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A variety of mathematical models of the cardiovascular system have been suggested over several years in order to describe the time-course of a series of physiological variables (i.e. heart rate, cardiac output, arterial pressure) relevant for the compensation mechanisms to perturbations, such as severe haemorrhage. The current study provides a simple but realistic mathematical description of cardiovascular dynamics that may be useful in the assessment and prognosis of hemorrhagic shock. The present work proposes a first version of a differential-algebraic equations model, the model dynamical ODE model for haemorrhage (dODEg). The model consists of 10 differential and 14 algebraic equations, incorporating 61 model parameters. This model is capable of replicating the changes in heart rate, mean arterial pressure and cardiac output after the onset of bleeding observed in four experimental animal preparations and fits well to the experimental data. By predicting the time-course of the physiological response after haemorrhage, the dODEg model presented here may be of significant value for the quantitative assessment of conventional or novel therapeutic regimens. The model may be applied to the prediction of survivability and to the determination of the urgency of evacuation towards definitive surgical treatment in the operational setting.

To evaluate the effects of rehabilitation (physical and cognitive) treatments on the diagnosis severity and Disability Rating Scale (DRS) scores, adjusted for a number of potential confounders measured at baseline, in a large cohort of patients with disorders of consciousness across time.An observational, longitudinal (2 evaluations), multicenter project was made in 90 Italian centers.Patients (N=364) with a diagnosis of disorders of consciousness.Primary outcome was the severity of diagnosis, expressed on an ordinal scale (OtherMCSVSdeath). In the Other group were included patients who emerged from an MCS and recovered consciousness. The secondary outcome was the DRS score (range of 0-30 with 30 being the worst value). The DRS is a tool used to define the level of residual disability, commonly used to classify the level of functional impairment in patients with acquired brain injury. Both outcomes were measured for each wave.A total of 364 subjects having a complete set of demographic, clinical, and pharmacologic data were included in the propensity score (PS) analysis. Results showed that the rehabilitation treatments (physical and cognitive) reduced the clinical worsening over time in both severity diagnosis and DRS (around 6.5 points) in patients with disorders of consciousness across different propensity score strategies (ie, PS matching, PS adjustment, and PS-weighted procedures). In addition, cognitive protocols seem to be limited to patients with a median value of DRS=23.Our propensity score analysis suggests that rehabilitation treatment protocols seem effective and should be applied to a broader spectrum of patients with disorders of consciousness.

Introduction: Penfield’s motor homunculus describes a caricaturised yet useful representation of the map of various body parts on the pre-central cortex. We propose a supplemental map of the clinically represented areas of human body in pre-central cortex and a novel subcortical corticospinal tract map that are accurate and essential for safe surgery in patients with eloquent brain lesions. Materials and methods: A single-institution retrospective cohort study of patients who underwent craniotomy for motor eloquent lesions with intraoperative motor neuromonitoring (cortical and subcortical) between 2015 and 2020 was performed. All positive cortical and subcortical stimulation points were taken into account and cartographic maps were produced to demonstrate cortical and subcortical areas of motor representation and their configuration. A literature review in PubMed was performed. Results: 180 patients (58.4% male, 41.6% female) were included in the study with 81.6% asleep and 18.4% awake craniotomies for motor eloquent lesions (gliomas 80.7%, metastases 13.8%) with intraoperative cortical and subcortical motor mapping. Based on the data, we propose a supplemental clinical cortical and a novel subcortical motor map to the original Penfield’s motor homunculus, including demonstration of localisation of intercostal muscles both in the cortex and subcortex which has not been previously described. Conclusion: The supplementary clinical cortical and novel subcortical motor maps of the homunculus presented here have been derived from a large cohort of patients undergoing direct cortical and subcortical brain mapping. The information will have direct relevance for improving the safety and outcome of patients undergoing resection of motor eloquent brain lesions.

BackgroundIn 2016 universal screening with mismatch repair protein immunohistochemistry in all newly diagnosed endometrial carcinomas was introduced in Western Australia.ObjectiveTo compare the prevalence of Lynch syndrome associated endometrial carcinomas between 2016 and 2019 with a historical control (2015). Additionally, to compare the number of cases appropriately referred for genetic assessment.MethodsA cross-sectional study of cases presented at the Western Australia gynecologic oncology tumor board was carried out. The primary outcome was the prevalence of Lynch syndrome associated endometrial carcinomas. A secondary outcome was the number of cases appropriately referred for genetic assessment. The following variables were extracted: date of birth; age at diagnosis; vital status; tumor mismatch repair protein expression status (retained or lost) and if lost, the specific mismatch repair protein deficiency; patients who were referred to a genetic clinic; and family history, if recorded. Data were collected from the clinical databases of the Familial Cancer Program at Genetic Services of Western Australia and WOMEN Center, to determine whether patients were appropriately referred for genetic evaluation and to ascertain the results of genetic testing.ResultsBetween 2016 and 2019, there were 1040 new endometrial carcinomas. Tumors of 883 (85%) patients underwent mismatch repair protein immunohistochemistry compared with 117 of 199 patients (59%) in 2015 (χ2 73.14, p2 6.28, p=0.02). No cases of Lynch syndrome were diagnosed in patients aged over 70 years.ConclusionsUniversal immunohistochemical screening did not increase the proportion of Lynch syndrome associated endometrial carcinomas identified, although the study was underpowered to detect small differences. There was an improvement in appropriate referrals for genetic assessment.

Objective: To emphasize the most appropriate magnetic resonance imaging (MRI) diffusion protocol for the detection of lesions that cause transient global amnesia, in order to perform an accurate examination, as well as to determine the ideal time point after the onset of symptoms to perform the examination. Materials and Methods: We evaluated five patients with a diagnosis of transient global amnesia treated between 2012 and 2015. We analyzed demographic characteristics, clinical data, symptom onset, diffusion techniques, and radiological findings. Examination techniques included a standard diffusion sequence (b value = 1000 s/mm2; slice thickness = 5 mm) and a optimized diffusion sequence (b value = 2000 s/mm2; slice thickness = 3 mm). Results: Brain MRI was performed at 24 h or 36 h after symptom onset, except in one patient, in whom it was performed at 12 h after (at which point no changes were seen) and repeated at 36 h after symptom onset (at which point it showed alterations in the right hippocampus). The standard and optimized diffusion sequences were both able to demonstrate focal changes in the hippocampi in all of the patients but one, in whom the changes were demonstrated only in the optimized sequence. Conclusion: MRI can confirm a clinical hypothesis of transient global amnesia. Knowledge of the optimal diffusion parameters and the ideal timing of diffusion-weighted imaging (> 24 h after symptom onset) are essential to improving diagnostic efficiency. Resumo Objetivo: Enfatizar o protocolo de difusão mais adequado para detecção de lesões da amnésia global transitória, a fim de realizar um exame preciso, em tempo ideal, após o início dos sintomas. Materiais e Métodos: Foram analisados cinco pacientes com diagnóstico de amnésia global transitória atendidos entre 2012 e 2015, considerando-se dados demográficos, clínicos, tempo do início dos sintomas, técnicas de difusão e achados radiológicos. As técnicas incluíram uma sequência de difusão padrão (b = 1000 s/mm2; espessura do corte = 5 mm) e uma sequência de difusão otimizada (b = 2000 s/mm2; espessura de corte = 3 mm). Resultados: A ressonância magnética de encéfalo foi realizada após 24 ou 36 horas do início dos sintomas, exceto em um paciente, em que foi realizada após 12 horas (sem alterações) e repetida após 36 horas (mostrando alterações hipocampais). Em todos os pacientes foram demonstradas alterações focais na difusão no hipocampo em ambas as técnicas, exceto em um paciente, em que as alterações foram demonstradas apenas na sequência otimizada. Conclusão: A ressonância magnética é capaz de confirmar a hipótese clínica de amnésia global transitória. O conhecimento dos parâmetros ótimos da técnica de difusão e o melhor tempo para a detecção das alterações (> 24 horas) são essenciais para aprimorar a eficiência diagnóstica.

