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Resume La complexite se definit comme un etat ou un caractere d’elements divers et entremeles. Apprehender la complexite en sante repose sur la capacite a relier des dimensions de nature differente biologique, physique, psychologique, sociale et spirituelle. A l’echelon du patient, cette capacite conduira a des decisions medicales pouvant etre simples, compliquees, voire complexes dans les pathologies chroniques ou les etats polypathologiques. Les echelons collectif (le travail pluri-professionnel et interdisciplinaire) et systemique (l’offre de soin) sont aussi contributifs a la pertinence de ces decisions. L’enseignement medical doit permettre a l’etudiant l’apprehension de la complexite en sante et l’apprentissage des decisions complexes. L’enseignement de la complexite en sante doit aussi integrer une ouverture aux humanites en sante, favoriser la curiosite de l’etudiant pour les arts et la beaute des sciences. Il doit enfin s’appuyer sur l’enjeu de la responsabilite sociale des facultes et du mandat de servir, la recherche de l’exigence scientifique et clinique, l’importance de l’interdisciplinarite et de l’interdependance des dimensions individuelle et systemique, pour permettre a l’etudiant de mieux saisir la complexite du reel.

This paper presents an innovative anti-seismic device for controlling the out-of-plane rocking motion of masonry walls with traditional tie-rods, called LInear COntrolled Rocking Device (LICORD). LICORD is a low-impact box connected to the extremity of the traditional tie-rod designed to mitigate rocking for medium–high intensity earthquakes. Additionally, the paper widens the knowledge about the dynamic behavior of rocking walls through the interpretation of the results of an extensive experimental campaign performed on masonry specimens composed by clay brick and cementitious mortar. Firstly, the LICORD’s single components are tested to identify their stiffness and damping properties. Secondly, free vibration tests provide actual values of coefficients of restitution on free-standing walls and walls restrained by LICORD, where the walls vary for the height to thickness ratio. For the stockier wall, the ratio of experimental/analytical coefficient of restitution varies from 88 to 98%, whereas for the slender wall, the results are less scattered, with a minimum value of 95% and a maximum value of 96%. The restrained walls are characterized by coefficients of restitution from 5 to 25% less than the values found for unrestrained walls, depending on the equivalent viscous coefficient of the shock absorbers. Moreover, LICORD demonstrated to properly absorb and damp the oscillations of the wall and control its rocking motion, strongly reducing the number of impacts and the rotation amplitudes up to 70%. Considerations about the effect of one-sided motion on the assessment of coefficient of restitution are also given. The equivalent viscous damping coefficients are observed to be on the range 4% (unrestrained wall) and 7–20% for walls restrained by LICORD.

This paper analyzes the influence of horizontal damped and undamped restraints in terms of the amplification of the response of rocking masonry walls subjected to seismic excitations. It al...

This study deals with the identification of the mechanical behavior of chemical anchors embedded in masonry walls. 108 pull-out tests are carried out in five types of masonry walls built with clay brick or vertically perforated units with cement mortar. Different parameters are taken into account: embedment depths, masonry type, anchor position (injection either in brick units or in mortar joints). The axial load capacity and the failure mode are observed for each test. The results are examined by means of elastic and plastic models assessing the efficiency of anchors installed in headers, stretchers or mortar joints. The anchors injected in mortar joints are shown to have much greater pull-out capacity than that found for anchors in bricks. Passing from 90 to 160 mm of embedment depth, a minimum increase by 40% of pull-out strength is observed. The most common failure modes are the sliding failure, which occurs for short anchors or weak masonry, and mixed sliding/cone failure, for long anchors or strong masonry. An analytical model is proposed to design anchors in order to avoid or at least to limit brittle masonry failures and to identify the field of application of uniform stress models.

