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Many regions in the world are affected by natural hazards such as earthquakes, tsunamis, volcanoes, floods, storms, landslides, etc., each of which can have devastating socio-economic impacts. Among these natural events, earthquakes, have been among the most recurrent and damaging hazards during last few decades, resulting in large numbers of casualties, and massive economic losses [30]. The problem of earthquake risk mitigation is faced using different approaches, depending upon the time scale being considered. Whilst over time scales of decades it is of utmost importance that land use regulations and building/infrastructure codes are continuously updated and improved, for time scales of a few years, the main risk mitigation actions are at the level of information and education in order to increase individual and social community awareness about potentially damaging hazards. Over shorter time scales (months to hours), it would naturally be of great benefit to society as a whole if the capability to accurately predict the time, location and size of a potentially catastrophic natural event were available. However, due to the great complexity of the natural processes of concern, such predictions are currently not possible. On the other hand, on very short time scales (seconds to minutes), new strategies for earthquake risk mitigation are being conceived and are under development worldwide, based on real-time information about natural events that is provided by advanced monitoring infrastructures, denoted as “early warning systems”

We systematically analysed the experimental data related to the specific conductivities and heats in excess of several serially diluted and agitated solutions (SDA for short). For all of the analysed samples, we found that both the excess conductivity, χE (μS cm−1), and excess heat, QmixE (J kg−1), varied with the age of the sample (up to 2 years of ageing). Furthermore, we found that after a certain period of ageing, small volume samples exhibited a much higher excess than large volume ones. The results we report in this paper are the product of a systematic study, during which we operated on known and constant volumes across the life of the samples. The incidence of volume on χE and QmixE turned out to be overwhelming when compared with that of time. The temporal evolution of the smaller samples was found significantly higher than that of the larger volume ones. A careful numerical analysis of the results uncovered an extraordinary and unexpected correlation, of exponential kind, between the excess parameters and the volume of the solution in the container. As for the temporal evolution of these systems, we found that the measured excess heats and conductivity often reach a maximum. That led us to the conclusion that the temporal evolution of the physico-chemical parameters is not caused by the slow process of equilibrium attainment; on the contrary, these systems are far from equilibrium systems, dissipative structures, whose experimental behaviour is certainly due to the variation of the super-molecular structure of the solvent, water. The agitation phase during the preparation could be the trigger for the formation of dissipative structures and the emergence of the novel behaviour. We put forth a simple rationalizing hypothesis, based on the general idea of water as an auto-organizing system that, when elicited by even small perturbations, can enter a far from equilibrium state, sustained by the dissipation of the electromagnetic energy coming from the environment. (Dissipative Structures).

We analysed the experimental data related to the specific conductivities of several serially diluted and agitated solutions (SDA for short). The experimental procedure consisted in measuring the specific conductivity, χ (μS cm − 1 ), of samples of SDA we prepared several months before. After characterizing the SDA, we diluted them with twice distilled water at several ratio of dilution, ranging from 1:1 to 1:10. The diluted solutions so obtained were systematically studied via conductometric measurements. The results put in evidence a new and extraordinary phenomenon, in that while χ of the diluted SDA followed the expected proportionality with the dilution ratio, their temporal evolution was greatly modified, giving rise to higher increases with age. Actually, in many cases, the conductivities of the “simply” diluted SDA were higher than those of the samples, of the same age, that were not subject to the dilution procedure. In such behaviour, that we call “constructive”, the experimental conductivity would more rapidly increase after the dilution, by using the added water. This new phenomenon does not fit into the framework of the thermodynamics of near equilibrium systems, and it seems natural to base its interpretation on the thermodynamics of far from equilibrium systems. A simple rationalizing hypothesis is put forth, based on the concept of dissipative structures, that is consistent with the more general idea of water as a system capable of auto-organizing, when elicited by even small perturbations, and then able to sustain a far from equilibrium state.

