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Since the advent of the Kidney Allocation System (KAS), matched candidates with high (>98%) panel reactive antibody (hPRA) are given priority over local candidates with lower PRA. This often leads to exporting of kidneys. Data for these kidneys are not detailed on routine reports. Twenty-two organ procurement organizations prospectively submitted data from August 2015 to July 2016, describing allocation practices of kidneys to hPRA patients and outcomes of these kidneys. Five hundred twenty out of 6924 procured kidneys were exported for hPRA recipients. Of these, 402 (77.3%) were transplanted into the intended recipient (IR); 100 (19.2%) were transplanted into unintended recipients (UR), and 18 (3.5%) were discarded. The most common reason for use in an UR was a positive crossmatch (XM) (63%). The most common reasons for discard were donor quality (44%) and ischemic time (39%). Prior to kidney export, when tissue crossmatching was done, 96.2% of the kidneys went to the IR, versus 80.7% following virtual CM, versus 56.7% when no crossmatching was performed (p < 0.0001). A significant number of kidneys exported for hPRA patients are not being used in the IR or are being discarded. The most common reason for this is positive tissue XM. We report that unintended use of the kidney was minimized when tissue was shipped and XM results were known prior to exporting the kidney.

Objectives To describe the integration of home-based Medication Therapy Management (MTM) into the ambulatory care infrastructure of a large urban health system and to discuss the outcomes of this service. Setting Minnesota from September 2012 to December 2013. The health system has more than 50 primary care and specialty clinics. Eighteen credentialed MTM pharmacists are located in 16 different primary care and specialty settings, with the greatest number of pharmacists providing services in the internal medicine clinic. Practice innovation Home-based MTM was promoted throughout the clinics within the health system. Physicians, advanced practice providers, nurses, and pharmacists could refer patients to receive MTM in their homes. A home visit had the components of a clinic-based visit and was documented in the electronic health record (EHR); however, providing the service in the home allowed for a more direct assessment of environmental factors affecting medication use. Evaluation Number of home MTM referrals, reason for referral and type of referring provider, number and type of medication-related problems (MRPs). Results In the first 15 months, 74 home visits were provided to 53 patients. Sixty-six percent of the patients were referred from the Internal Medicine Clinic. Referrals were also received from the senior care, coordinated care, and psychiatry clinics. Approximately 50% of referrals were made by physicians. More referrals (23%) were made by pharmacists compared with advanced practice providers, who made 21% of referrals. The top 3 reasons for referral were: nonadherence, transportation barriers, and the need for medication reconciliation with a home care nurse. Patients had a median of 3 MRPs with the most common (40%) MRP related to compliance. Conclusion Home-based MTM is feasibly delivered within the ambulatory care infrastructure of a health system with sufficient provider engagement as demonstrated by referrals to the service.

Background: As many as 40% of infants aged ≤12 months and 10%–28% of children aged 13–24 months are colonized by Clostridioides difficile. The IDSA and the SHEA recommend that testing should never be routinely recommended for infants ≤12 months of age and should not be routinely performed for children 1–2 years of age unless other causes are excluded. We report implementation of C. difficile diagnostic stewardship at 2 children’s hospitals. Methods: We implemented age-based restrictions for C. difficile testing at hospital A (∼200-bed, free-standing, children’s hospital) and hospital B (∼100-bed children’s hospital within a larger hospital). Both sites are part of the same multicampus institution, and both used nucleic acid amplification testing to detect C. difficile throughout the study. In May 2018, we implemented an electronic order set for C. difficile that provided alerts to avoid testing young infants and patients with recent use of laxatives, stool softeners, or enemas, but providers could order C. difficile testing at their discretion. In October 2018, we implemented a more restrictive diagnostic stewardship algorithm for C. difficile. No testing was allowed for infants aged ≤12 months. Approval pediatric infectious diseases staff was required to test children aged 13–24 months. Pathology resident approval was required to test children aged ≥24 months who had received laxatives, stool softeners, or enemas within ≤24 hours. Clinical microbiology laboratory supervisors reinforced rejection of nondiarrheal stool specimens for testing. Providers at both campuses were informed about the new testing guidelines by e-mail. We compared the number of tests sent and positive cases of healthcare facility-onset C. difficile (HO-CDI) by age strata before and after the implementation of the restrictive testing algorithm. Results: After the intervention, the number of tests in infants significantly declined; 2 infants aged ≤12 months and 4 infants aged 13–24 months were tested for C. difficile (Table). After the intervention, the number of tests per month declined at hospital A, as did the number of HO-CDI cases at both hospitals. Rejections of nondiarrheal stools significantly increased after the intervention (P < .001). Conclusions:C. difficile diagnostic stewardship for children was successfully implemented using a rule-based alert system in the electronic health record. This intervention was associated with a reduced number of tests sent and cases of HO-CDI. This strategy was cost-saving and prevented misdiagnosis, unnecessary antibiotic therapy, and overestimation of HO-CDI rates.Funding: NoneDisclosures: None

This paper reviews recent advances in three selected areas of pediatric invasive candidiasis: epidemiology, diagnosis, and treatment. Although the epidemiological trends of pediatric invasive candidiasis illustrate a declining incidence, this infection still carries a heavy burden of mortality and morbidity that warrants a high index of clinical suspicion, the need for rapid diagnostic systems, and the early initiation of antifungal therapy. The development of non-culture-based technologies, such as the T2Candida system and (1→3)-β-d-glucan detection assay, offers the potential for early laboratory detection of candidemia and CNS candidiasis, respectively. Among the complications of disseminated candidiasis in infants and children, hematogenous disseminated Candida meningoencephalitis (HCME) is an important cause of neurological morbidity. Detection of (1→3)-β-d-glucan in cerebrospinal fluid serves as an early diagnostic indicator and an important biomarker of therapeutic response. The recently reported pharmacokinetic data of liposomal amphotericin B in children demonstrate dose⁻exposure relationships similar to those in adults. The recently completed randomized clinical trial of micafungin versus deoxycholate amphotericin B in the treatment of neonatal candidemia provides further safety data for an echinocandin in this clinical setting.

