous system, iron in several proteins is involved in many important processes: oxygen transportation, oxidative phosphorylation, mitochondrial respiration, myelin production, the synthesis and metabolism of neurotransmitters. Abnormal iron homoeostasis can induce cellular damage through hydroxyl radical production, which can cause the oxidation, modification of lipids, proteins, carbohydrates, and DNA, lead to neurotoxicity. Moreover increased levels of iron are harmful and iron accumulations are typical hallmarks of brain ageing and several neurodegenerative disorders particularly PD. Numerous studies on post mortem tissue report on an increased amount of total iron in the substantia nigra in patients with PD also supported by large body of in vivo findings from Magnetic Resonance Imaging (MRI) studies. The importance and approaches for in vivo brain iron assessment using multiparametric MRI is increased over last years. Quantitative MRI may provide useful biomarkers for brain integrity assessment in iron-related neurodegeneration. Particularly, a prominent change in iron- sensitive T2* MRI contrast within the sub areas of the SN overlapping with nigrosome 1 were shown to be a hallmark of Parkinson's Disease with high diagnostic accuracy. Moreover, differential diagnosis between Parkinson's Disease (PD) and atypical parkinsonian syndromes (APS) remains challenging, mainly in the early phases of the disease. Advanced brain MR imaging enables to detect the pathological changes of nigral and extranigral structures at the onset of clinical manifestations and during the course of the disease. The Nigrosome-1 (N1) is a substructure of the healthy Substantia Nigra pars compacta enriched by dopaminergic neurons; their loss in Parkinson’s disease and atypical parkinsonian syndromes is related to the iron accumulation. N1 changes are supportive MR biomarkers for diagnosis of these neurodegenerative disorders, but its detection is hard with conventional sequences, also using high field (3T) scanner. Quantitative susceptibility mapping (QSM), an iron-sensitive technique, enables the direct detection of Neurodegeneration

Towards a sustainable approach for Cultural Heritage Conservation: developing micro-structured green materials and analytical protocols for their performance assessment

Cleaning is one of the most important and delicate procedures that are part of the restoration process. When developing new systems, it is fundamental to consider its selectivity towards the layer to-be-removed, non-invasiveness towards the one to-be-preserved, its sustainability and non-toxicity. Besides assessing its efficacy, it is important to understand its mechanism by analytical protocols that strike a balance between cost, practicality, and reliable interpretation of results. In this thesis, the development of cleaning systems based on the coupling of electrospun fabrics (ES) and greener organic solvents is proposed. Electrospinning is a versatile technique that allows the production of micro/nanostructured non-woven mats, which have already been used as absorbents in various scientific fields, but to date, not in the restoration field. The systems produced proved to be effective for the removal of dammar varnish from paintings, where the ES not only act as solvent-binding agents but also as adsorbents towards the partially solubilised varnish due to capillary rise, thus enabling a one-step procedure. They have also been successfully applied for the removal of spray varnish from marble substrates and wall paintings. Due to the materials' complexity, the procedure had to be adapted case-by-case and mechanical action was still necessary. According to the spinning solution, three types of ES mats have been produced: polyamide 6,6, pullulan and pullulan with melanin nanoparticles. The latter, under irradiation, allows for a localised temperature increase accelerating and facilitating the removal of less soluble layers (e.g. reticulated alkyd-based paints). All the systems produced, and the mock-ups used were extensively characterised using multi-analytical protocols. Finally, a monitoring protocol and image treatment based on photoluminescence macro-imaging is proposed. This set-up allowed the study of the removal mechanism of dammar varnish and semi-quantify its residues. These initial results form the basis for optimising the acquisition set-up and data processing.

Proximity detection protocols for IoT devices

In recent years, we have witnessed the growth of the Internet of Things paradigm, with its increased pervasiveness in our everyday lives. The possible applications are diverse: from a smartwatch able to measure heartbeat and communicate it to the cloud, to the device that triggers an event when we approach an exhibit in a museum. Present in many of these applications is the Proximity Detection task: for instance the heartbeat could be measured only when the wearer is near to a well defined location for medical purposes or the touristic attraction must be triggered only if someone is very close to it. Indeed, the ability of an IoT device to sense the presence of other devices nearby and calculate the distance to them can be considered the cornerstone of various applications, motivating research on this fundamental topic. The energy constraints of the IoT devices are often in contrast with the needs of continuous operations to sense the environment and to achieve high accurate distance measurements from the neighbors, thus making the design of Proximity Detection protocols a challenging task.

