Mixing Improvement in a T-Shaped Micro-Junction through Small Rectangular Cavities.

The T-shaped micro-junction is among the most used geometry in microfluidic applications, and many design modifications of the channel walls have been proposed to enhance mixing. In this work, we investigate through numerical simulations the introduction of one pair of small rectangular cavities in the lateral walls of the mixing channel just downstream of the confluence region. The aim is to preserve the simple geometry that has contributed to spread the practical use of the T-shaped micro-junction while suggesting a modification that should, in principle, work jointly with the vortical structures present in the mixing channel, further enhancing their efficiency in mixing without significant additional pressure drops.

Dysphagic disorder in a cohort of COVID-19 patients: Evaluation and evolution.

Background: COVID-19 is a multisystem disease complicated by respiratory failure requiring sustanined mechanical ventilation (MV). Prolongued oro-tracheal intubation is associated to an increased risk of dysphagia and bronchial aspiration. Purpose of this study was to investigate swallowing disorders in critically ill COVID-19 patients.

Hemoadsorption Treatment with CytoSorb® in Probable Hemophagocytic Lymphohistiocytosis: A Role as Adjunctive Therapy?

Acute hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease, with an annual incidence of 1 : 800,000 people. The disease is characterized by a cytokine storm, with concomitant macrophage and natural killer (NK) cell activation; death can occur from multiple organ failure or complications such as bleeding diathesis. Therefore, HLH treatment remains a challenging one.

Low PEEP Mechanical Ventilation and PaO/FiO Ratio Evolution in COVID-19 Patients.

Invasive mechanical ventilation (IMV) is the standard treatment in critically ill COVID-19 patients with acute severe respiratory distress syndrome (ARDS). When IMV setting is extremely aggressive, especially through the application of high positive-end-expiratory respiration (PEEP) values, lung damage can occur. Until today, in COVID-19 patients, two types of ARDS were identified (L- and H-type); for the L-type, a was supposed to be preferred, but data are still missing.

A Study on the Effect of Flow Unsteadiness on the Yield of a Chemical Reaction in a T Micro-Reactor.

Despite the very simple geometry and the laminar flow, T-shaped microreactors have been found to be characterized by different and complex steady and unsteady flow regimes, depending on the Reynolds number. In particular, flow unsteadiness modifies strongly the mixing process; however, little is known on how this change may affect the yield of a chemical reaction. In the present work, experiments and 3-dimensional numerical simulations are carried out jointly to analyze mixing and reaction in a T-shaped microreactor with the ultimate goal to investigate how flow unsteadiness affects the reaction yield.

Pseudoatrial Flutter: When the Problem Lies Outside the Heart.

Electrocardiogram (ECG) artifacts are a common problem in emergency medicine. Generally these artifacts are induced by movement disorders, which generate electrical interference with the ECG recording. If these disorders are not promptly recognized, consequences can lead to hospitalization and execution of unnecessary diagnostic tests, thereby increasing the costs and clinical risks such as nosocomial infections and thromboembolism.

Triphase Separation of a Ternary Symmetric Highly Viscous Mixture.

We discuss numerical results of diffusion-driven separation into three phases of a symmetric, three-component highly viscous liquid mixture after an instantaneous quench from the one-phase region into an unstable location within the tie triangle of its phase diagram. Our theoretical approach follows a diffuse-interface model of partially miscible ternary liquid mixtures that incorporates the one-parameter Margules correlation as a submodel for the enthalpic (so-called excess) component of the Gibbs energy of mixing, while its nonlocal part is represented based on a square-gradient (Cahn-Hilliard-type) modeling assumption. The governing equations for this phase-field ternary mixture model are simulated in 3D, showing the segregation kinetics in terms of basic segregation statistics, such as the integral scale of the pair-correlation function and the separation depth for each component.

Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories.

Background: The likelihood of return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) is influenced by unmodifiable (gender, aetiology, location, the presence of witnesses and initial rhythm) and modifiable factors (bystander CPR and the time to EMS arrival). All of these have been included in the ROSC After Cardiac Arrest (RACA) score.

Purpose: To test the ability of the RACA score to predict the probability of ROSC in two different regions with different local resuscitation networks: the Swiss Canton Ticino and the Italian Province of Pavia.

Dissolution or Growth of a Liquid Drop via Phase-Field Ternary Mixture Model Based on the Non-Random, Two-Liquid Equation.

We simulate the diffusion-driven dissolution or growth of a single-component liquid drop embedded in a continuous phase of a binary liquid. Our theoretical approach follows a diffuse-interface model of partially miscible ternary liquid mixtures that incorporates the non-random, two-liquid (NRTL) equation as a submodel for the enthalpic (so-called excess) component of the Gibbs energy of mixing, while its nonlocal part is represented based on a square-gradient (Cahn-Hilliard-type modeling) assumption. The governing equations for this phase-field ternary mixture model are simulated in 2D, showing that, for a single-component drop embedded in a continuous phase of a binary liquid (which is highly miscible with either one component of the continuous phase but is essentially immiscible with the other), the size of the drop can either shrink to zero or reach a stationary value, depending on whether the global composition of the mixture is within the one-phase region or the unstable range of the phase diagram.

Diffusion-Driven Dissolution or Growth of a Liquid Drop Embedded in a Continuous Phase of Another Liquid via Phase-Field Ternary Mixture Model.

We simulate the diffusion-driven dissolution or growth of a single-component (resp. two-component) drop embedded in a continuous phase of a binary (resp. single-component) liquid.

Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.

Aim: We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP).

