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Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques.What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting.What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic

This paper presents a participatory process aimed at improving outdoor education in a primary school in Milan. The rationale of this work was that the psycho-physical benefits for children from outdoor living could be enhanced through outdoor education. Indeed, open-air environments are fit for supporting learning experiences, bringing out different abilities and improving well-being. Moreover, during the COVID-19 pandemic, schoolyards turned out to be a resource for overcoming physical distancing. Nevertheless, the availability of flexible physical environments and proper equipment for the educational goals is a basic condition for overcoming difficulties in the extensive use of outdoor spaces in schools. The purpose of this work was to support the school in designing new outdoor educational environments with a focused vision on the pedagogical context. Thus, the process was developed by a multidisciplinary team with the involvement of the students and the teaching staff. By the initial analytical stage, site and use conditions as well as emerging needs were enlightened. These outcomes were assumed to develop a design solution both suitable for the innovation goals and attentive to environmental aspects. The proposal was selected for funding by the Municipality and implemented. Finally, a three-year post-occupancy evaluation program started in the earliest stages of use. In conclusion, by the first monitoring activities, it emerged that outdoor educational experiences increased and diversified from the past, together with students’ perception of opportunities and benefits achieved from more frequent and longer work in external environments, and their expectation of involvement in proposing further implementations.

DC microgrids initiated the change of a paradigm regarding the concept about electrical distribution networks, especially in the context of the distributed generation associated to renewable energies. However, this new reality opens a new area of research, in which several aspects must be carefully studied. Indeed, the bipolar design is one of the principal dc microgrid configurations considering its characteristic wiring. Although holding many promising advantages, the bipolar dc microgrid has a tendency towards voltage and current imbalances due to the unequal distribution of the loads and generators between the two poles. Thus, specific power-electronic-based solutions are required to ensure the balance of these dc microgrids. Within this frame, this article gives a comprehensive review of the multiple architectures and power electronic topologies proposed to mitigate/eliminate this undesired condition. The following provides an insightful classification and discussion with the pros and cons of these solutions. This work can serve as a timely review for researcher/engineers who want to enter the voltage balancing field in the bipolar dc grids and promote the innovation of their power-electronics-enabled solutions.

The Covid-19 pandemic emergency has further highlighted the centrality of primary care in health systems, fostering a new reform process towards new integrated community services called ‘Case della Comunità’. In the path dependency logic, the new proposal is part of regionalized reform paths, centered on the Case della Salute. The study analyzes three regional experiences (Piemonte, Marche, Puglia), investigating the continuity or fracture paths between implemented and announced reforms. The results highlight the heterogeneity in the implementation processes of the Case della Salute at regional level, both in terms of terminology and in the characteristics of the services, with marked criticalities in the integration paths of primary care with the rest of the community services, confirming the criticality in the transposition and implementation at the regional level of national policies.

