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In this paper, the complete procedure to design and construct reusable moulds for implant-based ear prosthesis and manufacture substructures by means of a computer aided design-computer aided manufacturing (CAD-CAM) procedure and rapid prototyping (RP) technology is presented. The scan of the healthy ear, the virtual superimposition of its mirrored image on to the defective side, and the rapid manufacturing of the substructure and of the mould eliminate several steps of traditional procedures (wax, stone, try-in). Moreover, the precise design and customization of the substructure is presented, with the original and engineered shape for the retention of the silicone. The time and cost saving results of this protocol are presented together with a discussion of the main design features that make the prosthesis a stable and reproducible system to improve rehabilitation of patients with auricular defects or absence.

Data on PAH levels in atmospheric paniculate were determined in the frame of the environment protection activities during the VI Italian Expedition in Antarctica. Samples were collected at the four cardinal points at about 200 metres from the central point of the Italian scientific base. Results are related to basic meteorological parameters, operating parameters and fuel consumption of the waste incinerator, power generators and other engines. Data show low levels of the individual PAH (95% in the range 1-50 pg/m3) confirming the absence, up to now, of relevant contamination from Italian base. On the basis of these preliminary results, monitor program will continue in the future expeditions in order to keep undercontrol the potential PAHs sources.

This study examines the interactions between tide, wave and surge in determining the total water level in the Mediterranean Sea, by using a high resolution finite element tide-wave-surge model.

The response of atmospheric convection to low-level shear is examined with highly idealized two-dimensional non-hydrostatic numerical experiments of intermediate (4 days) duration, where the environmental conditions for the development of convection are created by the solar cycle. Statistical properties of the simulated convective systems and their relation to environmental parameters are presented. Maxima of precipitation at intermediate values of low-level shear are obtained in days 2 to 4 of the simulation, but not in the first day, which might be too close to an arbitrary initial condition.

As part of a wider survey programme, in order to study the environmental fate of these compounds, organotins have been determined in water, sediment and mussel samples for 1 year. In a previous paper we presented two analytical methods for organotin determinations in water samples and some preliminary results. Here we present the results obtained from 1989 and 1990 sampling campaigns. Concentrations of butyl and phenyltin in water were found to be low.

Satellite images of 30 October 2008 show the development over north-central Italy of rainbands and multiple waves during a strong south-westerly wind episode associated with a deepening synoptic trough and cold front passage. The event was studied by means of the ISAC model chain constituted of the hydrostatic model BOLAM and the nested non-hydrostatic model MOLOCH at 1 kilometer resolution. Diagnostics of model output were performed to reveal characteristic features of symmetric instability.

Two distinct non-hydrostatic models, a 2D version of MOLOCH and the 3D ARPS, were used to perform idealized experiments on the development and structural organization of convection in environments which either have a high degree of imposed conditional innstability or are near a condition of radiative-convective equilibrium determined by a balancing of sensible/latent heat fluxes at the surface and imposed radiative cooling. Reference cases for both kinds of experiments are shown and their relation to the scientific objective of the project discussed.

A simple representation of the effects of latent heat release on meso- and synoptic scale dynamics is given by the use of small static stability for ascending motions. The specific location where this condition is applied and the value of static stability depends on environmental parameters, including relative humidity, and other thermodynamic assumptions. A primitive equation model in simplified geometry which implements the above representation of moist processes is used to study the modifications induced on baroclinic instability and the generation of eddy-scale kinetic energy. Results of preliminary simulations of the life cycles of baroclinic waves will be presented.

Thermal barrier coatings are gaining considerable importance for the improvement the energetic efficiency of turbines. These materials are often applied on the surface of blades and are based on a layer of antioxidation material (mainly MCrAlY alloys) and a top layer that acts as proper thermal barrier (normally Yttria partially stabilized Zirconia). Coating removal is an important aspect in the production of these blades. "Decoating" or "stripping" is needed for the production of new components as well as for the reconditioning of existing ones. The present paper is dedicated to the comparison of different stripping methods and to the characterization of the blades surface after removal of thermal spray coatings both of Zirconia and of MCrAlY. The results reported here show that chemical stripping is particularly suitable for MCrAlY coating removal and does not affect the substrate. Water jet stripping can successfully be used for Zirconia-MCrAlY system removal although care is needed to avoid substrate damage. Salt bath technologies have been formed to be effective for TBC removal but not for MCrAlY removal.

