Due to be launched in late 2021, the Imaging X-ray Polarimetry Explorer (IXPE) is a NASA Small Explorer mission designed to perform polarization measurements in the 2–8 keV band, complemented with ...imaging, spectroscopy and timing capabilities. At the heart of the focal plane is a set of three polarization-sensitive Gas Pixel Detectors (GPD), each based on a custom ASIC acting as a charge-collecting anode.
In this paper we shall review the design, manufacturing, and test of the IXPE focal-plane detectors, with particular emphasis on the connection between the science drivers, the performance metrics and the operational aspects. We shall present a thorough characterization of the GPDs in terms of effective noise, trigger efficiency, dead time, uniformity of response, and spectral and polarimetric performance. In addition, we shall discuss in detail a number of instrumental effects that are relevant for high-level science analysis—particularly as far as the response to unpolarized radiation and the stability in time are concerned.
Patients who no-show to primary care appointments interrupt clinicians' efforts to provide continuity of care. Prior literature reveals no-shows among diabetic patients are common. The purpose of ...this study is to assess whether no-shows to primary care appointments are associated with increased risk of future emergency department (ED) visits or hospital admissions among diabetics.
A prospective cohort study was conducted using data from 8,787 adult diabetic patients attending outpatient clinics associated with a medical center in Indiana. The outcomes examined were hospital admissions or ED visits in the 6 months (182 days) following the patient's last scheduled primary care appointment. The Andersen-Gill extension of the Cox proportional hazard model was used to assess risk separately for hospital admissions and ED visits. Adjustment was made for variables associated with no-show status and acute care utilization such as gender, age, race, insurance and co-morbid status. The interaction between utilization of the acute care service in the six months prior to the appointment and no-show was computed for each model.
The six-month rate of hospital admissions following the last scheduled primary care appointment was 0.22 (s.d. = 0.83) for no-shows and 0.14 (s.d. = 0.63) for those who attended (p < 0.0001). No-show was associated with greater risk for hospitalization only among diabetics with a hospital admission in the prior six months. Among diabetic patients with a prior hospital admission, those who no-showed were at 60% greater risk for subsequent hospital admission (HR = 1.60, CI = 1.17-2.18) than those who attended their appointment. The six-month rate of ED visits following the last scheduled primary care appointment was 0.56 (s.d. = 1.48) for no-shows and 0.38 (s.d. = 1.05) for those who attended (p < 0.0001); after adjustment for covariates, no-show status was not significantly related to subsequent ED utilization.
No-show to a primary care appointment is associated with increased risk for hospital admission among diabetics recently hospitalized.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Depression and dementia. A review Cipriani, G; Lucetti, C; Carlesi, C ...
European geriatric medicine,
10/2015, Letnik:
6, Številka:
5
Journal Article
Recenzirano
Abstract Although dementia is primarily considered a memory disorder, there are significant neuropsychiatric manifestations sufficient to cause decline in ability to carry out social or occupational ...functioning independently. Depressive symptoms are extremely common in demented patients, and may be present very early in the course of the disease. To describe depression observed in patients suffering from dementia. Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published before 2014. Search terms used included depression, dementia, behavioral and psychological symptoms of dementia (BPSD), Alzheimer's disease, dementia with Lewy bodies frontotemporal dementia, Huntington's disease, Parkinson's disease with dementia, vascular dementia. Publications found through this indexed search were reviewed for further relevant references. Depression and dementia are common in older people and their association is very complex. The reported prevalence of comorbid depression or depressive symptoms in individuals with dementia has been quite variable, likely due to differences in methods of assessment, diagnostic criteria, stages of dementia, and other factors. Little empirical evidence is available to guide the clinicians in the selection of treatment. Comorbid depression complicates diagnosis, affects treatment approaches and outcomes, and decreases the quality of life of affected individuals as well as their caregivers. The coexistence of depression and dementia has emerged as a significant public health problem leading to increased health care utilization and costs.
To describe the intraoperative appearance or improvement of lower extremity muscle motor evoked potentials (mMEPs) during tethered cord surgery for spinal dysraphisms. A 3-year old male child with ...dermal sinus and dorsal lipoma, and a 30-year old male with a sacral lipoma were operated on for untethering the cord under Intra-operative neurophysiological monitoring (IONM) surveillance. The IONM protocol included: Transcranially elicited mMEPs, Posterior Tibial Nerve Somatosensory Evoked Potentials (TPN-SSEPs), recording of the bulbo-cavernous reflex (BCR), and mapping of the cauda equina. Recording electrodes were inserted bilaterally in the Anterior Tibialis (AT), Gastrocnemius (GR), Abductor Hallucis Brevis (AHB), and the anal sphincter muscles (ASM). In the child, at baseline only the right AHB mMEP was elicitable at 200 mA. Following cord untethering a progressive reappareance of the left GR, AT and AHB mMEP was observed starting about 10 min. after the cord was completely untethered. In the adult case, all mMEPs were present at baselines but, in spite of unchanged stimulation intensity, after untethering the cord mMEP amplitude increased significantly in the left AHB and GR muscles. The anesthesiological regimen was stable throughout the procedures. IONM may detect acute improvement of mMEPs during cord untethering, possibly due to better oxidative metabolism in the conus.
