The concentration of surface ozone (O3) strongly depends on environmental and meteorological variables through a series of complex and non-linear functions. This study aims to explore the ...performances of an advanced machine learning (ML) method, the boosted regression trees (BRT) technique, in exploring the relationships between surface O3 and its driving factors, and in predicting the levels of O3 concentrations. To this end, a BRT model was trained on hourly data of air pollutants and meteorological parameters, acquired, over the 2016–2018 period, in a rural area affected by an anthropic source of air pollutants. The abilities of the BRT model in ranking, visualizing, and predicting the relationship between ground-level O3 concentrations and its driving factors were analyzed and illustrated. A comparison with a multiple linear regression (MLR) model was performed based on several statistical indicators. The results obtained indicated that the BRT model was able to account for 81% of changes in O3 concentrations; it slightly outperforms the MLR model in terms of the predictions accuracy and allows a better identification of the main factors influencing O3 variability on a local scale. This knowledge is expected to be useful in defining effective measures to prevent and/or mitigate the health damages associated with O3 exposure.
Identifying changes in ambient air pollution levels and establishing causation is a research area of strategic importance to assess the effectiveness of air quality interventions. A major challenge ...in pursuing these objectives is represented by the confounding effects of the meteorological conditions which easily mask or emphasize changes in pollutants concentrations. In this study, a methodological procedure to analyze changes in pollutants concentrations levels after accounting for changes in meteorology over time was developed. The procedure integrated several statistical tools, such as the change points detection and trend analysis that are applied to the pollutants concentrations meteorologically normalized using a machine learning model. Data of air pollutants and meteorological parameters, collected over the period 2013–2019 in a rural area affected by anthropic emissive sources, were used to test the procedure. The joint analysis of the obtained results with the available metadata allowed providing plausible explanations of the observed air pollutants behavior. Consequently, the procedure appears promising in elucidating those changes in the air pollutant levels not easily identifiable in the original data, supplying valuable information to identify an atmospheric response after an intervention or an unplanned event.
Haemophilus parainfluenzae endocarditis is a rare but dangerous disease. With this work, we intend to show the importance of early diagnosis and appropriate treatment in order to avoid complications. ...We also highlight the importance of local epidemiology to choose antibiotic prophylaxis for high‐risk procedures in selected predisposed patients.
This clinical report underlines the importance of appropriate investigations when endocarditis is suspected. The timing of therapy changes the outcome. Adequate indications need to be followed also to limit the emergence of resistant microorganisms.
Bacterial infections are frequent in patients with cirrhosis and increase the risk of death and drop-out from liver transplant (LT) waiting list. In patients with bacterial infections, LT is ...frequently delayed because of the fear of poor outcomes. We evaluated the impact of pre-LT infections on post-LT complications and survival.
From 2012 to 2018, consecutive patients transplanted at the Hospital of Padua were identified and classified in two groups: patients surviving an episode of bacterial infection within 3 months before LT (study group) and patients without infections before LT (control group). Post-LT outcomes (complications, new infections, survival) were collected.
A total of 466 LT recipients were identified (study group n = 108; control group n = 358). After LT, the study group had a higher incidence of new bacterial (57% vs. 20%, p <0.001) and fungal infections (14% vs. 5%, p = 0.001) and of septic shock (8% vs. 2%, p = 0.004) than the control group. Along with the model for end-stage liver disease (MELD) score and alcohol-related cirrhosis, bacterial infection pre-LT was an independent predictor of post-LT infections (odds ratio = 3.92; p <0.001). Nevertheless, no significant difference was found in 1-year (88% vs. 89%, p = 0.579) and 5-year survival rates (76% vs. 75%, p = 0.829) between the study group and control group. Within the study group, no association was found between the time elapsed from infection improvement/resolution to LT and post-LT outcomes.
Patients with pre-LT infections have a higher risk of new bacterial and fungal infections and of septic shock after LT. However, post-LT survival is excellent. Therefore, as soon as the bacterial infection is improving/resolving, transplant should not be delayed, but patients with pre-transplant bacterial infections require active surveillance for infections after LT.
