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Small group interactions and interactions with near-peer instructors such as learning assistants serve as fertile opportunities for student learning in undergraduate active learning classrooms. To understand what students take away from these interactions, we need to understand how and what they learn during the moment of their interaction. This study builds on practical epistemology analysis to develop a framework to study this in-the-moment learning during interactions by operationalizing it through the lens of discourse change and continuity toward three ends. Using video recordings of students and learning assistants interacting in a variety of contexts including remote, in-person, and hybrid classrooms in introductory chemistry and physics at two universities, we developed an analytical framework that can characterize learning in the moment of interaction, is sensitive to different kinds of learning, and can be used to compare interactions. The framework and its theoretical underpinnings are described in detail. In-depth examples demonstrate how the framework can be applied to classroom data to identify and differentiate different ways in which in-the-moment learning occurs.

Desktop 3D FDM (Fused Deposition Modelling) printers are usually employed for the production of nonstructural objects. In recent years, the present authors tried to use this technology also to produce structural elements employed in the construction of small UAVs (Unmanned Aerial Vehicles). Mechanical stresses are not excessive for small multirotor UAVs. Therefore, the FDM technique combined with polymers, such as the ABS (Acrylonitrile Butadiene Styrene) and the PLA(Poly Lactic Acid), can be successfully employed to produce structural components. The present new work is devoted to the production and preliminary structural analysis of sandwich configurations. These new lamination schemes could lead to an important weight reduction without significant decreases of mechanical properties. Therefore, it could be possible, for the designed application (e.g., a multifunctional small UAV produced via FDM), to have stiffener and lighter structures easy to be manufactured with a low-cost 3D printer. The new sandwich specimens here proposed are PLA sandwich specimens embedding a PLA honeycomb core produced by means of the same extruder, multilayered specimens with ABS external layers and an internal homogeneous PLA core using different extruders for the two materials, sandwich specimens with external ABS skins and an internal PLA honeycomb core using different extruders for the two materials, and sandwich specimens where two different extruders have been employed for PLA material used for skins and for the internal honeycomb core. For all the proposed configurations, a detailed description of the production activity is given.Moreover, several preliminary results about three-point bending tests, different mechanical behaviors and relative delamination problems for each sandwich configuration will be discussed in depth.

Abstract Background The outcome of kidney transplant recipients with a history of complement-mediated thrombotic microangiopathy (cTMA) and those who develop post-transplant de novo TMA (dnTMA) is largely unknown. Methods We retrospectively studied all kidney transplant recipients with end-stage kidney disease secondary to cTMA and those who developed dnTMA, between Jan 2000 and Dec 2020 in our center. Results We identified 134 patients, 22 with cTMA and 112 had dnTMA. Patients with cTMA were younger at the time of TMA diagnosis (age at diagnosis, 28.9 ± 16.3. vs 46.5 ± 16.0 years; P

Abstract Fracton phases of matter constitute an interesting point of contact between condensed matter and high-energy physics. The limited mobility property of fracton quasi-particles finds applications in many different contexts, including quantum information, spin liquids, elasticity, hydrodynamics, gravity and holography. In this paper we adopt a field theoretical approach to investigate the three dimensional action of a rank-2 symmetric tensor field invariant under the covariant fracton symmetry. The theory appears as a non-topological higher rank generalization of the ordinary Chern-Simons model, depending only on the traceless part of the tensor gauge field. After defining a field strength, a rank-2 traceless “electric” field and a “magnetic” vector field are identified, in analogy with the standard Chern-Simons ones. Once matter is introduced, a Hall-like behaviour with fractonic features emerges. In particular, our model shows a Hall-like dipole current, together with a vectorial “flux-attachment” relation for dipoles. This gives a possible starting point for a fracton-vortex duality. A gauge-fixing term is then introduced, from which propagators are computed and the counting of the degrees of freedom is performed. Finally, the energy-momentum tensor is shown to be conserved and the integrated energy density is proved to be zero, which reminds the topological nature of the standard Chern-Simons model.