Purpose: ‘Black Bone’ magnetic resonance imaging (BB MRI) is a novel sequence developed as an alternative to computed tomography (CT) for osseous imaging. We explored its potential utilisation in t...

The visual method for assessment of the structural behaviour of historic masonry walls, known by the acronym MQI (Masonry Quality Index) was introduced in 2002 by a team of researchers from the University of Perugia, Italy. This is based on a visual survey of the faces and the cross section of a wall panel, and it aims at verifying if a wall complies with the &ldquo, rules of the art&rdquo, Based on this analysis, it is possible to calculate a numerical index: numerous tests, carried out on site by the authors to validate the method, have demonstrated that the index is able to provide useful information about the mechanical characteristics and structural response, in general, of the analysed wall panel. The failure mode of a wall panel under the action of an earthquake is a critical aspect. In general, the failure modes can be categorized in two classes: masonry disaggregation and the development of a local or global mechanism of wall elements (macroelements). Several theoretical models and numerical simulations only consider the latter. In this paper, application of the MQI method is further investigated, with particular emphasis to those masonry typologies which are more prone to collapse by disaggregation during a seismic event. Under the action of an earthquake, some types of masonry are typically unable to deform and to split in macroelements, and another type of failure occurs: this is the so-called &ldquo, masonry disaggregation&rdquo, or &ldquo, masonry crumbling&rdquo, This type of failure anticipates the ones resulting from macroelement methods or stress analysis. As a conclusion, these latter methods become completely inappropriate and potentially hazardous, as they overestimate the seismic capacity of the building under investigation. The MQI method has been adapted to assess the structural response of different types of masonry under the action of an earthquake. In detail, the aim was to verify when the phenomenon of masonry disaggregation is likely to occur.

Introducción: La acrobacia en tela es una práctica circense con muchos adeptos en la población urbana. Consiste en sostenerse en altura tomado por dos extremos de tela, para realizar posturas fijas y cambiar entre ellas mediante deslizamiento y caídas. La práctica profesional no está libre de lesiones. Objetivo: Conocer la naturaleza de la lesión, reconocer los factores predisponentes de lesión y las medidas de prevención utilizadas, evaluar la cinemática, clasificar la lesión y analizar el tratamiento. Materiales y Métodos: Se incluyeron seis pacientes. Se evaluaron la estructura física personal, la cinemática de la caída, los sistemas de protección, la clasificación de las fracturas según la nueva clasificación AO, el cuadro neurológico, el tratamiento y las complicaciones. Resultados: La muestra incluyó a 6 mujeres, con un promedio de edad de 24 años y un índice de masa corporal de 19,29. Caída de 3,08 m de altura, cuatro con colchoneta, Introduction: Aerial silk is a circus practice that has become very popular in urban populations. It involves hanging from two pieces of fabric in order to make fixed positions and change between them by sliding and dropping from different heights. The professional practice is not free of injuries. Objective: To learn the nature of the injury, to recognize the injury predisposing factors and the safety measures used, to study the kinematics, to classify the injury, and to analyze the treatment. Materials and Methods: Six patients were included. The evaluation included individual body structure, drop kinematics, safety measures, classification of fractures according to the new AO classification, neurological symptoms, treatment, and complications. Results: The study included six female patients, averaging 24 years, a body mass index of 19.29 and a fall from 3.08m, 4 of which included mattress, Facultad de Ciencias Médicas

Distal femur fractures are complex and relatively rare. Conservative treatment has now been abandoned. The purpose of surgical treatment is to obtain an anatomical reduction of the articular surface, restoring the coronal and sagittal axis of the skeletal segment with a stable osteosynthesis, thus avoiding post-operative immobilization and allowing for early physical therapy. The literature reports similar results with different kinds of osteosynthesis: anterograde or retrograde nailing, dynamic compression screw plate, locking compression plates, and blade plates. Not only the type of fracture, but also the experience of the single surgeon should be taken into account when choosing the type of osteosynthesis.

