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The intergenerational dimension is a possible key to reading Christus vivit. Pope Francis' eyes show the right perspective with which to look at the juvenile world, capable of attitudes of willingness and holiness. Today it is difficult to define the periods of adolescence, youth, and adulthood; but the adult cannot separate themselves from their role, that they should develop first of all through example. To speak of youth means, furthermore, facing questions and reflections both bioethical and biopolitical. Today the virus of self-sufficiency threatens humanity and distances it from the discovery of its own origin, working to find oneself in God. The Synod an ecclesiological aspect, because dialogue also develops in the Church, where the identities and personalities of young people develop, in a manner of adequate communication to the times and that can be summarized in a single world: listening. [ABSTRACT FROM AUTHOR]

The author presents the writings of don Lorenzo Milani for the first time together in one edition. The body of work split into two volumes, offers the reader a view both organic and thorough, delving deeply into the thoughts and actions of the prior of Barbiana. The critical apparatus who add to the edition is particularly accurate in offering writings that deepen the foresight of Milani on themes still crucial today: education, inclusion, justice and the dignity of the human person. Most of all allowing to emerge the stature of the man and priest, whose highest intellectual work is clearly leaning towards a radical conversion of culture, humanity, politics and ministry. [ABSTRACT FROM AUTHOR]

The study presents a significant development of an advanced control strategy for stand‐alone three‐phase induction generators. The system under study consists of a squirrel‐cage induction generator driven mechanically by an internal combustion engine and electrically by a fault‐tolerant converter coupled with a LC filter. As a novelty, in this study three low‐cost electrical contactors are introduced in order to re‐arrange the converter topology after a fault occurrence and a proper re‐starting procedure is developed, allowing the converter to operate with only two legs. The control architecture is mainly described with respect to this last operating condition, evidencing its intrinsic robustness. The study focuses on the composite control of the converter and the prime mover in order to improve the dynamic assessment of the whole system. The converter control is designed around the sliding mode technique, due to its attractive performance, especially as far as parameter uncertainties are concerned. In order to validate the theoretical framework, this study presents the first ever made experimental tests of this system with reference to a generation unit of about 10 kVA. The results confirm the high capability of the proposed system in regulating voltage and frequency with very good dynamic features. [ABSTRACT FROM AUTHOR]

In this paper we present a vision based method for counting the number of persons which cross a virtual line. The method analyzes the video stream acquired by a camera mounted in a zenithal position with respect to the counting line, allowing to determine the number of persons that cross the virtual line and providing the crossing direction for each person. The proposed approach has been specifically designed to achieve high accuracy and computational efficiency, so as to allow its adoption in real scenarios. An extensive evaluation of the method has been carried out taking into account the main factors that may impact on the counting performance and, in particular, the acquisition technology (traditional RGB camera and depth sensor), the installation scenario (indoor and outdoor), the density of the people flow (isolated people and groups of persons), the acquisition frame rate, and the image resolution. We have also analyzed the combination of the outputs obtained from the RGB and depth sensors as a way to improve the counting performance. The experimental results confirm the effectiveness of the proposed method, especially when combining RGB and depth information, and the tests over three different CPU architectures demonstrate the possibility of deploying the method both on high-end servers for processing in parallel a large number of video streams and on low power CPUs as those embedded on commercial smart cameras. [ABSTRACT FROM AUTHOR]

Doxorubicin (DOXO) is commonly used to treat a wide range of malignant tumors, but its clinical use is limited by acute and chronic cardiotoxicity. The precise mechanism underlying DOXO-induced cardiotoxicity is still not completely elucidated, but cardiac inflammation seems to be involved. Effects of DOXO on proinflammatory cytokines, inflammatory cell infiltration, and necrosis have been proven only when a functional impairment has already occurred, so this study aimed to investigate the acute effect of DOXO administration in mouse heart. The results of our study demonstrated alterations in cardiac function parameters assessed by ultrasound within 24 h after a single injection of DOXO, with a cumulative effect along the increase of the dose and the number of DOXO administrations. At the same time, DOXO causes a significant production of proinflammatory cytokines (such as TNF-α and IL-6) with a concomitant reduction of IL-10, a well-known antiinflammatory cytokine. Furthermore, overexpression of inducible nitric oxide synthase (iNOS) in heart tissue and increased levels of serum nitrite in DOXO-treated mice were detected. Notably, DOXO administration significantly increased nitrotyrosine expression in mouse heart. Our data support the hypothesis that these early events, could be responsible for the later onset of more severe deleterious remodeling leading to DOXO induced cardiomyopathy. [ABSTRACT FROM AUTHOR]

The designation of the Extraordinary Jubilee of Mercy offers a chance to our author to have a deeper appreciation of the aspects of mercy, in particular of its close link with politics and welfare. In particular, mercy as fraternity and solidarity for the construction of the common good. Through reference to institutions that more specifically are always interested in practical charity, mercy, the author wants to underline that its practice should be common to the whole world and lay the basis for the social and civil organization of a community that give particular attention to the end result. The author, through a socio-political and cultural analysis of the reality in which we live and looking at, also, the Social doctrine of the Church, comes to the conclusion that it is necessary to construct a Community where everyone is disposed to recognize each other as a depository of this right. Mercy, is therefore the fundamental social right. [ABSTRACT FROM AUTHOR]

Objective To examine the spectrum of urological complications associated with bladder drainage of pancreatic allografts. Patients and method Between July 1991 and October 1996, 140 consecutive bladder–drained pancreatic allografts were performed and were reviewed retrospectively to determine the spectrum of post-operative urological complications. Ninety-five patients (68%) underwent simultaneous pancreas-kidney transplantation, 35 (25%) had the pancreas transplanted after the kidney, while 10 (7%) had a pancreas transplant alone. The mean follow–up was 35 months. Results Seventy patients (50%) had urological complications necessitating intervention: 17 (12%) had retained foreign bodies, bladder tumours occurred in three, 14 had bladder calculi and 15 (11%) had cystoscopic evidence of duodenitis. One patient developed an arteriovenous fistula and one had a necrotic duodenal allograft. Reflux pancreatitis occurred in six patients. Other complications included urethral stricture (three), urethral erosion (three), epididymitis (three), acute prostatitis (one) and prostatic abscess (one). One patient developed a urethrocutaneous fistula and another developed a vesicocutaneous fistula. In the series, 30 of the 140 patients (21%) required eventual conversion to enteric drainage of their allograft as definitive therapy. Conclusions Pancreatic transplantation with bladder drainage is associated with a wide range of significant urological problems. Although appropriate treatment can resolve most of the complications, this often entails additional operative intervention, which may increase the long-term morbidity or jeopardize graft function. As a result of the severity of these urological complications, some centres use primary enteric drainage as the method of choice for pancreatic transplantation. [ABSTRACT FROM AUTHOR]