Bacterial infections increase mortality and delay transplant in patients with cirrhosis awaiting liver transplantation (LT). Little is known about the impact of adequately treated infections before LT on post-transplant complications and outcomes. The study highlights that pre-LT infections increase the risk of post-LT infections, but post-LT survival rates are excellent despite the risk. These findings suggest that physicians should not delay LT because of concerns about pre-LT infections, but instead should actively monitor these patients for infections after surgery.
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•In patients with cirrhosis, the prognostic impact of pre-LT infections is not completely understood.•Pre-LT infections increase the risk of post-LT infections but do not affect patients’ survival.•Time from infection resolution to LT does not affect incidence of post-LT complication and survival rates.•As soon as infections are resolving, it is safe to proceed with LT without any delay.•Patients with pre-LT infection require active surveillance for infections after LT.
The purpose of this paper is to review and critique the literature on the role of smart cities within the healthcare context, providing an overview of the state of research and outlining a future ...research agenda. Initially, six hundred and seventeen newspaper articles were extracted from Scopus, and their content was analysed for the article selection process by the two researchers in parallel. Finally, forty-six articles dealing with smart cities in healthcare and published in various academic journals have been analysed through content analysis and bibliometric analysis. The results show that the literature on this research topic is somewhat scarce and dominated by unrelated research. Content analysis provides the emergence of three main strands of research: 1) Smart cities as a tool for health security; 2) Smart cities as sources of opportunities for data communication in healthcare; 3) Smart cities for the creation of knowledge and skills in healthcare. The paper presents the first attempt to provide a comprehensive, structured literature review of the role of smart cities in the healthcare environment after the outbreak of the Covid-19 pandemic. Despite the growing literature on smart cities, this research area contextualised the healthcare context is still fragmented and under-theorised. More systematic and holistic studies are needed, considering the technological, economic, and social aspects of the importance of smart cities in the healthcare system.
The possibility to discriminate between different emission sources and between natural and anthropogenic contributions is a key issue for planning efficient air pollution reduction and mitigation ...strategies. Moreover, the knowledge of the particulate matter (PM) chemical composition for the different size fractions is recognized as increasingly important, in particular with respect to health effects of exposed population. This study is focused on the characterization of PM10 and PM2.5 main sources located in the Civitavecchia harbor-industrial area (Central Italy), namely a large coal-fired power plant, a natural gas power plant, the harbor area, the vehicular traffic (due to both the local traffic and the highway crossing the area) and small industrial activities. The approach was based on PM10/PM2.5 samples monthly collected for one year and a further relative chemical characterization of organic and inorganic fractions. Wind-select sensors, allowing a selective PM10 and PM2.5 sampling downwind to specific emission sources, were used for the overall sampling. This methodology manages to explain specific emission patterns and to assess the concentration levels of the micro pollutants emitted by local sources and particularly toxic for health. A descriptive statistical analysis of data was performed, also verifying the occurrence of legislative threshold exceedances. Moreover, in order to highlight the contribution of specific sources, the differences in the measured micro pollutants concentrations between wind directions, PM size fractions and sampling sites have been investigated, as well as the seasonal trends of pollutants concentrations. These results allow to highlight that the applied methodology represents a valid support in source apportionment studies.
This study examines the complex and diverse process of how educational institutions incorporate digital technologies. The study examines the widespread incorporation of digital tools and methodology, ...analysing their influence on teaching methods, administrative models, and the overall educational experience for all involved parties. This essay thoroughly examines developing trends to explore the factors, difficulties, and consequences of digitalisation in education. This article presents a thorough and versatile structure to facilitate the process of digitising education.
Liver transplantation (LT) is the most successful treatment for patients with decompensated cirrhosis. The availability of effective and safe etiological treatments has altered the natural history of ...decompensated cirrhosis. Recently, the concept of recompensation has been defined. Patients who achieve recompensation may be removed from the waiting list for LT. Therefore, achieving an etiological cure is the cornerstone in the treatment of patients with decompensated cirrhosis. However, most patients improve their liver function after an etiologic cure, and only a proportion of patients achieve true recompensation after an etiological cure. Some patients maintain a condition of “MELD purgatory,” that is, an improvement in the Model for End-Stage Liver Disease score without relevant clinical improvement that prevents delisting and may be even detrimental because lower Model for End-Stage Liver Disease score delays LT. Herein, we review the available evidence regarding recompensation and the management of recompensated patients on the waiting list for LT.
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