Introducción: El injerto óseo autólogo tomado de la cresta ilíaca posterior para artrodesis de columna presenta ventajas: es osteogénico, osteoinductor y osteoconductor, y sus desventajas son ofrecer una cantidad limitada y las complicaciones del sitio dador (8-39%), como dolor de la zona dadora, lesión neurovascular y fracturas de pelvis. Los objetivos de este estudio fueron comparar la toma de injerto cortico-esponjoso de cresta ilíaca posterior mediante técnica con escoplo gubia frente a la toma con cureta; evaluar las complicaciones intraoperatorias y posoperatorias; cuantificar la cantidad recolectada y graduar el dolor en la zona dadora. Materiales y Métodos: Estudio prospectivo aleatorizado de 34 pacientes consecutivos para artrodesis posterolateral de columna torácica y lumbosacra (26 mujeres y 8 hombres, de entre 15 y 79 años de edad). Se los dividió en dos grupos: grupo 1, cureta y grupo 2, escoplo gubia. Se evaluaron el peso obtenido, el tiempo requerido y las complicaciones. Resultados: Grupo 1: 19 pacientes (14 mujeres y 5 hombres). Se requirieron, en promedio, 9.94 min para obtener 9,26 g. En el primer control, 13 pacientes presentaron un valor 1; 5, un valor 2 y uno, un valor 3. En el tercer control, 15 tuvieron un puntaje 1; 2, un puntaje 2 y 2, un puntaje 3. Grupo 2: 15 pacientes (12 mujeres y 3 hombres). Se tomaron 11,26 g en 8,6 min. En puntaje de dolor en el primer control fue: 10 pacientes con un valor 1; 2, con un valor 2 y 3, con un valor 3, todos tuvieron un puntaje 1 en el tercer control. Conclusiones: La toma de injerto de cresta ilíaca posterior utilizando escoplo gubia es más rápida, recolecta más injerto y provoca menos dolor a los 60 días., Introduction: The autologous bone graft harvested from the posterior iliac crest for spinal fusion presents osteogenic, osteoinductive and osteoconductive advantages; however, its disadvantages include a limited amount of available material and an incidence of donor site complications ranging from 8% to 39%, including donor site pain, neurovascular injury and pelvic fractures. Objectives: To compare the posterior iliac crest corticoancellous harvest using a chisel-gouge approach versus a curette approach; to evaluate intra-operative and post-operative complications; to quantify the harvested bone; to grade donor site pain. Materials and Methods: Prospective randomized study in 34 consecutive patients for posterolateral fusion of the thoracic and lumbosacral spine; 26 women and 8 men, between 15 and 79 years of age. Subjects were divided into two groups. Group 1: curette approach; and Group 2: chiselgouge approach. The evaluation included: the amount of bone harvested, the time required and complications. Results: Group 1: 19 patients, 14 women and 5 men. The procedure lasted an average of 9.94 min, and the harvested material averaged 9.26 g. Denis Pain Scale scores at the first follow-up survey: 13 patients scored 1; 5 scored 2; 1 scored 3. Denis Pain Scale scores at the third follow-up survey: 15 patients scored 1; 2 scored 2; 1 scored 3. Group 2: 15 patients, 12 women and 3 men. The procedure lasted an average of 8.6 min, and the harvested material averaged 9.26 g. Denis Pain Scale scores at their first follow-up: 10 patients scored 1; 2 scored 2; 3 scored 3. At the third follow-up, all patients scored 1. Conclusions: We observed that the posterior iliac crest graft harvested using the chisel-gouge approach is faster, provides more graft and results in less pain at 60 days., Facultad de Ciencias Médicas

A clear gap was identified in the literature regarding the in-depth evaluation of scaling up thermal energy storage components. To cover such a gap, a new methodological approach was developed and applied to a novel latent thermal energy storage module. The purpose of this paper is to identify some key aspects to be considered when scaling up the module from lab-scale to full-scale using different performance indicators calculated in both charge and discharge. Different normalization methods were applied to allow an appropriate comparison of the results at both scales. As a result of the scaling up, the theoretical energy storage capacity increases by 52% and 145%, the average charging power increases by 21% and 94%, while the average discharging power decreases by 16% but increases by 36% when mass and volume normalization methods are used, respectively. When normalization by the surface area of heat transfer is used, all of the above performance indicators decrease, especially the average discharging power, which decreases by 49%. Moreover, energy performance in charge and discharge decreases by 17% and 15%, respectively. However, efficiencies related to charging, discharging, and round-trip processes are practically not affected by the scaling up. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 768824 (HYBUILD). This work was partially funded by the Ministerio de Ciencia, Innovación y Universidades de España (RTI2018-093849-B-C31—MCIU/AEI/FEDER, UE) and by the Ministerio de Ciencia, Innovación y Universidades—Agencia Estatal de Investigación (AEI) (RED2018-102431-T). This work is partially supported by ICREA under the ICREA Academia programme.

Charged-particle spectra at midrapidity are measured in Pb-Pb collisions at the centre-of-mass energy per nucleon-nucleon pair $\sqrt{s_{\rm NN}}$ = 5.02 TeV and presented in centrality classes ranging from most central (0-5%) to most peripheral (95-100%) collisions. Possible medium effects are quantified using the nuclear modification factor ($R_{\rm AA}$) by comparing the measured spectra with those from proton-proton collisions, scaled by the number of independent nucleon-nucleon collisions obtained from a Glauber model. At large transverse momenta ($8, Comment: 24 pages, 7 captioned figures, 2 tables, authors from page 18, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/4437

The 2016 Umbrian earthquake caused the collapse of several medieval churches, while it was noted that ordinary buildings only reported moderate or little damage. Researchers and technicians are looking to these religious constructions with the aim of understanding their structural behavior under seismic action. Depending on the direction of the seismic action, the typical collapse mode was the overturning of the side walls or of the church façade. This often produced the collapse of the roof structure. In many situations, the overturning was facilitated by a weak connection between the load-bearing walls. In this article, the collapse modes of three mediaeval churches are investigated. The article goes into some detail about what considerations are relevant when analyzing a historic masonry construction. The churches object of this study are located in Campi, a hamlet of Norcia, Italy. Between 2000 and 2004, a research team from the Technical University of Milan in collaboration with the Italian Ministry of Culture carried out an extensive investigation on the historic buildings of Campi, providing interesting data about the maintenance level and a summary of the structural state of the churches. These data were used in this article for a critical analysis of the causes of collapse, performed in combination with numerical simulations of the global behavior and local instability.

The conservation and preservation of historic buildings affords many challenges to those who aim to retain our building heritage. In this area, the knowledge of the mechanical characteristics of the masonry material is fundamental. However, mechanical destructive testing is always expensive and time-consuming, especially when applied to masonry historic structures. In order to overcome such kind of problems, the authors of this article, proposed in 2014 a visual method for the estimation of some critical mechanical parameters of the masonry material. Based on the fact that the mechanical behavior of masonry material depends on many factors, such as compressive or shear strength of components (mortar and masonry units), unit shape, volumetric ratio between components and stone arrangement, that is the result of applying a series of construction solutions which form the “rule of art”. Taking into account the complexity of the problem due to the great number of variables, and being on-site testing a not-always viable solution, a visual estimate of the mechanical parameters of the walls can be made on the basis of a qualitative criteria evaluation. A revision of this visual method is proposed in this paper. The draft version of new Italian Building Code have been used to re-calibrate this visual method and more tests results have been also considered for a better estimation of the mechanical properties of masonry.

The use of latent heat thermal energy storage is an effective way to increase the efficiency of energy systems due to its high energy density compared with sensible heat storage systems. The design of the storage material encapsulation is one of the key parameters that critically affect the heat transfer in charging/discharging of the storage system. To fill the gap found in the literature, this paper experimentally investigates the effect of the macro-encapsulation design on the performance of a lab-scale thermal energy storage tank. Two rectangular slabs with the same length and width but different thickness (35 mm and 17 mm) filled with commercial phase change material were used. The results show that using thinner slabs achieved a higher power, leading to a reduction in the charging and discharging time of 14% and 30%, respectively, compared with the thicker slabs. Moreover, the variation of the heat transfer fluid flow rate has a deeper impact on the temperature distribution and the energy charged/released when thicker slabs were used. The macro-encapsulation design did not have a significant impact on the discharging efficiency of the tank, which was around 85% for the operating thresholds considered in this study. This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No. 764025 (SWS-HEATING). This work was partially funded by the Ministerio de Ciencia, Innovación y Universidades de España (RTI2018-093849-B-C31—MCIU/AEI/FEDER, UE) and by the Ministerio de Ciencia, Innovación y Universidades—Agencia Estatal de Investigación (AEI) (RED2018-102431-T). This work is partially supported by ICREA under the ICREA Academia program.