The paper suggests an energy management control strategy of wayside Li-ion capacitor (LiC) based energy storage for light railway vehicles (LRV). The installation of wayside supercapacitor (SC) storage devices, as widely recognized, allows the recovery of the braking energy for increasing the system efficiency as well as a better pantograph voltage profile. A new type of SC, LiC, interfaced with dc-interleaved converter has been presented. This technology has an energy density comparable to batteries and power density much higher than the batteries. The authors propose a control strategy based on the maximum kinetic energy recovery throughout braking operations of the running vehicles. The stored energy comes back to the vehicles during the accelerations. The strategy stays on the knowledge of the state of charge of LiC device and the actual vehicle speeds. In particular, the control algorithm evaluates, in real time, the actual value of LiC voltage and current references on the basis of the vehicles inertial forces and acceleration estimations, taking into account the power losses of the system. Experimental tests made on electromechanical simulator, equipped with a 136-V, 30.5-F LiC module, fully confirm the validity of the suggested control. Finally, experimental characterization of LiC module has been achieved. [ABSTRACT FROM AUTHOR]

From the 47th Social week in Turin of Italian Catholics a deepned and sharp reflection on the family today and in its future starts. This journey, among history, sociology, philosophy and theology, in the light of the social magisterium, arrives at the concept of Christian family that bring us up, not only to the “good life of the Gospel” but also to “the social life and politics”. The author starts from the transformation of the family model that today is the mirror of the social chaos to set then against the cultural, social, political and pastoral terms. He dwells upon the attention that the economic and social politics of the governments keep for the family and he would like the passage from welfare state to a welfare society. The reflection ended by defining the connotations of a family. The conclusion: a strong appeal to the laity to engage in politics and to address issues in the light of the Gospel; a strong appeal to the role of the parish, a place to welcome its families and to train of its new builders. [ABSTRACT FROM AUTHOR]

The Year of faith causes many reflections on the human subject. The author reflects on both its current and complex aspect: that of the commitment of Christians in its institutions and for its institutions. Today there is a widespread attitude of apathy and indifference. The starting point is to discover that faith is the basis not only of the relationship with God, but the relationship between all men to trust and rely on each other. This is the dynamic of human coexistence. The focal point is the coherence between faith and life, that man must be faithful to his commitments and must be able to not disappoint. There needs to be consistency between the Gospel and culture. Another crucial point is the comparison of the reasons for faith and the reasons why we have faith. The possible relationship between faith and politics is a dialogue of mutual recognition. The Christian is called to give through his commitment and testimony, the face of God revealed in Jesus Christ, the model of charity and justice, not only for individuals but for society as a whole. [ABSTRACT FROM AUTHOR]

AIM: The purpose of this study was to assess the ability of enamel matrix derivative (EMD) to improve root coverage with a coronally advanced flap (CAF) during a 2-year follow-up. METHODS: Fifteen patients each with two single and similar bilateral Miller Class I or II gingival recessions (30 recessions) were selected. Each recession was randomly assigned to the test group (CAF+EMD) or the control group (CAF only). Clinical parameters recorded at baseline and at 6, 12 and 24 months were recession depth (R), recession width (WR), probing depth (PD), clinical attachment level (CAL) and keratinized tissue (KT). RESULTS: Reduction of R resulted in a significant CAL gain in both groups, whereas PD was not altered. In the test group, R decreased from 4.07 mm (SD+/-0.59) at baseline to 0.47 mm (SD+/-0.74) at 24 months, corresponding to a mean root coverage (MRC) of 90.67%, whereas in the control group R shrank from 4.13 mm (SD+/-0.74) at baseline to 0.60 mm (SD+/-0.83) at 24 months (MRC=86.67%). Complete root coverage was achieved at 24 months in 73.33% and 60% of the two groups. A significant KT increase was observed in both groups. CONCLUSIONS: Root coverage outcomes were similar in both groups and no statistically significant differences were found at all between them. Hence, the additional use of EMD to CAF is not justified for clinical benefits of root coverage, but as an attempt of achieving periodontal regeneration rather than repair. Copyright (c) Blackwell Munksgaard, 2005. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to assess the ability of enamel matrix derivative (EMD) to improve root coverage with a coronally advanced flap (CAF) during a 2-year follow-up. Methods: Fifteen patients each with two single and similar bilateral Miller Class I or II gingival recessions (30 recessions) were selected. Each recession was randomly assigned to the test group (CAF+EMD) or the control group (CAF only). Clinical parameters recorded at baseline and at 6, 12 and 24 months were recession depth (R), recession width (WR), probing depth (PD), clinical attachment level (CAL) and keratinized tissue (KT). Results: Reduction of R resulted in a significant CAL gain in both groups, whereas PD was not altered. In the test group, R decreased from 4.07 mm (SD±0.59) at baseline to 0.47 mm (SD±0.74) at 24 months, corresponding to a mean root coverage (MRC) of 90.67%, whereas in the control group R shrank from 4.13 mm (SD±0.74) at baseline to 0.60 mm (SD±0.83) at 24 months (MRC=86.67%). Complete root coverage was achieved at 24 months in 73.33% and 60% of the two groups. A significant KT increase was observed in both groups. Conclusions: Root coverage outcomes were similar in both groups and no statistically significant differences were found at all between them. Hence, the additional use of EMD to CAF is not justified for clinical benefits of root coverage, but as an attempt of achieving periodontal regeneration rather than repair. [ABSTRACT FROM AUTHOR]

Abstract Objectives: The aim of this study is to evaluate early healing results of the palatal wound by comparing three different surgical procedures for harvesting a connective tissue graft: the single-incision (SI), the free gingival graft (FGG) and the trap-door (TD) techniques. Material and methods: 36 patients requiring a root coverage procedure were selected for treatment using a bilaminar technique and randomly assigned (12 per group) to the FGG, TD or SI groups. The size of the graft was standardised to 12 × 8 mm and the thickness ranged from 1 to 1.5 mm. The following parameters were recorded at 1, 2, 3, 4, 6 and 8 weeks postsurgery: immediate and delayed bleeding (iB, dB), sensibility (S), complete epithelialisation (CE), discomfort (D), and variation of feeding habits (FH). Results: The difference in CE between the SI and FGG groups was statistically significant at the third postoperative week (100% and 50%, respectively). The discomfort rate at the first week postsurgery was the same in the SI and TD groups (50% without discomfort), but results were statistically significant different in the FGG group (0% without discomfort). No significant differences were found between the three groups for the other parameters. Conclusions: Statistically significant differences were found between the SI and FGG techniques in terms of CE, which occurred faster in the SI group. The discomfort rate recorded for both SI and TD groups was significantly lower than for FGG group. No marked differences were noted between SI and TD procedures. The latter was confirmed by patient interviews. The results of this preliminary study have little statistical significance because of the limited number of patients but they represent an important basis for a comparative clinical study, with a larger sample of participants, which is currently in progress. [ABSTRACT FROM AUTHOR]