The “extremely diluted solutions” (EDS) have revealed a really intriguing behaviour, characterized by multiple independent variables. Because of their behaviour, EDS can be described as far-from-equilibrium systems, capable of auto-organizing as a consequence of little perturbations. We measured the heats of mixing of basic and acid solutions with such EDS and their electrical conductivity, comparing with the analogous heats of mixing and electrical conductivity of the untreated solvent. In particular, calorimetric titrations have been performed with NaOH or HCl solutions at various concentrations. Plots of the excess heat as a function of the concentration of titrant reveal differences and similarities between the two. By analysing these plots we were able to formulate new hypotheses about the supramolecular organization of the solvent water, when subject to mechanical perturbations stemming from the EDS preparation protocol, that is comprised of an iterative process of successive dilutions and succussions.

A large number of thermodynamic and transport measurements were conducted on ‘extremely diluted solutions’ (EDS). The physico-chemical results presented here allow us to hypothesize that the process of iterated dilutions and succussions is capable of modifying in a permanent way the features of water. A really intriguing phenomenon was the evolution of two physico-chemical properties with time. The calorimetric and conductometric measures were carried out as a function of the age of the samples. We found a good linear correlation between these two independent parameters, also as a function of time. A careful study of the phenomenon puts in evidence that these solutions are characterised by multiple independent variables. The EDS behave as complex systems, influenced by peculiar aspects of the preparation technique and also by the storage conditions. The EDS are far-from-equilibrium systems, capable of auto-organising themselves as a consequence of little perturbations.

We present an approach to Earthquake Early Warning for Southern Italy that integrates regional and on-site systems. The regional approach is based on the PRobabilistic and Evolutionary early warning SysTem (PRESTo) software platform. PRESTo processes 3-components acceleration data streams and provides a peak ground-motion prediction at target sites based on earthquake location and magnitude computed from P-wave analysis at few stations in the source vicinity. On the other hand, the on-site system is based on the real-time measurement of peak displacement and dominant period, on a 3 s P-wave time-window. These values are compared to thresholds, set for a minimum magnitude 6 and instrumental intensity VII, derived from empirical regression analyses on strong-motion data. Here we present an overview of the system and describe the algorithms implemented in the PRESTo platform.We also show some case-studies and propose a robust methodology to evaluate the performance of this Early Warning System.

Due to toxicities associated with their malignancies and treatments, adolescent and young adult survivors of childhood cancer (AYASCC) are at high risk for developing chronic diseases. This can be compounded by a greater prevalence of unhealthy behaviors relative to similarly aged non-cancer peers. Disparities in health behaviors have been noted for Black and Hispanic AYASCC, but data on Asian American (AA) or Native Hawaiian and Other Pacific Islander (NHOPI) minorities are lacking. The purpose of this study was to help bridge these information gaps by gathering data from Hawai‘i AA and NHOPI AYSCC. Telephone surveys were used to collect health behavior data from survivors 13–24 years of age (N=64); 55% of the sample was female, 77% AA or NHOPI, 63% leukemia/lymphoma survivors, and 32% overweight/obese. These were compared to state/national survey data for similarly aged individuals (Youth Risk Behavior Surveillance System data for 13–17 year olds, and Behavioral Risk Factor Surveillance System data for 18–24 year olds). While Hawai‘i AYASCC had significantly lower rates of tobacco/alcohol use, a higher proportion did not eat five fruits/vegetables a day (96%) compared to state (83%) and national (78%) samples (P < .001). Although many met age-specific physical activity recommendations, 44% of

We have deposited TiAlN films by using the reactive laser ablation technique. TiAl targets were ablated in low-pressure N2 (0.1–10 Pa) atmosphere by 2×104 XeCl excimer laser pulses at the repetition rate of 10 Hz. The laser fluence at the target was set at 6 J/cm2, corresponding to a power density of 0.2 GW/cm2. The films were deposited on Si substrates at room temperature, placed at 40 mm from the target. Their characteristics were investigated by many different techniques. Scanning electron micrographs show that surfaces are plane without cracks or corrugations. From Rutherford backscattering spectra it results that the thickness vary from ∼100 nm for films deposited at 0.1–0.5 Pa to 50 nm for the film deposited at 10 Pa. The mean composition is close to TiAlN for the film deposited at 0.1 Pa and close to TiAlN2 for the film deposited at 0.5 Pa. X-Ray diffraction analysis points to an amorphous structure of the film deposited at the lowest pressure (0.1 Pa), while peaks of fcc TiN and hexagonal Ti3Al2N2 appear in the spectra of the films deposited at higher N2 pressures. The complex chemical bonding of the top surface layer of the films was studied by X-ray photoelectron spectroscopy.