Giant Cell Tumor (GCT), a benign tumor with local aggression, corresponds to 5% of primary tumors. Fifteen percent of these are located in the sacrum. En bloc resection is an effective treatment, but when it cannot be performed, Denosumab may be indicated as an alternative treatment. The objectives of this work are: to justify the indication; determine the best dose and time of use; and recognize the need for posttreatment surgery. Methods: A systematic search of clinical trials. Twenty-five articles were selected, ten of which met the inclusion criteria. The use of Denosumab is justified in advanced stages, with a dose of 120 mg administered subcutaneously, every 7 days in the first month and then maintained every 4 weeks, for 2.5 to 13 months. Adverse events are mild and can be observed in 84% of patients. With Denosumab, surgery may be less aggressive or even unnecessary. The bibliography justifies the indication of Denosumab in advanced stages of GCT, with a dose of 120 mg administered subcutaneously; there is no consensus as to the maintenance dose, which is a weekly dose in the first month and then every four weeks for 2.5 to 13 months. Complications are frequent but mild. Level of evidence III; Systematic review., El tumor de células gigantes (TCG), un tumor benigno con agresión local, corresponde a 5% de los tumores primarios. Quince por ciento de éstos están localizados en el sacro. La resección en bloque es un tratamiento eficaz, pero cuando no puede ser realizada, el Denosumab puede ser indicado como tratamiento alternativo. Los objetivos de este estudio consisten en justificar la indicación, determinar la mejor dosis y tiempo de uso, y reconocer la necesidad de cirugía postratamiento. Métodos: Fue realizada una búsqueda sistemática de ensayos clínicos, siendo que fueron seleccionados veinticinco artículos, de los cuales diez atendieron los criterios de inclusión. El uso de Denosumab está justificado en etapas avanzadas, con una dosis de 120 mg administrada por vía subcutánea, a cada 7 días en el primer mes y, después, mantenida a cada 4 semanas, durante 2,5 a 13 meses. Los eventos adversos son leves y pueden observarse en 84% de los pacientes. Con el Denosumab, la cirugía puede ser menos agresiva o ni necesaria. La bibliografía justifica la indicación de Denosumab en etapas avanzados de TCG, con dosis de 120 mg administrada por vía subcutánea; no hay consenso cuanto a la dosis de mantenimiento, la cual es una dosis semanal en el primer mes y después a cada cuatro semanas durante 2,5 a 13 meses. Las complicaciones son frecuentes, aunque leves. Nivel de evidencia III; Revisión Sistemática., O tumor de células gigantes (TCG), um tumor benigno com agressão local, corresponde a 5% dos tumores primários. Quinze por cento desses estão localizados no sacro. A ressecção em bloco é um tratamento eficaz, mas quando não pode ser realizada, o Denosumabe pode ser indicado como tratamento alternativo. Os objetivos desse estudo consistem em justificar a indicação; determinar a melhor dose e tempo de uso e reconhecer a necessidade de cirurgia pós-tratamento. Métodos: Foi realizada uma busca sistemática de ensaios clínicos, sendo que foram selecionados 25 artigos, dos quais dez atenderam aos critérios de inclusão. O uso do Denosumabe é justificado em estágios avançados, com uma dose de 120 mg administrada por via subcutânea, a cada 7 dias no primeiro mês e, depois, mantida a cada 4 semanas, durante 2,5 a 13 meses. Os eventos adversos são leves e podem ser observados em 84% dos pacientes. Com o Denosumabe, a cirurgia pode ser menos agressiva ou nem necessária. A bibliografia justifica a indicação de Denosumabe em estágios avançados do TCG, com dose de 120 mg administrada por via subcutânea; não há consenso quanto à dose de manutenção, a qual é uma dose semanal no primeiro mês e depois a cada quatro semanas durante 2,5 a 13 meses. As complicações são frequentes, porém leves. Nível de evidência III; Revisão sistemática., Facultad de Ciencias Médicas

Hilly terrain may considerably influence energy yield and structural loading of wind turbines. Wind energy developers are therefore required to accurately predict wind characteristics at the wind farm site already in the designing phase. It is necessary to determine how particular hill shape and size affect wind characteristics at the location of wind turbines operating in the wake of a hill. In order to address this complex issue, small-scale laboratory experiments were carried out in a boundary layer wind tunnel (BLWT). The focus was on characteristics of the flow at the same position downstream of the hill and the wind turbine models studied on various sizes and shapes of the hill model. Three hill models (a small and a large hill with laterally uniform heights and a hill with a bay) were exposed to the thermally neutrally stratified atmospheric boundary layer (ABL) simulation. In each experiment, there was only one hill model in the BLWT test section. The configuration without the hill, i.e. the flat terrain model, was tested as a reference case. Downstream of the hill model, there was a single (alone-standing) wind turbine model. Flow characteristics were studied downstream (behind) the wind turbine model. The wind turbine model was in the parking position in order to study wind characteristics in the situation with a strong wind when there is no rotation of rotor blades. The experimental results indicate a velocity decrease and stronger turbulence in the wind turbine wake in the presence of a hill, which trend is more pronounced in the case of larger hills. Strong velocity gradients are observed around the hub height in the large hill configuration, while this velocity deficit is the smallest in the hill with a bay configuration due to flow channeling. The velocity power spectra reveal the characteristic peak due to the vortex shedding from the hill ridge. The obtained results provide a new insight into the turbulent wake characteristics of a single wind turbine placed downstream of a hill with a potential to serve as a validation tool for computational studies.

Liquid Air Energy Storage is one of the most promising novel energy storage concept that guarantees at the same time viable capital cost, high energy density and no geographical/geological constrains. Considering the complexity of the plant, composed by three different phases (charge, discharge and storage), thermodynamic modelling could be a challenging undertaking. Making use of the strong similitude with gas turbine technology, this paper aims to deliver new generalized performance maps for Liquid Air Energy Storage system. The performance maps, validated against the experimental results of Highview Power pilot plant, have been modelled by means of a comprehensive sensitivity analysis carried out considering three macro-scenarios imposing the storage pressures and the turbomachinery performance (design/off-design conditions). By means of the performance maps, the impact of the main LAES operative parameters, as well as the effect of the cold/warm thermal energy storage utilization factor, over the key performance indicators has been assessed and analysed. The analysis shows that at design condition the higher is the value of the high grade cold thermal energy storage utilization factor, the lower is the positive impact of charge pressure over the specific consumption. For off-design condition of the main turbomachinery, the negative effect of lower isentropic efficiency of the main turbomachinery on the round trip efficiency is amplified by the choice of the charge pressure. At high value of the warm energy storage utilization factor, this negative effect can be partially offset by the higher Turbine Inlet Temperature available for the expansion process of the discharge phase.

