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An archaeological watching brief was undertaken by Cotswold Archaeology during the excavation of a new service trench at the site. A possible surface, a wall and a make-up deposit of Roman date were identified at the base of the trench In November 2019, Cotswold Archaeology carried out an archaeological watching brief during groundworks associated with the excavation of a new service trench at the Earle & Ludlow Site, 77 Victoria Road, Cirencester, Gloucestershire. A possible surface, a wall and a made ground deposit of Roman date were identified during the monitored groundworks.

L’evoluzione tardo-quaternaria della Piana Campana (Campania, Italia) è stata condizionata dall’attività vulcanica dei Campi Flegrei il cui prodotto più diffuso è il Tufo Grigio Campano (TGC, ~39 ka), depositatosi sull’intera Piana. Viene qui presentata la ricostruzione delle caratteristiche geologiche del TGC tra la porzione settentrionale della Città Metropolitana di Napoli e il bordo meridionale della provincia di Caserta. Le buone caratteristiche meccaniche di questo materiale hanno fatto sì che esso fosse oggetto di escavazioni in sotterraneo sin da tempi antichi. Un fitto network di cavità è stato eredi-tato dai centri urbani che si sono sviluppati in questo territorio. Viene proposto un primo database degli aspetti geologici del sottosuolo e delle cavità riconosciute relativi alla porzione meridionale della provincia di Caserta e che rappresenta una integrazione ed implementazione di quello realizzato da ISPRA per la Città Metropolitana di Napoli. Sono stati inoltre analizzati, in via preliminare, gli aspetti di rischio per le aree urbane legati all’estrazione di tufo nel sottosuolo ed il possibile legame con lo sviluppo dell’urbanizzazione nel tempo. The Late Quaternary geological evolution of the northern Campania Plain was affected by the volcanic activity of the Phlegrean Field. The geological features of the Campania Grey Tuff (CGT, ~39 Ky), deposited on the whole Campania Plain, were reconstructed across the northern metropolitan area of Naples and the southern part of the Campania Plain in the Caserta metropolitan area. Since the tuff has good mechanical properties, it was involved since historical times in an extensive mining activity, from which a very dense network of quarries and underground cavities was inherited, strongly related to the lithofacies distribution. We provided a first caves and geological underground database of the southern met-ropolitan area of Caserta, which represents an upgrade of the one designed by ISPRA for the Naples’ Metropolitan city. Furthermore, we analyzed the hazard aspects related to the mining activities and urban development through time.

In September 2020, Cotswold Archaeology carried out an archaeological evaluation Blackbridge Community Sports Hub, Podsmead, Gloucester. A total of five trenches were excavated. No archaeological remains were observed in any of the trenches.

This document was prepared for the CD2/3 Review on June 25 – 26, 2015.

The fieldwork followed the methodology set out within the WSI (CA 2019a). An archaeologist was present during intrusive groundworks comprising the hand and mechanical excavation of a shallow rafted foundation, typically 0.25m in depth with deeper groundworks penetrating to 0.38m in depth around the foundation perimeter (see Fig. 2). No archaeological deposits were encountered but written, graphic and photographic records were compiled of the observed deposit, in accordance with CA Technical Manual 1: Fieldwork Recording Manual. The archive from the watching brief is currently held by CA at their offices in Kemble and will be deposited with the Corinium Museum. A summary of information from this project, set out within Appendix B, will be entered onto the OASIS online database of archaeological projects in Britain. An archaeological watching brief was undertaken by Cotswold Archaeology during groundworks associated with construction of a two-storey extension at 23 Querns Lane, Cirencester, Gloucestershire. No features or deposits of archaeological interest were observed during the groundworks, and no artefactual material pre-dating the modern period was recovered.

