Search

This study explores the downsizing propensity of family and non-family firms by considering their territorial embeddedness during both periods of economic stability and financial crisis. By drawing on a panel dataset of Spanish manufacturing firms for the period 2002–2015, we show that, all things being equal, family firms have a lower propensity to downsizing than non-family firms. When considering the effect of territorial embeddedness, we found that territorially embedded family firms have an even lower propensity to downsizing than their non-family counterparts. Furthermore, the concern of territorially embedded family firms for their employees’ welfare was particularly pronounced during the years of the global financial crisis. This result is explained by the existence of socially proximate relationships with the firms’ immediate surroundings, based on similarity and a sense of belonging, which push deeply rooted family firms to treat their employees as salient stakeholders during hard times. Overall, our study stresses the importance of local roots in moderating the relationship between family firms and downsizing.

PurposeThis study investigates the relationship between family-managed firms and firm employment growth by considering the effects of location and economic crisis as moderating variables.Design/methodology/approachThe study uses random-effect models on a large panel dataset of Spanish manufacturing firms covering 2003 to 2015 to estimate the joint effects of municipality size and economic crisis on firm employment growth.FindingsThe analysis reveals a positive association between family-managed firms and employment growth. However, this association is not uniform across space and time. When it considers location, the study finds that municipality size positively affects employment growth in family-managed firms but not in non-family firms. Additionally, while the study reveals that both firm types experience negative employment growth during the early stage of the global economic crisis (2007–08), it also finds that family-managed firms located in small municipalities downsize less than their non-family counterparts.Originality/valueThis study provides new evidence on the resilience of family-managed firms during economic crises, particularly those located in geographically bounded settings, such as small municipalities. When an adverse event, such as an economic crisis, jeopardizes employment levels, the embedded and trust-based relationships, between a family firm and its community leads them to prioritize employees' claims. However, family-managed firms' commitment to preserve jobs in small municipalities cannot be maintained over the long term; this effect disappears if the economic crisis is protracted. This study sheds new light on family-managed firms' distinctive behavior toward with local communities.

By combining arguments from regional economics and family business research, the aim of this article is to test the relationships among local export spillovers, management characteristics, and expo...

Family firms are a keystone in many countries as they provide employment opportunities and help the economy grow and prosper. As a result, family firms have been extensively studied; however, there are important aspects that still need to be better understood. One of these is the relationship between family firms and the socio-spatial context in which they act, that is, their local embeddedness. This study adds to existing research by placing family firms in their regional context and assessing whether and to what extent they are more locally embedded than their non-family counterparts. We measure local embeddedness through place tenure and distance to the local firm for key firm stakeholders. Our findings show that family firms rely greatly on more enduring and spatially proximate stakeholders and therefore show a stronger link with the socio-economic milieu in which they dwell. Relevant contributions to family business and regional studies, together with public policy implications, are discussed.

Background: Peach gibberellin-regulated protein (peamaclein) has recently emerged as a relevant food allergen in cypress pollen–hypersensitive patients. Objective: We investigated monosensitization to peamaclein among Italian cypress pollen–allergic patients. Patients: A total of 835 cypress pollen–hypersensitive patients from 28 Italian allergy centers underwent a thorough work-up to determine food-allergic reactions and performed skin prick testing with a commercial peach extract containing peamaclein. IgE to rPru p 3 was measured in peach reactors, and those with negative results were enrolled as potentially monosensitized to peamaclein. IgE reactivity to rPru p 7 was evaluated using immunoblot and an experimental ImmunoCAP with rPru p 7. Results: Skin prick tests were positive to peach in 163 patients (19.5%); however, 127 (77.9%) were excluded because they reacted to Pru p 3. Twenty-four patients (14.7%) corresponding to 2.8% of the entire study population) were considered potentially monosensitized to peamaclein. No geographic preference was observed. Seventeen of the 24 patients (70.8%) had a history of food allergy, mainly to peach (n=15). Additional offending foods included other Rosaceae, citrus fruits, fig, melon, tree nuts, and kiwi. On peach immunoblot, only 3 of 18 putative peamaclein–allergic patients reacted to a band at about 7 kDa; an additional 4 patients reacted at about 50-60 kDa. Ten of 18 patients (56%) had a positive result for Pru p 7 on ImmunoCAP. Conclusion: Allergy and sensitization to peamaclein seem rare in Italy. Most patients react to peach, although other Rosaceae fruits and several citrus fruits may also be offending foods. Peach and cypress pollen probably also share cross-reacting allergens other than peamaclein.