The use of plane parallel ionization chambers with electron beams with high dose per pulse entails dose uncertainties due to the overestimation of the ion recombination factor, k, up to 20% if conventional dosimetric protocols are used. In this work MD-55-2 radiochromic films have been used as reference dosimeters to obtain dose to water per pulse DGAF(w) values for three Novac7 (Hitesys) electron beams of E0 = 5.8 MeV. However, the beam calibration by MD-55-2 films is time consuming and the use of plane parallel chambers is fundamental for a periodic quality control procedure. Three plane parallel chambers have been used and the general formula for the k determination has been tested using the calibration doses, DGAF(w). In particular, consistent ion recombination factors ksat(V0) (with the ion chamber polarized at V0), that follow the Boag theory, have been estimated at different dose per pulse values for the three plane parallel ionization chambers. This means that at present any ion chamber needs a specific ksat (V0) determination by using a reference dosimeter for which the response is independent of the dose rate. An accurate determination of ksat(V0), using a reference quality beam, can be used to determine the dose to water per pulse for electron beams of different quality and geometrical configuration.

This paper describes the architecture of a system, a prototype of which is being developed by the authors at IBM Rome Scientific Centre, providing an interactive approach to the printing process, starting from the input of the basic components (images, texts and graphics) up to the definition and modification of page layout and finally to driving high resolution output devices. The system manages collections of pages, called “documents”; in turn each page is defined as a spatial composition of elementary boxes distributed on different levels. The main characteristics of the system architecture are interactivity, modularity and non-procedurality (the user has only to describe “what” has to be done, rather “how” to do it).

The choice of the type of film must be done carefully in regard to the particle characteristics to obtain the maximum LET. The Boron 10 Converter we have prepared gives a four times higher response to neutrons than Standard B Converter. Detection by neutron irradiation of very small quantities of Boron and Lithium is improved by a new isotope 15 nitrogen cellulose nitrate.

A facility for the irradiation of biological samples for the purpose of thermal neutron microradiography at the R2-0 reactor in Studsvik, Sweden, is presented. Analysis of boron was carried out in cultivated cells and thin histological sections using cellulose nitrate film detectors. The aim was to determine concentrations of boron in the interval 0.01–10 ppm with or without spatial representation at microscopic resolution. Examples of the results are presented from current studies of tumour-seeking boron compounds developed for their potential usefulness in neutron capture therapy in malignant disease. Special emphasis is on problems encountered at low boron concentration and the experimental requirements for cellular localization of boron. Current developments are presented and discussed.

The Authors estimated the influence of carbamazepine on both free and linked albumin triptofane in the plasma of 6 epileptic patients and of 6 healthy volunteers, during a period of observation lasting 7 days. The relation free/linked triptofane decreased significantly in the epileptic patients after the first day of treatment, while an analogous phenomenon was observed in healthy people only after the seventh day. Part of triptofane disappeared from plasma thus suggesting a cerebral uptake of the synthesis of serotonin. Carbamazepine displaced some unknown compounds from their links with plasmatic albumin, thus allowing triptofane to link itsel. The Authors therefore confirm the role played by anticonvulsive drugs in modifying the pool of free aminoacids in plasma.

The relatively low, but adjustable contrast given by cellulose nitrate films permits, in neutron radiography to record very fine details in images contrary to the high contrasted silver halide images. The resolution is excellent. The simplicity of use is remarkable: all operations are made in full light, the insensivity to gamma rays permits use in direct, non filtered neutron beams and the radiography of gamma active objects. The converter screens used with cellulose nitrate are non-activable. This is not the case for converters used with X rays films. Cellulose nitrate films are excellent for alpha or proton autoradiographs, visualising Boron, Lithium, Nitrogen, etc. extremely interesting for Medicine, Biology, Industry, etc.