The scattering and absorption of light by nano-objects is a key physical property exploited in many applications, including biosensing and photovoltaics. Yet, its quantification at the single object level is challenging, and often requires expensive and complicated techniques. We report a method based on a commercial transmission microscope to measure the optical scattering and absorption cross-sections of individual nano-objects. The method applies to micro-spectroscopy and wide-field image analysis, offering fine spectral information and high throughput sample characterization. Accurate cross-section determination requires a detailed modeling of the measurement, which we develop, accounting for the geometry of the illumination and detection, as well as for the presence of a sample substrate. We demonstrate the method on three model systems (gold spheres, gold rods, and polystyrene spheres), which include metallic and dielectric particles, spherical and elongated, placed in a homogeneous medium or on a dielectric substrate. Furthermore, by comparing the measured cross-sections with numerical simulations, we are able to determine structural parameters of the studied system, such as the particle diameter and aspect ratio. Our method therefore holds the potential to complement electron microscopy as a simpler and cost-effective tool for structural characterization of single nano-objects.

Aromatic- l -amino acid decarboxylase (AADC) deficiency is an ultra-rare inherited autosomal recessive disorder characterized by sharply reduced synthesis of dopamine as well as other neurotransmitters. Symptoms, including hypotonia and movement disorders (especially oculogyric crisis and dystonia) as well as autonomic dysfunction and behavioral disorders, vary extensively and typically emerge in the first months of life. However, diagnosis is difficult, requiring analysis of metabolites in cerebrospinal fluid, assessment of plasma AADC activity, and/or DNA sequence analysis, and is frequently delayed for years. New metabolomics techniques promise early diagnosis of AADC deficiency by detection of 3-O-methyl-dopa in serum or dried blood spots. A total of 82 dopa decarboxylase (DDC) variants in the DDC gene leading to AADC deficiency have been identified and catalogued for all known patients (n = 123). Biochemical and bioinformatics studies provided insight into the impact of many variants. c.714+4A>T, p.S250F, p.R347Q, and p.G102S are the most frequent variants (cumulative allele frequency = 57%), and c.[714+4A>T];[714+4A>T], p.[S250F];[S250F], and p.[G102S];[G102S] are the most frequent genotypes (cumulative genotype frequency = 40%). Known or predicted molecular effect was defined for 79 variants. Most patients experience an unrelenting disease course with poor or no response to conventional medical treatments, including dopamine agonists, monoamine oxidase inhibitors, and pyridoxine derivatives. The advent of gene therapy represents a potentially promising new avenue for treatment of patients with AADC deficiency. Clinical studies based on the direct infusion of engineered adeno-associated virus type 2 vectors into the putamen have demonstrated acceptable safety and tolerability and encouraging improvement in motor milestones and cognitive symptoms. The success of gene therapy in AADC deficiency treatment will depend on timely diagnosis to facilitate treatment administration before the onset of neurologic damage.

This paper aims to deliver new performance maps for “microgrid scale” Liquid Air Energy Storage system with a liquid air production of 1000 kg/h. By means of the performance maps, the impact of the main Liquid Air Energy Storage operative parameters, as well as the effect of the cold/warm thermal energy storage utilization factor, over the key performance indicators has been assessed and analyzed. The thermodynamics and sub-processes of the Liquid Air Energy Storage system are described in details and simulated by means of the software Aspen Hysys. Each performance map has been modelled by means of a sensitivity analysis carried out for the system operative parameters. Such a new methodology allows to select Liquid Air Energy Storage size and its related performance by means of a simple tool without the implementation of any complex numerical model. Published version

Silver-plated copper busbars are screen printed onto silicon solar cells and have the key role to collect the electric current produced by the solar cell. Busbars of two adjacent solar cells are then connected by a soldered ribbon made of the same material. Due to mechanical and thermal loads, such a ribbon is subject to axial deformation that, often, causes plasticity and, in some cases, its breakage due to crack growth. A procedure based on the gradient-descent method and particle swarm optimization is herein proposed for the identification of elasto-plastic and nonlinear (cohesive zone model, CZM) fracture mechanics parameters of silver-plated copper busbars. The proposed method requires the experimental determination of the force-displacement curves from uniaxial tensile tests on busbar samples with and without initial notches. The inspection of in situ SEM images during the tests allows also the estimation of the crack opening, which is found to be an important local quantity to assess the reliability of different CZMs in simulating a crack growth process consistent with the real one.

As molecular spectroscopy makes its comeback to the limelight of fundamental sciences, scientists need ever better coherent light sources and diagnostic methods. Of particular importance for molecular spectroscopy is the mid infrared spectral region, where strong and narrow ro-vibrational excitations have their fundamental transition frequencies. Unfortunately, much technology in some portions of this spectral region is still rather pioneering. Here we present a high-resolution spectroscopy experiment, based on a molecular beam setup, which pushes the measured linewidth close to the transit time limit, on the order of 100 kHz. Moreover, we discuss the issue of frequency-noise characterization and the linewidth measurement of the ultrastable infrared laser used in the experiment.

Atherosclerosis and abdominal aortic aneurysms (AAAs) have several similar risk factors but different pathogenesis. Inflammation of the arteries is common to both. Central obesity can act as an endocrine organ through the secretion of inflammatory cytokines, and the perivascular fat has a local effect that could contribute to diseases of the abdominal aorta. Although the relation between central obesity and atherosclerosis occlusive arterial disease has been demonstrated, the correlation with AAA has conflicting results. The aim of this study was to analyze the correlation between central obesity and the presence of abdominal aortic diseases using computed tomography.Six hundred thirty-nine consecutive patients classified into 3 groups (AAA, aortic atherosclerotic occlusive disease (AAOD), and without aortic disease [control group]) who underwent computed tomography had the aorta diameter, the visceral fat area (VFA), and the subcutaneous fat area (SFA) measured at the level of third and fourth lumbar vertebrae.VFA showed no difference between the groups. SFA was lower in atherosclerotic group (AAOD) than control (P 0.01 in general and P 0.04 in male). In AAA group, we found in men that the first tertile of aorta diameter had higher VFA than third tertile (P = 0.02).There was no difference in VFA between patients in AAA, AAOD, and without aortic disease groups. In men with aneurysm, there was an inverse relationship between VFA and aortic diameter. In AAOD, visceral to subcutaneous ratio is higher due to lower SFA.