Summary The clinical usefulness of two commercial peach extracts for SPT (by Lofarma SpA and ALK-Abello, respectively) was compared in a multicenter study carried out in Italy. Peach allergic patients were tested with the two extracts in parallel and underwent the detection of IgE specific for all three peach allergens currently available (Pru p1, Pru p3, and Pru p4, respectively). The two extracts were almost identical in terms of sensitivity and specificity, being able to detect virtually all patients sensitized to stable peach allergens (lipid transfer protein (LTP) and, presumably, peamaclein) but scoring negative in patients exclusively sensitive to labile allergens (either PR-10 and/or profilin). Thus, the two extracts represent an excellent tool to carry out a preliminary component-resolved diagnosis of peach allergy at the first patient visit.

According to a recent trend of research, there is a growing interest in applications of machine learning techniques to business analytics. In this work, both supervised and unsupervised machine learning techniques are applied to the analysis of a dataset made of both family and non-family firms. This is worth investigating, because the two kinds of firms typically differ in some aspects related to performance, which can be reflected in balance sheet data. First, binary classification techniques are applied to discriminate the two kinds of firms, by combining an unlabeled dataset with the labels provided by a survey. The most important features for performing such binary classification are identified. Then, clustering is applied to highlight why supervised learning can be effective in the previous task, by showing that most of the largest clusters found are quite unequally populated by the two classes.

Clinical relevance of Der p23 in a multicenter Italian study

Key attributes of Embedded Charge Trap (eCTTM) Flash technology are presented. Automotive MCUs with 40nm eCT Flash are currently in volume production at UMC. The eCT technology features industry-leading cell size at the 40nm node, and scaling by more than 30% has been demonstrated at the 22nm node. eCT utilizes source-side injection (SSI) for programming and band-to-band (BTB) hot- hole injection for erasing to meet the high-speed requirements of automotive applications. Furthermore, random access time of 8 ns is achieved across the full range of operational temperature (-40 °C to 150 °C) and voltage (0.99 V to 1.21 V).

Summary The nocebo reaction, namely the undesirable effect of an inert substance (placebo), is a phenomenon rarely investigated in literature. A better knowledge of this reaction may help clinicians in the management of these patients in clinical practice. Patients with drug adverse reactions (ADR) undergoing the drug challenge test are an ideal model for studying the nocebo effect, and the study aims to investigate their clinical and psychological features. One hundred and twenty patients (Mage = 46.59, SD = 15.5; 82% female), of which 90 non responders and 30 with nocebo reactions (25%) were recruited, and completed a battery of psychological measures: State-Trait Anxiety Inventory X1-X2, Beck Depression Inventory II, Symptoms Checklist-90-R, Difficulties in Emotion Regulation Scale, Toronto Alexithymia Scale. Clinical features (individual characteristics and ADR clinical history) were collected by clinicians. The results show that older age (p = 0.002), low level of education (p = 0.039) and a depressive tendency (p = 0.030) appear to be potential risk factors for nocebo effects. Although none of the features related to the previous clinical history appear to represent a risk factor for the nocebo reactions (p minor 0.05), significant correlations between some of the clinical and psychological characteristics considered (p values from 0.005 to 0.042) help to better delineate the profile of these reactive patients. A specific training of the sanitary team about psychological aspects is recommendable.

Background and objective Skin prick testing (SPT) with commercial extracts is the first step in the diagnosis of shrimp allergy, although its clinical efficiency is unknown. Objective: To analyze the clinical usefulness of all commercial crustacean extracts available for SPT in Italy. Methods We performed a multicenter study of 157 shrimp-allergic patients who underwent SPT with 5 commercial crustacean extracts and with house dust mite (HDM) extract. Commercial extracts were analyzed using SDS-PAGE and compared with a freshly prepared in-house shrimp extract. IgE to Pen a 1/Pen m 1, Pen m 2, and Pen m 4 was determined, and immunoblot analysis was performed on a large number of sera. Results The skin reactions caused by commercial crustacean extracts were extremely heterogeneous, resulting in 32 clinical profiles, with marked differences in protein content and missing proteins at molecular weights corresponding to those of major shrimp allergens. Only strong Pen a 1/Pen m 1 reactors reacted to both HDM and all 5 commercial extracts in SPT. Most patients, including those who were tropomyosin-negative, reacted to HDM. Patients reacted to a large and variable array of proteins, and IgE reactivity was common at high molecular weights (>50 kDa). Conclusions The in vivo diagnosis of shrimp allergy must continue to be based on SPT with fresh material. Shrimp-allergic patients frequently react to a number of ill-defined high-molecular-weight allergens, thus leaving currently available materials for component-resolved diagnosis largely insufficient. Mites and crustaceans probably share several allergens other than tropomyosin.