The recording of neutronic images on plastic polymer films is carried out via α particles. Boron and lithium are the only n,α conversion elements having a high yield.

The light depolarization method for the measurement of the optical densities of a picture on cellulose nitrate film was used to plot the precise sensitometric curves of these films.

The use of plastic films especially cellulose nitrate, presents many advantages. But the direct examination of frosted images is rarely possible. The most used way is the projection print on a photographie surface.

This paper describes the architecture of a system, providing an integrated approach to the printing process, starting from the input of the basic components (images, texts, and graphics) up to the definition and modification of page layout and finally to driving high resolution output devices. The system allows an interactive management of the documents to be printed as well as of their elementary components, i.e. the pages, and at a lower level, the boxes, containing texts, images and graphics. The main peculiarities of the system architecture are interactivity, modularity and non-procedurality discussed in more details and some of its functions are illustrated by means of some system outputs.

The original properties of cellulose nitrate have permit to improve its possibilities and applications. The dosimetry of protons is now easy. Biological and medical applications have been developed by lowering the background of detection films. The counting methods: optical scanning and sparking, are now simplified and fast.

Coloured cellulose nitrate detectors are now routinely used, especially for dosimetry. Consequently, the problem of customers is the etching treatment of sets of samples in order to avoid aspect defects unknown when etching sheets are handled one by one. Major parameters for getting good results are: the speed and orientation of stirring, a permanent filtering of the etching solution, a very good regulation of temperature, the vertical position of samples, and a fast flow of water when rinsing.

The quality of tracks depends of the nature of the etching chemical, the concentration of solutions, the temperature of solutions, the etching time, the stirring conditions, the nature and quality of additives in the polymer. It depends too, of impurities in alkalis, impurities brought by containers, supporting devices of films, feeding pumps, time and conditions of keeping of stocked films, injuries of all kinds on the surface of the film, excessive local pressure, kinks, contact with plastics releasing plasticizers, marking with inks containing solvents.

In Italia aumentano in modo impressionante, anche a causa dell’elevata aspettativa di vita, il numero di malati cronici, con molti anni vissuti in condizioni di non autosufficienza. Persone anziane e malate, tuttavia, hanno il diritto ad una vita dignitosa e di qualità. Un ben vivere, perché no? La qualità della vita dei malati cronici varia enormemente a seconda del tipo di patologia e della fase. La malattia ha effetti sul fisico, eminentemente per il dolore e la sofferenza che questa comporta. Ha certamente effetti psicologici per l’incertezza e le preoccupazioni che l’accompagnano. Il contesto di malattia, ovvero la famiglia del malato, la più estesa comunità nella quale egli/ella vive, e anche il suo personale livello di istruzione e reddito modificano la qualità della sua vita con la malattia. Inoltre, la malattia cronica rende evidente il legame tra benessere dei pazienti e dei loro familiari, che spesso svolgono la maggior parte del lavoro di assistenza. L’obiettivo del contributo è quello di pensare al benessere nella malattia, rivedendo il concetto di salute in termini di capacità di creare nuove relazioni. Si può pensare all’idea di una comunità “accogliente”, che dia numerose possibilità di socializzazione, eventualmente stimolata dal volontariato e dalla municipalità. Inoltre, la salute digitale è ormai una realtà imprescindibile. Gli anziani di oggi, ma soprattutto di domani, sono sempre più digitalizzati. Attraverso computer e smartphone, è possibile accedere a un numero elevatissimo di servizi e possibilità di comunicazione. Infine, per anticipare cronicità e anni in disabilità è bene coltivare stili di vita sani e pratiche di wellness. Alla politica spetta di stimolare queste possibilità rimuovendo o comunque minimizzando le posizioni di svantaggio.