In the past, liquid/solid extractions were performed with systems that required the use of different solvents, such as the Soxhlet method. Currently, everything has changed with the introduction of tools that reduce extraction times, reduce solvent consumption, improve extraction efficiency and reduce environmental impact (green extractions). All this is based on a new way of thinking about chemistry, the so-called green chemistry, based on the prevention of pollution that involves the development of systems that use and produce substances that are of lower risk for human health and low environmental impact. Exploiting the principles of green chemistry means implementing a series of principles that reduce or eliminate the use and production of hazardous substances during all stages of processing. In this context, the Rapid Dynamic Liquid Solid Extraction (RSLDE), through the use of the Naviglio extractor, represents a forerunner technique in the field of green extractions. The extraction takes place by generating a negative pressure gradient from the inside towards the outside of the solid matrix, so it can be conducted at room temperature or even sub-environment (Naviglio, 2003). Literature data have shown the versatility of RSLDE in various fields of application: pharmaceutical, cosmetic, herbalist, food and beverage and not least of food waste. Furthermore, the reproducibility of the extraction on the same matrix in weight terms was tested and comparison experiments were conducted with the other extraction techniques, which showed a higher recovery in favour of the RSLDE, as well as a higher extract quality and in no case it was detected alteration of thermolabile substances.

Invasive fungal disease contributes significantly to morbidity and mortality in the hospitalized pediatric patient. Intensive care unit patients, secondary to both their underlying illness and exposure to known risk factors, represent a high-risk group. Significant diagnostic limitations make early detection and treatment initiation difficult, with treatment delays associated with worse outcomes. Early detection therefore requires clinicians to maintain a high index of suspicion. While the use of biomarkers and fungal PCR represent a promising avenue for earlier diagnosis, most tests have not yet been validated in pediatric patients. Until then, the clinician should limit testing to those patients with known risk factors and interpret results within the larger clinical picture. Empiric therapy with respect to invasive candidiasis should be restricted to patients with known risk factors and a sepsis-like picture who fail to respond to broad-spectrum antibiotic therapy within a 72-h time frame, noting again that this is not a standardized guideline. Clinicians must be mindful of pharmacokinetic variation and dosing variability when implementing treatment in the pediatric population.

Background. Fungal infections of the central nervous system (FICNS) are important causes of morbidity and mortalityamong immunocompromised pediatric patients. Standard diagnostic modalities lack the sensitivity for detecting and therapeutically monitoring these life-threatening diseases. Current molecular methods remain investigational. (1!3)-β-D-glucan (BDG) is a cell wall component found in several fungal pathogens, including Candida and Aspergillus spp. Detecting BDG in cerebrospinal fluid (CSF) may be an important approach for detecting and therapeutically monitoring FICNS. To date, there has been no study that has investigated the effectiveness of CSF BDG as a diagnostic and therapeutic marker of FICNS in children. Methods. Serial BDG levels were measured in serum and CSF samples obtained from pediatric patients (aged 0–18 years) with a diagnosis of probable or proven Candida or Aspergillus CNS infection. Results. Nine cases of FICNS were identified in patients aged 1 month to 18 years. Two patients were infected with an Aspergillus species, and 7 patients were infected with a Candida species. All the patients at baseline had detectable BDG in their CSF. Among 7 patients who completed therapy for an FICNS, all elevated CSF BDG levels decreased to

SubCons is a recently developed method that predicts the subcellular localisation of a protein. It combines predictions from four predictors using a Random Forest classifier. Here, we present the user-friendly web-interface implementation of SubCons. Starting from a protein sequence, the server rapidly predicts the subcellular localisations of an individual protein. Additionally, the server accepts the submission of sets of proteins either by uploading the files or programmatically by using command line WSDL API scripts. This makes SubCons ideal for proteome wide analyses allowing the user to scan a whole proteome in few days. From the web page, it is also possible to download pre-calculated predictions for several eukaryotic organisms. To evaluate the performance of SubCons we present a benchmark of LocTree3 and SubCons using two recent mass-spectrometry based datasets of mouse and drosophila proteins. The server is available at http://subcons.bioinfo.se/ This article is protected by copyright. All rights reserved.

SubCons is a recently developed method that predicts the subcellular localization of a protein. It combines predictions from four predictors using a Random Forest classifier. Here, we present the user-friendly web-interface implementation of SubCons. Starting from a protein sequence, the server rapidly predicts the subcellular localizations of an individual protein. In addition, the server accepts the submission of sets of proteins either by uploading the files or programmatically by using command line WSDL API scripts. This makes SubCons ideal for proteome wide analyses allowing the user to scan a whole proteome in few days. From the web page, it is also possible to download precalculated predictions for several eukaryotic organisms. To evaluate the performance of SubCons we present a benchmark of LocTree3 and SubCons using two recent mass-spectrometry based datasets of mouse and drosophila proteins. The server is available at http://subcons.bioinfo.se/.