Background: Learning assistants (LAs) in undergraduate STEM lectures facilitate discussions between students in small groups. In this research study, we investigate the impact of LA facilitation on student learning as it occurs during LA-student interactions. To do so, our work builds on two sociocultural frameworks focused on LA facilitation and student in-the-moment learning. We conceptualize LA facilitation as either authoritative if it centers one perspective or dialogic if it centers multiple perspectives. Student in-the-moment learning is understood as the progression of student needs and the filling of those needs with LA and student ideas. Results: Our analysis of 78 video recordings of LA-student interactions from 37 different chemistry and physics LAs revealed that LA facilitation had four major impacts on student in-the-moment learning: increasing grappling, reaching closure, sharing ideas and reasoning, and revisiting an earlier need. Rather than these impacts differing upon the use of authoritative and dialogic facilitation, all four impacts sometimes resulted from authoritative and sometimes from dialogic facilitation. However, authoritative facilitation was more often correlated with LA-centered manifestation of these impacts, while dialogic facilitation was more often correlated with student-centered manifestation. In addition to these conceptual impacts, we also found five socioemotional impacts: less participation, dominance continues, fostering participation, students choose not to participate, and lighthearted conversation. LAs added socioemotional components to both authoritative and dialogic facilitation, and actions aimed at bringing more students into the conversation indeed had this impact, while actions addressing specific students often continued to privilege the participation of the same students. Conclusion: Our study expands theory on authoritativeness and dialogicity as it empirically validates that authoritative facilitation is more often correlated with LA-centered learning and dialogic facilitation is more often correlated with student-centered learning. Further, our work is the first to explore the socioemotional impact of LAs in the moment of interaction. Our findings can be used in LA trainings to teach LAs how to intentionally use authoritative and dialogic facilitation, how to incorporate socioemotional components to their facilitation, and how to adjust their practice to align with learning goals for students in their context.

Electromechanical actuators (EMAs) based on Permanent Magnet Synchronous Motors (PMSMs) are currently employed on various aircraft systems, and are becoming more and more widespread in safety critical applications. Compared to other electrical machines, PMSM offer a high power to weight ratio and low cogging: this makes them suited for position control and actuation tasks. EMAs offer several advantages over hydraulic servoactuators, in terms of modularity, mechanical simplicity, overall weight and fuel efficiency. At the same time, their basic reliability is inherently lower compared to hydraulic actuators. Then, the use of EMAs for safety critical aircraft systems requires the adoption of risk mitigation techniques to counter this issue. In this framework, diagnostic and prognostic strategies can be used for the system health management, to monitor its behaviour in search of the early signs of the most common or dangerous failure modes. We propose a low fidelity model of a PMSM based EMA, intended for model-based diagnostic and prognostic monitoring. The model features low computational cost, allowing the execution in nearly real-time, combined with suitable accuracy in the simulation of faulty system operations. This simplified emulator is validated by comparing its behaviour to a higher fidelity model, employed as a simulated test bench.

Aircraft systems are becoming more and more complex, as they are required to perform multiple functions. For example, smart systems need to be able to self-monitor their working parameters, in order to infer their health status. All these additional functions require the system to acquire a multitude of measurements; albeit sometimes it is possible to implement virtual sensor techniques, dedicate sensing hardware is usually needed. As a main drawback, the installation of the needed sensors adds up to the total complexity, weight, cost and failure rate of the system. In this context, minimally invasive sensors can be used to measure the system parameters with high spatial resolution and minimal added complexity. One key technology in this field is the Fiber Bragg Gratings (FBG) optical sensors, used to perform strain and temperature measurements. This work describes an experimental campaign intended to assess and validate several installation techniques for FBGs as strain sensors. Two test benches were developed for different measurement setups. One is intended for creep and repeatability tests of a FBG sensor glued at both ends; the other was used to compare point gluing and continuous gluing techniques on an aluminium beam subject to a bending load. Results are compared with numerical simulations of the structure and measurements performed with traditional strain gages.

