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Search Results: 1 - 10 of 461998 matches for " A. Rotondi "
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eICU program favorably affects clinical and economic outcomes
Jason R Leong, Carl A Sirio, Armando J Rotondi
Critical Care , 2005, DOI: 10.1186/cc3814
Abstract: Telemedicine for the intensive care unit (ICU) has been proposed as potential means of leveraging clinical expertise and bringing that expertise to hospitals with inadequate or complete lack access to intensive care specialists (intensivists).To examine whether a supplemental remote intensive care unit care program, implemented by an integrated delivery network using a commercial telemedicine and information technology system, can improve clinical and economic performance across multiple ICUs.Before-and-after trial to assess the effect of adding a supplemental remote ICU telemedicine program.Two adult ICUs in a 650 bed tertiary care teaching hospital, with a total of 2,140 patients receiving ICU care between 1999 and 2001 (n = 1396 before and n = 744 after implementation).The remote care program used intensivists and physician extenders to provide supplemental monitoring and management of ICU patients for 19 hrs/day (noon to 7 am) from a centralized, off-site facility (eICU). Supporting software, including electronic data display, physician note- and order-writing applications, and a computer-based decision-support tool, were available both in the ICU and at the remote site. Clinical and economic performance during 6 months of the remote intensivist program was compared with performance before the intervention.Primary clinical outcomes were ICU and hospital mortality and length of stay, while primary economic outcomes were variable cost per case and average per patient hospital revenue.Hospital mortality for ICU patients was lower during the period of remote ICU care (9.4% vs. 12.9%; relative risk, 0.73; 95% confidence interval [CI], 0.55–0.95), and ICU length of stay was shorter (3.63 days [95% CI, 3.21–4.04] vs. 4.35 days [95% CI, 3.93–4.78]). Lower variable costs per case and higher hospital revenues (from increased case volumes) generated financial benefits in excess of program costs.The addition of a supplemental, telemedicine-based, remote intensivist program
High Pre-Transplant Serum Levels of CXCL10 Predict Early Renal Allograft Failure
E. Bertoni,P. Romagnani,M. Rotondi,A. Rosati
Transplantationsmedizin , 2003,
Abstract: Background: The chemokine CXCL10 is a potent chemoattractant for activated lymphocytes and dendritic cells and mediates vascular injury by inducing intimal hyperplasia and inhibition of endothelial cell growth. Neutralisation of CXCL10 prolongs allograft survival and transplant knock-out models have shown that this chemokine is required for the initiation and development of graft failure due to both acute and chronic rejection. In the present study, we investigated whether pre-transplant CXCL10 serum levels may predict the recipient risk of graft rejection and transplant failure. Methods: Pre-transplant sera of 299 cadaver kidney graft recipients were tested retrospectively for serum CXCL10 levels by a quantitative sandwich immunoassay.Results: Kidney graft recipients with normally functioning grafts showed higher pre-transplant CXCL10 serum levels than healthy controls, but significantly lower than patients who experienced graft failure (133.47± 119.6 vs. 182.8± 155.01 pg/ml; p<0.05). After the assignment of all patients to four groups at 25°, 50° and 75° centiles according to serum CXCL10 levels, the censored survival rates of grafts were 97.3%, 94%, 93.3%, 85.3% at 1-year. Accordingly, patients with the highest pre-transplant serum CXCL10 levels (75°-100°) centiles showed an increased frequency and severity of rejection episodes in the first month after transplantation. Conclusions: The results of this study show that high pre-transplant serum CXCL10 levels represent an important predictive risk factor for the development of rejection and transplant failure, thus suggesting that measurement of pre-transplant serum CXCL10 levels might represent a clinically useful marker for the transplant outcome.
The intensity attenuation of Colfiorito and other strong earthquakes: the viewpoint of forecasters and data gatherers
R. Rotondi,A. Tertulliani,C. Brambilla,G. Zonno
Annals of Geophysics , 2008, DOI: 10.4401/ag-4447
Abstract: This article has been originated by thoughts on previous analyses related to the proba- bilistic treatment of the macroseismic attenuation, from which it turns out that in Italian territory the intensity decay I varies greatly from one region to another, depending on many factors, some of them not easily measurable. By applying a clustering algorithm we classified some macroseismic fields drawn from the Italian felt report database in three classes. Earthquakes into the same class constituted the input of a two-step procedure for the Bayesian estimation of the probability distribution of I at any distance from the epicenter, conditioned on I0, where I is considered an integer, random variable, following a binomial distribution. The estimated distributions were validated by forecasting the macroseismic field of the Colfiorito earthquake. In this article we deal with the issues left open by those statistical analyses by following two ways: on one hand we test the procedure by forecasting the macroseismic field of other strong earthquakes recorded in Italy during the last century and, on the other hand, we ask the reasons of peculiarities in the results to experts in other fields. The article is hence an introductory work, an example of the possibility and of the need of exchange of knowledge.