In seismically active areas the design of wind turbine must be verified for seismic load combinations. These consider a certain likelihood of earthquake occurrence during normal operation, which could eventually lead to an emergency stop. In order to simulate these scenarios, the computational model should take into account the aerodynamics of the rotor, the flexibility of tower and soil, transient operational phases and, first and foremost, the interrelation of all these aspects. At the same time, the complexity should be reduced in order to avoid enormous computational costs, especially when the soil-structure interaction is taken into account. This study presents a practical model for the analysis of the soil-structure interaction effects on the seismic behavior of wind turbine, during normal power production and emergency shutdown. The presented model is based on simplified lumped parameter model for the soil-foundation subsystem and is validated against a detailed model, based on a 3D coupled finite element method and scaled boundary finite element method approach. This article shows a demonstrative example for a reference 5MW wind turbine subjected to a seismic event which triggers an emergency shutdown. The application of the lumped parameter model allows a significant model size reduction and accurate approximation of the soil-structure behavior in time domain.

Investigating the nonlinear dynamic response of reinforced concrete (RC) structures is of significant importance in understanding the expected behavior of these structures under dynamic loading. This becomes more crucial during the design of new or the assessment of the existing RC structures that are located in seismically active areas. The numerical simulation of this problem through the use of detailed 3D modeling is still a subject that has not been investigated thoroughly due to the significant challenges related to numerical instabilities and excessive computational demand, especially when the soil–structure interaction (SSI) phenomenon is accounted for. This study aims at presenting a nonlinear simulation tool to investigate this numerically cumbersome problem in order to provide further inside into the SSI effect on RC structures under nonlinear dynamic loading conditions. A detailed 3D numerical model of full-scale RC structures considering the SSI effect through modeling the nonlinear frame and soil domain is performed and discussed herein. The constructed models are subjected to dynamic loading conditions and an elaborate investigation is presented considering different type of structures, material properties of soil domains and depths. The RC structures and the soil domains are modeled through 8-noded hexahedral isoparametric elements, where the steel bar reinforcement of concrete is modeled as embedded beam and truss finite elements. The Ramberg–Osgood constitutive law was used for modeling the soil domain. It was shown that the SSI effect can significantly increase the flexibility of the system, altering the nonlinear dynamic response of the RC frames causing local damages that are not observed when the fixed-base model is analyzed. Furthermore, it was found that the structures founded on soft soil developed larger base-shear compared to the fixed-base model which is attributed to resonance phenomena connected to the SSI effect and the imposed accelerograms.

In order to simulate wind turbines under different load scenarios, the computational model should take into account the aerodynamics of the rotor, the flexibility of tower, foundation and soil, transient operational phases and, first and foremost, the interaction of all these aspects. Whenever vibrations are emitted to soil, they induce waves traveling through the ground. Here, the main focus lies on the Soil-Structure-Interaction (SSI) effects on the dynamic behavior of operating wind turbines. The wind turbine with its foundation and the surrounding soil is modeled by a coupled Finite Element Method/Scaled Boundary Finite Element Method approach.

In questo lavoro, a partire da una matrice disidratata di zucca (Cucurbita spp), è stato estratto mediante CO2 supercritica (SC-CO2), un olio contenente l'intero complesso lipofilico (principalmente carotenoidi, tococromanoli, fitosteroli e acidi grassi polinsaturi) (Durante et al., 2014a, 2014b). L'olio di zucca è stato incapsulato in ?-ciclodestrine (?-CD) per migliorare la stabilità ossidativa delle molecole bioattive in esso contenute (Durante et al., 2016). L'olio di zucca, estratto con SC-CO2 in forma libera e incapsulata in ?-CDs è stato utilizzato come ingrediente per la formulazione di paste arricchite. Sono state preparate quattro diverse tipologie di pasta: (i) spaghetti tradizionali (controllo; S-CTRL); (ii) spaghetti supplementati con ?-CDs (S-?-CD); (iii) spaghetti supplementati con olio di zucca (S-Oil) e (iv) spaghetti supplementati con il complesso olio di zucca/?- CD liofilizzato (S-Oil/?-CD). I campioni di pasta S-Oil e S-Oil/?-CD risultano significativamente arricchiti in molecole bioattive e possono contribuire in maniera significativa alla dose giornaliera raccomandata. Inoltre gli spaghetti contenenti ?-CD risultano arricchiti in fibra e amido resistente. L'incapsulamento dell'olio in ?-CD aumenta la stabilità delle molecole bioattive durante la pastificazione e migliora i parametri strutturali e sensoriali della pasta cotta rispetto a quella arricchita con olio non incapsulato. Pertanto, la pasta preparata col complesso S-Oil/?-CD è un prodotto innovativo che può essere apprezzato dal consumatore grazie al buon equilibrio tra qualità funzionale ed elementi edonistici e potrebbe essere una risposta all'esigenza di prodotti arricchiti per specifiche esigenze nutrizionali.