Part 8: Modular Design and Products; International audience; In business to business manufacturing, a major competitive advantage comes from the personalization of the product for the customer. In order to customize a product, companies go through a long process of customer interviews and specialized product development processes: this results in a time-consuming design phase and in a highly variable production process. In this paper, a method to improve the efficiency of product development and manufacturing, keeping a high degree of customization, is presented. A standardization effort is performed to identify a set of interchangeable components and to define a set of functional constraints. The consequences of such standardization are a dramatic reduction of the time expected to design and produce an item, as well as in lowered degree of variability of both the manufacturing process and the warehouses content. The presented methodology has been applied to a manufacturer of ink dispensing systems.

Background Most cases of beer allergy reported so far have been associated with hypersensitivity to the non-specific lipid transfer protein (LTP). In view of the marked differences in brewing processes we assessed IgE reactivity as well as tolerance to many different beers in an allergic patient. Methods A 45 year-old man hypersensitive to grass pollen, cat dander and Alternaria tenuis with a history of urticaria and dyspnoea after drinking beer and a weak skin reactivity to commercial corn extract was studied. The patient underwent SPT with 36 different brands of beer and an open challenge with those scoring negative was performed. An immunoblot analysis was carried out using 2 SPT-positive beers, 2 SPT-negative beers, and barley, wheat, and maize extracts using both patient's serum and a maize LTP-specific in-house developed polyclonal antibody from rabbit. Further, the immune reactive LTP of one beer was separated by HPLC and the chromatogram was compared to that of purified maize LTP. Results Beer SPT scored positive in 30/36 cases. The immunoblot analysis showed IgE reactivity at about 10 kDa against the two SPT-positive beers and against maize with both patient's serum and the polyclonal anti-LTP rabbit serum, whereas the two SPT-negative beers, and barley extract scored negative. The immunodetected protein co-migrated with maize LTP. Conclusion In beer-allergic patients the diagnostic workup may point to the detection of some tolerated products that can be consumed risk-free.

Background: Shrimp is a frequent cause of food allergy worldwide. Besides tropomyosin, several allergens have been described recently. Objective: We investigated which allergens are involved in Italian shrimp-allergic adults. Methods: Sera from 116 shrimp-allergic patients selected in 14 Italian allergy centers were studied. Skin prick tests with house dust mite (HDM) as well as measurements of IgE to Pen a 1 (shrimp tropomyosin) and whole shrimp extract were performed. All sera underwent shrimp immunoblot analysis, and inhibition experiments using HDM extract as inhibitor were carried out on some Pen a 1-negative sera. Results: Immunoblots showed much variability. IgE reactivity at about 30 kDa (tropomyosin) was found in 90 kDa was frequent. Further reactivities at 14–18, 25, 43–50, about 60 and about 80 kDa were detected. Most subjects had a history of shrimp-induced systemic symptoms irrespective of the relevant allergen protein. IgE to Pen a 1 were detected in sera from 46 (41%) patients. Skin reactivity to HDM was found in 43/61 (70%) Pen 1-negative subjects and inhibition studies showed that pre-adsorption of sera with HDM extract induced a marked weakening of the signal at >67 kDa. Conclusions: Several allergens other than tropomyosin are involved in shrimp allergy in adult Italian patients. Some hitherto not described high molecular weight allergens seem particularly relevant in this population and their cross-reactivity with HDM allergens makes them novel potential panallergens of invertebrates.