In this work, we report on a structural and compositional characterization of B-C-N thin films deposited by laser reactive ablation of a B4C target, in low-pressure (5 Pa) nitrogen atmosphere. For target ablation, a KrF excimer laser (lambda = 248 nm, tau = 20 ns) has been used, at the fluences of 6 and 12 J/cm(2). Films have been deposited on silicon (100) substrates at room temperature. Scanning electron miroscopy (SEM), Auger electron spectroscopy (AES), X-ray photoelectron spectroscopy (XPS), time-of-night secondary ion mass spectrometry (ToF-SIMS), and Fourier transform-infrared spectroscopy (FT-IR) characterization techniques were used to analyze the composition and the structure of the deposited films. The film results to be a mixture of sp(2)/sp(3) BN and sp(2)/sp(3) nitrogenated C phases. The concentration of the different BN phases depends on the used laser fluence for the deposition of the film.

The chromosomal breakpoints of t(4;11) translocation of acute lymphoblastic leukemia (ALL) have been recently identified at molecular level and shown to involve the AF4 (FEL) gene on chromosome 4 and the ALL-1 (MLL, Hrx) gene on chromosome 11. The ALL-1/AF4 fusion gene is transcribed into a chimeric mRNA. Using primer sets derived from ALL-1 and AF4 cDNAs by reverse transcription-polymerase chain reaction (RT- PCR), we were able to amplify the breakpoint sites of the fusion transcript of all 15 ALL cases with karyotypic or molecular evidence of the t(4;11). DNA fragments of different size were obtained as the consequence of different breakpoints on chromosome 11 and the presence of alternative splicing of ALL-1 exon 8. The feasibility of monitoring the residual cells carrying the t(4;11) in 2 ALL patients with different clinical outcome was evaluated. Overall, the presented results provide evidence that RT-PCR can be used as a rapid method for detecting this chromosomal abnormality and following the patient's response to therapy.

We ablated Si, SIO and ITO targets in low-pressure O2 with XeCl and KrF laser pulses at fluences of 5-8 J/cm2. The films were deposited on Si and glass substrates at temperatures of 20-600 degrees C. The substrates were generally set parallel to the target. To reduce droplet deposition, some films were deposited in off-axis configuration or using the so-called 'eclipse method', characterized by a shadow mask between target and substrate. Dense, continuos ITO films with resistivity as low as 1.6 by 10-4 (Omega) cm and a high transparency in the visible region were deposited. Ultra-thin films were deposited and successfully used as electrodes in optoelectronic devices. Dense, stoichiometric, thick SiO2 films were deposited on substrates either at room temperature or heated at moderate temperatures. Droplet density and surface roughness are kept quite low by using special deposition configurations. It results that multi- component films like ITO and silica can be efficiently deposited by using the reactive pulsed laser deposition.© (2001) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Background: Both short and long duration of habitual sleep are associated with adverse health outcomes. Objective: To assess the population longitudinal evidence of a relationship between duration of sleep and morbidity and mortality from coronary heart disease (CHD), stroke and total cardiovascular disease (CVD), and to obtain estimates of risk. Methods and Results: We performed a systematic search of publications using MEDLINE (1966–2009), EMBASE (from 1980), the Cochrane Library and manual searches without language restrictions. Studies were included if they were prospective, follow up >3 years, had duration of sleep at baseline and cases of fatal and non-fatal CHD, stroke or total CVD assessed prospectively. Relative risks (RR) and 95% C.I. were extracted and pooled using a random effect model. Sensitivity analysis was performed, heterogeneity and publication bias were also assessed. Overall, 15 studies provided 24 independent cohort samples, including 474,866 male and female participants (follow-up range 6.9 to 25 years), and 16,502 fatal and non-fatal events (3,753 for CHD, 3,163 for stroke and 9,586 for total CVD). Sleep duration was assessed by questionnaire, death through certification and non-fatal events event registers. In the pooled analyses, short duration of sleep was associated with a greater risk of developing or dying of CHD (RR: 1.48; 95% CI 1.22 to 1.80; p Conclusion: Both short and long duration of sleep are significant predictors of cardiovascular outcomes in prospective population studies.