Methods: The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander's call, the EMS dispatcher sends one ambulance and alerts the first-responders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called "traditional" first responders, and - if the scene was considered safe - lay responders as well.

Comparative performance assessment of commercially available automatic external defibrillators: A simulation and real-life measurement study of hands-off time.

Purpose: Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness.

Methods: The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time.

Spinodal decomposition of chemically reactive binary mixtures.

We simulate the influence of a reversible isomerization reaction on the phase segregation process occurring after spinodal decomposition of a deeply quenched regular binary mixture, restricting attention to systems wherein material transport occurs solely by diffusion. Our theoretical approach follows a diffuse-interface model of partially miscible binary mixtures wherein the coupling between reaction and diffusion is addressed within the frame of nonequilibrium thermodynamics, leading to a linear dependence of the reaction rate on the chemical affinity. Ultimately, the rate for an elementary reaction depends on the local part of the chemical potential difference since reaction is an inherently local phenomenon.

Buoyancy-driven detachment of a wall-bound pendant drop: interface shape at pinchoff and nonequilibrium surface tension.

We present numerical results from phase-field simulations of the buoyancy-driven detachment of an isolated, wall-bound pendant emulsion droplet acted upon by surface tension and wall-normal buoyancy forces alone. Our theoretical approach follows a diffuse-interface model for partially miscible binary mixtures which has been extended to include the influence of static contact angles other than 90^{∘}, based on a Hermite interpolation formulation of the Cahn boundary condition as first proposed by Jacqmin [J. Fluid Mech.

Better management of out-of-hospital cardiac arrest increases survival rate and improves neurological outcome in the Swiss Canton Ticino.

Aim: To determine the incidence of out-of-hospital cardiac arrest (OHCA) fulfilling Utstein criteria in the Canton Ticino, Switzerland, the survival rate of OHCA patients and their neurological outcome.

Methods And Results: All OHCAs treated in Canton Ticino between 1 January 2005 and 31 December 2014 were followed until either death or hospital discharge. The survival and neurological outcome of those OHCA fulfilling Utstein criteria are reported.

Intraoperative three-dimensional versus two-dimensional echocardiography for left ventricular assessment.

Background: Three-dimensional (3D) transesophageal echocardiography (TEE) technology is now widely used intraoperatively in cardiac surgery. Left ventricular (LV) measurements with 3D transthoracic echocardiography correlate better with cardiac magnetic resonance measurements compared with traditional two-dimensional (2D) transthoracic echocardiography. In this study, we compared intraoperative 3D TEE against 2D TEE regarding quantitative indices of LV function.

Genetic Drift: the Salernitan school of medicine: women, men, and children. A syndromological review of the oldest medical school in the western world.

Ever since the 9th century during the High Middle Ages, the "Schola Medica Salernitana," believed to be the first medical school in the western world, flourished in Salerno, a city in southern Italy. Although an important role is attributed to several men of this school, who were recognized as wise and learned doctors, modern historiography has also reevaluated and extolled the praiseworthy role of women. Contrary to the common beliefs and expectations of a woman's "place" at the time, these women were fully titled physicians.

[EMG and forces during manoeuvring of ceiling-based and floor-based patient transfer devices].

A laboratory and on-the-field study was conducted to compare Floor-Based (FB) and Ceiling-Based (CB) patients transfer devices. Pushing and pulling forces were measured by means of computer assisted dynamometer. EMG signals were measured.

Mitral valve replacement in pregnancy: a successful strategy for fetal survival.

The incidence of bacterial endocarditis (BE) during pregnancy is about 0.01%, while maternal and fetal mortality rates due to BE are 22% and 15%, respectively. Fetal survival is <15% until week 25 of gestation, and cesarean delivery is recommended before cardiopulmonary bypass in the third trimester.

Continuous veno-venous hemofiltration with regional citrate anticoagulation: a four-year single-center experience.

Background: Hemofiltration protocols using a citrate-buffered replacement solution offer the advantage of regional anticoagulation and a buffer effect. The role played by such fluids in clinical practice is not yet well established. The risk of electrolytic disorders, acid-base imbalance, or citrate accumulation should be clarified.

Unusual complication after aortic valve replacement.

We present a report of a postoperative left ventricular-right atrial (LV-RA) communication after aortic valve replacement. Such intracardiac defects are rare but encountered occasionally after valve surgery. The diagnosis was made by use of transesophageal echocardiography with echo-Doppler and color-flow imaging.

Multiple valve replacement in limited access: a case report.

Nowadays minimally invasive surgery represents an accepted technique to treat heart valve disease. We report a case of surgical correction of multiple valve disease in a 61-year-old woman through a minimally invasive right anterolateral minithoracotomy. The intervention was performed under transesophageal echocardiography and videoscopic guidance.

Experimental evidence of the motion of a single out-of-equilibrium drop.

We show experimentally that when a single, neutrally buoyant drop is injected into a binary mixture either it remains quiescent or it moves, depending on whether the composition of the drop and that of the surrounding phase coincide with the equilibrium concentrations. In general, the movement of out-of-equilibrium drops, which is called diffusiophoresis, is induced by the Korteweg body force. This force is proportional to the chemical potential gradient and is therefore nonzero only when the system is in chemical nonequilibrium.

Effects of quenching rate and viscosity on spinodal decomposition.

Spinodal decomposition of deeply quenched mixtures is studied experimentally, with particular emphasis on the domain growth rate during the late stage of coarsening. We provide some experimental evidence that at high Péclet number, the process is isotropic and the domain growth is linear in time, even at finite quenching rates. In fact, the quenching rate appears to influence the magnitude of the growth rate, but not its scaling law.