Previous studies suggest cross-reactivity between specific ragweed pollen and melon allergens. This study was designed to clarify the origin of the cross-reactivity between ragweed pollen and the gourd family. One thousand ragweed-allergic subjects were interviewed about the presence of oral allergy syndrome (OAS) induced by melon or watermelon and were divided into reactive to ≤3 seasonal allergen sources or3 seasonal allergen sources. Patients reporting melon and/or watermelon allergy underwent a skin-prick test (SPT) with fresh melon and, after 2006, also with profilin-enriched date palm pollen extract. Because no IgE reactivity to melon extract was detected in vitro, ELISA was performed using date palm pollen extract, and inhibition experiments were performed using grass pollen, date palm profilin, and bovine serum albumin (BSA) as inhibitors. Six hundred forty-six and 354 subjects reacted to ≤3 seasonal allergens or3 seasonal allergens, respectively; 4/646 (1%) and 81/354 (23%) reported a history of melon/watermelon-induced OAS (p0.0001). Forty-three of 46 (93%) melon reactors scored positive on SPT with the profilin-enriched extract, which was positive in 0/2 (0%) versus 43/44 (98%) reactive to ≤3 or3 seasonal allergen sources, respectively (p0.0001). in vitro, serum from melon-allergic subjects showed a strong IgE reactivity to the profilin-enriched date palm pollen extract, which was abolished by preabsorption with both grass pollen extract and date palm pollen extract, but not by BSA. In ragweed pollen-allergic subjects, melon allergy is most likely associated with cross-sensitization to the plant pan-allergen profilin and not to specific ragweed pollen allergens. This study confirms the association between profilin sensitization and melon allergy.

To cite this article: Heffler E, Nebiolo F, Asero R, Guida G, Badiu I, Pizzimenti S, Marchese C, Amato S, Mistrello G, Canaletti F, Rolla G. Clinical manifestations, co-sensitizations, and immunoblotting profiles of buckwheat-allergic patients. Allergy 2011; 66: 264–270. Abstract Background: Buckwheat allergy is a rare food allergy in Europe and North America, whereas it is often described and studied in Asia. The aim of this study was to describe a series of patients with proven buckwheat allergy evaluated in an Italian allergy clinic. Co-sensitization to other food and inhalant allergens and immunoblotting profiles of buckwheat-allergic patients were studied. Methods: Patients with suspected buckwheat allergy who attended the allergy clinic between January 1, 2006, and September 30, 2008, were evaluated. All patients underwent skin prick tests for a standard panel of inhalant and food allergens, prick-by-prick with buckwheat flour, buckwheat-specific IgE determinations, and double-blind placebo-controlled food challenge (DBPCFC) with buckwheat flour. Immunoblotting with buckwheat flour extract was performed on sera from buckwheat-allergic patients. Results: Among 72 patients with suspected buckwheat allergy, 30 (41.7%) were sensitized to buckwheat and 24 had a positive DBPCFC. The mean buckwheat IgE level was 6.23 kUA/l (range, 0.16 to >100 kUA/l). Several IgE-binding proteins were identified and grouped into three patterns: a 16-kDa band in patients with predominantly gastrointestinal symptoms with grass and wheat flour co-sensitization, a 25-kDa band in patients with predominantly cutaneous symptoms and a low frequency of co-sensitization, and a 40-kDa band in patients with anaphylaxis and a low frequency of co-sensitization. Conclusions: Buckwheat allergy is an emerging food allergy in Italy. We identified three distinct patterns of clinical and laboratory characteristics, suggesting that specific allergens could be more frequently associated with clinical manifestations of different severity.

Background: Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen. Adverse reactions to Rosaceae, tree nuts, peanut, beer, maize, mustard, asparagus, grapes, mulberry, cabbage, dates, orange, fig, kiwi, lupine, fennel, celery, tomato, eggplant, lettuce, chestnut and pineapple have been recorded. Objective: To detect vegetable foods to be regarded as safe for LTP-allergic patients. Methods: Tolerance/intolerance to a large spectrum of vegetable foods other than Rosaceae, tree nuts and peanut was assessed by interview in 49 subjects monosensitized to LTP and in three distinct groups of controls monosensitized to Bet v 1 (n = 24) or Bet v 2 (n = 18), or sensitized to both LTP and birch pollen (n = 16), all with a history of vegetable food allergy. Patients and controls underwent skin prick test (SPT) with a large spectrum of vegetable foods. The absence of IgE reactivity to foods that were negative in both clinical history and SPT was confirmed by immunoblot analysis and their clinical tolerance was finally assessed by open oral challenge (50 g per food). Results: All patients reported tolerance and showed negative SPT to carrot, potato, banana and melon; these foods scored positive in SPT and elicited clinical symptoms in a significant proportion of patients from all three control groups. All patients tolerated these four foods on oral challenge. Immunoblot analysis confirmed the lack of IgE reactivity to these foods by LTP-allergic patients. Conclusion: Carrot, potato, banana and melon seem safe for LTP-allergic patients. This finding may be helpful for a better management of allergy to LTP.