Grant-free protocols for massive multiple access

In next generation Internet-of-Things, the overhead introduced by grant-based multiple access protocols may engulf the access network as a consequence of the proliferation of connected devices. Grant-free access protocols are therefore gaining an increasing interest to support massive multiple access. In addition to scalability requirements, new demands have emerged for massive multiple access, including latency and reliability. The challenges envisaged for future wireless communication networks, particularly in the context of massive access, include: i) a very large population size of low power devices transmitting short packets; ii) an ever-increasing scalability requirement; iii) a mild fixed maximum latency requirement; iv) a non-trivial requirement on reliability. To this aim, we suggest the joint utilization of grant-free access protocols, massive MIMO at the base station side, framed schemes to let the contention start and end within a frame, and succesive interference cancellation techniques at the base station side. In essence, this approach is encapsulated in the concept of coded random access with massive MIMO processing. These schemes can be explored from various angles, spanning the protocol stack from the physical (PHY) to the medium access control (MAC) layer. In this thesis, we delve into both of these layers, examining topics ranging from symbol-level signal processing to succesive interference cancellation-based scheduling strategies. In parallel with proposing new schemes, our work includes a theoretical analysis aimed at providing valuable system design guidelines. As a main theoretical outcome, we propose a novel joint PHY and MAC layer design based on density evolution on sparse graphs.

Dosimetric optimization of CT protocols for the preoperative planning of hip arthroplasty

Radiation dose in x-ray computed tomography (CT) has become a topic of great interest due to the increasing number of CT examinations performed worldwide. In fact, CT scans are responsible of significant doses delivered to the patients, much larger than the doses due to the most common radiographic procedures. This thesis work, carried out at the Laboratory of Medical Technology (LTM) of the Rizzoli Orthopaedic Institute (IOR, Bologna), focuses on two primary objectives: the dosimetric characterization of the tomograph present at the IOR and the optimization of the clinical protocol for hip arthroplasty. In particular, after having verified the reliability of the dose estimates provided by the system, we compared the estimates of the doses delivered to 10 patients undergoing CT examination for the pre-operative planning of hip replacement with the Diagnostic Reference Level (DRL) for an osseous pelvis examination. Out of 10 patients considered, only for 3 of them the doses were lower than the DRL. Therefore, the necessity to optimize the clinical protocol emerged. This optimization was investigated using a human femur from a cadaver. Quantitative analysis and comparison of 3D reconstructions were made, after having performed manual segmentation of the femur from different CT acquisitions. Dosimetric simulations of the CT acquisitions on the femur were also made and associated to the accuracy of the 3D reconstructions, to analyse the optimal combination of CT acquisition parameters. The study showed that protocol optimization both in terms of Hausdorff distance and in terms of effective dose (ED) to the patient may be realized simply by modifying the value of the pitch in the protocol, by choosing between 0.98 and 1.37.

An Efficient Protocol For The Generation Of Monocyte Derived Dendritic Cells Using Serum-free Media For Clinical Applications In Post Remission Aml Patients.

Protocols for the generation of dendritic cells (DCs) using serum as a supplementation of culture media leads to reactions due to animal proteins and disease transmissions. Several types of serum-free media (SFM), based on good manufacture practices (GMP), have recently been used and seem to be a viable option. The aim of this study was to evaluate the results of the differentiation, maturation, and function of DCs from Acute Myeloid Leukemia patients (AML), generated in SFM and medium supplemented with autologous serum (AS). DCs were analyzed by phenotype characteristics, viability, and functionality. The results showed the possibility of generating viable DCs in all the conditions tested. In patients, the X-VIVO 15 medium was more efficient than the other media tested in the generation of DCs producing IL-12p70 (p=0.05). Moreover, the presence of AS led to a significant increase of IL-10 by DCs as compared with CellGro (p=0.05) and X-Vivo15 (p=0.05) media, both in patients and donors. We concluded that SFM was efficient in the production of DCs for immunotherapy in AML patients. However, the use of AS appears to interfere with the functional capacity of the generated DCs.

Microbial Evaluation Of Traumatized Teeth Treated With Triple Antibiotic Paste Or Calcium Hydroxide With 2% Chlorhexidine Gel In Pulp Revascularization.

Revascularization outcome depends on microbial elimination because apical repair will not happen in the presence of infected tissues. This study evaluated the microbial composition of traumatized immature teeth and assessed their reduction during different stages of the revascularization procedures performed with 2 intracanal medicaments. Fifteen patients (7-17 years old) with immature teeth were submitted to the revascularization procedures; they were divided into 2 groups according to the intracanal medicament used: TAP group (n = 7), medicated with a triple antibiotic paste, and CHP group (n = 8), dressed with calcium hydroxide + 2% chlorhexidine gel. Samples were taken before any treatment (S1), after irrigation with 6% NaOCl (S2), after irrigation with 2% chlorhexidine (S3), after intracanal dressing (S4), and after 17% EDTA irrigation (S5). Cultivable bacteria recovered from the 5 stages were counted and identified by means of polymerase chain reaction assay (16S rRNA). Both groups had colony-forming unit counts significantly reduced after S2 (P < .05); however, no significant difference was found between the irrigants (S2 and S3, P = .99). No difference in bacteria counts was found between the intracanal medicaments used (P = .95). The most prevalent bacteria detected were Actinomyces naeslundii (66.67%), followed by Porphyromonas endodontalis, Parvimonas micra, and Fusobacterium nucleatum, which were detected in 33.34% of the root canals. An average of 2.13 species per canal was found, and no statistical correlation was observed between bacterial species and clinical/radiographic features. The microbial profile of infected immature teeth is similar to that of primarily infected permanent teeth. The greatest bacterial reduction was promoted by the irrigation solutions. The revascularization protocols that used the tested intracanal medicaments were efficient in reducing viable bacteria in necrotic immature teeth.