Abstract The innate immune system is the first responder to infectious agents, cellular debris, and cancerous growths. This system plays critical roles in the antitumor immune responses by boosting and priming T cell-mediated cytotoxicity but is understudied due to the complexity and redundancy of its various downstream signaling cascades. We utilized a mathematical tool to holistically quantify innate immune signaling cascades and immunophenotype over 8,000 tumors from The Cancer Genome Atlas (TCGA). We found that innate immune activation was predictive of patient mortality in a subset of cancers. Further analysis identified PHF genes as transcripts that were associated with genomic stability and innate activation. Knockdown of PHF gene transcripts in vitro led to an increase in cell death and IFNB1 expression in a cGAS-dependent manner, validating PHF genes as potential anti-tumor targets. We also found an association between innate immune activation and both tumor immunogenicity and intratumor microbes, which highlights the versatility of this model. In conclusion, interrogating activation of innate immune signaling cascades demonstrated the importance of studying innate signaling in cancer and broadened the search for new therapeutic adjuvants.

Abstract Background Discomfort can be the cause of noninvasive respiratory support (NRS) failure in up to 50% of treated patients. Several studies have shown how analgosedation during NRS can reduce the rate of delirium, endotracheal intubation, and hospital length of stay in patients with acute respiratory failure. The purpose of this project was to explore consensus on which medications are currently available as analgosedatives during NRS, which types of patients may benefit from analgosedation while on NRS, and which clinical settings might be appropriate for the implementation of analgosedation during NRS. Methods The Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) selected a panel of experts and asked them to define key aspects of the use of analgesics and sedatives during NRS treatment. The methodology applied is in line with the principles of the modified Delphi and RAND-UCLA methods. The experts developed statements and supportive rationales which were then subjected to blind votes for consensus. Results The use of an analgosedation strategy in adult patients with acute respiratory failure of different origins may be useful where there is a need to manage discomfort. This strategy should be considered after careful assessment of other potential factors associated with respiratory failure or inappropriate noninvasive respiratory support settings, which may, in turn, be responsible for NRS failure. Several drugs can be used, each of them specifically targeted to the main component of discomfort to treat. In addition, analgosedation during NRS treatment should always be combined with close cardiorespiratory monitoring in an appropriate clinical setting. Conclusions The use of analgosedation during NRS has been studied in several clinical trials. However, its successful application relies on a thorough understanding of the pharmacological aspects of the sedative drugs used, the clinical conditions for which NRS is applied, and a careful selection of the appropriate clinical setting.

Abstract Background Lung ultrasonography (LUS) is a non-invasive imaging method used to diagnose and monitor conditions such as pulmonary edema, pneumonia, and pneumothorax. It is precious where other imaging techniques like CT scan or chest X-rays are of limited access, especially in low- and middle-income countries with reduced resources. Furthermore, LUS reduces radiation exposure and its related blood cancer adverse events, which is particularly relevant in children and young subjects. The score obtained with LUS allows semi-quantification of regional loss of aeration, and it can provide a valuable and reliable assessment of the severity of most respiratory diseases. However, inter-observer reliability of the score has never been systematically assessed. This study aims to assess experienced LUS operators’ agreement on a sample of video clips showing predefined findings. Methods Twenty-five anonymized video clips comprehensively depicting the different values of LUS score were shown to renowned LUS experts blinded to patients’ clinical data and the study’s aims using an online form. Clips were acquired from five different ultrasound machines. Fleiss-Cohen weighted kappa was used to evaluate experts’ agreement. Results Over a period of 3 months, 20 experienced operators completed the assessment. Most worked in the ICU (10), ED (6), HDU (2), cardiology ward (1), or obstetric/gynecology department (1). The proportional LUS score mean was 15.3 (SD 1.6). Inter-rater agreement varied: 6 clips had full agreement, 3 had 19 out of 20 raters agreeing, and 3 had 18 agreeing, while the remaining 13 had 17 or fewer people agreeing on the assigned score. Scores 0 and score 3 were more reproducible than scores 1 and 2. Fleiss’ Kappa for overall answers was 0.87 (95% CI 0.815–0.931, p