Si offre una accurata panoramica dei risultati più rilevanti dei primi due anni di ricerche svolte nell'ambito del The Bisenzio Project

An archaeological evaluation was undertaken by Cotswold Archaeology in March 2019 within a southern parcel of land at Cribbs Causeway, South Gloucestershire. Ten trenches were excavated. An area of probable late prehistoric to Roman activity was identified within the north-western part of site, with deposits and linear features identified. These features potentially indicate an area of settlement or agricultural activity. An undated ditch and posthole were also identified in the eastern half of the site, whilst the presence of furrows was recorded in the southern part of site.

An archaeological evaluation was undertaken by Cotswold Archaeology between 23 April 2019 and 1 May 2019 on land south of Horwood Lane, Wickwar, South Gloucestershire. Thirty-eight trenches were excavated. A number of ditches and amorphous pits were identified throughout the site, with a single ditch potentially dating to the Roman period. The majority of features recorded dated to the post-medieval period and, coupled with the findings of preceding geophysical survey and studies of historic mapping, it is likely that the features represent post-medieval field boundaries and agricultural activities.

An archaeological evaluation was undertaken by Cotswold Archaeology in January 2018 on land at Wingmoor Farm, Long Marston, Warwickshire. Three trenches were excavated. Remains of north-south aligned ditches were identified in both the northern and southern areas of the site. A large and undefined spread was found across toward the western extent of the site which may also represent a dense area of pits or ditches. The artefacts recovered from the excavated ditches and spread were dated to the 12th to 13th centuries.

An archaeological evaluation was undertaken by Cotswold Archaeology in March 2018 at Land at Manders Croft, Southam, Warwickshire. Five trenches were excavated. All trenches showed evidence of ridge and furrow confirming the use of the land for agricultural purposes during the post medieval period. No other artefacts or deposits of archaeological interest were identified in any of the trenches.

The fieldwork comprised the excavation of three trenches. Trenches 1 and 2 measured 10m in length and 2m in width and Trench 3 measured 15m in length and 2m in width. Trench 3 was moved slightly from its original position, as set out in the WSI, due to the presence of asbestos. An archaeological evaluation was undertaken by Cotswold Archaeology in May 2018 at Globe House, Eugene Street Bristol. A total of three trenches was excavated. A number of limestone walls and surfaces, identified in the south-western part of the site, appear to relate to a building fronting Eugene Street, first depicted on Roqcue's map of 1742. The exact function of this building remains unclear; however evidence from later historic mapping suggests that it is most likely to represent a terrace of small domestic properties. Two sub-rectangular graves, both of which contained articulated human bone and are located within the confines of a former burial ground depicted by 19th-century cartographic sources, were identified in the north-western and central-northern parts of the site. A further, similarly-shaped, feature was also identified in the north-western part of the site but was found to be devoid of human remains. The presence of these graves indicates that the burial ground was not fully cleared following its closure; however a possible charnel pit, also identified in the north-western part of the site suggest that at least some clearance of burials took place. A number of limestone walls and surfaces, identified in the central-northern part of the site, appear to relate to a group of buildings first depicted on Ashmead's map of 1828. The function of these buildings remains unclear; however later historic mapping indicates that these buildings were amalgamated into, or subsumed within, a single larger industrial building occupying this part of the site. A limestone and red brick wall and a red brick, ash and slab surface, identified in the northwestern part of the site, appear to relate to a former industrial building, possibly associated with the Eastabrook & Sons Globe Steam Joinery Works, first depicted on the First Edition 1884 OS map.