Depicting numbers in a graphical way has always been crucial to understand and explain the physical phenomena behind. Interactive graphical applications bring the understanding to a higher level, where the users get actively engaged. Moreover, interactive visualization of data, equations etc.… help to motivate students and strengthen the sharing of knowledge. At the Technical University of Munich, the Chair of Structural Mechanics and the Research Group Algebra developed interactive applications in the fields of mechanics and higher mathematics. Students can access the applications online at any time, without installation or special requirements, and, thus, can actively explore the content with a very low entry barrier. For example, they can experiment with a spring‐mass‐damper system and let it enter the resonance by changing the frequency of the excitation; or they can search for local maxima and minima of a function with side conditions with the Lagrange multipliers in an interactive and graphical way. The interactive process enhances the understanding, even if the user does not interact with a strategy but just uses his intuition. These applications can be also used to explain complex concepts to the general public. The source code is publicly available on https://github.com/ChairOfStructuralMechanicsTUM/Mechanics_Apps .

The recent finding of nutrigenomics and the growing trend towards personalized nutrition encourage research directed towards innovative functional food development [1]. Dry pasta, coming widely and frequently in the Mediterranean diet, is considered an optimal, economic and easy-to-use vehicle for phytochemicals acting as nutrition enhancers or providing specific physiological functions. Pasta, made from refined wheat, lacks many of the nutrients found in whole grains. As such, it has been the object of many supplementation strategies to improve pasta nutritional value and functional attributes. Pumpkin (Cucurbita spp.) fruits and seeds have received considerable attention in recent years because of the nutritional and health benefits of the presence on many lipophylic biologically active compounds, mainly carotenoids, tocochromanols, phytosterols and PUFA [2]. Supercritical carbon dioxide (SC-CO2) pumpkin extracted oils contain the broad lipophilic phytocomplex of the starting matrix in a highly bioavailable form [3]. Phytocomplex constituents, alone or synergistically, act as antioxidants, vitamins, anti-inflammatory and anticancer agents, as well as in cell signaling and gene expression regulation, playing a pivotal role in building and maintaining our health [4]. The limited stability of the oils over time and/or during food processing and storage is the main drawback for their usage in the formulation of functional products. Most bioactives are, in fact, very reactive to light, oxygen and free radicals and/or susceptible to thermal degradation. Encapsulation into micro or nano particles is the most promising technique to increase oil stability. The feasibility of chlatrating the oil in ?-Cyclodextrin (?-CD) complexes to improve its chemical stability and prepare powders useful as ready-to-mix ingredients for novel functional food formulations was also demonstrated [5]. The aim of this study was to explore the feasibility of producing an innovative supplemented durum wheat pasta enriched in the lipophilic phytocomplex extracted by SC-CO2 from ripe pumpkin peponides. The oil was mixed to the dough as free or as ready-to-mix oil/?-CDs powder. Four types of pasta were prepared: (i) control spaghetti (S-CTRL); (ii) spaghetti supplemented with ?-CDs (S-?-CD); (iii) spaghetti supplemented with pumpkin oil (S-Oil) and (iv) spaghetti supplemented with the pumpkin oil/?-CD powder (S-Oil/?-CD). The biochemical, antioxidant, textural and sensory attributes of pasta types were evaluated and compared. The results showed that S-Oil and S-Oil/?-CD spaghetti were significantly enriched in phytosterols, squalene, carotenoids, tocochromanols and unsaturated fatty acids, providing a substantial proportion of the recommended daily allowance (RDA) for A and E vitamins, as well as increased lipophilic antioxidant capacity. Furthermore, ?-CD pumpkin oil complexation increased the stability of some of the bioactive components. With regard to the sensory evaluation of the textural properties of cooked pasta, although s-CTRL registered the highest score, all samples resulted acceptable by the panel of experts. Therefore, S-Oil/?-CD pasta is an innovative product potentially appreciated by consumers because of the good balance of functional quality and hedonistic features and could be an answer to the requirement for supplemented products for specific nutritional needs. Keywords: antioxidant activity; bioactive compounds; functional foods; oil encapsulation; supercritical fluid extraction References [1] Ilahy et al. (2018). Critical Reviews in Plant Sciences, 37, 15-53. [2] Durante et al. (2014a). International Journal of Molecular Sciences, 15, 6725-6740. [3] Durante et al. (2014b). Food chemistry, 148, 314-320. [4] Bruno et al. (2018). Journal of Food Composition and Analysis, 65, 23-32. [5] Durante et al. (2016) Food Chemistry, 199, 684-693.