The Fused Deposition Modelling (FDM) technology is widely used in rapid prototyping. 3D printers for home desktop applications are usually employed to make non-structural objects. When the mechanical stresses are not excessive, this technology can also be successfully employed to produce structural objects, not only in prototyping stage but also in the realization of series pieces. The innovative idea of the present work is the application of this technology, implemented in a desktop 3D printer, to the realization of components for aeronautical use, especially for unmanned aerial systems. For this purpose, the paper is devoted to the statistical study of the performance of a desktop 3D printer to understand how the process performs and which are the boundary limits of acceptance. Mechanical and geometrical properties of ABS (Acrylonitrile Butadiene Styrene) specimens, such as tensile strength and stiffness, have been evaluated. ASTM638 type specimens have been used. A capability analysis has been applied for both mechanical and dimensional performances. Statistically stable limits have been determined using experimentally collected data.

The complexity of aircraft systems is steadily growing, allowing the machine to perform an increasing number of functions; this can result in a multitude of possible failure modes, sometimes difficult to foresee and detect. A prognostic tool to identify the early signs of faults and perform an estimation of Remaining Useful Life (RUL) can allow adaptively scheduling maintenance interventions, reducing the operating costs and increasing safety [1-4]. A first step for the RUL estimation is an accurate Fault Detection & Identification (FDI) to infer the system health status, necessary to determine when the components will no more be able to match their requirements [5]. With a model-based approach, the FDI is a model-matching problem, intended to adjust a parametric Monitor Model (MM) to reproduce the response of the system. The MM shall feature a low computational cost to be executed iteratively on-board; at the same time, it shall be detailed enough to account for a several failure modes [6]. We propose the simplification of an Electromechanical Actuator (EMA) dynamical model [7] for model-based FDI, focusing on the BLDC motor and Power Electronics, which account for most the computational cost of the original high fidelity model.

Progressive failures affecting onboard electromechanical actuators (EMA), especially if related to primary flight commands, could be a critical issue for the aircraft reliability and, in the worst cases, could compromise its safety. In the last years strong interest is expected by the development of prognostic algorithms able to provide an early identification of the precursors of EMA progressive failures. In this work authors proposes a new prognostic method based on two artificial neural networks (ANN), a basic and an enhanced feedforward neural network, performing the fault detection and identification of two critical progressive faults often affecting the EMA brushless motor (i.e. turn-to-turn short circuit of a stator coil and rotor static eccentricity); in order to identify a suitable data set able to guarantee an affordable ANN classification, the said failures precursors are properly pre-processed by a Discrete Wavelet Transform, extracting several features used as input of the proposed prognostic algorithm.

This paper is on the Failure Modes and Effects and Criticality Analysis and Fault Tree Analysis methodologies applied to the equipment and functional subsystems of Remotely Piloted Aircraft Systems (RPAS). Such aerial vehicles have been used almost exclusively for military purposes until the first decade of the 2000s. The debate then was focused both on technical and regulatory issues and research activities. Thanks to this renewed interest on unmanned systems and thanks to relatively recent improvements in information science, telecommunication, electronics and material science a strong awareness on the potential extension of unmanned technologies to civil applications arose up. A variety of economic benefits has been recognized by the aviation community from the civil use of RPAS, but, due to the absence of the pilot on board both military and civilian RPAS have always been relegated to fly into segregated airspaces. Technical potentialities of RPAS will be fully exploited integrating them into controlled airspaces in a reliable and safe way. This paper shows an example of application of FMECA and FTA to RPAS and discuss the most critical issues related to the performed analyses as well as possible future developments of this work.