Background The erosion of the early mortality advantage of elective endovascular aneurysm repair (EVAR) compared with open repair of abdominal aortic aneurysm remains without a satisfactory explanation. Methods An individual-patient data meta-analysis of four multicentre randomized trials of EVARversus open repair was conducted to a prespecified analysis plan, reporting on mortality, aneurysm-related mortality and reintervention. Results The analysis included 2783 patients, with 14 245 person-years of follow-up (median 5·5 years). Early (0–6 months after randomization) mortality was lower in the EVAR groups (46 of 1393 versus 73 of 1390 deaths; pooled hazard ratio 0·61, 95 per cent c.i. 0·42 to 0·89; P = 0·010), primarily because 30-day operative mortality was lower in the EVAR groups (16 deaths versus 40 for open repair; pooled odds ratio 0·40, 95 per cent c.i. 0·22 to 0·74). Later (within 3 years) the survival curves converged, remaining converged to 8 years. Beyond 3 years, aneurysm-related mortality was significantly higher in the EVAR groups (19 deaths versus 3 for open repair; pooled hazard ratio 5·16, 1·49 to 17·89; P = 0·010). Patients with moderate renal dysfunction or previous coronary artery disease had no early survival advantage under EVAR. Those with peripheral artery disease had lower mortality under open repair (39 deaths versus 62 for EVAR; P = 0·022) in the period from 6 months to 4 years after randomization. Conclusion The early survival advantage in the EVAR group, and its subsequent erosion, were confirmed. Over 5 years, patients of marginal fitness had no early survival advantage from EVAR compared with open repair. Aneurysm-related mortality and patients with low ankle : brachial pressure index contributed to the erosion of the early survival advantage for the EVAR group. Trial registration numbers: EVAR-1, ISRCTN55703451; DREAM (Dutch Randomized Endovascular Aneurysm Management), NCT00421330; ACE (Anévrysme de l'aorte abdominale, Chirurgie versus Endoprothèse), NCT00224718; OVER (Open Versus Endovascular Repair Trial for Abdominal Aortic Aneurysms), NCT00094575.

An archaeological watching brief was undertaken by Cotswold Archaeology during groundworks associated with the conversion of existing buildings and construction of new buildings and associated infrastructure at 23-25 and 27-29 Commercial Road, Gloucester, Gloucestershire. No features or deposits of archaeological interest were observed during groundworks, and no artefactual material pre-dating the modern period was recovered.

We construct the universal type structure for conditional probability systems without any topological assumption, namely a type structure that is terminal, belief-complete, and non-redundant. In particular, in order to obtain the belief-completeness in a constructive way, we extend the work of Meier [An Infinitary Probability Logic for Type Spaces. Israel Journal of Mathematics, 192, 1-58] by proving strong soundness and strong completeness of an infinitary conditional probability logic with truthful and non-epistemic conditioning events., Comment: In Proceedings TARK 2017, arXiv:1707.08250

Elevated plasma homocysteine levels have been associated with higher risks of cardiovascular disease, but the effects on disease rates of supplementation with folic acid to lower plasma homocysteine levels are uncertain. Individual participant data were obtained for a meta-analysis of 8 large, randomized, placebo-controlled trials of folic acid supplementation involving 37 485 individuals at increased risk of cardiovascular disease. The analyses involved intention-to-treat comparisons of first events during the scheduled treatment period. There were 9326 major vascular events (3990 major coronary events, 1528 strokes, and 5068 revascularizations), 3010 cancers, and 5125 deaths. Folic acid allocation yielded an average 25% reduction in homocysteine levels. During a median follow-up of 5 years, folic acid allocation had no significant effects on vascular outcomes, with rate ratios (95% confidence intervals) of 1.01 (0.97-1.05) for major vascular events, 1.03 (0.97-1.10) for major coronary events, and 0.96 (0.87-1.06) for stroke. Likewise, there were no significant effects on vascular outcomes in any of the subgroups studied or on overall vascular mortality. There was no significant effect on the rate ratios (95% confidence intervals) for overall cancer incidence (1.05 [0.98-1.13]), cancer mortality (1.00 [0.85-1.18]) or all-cause mortality (1.02 [0.97-1.08]) during the whole scheduled treatment period or during the later years of it. Dietary supplementation with folic acid to lower homocysteine levels had no significant effects within 5 years on cardiovascular events or on overall cancer or mortality in the populations studied.

