Validated tools for predicting individual in-hospital mortality of COVID-19 are lacking. We aimed to develop and to validate a simple clinical prediction rule for early identification of in-hospital ...mortality of patients with COVID-19.
We enrolled 2191 consecutive hospitalized patients with COVID-19 from three Italian dedicated units (derivation cohort: 1810 consecutive patients from Bergamo and Pavia units; validation cohort: 381 consecutive patients from Rome unit). The outcome was in-hospital mortality. Fine and Gray competing risks multivariate model (with discharge as a competing event) was used to develop a prediction rule for in-hospital mortality. Discrimination and calibration were assessed by the area under the receiver operating characteristic curve (AUC) and by Brier score in both the derivation and validation cohorts. Seven variables were independent risk factors for in-hospital mortality: age (Hazard Ratio HR 1.08, 95% Confidence Interval CI 1.07-1.09), male sex (HR 1.62, 95%CI 1.30-2.00), duration of symptoms before hospital admission <10 days (HR 1.72, 95%CI 1.39-2.12), diabetes (HR 1.21, 95%CI 1.02-1.45), coronary heart disease (HR 1.40 95% CI 1.09-1.80), chronic liver disease (HR 1.78, 95%CI 1.16-2.72), and lactate dehydrogenase levels at admission (HR 1.0003, 95%CI 1.0002-1.0005). The AUC was 0.822 (95%CI 0.722-0.922) in the derivation cohort and 0.820 (95%CI 0.724-0.920) in the validation cohort with good calibration. The prediction rule is freely available as a web-app (COVID-CALC: https://sites.google.com/community.unipa.it/covid-19riskpredictions/c19-rp).
A validated simple clinical prediction rule can promptly and accurately assess the risk for in-hospital mortality, improving triage and the management of patients with COVID-19.
A Monte-Carlo based computational approach for the statistical characterization of the whole-body specific absorption rate (wbSAR) variability in large cohorts of rodents exposed to radio-frequency ...(RF) energy in reverberation chambers (RCs) is applied to adult male rat exposures illustrative of those in a US National Toxicology Program (NTP) cancer bioassay. A large number of 3D electromagnetic field realizations fulfilling Rayleigh fading properties were generated within an electrically-large volume representative of an ideal RC, yielding granular wbSAR distributions for an ensemble of 96 homogeneous rodent models with random mass distribution, postures, positions and orientations. Two case studies were addressed: a "momentary exposure" with each rat fixed in posture, position and orientation, and a "day-long exposure" in which the position, orientation and posture were varied randomly for each subsequent Rayleigh field realization. Over 500 and 2500 field realizations or "snapshots", respectively, the rats' instantaneous wbSARs, as well as their individual time-averaged wbSARs, were found to be well fit by lognormal distributions. The large variability in instantaneous wbSARs in the cohort was due in part to the inherent Rayleigh field variability in RCs (70-80%) and in part to weight, posture and position variations (20-30%), while the effect of cage location was found to be small over day-long exposures. Averaging the exposure over field realizations substantially reduces the range of wbSARs in the cohort. Hence, when RF-induced thermal effects are studied, the relevant exposure metric (wbSAR averaged over appropriate times) features a narrower range than instantaneous wbSAR, which is the relevant metric in studies dealing with non-thermal effects. Compared to previous studies, the present approach was found to be computationally more efficient enabling thus a Monte-Carlo analysis by varying concurrently the incident field and the animals posture, position, and orientation. In practice, it can inform the choice of wbSAR targets in rodent bioassay, allowing to identify possible dose-effect trends while avoiding undue thermal stress.
Accurate Rayleigh propagation environments within an ideal reverberation chamber (RC) are synthesized computationally using a superposition of plane-waves (PWs). Randomness in the electro-magnetic ...(EM) field distribution is achieved by synthesizing many field realizations featuring slant-polarized PWs with randomly defined transverse field components. These PWs propagate along a large number of predefined and uniformly distributed directions determined only once via an efficient spiraling sampling scheme over the unit sphere. Comparisons with theoretical Rayleigh field statistics indicate that the proposed method yields random EM field distributions that in several cases follow more closely the field spatial correlation properties, for comparable numerical burden, than other available numerical techniques. Finally, a formula relating the number of PWs to the size of a desired RC analysis volume was provided.
The employability of photonics technology in the modern era's highly demanding and sophisticated domain of aerospace and submarines has been an appealing challenge for the scientific communities. In ...this paper, we review our main results achieved so far on the use of optical fiber sensors for safety and security in innovative aerospace and submarine applications. In particular, recent results of in-field applications of optical fiber sensors in aircraft monitoring, from a weight and balance analysis to vehicle Structural Health Monitoring (SHM) and Landing Gear (LG) monitoring, are presented and discussed. Moreover, underwater fiber-optic hydrophones are presented from the design to marine application.