Objective There is a pressing need to assess user-dependent reproducibility of multi-fibre probabilistic tractography in order to encourage clinical implementation of these advanced and relevant approaches. The goal of this study was to evaluate both intrinsic and inter-user reproducibility of corticospinal tract estimation. Materials and methods Six clinical datasets including motor functional and diffusion MRI were used. Three users performed an independent tractography analysis following identical instructions. Dice indices were calculated to quantify the reproducibility of seed region, fMRI-based end region, and streamline maps. Results The inter-user reproducibility ranged 41–93%, 29–94%, and 50–92%, for seed regions, end regions, and streamline maps, respectively. Differences in streamline maps correlated with differences in seed and end regions. Good inter-user agreement in seed and end regions, yielded inter-user reproducibility close to the intrinsic reproducibility (92–97%) and in most cases higher than 80%. Discussion Uncertainties related to user-dependent decisions and the probabilistic nature of the analysis should be considered when interpreting probabilistic tractography data. The standardization of the methods used to define seed and end regions is a necessary step to improve the accuracy and robustness of multi-fiber probabilistic tractography in a clinical setting. Clinical users should choose a feasible compromise between reproducibility and analysis duration.

In the quest to decipher the chain of life from molecules to cells, the biological and biophysical questions being asked increasingly demand techniques that are capable of identifying specific biomolecules in their native environment, and can measure biomolecular interactions quantitatively, at the smallest possible scale in space and time, without perturbing the system under observation. The interaction of light with biomolecules offers a wealth of phenomena and tools that can be exploited to drive this progress. This Roadmap is written collectively by prominent researchers and encompasses selected aspects of bio-nano-photonics, spanning from the development of optical micro/nano-spectroscopy technologies for quantitative bioimaging and biosensing to the fundamental understanding of light–matter interaction phenomena with biomolecules at the nanoscale. It will be of interest to a wide cross-disciplinary audience in the physical sciences and life sciences.

BACKGROUND Pelvic organ prolapse (POP) etiology is a combination of anatomical, physiological, genetic, lifestyle, and reproductive factors determine pelvic floor dysfunction. POP is very common across all ages women worldwide and has become an increasing socioeconomic problem with public health consequences, with symptoms that could lead to a significant decrease in quality of life. METHODS This study retrospectively analyzes a small case series of our initial experience of laparoscopic vaginal suspension with mesh focusing on the technical aspects of the technique. Although sacrocolpopexy and sacrohysteropexy are the most performed surgical techniques, they are associated with serious complications. Laparoscopic vaginal suspension appears reproducible and safe to learn. RESULTS Between November 2017 and January 2020, fifteen patients underwent laparoscopic vaginal suspension for pelvic organ prolapse repair. Despite the small number, for a minimally invasive skilled surgeon, we notice a significative reduction of the learning curve to become proficient in this procedure. CONCLUSIONS The diagnosis and management of pelvic organ prolapse are further complicated by what is considered "successful" treatment. Laparoscopic vaginal suspension is a feasible surgical procedure for one-stage treatment of pelvic organ prolapse.

Gas sensors with high sensitivity, wide dynamic range, high selectivity, fast response, and small footprint are desirable across a broad range of applications in energy, environment, safety, and public health. However, designing a compact gas sensor with ultra-high sensitivity and ultra-wide dynamic range remains a challenge. Laser-based photoacoustic spectroscopy (PAS) is a promising candidate to fill this gap. Herein, we report a novel method to simultaneously enhance the acoustic and light waves for PAS using integrated optical and acoustic resonators. This increases sensitivity by more than two orders of magnitude and extends the dynamic range by more than three orders of magnitude, compared with the state-of-the-art photoacoustic gas sensors. We demonstrate the concept by exploiting a near-infrared absorption line of acetylene (C2H2) at 1531.59 nm, achieving a detection limit of 0.5 parts-per-trillion (ppt), a noise equivalent absorption (NEA) of 5.7×10-13 cm-1 and a linear dynamic range of eight orders of magnitude. This study enables the realization of compact ultra-sensitive and ultra-wide-dynamic-range gas sensors in a number of different fields.

This paper studies the systemic risk contribution of a set of large publicly traded European banks. Over a sample covering the last twenty years and three different crises, we find that all banks in our sample significantly contribute to systemic risk. Moreover, larger banks and banks with a business model more exposed to trading and financial market volatility, contribute more. In the shorter sample characterized by the Covid-19 shock, sovereign default risks significantly affected the systemic risk contribution of all banks. However, the ECB announcement of the Pandemic Emergency Purchasing Programme restored calm in the European banking sector.

This study aims to develop a reliable and reproducible inflammatory bowel disease (IBD) murine model based on a careful spatial–temporal histological characterization. Secondary aims included extensive preclinical studies focused on the in situ expression of clinically relevant biomarkers and targets involved in IBD. C57BL/6 female mice were used to establish the IBD model. Colitis was induced by the oral administration of 2% Dextran Sulfate Sodium (DSS) for 5 days, followed by 2, 4 or 9 days of water. Histological analysis was performed by sectioning the whole colon into rings of 5 mm each. Immunohistochemical analyses were performed for molecular targets of interest for monitoring disease activity, treatment response and predicting outcome. Data reported here allowed us to develop an original scoring method useful as a tool for the histological assessment of preclinical models of DSS-induced IBD. Immunohistochemical data showed a significant increase in TNF-α, α4β7, VEGFRII, GR-1, CD25, CD3 and IL-12p40 expression in DSS mice if compared to controls. No difference was observed for IL-17, IL-23R, IL-36R or F480. Knowledge of the spatial–temporal pattern distribution of the pathological lesions of a well-characterized disease model lays the foundation for the study of the tissue expression of meaningful predictive biomarkers, thereby improving translational success rates of preclinical studies for a personalized management of IBD patients.

Background Clinical examination and lymphoscintigraphy are the current standard for investigating lymphatic function. Magnetic resonance imaging (MRI) facilitates three-dimensional (3D), nonionizing imaging of the lymphatic vasculature, including functional assessments of lymphatic flow, and may improve diagnosis and treatment planning in disease states such as lymphedema. Purpose To summarize the role of MRI as a noninvasive technique to assess lymphatic drainage and highlight areas in need of further study. Study type Systematic review. Population In October 2019, a systematic literature search (PubMed) was performed to identify articles on magnetic resonance lymphangiography (MRL). Field strength/sequence No field strength or sequence restrictions. Assessment Article quality assessment was conducted using a bespoke protocol, designed with heavy reliance on the National Institutes of Health quality assessment tool for case series studies and Downs and Blacks quality checklist for health care intervention studies. Statistical tests The results of the original research articles are summarized. Results From 612 identified articles, 43 articles were included and their protocols and results summarized. Field strength was 1.5 or 3.0 T in all studies, with 25/43 (58%) employing 3.0 T imaging. Most commonly, imaging of the peripheries, upper and lower limbs including the pelvis (32/43, 74%), and the trunk (10/43, 23%) is performed, including two studies covering both regions. Imaging protocols were heterogenous; however, T2 -weighted and contrast-enhanced T1 -weighted images are routinely acquired and demonstrate the lymphatic vasculature. Edema, vessel, quantity and morphology, and contrast uptake characteristics are commonly reported indicators of lymphatic dysfunction. Data conclusion MRL is uniquely placed to yield large field of view, qualitative and quantitative, 3D imaging of the lymphatic vasculature. Despite study heterogeneity, consensus is emerging regarding MRL protocol design. MRL has the potential to dramatically improve understanding of the lymphatics and detect disease, but further optimization, and research into the influence of study protocol differences, is required before this is fully realized. Level of evidence 2 TECHNICAL EFFICACY: Stage 2.