Summary Public health technical expertise is of crucial importance to inform decision makers’ action in the field of health and its broader determinants. Improving education and training of public health professionals for both practice and research is the starting point to strengthen the role of public health so that current health challenges can be efficiently tackled. At the Association of Schools of Public Health in the European Region (ASPHER) Deans’ & Directors’ 2017 Annual Retreat, we presented the structure and management of public health training system in Italy, and we reported recent data on Italian public health specialists’ educational experience, employment opportunities and job satisfaction. Public health training in Italy is implemented in the context of the post-graduate medical education residency programme in Hygiene and Preventive Medicine, delivered by 34 University-based Schools of Public Health. We report relatively high employment rates across the county and wide spectrum of career opportunities for young public health specialists. However, job security is low and training expectations only partially met. We call upon other Schools of Public Health to scale up the survey within the broad ASPHER community in a shared and coordinated action of systematically collecting useful data that can inform the development of public health education and training models, their implementation and fruitful interaction with population health, health systems and services.

Purpose. This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs) and CAD-CAM customized pure and porous hydroxyapatite (HA) scaffolds to replace the temporomandibular joint (TMJ) condyle.Methods. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right) of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed.Results. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P<0.05). The bone ingrowth (BI) relative values of split-mouth comparison (right versus left side) showed a significant difference between condyles with and without MSCs (P<0.05). Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation.Conclusion. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs.

Ear defects in patients affected by Treacher Collins syndrome necessitate the replacement of the existing anatomic residuals of the ears with custom-made prostheses. This paper describes a multidisciplinary protocol involving both medicine and computer-aided design/computer-aided manufacturing for manufacturing ear prostheses. Using innovative prototyping technologies together with conventional silicone processing procedures, a step-by-step procedure is presented. The complete workflow includes laser scanning of the defective regions of a patient's face, the use of 3D anatomic models from an ear digital library and rapid prototyping of both substructures for bar anchoring and moulds for silicone processing.

Recent statistics on causes of aviation accidents and incidents demonstrate that to increase air-transportation safety, we must reduce human errors' impact on operations. So, the industry should first address human factors related to people in stressful roles to significantly minimize such errors. In particular, aviation maintenance employees work under high-pressure conditions- that is, they're under strict time constraints and must adhere to stringent guidelines. Because of such constraints, they might be prone to making errors. Unfortunately, many of these errors might not become apparent until an accident occurs. Although maintenance errors are a recognized threat to aviation safety, there are few simulation and computer-based tools for managing human factor issues in this field. The main advantages in using computer-based systems to train or support technicians are that computers don't forget and that they can help humans clearly understand facts. Such features can help reduce errors due to procedure violations, misinterpretation of facts, or insufficient training. Toward that end, augmented reality (AR) is a promising technology to build advanced interfaces using interactive and wearable visualization systems to implement new methods to display documentation as digital data and graphical databases. Nevertheless, many factors-such as cumbersome hardware, the need to put markers on the aircraft, and the need to quickly create digital content-seem to hinder its effective implementation in industry.

Background The Italian Ministry of Health declared oncology a priority and stressed the importance of ensuring continuity and integration in cancer care pathways. In order to monitor the quality of cancer care pathways, we need to explore patients’ experience of the continuity of care, identifying the dimensions that define continuity Methods We found 886 relevant articles in the Pubmed database from 1987 to 5 November 2013. The search strategy for the electronic database was defined using the Population, Intervention, Comparison and Outcome(s) framework (PICO) to identify keywords. Two researchers independently reviewed records identified through the search strategy, analyzing continuity dimensions, specificity and/or transversal domains Results We selected 20 articles that measure the patients’ experience of continuity of care: 7 articles including 5 questionnaires [Questionnaire by King et al. 2008; Cancer care coordination Questionnaire (Cccq); Patient Continuity of Care Questionnaire (Pccq); Medical Care Questionnaire (Mcq); Continuity and Coordination of Care Questionnaire (CCCQ)]; 6 articles evaluating the relationship between patient and his/her physician (the same across the care pathway) in terms of frequency and/or dispersion; 6 articles considering one subscale of larger scales designed to evaluate the generic cancer care service patient experience; 1 revealing four organizational indicators of care pathway continuity / discontinuity Conclusion We traced 3 transversal dimensions across the individual analyses: informational, organizational, relational continuity. It follows that in order to cater to the needs of cancer patients, we need to simultaneously focus on these three dimensions along the cancer care pathway. In line with these results, we promoted the “R.In.Cu.ORAM.i” study (Networks for Integrated Treatment of colorectal and breast cancer), in Area Vasta Romagna Area (Italy), and developed a continuity of care patient-experience continuity tool