The reputation of a newborn central bank
Zeno Rotondi,Giacomo Vaciago
PSL Quarterly Review , 2003,
Abstract: Most of the problems that the European Central Bank has encountered are due to the slow progress made in improving the quality of the monetary union. The increasing variance of the inflationary process among the 12 countries, especially at the extremes of income level distribution – between Germany and Portugal, say – has meant that the common monetary policy is not yet the best possible. The quest for an optimum currency area continues.
Bayesian analysisof a probability distribution for local intensity attenuation
R. Rotondi,G. Zonno
Annals of Geophysics , 2004, DOI: 10.4401/ag-3356
Abstract: Intensity attenuation and its variation as a function of the distance and earthquake size is still a critical issue in evaluating seismic hazard. We present a method that allows us to incorporate additional information from the historical earthquake felt reports in the probability estimation of local intensity attenuation. The approach is based on two ideas: a) standard intensity versus epicentral distance relationships constitute an unnecessary filter between observations and estimates; and b) the intensity decay process is affected by many, scarcely known elements (the physical parameters of the source, propagation path effects, building vulnerability, the semi-qualitative character of macroseismic scales, etc.). Hence intensity decay should be treated as a random variable as is the macroseismic intensity. We assume here that decay, defined on the set {0,1, ..., I0}, follows a binomial distribution with parameters (I0, p); p depends on the distance from the epicenter and is related to the probability of null decay at that distance. According to the Bayesian approach this p parameter is, in turn, a Beta random variable. The observations related to earthquakes with their epicenter outside the area concerned, but belonging to homogeneous zones, are used as prior knowledge of the phenomenon, while the data points of events inside the area are used to update the estimates through the posterior means of the quantities involved. Our methodology is described in detail in an application to the Umbria-Marche area in Central Italy. The data sets examined are the macroseismic intensity database DOM4.1 and the zonation ZS.4, both compiled by the Italian Group for Defence against Earthquakes (GNDT). The method is validated by comparing the observed and the estimated intensity data points of the Camerino (28/07/1799) and of the Colfiorito (26/09/1997) earthquakes.
Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
Rotondi,Michael Anthony; Khobzi,Nooshin;
Bulletin of the World Health Organization , 2010, DOI: 10.1590/S0042-96862010000900014
Abstract: objective: to assess the relationship between the prevalence of vitamin a deficiency among pregnant women and the effect of neonatal vitamin a supplementation on infant mortality. methods: studies of neonatal supplementation with vitamin a have yielded contradictory findings with regard to its effect on the risk of infant death, possibly owing to heterogeneity between studies. one source of that heterogeneity is the prevalence of vitamin a deficiency among pregnant women, which we examined using meta-regression techniques on eligible individual and cluster-randomized trials. adapting standard techniques to control for the inclusion of a cluster-randomized trial, we modelled the logarithm of the relative risk of infant death comparing vitamin a supplementation at birth to a standard treatment, as a linear function of the prevalence of vitamin a deficiency in pregnant women. findings: meta-regression analysis revealed a statistically significant linear relationship between the prevalence of vitamin a deficiency in pregnant women and the observed effectiveness of vitamin a supplementation at birth. in regions where at least 22% of pregnant women have vitamin a deficiency, giving neonates vitamin a supplements will have a protective effect against infant death. conclusion: a meta-regression analysis is observational in nature and may suffer from confounding bias. nevertheless, our study suggests that vitamin a supplementation can reduce infant mortality in regions where this micronutrient deficiency is common. thus, neonatal supplementation programmes may prove most beneficial in regions where the prevalence of vitamin a deficiency among pregnant women is high.