The direct integration of phase change materials (PCM) into refrigeration and air conditioning systems through compact modules is an identified literature gap. In response to the literature gap, this paper provides a detailed energy analysis of a novel compact thermal energy storage module, that allows its direct integration into a refrigeration system as the evaporator. The study addresses key aspects of thermal energy storage (TES) and heat transfer mechanism that complement the previous analyses of the novel concept. Here the total energy stored in the module (including in all auxiliary parts), the charging/discharging power, and the behaviour of the module when used as a TES module and as a heat exchanger (HEX) are assessed. The results demonstrate the feasibility of the module to work as a TES and as a HEX. When working as a TES, complete charging and discharging was achieved, and 54% of the total energy was stored in the PCM although the PCM only accounts for around 14% of the total mass. Moreover, the highest charging/discharging power was obtained within the temperature range where most of the phase change occurred. When the module works as a HEX, it initially charges/discharges partially until a thermal equilibrium is achieved and the level of charge responds to the variation in the energy supply and demand. This work was partially funded by the Ministerio de Ciencia, Innovación y Universidades de España (RTI2018-093849-B-C31 - MCIU/AEI/FEDER, UE) and by the Ministerio de Ciencia, Innovación y Universidades - Agencia Estatal de Investigación (AEI) (RED2018-102431-T). The authors would like to thank the Catalan Government for the quality accreditation given to their research group GREiA (2017 SGR 1537). GREiA is a certified agent TECNIO in the category of technology developers from the Government of Catalonia. This work is partially supported by ICREA under the ICREA Academia programme. Boniface Dominick Mselle would like to thank Programa Santander Predoc UdL for his research fellowship.

We present a novel shot-noise-limited balanced-homodyne detector operating in the mid-infrared useful for revealing possible non-classicality in quantum cascade lasers emission. We will give a view to quantum-technologies applications such as free-space quantum communication.

In the field of spatial planning, the role of knowledge resulting from a cognitive bottom-up approach is increasing. In a “cognitive planning” approach the environment represents a biological and cultural expression of the relationship between population, activities and places. Yet defining an appropriate model to represent the different cognitive frames and interests arising from this complex relationship is difficult. In this context, investigating on knowledge representation is of great importance, today augmented using intelligent cognitive tools and models. This work shows a case-based approach based combining traditional participatory techniques with knowledge elicitation and exchange support for bottom-up spatial planning. Specifically, a scenario-building approach has been implemented in an ICT-based environment that has allowed a widespread data collection on an extended sample of citizens. Visions and strategic actions proposed by the citizens involved have been formalized through formal data analyses, so becoming useful material to test the effectiveness of strategies proposed in a decision-support system architecture. The methodology was applied on an experimental basis during the knowledge-building phase of public participation for the new Master plan of the city of Brindisi (Italy).

We present the characterization of a novel balanced homodyne detector operating in the mid-infrared. The challenging task of revealing non-classicality in mid-infrared light, e.~g. in quantum cascade lasers emission, requires a high-performance detection system. Through the intensity noise power spectral density analysis of the differential signal coming from the incident radiation, we show that our setup is shot-noise limited. We discuss the experimental results with a view to possible applications to quantum technologies, such as free-space quantum communication., Comment: 15 pages, 6 figures

Wind‐tunnel experiments were performed to study the wind characteristics on a parked wind turbine downwind of three types of hill and over a flat terrain. The focus of the study is on comparing wind characteristics on (a) a wind turbine standing alone and (b) this same type of wind turbine embedded in a wind farm. Particular emphasis is placed on the hill size and shape and the distance between the hill and the wind farm. The hill and wind‐farm models were subjected to an atmospheric boundary layer simulation to create realistic atmospheric conditions. Flow and turbulence were analyzed based on the measured mean flow velocity, Reynolds shear stress, turbulence intensity, and the power spectral density of velocity fluctuations. The experimental results reveal similar trends concerning (a) the wind characteristics obtained on a parked wind turbine embedded in a wind farm downwind of hills of various sizes and shapes and (b) the wind characteristics on this same type of parked wind turbine standing alone in the same position downwind of the same hills. In particular, the discrepancies in the mean flow velocity and turbulence intensity between these test cases are mostly below 5%, thus indicating that a complex terrain clearly has a dominant effect on the wind characteristics, while the effects of parked wind turbines on the wind characteristics are negligible. This important finding indicates that the structural loading of parked wind turbines situated on a complex terrain may be well calculated using the same procedures both for wind turbines standing alone and wind turbines embedded in wind farms if they are both placed at the same distance downwind of the same hills.

Increasing the energy efficiency of residential and non-residential buildings is a crucial point towards the development of the sustainable cities of the future. To reach such a goal, the commonly employed intervention measures (for instance, on facades and glass) are not sufficient and efforts in reaching a fully renewable energy generation are mandatory. In this context, this paper discusses the applicability of a system with solar and biomass as the main energy sources in different climates for heating, cooling, domestic hot water and electricity generation in office buildings. The energy system includes solar thermal collectors with thermoelectric generators, a biomass boiler, a reversible heat pump/organic Rankine cycle and an adsorption chiller. The results showed that the system can operate with a share of renewables higher than 70% for all energy needs, with up to 80% of the overall energy demand supplied only by solar and biomass sources even in the northern locations. This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 814945 (SolBio-Rev)