Adjuvant therapy represents the gold standard treatment for radically resected pancreatic cancer. Results from randomized clinical trials confirmed the efficacy of adjuvant therapy for pancreatic cancer but did not define what is the "right choice" in terms of type of antiblastic drug (among gemcitabine, 5-fluorouracil or other drugs), role of polychemotherapy and chemoradiotherapy. The objective of our study was to evaluate the efficacy and toxicity of adjuvant chemotherapy and chemoradiotherapy for radically resected pancreatic cancer through a systematic review of literature data, emphasizing the benefits regarding overall survival, disease-free survival and toxicity.

The cellular basis of heart's pacemaking activity, and specifically the degree of contribution of the different mechanisms involved, is still debated. Reliable computational models of the sinoatrial (SAN) action potential (AP) may help gain a deeper understanding of the phenomenon. Recently, novel models incorporating a detailed calcium-handling dynamics have been proposed, but they fail in reproducing experimental effects of “funny” current (If) reduction. We therefore developed a SAN AP model, based on available experimental data, to reproduce and investigate autonomic and drug-induced rate modulation.Cell compartmentalization and all the intracellular Ca2+ handling mechanisms were formulated as in the Maltsev-Lakatta model. Membrane current equations were revised on the basis of published experimental data. Modifications to the current formulations to simulate autonomic modulation and drug effects (Acetylcholine, Isoprenaline, Ivabradine, Cesium, BAPTA, Ryanodine) were derived from experimental data.The model generates AP waveforms typical of rabbit SAN cells, whose parameters fall within the experimental ranges: 176ms AP duration, 329ms cycle length, 73mV AP amplitude, −56mV maximum diastolic potential and 6.23V/s maximum upstroke velocity. Rate modulation by If-blocking drugs agrees with experimental findings: 18% and 20% Cesium-induced (5mM) and Ivabradine-induced (3μM) rate reductions, respectively. The model reproduces the autonomic modulation effects, with Acetylcholine- and Isoprenaline-induced rate variations, in a way that is quantitatively consistent with experimental data. Model testing of Ryanodine and BAPTA effects showed slowing of rate without cessation of beating.Our up-to-date model describes satisfactorily experimental data concerning autonomic stimulation, funny-channel blockade and inhibition of the Ca-related system by specific drugs, making it a useful tool for further investigations. Simulation results suggest that a detailed description of the intracellular calcium fluxes is fully compatible with the observation that If is a major component of pacemaking and rate modulation.

In questo lavoro si presenta un metodo per la ricerca automatica dell’orientamento basato sull’impiego di algoritmi genetici. Lo scopo è fornire un supporto alle decisioni per l’uso efficiente dei sistemi di Prototipazione Rapida. Il metodo viene prima validato su un modello campione e poi dimostrato su un modello di forma libera per applicazioni biomedicali.

In this paper, the complete procedure to design and construct reusable moulds for implant-based ear prosthesis and manufacture substructures by means of a computer aided design-computer aided manufacturing (CAD-CAM) procedure and rapid prototyping (RP) technology is presented. The scan of the healthy ear, the virtual superimposition of its mirrored image on to the defective side, and the rapid manufacturing of the substructure and of the mould eliminate several steps of traditional procedures (wax, stone, try-in). Moreover, the precise design and customization of the substructure is presented, with the original and engineered shape for the retention of the silicone. The time and cost saving results of this protocol are presented together with a discussion of the main design features that make the prosthesis a stable and reproducible system to improve rehabilitation of patients with auricular defects or absence.