Efficacy Of Ethylene-diamine-tetra-acetic Acid Associated With Chlorhexidine On Intracanal Medication Removal: A Scanning Electron Microscopy Study.

The aim of this study was to evaluate the effectiveness of 17% ethylene-diamine-tetra-acetic acid (EDTA) used alone or associated with 2% chlorhexidine gel (CHX) on intracanal medications (ICM) removal. Sixty single-rooted human teeth with fully formed apex were selected. The cervical and middle thirds of each canal were prepared with Gates Glidden drills and rotary files. The apical third was shaped with hand files. The specimens were randomly divided into two groups depending on the ICM used after instrumentation: calcium hydroxide Ca(OH)(2) +CHX or Ca(OH)(2) +sterile saline (SS). After seven days, each group was divided into subgroups according to the protocol used for ICM removal: instrumentation and irrigation either with EDTA, CHX+EDTA, or SS (control groups). All specimens were sectioned and processed for observation of the apical thirds by using scanning electron microscopy. Two calibrated evaluators attributed scores to each specimen. The differences between the protocols for ICM removal were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Friedman and Wilcoxon signed rank tests were used for comparison between the score of debris obtained in each root canal third. Remains of Ca(OH)(2) were found in all specimens independently of the protocol and ICM used (P > 0.05). Seventeen percent EDTA showed the best results in removing ICM when used alone (P < 0.05), particularly in those associated with CHX. It was concluded that the chelating agent 17% EDTA significantly improved the removal of ICM when used alone. Furthermore, the type of the vehicle associated with Ca(OH)(2) also plays a role in the ICM removal.

The Effect Of Poly(methyl Methacrylate) Surface Treatments On The Adhesion Of Silicone-based Resilient Denture Liners.

Different surface treatment protocols of poly(methyl methacrylate) have been proposed to improve the adhesion of silicone-based resilient denture liners to poly(methyl methacrylate) surfaces. The purpose of this study was to evaluate the effect of different poly(methyl methacrylate) surface treatments on the adhesion of silicone-based resilient denture liners. Poly(methyl methacrylate) specimens were prepared and divided into 4 treatment groups: no treatment (control), methyl methacrylate for 180 seconds, acetone for 30 seconds, and ethyl acetate for 60 seconds. Poly(methyl methacrylate) disks (30.0 × 5.0 mm; n = 10) were evaluated regarding surface roughness and surface free energy. To evaluate tensile bond strength, the resilient material was applied between 2 treated poly(methyl methacrylate) bars (60.0 × 5.0 × 5.0 mm; n = 20 for each group) to form a 2-mm-thick layer. Data were analyzed by 1-way ANOVA and the Tukey honestly significant difference tests (α = .05). A Pearson correlation test verified the influence of surface properties on tensile bond strength. Failure type was assessed, and the poly(methyl methacrylate) surface treatment modifications were visualized with scanning electron microscopy. The surface roughness was increased (P < .05) by methyl methacrylate treatment. For the acetone and ethyl acetate groups, the surface free energy decreased (P < .05). The tensile bond strength was higher for the methyl methacrylate and ethyl acetate groups (P < .05). No correlation was found regarding surface properties and tensile bond strength. Specimens treated with acetone and methyl methacrylate presented a cleaner surface, whereas the ethyl acetate treatment produced a porous topography. The methyl methacrylate and ethyl acetate surface treatment protocols improved the adhesion of a silicone-based resilient denture liner to poly(methyl methacrylate).

Management Of Severe Thoracic Impalement Trauma Against Two-wheeled Horse Carriage: A Case Report And Literature Review.

Thoracic injuries in general are of great importance due to their high incidence and high mortality. Thoracic impalement injuries are rare but severe due to the combination of cause, effect and result. This study's primary objective is to report the case of a young man who was impaled by a two-wheeled horse carriage shaft while crashing his motorcycle in a rural zone. An EMT-B ferry was called at the crash scene and a conscious patient was found, sustaining a severe impalement injury to the left hemithorax, suspended over the floor by the axial skeleton with the carriage shaft coming across his left chest. As a secondary objective, a literature review of thoracic impalement injuries is performed. Cases of thoracic impalement injury require unique and individualized care based on injury severity and affected organs. Reported protocols for managing impalement injuries are entirely anecdotal, with no uniformity on impaled patient's approach and management. In penetrating trauma, it is essential not to remove the impaled object, so that possible vascular lesions remain buffered by the object, avoiding major bleeding and exsanguination haemorrhage. Severed impaled thoracic patients should be transferred to a specialist centre for trauma care, as these lesions typically require complex multidisciplinary treatment. High-energy thoracic impalement injuries are rare and hold a high mortality rate, due to the complexity of trauma and associated injuries such as thoracic wall and lung lesions. Modern medicine still seems limited in cases of such seriousness, not always with satisfactory results.