BackgroundThe effects of an early and prolonged lockdown during the coronavirus disease 2019 (COVID-19) pandemic on cardiovascular intensive care units (CICUs) are not well established.ObjectivesThis study analyses patterns of admission, mortality and performance indicators in a CICU before and during the Argentine lockdown in the COVID-19 pandemic.MethodsThis is a retrospective observational cross-sectional study of all consecutive patients aged 18 years or more admitted to the cardiac intensive care unit at a high-volume reference hospital in Buenos Aires, Argentina, comparing hospitalization rates, primary causes of admission, inpatient utilization indicators, pharmacy supplies’ expenditures and in-hospital mortality between 5 March and 31 July 2020, with two corresponding control periods in 2019 and 2018.ResultsWe included 722 female patients [mean age of 61.6 (SD 15.5) years; 237 (32.8%)]. Overall hospitalizations dropped 53.2% (95%CI: 45.3, 61.0%), from 295.5 patients/year over the periods 2018/2019 to 137 patients in 2020. Cardiovascular disease–related admissions dropped 59.9%, while admission for non-cardiac causes doubled its prevalence from 9.6% over the periods 2018/2019 to 22.6% in the study period (P In the period 2020, the bed occupancy rate fell from 82.2% to 77.4%, and the bed turnover rate dropped 50% from 7.88 to 3.91 monthly discharges/bed. The average length of stay doubled from 3.26 to 6.75 days, and the turnover interval increased from 3.8 to 8.39 days in 2020.Pharmacy supplies’ expenditures per discharge increased 134% along with a rise in antibiotics usage from 6.5 to 11.4 vials/ampoules per discharge (P Overall mortality increased from 7% (n = 41) to 13.9% (n = 19) (P = 0.008) at the expense of non-cardiac-related admissions (3.6–19.4%, P = 0.01).ConclusionsThis study found a significant reduction in overall and cardiovascular disease–related causes of admission to the cardiac intensive care unit, worse performance indicators and increased in-hospital mortality along the first 5 months of the early and long-lasting COVID-19 lockdown in Argentina. These results highlight the need to foster public awareness concerning the risks of avoiding hospital attendance. Moreover, health systems should follow strict screening protocols to prevent potential biases in the admission of patients with critical conditions unrelated to the COVID-19 pandemic.

The analysis and control of time-delay systems has gained increasing interest in the last decades due to the effectiveness of delay differential equations (DDEs) in modeling a wide range of physical and engineering frameworks, such as ecological systems, industrial processes, telerobotic systems, earth-controlled satellite devices, and biomedical engineering. Another significant application area that has recently gained widespread attention is networked and distributed control, which may naturally induce nonnegligible and possibly time-varying delays in the input/output channels. As in the case of systems described by ordinary differential equations (ODEs), a crucial point in most advanced control approaches, such as optimal and robust control, is the possibility to solve the observer problem, that is the design of algorithms that provide full information on the state of the system by real-time processing of few measurements. The reader can refer to the recent edited book on nonlinear delay systems [1] and references therein.

Historic walls were designed in the past to withstand vertical compressive loads. However, during seismic events, walls withstand lateral loads and their response is usually unsatisfactory. Reinforcement is often needed and several retrofitting methods have been proposed in the last decades. This paper analyses and compares the strength results of several experimental campaigns, recently carried out by the authors, with the specifications and mechanical properties suggested by the new (2018) Italian Seismic Code. Two retrofitting methods are considered: grout injections, alone, and in combination with jacketing. The effect of combined retrofitting methods was also investigated in this paper with the aim at studying the limitations of the actual Italian Building Code for interventions on listed buildings. Shear tests were carried out on-site and the effectiveness of the two retrofitting methods was discussed.

Background This study analyzed the short- and long-term outcomes of robotic-assisted thoracic surgery (RATS) for early stage non-small cell lung cancer (NSCLC). Methods From November 2006 to December 2016, we performed 363 RATS procedures. This study retrospectively reviewed 339 patients who underwent RATS for clinical stages I (n = 318) or II (n = 21) NSCLC. Results Twenty-nine patients underwent segmentectomy, 307 lobectomy, and 3 pneumonectomy. Conversion occurred in 22 patients (6.5%): 15 (4.4%) due to technical issues, 4 (1.2%) for oncological reasons, and 3 (0.9%) for bleeding. The median number of N1 and N2 stations resected was 2 and 3, respectively, and the median number of N1 and N2 lymph nodes resected was 9 and 6, respectively. Median operative time was 192 minutes for lobectomy, 172 minutes for segmentectomy, and 275 minutes for pneumonectomy. Median length of hospital stay was 5 days (2–191). The most common postoperative complication was prolonged air leak (12.1%). Major complications occurred in eight patients (2.4%). The 30-day and 90-day operative mortality was 0% and 0.3%, respectively. Two and 5-year cancer-specific survival rate was 96.1% and 91.5%, respectively. Five-year survival rate was 96.2% for patients who underwent segmentectomy, and 89.1% for lobectomy. All three patients who underwent pneumonectomy were alive at 5 years with no disease. Conclusions Besides the well-known short-term outcomes showing very low morbidity and mortality rates, mediastinal lymph node dissection during RATS adequately assesses lymph node stations detecting occult lymph node metastasis and leading to excellent oncologic results. However, these results await longer follow-up studies.

Four regions of central Italy were struck by the seismic sequence of the 2016 earthquake in the country: Lazio, Abruzzo, Umbria and Marche. This highlighted the different behaviour of masonry constructions depending on the prevention actions carried out after previous earthquakes. In particular, although damaged, the masonry buildings in the historical centre of Norcia (Umbria region) behaved significantly better than those in other regions. Indeed, the strengthening interventions carried out after the earthquakes of 1971, 1979 and 1997 greatly affected the seismic behaviour of masonry aggregates (contiguous masonry structural units, MSUs) in the historical centre, which sustained limited damage and a low number of collapses. This paper discusses the empirical data on damage collected with respect to 670 MSUs by means of the first level survey form concerning post-earthquake damage, and usability assessments (AeDES). The forms completed for the survey relate to MSUs in the historical centre of Norcia and were produced by the technicians of the Umbria Seismic Risk Office. The analysis shows the correlation between the MSU characteristics of: age of construction and renovation work; type of vertical and horizontal structures; roof types and usability rating; and the damage level and extent thereof detected in vertical structures. The effectiveness of previous strengthening interventions and the analyses of the types of strengthening solution are also discussed. A case study aggregate is analyzed in detail in order to illustrate the importance of strengthening interventions on vertical bearing elements. The strengthening interventions resulted in a sound strategy to strongly reduce losses, even in a very vulnerable centre comprised of old residential masonry aggregates.

Italy is the leading European rice producer. The transition to organic farming of rice farms could represent a solution for environmental protection, as well as for their economic sustainability, consumer safety, and as a measure of climate mitigation. However, there are currently several weaknesses in the control and certification system. The objective of the current study was to propose advice for improving the control and certification scheme in the organic rice sector. The goal was achieved by adopting a qualitative methodology based on participant observation at stakeholder meetings and community-led workshops, and information collected in focus groups and deep interviews with relevant local actors. The findings show that there are some solutions to mitigate the weakness of the Italian certification scheme. The study also contributes to improving the Italian organic rice sector by highlighting that a revision of procedures and sanctions alone is not enough, and that an ethical and cultural change is also needed along the whole value chain.