The term Industry 4.0 has been coined in Germany in 2011 and since then, it has officially started the so-called fourth industrial revolution. In the herein presented review, the industrial digitalization process of Italy is explored and cross-compared to the German one, in order to unearth and analyze the intrinsic systemic key-elements, which are responsible for the differentiated digital industrial development among the examined countries. As evidenced by the analytical study, which also entails the results of a survey conducted over 238 companies in Italy, the main responsible factor for the industrial digital gap among the countries seems to be represented by a digital holistic-based approach across the entire value chain of the product. This finding, besides being reflected into the very different nature of the two Industry 4.0 policy frameworks, is also supported by survey data, since the majority of the investigated performed interventions can mainly be applied to the production process, rather than to other crucial steps of the value chain. In this regard, the survey analysis suggests also that a lack of perception of the beneficial potential effect of the change of “digital paradigm” from the production process to the product itself is yet lacking within the Italian industrial mindset. Finally, the survey results support the widely discussed synergistic beneficial effect among ecology and digitalization. Indeed, the majority of the interviewed companies have reported that many of the carried-out digitalization measures have positively affected the energetic and sustainability-related dimensions.

Abstract Background Noninvasive ventilation (NIV) is widely employed as the initial treatment for patients with chronic acute exacerbation of obstructive pulmonary disease (AECOPD). Nevertheless, high-flow nasal cannula (HFNC) has been increasingly utilized and investigated to mitigate the issues associated with NIV. Flow rate may play a significant role in diaphragmatic function among subjects recovering from AECOPD. Based on these observations, we conducted a physiological study to assess the impact of HFNC therapy on diaphragmatic function, as measured by US, respiratory rate (RR), gas exchange, and patient comfort at various flow rates. Methods A prospective physiological pilot study enrolled subjects with a diagnosis of AECOPD who required NIV for more than 24 h. After stabilization, these subjects underwent a 30-min trial using NIV and HFNC at different sequential flow rates (30–60 L/min). At the end of each trial, diaphragmatic displacement (DD, cm) and diaphragmatic thickness fraction (DTF, %) were measured using ultrasound. Additionally, other physiological variables, such as RR, gas exchange, and patient comfort, were recorded. Results A total of 20 patients were included in the study. DD was no different among trials (p = 0.753). DTF (%) was significantly lower with HFNC-30 L/min compared to HFNC-50 and 60 L/min (p 0.050). During HFNC trials, RR remained unchanged without statistically significant differences (p = 0.611). However, we observed that HFNC improved comfort compared to NIV (p

Abstract Objectives Mandatory newborn screening (NBS) for spinal muscular atrophy (SMA) was implemented for the first time in Italy at the end of 2021, allowing the identification and treatment of patients at an asymptomatic stage. Methods DNA samples extracted from dried blood spot (DBS) from newborns in Apulia region were analysed for SMA screening by using a real‐time PCR‐based assay. Infants harbouring homozygous deletion of SMN1 exon 7 confirmed by diagnostic molecular tests underwent clinical and neurophysiological assessment and received a timely treatment. Results Over the first 20 months since regional NBS introduction, four out of 42,492 (0.009%) screened children were found to carry a homozygous deletion in the exon 7 of SMN1 gene, with an annual incidence of 1:10,623. No false negatives were present. Median age at diagnosis was 7 days and median age at treatment was 20.5 days. Three of them had two copies of SMN2 and received gene therapy, while the one with three SMN2 copies was treated with nusinersen. All but one were asymptomatic at birth, showed no clinical signs of disease after a maximum follow‐up of 16 months and reached motor milestones appropriate with their age. The minimum interval between diagnosis and the treatment initiation was 9 days. Interpretation The timely administration of disease‐modifying therapies prevented presymptomatic subjects to develop disease symptoms. Mandatory NBS for SMA should be implemented on a national scale.

The term “non-alcoholic fatty liver disease” (NAFLD) has been, for a long time, used to describe the spectrum of liver lesions encompassing steatosis, steatohepatitis (NASH), and steatotic cirrhosis [...]