• The inertia is studied with reference to systems with significant penetration of renewable sources. • An online method for analysis and prediction of system inertia is proposed. • A Minimum Variance Harmonic Finite Impulse Response Filter is adopted to estimate the system inertia. • Numerical applications are proposed and discussed based on the actual data of the Italian transmission system. This paper deals with the inertia estimation of power systems in presence of significant contribution provided by renewable energy sources. The efforts to decommission conventional power plants and replace them with renewable resources could affect the robust and reliable operation of future power systems. The main issue related to the integration of renewable-based generation in the networks deals with the substitution of conventional synchronous generators connected to the grid and equipped by rotating masses, with converter-based generator which have not rotating masses, or they are decoupled by the grid due to the presence of interfacing power converters. Since the system inertia is the inherent ability of the online synchronous machines to oppose sudden changes in generation or load, the increasing share of renewable generators, such as wind and solar, the overall system inertia could decrease. This leading network operators to introduce new tools for monitoring the system inertia values, to contain them within admissible values, and to better prepare for different kinds of operational scenarios with undesired reduction of the system inertia. At this purpose, in this paper a tool for the analysis and prediction of inertia is proposed. The proposed method is based on a minimum variance harmonic finite impulse response and can consider the actual penetration of renewable energy sources. The proposed approach is tailored for online monitoring and exploits the real time measurements of relevant features of the network. The method is tested with actual data of the Italian Transmission Network and its effectiveness is studied by comparisons with some popular and well-established method of analysis and prediction. [ABSTRACT FROM AUTHOR]

[Display omitted] • A normalised method for Tyre Cavity Noise measurements is not available. • Based on an existing CPX method, a normalisation procedure was designed. • This method was used on 24 road surfaces, together with CPX and texture measurements. • Results show that TCN is correlated to road texture levels within the 100 mm band. • TCN measurements could represent an adequate tool for road surface monitoring. In this work, a protocol to study Tyre Cavity Noise (TCN) was developed. Using this new method, TCN was measured on 24 different road pavements, together tyre noise emission measured with the Close-Proximity (CPX) method and road texture measurements. The results were used to model the relationship between TCN and road surface parameters. The analysis shows that the Standard Reference Test Tyre's (SRTT) TCN is correlated to megatexture at low frequencies and that the correlation between TCN and outside noise emission is significant for frequencies lower than 1 kHz. The use of sensors placed inside the tyre for monitoring the acoustic performance of road pavements presents several advantages compared to the CPX method, such as a more compact design, lower cost and lower hazards both for the instrumentation and for other vehicles. [ABSTRACT FROM AUTHOR]

Analyzes various knee score rating systems which evaluates outcome of anterior cruciate ligament reconstruction among patients who underwent the procedure in the United States. Lysholm knee scoring scale as a subjective assessment of function; Cincinnati Knee Ligament Rating system's focus on activity-related symptoms and function; Sources of error in evaluation.

Sixty-five patients who consecutively underwent anterior cruciate ligament reconstruction were studied using four individual, categoric, knee score rating systems. Different results were noted at followup (mean, 35 months; range, 24 to 58) depending on the rating method used. All patients were graded using the Hospital for Special Surgery, Lysholm, Tegner activity, and Cincinnati Knee Ligament rating systems. The Cincinnati Knee Ligament rating individual scores were noted to be lower than the Hospital for Special Surgery and Lysholm scores for subjective and objective outcome assessment. The Hospital for Special Surgery and Lysholm scores did not correlate highly with the Cincinnati Knee Ligament rating final rating, but they did correlate with each other. The use of ligament rating scores tended to inflate results, particularly when raw scores were converted to overall categoric ratings (e.g., excellent, good). The Cincinnati Knee Ligament rating system correlates more highly with individual grading and most precisely defines outcome in athletically active patients. Sources of error may be introduced by a disproportionate combination of unrelated scores or by overrating low-activity-level individuals who avoid stressing their knees. Avoidance of data generalization remains the optimal method for studying anterior cruciate ligament surgery outcome. [ABSTRACT FROM AUTHOR]

Determines and compares the results of arthroscopic treatment of anterior cruciate ligament deficiency using pes anserine tendons in a consecutive series of patients with acute and chronic deficiency. Subjective assessments; Anterior patellofemoral pain assessment; Physical examinations; Ligament testing; Instrumented testing; Post-operative complications.

Fifty anterior cruciate ligament-deficient knees treated consecutively with arthroscopically assisted reconstruction using a pes anserine tendon autograft were retrospectively studied. The mean followup was 36.7 months (range, 26 to 58). All patients had reconstruction with a double-stranded graft. The mean injury to surgery interval was 9.6 days in 22 patients (acute group) and 22.5 months in 28 patients (chronic group). Objective outcome, which was noted to be more optimal in the acute group, was better than subjective outcome in either group. Examination revealed 95% of patients treated acutely and 82% of those treated later to have 1 + or less Lachman test result (P < 0.036) and 96% of the acute group and 82% of the chronic group to have an absent pivot shift (P < 0.036). Eighty-eight percent of acutely treated patients had a KT-1000 result of < or = 3 mm, as compared to 61% of chronically treated patients (P < 0.001). Loss of range of motion was significantly greater in the acute group (P < 0.018). Using a strict overall rating system, patients reconstructed earlier were noted to have a better outcome compared to those after delayed reconstruction (P < 0.021). Cumulative meniscal injury appears to be the most significant contributing factor. [ABSTRACT FROM AUTHOR]