Behavioural disturbances are frequently observed in Parkinson's disease (PD), including mood and anxiety disorders. The existence of a comorbidity between such psychiatric disorders in PD patients ...has been suggested only in a few studies. To assess the prevalence of mood and anxiety disturbances, and the rate of comorbidity of such disorders in PD. Secondary aim was to correlate the prevalence of psychiatric disorders in PD with age, sex, laterality of motor symptomatology, clinical features, severity of disease, age of onset and PD duration, and anti‐parkinsonian therapy. Ninety consecutive PD outpatients, and 90 age‐ and sex‐matched controls were included. All PD patients enrolled were non‐fluctuating (21 de novo, 69 treated with levodopa or dopamine agonists). PD patients and controls with Mini Mental State Examination score <23 were excluded. Psychiatric diagnosis was performed by semistructured interview according with DSM‐IV criteria and the severity of depressive and anxious symptoms was rated with clinical rating scales. Major depression was found in 21.1% PD patients vs. 3.3% controls (P < 0.01, chi‐square analysis), dystimia in 18.8% PD patients vs. 4.4% controls (P < 0.05), panic disorders in 30% PD patients vs. 5.5% controls (P < 0.01). No difference in the prevalence of other anxiety disorders was observed between the two groups. The comorbidity of mood and anxiety disorders was found in 19.3% PD patients vs. 8.6% controls (P < 0.01). No correlation was reported between the prevalence of behavioural disturbances and any of the demographic, clinical or pharmacological data taken into account. Our findings might suggest the existence of a wide spectrum of psychiatric disorders in PD ranging from pure depressive disorders, comorbid depressive and anxiety disorders, and pure anxiety disorders, presumably linked to the same neurobiological substrate.
Sundown syndrome and dementia Cipriani, G; Lucetti, C; Carlesi, C ...
European geriatric medicine,
07/2015, Letnik:
6, Številka:
4
Journal Article
Recenzirano
Abstract The terms “sundown syndrome” or “sundowning” are used to describe a wide range of neuropsychiatric symptoms often occurring in individuals with dementia. It is a poorly defined entity. The ...goal of this review is to describe the phenomenon of this syndrome, its clinical characteristics and management. Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published before 2014. Search terms used included behavioural and psychological symptoms of dementia (BPSD), circadian rhythms, dementia, sundowning, sundown syndrome. Publications found through this indexed search were reviewed for further relevant references. Sundowning is a complex behavioural disorder with tremendous costs for families, caretakers, and patients themselves. Increased understanding of the sundowning syndrome may lead to more effective environmental, behavioural, or pharmacological interventions.
To assess the influence of social media platforms, including TikTok, Instagram, and Facebook, in shaping public perceptions about tonsillectomies and to identify the nature of the content ...disseminated on these platforms.
A comprehensive analysis of 1482 relevant social media posts related to tonsillectomies was conducted across major platforms, including TikTok, Instagram, and Facebook. Content was categorized based on author, topic of the post, timeframe, and overall tone. The study also compared engagement metrics across platforms.
TikTok emerged as the most engaging platform with a mean of 3272.8 likes per post. Patients drove 61.6 % of the discourse, with 63.9 % of discussions being lifestyle oriented. Educational content constituted 12.5 % of the overall discourse. Sentiments towards the procedure were almost evenly split, with 29.4 % positive and 28.5 % negative; 92 % of the negative posts were authored by patients.
Patients were the most common social media authors, driving the conversation and a significant portion expressing negative views. Physicians, conversely, showed a low level of social media engagement. By understanding and addressing online narratives, clinicians can offer more informed patient support, debunk myths, and provide empathetic insights, ensuring positive patient experiences in the era of digital health communication.
Purpose
We analyzed the published literature on return-to-driving (RTD) recommendations following lower extremity orthopedic surgery, including knee and hip arthroplasty and ankle and foot surgery.
...Methods
We conducted a PubMed MEDLINE database search for the relevant literature spanning from 1988 to 2022. Data were extracted from the selected articles independently by six investigators, and the mean, standard deviation, and range of RTD recommendations for each surgical region and procedure were calculated.
Results
The 34 studies included in our review evaluated brake response time, reaction time, movement time, braking force, and other parameters. Average RTD recommendations in weeks were: hip surgeries, 4.1 (± 2.7); foot surgeries, 6.67 (± 0.94); Achilles surgeries, 6.67 (± 0.25); ankle surgeries, 4 (± 2); knee surgeries, 5.42 (± 0.77); and multiple lower extremity surgeries, 3.85 (± 0.15).
Conclusion
Our findings can assist physicians in providing informed recommendations to patients, promoting safe driving practices, and optimizing postoperative recovery.
Level of evidence
Therapeutic, Level III: Retrospective comparative study.
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