The development of micro-scale mechanical systems has been moving rapidly, allowing an opportunity to the semiconductor detectors to have ever more power located on the active region. Miniaturization ...associated with micro-channel technologies allows the design of micro-system structures that are able to cool silicon pixel detectors with power of the order of some W/cm
2 with thickness less than 0.3% of radiation length. We present the design and thermo-hydraulic test results for low material budget support and cooling obtained through
forced liquid convection in micro-channels, developed for the innermost layer (Layer 0) of SuperB silicon vertex tracker.
Pixel detectors at future colliders will need to match very stringent requirement on position resolution. To ensure the needed mechanical stability and the removal of the power dissipated by the ...read-out electronic, the support structure and cooling add an important contribution to the total material in the active area, in terms of radiation length. We present the development, the construction and the mechanical–thermal characterization of prototypes of light material support for pixel detectors with microchannel for heat evacuation through forced convection of liquid coolant.
The solution we choose shows several advantages: heat exchange is taking place efficiently due to the high ratio surface/volume and so high thermal conductivities can be obtained, minimally affecting the stiffness of the structure; the thermal resistances are reduced because of the contiguity between the fluid and the circuit dissipating power; the uniformity of temperature on the surface covered by of the sensors is also kept under control. Several prototypes implementing different geometries of micro-machined channels have been realized in composites materials (CFRP). FEA studies have been performed to validated the experimental test conducted in the thermo-fluid dynamic test bench we recently assembled in the INFN Pisa laboratory.
Combination of silicon heterojunction cell technology (SHJ) with bifacial module architecture is an appealing solution for manufactures who are focused on PV system performances. In this paper, we ...will present a study with an industrial perspective, initiated to address specific challenges of producing SHJ cells and modules in Europe. The impact of incoming wafer quality has been studied by analyzing at full ingot scale the efficiency performances of SHJ cells. The impact of long queue time prior to deposition is also reported. Finally, results of full size modules with 72 cells are presented.
Obiettivo I disordini temporomandibolari sono un gruppo eterogeneo di disordini muscoloscheletrici che coinvolgono le articolazioni temporo-mandibolari, i muscoli della masticazione e i tessuti ...associati. Escludendo le forme attribuibili a cause specifiche o sistemiche, la maggior parte dei disordini temporomandibolari possono essere attribuite a fattori psicosociali e funzionali e tra i vari sintomi descritti dai pazienti con disordini temporomandibolari può essere incluso il dolore cervicale. Scopo del presente studio è stato quello di indagare sulla prevalenza di dolore cervicale in un gruppo di pazienti con disordini temporomandibolari, considerando anche la prevalenza di tale dolore riferito nei diversi gruppi diagnostici secondari (disordini muscolari, disordini articolari, disordini misti). Materiali e Metodi È stato selezionato un campione di pazienti visitati per dolore craniofacciale o problemi funzionali mandibolari presso un ambulatorio esterno di pratica odontoiatrica orientata alla gnatologia clinica e ai dolori oro-facciali. Dopo aver applicato criteri di inclusione ed esclusione, il campione finale consisteva in 238 pazienti adulti con età media 43±14 anni e 79,4% di genere femminile. È stata quindi indagata la prevalenza di dolore cervicale sul nostro campione di studio, considerando anche la prevalenza nei diversi gruppi diagnostici secondari (test chi2; α =.05). Risultati Nel nostro campione di studio la prevalenza di dolore cervicale era pari a 60% (p <0,05). La prevalenza di dolore cervicale nei diversi gruppi diagnostici secondari era compresa tra 45% e 71,4%, senza differenze statisticamente significative (p>0,05). Discussione In accordo con diversi studi presenti in letteratura, nel presente lavoro è stata registrata in pazienti con disordini temporomandibolari una prevalenza di dolore cervicale riferito maggiore della metà dei casi. Nonostante la tradizionale convinzione di una associazione tra disordini temporomandibolari di tipo muscolare e dolore cervicale, nel nostro studio è stata individuata una equidistribuzione nella prevalenza di dolore cervicale nei disordini muscolari, articolari e misti. Dunque, genere, età e sito del disordine costituivano probabilmente variabili non coinvolte nell’associazione tra disordini temporomandibolari e dolore cervicale, mentre appariva più adeguato ipotizzare un ruolo concomitante per fattori di natura psicosociale o funzionale nel legame tra i due fenomeni. Conclusioni Il dolore cervicale è un sintomo frequentemente associato ai disordini temporomandibolari. Probabilmente le variabili di genere, età e diagnosi secondaria di disfunzione temporomandibolare non sono fattori coinvolti nell’associazione, tuttavia informazioni conclusive non sono disponibili. La natura multifattoriale dei disordini temporomandibolari e del dolore cervicale aspecifico, con fattori predisponenti, scatenanti e perpetuanti, suggeriscono una gestione gnatologica conservativa e multimodale. Parole chiave: Disordini Temporomandibolari, Dolore Cervicale, Dolore al Collo, Odontoiatria.