Persistent organic pollutants (POPs), which encompass pesticides and industrial chemicals widely utilized across the globe, pose a covert threat to human health. β-hexachlorocyclohexane (β-HCH) is an organochlorine pesticide with striking stability, still illegally dumped in many countries, and recognized as responsible for several pathogenetic mechanisms. This study represents a pioneering exploration into the neurotoxic effects induced by the exposure to β-HCH specifically targeting neuronal cells (N2a), microglia (BV-2), and C57BL/6 mice. As shown by western blot and qPCR analyses, the administration of β-HCH triggered a modulation of NF-κB, a key factor influencing both inflammation and pro-inflammatory cytokines expression. We demonstrated by proteomic and western blot techniques epigenetic modifications in H3 histone induced by β-HCH. Histone acetylation of H3K9 and H3K27 increased in N2a, and in the prefrontal cortex of C57BL/6 mice administered with β-HCH, whereas it decreased in BV-2 cells and in the hippocampus. We also observed a severe detrimental effect on recognition memory and spatial navigation by the Novel Object Recognition Test (NORT) and the Object Place Recognition Task (OPRT) behavioural tests. Cognitive impairment was linked to decreased expression of the genes BDNF and SNAP-25, which are mediators involved in synaptic function and activity. The obtained results expand our understanding of the harmful impact produced by β-HCH exposure by highlighting its implication in the pathogenesis of neurological diseases. These findings will support intervention programs to limit the risk induced by exposure to POPs. Regulatory agencies should block further illicit use, causing environmental hazards and endangering human and animal health.

Pediatric autoimmune hepatitis (PAIH) is a rare necro-inflammatory disease of the liver of unknown etiology thought to derive from the dysregulation of the immune response upon exposure to environmental triggers in genetically predisposed individuals [...]

Abstract In critically ill patients with acute respiratory failure, thoracic images are essential for evaluating the nature, extent and progression of the disease, and for clinical management decisions. For this purpose, computed tomography (CT) is the gold standard. However, transporting patients to the radiology suite and exposure to ionized radiation limit its use. Furthermore, a CT scan is a static diagnostic exam for the thorax, not allowing, for example, appreciation of "lung sliding". Its use is also unsuitable when it is necessary to adapt or decide to modify mechanical ventilation parameters at the bedside in real-time. Therefore, chest X-ray and lung ultrasound are today's contenders for shared second place on the podium to acquire a thoracic image, with their specific strengths and limitations. Finally, electrical impedance tomography (EIT) could soon have a role, however, its assessment is outside the scope of this review. Thus, we aim to carry out the following points: (1) analyze the advancement in knowledge of lung ultrasound use and the related main protocols adopted in intensive care units (ICUs) over the latest 30 years, reporting the principal publications along the way, (2) discuss how and when lung ultrasound should be used in a modern ICU and (3) illustrate the possible future development of LUS.

Background Survival rates for breast cancer are increasing, but many clinical needs in a larger and larger population of survivors are not properly met. During and beyond cancer treatments, patients tend to reduce their physical activity levels, gain weight and may complain about chronic pain, lymphedema, fatigue, cognitive problems, depression and anxiety, reduced social contacts and difficulties in resuming daily activities. In addition, younger women must also face fertility issues and early menopause, higher levels of distress regarding body image, sexual health, childcare and career management. Beside this, all the survivors may feel a fear for disease recurrence and many of them are not educated to identify and express their needs. Materials and Methods Tailored supportive strategies, including physical and psychological interventions, should be offered since the time of diagnosis and along the entire cancer journey and the follow up period. They should be aimed not only to the prevention and control of psychological and physical impairments (such as anxiety, stress, depression, lymphedema, genitourinary symptoms and sexual dysfunctions), but also to encourage remodulation of personal lifestyles for tertiary prevention and nurture patient’s resources that can promote a personal growth after the traumatic experience of cancer. Conclusions Toward this goal, many cancer centres worldwide including ours offer dedicated programs of psycho-oncological support, nutritional and physical activity counselling and evidence based complementary treatments (such as acupuncture, mindfulness, meditation, reflexology, herbal medicine, music therapy and more).