De Prospectiva Pingendi is a Treatise whose destiny is best reflected in the title: a work dedicated to painters, that teaches them the art of illusion. It therefore teaches them to construct an image that evokes the depths of space, passing through walls and painted tablets, to show landscapes, envi-ronments and human figures, seen as we see them in our daily experience of the world. Thus, for centuries, what has attracted the attention of readers and exegetes to this work, was the final result of Piero’s teaching: the prospective or, to better say, the perspective image. Consequently, the Trea-tise has been thoroughly investigated in the context of art history, less in the history of methods of representation. On the occasion of the Italian national print edition which, for the first time, con-templates the Latin and Vernacular manuscripts, as well as all of Piero della Francesca’s original drawings, the treatise has been the object of in-depth analysis and critical review. This review high-lights the two space models Piero mastered permitting the construction of perspective. The first of these models, used in the first and second books, is that of the space as it appears, or as we would say today, the projective space. Piero states the law that describes the compression of this space as a function of the distance by the observer as a succession of magnitudes. This law has an unsuspected generality and alone provides a theoretical support to all subsequent perspective constructions, even in the absence of expedients, such as the distance point, that appears unrelated to Piero della Fran-cesca’s concept. The second model, which is used in the third book, is that of space as it is. This model is not theorized, but only practiced. And yet we can find, in the model, characters that are specific to the method in its full maturity: the presence of associated orthogonal projections, the control of movements in order to handle items in general location and the discretization of the mod-eled forms. Perspective is a bridge between those two conceptions of space and between the ancient and the modern world.

Skeletal infections secondary to Candida albicans are uncommon and described primarily in adults. Nearly all 22 pediatric cases of C. albicans osteomyelitis described to date have occurred in neonates with specific risk factors or in children with a severe immunodeficiency. We report an unusual presentation of C. albicans osteomyelitis and arthritis in a 1-year-old boy without an immunodeficiency, which led to a delayed diagnosis. He most likely developed C. albicans arthritis and osteomyelitis during the neonatal period with a subsequent indolent and subacute presentation. Our literature search found no prior or recent reviews of C. albicans osteomyelitis in pediatric patients. On the basis of this patient and the case reports previously published, we discuss an approach to the evaluation and management of pediatric patients with Candida osteomyelitis.

To date, no studies have explored the effect of abnormal cerebral venous circulation on brain disorders, whereas many studies have investigated neurodegenerative brain anomalies associated with arterial diseases. The aim of our study was to demonstrate the feasibility of different surgical techniques to induce venous obstruction of cerebral brain drainage. Six C57/black mice underwent bilateral occlusion of the external jugular vein (group EJV), six underwent bilateral occlusion of the internal jugular vein (group IJV); and six underwent bilateral occlusion of both the EJV and the IJV (group EJV/IJV). Within each group, the interruption of blood flow was obtained via monopolar electro-coagulation (ME) in three mice and via surgical ligation (SL) in the remaining three mice. A “sham group” of two mice was used as the control. High-frequency ultrasound (HFUS) was used to detect the absence of blood flow in the examined vessel. The ME procedure led to successful results in 2/9 (22%) mice, one in the EJV group, one in the EJV/IJV group, and zero in the IJV group, and 4/18 (22%) when considering individual veins (i.e., total number of EJVs and IJVs occluded). The SL procedure was successful in 2/3 (67%) mice in the EJV group, in 3/3 (100%) mice in the IJV and in 3/4 (75%) mice in the EJV/IJV group. Therefore, the overall success rate was 8/10 (80%) when considering mice, and 20/26 (77%) when considering individual veins. The monopolar electro-coagulation method exhibited a high mortality due to cardiorespiratory arrest, while the results of the bilateral surgical ligation of EJVs and IJVs show that it is technically feasible and safe.

Citation: Maurea S, Mainenti PP, Ponsiglione A, Salvatore M (2015) Advanced Adrenal Imaging: Comparison between Radionuclide and MR Techniques. J Adv Radiol Med Image 1(1): 103 Volume 1 | Issue 1 Journal of Advances in Radiology and Medical Imaging

Single-institution, retrospective case series.To determine whether the microbiology of deep surgical site infections (SSIs) after spinal fusion surgery for deformity has changed over the last decade at our institution.SSI after pediatric spinal deformity surgery results in significantly increased patient morbidity and health care costs. Although risk factors are multifactorial, prophylactic and treatment antibiotic coverage is based in part on historical epidemiologic data, which may evolve over time.This study represents a retrospective review of clinical and microbiology records of patients less than 21 years old who underwent spinal deformity surgery at a single institution between 2000 and 2012. Patients were included who underwent index surgery at our institution and developed a deep SSI. Patients with growth-preserving spine constructs were excluded.The overall incidence of deep SSI was 3.6% (39/1094). The incidence of deep SSI following primary surgery was 3.3% (34/1034) and 8.3% (5/60) following revision surgery. The incidence of deep SSI varied by primary diagnosis: idiopathic (1.0%), neuromuscular (14.3%), syndromic (5.3%), congenital (5.7%), and kyphosis (0.0%). The most common inciting pathogens were Staphylococcus epidermidis (26%), methicillin-sensitive Staphylococcus aureus (MSSA, 18%), Propionibacterium acnes (P. acnes; 18%), and Escherichia coli (18%). Sixteen of the 18 (89%) gram-negative infections occurred in neuromuscular patients (P = 0.006). Between 2000 and 2006 and between 2007 and 2012, MSSA occurred in 2/18 (11%) and 5/21 (24%) of cases (P = 0.41), methicillin-resistant S. aureus occurred in 1/18 (6%) and 3/21 (14%) (P = 0.61), and P. acnes occurred in 3/18 (17%) and 4/21 (19%) (P = 1.0).The epidemiology of deep SSI following spinal fusion for deformity in pediatric patients at our institution has not changed significantly during 13 years. Prophylactic antibiotic coverage for both gram-positive and gram-negative organisms may be indicated for patients with primary neuromuscular diagnoses.4.