We evaluated the antihypertensive activity, glucose homeostasis and plasma lipid profile in patients with mild hypertension and type 2 diabetes mellitus treated by diet and exercise, and not in ...receipt of oral hyperglycemics, following 12-month treatment with either telmisartan or eprosartan. In this double-blind, placebo-controlled trial, 119 patients with mild essential hypertension (diastolic blood pressure DBP 91-104 mmHg) and type 2 diabetes were divided into three groups and randomized to receive once-daily telmisartan 40 mg, eprosartan 600 mg, or placebo for 12 months. At enrollment, patients were advised on diet (1,400-1,600 kcal/day) and exercise (physical aerobics on a bicycle for at least 30 min on 4 days each week). Compared with baseline, a significant reduction (p <0.01) in seated trough systolic blood pressure (SBP) was detected after 12-month treatment with either telmisartan or eprosartan. Seated trough DBP was also reduced by telmisartan (p <0.01) and eprosartan (p <0.05); the antihypertensive effect of telmisartan was significantly superior (p <0.05). No change in body mass index or glucose metabolism was observed with either active treatment, or with placebo. Telmisartan, but not eprosartan, significantly improved plasma total cholesterol (p <0.01), low-density lipoprotein cholesterol (p <0.01) and triglycerides (p <0.05) compared with eprosartan. In conclusion, 12-month telmisartan treatment produced a significantly greater reduction in DBP than eprosartan and significantly improved plasma lipids. The improvement could be due to varying pharmacokinetic/pharmacodynamic properties of telmisartan compared with eprosartan, even if it is not clear about the relationship between angiotensin-II receptor blockade and 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibition. (Hypertens Res 2004; 27: 457-464)
Incretin-based therapies have provided additional options for the treatment of type 2 diabetes mellitus. The aim of our study was to evaluate the effects of exenatide compared to glibenclamide on ...body weight, glycemic control, beta-cell function, insulin resistance, and inflammatory state in patients with diabetes.
One hundred twenty-eight patients with uncontrolled type 2 diabetes mellitus receiving therapy with metformin were randomized to take exenatide 5 microg twice a day or glibenclamide 2.5 mg three times a day and titrated to exenatide 10 microg twice a day or glibenclamide 5 mg three times a day. We evaluated body weight, body mass index (BMI), glycated hemoglobin (HbA(1c)), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance (HOMA-IR) index, homeostasis model assessment beta-cell function (HOMA-beta) index, plasma proinsulin (PPr), PPr/FPI ratio, resistin, retinol binding protein-4 (RBP-4), and high-sensitivity C-reactive protein (Hs-CRP) at baseline and after 3, 6, 9, and 12 months.
Body weight and BMI decreased with exenatide and increased with glibenclamide. A similar improvement of HbA(1c), FPG, and PPG was obtained in both groups, whereas FPI decreased with exenatide and increased with glibenclamide. The HOMA-IR index decreased and the HOMA-beta index increased with exenatide but not with glibenclamide. A decrease of PPr was reported in both groups, but only glibenclamide decreased the PPr/FPI ratio. Resistin and RBP-4 decreased with exenatide and increased with glibenclamide. A decrease of Hs-CRP was obtained with exenatide, whereas no variations were observed with glibenclamide.
Both exenatide and glibenclamide gave a similar improvement of glycemic control, but only exenatide gave improvements of insulin resistance and beta-cell function, giving also a decrease of body weight and of inflammatory state.