The fieldwork comprised the excavation of one 1.5m by 1.5m trench. Due to the presence of large trees, the location of the trench was measured off the walls of the Church and surveyed. The trench was hand excavated to the top of the natural substrate. Where archaeological deposits were encountered they were excavated by hand. Deposits were assessed for their palaeoenvironmental potential and no deposits were identified that required sampling. An archaeological evaluation was undertaken by Cotswold Archaeology in September 2016 at the Church of St Peter, Upper Slaughter, Gloucestershire. One trench was excavated. Two probable post-medieval graves were encountered. The graves cut a make-up deposit that contained medieval pottery and were sealed by another layer of make-up which contained post-medieval pottery. No other archaeological feature or deposits were identified.

Si presentano i risultati più rilevanti dello studio geologico del istretto del sito rcheologico di Bisenzio presso Capodimonte sul Lago di Bolsena (VT)

Background Recurrent vascular events remain a major source of morbidity and mortality after stroke or transient ischemic attack (TIA). The IRIS Trial is evaluating an approach to secondary prevention based on the established association between insulin resistance and increased risk for ischemic vascular events. Specifically, IRIS will test the effectiveness of pioglitazone, an insulin-sensitizing drug of the thiazolidinedione class, for reducing the risk for stroke and myocardial infarction (MI) among insulin resistant, nondiabetic patients with a recent ischemic stroke or TIA. Design Eligible patients for IRIS must have had insulin resistance defined by a Homeostasis Model Assessment–Insulin Resistance >3.0 without meeting criteria for diabetes. Within 6 months of the index stroke or TIA, patients were randomly assigned to pioglitazone (titrated from 15 to 45 mg/d) or matching placebo and followed for up to 5 years. The primary outcome is time to stroke or MI. Secondary outcomes include time to stroke alone, acute coronary syndrome, diabetes, cognitive decline, and all-cause mortality. Enrollment of 3,876 participants from 179 sites in 7 countries was completed in January 2013. Participant follow-up will continue until July 2015. Summary The IRIS Trial will determine whether treatment with pioglitazone improves cardiovascular outcomes of nondiabetic, insulin-resistant patients with stroke or TIA. Results are expected in early 2016.

Summary Background Some countries fortify flour with folic acid to prevent neural tube defects but others do not, partly because of concerns about possible cancer risks. We aimed to assess any effects on site-specific cancer rates in the randomised trials of folic acid supplementation, at doses higher than those from fortification. Methods In these meta-analyses, we sought all trials completed before 2011 that compared folic acid versus placebo, had scheduled treatment duration at least 1 year, included at least 500 participants, and recorded data on cancer incidence. We obtained individual participant datasets that included 49 621 participants in all 13 such trials (ten trials of folic acid for prevention of cardiovascular disease [n=46 969] and three trials in patients with colorectal adenoma [n=2652]). All these trials were evenly randomised. The main outcome was incident cancer (ignoring non-melanoma skin cancer) during the scheduled treatment period (among participants who were still free of cancer). We compared those allocated folic acid with those allocated placebo, and used log-rank analyses to calculate the cancer incidence rate ratio (RR). Findings During a weighted average scheduled treatment duration of 5·2 years, allocation to folic acid quadrupled plasma concentrations of folic acid (57·3 nmol/L for the folic acid groups vs 13·5 nmol/L for the placebo groups), but had no significant effect on overall cancer incidence (1904 cancers in the folic acid groups vs 1809 cancers in the placebo groups, RR 1·06, 95% CI 0·99–1·13, p=0·10). There was no trend towards greater effect with longer treatment. There was no significant heterogeneity between the results of the 13 individual trials (p=0·23), or between the two overall results in the cadiovascular prevention trials and the adenoma trials (p=0·13). Moreover, there was no significant effect of folic acid supplementation on the incidence of cancer of the large intestine, prostate, lung, breast, or any other specific site. Interpretation Folic acid supplementation does not substantially increase or decrease incidence of site-specific cancer during the first 5 years of treatment. Fortification of flour and other cereal products involves doses of folic acid that are, on average, an order of magnitude smaller than the doses used in these trials. Funding British Heart Foundation, Medical Research Council, Cancer Research UK, Food Standards Agency.

