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Large calderas are among the Earth's major volcanic features. They are associated with large magma reservoirs and elevated geothermal gradients. Caldera-forming eruptions result from the withdrawal and collapse of the magma chambers and produce large-volume pyroclastic deposits and later-stage deformation related to post-caldera resurgence and volcanism. Unrest episodes are not always followed by an eruption; however, every eruption is preceded by unrest. The Campi Flegrei caldera (CFc), located along the eastern Tyrrhenian coastline in southern Italy, is close to the densely populated area of Naples. It is one of the most dangerous volcanoes on Earth and represents a key example of an active, resurgent caldera. It has been traditionally interpreted as a nested caldera formed by collapses during the 100–200 km3 Campanian Ignimbrite (CI) eruption at ∼39 ka and the 40 km3 eruption of the Neapolitan Yellow Tuff (NYT) at ∼15 ka. Recent studies have suggested that the CI may instead have been fed by a fissure eruption from the Campanian Plain, north of Campi Flegrei. A MagellanPlus workshop was held in Naples, Italy, on 25–28 February 2017 to explore the potential of the CFc as target for an amphibious drilling project within the International Ocean Discovery Program (IODP) and the International Continental Drilling Program (ICDP). It was agreed that Campi Flegrei is an ideal site to investigate the mechanisms of caldera formation and associated post-caldera dynamics and to analyze the still poorly understood interplay between hydrothermal and magmatic processes. A coordinated onshore–offshore drilling strategy has been developed to reconstruct the structure and evolution of Campi Flegrei and to investigate volcanic precursors by examining (a) the succession of volcanic and hydrothermal products and related processes, (b) the inner structure of the caldera resurgence, (c) the physical, chemical, and biological characteristics of the hydrothermal system and offshore sediments, and (d) the geological expression of the phreatic and hydromagmatic eruptions, hydrothermal degassing, sedimentary structures, and other records of these phenomena. The deployment of a multiparametric in situ monitoring system at depth will enable near-real-time tracking of changes in the magma reservoir and hydrothermal system.

A granular multiphase model has been used to evaluate the action of differently sized particles on the dynamics of fountains and associated pyroclastic density currents. The model takes into account the overall disequilibrium conditions between a gas phase and several solid phases, each characterized by its own physical properties. The dynamics of the granular flows (fountains and pyroclastic density currents) has been simulated by adopting a Reynolds-averaged Navier-Stokes model for describing the turbulence effects. Numerical simulations have been carried out by using different values for the eruptive column temperature at the vent, solid particle frictional concentration, turbulent kinetic energy, and dissipation. The results obtained provide evidence of the multiphase nature of the model and describe several disequilibrium effects. The low concentration (≤5 × 10−4) zones lie in the upper part of the granular flow, above the fountain, and above the tail and body of pyroclastic density current as thermal plumes. The high concentration zones, on the contrary, lie in the fountain and at the base of the current. Hence, pyroclastic density currents are assimilated to granular flows constituted by a low concentration suspension flowing above a high concentration basal layer (boundary layer), from the proximal regions to the distal ones. Interactions among the solid particles in the boundary layer of the granular flow are controlled by collisions between particles, whereas the dispersal of particles in the suspension is determined by the dragging of the gas phase. The simulations describe well the dynamics of a tractive boundary layer leading to the formation of stratified facies during Strombolian to Plinian eruptions.

Large ignimbrites are the product of devastating explosive eruptions that have repeatedly impacted climate and life on global scale. The assemblage of vertical and lateral lithofacies variations within an ignimbrite sheet, its internal architecture, may help to determine how the parental pyroclastic current evolves in time and space. The 39 ka Campanian Ignimbrite eruption, vented from Campi Flegrei caldera, laid down a thick ignimbrite over an area of thousands of km 2 . A detailed reconstruction of the vertical and lateral variation of the seven lithofacies recognised in the ignimbrite medial sequence constrains the behaviour of this event. The pyroclastic current flowed over a wide area around Campi Flegrei without depositing (bypass zone), and inundated a huge area during most of the paroxysmal, waxing phase, emplacing a mainly incipiently- to strongly- welded ignimbrite. Following this waxing phase, the leading edge of the current retreated back towards the source as the current waned, impacting a progressively smaller area and leaving an unconsolidated ash and lapilli deposit, later lithified. Our study illustrates how large pyroclastic currents can evolve in time and space and the importance of both internal (eruptive and transport mechanisms) and external (topography, surficial water and rain) factors in governing their behaviour.