GNSS (Global Navigation Satellite System) receivers are not only able to accurately determine position, but also velocity, knowledge of which could be important in several applications. The most adopted technique for velocity estimation exploits the Doppler shift due to the relative motion between the signal source and the receiver. Alternatively, the TDCP (Time-Differenced Carrier Phase) technique, based on the differences between consecutive carrier-phase measurements, can be used. TDCP is theoretically able to achieve better performance compared with the Doppler-based approach, exploiting the high precision of a carrier-phase observable, and without suffering the ambiguity issue. The main objective of this study is to analyze TDCP performance on a smartphone GNSS chip. Smartphones GNSS receivers are usually characterized by noisy observables owing to the low quality of the antenna used; it is, therefore, interesting to compare the smartphone TDCP performance with that of the Doppler-based technique. To evaluate the benefits that TDCP can provide, especially in terms of the smartphone chip, these two approaches to velocity determination are compared using three different devices: a Novatel geodetic receiver, a u-blox multi-frequency receiver, and a Xiaomi Mi8 smartphone. The results demonstrate a performance degradation in the smartphone GNSS chip when TDCP is used, compared with the performance of higher-grade receivers. In fact, the Xiaomi Mi8 maximum errors are greater than those of the Novatel geodetic receiver, but they are still acceptable as they do not exceed 6 cm/s, making the TDCP technique a valid approach for advanced algorithms; indeed, TDCP velocity demonstrates a few mm/s accuracy with a smartphone. The application of a RAIM algorithm enables error reduction and the achievement of reliable information; the obtained solution reliability is about 89%. [ABSTRACT FROM AUTHOR]

Background: Pyogenic granulomas are acquired, benign growths of capillary blood vessels that are commonly seen in the pediatric population. Patients with these lesions often present to emergency departments and urgent care centers with persistent bleeding after minor trauma. Much of the published literature describing the management of pyogenic granulomas, however, is focused on outpatient or definitive therapies, and there is limited information on the management of acute bleeding.Objective: We conducted a narrative review to present and evaluate strategies and therapies available to emergency physicians for managing actively bleeding pyogenic granulomas in acute care settings.Discussion: Multiple options are available to emergency physicians to achieve hemostasis. Direct pressure with a nonadherent dressing remains first-line treatment. Additional therapeutic options, such as dressings impregnated with topical vasoconstrictors or hemostatic dressings or agents, can be used if bleeding persists. Certain approaches-silver nitrate, suture ligation, or electrocautery-may be available to some emergency physicians. These therapies, however, can compromise future histologic analysis of tissue for definitive diagnosis and have potential risks.Conclusion: Although there are multiple options to achieve hemostasis in cases of bleeding, some treatments may lead to suboptimal cosmesis or interfere with future management. Many bleeding pyogenic granulomas will become hemostatic with treatments available to emergency physicians. Surgical consultation may be warranted for pyogenic granulomas that are unresponsive to the therapies described in this review. [ABSTRACT FROM AUTHOR]

The article presents the case study of a 14-year-old female who presented to the emergency center with a complaint of abdominal pain, distention and worry for pregnancy. According to the patient's medical history, she had bipolar disorder and scoliosis. Several factors that complicate the social history of the patient include frequent foster home changes, physical abuse, and sexual abuse. She was diagnosed of having pseudocyesis and gastritis.

Cystic Fibrosis (CF) is a genetic disease inherited by an autosomal recessive mechanism and characterized by a progressive and severe multi-organ failure. Mutations in Cystic Fibrosis Conductance Regulator (CFTR) protein cause duct obstructions from dense mucus secretions and chronic inflammation related to organ damage. The progression of the disease is characterized by a decline of lung function associated with metabolic disorders and malnutrition, musculoskeletal disorders and thoracic deformities, leading to a progressive decrement of the individual's quality of life. The World Health Organization (WHO) qualifies Physical Activity (PA) as a structured activity produced by skeletal muscles' movements that requires energy consumption. In the last decade, the number of studies on PA increased considerably, including those investigating the effects of exercise on cognitive and brain health and mental performance. PA is recommended in CF management guidelines, since it improves clinic outcomes, such as peripheral neuropathy, oxygen uptake peak, bone health, glycemic control and respiratory functions. Several studies regarding the positive effects of exercise in patients with Cystic Fibrosis were carried out, but the link between the effects of exercise and cognitive and brain health in CF remains unclear. Animal models showed that exercise might improve learning and memory through structural changes of brain architecture, and such a causal relationship can also be described in humans. Indeed, both morphological and environmental factors seem to be involved in exercise-induced neural plasticity. An increase of gray matter volume in specific areas is detectable as a consequence of regular training in humans. Neurobiological processes associated with brain function improvements include biochemical modifications, such as neuromodulator or neurohormone release, brain-derived neurotrophic factor (BDNF) production and synaptic activity changes. From a functional point of view, PA also seems to be an environmental factor enhancing cognitive abilities, such as executive functions, memory and processing speed. This review describes the current state of research regarding the impacts of physical activity and exercise on cognitive functions, introducing a possible novel field of research for optimizing the management of Cystic Fibrosis. [ABSTRACT FROM AUTHOR]

The paper firstly summarizes a simple analytical model of the air gap flux-density distribution for isotropic permanent magnet (PM) synchronous machines, in the presence of static eccentricity. The model was proposed by the authors in a previous paper and is based on an efficacious analytical expression of the variable length of air gap magnetic field lines which occur in eccentric brushless machines with surface-mounted permanent magnets. The approximate expression of the air gap field makes it possible to achieve a mathematical model with concentrated parameters close to that of a PM machine without eccentricity. The expression of the armature voltages and electromagnetic torque are found, also with reference to steady-state operating conditions at fixed rotor speed and impressed currents. The differences introduced by the considered type of eccentricity are evaluated and highlighted especially with reference to the air gap inductance and to waveforms and frequency spectra of voltages and shaft torque. Numerical results in a case-study of an 8-pole, 110 kW PM motor are compared to those obtained by using finite element analysis. [ABSTRACT FROM AUTHOR]

Road traffic noise is the most common source of environmental pollution in urban areas and therefore, the study of noise mitigation actions is fundamental for urban planning. The main source of road traffic noise is tyre/road interaction; thus, the use of low noise road surfaces represents an optimal solution for its mitigation. Several studies tried to find a correlation between road texture and broadband noise data, trying to provide guidelines for the development of acoustically optimised road surfaces. The present work studies the correlation between road texture and tyre/road noise from an experimental point of view, by analysing texture and noise spectra on ten different road surfaces. Tyre deformation has also been addressed by analysing two already existing tyre envelopment algorithms. The first algorithm, proposed by Von Meier and based on the limitation of the second order derivative of the profile signal, shows poor correlation with high frequency noise, while the second algorithm, based on a novel method proposed by Sandberg and Goubert and called indenter method, enhances correlation with low frequency noise and preserves information at higher frequencies. Correlation patterns show that rolling noise can be separated in three main contributions: low, middle and high frequency noise. Finally, experimental tyre/road noise and enveloped texture data obtained with the indenter algorithm have been used to elaborate a linear model that relates low and high frequency noise to texture one-third octave bands. This model deepens knowledge on tyre/road interaction. [ABSTRACT FROM AUTHOR]