Water scarcity in many regions of the world and the global demographic growth make the desalination of seawater and/or brackish an effective solution to meet the growing demand for freshwater. Nowadays, reverse osmosis has the largest share of the global installed desalination capacity. The impelling need to reduce greenhouse gas emissions has been pushing the search for sustainable technologies to produce the electricity needed to power reverse osmosis plants. Among solar technologies, little attention has been paid to the possibility of powering reverse osmosis with electricity from the dish-Stirling concentrator. To fill this knowledge gap, this paper assesses the energy-saving potential of a reverse osmosis plant coupled with a cogenerative dish-Stirling concentrator on a small island in the Mediterranean Sea. A model of the integrated systems was developed based on data measured on a real dish-Stirling concentrator, and variation of the energy consumption of the reverse osmosis plant with the temperature of the feedwater solution was also accounted for. Hourly simulations showed that almost 36% of the annual water demand could be covered by driving the plant using electricity from the concentrator, and the solar fraction of the electricity consumed by the reverse osmosis plant accounted for 57%. Finally, the analysis revealed that only a 1% decrease in solar fraction resulted when the heat recovered from the concentrator is not used for the feedwater preheating.

PURPOSE To describe the in vivo vascularization of middle ear by an endoscopic point of view, particularly focusing on the medial wall of tympanic cavity and incudostapedial region (ISR). STUDY DESIGN Case series with surgical videos review and anatomical description. METHODS 48 videos from exclusive endoscopic middle ear surgery performed at the University Hospital of Modena from November 2015 to July 2017 were reviewed. Data about anatomy of vessels, and blood flow direction (BFD) were collected in an appropriate database for further analyses. RESULTS 48 cases were included in the present study. In 18/48 patients (37,5%), a clearly identifiable inferior tympanic artery (ITA) was present, running just anteriorly to the round window (RW), with a superior BFD (65% of cases) from the hypotympanic region toward the epitympanum. Some promontorial variants were described in 67% of cases and the most common finding was a mucosal vascular network with a multidirectional BFD. On the ISR, an incudostapedial artery (ISA) was detected in 65% of cases with BFD going from the long process of the incus (LPI) toward the pyramidal eminence in the majority of cases. CONCLUSION The vascular anatomy and BFD of the medial wall of the tympanic cavity can be easily studied in transcanal endoscopy. ITA (with a superior BFD in most cases) and ISA (with a main BFD from the incus to the stapes) are the most constant identifiable vessels.

Objective: Transcanal exclusive endoscopic ear surgery requires the management of the endoscope and the surgical instruments in the external auditory canal. Bleeding in this narrow space is one of the most challenging issues, especially for novice endoscopic ear surgeons. We aim to assess the severity and occurrence of bleeding and describe strategies to control the bleeding during endoscopic ear surgery. We hypothesize that bleeding is reasonably controllable in endoscopic ear surgery. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: We retrospectively assessed 104 consecutive cases of exclusive endoscopic ear surgery at the University Hospital of Modena, Italy. The surgical videos and the patient charts were carefully investigated and analyzed. Results: Hemostatic agents included injection of diluted epinephrine (1:200,000, 2% mepivacaine), cottonoids soaked with epinephrine (1:1000), mono- or bipolar cautery, washing with hydrogen peroxide, and self-suctioning instruments. The localization of bleeding in the external auditory canal was most frequently the posterior superior part, and inside of the middle ear, it was the pathology itself. Statistical analysis revealed significant differences comparing the mean arterial pressure and the type of intervention among bleeding scores. Conclusion: The management of bleeding in endoscopic ear surgery is feasible through widely available hemostatic agents in reasonable frequency. This study gives an instructive overview on how to manage the bleeding in the exclusive endoscopic technique. Even the highest bleeding scores could be managed in an exclusively endoscopic technique.