This study was developed to carry out a comprehensive radiological assessment of natural radioactivity for river sediment samples from Calabria, southern Italy, and to define a baseline background ...for the area on a radiation map. In the studied area, elevated levels of natural radionuclides are expected, due to the outcropping acidic intrusive and metamorphic rocks from which the radioactive elements derive. To identify and quantify the natural radioisotopes, ninety river sediment samples from nine selected coastal sampling points (ten samples for each point) were collected as representative of the Ionian and the Tyrrhenian coastline of Calabria. The samples were analyzed using a gamma ray spectrometer equipped with a high-purity germanium (HPGe) detector. The values of mean activity concentrations of 226Ra, 232Th and 40K measured for the studied samples are (21.3 ± 6.3) Bq kg−1, (30.3 ± 4.5) Bq kg−1 and (849 ± 79) Bq kg−1, respectively. The calculated radiological hazard indices showed average values of 63 nGy h−1 (absorbed dose rate), 0.078 mSv y−1 (effective dose outdoors), 0.111 mSv y−1 (effective dose indoors), 63 Bq kg−1 (radium equivalent), 0.35 (Hex), 0.41 (Hin), 0.50 (activity concentration index) and 458 µSv y−1 (Annual Gonadal Equivalent Dose, AGED). In order to delineate the spatial distribution of natural radionuclides on the radiological map and to identify the areas with low, medium and high radioactivity values, the Surfer 10 software was employed. Finally, the multivariate statistical analysis was performed to deduce the interdependency and any existing relationships between the radiological indices and the concentrations of the radionuclides. The results of this study, also compared with values of other locations of the Italian Peninsula characterized by similar local geological conditions, can be used as a baseline for future investigations about radioactivity background in the investigated area.
In order to complete this set of three companion papers, in this last, we focus our attention on environmental monitoring by taking advantage of photonic technologies. After reporting on some ...configurations useful for high precision agriculture, we explore the problems connected with soil water content measurement and landslide early warning. Then, we concentrate on a new generation of seismic sensors useful in both terrestrial and under water contests. Finally, we discuss a number of optical fiber sensors for use in radiation environments.
Our group, involving researchers from different universities in Campania, Italy, has been working for the last twenty years in the field of photonic sensors for safety and security in healthcare, ...industrial and environment applications. This is the first in a series of three companion papers. In this paper, we introduce the main concepts of the technologies employed for the realization of our photonic sensors. Then, we review our main results concerning the innovative applications for infrastructural and transportation monitoring.
The incorporation of hysteresis models in computational electromagnetic software is of paramount importance for the accurate prediction of the ferromagnetic devices’ performance. The Preisach and ...Jiles-Atherton (J-A) models are frequently used for this purpose. The former is more accurate and can represent a broad range of magnetic materials, but it is computationally expensive. The latter is more efficient but can accurately model only soft ferromagnetic materials. In this paper, a recently proposed hysteresis model, referred to as the D’Aloia-Di Francesco-De Santis (D-D-D) model, is shown to have the best trade-off between accuracy and computational burden. For the first time, a numerical comparison between the Preisach, J-A and D-D-D models is provided for a large class of hysteresis loops including soft, semi-hard and hard ferromagnetic materials.
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•PGI and Not PGI cherry tomatoes belonged to cv “Naomy” were investigated for traceability purposes.•Protected and not protected cherry tomatoes from different production areas were ...considered.•Mineral profiles were determined by ICP-MS and analyzed by PCA and CDA.•The approaches could be used to guarantee the PGI products from food fraud.•Lycopersicon esculentum PGI fingerprint was realized thanks to inorganic markers.
To prevent PGI (Protected Geographical Indication) cherry tomato of Pachino (Sicily, Italy) from frauds, an alternative method, which includes chemometric treatments, was proposed. The content of 32 inorganic elements (macro-micronutrients and lanthanides) present in 16 PGI and 24 not PGI cherry tomato samples cv Naomy, and in 16 PGI and 8 not PGI soil samples, was determined by Inductively Coupled Plasma - Mass Spectrometer (ICP-MS). To identify the elements able to differentiate PGI and not PGI cherry tomato samples, Principal Components Analysis (PCA) and Canonical discriminant analysis (CDA) were performed. The first two principal components (PC1-PC2) explain a total variance of 71,41% between PGI and not PGI group, whereas CDA showed Zn, Cd, Mn and Ca as inorganic markers able to correctly classify the 100% of samples. Furthermore, with a translocation factor (K), evaluated in soil/plant chain, the comparison of absorption trends for PGI and not PGI samples was realized.