Summary
Since sperm require high energy levels to perform their specialised function, it is vital that essential nutrients are available for spermatozoa when they develop, capacitate and acquire ...motility. However, they are vulnerable to a lack of energy and excess amounts of reactive oxygen species, which can impair sperm function, lead to immotility, acrosomal reaction impairment, DNA fragmentation and cell death. This monocentric, randomised, double‐blind, placebo‐controlled trial investigated the effect of 6 months of supplementation with l‐carnitine, acetyl‐l‐carnitine and other micronutrients on sperm quality in 104 subjects with oligo‐ and/or astheno‐ and/or teratozoospermia with or without varicocele. In 94 patients who completed the study, sperm concentration was significantly increased in supplemented patients compared to the placebo (p = .0186). Total sperm count also increased significantly (p = .0117) in the supplemented group as compared to the placebo group. Both, progressive and total motility were higher in supplemented patients (p = .0088 and p = .0120, respectively). Although pregnancy rate was not an endpoint of the study, of the 12 pregnancies that occurred during the follow‐up, 10 were reported in the supplementation group. In general, all these changes were more evident in varicocele patients. In conclusion, supplementation with metabolic and antioxidant compounds could be efficacious when included in strategies to improve fertility.
Postnatal depression (PND) is a major depressive disorder in the year following childbirth, which impacts on women, their infants and their families. A range of interventions has been developed to ...prevent PND.
To (1) evaluate the clinical effectiveness, cost-effectiveness, acceptability and safety of antenatal and postnatal interventions for pregnant and postnatal women to prevent PND; (2) apply rigorous methods of systematic reviewing of quantitative and qualitative studies, evidence synthesis and decision-analytic modelling to evaluate the preventive impact on women, their infants and their families; and (3) estimate cost-effectiveness.
We searched MEDLINE, EMBASE, Science Citation Index and other databases (from inception to July 2013) in December 2012, and we were updated by electronic alerts until July 2013.
Two reviewers independently screened titles and abstracts with consensus agreement. We undertook quality assessment. All universal, selective and indicated preventive interventions for pregnant women and women in the first 6 postnatal weeks were included. All outcomes were included, focusing on the Edinburgh Postnatal Depression Scale (EPDS), diagnostic instruments and infant outcomes. The quantitative evidence was synthesised using network meta-analyses (NMAs). A mathematical model was constructed to explore the cost-effectiveness of interventions contained within the NMA for EPDS values.
From 3072 records identified, 122 papers (86 trials) were included in the quantitative review. From 2152 records, 56 papers (44 studies) were included in the qualitative review. The results were inconclusive. The most beneficial interventions appeared to be midwifery redesigned postnatal care as shown by the mean 12-month EPDS score difference of -1.43 (95% credible interval -4.00 to 1.36), person-centred approach (PCA)-based and cognitive-behavioural therapy (CBT)-based intervention (universal), interpersonal psychotherapy (IPT)-based intervention and education on preparing for parenting (selective), promoting parent-infant interaction, peer support, IPT-based intervention and PCA-based and CBT-based intervention (indicated). Women valued seeing the same health worker, the involvement of partners and access to several visits from a midwife or health visitor trained in person-centred or cognitive-behavioural approaches. The most cost-effective interventions were estimated to be midwifery redesigned postnatal care (universal), PCA-based intervention (indicated) and IPT-based intervention in the sensitivity analysis (indicated), although there was considerable uncertainty. Expected value of partial perfect information (EVPPI) for efficacy data was in excess of £150M for each population. Given the EVPPI values, future trials assessing the relative efficacies of promising interventions appears to represent value for money.
In the NMAs, some trials were omitted because they could not be connected to the main network of evidence or did not provide EPDS scores. This may have introduced reporting or selection bias. No adjustment was made for the lack of quality of some trials. Although we appraised a very large number of studies, much of the evidence was inconclusive.
Interventions warrant replication within randomised controlled trials (RCTs). Several interventions appear to be cost-effective relative to usual care, but this is subject to considerable uncertainty.
Several interventions appear to be cost-effective relative to usual care, but this is subject to considerable uncertainty. Future research conducting RCTs to establish which interventions are most clinically effective and cost-effective should be considered.
This study is registered as PROSPERO CRD42012003273.
The National Institute for Health Research Health Technology Assessment programme.
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