Migraine can induce ischaemic stroke, and is considered an independent risk factor for stroke in the young. To date, the nature of the link between migraine and stroke is essentially unknown. Forty-five children were studied. Homocysteine levels (fasting and post methionine load), vitamin B12 and plasma folate levels, factor V Leiden, factor II G20210A, methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C mutations were examined. Compared with controls, patients with migraine had higher levels of post-methionine load homocysteine values (19.5 ± 4.9 vs. 16.9 ± 1.9; P = 0.025) and significantly lower folate levels (5.8 ± 2.6 vs. 7.5 ± 2.1; P = 0.002). We found a trend toward an increased risk of migraine in subjects carrying a homozygous mutant genotype for MTHFR C677T and MTHFR A1298C polymorphisms. Genetic prothrombotic conditions do not seem to be related to migraine in the young, whereas the biochemical differences between migrainous patients and controls are an appealing topic for further investigation.

Lipid transfer protein (LTP), the major allergen in Rosaceae in geographic areas where the prevalence of birch pollen allergy is low, is a widely cross-reacting pan-allergen, but the pattern of cross-reactivity to plant-derived foods botanically unrelated to Rosaceae shows much variability.To examine the relationship between peach LTP specific IgE levels and cross-reactivity to several non-Rosaceae, plant-derived foods.IgE specific for peach LTP was measured by enzyme-linked immunosorbent assay in serum samples from 40 patients with Rosaceae allergy monosensitized to LTP. Patients were considered monosensitized to this protein in the absence of sensitization to other cross-reacting, plant-derived foods as shown by negative skin prick test (SPT) results with both birch and mugwort pollen. SPTs with commercial extracts of walnut, hazelnut, peanut, celery, maize, rice, tomato, orange, and onion were performed to detect possible immunologic cross-reactivity to these foods.Patients with negative SPT results with non-Rosaceae foods showed significantly lower levels of IgE to peach LTP than patients showing skin reactivity to one or more non-Rosaceae foods (P.001). A significant difference in specific IgE to peach LTP between patients with positive or negative SPT results was observed with each individual food (P.001 in all cases). The level of IgE to peach LTP was strongly related to the number of positive SPT results with non-Rosaceae foods (r = 0.78; P.001). Increasing levels of IgE to peach LTP were associated with skin reactivity to nuts (29/40 [72%]), peanut (27/40 [67%]), maize (16/39 [41%]), rice (14/39 [36%]), onion (13/37 [35%]), orange (9/32 [28%]), celery (11/40 [27%]), and tomato (8/39 [20%]).This study suggests that all allergenic determinants in LTP from vegetable foods other than peach cross-react with peach LTP determinants, whereas only some peach LTP epitopes cross-react with allergenic determinants on botanically unrelated, plant-derived foods. The high levels of IgE to peach LTP seem to reflect the presence of IgE targeting common allergenic determinants of LTP, causing cross-reactivity to botanically unrelated, vegetable foods. In LTP-allergic patients, increasing levels of IgE to peach LTP are paralleled by an increasing number of foods other than Rosaceae positive on SPT that cause clinical symptoms.