In questo lavoro è riportata l’attività di verifica della realizzazione e ottimizzazione delle tecniche, dei dispositivi di protezione e delle procedure operative adottate in un moderno impianto di Diagnostica PET, dotato di ciclotrone per la produzione di radiofarmaci con accelerazione di protoni fino a 16,5 MeV di energia. Con riferimento alla realizzazione di un insediamento all’interno di una Azienda Ospedaliera della città di Palermo, inserita in un contesto cittadino, una analisi approfondita dei sistemi di sicurezza insieme alla identificazione di alcune criticità ha consentito di riconsiderare alcuni dispositivi, anche alla luce di più moderne tecnologie, e di riesaminare l’effettiva interconnessione dei vari sistemi. Alcuni interventi di ottimizzazione hanno riguardato, ad esempio, la schermatura del ciclotrone e dei vari laboratori, di particolare importanza per la sicurezza dei lavoratori, le tecniche di valutazione e controllo della dose (da neutroni e da radiazioni elettromagnetiche), gli impianti di ventilazione e monitoraggio nonché tutte le procedure di radioprotezione adottate per un uso sicuro dei radionuclidi prodotti. Particolare attenzione, proprio in riferimento al contesto dell’impianto, è stata rivolta alla ottimizzazione dei sistemi di ventilazione, con la previsione di una stazione di compressione di aria in grado di contenere in apposite bombole tutta l’attività indotta nell’aria del bunker e/o delle celle sia durante che dopo la produzione dei radiofarmaci. In tal modo, l’attività immessa nell’ambiente è praticamente nulla, con grande vantaggio in termini di dose alla popolazione e di impatto ambientale. La sperimentazione in campo delle modifiche suggerite durante il processo di ottimizzazione ha consentito tra l’altro di migliorare, in corso d’opera, alcuni dei dispositivi di protezione e di controllo. I test finali hanno confermano la bontà del progetto iniziale ma anche l’adeguatezza degli interventi di ottimizzazione adottati durante la verifica, l’efficacia degli stessi e il miglioramento delle condizioni di sicurezza con una riduzione delle dosi indebite a pazienti, lavoratori e alla popolazione.

Il numero di impianti per la produzione di radiofarmaci con ciclotrone è in continuo aumento, grazie alla disponibilità sul mercato di macchine acceleratrici con costi accessibili e di facile installazione e impiego. Un aspetto non secondario, per un utilizzo sicuro di tali impianti, riguarda la predisposizione di sistemi di sicurezza, attiva e passiva, per la tutela dei lavoratori e della popolazione anche verso possibili incidenti. E’ interessante ed attuale lo studio di ottimizzazione dei sistemi di sicurezza sia per una più efficace logica di intervento e prevenzione, sia per tenere conto delle nuove possibilità di realizzazione consentite dai progressi tecnologici. Nel presente lavoro vengono indicate alcune possibili ottimizzazioni dei sistemi di sicurezza attiva, in qualche caso mutuandole da impianti più complessi, a seguito di un riesame critico della logica di sicurezza, in installazioni già realizzate con sistema a componenti discreti, proponendo, come eventuale possibile miglioramento, l’uso di adatti PLC.

An identification and activity evaluation of the predominant gamma-emitting radionuclides in activated parts of a medical cyclotron plant by high resolution gamma-ray spectrometry were performed. The use of LaBr3:Ce scintillation and HPGe detectors was examined in order to solve the measurement problems due to high activity of some components used inside a plant provided with an IBA CYCLONE 18/9 cyclotron. For each component, the identification of some key-radionuclides allows to evaluate the surface dose behaviour as function of decay time. The largest activity values are related to radionuclides with half-life of 70-80 days, while radionuclides with higher half-lives represent less than 10 per cent of the total activity. The surface dose rate will be reduced to about 1/1000 of the starting value after a decay period of approximately 3 years, with a relatively safety at product disposal work.