In this contribution we present a strategy to investigate the vibrations of onshore wind turbines subjected to simultaneous aerodynamic loads and seismic loads. The latter result from the propagation of seismic waves through the underlying soil and are governed by the Lamé’s equations. The structure and its foundation as well as parts of the soil are modeled by Finite Element Method (FEM). The infinite half-space is discretized by Scaled Boundary Finite Element Method (SBFEM). Both methods are coupled at the common interface. The seismic excitation is expressed as a 3D seismic wave field and transformed into boundary tractions, which are then applied at the interface between the near and far fields. The aerodynamic actions are generated with an additional aerodynamic tool and are applied at the tower head. The proposed method can be used also to investigate the 3D nonlinear response of the near field, where nonlinear material properties can be assigned to any element of FEM part.

Chemical shifts of the ethylenic protons Hα and Hβ in cis and trans β-arylthio-,β-arylsulfinyl- and β-arylsulfonyl-acrylic acids have been determined in acetone and in Na2CO3/D2O solution. The absorption signals were assigned unambiguously by β-deuteration. An increase of electron-withdrawing power of the β-substituent (ArSO2 > ArSO > ArS) causes an increase in shielding of Hβ proton and a decrease in that of Hα proton. The τ-values of the Hβ protons are lower in the trans than in the corresponding cis acids, which may be explained in terms of magnetic anisotropy effects of the carboxyl group in the trans acids. Generally, the τ-values of the Hβ protons are lower, and those of the Hα protons higher, in acetone than in Na2CO3/D2O solution; this is probably due to differences in electron-withdrawing power of the COOH and COO⊙ groups. In all trans derivatives the average values of the coupling constants Jαβ are 15.3 c./sec., and lie between 10.1-11.4 c./sec. for the cis derivatives. The effects of para-substituents (CH3O, CH3, H, Cl, NO2) on the chemical shifts of the Hα and Hβ protons in cis and trans β-arylthio-, β-arylsulfinyl-, and β-arylsulfonyl-acrylic acids are correlated with the Hammett σ-constants.

The introduction of new applications such as the spatiotemporal image correlation (STIC) and the tomographic ultrasound imaging (TUI) has greatly enhanced the study of cardiac and vessels anatomy. The aim of our study was to assess the feasibility of including real-time volumetric 3D reconstruction of heart anatomy and Doppler angiography of great vessels during routine second trimester pregnancy scan, in a low-risk population. Visualization of the pulmonary veins, ductus venosus and inferior vena cava was significantly superior with 3D ultrasound. Therefore, STIC makes it possible to store heart beats for a mean time of 10 s, to replay acquired volumes in slow motion, to study the heart atrium along three axes and retrace volumetric image storage inversely from the apex to the base of the heart, making reconstruction of the four-chamber view and great artery outflow tract much easier and faster. Furthermore, the use of digital communication allow operators to store and send volume of images that can be postprocessed by external consultant specialists worldwide. Although 3D echocardiography is less time-consuming and independent of fetal positioning in utero when compared with 2D it may be premature to include 3D and 3D Doppler angiography among routine examination. However, the study of the outflow tracts by 2D echocardiography should be implemented in order to improve the diagnostic accuracy of CHDs. At present, only "targeted" cases in which a routine 2D scan has raised diagnostic doubts should undergo a second level sonography for a thorough 2D-3D examination of cardiac and vessels anatomy.