Sudden death is a possible occurrence for newborns younger than 1 year with severe aortic coarctation (CoA) before surgical correction. In our previous study, we showed a significant increase of QTc-D and JTc-D in newborns with isolated severe aortic coarctation, electrocardiographic parameters that clinical and experimental studies have suggested could reflect the physiological variability of regional and ventricular repolarization and could provide a substrate for life-threatening ventricular arrhythmias. The aim of the current study was to evaluate the effect of surgical repair of CoA on QTc-d, JTc-d in severe aortic coarctation newborns with no associated congenital cardiac malformations. The study included 30 newborns (18M; 70+/-12 h old) affected by severe congenital aortic coarctation, without associated cardiac malformations. All newborns underwent to classic extended end-to-end repair. Echocardiographic and electrocardiographic measurements were performed in each patient 24 h before and 24 h after the interventional procedure and at the end of the follow-up period, 1 month after the surgical correction. All patients at baseline, 24 h and one month after CoA surgical repair did not significantly differ in terms of heart rate, weight, height, and echocardiographic parameters. There were no statistically significant differences in QTc-D (111.7+/-47.4 vs 111.9+/-63.8 ms vs 108.5+/-55.4 ms; P=0.4) and JTc-D (98.1+/-41.3 vs 111.4+/-47.5 vs 105.1+/-33.4 ms; P=0.3) before, 24 h and 1 month after CoA surgical correction. In conclusions, our study did not show a statistically significant decrease in QTc-D and JTc-D, suggesting the hypothesis that the acute left ventricular afterload reduction, related to successful CoA surgical correction, may not reduce the ventricular electrical instability in the short-term follow-up.

The Italian cancer registries network has not been sufficiently developed in the Southern regions. General practitioners (GPs) are knowledgeable about the prevalence, incidence and mortality for different types of cancer in their patient populations. The aim of this pilot study was to verify the feasibility and reliability of the characterization of cancer populations using GP databases in order to evaluate the impact of cancer in the general population of Naples. The characteristics of the cases studied have been collected by interview or electronic health record and recorded on paper or magnetic supports, appropriately conforming to the current privacy law. Databases are centralized, stored and codified on electronic data-sheets and periodically elaborated by the 'Consorzio Nazionale delle Cooperative Mediche' and 'Federico II' University. The present study was initiated on September 15, 2004. The analysed geographical area included the suburbs of 'Stella' and 'San Carlo all'Arena', situated in the historical center of Naples and corresponding to Health Care District 29 of the local health service. The analysis included 16,927 men and women (age range, 6-97 years) from the outpatient offices of 12 GPs who agreed to participate in the study. Results showed that the analysed population represents 16.3% of the general population residing in the area under study. We identified 342 (2%) patients with cancer, 143 (0.8%) of whom were men and 199 (1.2%) women (M/F ratio of 0.7). Of the 342 patients, 10 (5 men and 5 women) had a double cancer; thus, a total of 352 malignancies was characterized. Cancer prevalence was 2,020/100,000 inhabitants. This estimate is lower compared to the national prevalence (2,683/100,000 inhabitants) but higher compared to that in other southern Italian areas. Results, stratified by International Classification of Disease, ninth revision (ICD-IX), based on factors including gender and age, demonstrated that breast cancer, urogenital tumours and colorectal cancer are the most frequently occurring types of cancer identified among the inhabitants of Naples. Cancer prevalence in the historical center of Naples is in concordance with national estimates and projections and National Cancer Registries may be easily and accurately supported by GP medical databases.

Background: Transcatheter closure is now accepted as the first-choice therapeutic option in patients with patent ductus arteriosus (PDA). However, this procedure is still challenging in large PDA and/or younger patients. This study evaluated feasibility and results of this approach in large, symptomatic PDA using different devices., Methods: Between April 2000 and July 2004, 57 patients underwent attempt of transcatheter closure of a large PDA at our Institution. Nineteen patients (33.3 %) were on pharmacologic therapy for congestive heart failure. PDA diameter was 3.2+/-1.2 mm (range 1.8-9 mm), resulting in a pulmonary to systemic flow ratio of 2.1+/-1.8 (range 1.4-5)., Results: The procedure was successfully performed in 54 patients (94.7%), using the Amplatzer duct occluder (ADO) device (34 patients) or a multiple detachable coil approach (20 patients). Complete PDA occlusion was recorded in 77.8% of patients at 24 hours, 92.6% at 1 month, and 94.4% at last follow-up control (23+/-12 months). PDA morphology and pulmonary to systemic flow ratio did not influence the success rate of the procedure or the residual shunt. A trend toward a higher occlusion rate at any follow-up point was recorded in the ADO group (79.5 vs 75.0% at 24 hours, 97.1 vs 85.0% at 1 month, and 97.1 vs 90% at last follow-up control, p = NS for all comparisons)., Conclusions: Percutaneous closure might be considered effective and safe also in large, clinically significant PDA, by tailoring the device choice to the patient size and ductal morphology. In this setting, the multiple coil option revealed as effective as the ADO device over a mid-term follow-up.

The authors have reviewed the symptom hematuria in childhood, suggesting a simple flow chart for ambulatorial pediatricians.