The paper is focused on the formalization of an experimental procedure aimed to characterize the efficiency behaviour of a Permanent Magnet Synchronous Motor-based drive. The characterization is intended to expose the analytical behaviour of the system efficiency by the actual operating condition assigned through torque/speed value. The availability of such a relation in a simple analytical form would allow for real-time adjustment by advanced power management strategies to maximize the whole system efficiency. The proposed method is based on a defined set of measures corresponding to several drive operating conditions. A straightforward elaboration procedure is then formulated with the aim to quantify the different parameters, which intervene in the efficiency characterization. The method has been applied on a 155 kW drive. The results show that good accuracy is achieved while keeping the analytical approach relatively simple. [ABSTRACT FROM AUTHOR]

Despite low energy and fuel consumption levels in the rail sector, further improvements are being pursued by manufacturers and operators. Their primary efforts aim to reduce traction energy demand, replace diesel, and limit the impact of electrified overhead infrastructures. From a system‐level perspective, the integration of alternative energy sources on board rail vehicles has become a popular solution among rolling stock manufacturers. Surveys are made of many recent realizations of multimodal rail vehicles with onboard electrochemical batteries, supercapacitors, and hydrogen fuel cell systems. The ratings, technical features, and operating data of onboard sources are gathered for each application, and a comparison among different technologies is presented. Traction system architectures and energy‐control strategies of actual multimodal units are explored and compared with literature research. Moreover, the maturity and potential of recent technologies and alternative topologies of power converters for multimodal traction systems are discussed. Ultimately, onboard storage systems are compared with other solutions for energy‐saving and catenary‐free operation, with particular focus on their current techno‐economic attractiveness as an alternative to diesel propulsion. [ABSTRACT FROM AUTHOR]

In recent years the aerospace industry has made a growing effort to develop a quieter and more environmentally friendly aircraft. In particular, several research activities have been focused on innovative solutions aimed at the design/optimization of an on-board electric system fully compatible with this new approach. A first important step in the evolution towards an All Electric Aircraft (AEA) is the replacement of the hydraulic actuators with fully electric ones. The transition process is not easy to carry out, since weight, size and reliability represent highly critical issues for aircraft applications. In this context, the significant improvements in semiconductor technologies can be exploited as a critical means to overcome the constraints mentioned. Indeed, this work proposes a Silicon Carbide (SiC) based Power Factor Correction (PFC) converter, whose design and control have been tailored in order to properly supply a wide range of on-board Electro-Mechanical Actuators (EMA). In particular, while the adopted circuit topology allows for power factor correction and bi-directional power flow, the SiC technology, thanks to the higher efficiency with respect to other semiconductor-based technologies, leads to a significant reduction in the overall system weight/volume. Furthermore, to meet the strict requirements in terms of dynamic and steady state performance imposed by the application, a novel adaptive regulator is conceived. A reduced-scale laboratory prototype of the SiC-based converter (3 kVA) is realized in order to verify the effectiveness of the proposed design and control approach. [ABSTRACT FROM AUTHOR]

The paper deals with a grid-connected single-phase battery charger integrated with photovoltaic generators (PVGs). The circuit topology consists of a multilevel architecture based on a Cascaded H-Bridge (CHB) rectifier. Its main task is to charge the batteries, primarily from the PVGs, by also assuring to keep their state-of-charge (SOC) balanced. Nevertheless, when the battery SOC overcomes a predefined upper limit, beyond which the charging process could be interrupted, the available PV power can no longer be transferred to the batteries. Therefore, to avoid an undesired curtailment of PV power production, this latter can be supplied to the grid by inverting the system operation. The paper shows how to achieve this result by implementing a dedicated control action based on a multi-step procedure. Numerical investigations are carried out on a 19-level CHB converter implemented in the PLECS environment to validate the feasibility and effectiveness of the proposed control technique. [ABSTRACT FROM AUTHOR]

Punta Licosa promontory is located in the northern part of the Cilento coast, in the southern Tyrrhenian basin. This promontory is bordered by sea cliffs connected to a wide shore platform sloping slightly towards the sea. This area has been considered stable at least since Late Pleistocene, as testified by a series of evidence well known in the literature. The aim of this research is to reconstruct the main coastal changes that have occurred in this area since the middle Holocene by means of the literature data, aerial photo interpretation, satellite images, GPS measurements, direct underwater surveys, GIS elaborations of high-resolution DTMs, bathymetric data and high-resolution orthophotos taken by UAV. Particular attention was paid to the wide platform positioned between −7.2 ± 1.2 m MSL and the present MSL, this being the coastal landform interpreted as the main consequence of sea cliff retreat. The elevation of this landform was compared with the GIA models calculated for the southern Tyrrhenian area, allowing establishing that it was shaped during the last 7.6 ± 1.1 ky BP. Moreover, the interpretation of archaeological and geomorphological markers led to the reconstruction of the shoreline evolution of this coastal sector since 7.6 ky BP. This research evaluates the cliff retreat under the effect of Holocene RSL variation on Cilento promontories, located in the western Mediterranean and characterised by the presence of monophasic platforms, and the applied method can be considered more effective and less complex and expensive if compared to other effective approaches such as those based on the usage of cosmogenic nuclides. [ABSTRACT FROM AUTHOR]

This study deals with direct torque control (DTC) of induction motor drives when a multilevel inverter is involved. The proposed control technique is finalised to reduce the amplitude of torque oscillations and to improve the motor dynamic response regardless of operating speed conditions while assuring a satisfactory input current distortion. This is achieved by using a special look‐up‐table built with a novel approach. The control itself is based on the application in each sampling interval of one or two voltage vectors suitably selected, in order to ensure low electromagnetic torque ripple in steady‐state operations and fast dynamic behaviour in transient operations. In the algorithm, the converter voltage vectors selection is carried out by using a novel look‐up table whose entry points are computed by means of a specialised relation, starting from the outputs of multilevel hysteresis controllers. The suggested method, suitable for a generic multilevel inverter, is detailed for a neutral point clamped three‐level inverter. The proposed algorithm is validated by several numerical results, and compared with a DTC algorithm based on a traditional three‐speed range look‐up tables. Finally, some experimental results, obtained with a scale laboratory setup, are shown, discussed and compared with the numerical ones. [ABSTRACT FROM AUTHOR]