Objective To study the backgrounds of women requesting hymen 'repair', to assess the effects of extensive counselling, and the effects of hymen reconstruction. Methods A two-centre qualitative study, consisting of a semi-structured interview, education, discussion of alternatives, and instructions for self-examination (first visit), educational examination (second visit), decision on operation or alternative (third visit), and follow-up (fourth visit). Results Eighty-two women were interviewed at first visit. Sixty-eight women were followed until their decision to be operated upon or not. Forty-eight percent of all subjects reported a history of sexual violence, and 37% had had one or more abortions. Only 29% eventually decided to be operated. Seventeen of the 19 women who submitted to an operation and attended the follow-up visit reported no blood loss at first marital intercourse. Conclusions Most women requesting hymen reconstruction had a history complicated by critical life events related to their request. All women were afraid they would not bleed and/or would not be 'tight' enough during the wedding night. For 75% of the women empowerment by means of extensive counselling resulted in a decision against operation. Hymenoplasty alone does not help women because most operated women will not bleed and because they often also have to prove to be 'tight' enough.

The study illustrates the solution of the three point space resection problem, treated by Gaspard Monge in Section V of Leçons de Geometrie Descriptive. The problem entails the construction of the intersection curves of three tori. To solve this problem, Monge introduces several simplifications but, nevertheless, makes a mistake; this mistake has al-ready been pointed out by Gino Loria regarding the number of solutions allowed by the problem [11]. The mathematical representation, thanks to its high level of accuracy, today permits not only an efficacious solution of the general case, it also highlights without difficulty the right number of so-lutions. We applied this theory to a case of photogrammetric rendering, difficult to carry out by means of the tools offered by commercial software. Case in question concerns the reconstruction of the archi-tectural volumes, now lost, which were located along the road that crosses a village, near Rome. As is known, the reconstruction of points in space from two images is possible if these images are pro-jective and we have at least two projective orientated stars. The first image is a vintage photograph (1892), the second image is a surveyed plan of the masonry still present at the site. Therefore, one of the two projective stars is assimilated to a class of vertical straight lines. With regard to photography, the problem is articulated in two typical phases of photogrammetric processes: internal orientation and absolute orientation. For the absolute orientation we used the pyramid vertex method, in use since the Eighteenth Century, which consists in determining the projection center from three given points of which the positions in space are known. The solution to the problem posed by the case study can be considered as a useful result. More in-teresting, however, is the result of the intersection of the three tori with the incident axes (fig. 1). It is, in fact, a graphic process that Gaspard Monge had already proposed in 1798 as a suitable alterna-tive to a system of equations that he considered difficult to solve. In particular, Monge explains how the descriptive geometrical procedure, involving the vision of the represented forms, allows you to exclude in a simple and direct manner the solutions that resolve the problem from theoretical point of view, but do not solve it in the real case because they lead to unrealistic placements of the projec-tion center. Thus, the symbiosis between calculation and analog description, Monge had predicted in these words: «[…] la géométrie descriptive porteroit dans les opérations analytiques le plus compli-quées l'évidence qui est son caractère, et, à son tour, l'analyse porteroit dans la géométrie la general-ité qui lui est propre […]» [18].

Questo contributo intende illustrare le problematiche principali legate alla costruzione di modelli di architettura destinati alla realizzazione di modelli fisici, maquette in scala, controllabili attraverso sistemi Cad, nell’ambito della stampa 3D con particolare riferimento alla stereolitografia. Le problematiche legate alla costruzione di modelli di questo tipo sono descritte in relazione ad una esperienza maturata nell’ambito del Nervilab (Nervi Virtual Lab), laboratorio di ricerca dalla Sapienza di Roma, che ha visto nel 2010 la realizzazione di 12 modelli in ABS, in scala compresa fra 1:50 / 1:100, redatti per la mostra itinerante Pier Luigi Nervi Architettura come sfida.