A proper classification of patients allergic to plant-derived foods is of pivotal importance because the clinical features of allergic reactions to fruits and vegetables depend on the nature and characteristics of proteins responsible for sensitization. However, in normal clinical settings this is presently impossible.We sought to detect clinical markers of sensitization to profilin.Seventy-one patients allergic to fruits and vegetables but not sensitized to lipid transfer protein or natural rubber latex were studied. Food allergy was ascertained on the basis of clinical history and positive skin prick test responses with fresh foods, commercial extracts, or both. Allergies to foods that had caused less than 2 adverse reactions were confirmed by means of open oral challenge. IgE reactivity to rBet v 1/rBet v 2 and to natural Phleum species profilin were detected. Moreover, IgE to the 30- to 40-kd and 60- to 90-kd birch pollen-enriched fractions, which also can be involved in cross-reactivity phenomena, were measured in sera from 52 patients by means of ELISA.On the basis of in vitro tests, 24, 18, and 25 patients turned out to be sensitized to Bet v 1, Bet v 2, or both, respectively. Four patients had negative test results for both allergens. Hypersensitivity to Bet v 2 was strongly associated with clinical allergy to citrus fruits (39% in patients monosensitized to Bet v 2 vs 4% in patients monosensitized to Bet v 1, P.025), melon or watermelon (67% vs 0%, P.001), banana (66% vs 8%, P.001), and tomato (33% vs 0%, P.05), whereas Bet v 1 sensitivity was associated with clinical allergy to apple (100% vs 39%, P.001) and hazelnut (56% vs 0%, P.001). The sensitivity of a history of allergy to gourd fruits, citrus fruits, tomato, banana, or a combination thereof as a means to detect profilin-hypersensitive patients was 85% (41/48). The specificity of an allergy to any of these fruits exceeded 85%, with positive predictive values ranging between 68% and 91%.In clinical settings in which laboratory investigations are not easily accessible, allergy to melon, watermelon, citrus fruits, tomato, and banana can be used as a marker of profilin hypersensitivity once a sensitization to natural rubber latex and lipid transfer protein is ruled out.

Antiphospholipid antibodies (aPL) are frequently associated with thrombotic disorders in the so-called antiphospholipid syndrome. Together with anticardiolipin antibodies (aCL), lupus anticoagulant (LA) is the main diagnostic tool for aPL detection. Since LA determination is based on the finding of prolonged clotting time in vitro, concomitant anticoagulant therapy may significantly interfere with its detection. We report a case of a boy in whom recurrent aPL-related thrombosis heralded for several months the onset of systemic lupus erythematosus (SLE). Abnormally increased in vitro clotting times at the time of the second thrombotic event led to the suspicion of the presence of LA activity. However, this latter finding was difficult to interpret since the patient was already on heparin treatment at the time of our first observation. Thus, LA was assayed using a commercial kit in which a heparin neutralizer is included (Staclot LA). Two consecutive samples from the patient were compared with eight patients on anticoagulant therapy for non-aPL-related thrombotic events and 20 healthy controls. The study showed that, taking into account the concomitant anticoagulant treatment, Staclot LA was positive only in the propositus, raising the suspicion of a possible aPL-related origin of the thrombotic event. This issue was definitively confirmed in a subsequent follow-up.The present report shows that aPL-related deep vein thrombosis can be the earliest clinical manifestation of pediatric SLE, and that Staclot LA may have a role in LA detection during the course of anticoagulant treatment.

This case report describes a patient with bee moth-induced rhinoconjunctivitis, asthma and contact urticaria. Immunoblot analysis showed IgE reactivity to two distinct bee moth proteins at 23 and 70 kDa, respectively. ELISA inhibition studies excluded cross-reactivity to the other popular live bait, fly larva.

Tenaris and Centro Sviluppo Materiali (CSM) carried out a Joint Industrial Project aimed at developing heavy wall line pipes. The suitability for very severe applications, involving high service pressures and temperatures, the latter causing large strain fluctuations, in presence of an aggressive sour environment, is analyzed both theoretically and experimentally, including small and full pipe models and tests. Five papers have been already presented on this project, in previous OMAE conferences. The present paper focusses on Lined Heavy Wall Pipes for the adoption in presence of extremely aggressive conveyed fluids. As in-service large strains are involved in the JIP envisaged scenarios, the risk of liner buckling is necessarily concerned. To evaluate the suitability of lined heavy pipes in presence of in-service severe straining, a finite element study has been performed aimed at quantifying the limits for pipe deformability without occurrence of liner buckling. Two full scale tests on lined pipe strings have been also performed, imposing the very severe straining sequence previously determined as extreme for pipeline resistance. The sequence has been applied both in pure axial (tensile / compressive) loading and in bending conditions. The latter has been performed in very low internal pressure conditions to conservatively verify the resistance to liner buckling. In both cases, the lined heavy wall pipe resisted the severe straining sequence without any liner buckling, pipe excessive ratcheting or any other damage compromising the serviceability of the pipe.