Twenty-five patients (22 adults and 3 infants) with ALL1/AF4-positive acute lymphoblastic leukemia (ALL) were prospectively monitored by reverse transcriptase-polymerase chain reaction (RT-PCR) between January 1992 and July 1999. After high-dose induction and consolidation chemotherapy without bone marrow transplantation, all patients had a complete hematologic remission. Using nested RT-PCR (sensitivity 10(-4)), we observed conversion to PCR negativity in 11 (44%) of the patients. Thirteen of the 14 patients who did not have a molecular remission had a relapse at a median time of 4 months (range, 1 - 20 months). Of the 11 patients who had a conversion to PCR negativity, 5 reconverted to PCR positivity within 1 to 14 months. These 5 patients all progressed to hematologic relapse after 2, 3, 4, 4, and 7 months, respectively. Of the remaining 6 patients, 4 are in persistent hematologic and molecular remission at 12, 14, 88, and 96 months, whereas 2 are early in their follow-up. Actuarial probabilities of relapse and overall survival were 100% and 0% at 14 and 24 months and 67% and 43% at 96 and 100 months, respectively, in patients who had persistent RT-PCR positivity and in those who had a molecular remission. For both relapse and survival, the differences observed between the two groups were significant (P =.003 and P.005, respectively). This study, which represents the first prospective analysis of residual-disease monitoring carried out in a substantial series of patients with t(4;11)-positive ALL, emphasizes the clinical relevance of RT-PCR-based methods to monitor minimal residual disease in this leukemia subset. (Blood. 2000;95:96-101)

Twelve consecutive children with high-risk leukemia have been submitted to UCB transplant from unrelated 1 or 2 loci HLA-mismatched donor. All patients received an identical regimen for conditioning and GVHD prophylaxis. The median dose of viable nucleated cells infused was 2.8 x 10(7)/kg bw (range 1.4-7.9). Of 11 patients evaluable for engraftment, the hematopoiesis was of full donor origin in seven patients and autologous in four. The probability of disease-free survival at 1 and 2 years from UCB transplant is 60 and 42%, respectively.

A comprehensive baseline of emotional functioning was established for adults with Down syndrome. Five emotional factors were studied using groups of (a) adults with Down syndrome (n = 30), (b) clinical control subjects with dementia of the Alzheimer type (n = 18), and (c) elderly control subjects without mental retardation (n = 25). Results of planned statistical comparisons showed indifference, pragnosia, and inappropriateness as primary emotional factors separating Down syndrome and Alzheimer disease groups from elderly control subjects without mental retardation. Indifference was also shown to covary with cognitive mental state, whereby increased levels of indifference were associated with decreased levels of cognitive functioning. The possibility of noncognitive variables signalling dementia of the Alzheimer type in individuals with Down syndrome was discussed.

There are many current opinions of how to diagnose and treat carcinoma of the prostate. The authors' believe that it is imperative to remember that physicians are treating people with disease and not the disease itself. Especially in the geriatric population with concurrent medical diseases, physicians must be sure that the treatment benefits the individual patient.