Lo scopo della restituzione della fotografia in esame è la ricostruzione dei volumi, oggi perduti, disposti oltre la strada che attraversa il borgo, sulla sinistra della foto. La restituzione di punti nello spazio da immagini bidimensionali è possibile se queste sono di natura proiettiva e si dispone di almeno due stelle proiettive orientate. La prima immagine è la foto d’epoca, la seconda si ricostruisce da una foto aerea della AM del 1938 e dal rilievo delle murature ancora presenti sul luogo. Per il rilievo, l’una delle due stelle proiettive si assimila ad una classe di rette verticali. Per la fotografia, il problema si scompone nelle due fasi tipiche dei procedimenti fotogrammetrici: l’orientamento interno e l’orientamento assoluto. Per l’orientamento assoluto è stato usato il metodo del vertice di piramide che, in uso già dal XVIII sec., consiste nel determinare il centro di proiezione dati tre punti dei quali sia nota la posizione nello spazio., DISEGNARECON, Vol. 6, n. 12 (2013) - Disegnare con la fotografia digitale, a cura di Pablo Rodríguez-Navarro

To address the frequency of identifying nonsolid nodules, diagnosing lung cancer manifesting as such nodules, and the long-term outcome after treatment in a prospective cohort, the International Early Lung Cancer Action Program.A total of 57,496 participants underwent baseline and subsequent annual repeat computed tomographic (CT) screenings according to an institutional review board, HIPAA-compliant protocol. Informed consent was obtained. The frequency of participants with nonsolid nodules, the course of the nodule at follow-up, and the resulting diagnoses of lung cancer, treatment, and outcome are given separately for baseline and annual repeat rounds of screening. The χ(2) statistic was used to compare percentages.A nonsolid nodule was identified in 2392 (4.2%) of 57,496 baseline screenings, and pathologic pursuit led to the diagnosis of 73 cases of adenocarcinoma. A new nonsolid nodule was identified in 485 (0.7%) of 64,677 annual repeat screenings, and 11 had a diagnosis of stage I adenocarcinoma; none were in nodules 15 mm or larger in diameter. Nonsolid nodules resolved or decreased more frequently in annual repeat than in baseline rounds (322 [66%] of 485 vs 628 [26%] of 2392, P.0001). Treatment of the cases of lung cancer was with lobectomy in 55, bilobectomy in two, sublobar resection in 26, and radiation therapy in one. Median time to treatment was 19 months (interquartile range [IQR], 6-41 months). A solid component had developed in 22 cases prior to treatment (median transition time from nonsolid to part-solid, 25 months). The lung cancer-survival rate was 100% with median follow-up since diagnosis of 78 months (IQR, 45-122 months).Nonsolid nodules of any size can be safely followed with CT at 12-month intervals to assess transition to part-solid. Surgery was 100% curative in all cases, regardless of the time to treatment.

Dedicated high-resolution detectors are required for detection of small cancerous breast tumours by molecular imaging with radionuclides. Absorptive collimation is normally applied in imaging single photon emitters, but it results in a strong reduction in detection efficiency. Systems based on electronic collimation are complex and expensive. For these reasons simulations and measurements have been performed to design optimised dedicated high-resolution mini gamma camera. Critical parameters are contrast and signal-to-noise ratio (SNR). Intrinsic performance (spatial resolution, pixel identification, and response linearity and uniformity) were first optimised. Pixellated scintillator arrays (NaI(Tl)) of different pixel size were coupled to arrays of PSPMTs with different anode pad dimensions (6 6m m 2 and 3 3m m 2 ). Detectors having a field of view (FOV) of 100 100 mm 2 and 150 200 mm 2 were designed and built. The electronic system allows read out of all the anode pad signals. The collimation technique was then considered and limits of coded aperture option were studied. Preliminary results are presented.

Questo studio propone un metodo sintetico per la costruzione degli assi principali di una superficie quadrica, a partire da una sua generica porzione. La costruzione degli assi di una quadrica fa parte dei problemi del repertorio classico della geometria descrittiva, ed è particolarmente complessa se affrontata con i metodi grafici della rappresentazione. Il metodo proposto, sintetico e cioè grafico, è elaborato attraverso il disegno digitale tridimensionale. La costruzione descritta, applicata al caso di un cono quadrico, è generalizzata ed estesa a tutte le altre superfici quadriche.

The contribution of NerViLab (Nervi Virtual Lab, coordinator prof. Francesco Romeo, Sapienza University of Rome, http:// w3.disg.uniroma1.it/nervilab) as part of the exhibition Pier Luigi Nervi, Architecture as a challenge, focused on the analysis of structural, geometric formal and constructivem aspects in a series works of Pier Luigi Nervi. The exhibition, curated by Carlo Olmo, consists of a large international cycle of exhibitions dedicated to the great Italian talent and is sponsored by Pier Luigi Nervi Research and Knowledge Management Project, the CIVA Centre International pour la Ville, l’Architecture et le Paysage in Brussels and from the MAXXI, in collaboration with CSAC Research Center and Archive Communication of Parma. The research of NerViLab focuses on the operation of Reverse Modeling using a research methodology based on virtual laboratory in which computer models of the architecture choices are develop; the three-dimensional mathematical model is aimed at the creation of physical models for prototyping by stereolithography. Unlike the standard process of Reverse Engineering, in which the mathematical description (CAD) is obtained from the physical model, for Nervi’s architectures the archive sources were the natural starting point. The research work has been inspired by a scientific collaboration agreement between the Department of Structural and Geotechnical Engineering of Sapienza University of Rome and the Archive Centre of MAXXI, as well as the information made available from the archives of CONI and the CSAC in Parma.

Il contributo illustra la teoria delle linee di curvatura e un’applicazione delle proprietà di queste curve alla stereotomia della pietra, in particolare alla costruzione di una volta ellissoidale. L’intento è quello di trasferire in ambiente digitale la costruzione delle linee di curvatura per intersezione di quadriche confocali, elaborando un metodo sintetico utile alla costruzione di tali linee. Si vuole mostrare come principi geometrici apparentemente astratti abbiano ricadute significative in architettura attraverso un tema di attualità come quello delle linee di curvatura.