The paper deals with the control of three-phase voltage source rectifiers (VSRs) with an arbitrary number of voltage levels. By means of an approach borrowed from the “Direct Torque Control” of AC drives, the paper presents an enhanced direct power control (DPC) strategy for VSRs which directly controls both active ( P ) and reactive ( Q ) line power by considering the values of their time derivatives. This control strategy can be applied both to the Neutral Point Clamped and to Cascaded H-bridge multilevel converters. In every sampling interval the proposed control technique is able to select the most suitable converter voltage vector to obtain good dynamic response and to maintain P and Q within their respective reference bands. This result is achieved in the different operating conditions by means of a Dynamic Look-Up Table (D-LUT) of the converter voltage vectors, which are ordered on the basis of their influence on P and Q time derivatives. The mentioned D-LUT depends on the instantaneous operating point and is not predetermined. Some significant operating conditions are numerically investigated in order to show the capability of the modified DPC technique to ensure good values of power quality indexes for the grid. Experimental results on a laboratory setup based on a three-level VSR show good accordance with the simulation ones. [ABSTRACT FROM AUTHOR]

Simple Summary: The high incidence and death rates of breast cancer make the development of new therapies an urgent need. The introduction into the clinic of the anti-HER2 monoclonal antibody trastuzumab considerably improved the overall survival and time-to-disease progression of patients with HER2-positive breast cancer. However, many patients do not benefit from it because of resistance to therapy. Cancer vaccines, by inducing into the patient an anti-cancer specific immunity, might represent an alternative immunotherapeutic approach, but despite promises, so far no anti-HER2 cancer vaccine has been approved for human use. In this study, we propose therapeutic phage-based vaccines, against HER2 and its aggressive isoform Δ16HER2, able to elicit a protective immunity and potentially capable of preventing relapse in HER2-positive breast cancer patients, even in those who develop trastuzumab resistance. The advent of trastuzumab has significantly improved the prognosis of HER2-positive (HER2+) breast cancer patients; nevertheless, drug resistance limits its clinical benefit. Anti-HER2 active immunotherapy represents an attractive alternative strategy, but effective immunization needs to overcome the patient's immune tolerance against the self-HER2. Phage display technology, taking advantage of phage intrinsic immunogenicity, permits one to generate effective cancer vaccines able to break immune tolerance to self-antigens. In this study, we demonstrate that both preventive and therapeutic vaccination with M13 bacteriophages, displaying the extracellular (EC) and transmembrane (TM) domains of human HER2 or its Δ16HER2 splice variant on their surface (ECTM and Δ16ECTM phages), delayed mammary tumor onset and reduced tumor growth rate and multiplicity in ∆16HER2 transgenic mice, which are tolerant to human ∆16HER2. This antitumor protection correlated with anti-HER2 antibody production. The molecular mechanisms underlying the anticancer effect of vaccine-elicited anti-HER2 antibodies were analyzed in vitro against BT-474 human breast cancer cells, sensitive or resistant to trastuzumab. Immunoglobulins (IgG) purified from immune sera reduced cell viability mainly by impairing ERK phosphorylation and reactivating retinoblastoma protein function in both trastuzumab-sensitive and -resistant BT-474 cells. In conclusion, we demonstrated that phage-based HER2 vaccines impair mammary cancer onset and progression, opening new perspectives for HER2+ breast cancer treatment. [ABSTRACT FROM AUTHOR]

Container ships emit airborne noise that can vary significantly due to diverse vessel characteristics and operating conditions. This study aims to investigate the factors influencing noise emission from container ships moving in ports to enhance our understanding and improve noise prediction models. Using a dataset comprising long-term sound pressure level measurements, video recordings, and weather station data, a multiple regression analysis was conducted to assess the impact of static (ship-specific) and dynamic (pass-by specific) variables on noise emission. Static variables included ship dimensions and age, while dynamic variables encompassed distance from the microphone, speed, and draught. A k-means unsupervised clustering analysis was performed using 1/3rd octave band spectra to identify subcategories of container carriers based on sound emission characteristics. Significant correlations between emissions and both static and dynamic variables were found. The k-means clustering analysis yielded distinct subcategories of container carriers based on their sound emission profiles. This study highlights the importance of considering various factors, including ship characteristics and operating conditions, when assessing noise emission from container ships. By better understanding the factors contributing to noise emission, we can effectively mitigate noise pollution and minimize the impact on surrounding communities. • Airborne noise emissions from container ships moving in ports can be impactful on population. • Detailed sound power levels and 1/3rd octave band spectra have been calculated for different vessels' categories. • A multiple regression analysis investigated the effect of ship-specific and pass-by specific variables on emissions. • K-means unsupervised clustering identified subcategories of container carriers based on sound emission characteristics. • Vessel characteristics and operating conditions are important parameters for large such sound emitters. [ABSTRACT FROM AUTHOR]

What's known on the subject? and What does the study add? Nephron-sparing surgery is now the gold standard for the treatment of small renal masses. Robotic partial nephrectomy represents an emerging minimally-invasive option for nephron-sparing surgery. Initial case series have described the evolution of technique and perioperative outcomes. This review summarizes recent case series regarding robotic partial nephrectomy and provides an analysis of studies comparing robotic partial nephrectomy to laparoscopic partial nephrectomy. Exciting technical advances are centered around reducing ischemia time. Finally, future directions for robotic partial nephrectomy include options for cold ischemia, real-time integration of radiographic imaging, and advancements in robotic technology. OBJECTIVE [ABSTRACT FROM AUTHOR]