Tenaris and Centro Sviluppo Materiali (CSM) are carrying out a Joint Industrial Project aimed at developing heavy wall line pipes. The suitability for very severe applications, involving high service pressures and temperatures, the latter causing large strain fluctuations, in presence of an aggressive sour environment, is analyzed both theoretically and experimentally, including small and full pipe models and tests. The full project program aims at developing a new generation heavy wall product, supported by a comprehensive laboratory analysis of the material response under severe mechanical loading in aggressive environment and a full scale testing program, including both pipe and girth weld. Both investigations are mainly addressed to basic understanding of impact on design criteria of interaction between severe loading and aggressive environment. Four papers, [2], [3], [4] and [5], have been already presented, in previous OMAE conferences, on this project. The present paper focusses on the full scale testing performed on strings of pipeline consisting of different pieces of pipe. In particular, two full scale testing have been performed applying the severe straining sequence defined as extreme in term of resistance against ratcheting, also involving plastic straining, as deduced in a previous work inside the project. The loading sequence was applied in global strain control, averaged on the whole string length, but necessarily the local distributions of strain differs in the three pieces of pipe. Analytical considerations are done about the expected straining behaviour and experimental results confirmed the theoretical considerations. The high strain hardening capability of the X65 steel pipes, metallurgically designed for strain based applications, guaranteed a good recovery of any non-homogeneity in straining, both during cycling that in larger axial deformation of the string. During severe cycling in elastic-plastic regime in presence of pipe internal pressure, the strings demonstrated good resistance to ratcheting. In fact, due to the material capability to redistribute the cycling strains along the whole sample length, any section experienced limited ratcheting with unreversed circumferential expansion, during cycling, well within limits of tolerability. It is worth noting that, even in presence of severe cycling conditions, both on-shore type girth welds (SAW for double joint) and off-shore type (GMAW in Narrow Groove Bevel Preparation) preserved their integrity with no cracking or other damage.

Varicella-associated stroke has been reported with increasing frequency in recent years. In many cases, diagnosis is difficult because of the late onset of manifestations after the acute infectious episode. Four cases of cerebrovascular disease after varicella infection were observed. Three children presented hemiparesis and one facial paresis. The neuroradiological findings comprised stenosis/occlusion of middle cerebral artery or nucleo capsular signal alteration. Because, several pathogenetic mechanisms have been proposed as the cause of stroke, the relationship between prothrombotic conditions, antipospholipid antibodies and stroke in these patients is discussed. The difficulty in defining the pathogenesis of the ischemic episode is related to problems in the choice of antithrombotic treatment, which is still not standardized and must be decided on individual basis. In the event of rapid onset of stroke after exanthem high dose antiviral therapy seems to be justified. On the basis of our experience and of literature data on varicella-associated stroke, we recommend that VZV infection be taken into account in every episode of stroke in children.

EPIDEMIOLOGIC ASPECTS OF THROMBOSIS IN CHILDREN: EXPERIENCE OF G. GASLINI CHILDREN'S RESEARCH HOSPITAL

Protein C deficiency is one of the most important cause of thrombosis during early infancy and may have different ways of presentation. We have collected 11 patients, 10 with portal vein thrombosis, 1 with thrombosis of both right and left jugular vein after a Broviac catheter insertion. As far as the time and the trigger event are concerned, we suppose that the thrombosis took place in 9 patients during the neonatal period. Seven out of the nine patients with portal vein thrombosis had umbilical catheterization during neo-natal period (4 due to hyperbilirubinemia and 3 due to prematurity), one patient received surgery in the first day of life because anorectal malformation, whereas we have no information about the last patient. The early symptoms of thrombosis started within the first year of life in 5 patients and within the forth year in 4. In 9 patients the symptoms were, in sequence: splenomegaly, esophageal varices and hypersplenism. The diagnosis of protein c deficiency has been made from 6th month to 14th year after the trigger event. Protein c biological activity values was X = 47% ±9.03 (n.v. 65-128%) and Protein c antigen was X = 51% ±14 (n.v. 68-110%). Antithrombin III (ATIII) was slightly decreased in 7 patients, protein s in 2, factor v below the normal in 3, whereas FII was in the normal range. Four of these patients received Protein c concentrate (Immuno - Vienna), together with heparin treatment during vascular surgery (spleen, renal vein, shunt). In conclusion we can say that all our patients had a more or less marked first type Protein c congenital deficiency. From the pathogenetic point of view we can speculate that the mechanical and chemical action on the vessell wall due to the catheter and the fluid, associated with the prematurity related disorders, can trigger the thrombotic mechanism.