This study proposes a synthetic solution to the problem of the construction of the axes of a quadric cone. It also proposes the extension of this method to the construction of the elliptic hyperboloid given three skew lines. The above problems are particularly complex when addressed in Descriptive Geometry (DG) with classical graphic methods of representation. Today, the introduction of digital methods of representation and the ability to draw directly into space with high levels of accuracy, allows a revisitation of some of the problems of the traditional repertoire of DG, studying them in space, and developing simple solutions. This is the case study presented here. The construction of the axes of the cone is followed by a historical-critical survey of an experimental nature regarding some alternative solutions of the traditional heritage of the DG. In particular, two solutions are elaborated: one graphical, the other theoretical, by, respectively, Théodore Olivier and Otto Wilhelm Fiedler. The paper concludes with the extension of the construction of the axes of the cone to the construction of the elliptic hyperboloid given three skew lines. This study is an opportunity to show the potential of digital tools in the renewal of DG. As, in fact, Gaspard Monge teaches: «DG has two main objectives. The first is to accurately represent, in the drawings that have only two dimensions, objects that have three [...]. The second objective of DG is to deduce, from the exact description of the bodies, all that necessarily follows from their respective positions and shapes». In other words, to visualize forms in space through knowledge of the methods of representation and to construct and understand geometric entities, their properties, their relationships. «In this sense – continues Monge - it is a means of seeking truth and it provides examples of the continuous passage from the known to the unknown». Today, information technology has rendered automatic the initiatial objective, which is the visualization and, at the same time, has expanded the second one, the construction. The ability to directly represent in space, with micron level accuracy, strengthens the heuristic value of the design and enhances the experimental nature of the same that includes discovery/invention, i.e., the passage from the known to the unknown.

Il contributo del NerViLab (Nervi Virtual Lab, Sapienza Università di Roma) nell’ambito del progetto espositivo Pier Luigi Nervi, architettura come sfida, verte sull’analisi degli aspetti strutturali, geometrico-formali e costruttivi di una serie di opere di Pier Luigi Nervi. Il progetto espositivo, a cura di Carlo Olmo, si compone di un ampio ciclo internazionale di mostre dedicate al grande talento italiano ed è promosso dall’Associazione Pier Luigi Nervi Research and Knowledge Management Project, dal CIVA Centre International pour la Ville, l'Architecture et le Paysage di Bruxelles, dal MAXXI, con la collaborazione di CSAC Centro Studi e Archivio della Comunicazione di Parma. Alla prima mostra, inaugurata a Bruxelles nel giugno 2010, stanno seguendo esposizioni che, oltre ad un nucleo costante di contenuti, presentano ogni volta nuovi tagli ed approfondimenti; tra queste, si segnala l’esposizione in corso di svolgimento a Roma, presso il MAXXI fino al 20 marzo 2011, con l’approfondimento sulle opere di Nervi per le Olimpiadi del 1960 curato da Sergio Poretti e Tullia Iori. Per rappresentare e analizzare l’esemplare sintesi nerviana tra composizione strutturale, forma geometrica e costruzione l’attività di ricerca del NerViLab si incentra su un’operazione di Reverse Engineering facendo uso di una metodologia di ricerca basata sul laboratorio virtuale nell’ambito del quale si sviluppano i modelli informatici delle architetture scelte; la modellazione matematica tridimensionale è finalizzata alla realizzazione di modelli fisici per la prototipazione tramite stereolitografia. A differenza del processo standard di Reverse Engineering, nel quale la descrizione matematica (CAD) si ottiene a partire dal modello fisico, per le architetture nerviane investigate le fonti di archivio sono state il naturale punto di partenza. In particolare, il lavoro di ricerca, sviluppatosi secondo le fasi di ridisegno, di modellazione e prototipazione, ha preso le mosse da un accordo di collaborazione scientifica tra il Dipartimento di Ingegneria Strutturale e Geotecnica della Sapienza Università di Roma ed il Centro Archivi del MAXXI, nonchè dalla documentazione resa disponibile dall’archivio del CONI e dallo CSAC di Parma. Alla ricerca svolta dal NerViLab sarà dedicata una mostra a Roma, dal 17 febbraio al 3 aprile 2011, presso l’Academia Belgica. Il ricorso a modelli fisici in ambito architettonico è tradizionalmente legato alla necessità di comunicare gli intenti progettuali nello spazio. Nelle fasi iniziali dell’iter progettuale, semplici modelli fisici consentono una verifica preliminare dei rapporti spaziali tra volumi; nelle fasi conclusive, modelli più dettagliati mirano a una rappresentazione verosimile in scala ridotta e vengono realizzati sia per la committenza, in ambito professionale, sia per un pubblico più vasto, in ambiti espositivi. Diversamente da tali tradizionali finalità, i modelli fisici delle opere presentate in mostra sono stati ideati dal NerViLab al fine di contribuire alla comprensione della profondità del pensiero nerviano puntando a trasmetterne l’esito più felice: l’espressività spaziale delle composizioni strutturali comunicate tramite il linguaggio geometrico. L’evidente ricorso a tale linguaggio colloca l’approccio nerviano nella tradizione classica dell’architettura nella quale, secondo Viollet–le-Duc, occorre stabilire le proporzioni sulla base delle esigenze statiche, le quali, a loro volta, derivano dalla geometria; struttura e geometria sono dunque legate in modo indissolubile. Per Nervi tale legame non sembra limitare le possibilità espressive, quanto, piuttosto, sembra mutuare in ambito architettonico il pensiero di Queneau, secondo cui il classico che scrive la sua tragedia osservando un certo numero di regole che conosce sia più libero del poeta che scrive quello che gli passa per la testa ed è schiavo di altre regole che ignora. L’essenza stessa della geometria, al contempo razionale ed oggettiva ...