The objective of this work is the evaluation of the performances of EGNOS (European Geostationary Navigation Overlay System) augmentation system in maritime navigation by comparing them with those obtained by other positioning methods as Single Point Positioning (SPP) and Differential Global Positioning System (DGPS). Preliminarily, EGNOS performances in an open-sky context were evaluated through static data downloaded by EGNOS RIMS (Ranging and Integrity Monitoring Stations) located in Rome. Then, for the maritime test carried out onboard a boat in the Gulf of Naples, two dual-frequency receivers were used: Xiaomi Mi 8 smartphone and u-blox ZED-F9P multi-band GNSS (Global Navigation Satellite System) receiver, both in kinematic mode. At last, IMO (International Maritime Organization) requirements, established in IMO Resolution A.1046 (27), that a SBAS (Satellite Based Augmentation System) system in particular scenarios (coastal, inland-water, harbor navigation and ocean waters) must respect, were verified. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To report the feasibility of the laparoscopic approach for management of xanthogranulomatous pyelonephritis (XGP). Methods: From 2002 to 2005, 11 patients underwent laparoscopic (n = 7) or hand-assisted laparoscopic (n = 4) nephrectomy by a single surgeon for pathologically confirmed XGP. The preoperative presentation, operative details, postoperative recovery, and complications were recorded. Results: A total of 5 men and 6 women were included in this study, and the mean patient age was 51 years (range 28 to 78). All cases began with the laparoscopic approach (6 left and 5 right). Four cases were converted to the hand-assisted technique because of the difficulty in progression, but no case required conversion to open nephrectomy. The mean operative time was 157 minutes (range 101 to 201), with a mean estimated blood loss of 217 mL (range 50 to 440). No intraoperative complications occurred. The mean hospital duration was 2.4 days (range 1.5 to 4). Four patients had postoperative complications, including two with an ileus, one with a persistent fever requiring intravenous antibiotics, and one with a renal fossa abscess requiring percutaneous drainage. All specimens were pathologically confirmed to be XGP. Conclusions: Laparoscopic nephrectomy for XGP is complicated and more technically demanding than the laparoscopic nephrectomy for noninfectious etiologies. Consideration should be made for using a hand port should the laparoscopic procedure fail to progress in a satisfactory manner. In experienced hands, the laparoscopic approach presents a reasonable surgical option for the treatment of XGP. For the novice laparoscopist, however, the open approach should remain the modality of choice. [Copyright &y& Elsevier]

Percutaneous ablation is an established alternative to surgical intervention for small renal masses. Radiofrequency and cryoablation have been studied extensively in the literature. To date, series assessing the efficacy and safety of microwave ablation (MWA) are limited. We present a cohort of 110 renal tumors treated with MWA. A review of the medical record between January 2015 and July 2019 was performed, retrospectively identifying 101 patients (110 tumors). All ablations were performed by a single board-certified urologist/interventional radiologist. Demographic information, intraoperative, postoperative, and follow-up surveillance data were recorded. Median (IQR) age was 69.7 years (60.8–77.0); 27 (24%) were female. Median (IQR) BMI was 27.0 (25.1–30.2) and Charleston Comorbidity Index was 5.0 (4.0–6.0). 82 tumors were biopsy-confirmed renal cell carcinoma/oncocytic neoplasms. Median (IQR) tumor size was 2.0 cm (1.5–2.6). Median (IQR) RENAL nephrometry score was 6.0 (5.0–8.0). Technical success was achieved in all patients and all but one patient were discharged on the same day. Median (IQR) eGFR at baseline and 1 year were 71.9 mL/min/1.73 m2 (56.5–82) and 63.0 mL/min/1.73 m2 (54.0–78.2); the difference was −5.3 (p = 0.12). Two Clavien-Dindo type-I complications, one type-II complication, and one type-III complication were experienced in this cohort. Median radiographic follow-up was 376.5 days with 2 tumors (2.4% of RCC/oncocytic neoplasms) having recurred to date. MWA is a safe and efficacious treatment option for small renal masses with minimal adverse events and low rates of recurrence in this cohort of 101 patients. Continued follow-up is needed to assess long-term outcomes. • Microwave ablation is comparably as safe with similar complication rates as other thermal ablation techniques. • Microwave ablation of small renal masses has local recurrence rates similar to other thermal ablation techniques. [ABSTRACT FROM AUTHOR]

Introduction: Kidney transplant candidates are occasionally found during the pre-transplant evaluation to have a suspicious mass in a native kidney. Further work-up and management of such a mass may delay transplantation for several months, which may create logistic barriers to transplant, particularly if there are timing constraints of the donor. In this study, we report our experience with simultaneous living donor kidney transplant and laparoscopic native nephrectomy, where the indication for nephrectomy was a suspicious lesion. Methods: We performed a retrospective review of patients who underwent simultaneous kidney transplant and native nephrectomy using prospectively collected data. We analyzed relevant patient characteristics, surgical details, pathologic results, and long-term follow-up. Results: We identified 16 patients who underwent simultaneous living donor kidney transplantation and laparoscopic native nephrectomy at our institution between 2013 and 2018. Ten (62.5%) patients were found to have renal-cell carcinoma (RCC) on the final pathology. No patients had recurrent RCC, at a median follow-up of 4 years. Conclusion: For patients who are planning to undergo a living donor kidney transplant and are found to have a small mass that is suspicious for RCC, a simultaneous living donor kidney transplant and laparoscopic native nephrectomy is a possible approach in selected patients. [ABSTRACT FROM AUTHOR]

Purpose: To identify clinical and non-clinical predictors of treatment failure and perioperative complications following ureterorenoscopy versus shockwave lithotripsy. Methods: The New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) database was used to identify 226,331 patients who underwent index ureteroscopy or shockwave lithotripsy for renal stones from 2000 to 2016. Propensity-matched generalized linear-mixed modeling was utilized to compare failure and complication rates between the two procedure groups. Results: 219,383 individuals meeting inclusion criteria who underwent either ureterorenoscopy (n = 124,342) or shockwave lithotripsy (n = 95,041) in New York State between 2000 and 2016 were included in our analysis. After propensity score matching, patients undergoing shockwave lithotripsy were found to have decreased odds of experiencing any type of 30-day complication (P < 0.001 for all) but increased odds of treatment failure at both 90 (OR 1.70, 95% CI 1.64–1.77) and 180 (OR 1.83, 95% CI 1.76–1.89) days (P < 0.001 for both). Conclusion: Patients undergoing shockwave lithotripsy experienced significantly higher odds of treatment failure, although this undesirable outcome appears to be partially offset by lower 30-day complication rates. [ABSTRACT FROM AUTHOR]