Monitoring Utilization of a Large Scale Addiction Treatment System: The Drug and Alcohol Treatment Information System (DATIS)
Nooshin Khobzi Rotondi and Brian Rush
Substance Abuse: Research and Treatment , 2012, DOI: 10.4137/SART.S9617
Abstract: Client-based information systems can yield data to address issues of system accountability and planning, and contribute information related to changing patterns of substance use in treatment and, indirectly, general populations. The Drug and Alcohol Treatment Information System (DATIS) monitors the number/types of clients treated in approximately 170 publicly-funded addiction treatment agencies in Ontario. The purpose of this study was to estimate the caseload of addiction treatment agencies, and describe important characteristics of clients, their patterns of service utilization and trends over-time from 2005 to 2010. In 2009–2010, 47,065 individuals were admitted to treatment. Since 2005–2006, there has been an increase in adolescents/youth in treatment, and a decrease in the male-female gender ratio. Alcohol problems predominated, but an increasing proportion of clients used cannabis and prescription opioids. DATIS is an evolving system and an integral component of Ontario's performance measurement system. Linkages with healthcare information systems will allow for longitudinal tracking of client health-related outcomes.
Monitoring Utilization of a Large Scale Addiction Treatment System: The Drug and Alcohol Treatment Information System (DATIS)
Nooshin Khobzi Rotondi,Brian Rush
Substance Abuse: Research and Treatment , 2012,
Abstract:
Leptospira interrogans Endostatin-Like Outer Membrane Proteins Bind Host Fibronectin, Laminin and Regulators of Complement
Brian Stevenson, Henry A. Choy, Marija Pinne, Matthew L. Rotondi, M. Clarke Miller, Edward DeMoll, Peter Kraiczy, Anne E. Cooley, Trevor P. Creamer, Marc A. Suchard, Catherine A. Brissette, Ashutosh Verma, David A. Haake
PLOS ONE , 2007, DOI: 10.1371/journal.pone.0001188
Abstract: The pathogenic spirochete Leptospira interrogans disseminates throughout its hosts via the bloodstream, then invades and colonizes a variety of host tissues. Infectious leptospires are resistant to killing by their hosts' alternative pathway of complement-mediated killing, and interact with various host extracellular matrix (ECM) components. The LenA outer surface protein (formerly called LfhA and Lsa24) was previously shown to bind the host ECM component laminin and the complement regulators factor H and factor H-related protein-1. We now demonstrate that infectious L. interrogans contain five additional paralogs of lenA, which we designated lenB, lenC, lenD, lenE and lenF. All six genes encode domains predicted to bear structural and functional similarities with mammalian endostatins. Sequence analyses of genes from seven infectious L. interrogans serovars indicated development of sequence diversity through recombination and intragenic duplication. LenB was found to bind human factor H, and all of the newly-described Len proteins bound laminin. In addition, LenB, LenC, LenD, LenE and LenF all exhibited affinities for fibronectin, a distinct host extracellular matrix protein. These characteristics suggest that Len proteins together facilitate invasion and colonization of host tissues, and protect against host immune responses during mammalian infection.
Olive Tree in Emilia Romagna Region: an Ancient Crop, a New Environmental and Cultural Economic Resource
Enrico Licausi,Nicola Di Virgilio,Annalisa Rotondi,Massimiliano Magli
Italian Journal of Agronomy , 2010, DOI: 10.4081/ija.2010.27
Abstract: The National Research Council Institute of Biometeorology of Bologna (IBIMET-CNR) carried out a study aimed to the safeguard of autochthonous cultivars, through the census of secular olive tree plants, belonging to varieties at extinction risk or located in sites with historical or landscape add value in the Province of Bologna (North Italy) with particular attention to phytometric characters, sanitary status of the plants and the relation with their location characteristics. The presence of ancient plants in a specific site may indicate the absence of limiting factors for olive trees development. Considering the environmental factor values of these locations, a classification of the territory in classes of suitability for the cultivation was defined, with the support of a Geographic Information System (GIS). Ancient olive trees data were also collected and catalogued in an internet site (http://olivisecolari.ibimet.cnr.it) where it is possible to reach a virtual journey through studied olive trees. All plants are supplied with a phytometric card and a visualization on a map providing the exact location. The GIS elaboration of the environmental factors considered for the definition of the suitable lands for olive trees cultivation, identified 3556 ha as suitable, of which 972 ha highly suitable belonging to class I, where olive trees cultivation could be profitable because of suitable land morphology and the possibility of a good mechanization due to low field slopes.
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