We have assembled a prototype system for multimodal (radionuclide and optical) in vivo planar imaging of small animals (mice) using single photon emission radiotracers (Tc-99m) and a fluorescent marker (hematoporphyrin). Preliminary tests of the separate (optical and radionuclide) prototype imaging systems are presented, aimed at assessing their features and at determining the experimental protocol for in vivo imaging. Tests were performed on anesthetized healthy or tumor bearing mice. The gamma radiation detector is a small area (11 /spl times/ 11 mm/sup 2/) hybrid pixel detector based on the Medipix1 ASIC readout technology (64 /spl times/ 64 square pixels of 170 /spl mu/m by side), bump-bonded to a 300 /spl mu/m thick silicon detector. High spatial resolution in radioimaging (in the order of 1 mm) is achieved in vivo with a pinhole tungsten collimator (0.35 mm diameter, 90/spl deg/ acceptance angle, field of view of over 20 mm at 10 mm source distance). A future setup will use the Medipix2 hybrid detector (256 /spl times/ 256 square pixels, 55 /spl mu/m by side) bump-bonded to a 1 mm thick CdTe pixel detector. The laser-induced in vivo fluorescence imaging system comprises a pulsed light source (Nd:YAG laser, /spl lambda/=532 nm, energy/pulse = 30 mJ, pulse width = 50 ps, repetition rate = 10 Hz) used to excite the fluorescence emission (600-760 nm) of injected hematoporphyrin compound, a low sensitivity CCD camera and a commercial image analysis system. Images of normal and tumor regions are acquired by using a cut-on filter (/spl lambda/>600 nm). Digital image subtraction then enhances the tumor contrast with respect to the background. The final experimental protocol, only partly implemented here, includes independent and then combined optical/radio imaging of control mice and of a solid tumoral area (human thyroid derived anaplastic carcinoma) after injection of the radiotracer and/or of the fluorophore. In this work, the accumulation of the radionuclide in selected organs and of the fluorophore in the tumor provides the signal contrast in the two imaging modalities. Fluorescence spectroscopy of excised tissue samples is also performed to help the interpretation of fluorescence images. Results of in vivo combined imaging on tumor in mice will be shown in a next paper.

Il contributo del NerViLab (Nervi Virtual Lab) nell’ambito del progetto espositivo “Pier Luigi Nervi: Arte e Scienza del Costruire” verte sull’analisi degli aspetti strutturali, geometrico-formali e costruttivi di alcune opere di Pier Luigi Nervi. Per rappresentare ed analizzare l’esemplare sintesi nerviana tra struttura, forma geometrica e costruzione l’attività di ricerca è incentrata su di un’operazione di Reverse Engineering facendo uso di una metodologia di ricerca basata sul laboratorio virtuale nell’ambito del quale si sviluppano i modelli informatici delle architetture scelte. La finalità della modellazione matematica tridimensionale condotta dal NerViLab è duplice: da un lato, la realizzazione di modelli fisici per la prototipazione tramite stereolitografia, dall’altro, l’analisi degli organismi strutturali nerviani con l’ausilio degli attuali strumenti della meccanica computazionale (FEM). Occorre sottolineare come entrambe le finalità costituiscano, a loro volta, la base di partenza per ulteriori indagini su aspetti peculiari delle opere di Pier Luigi Nervi quali la morfogenesi strutturale, analizzando la genesi geometrica originale e perlustrando eventuali soluzioni alternative, il calcolo strutturale, prevedendo studi sul comportamento meccanico spaziale ed analisi in campo anelastico e nonlineare, ed infine le tecniche costruttive, indagando le tematiche legate al cemento armato, quali le prestazioni, gli aspetti normativi, il cantiere e la prefabbricazione. Ponendo in questa sede l’attenzione sull’attività svolta ai fini della prototipazione, è ben noto come il ricorso a modelli fisici in ambito architettonico sia tradizionalmente legato alla necessità di comunicare gli intenti progettuali nello spazio naturale tridimensionale. I propositi di tale comunicazione sono molteplici. Nelle fasi iniziali dell’iter progettuale, semplici modelli fisici consentono una verifica preliminare dei rapporti spaziali tra volumi; nelle fasi conclusive, modelli più dettagliati che mirano ad una rappresentazione verosimile in scala ridotta vengono realizzati sia per la committenza, in ambito professionale, sia per un pubblico più vasto, in ambiti espositivi. Oltre a rendere agevole e diretta la comprensione delle forme architettoniche, l’utilizzo dei modelli fisici può anche essere orientato ad analizzare aspetti prestazionali della progettazione. Si parla in tale contesto di modelli sperimentali, concepiti per la simulazione sia del comportamento strutturale che delle soluzioni impiantistiche, quali illuminazione, acustica o ventilazione, nonché per la verifica delle fasi costruttive. I modelli fisici delle opere presentate nella serie di esposizioni dedicate a Pier Luigi Nervi sono stati ideati al fine di contribuire alla comprensione del pensiero nerviano puntando a trasmetterne l’esito più felice: l’espressività spaziale delle composizioni strutturali comunicate tramite il linguaggio geometrico. Da qui è nata la scelta di proporre modelli fisici astratti, nei quali gli schemi statici, le geometrie degli elementi strutturali e delle loro connessioni, le trame delle nervature e le tessiture degli elementi modulari fossero chiaramente leggibili. Si è cercato, in altre parole, di rendere fruibile anche ai non addetti ai lavori la sapiente ricerca nerviana della sintesi tra i requisiti oggettivi e soggettivi della progettazione. Alla luce degli obiettivi indicati la scala di riduzione dei modelli è stata calibrata in funzione della visibilità degli elementi strutturali distintivi; sfruttando le simmetrie e le distribuzioni spaziali dei singoli progetti, sono state modellate solo porzioni significative che, se da un lato hanno permesso la leggibilità degli spazi interni, dall’altro, hanno consentito di limitare i costi legati alle considerevoli dimensioni dei modelli (Figura 1). Si è dunque optato per la prototipazione rapida, tecnologia ormai consolidata nell’ambito del disegno industriale ed applicata solo di recente...