The impact of granular microstructure on permanent magnets on eddy current losses is investigated. A numerical homogenization procedure for electrical conductivity is defined. Then, an approximated simple analytical model for the homogenized conductivity able to capture the main features of the geometrical and material dependences is derived. Finally, analytic calculations of eddy current losses are given, and the two asymptotic expressions for losses in the stationary conduction limit and advanced skin effect limit are derived and discussed. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a communicable pulmonary disease that still nowadays remains one a major cause of ill health, ranking one of the top 10 causes of death worldwide. Also, it is the leading cause of death from a single infectious agent rating above HIV/AIDS. According to the World Health Organization, almost 10 million people fell ill with TB in 2019, with an estimated 1.4 million deaths globally. Unfortunately, the number of infected people decreases slowly every year as well as current therapeutical strategies are showing their limitations due to multi-drug resistant strains. Totally effective vaccines are still not available. Moreover, the origin and the evolution of TB is still not fully understood. Therefore, understanding its origins and history is a relevant issue to assess this medical problem from an evolutionary perspective. The principal causative organism of TB is Mycobacterium tuberculosis, an obligate pathogen that is a member of the M. tuberculosis complex (MTBC) which is mainly spread by air. The disease typically affects the lungs but can also affect other sites (extrapulmonary TB). Of those, the most common and characteristic are the skeletal changes affecting the spine, such as Pott's disease. The bacilli locate in the anterior portion of the vertebral bodies (mainly at the thoracic tract). Afterward, these lesions can cause vertebral collapse (from one to three in most cases) and fusion of the vertebrae themselves producing the curved spine known as Pott's disease. This condition which results from the exaggeration of the physiological kyphosis of the thoracic spine was named after Sir Percivall Pott (1714-1788) who, as a surgeon at St Bartholomew's Hospital in London, first described it in 1779. Moreover, Pott's disease might be identified studying the morphology and shape of the gibbus in which there is loss of function in the lower limbs due to damage to the spinal column. Therefore, studying the skeletal remains dating back thousands of years could be very important in order to better understand the evolution and the mechanism of infection of TB. Here, we offer a comprehensive review of the history of Pott disease as well a full contextualization of Pott's disease in the ancient times. [ABSTRACT FROM AUTHOR]

A large part of the archaeological remains still to be discovered and excavated are not in remote and depopulated areas of the earth but are often beneath urban centres that have buried them with centuries of debris and later constructions. Excavating in these contexts is much more complex than digging in rural or sparsely inhabited areas because of the constraints imposed by existing buildings and infrastructure. It should also be considered that within an urbanised area, any archaeological remains are concentrated in the subsoil of the historic centre, which is, therefore, often surmounted by buildings that are more recent than the remains but historical as well, and thus, of considerable value and vulnerability. For this reason, an archaeological excavation in an urban area must be preceded by a real feasibility study, where the potential risks for the structures above are minimised and accurately quantified. In many situations, as in the case under study, the discovery of a small segment of a structure is the only clue to reconstruct the development of the remaining part still to be excavated, which may stretch tens or hundreds of metres away from the measurable part. As a consequence, an error of a few centimetres in the survey of the excavated part can lead to errors of metres in estimating the positions of the far parts still to be excavated, and this, in many cases, as in the one under study, must absolutely be avoided. In practice, high-precision geomatic surveys, in support of the archaeological and historical interpretation of the observable structures, will help to establish the exact locations to possibly continue the excavations, helping the accurate planning of the excavation itself. Here, we have shown how the various techniques, compared to each other, have made it possible to reconstruct the location of a short stretch (less than 7 m) of the Emperor Augustus' Sundial, the only currently visible evidence of a scientific instrument of imposing dimensions (tens of metres in length and height) that served to define some of the characteristics of the calendar that we still use today. The portion of the sundial currently observable, according to the most reliable hypotheses, is located approximately at one end of a structure and extends for several tens of metres. The accurate positioning of the observable parts in a geodetic reference system will enable to identify with certainty the possible areas in which excavation may continue and will also allow to accurately reconstruct the principle of operation of the sundial through an approach that could be defined as "reverse engineering" of the scientific instrument itself. The aim of this work is to study and thus define the combination and integration of existing geomatic techniques for this specific field of application. [ABSTRACT FROM AUTHOR]

• The use of low-noise surfaces is the best solution to mitigate tyre/road noise. • Green Public Procurement (GPP) requires CPX measurements on new low-noise pavements. • Modelling CPX levels in function of the mix properties is necessary to reduce costs. • Two models were elaborated, using two frequency separations for tyre/road noise. • The variables used are related to volumetric and composition properties of the mix. Road traffic in urban contexts produces noise mainly by the interaction of tyres with pavement surface and, therefore, the use of low-noise surfaces represents the best solution since they aim to mitigate the source. Moreover, in urban contexts it is often the only viable solution, together with a careful traffic planning. The main challenge in their adoption as noise mitigation actions is to be able to forecast the acoustical performances that the new road surface will be able to offer. In the UE, the new Green Public Procurement requires experimental verification of noise performance compliance: the designer must declare the acoustical performance of the proposed low-noise pavement and, a few months after the laying, the actual performance of the road surface must be tested using the Close Proximity Method (CPX). Due to the importance of being able to forecast CPX levels, the present work reports a novel way to model CPX broadband levels of newly laid low-noise road surfaces using only data available to the designer before the laying or easily obtained through coring tests, such as grading curve, fractal dimension, asphalt binder content, air voids, voids in mineral aggregates. Two models were elaborated, using two different frequency separations for tyre/road noise. The first model separates low and high frequency contributions, while the second one also considers noise around 1 kHz separately, using a three-band model. Both models are capable of forecasting the acoustic performance of newly laid low-noise road surfaces, using different road mixture parameters at different frequency ranges. The three band model shows a lower RMSE. [ABSTRACT FROM AUTHOR]

Purpose: To validate prognostic factors and determine the impact of obesity, hypertension, smoking and diabetes mellitus (DM) on risk of recurrence after surgery in patients with localized renal cell carcinoma (RCC). Materials and methods: We performed a retrospective cohort study among patients that underwent partial or radical nephrectomy at Weill Cornell Medicine for RCC and collected preoperative information on RCC risk factors, as well as pathological data. Cases were reviewed for radiographic evidence of RCC recurrence. A Cox proportional-hazards model was developed to determine the contribution of RCC risk factors to recurrence risk. Disease-free survival and overall survival were analyzed using the Kaplan-Meier method and log-rank test. Results: We identified 873 patients who underwent surgery for RCC between the years 2000–2015. In total 115 patients (13.2%) experienced a disease recurrence after a median follow up of 4.9 years. In multivariate analysis, increasing pathological T-stage (HR 1.429, 95% CI 1.265–1.614) and Nuclear grade (HR 2.376, 95% CI 1.734–3.255) were independently associated with RCC recurrence. In patients with T1-2 tumors, DM was identified as an additional independent risk factor for RCC recurrence (HR 2.744, 95% CI 1.343–5.605). Patients with DM had a significantly shorter median disease-free survival (1.5 years versus 2.6 years, p = 0.004), as well as median overall survival (4.1 years, versus 5.8 years, p<0.001). Conclusions: We validated high pathological T-stage and nuclear grade as independent risk factors for RCC recurrence following nephrectomy. DM is associated with an increased risk of recurrence among patients with early stage disease. [ABSTRACT FROM AUTHOR]