© The Authors 2020. The present research has been funded by projects Spanish Ministry of Science projects PGC2018-095154-B-I00 (AN) and PID2019-109608GB-I00 (FM and JM). JF is supported by an Atracción Talento senior fellowship (2018-T1/AMB/11493) funded by Comunidad Autónoma de Madrid (Spain). This work has been done using the facilities of the Laboratory of Geodynamic Modelling from Geo3BCN-CSIC. We thank the Computational Infrastructure for Geodynamics (geodynamics. org) which is funded by the National Science Foundation under award EAR-0949446 and EAR-1550901 for supporting the development of ASPECT. We acknowledge constructive reviews by the two reviewers. Juliane Dannberg is kindly acknowledged for her support with ASPECT simulations. Figures were created with ParaView, Gnuplot, GMT, and Matlab environments., Lithospheric tearing at slab edges is common in scenarios where retreating slabs face continental margins. Such tearing is often accommodated via subvertical STEP (SubductionTransform Edge Propagator) faults that cut across the entire lithosphere and can result in sharp lateral thermal and rheological variations across the juxtaposed lithospheres. This setting favors the occurrence of continental delamination, i.e., the detachment between the crust and the lithospheric mantle. In order to evaluate this hypothesis, we have chosen a wellstudied natural example recently imaged with unprecedented seismic resolution: the STEP fault under the central Betic orogen, at the northern edge of the Gibraltar Arc subduction system (westernmost Mediterranean Sea). The Gibraltar Arc subduction is the result of the fast westward roll-back of the Alboran slab and it is in its last evolutionary stage, where the oceanic lithosphere has been fully consumed and the continental lithosphere attached to it collides with the overriding plate. In this study we investigate by means of thermo-mechanical modeling the conditions for, and consequences of, delamination post-dating slab tearing in the central Betics. We consider a setup based on a STEP fault separating the orogenic Betic lithosphere and the adjacent thinned lithosphere of the overriding Alboran domain. Our model analysis indicates that delamination is very sensitive to the initial thermal and rheological conditions, transitioning from a stable to a very unstable and rapidly evolving regime. We find two clearly differentiated regimes according to the time at which the process becomes unstable: fast and slow delamination. Although the final state reached in both the fast and slow regimes is similar, the dynamic surface topography evolution is dramatically different. We suggest that given a weak enough Iberian lower crust the delaminating lithospheric mantle peels off the crust and adopts a geometry consistent with the imaged southward, Ministerio de Ciencia e Innovación (MICINN), Comunidad de Madrid, Laboratory of Geodynamic Modelling, National Science Foundation under Computational Infrastructure for Geodynamics, Depto. de Física de la Tierra y Astrofísica, Fac. de Ciencias Físicas, TRUE, pub

L’emergenza pandemica ha messo in evidenza numerose e importanti falle nell’organizzazione dell’erogazione delle cure primarie e delle azioni di care, nonostante la capacità di reazione dimostrata già a partire dagli esordi dell’epidemia. Le falle non riguardano esclusivamente aspetti organizzativi, ma si radicano nella difficoltà, di ordine innanzitutto culturale e politico, di intrecciare dimensioni sanitarie e sociali, individuali e comunitarie, istituzionali e inter-istituzionale in modo efficace, produttivo, protettivo. Si tratta, più in generale, del fallimento di una sanità strutturata a partire dall’offerta dei servizi di salute e non a partire dai bisogni, sanitari e sociali, delle persone e delle comunità, letti e interpretati in modo integrato.

Lithospheric tearing at slab edges is common in scenarios where retreating slabs face continental margins. Such tearing is often accommodated via subvertical STEP (Subduction-Transform Edge Propagator) faults that cut across the entire lithosphere and can result in sharp lateral thermal and rheological variations across the juxtaposed lithospheres. This setting favors the occurrence of continental delamination, i.e., the detachment between the crust and the lithospheric mantle. In order to evaluate this hypothesis, we have chosen a well-studied natural example recently imaged with unprecedented seismic resolution: the STEP fault under the central Betic orogen, at the northern edge of the Gibraltar Arc subduction system (westernmost Mediterranean Sea). The Gibraltar Arc subduction is the result of the fast westward roll-back of the Alboran slab and it is in its last evolutionary stage, where the oceanic lithosphere has been fully consumed and the continental lithosphere attached to it collides with the overriding plate. In this study we investigate by means of thermo-mechanical modeling the conditions for, and consequences of, delamination post-dating slab tearing in the central Betics. We consider a setup based on a STEP fault separating the orogenic Betic lithosphere and the adjacent thinned lithosphere of the overriding Alboran domain. Our model analysis indicates that delamination is very sensitive to the initial thermal and rheological conditions, transitioning from a stable to a very unstable and rapidly evolving regime. We find two clearly differentiated regimes according to the time at which the process becomes unstable: fast and slow delamination. Although the final state reached in both the fast and slow regimes is similar, the dynamic surface topography evolution is dramatically different. We suggest that given a weak enough Iberian lower crust the delaminating lithospheric mantle peels off the crust and adopts a geometry consistent with the imaged southwa