Under a Creative Commons license., The Tracker Group of the CMS Collaboration.-- et al., The response of n+p silicon strip sensors to electrons from a 90Sr source was measured using a multi-channel read-out system with 25 ns sampling time. The measurements were performed over a period of several weeks, during which the operating conditions were varied. The sensors were fabricated by Hamamatsu Photonics on 200 μm thick float-zone and magnetic-Czochralski silicon. Their pitch was 80 μm, and both p-stop and p-spray isolation of the n+ strips were studied. The electrons from the 90Sr source were collimated to a spot with a full-width-at-half-maximum of 2 mm at the sensor surface, and the dose rate in the SiO2 at the maximum was about 50 Gy(SiO2)/d. After only a few hours of making measurements, significant changes in charge collection and charge sharing were observed. Annealing studies, with temperatures up to 80 °C and annealing times of 18 h showed that the changes can only be partially annealed. The observations can be qualitatively explained by the increase of the positive oxide-charge density due to the ionization of the SiO2 by the radiation from the β source. TCAD simulations of the electric field in the sensor for different oxide-charge densities and different boundary conditions at the sensor surface support this explanation. The relevance of the measurements for the design of n+p strip sensors is discussed., The research leading to these results has received funding from the European Commission under the FP7 Research Infrastructures project AIDA, grant agreement no. 262025. We are also grateful to the HGF Alliance Physics at the Terascale, which has partially funded the setup used for the measurements, and to the BMBF, the Ministry of Research and Education of the German Federal Republic, for funding the Ph.D. position of J. Erfle within the Forschungsschwerpunkt FSP-102, Elementarteilchenphysik mit dem CMS-Experiment., Open Access funded by CERN.

We report our experience with a 9-month-old infant treated with intravenous polymyxin B for multidrug-resistant Klebsiella pneumoniae bacteremia. Serial blood samples were obtained at steady state and serum drug concentrations were determined using a validated liquid chromatography-mass spectrometry method. The elimination half-lives of polymyxin B1 and isoleucine-polymyxin B1 were found to be 3.1 and 4.7 hours, respectively.

Objective. To study distal interphalangeal (DIP) joints in patients with psoriatic arthritis (PsA) with or without onychopathy, using magnetic resonance imaging (MRI). Methods. Twenty-three patients with PsA (9/14 F/M, median age 47 yrs), 12 with onychopathy (2/10 F/M, median age 44 yrs) and 11 without (7/4 F/M, median age 52 yrs), and 10 control subjects (5/5 F/M, median age 43.2 yrs) were enrolled. MRI of nail and distal phalanx (DP) including examination of DIP joints was carried out. MRI was performed with a surface coil in a 1.5 T device. For each selected finger, both longitudinal and axial scans were performed. The involvement of nail, DP, and DIP joint was scored. Results. Nail thickening with or without surface irregularity occurred in 95.7% of cases (100% with onychopathy and 90.9% without). MRI nail involvement was more frequent in patients with clinical evidence of onychopathy than in those without (p = 0.003). Similarly, 95.7% of patients showed MRI abnormalities of DP (100% with onychopathy and 90.9% without). MRI DP abnormalities were more marked in patients with clinical evidence of onychopathy than in those without (p = 0.009). Involvement of DIP joints was present in 34.8% of cases (58.3% with onychopathy and 9.1% without), and onychopathic patients showed marked MRI DIP joint involvement in 5 cases and mild in 2, while patients without onychopathy showed minimal changes in one case (p = 0.03). Considering the entire group of patients, MRI involvement of DIP joints was always associated with MRI DP changes, and in no case was it present alone. Conclusion. MRI nail involvement was present in almost all patients with PsA studied, even in those without clinically evident onychopathy. MRI involvement of DP always overlapped with nail involvement, since it was present in all psoriatic cases showing MRI nail involvement. In contrast, MRI DIP joint involvement was almost exclusively in a lower percentage of the patients with clinical nail involvement and was always associated with MRI DP changes. Our results suggest that DIP joint involvement is always secondary to nail and DP involvement.