Background:Increasing evidence suggests an association between both short and long duration of habitual sleep with adverse health outcomes.Objectives:To assess whether the population longitudinal evidence supports the presence of a relationship between duration of sleep and all-cause mortality, to i

Human immunodeficiency virus (HIV) infection has spread to almost every country so as to show the characteristics of a pandemic. According to WHO estimates, there are over 10 million infected subjects all over the world of whom two thirds are believed to be Africans. The infection is transmitted mainly heterosexually, and therefore spreads especially among young people, hence the growing number of seropositive infants, particularly in Africa. In certain European nations including France, Spain, and Italy, the percentage of infected babies is associated with maternal drug addiction whereas in Romania pediatric transmission is horizontal. According to WHO estimates, AIDS will become the main cause of death for children in many African and American Countries in the next few years. In addition, there will be a considerable number of orphans below the age of 10 whose number is expected to rise to 10 million in the course of the nineties.

VAHS (virus associated hemophagocytic syndrome) is a severe clinical and biological condition associated with certain menacing viral infections. It has been observed in patients with manifest immunodeficiency but also in previously apparently healthy children. Epstein-Barr virus (EBV) infection, although it is sometimes unrecognized and insidious, is one of the etiologies to be considered. Differential diagnosis with other causes of macrophage activation is a delicate task in pediatrics. Better understanding of the pathophysiology of the syndrome offers interesting therapeutic prospects.

BLOOD COAGULATION AND PLATELET AGGREGATION IN A GROUP OF CHILDREN WITH CONGENITAL HYPOTHYROIDISM 165

Functional results of resection arthroplasty are currently considered poor. In 104 hip prosthesis removals after either septic or aseptic loosening, pain, walking, joint motility, life style, and patient's opinion were evaluated. A satisfactory result was recorded in 72% of cases. Prognosis is poorer in patients who are young, have septic loosening, and have poor residual mobility. Resection arthroplasty should be considered a salvage procedure in cases of septic loosening and/or bone stock deficiency after a failed total hip arthroplasty.

Endoscopic restoration of a totally obstructed ureteroileal anastomosis was accomplished in 3 patients. The combined use of rigid endoscopy of the ileal conduit and flexible nephroureteroscopy provided full visualization of the blind-ending segments and allowed location of the shortest segment between the lumina. A guide wire was passed through intervening tissue with fluoroscopic monitoring to re-establish internal drainage. This technique offers an alternative to laparotomy and reimplantation in selected cases of ureteroileal stricture.

Summary form only. The prediction of a covalently bound carbon nitride solid /spl beta/-C/sub 3/N/sub 4/ with characteristics (hardness, bulk modulus) comparable to or even better than those of diamond, stimulated many attempts to synthesise and deposit thin films of this material. Pulsed laser ablation is among the most promising technique to achieve this result.

After underlining the serious psychological consequences of radical mastectomy for carcinoma and the importance of breast reconstruction for the patient's complete recovery, the paper briefly reviews the main reconstruction techniques employed in restoring breast volume which is essentially achieved by inserting an artificial prosthesis below a myocutaneous skin flap often taken from the great dorsal. Some mention is also made of recently developed alternative techniques.

Remote practice offices (RPOs) offer unique opportunities for hospitals and physicians to increase market share from targeted areas where previously only limited demand existed. This article discusses the benefits and explores the fundamentals of developing a remote practice office.

The biological and synthetic materials employed over the years for filling breasts after mastectomy or for congenital malformations are reviewed. At the start of the century, breast shape and volume were changed by adipose tissue grafts. In the 50s and 60s dermo-fibro-adipose grafts and later auto-grafts and grafts of the large epiploon were used. Synthetic materials have also developed, from early century attempts using paraffin injections to the discovery for industrial use of plastics. Following the first polyvinyl prostheses, Cronin developed silicon prostheses for medical purposes and in later years these went through numerous changes in form, volume and design up to the recent skin expanders. Polyurethane has also been used in attempts to reduce capsular retraction.

After pointing out the need for reconstruction of the nipple-areola complex and the restoration of symmetry between the two breasts after radical mastectomy for cancer, the paper briefly examines the techniques currently available for the achievement of these "finishing touches" that usually take longer then the primary and fundamental breast reconstruction.

Faced with a crunch on inpatient admissions, hospitals are re-examining relationships with their medical staffs to strengthen physician loyalty. A physician liaison program lets a hospital address both its physicians' and patients' needs. The author discusses the benefits of a physician detail program and offers strategies for success.