UNLABELLED A Methodical Study: AIM OF THE STUDY To analyse the feasibility of colour and spectral Doppler assessment of blood flow in the fetal right (RPA) and left (LPA) main pulmonary arteries in relation to fetal position and to gestational age. STUDY DESIGN The fetal position was a priori divided into 3 types, depending on whether the fetal heart was visualised apically (Type 1), from the right side (Type 2) or from the left side (Type 3). Three groups A (19-25 weeks gestation), B (26-32) and C (33-39) including 33 consecutive pregnancies each, were examined to document the fetal position as well as the rate of the successful Doppler examinations of the RPA and/or LPA. RESULTS The fetal position Type 2 was most common throughout gestation (in group A = 42%, B = 36%, C = 51%) followed by the type 3 and then type 1. The rate of successful Doppler records from the RPA and LPA depended on the fetal position: In Type 2 RPA in 98%; in Type 3, LPA in 100%; but the apical approach was not effective ( 85%), whereas successful examination of both vessels was unlikely (12%). CONCLUSIONS In the second half of pregnancy, independent of fetal position, Doppler examination of at least one pulmonary artery is successful in most cases, whereas the assessment of both vessels is rather difficult.

According to the Oxford English Dictionary, ‘real-time’ means the actual time during which a process or event takes place, particularly an event or process analyzed by a computer. As opposed to ‘real time’, ‘subsequent time’ indicates a later time at which an event can be elaborated by a computer or at which a recording can be reproduced. For what specifically concerns ultrasound imaging, the expression ‘real-time’ should be reserved to describe the ability of an ultrasound system to image moving anatomical structures at the exact time when anatomical data are acquired, or in the worst case to do it with a negligible time delay between acquisition and visualization. This would imply that 2D images or 3D volumes are refreshed with a frequency equal or higher to human retinal vision persistence.

The number of patients affected by systemic lupus erythematosus (SLE) that decide to have children has greatly increased probably because of recent improvements in the diagnosis and management of the disease. This has stimulated our interest in defining the outcome of children, focusing both on neonatal problems and long term development. SLE patients still carry a risk of pregnancy loss. However, due to careful monitoring and treatment by a multidisciplinary team, the number of losses has dramatically decreased, but an increased number of preterm deliveries is still a problem. Neonatal lupus is linked to the presence of anti-Ro/SS-A and anti-La/SS-B antibodies in the mother, although other factors probably of fetal origin are important. Neonatal lupus is a complex condition whose most serious manifestation is the congenital heart block (CHB). Usually, children with complete CHB need permanent pacing, but apparently do not have neuropsychological problems. Studies focusing on the neuropsychological development of SLE offspring show an increased number of learning disabilities in children with normal intelligence levels. Fetal consequence of maternal treatment need to be considered choosing non teratogenic drugs, but the withdrawal of medications just because the patient is pregnant should be avoided to avoid SLE flares.

If a woman suffers from autoimmune disease (AD), several factors can affect pregnancy or neonatal outcome: repeated spontaneous pregnancy losses (frequently related to antiphospholipid antibodies (aPL)), neonatal lupus with complete congenital heart block (CHB) (linked to transplacental passage of IgG anti Ro/SS-A antibodies) and the disease activity itself that can affect the mother, the pregnancy and fetal outcome. If appropriately managed, the antiphospholipid syndrome (APS) is "one of the few tractable causes of pregnancy losses." A recent case control study, on babies from APS-mothers and healthy mothers, did not show any difference in the occurrence of neonatal complications. There are few data about the long-term outcome of babies born to patients with AD. We recently reported increased occurrence of learning disabilities in children born to aPL positive mothers with systemic lupus erythematosus (SLE). The modern management of pregnancy in patients with AD includes the treatment of disease flares, using drugs effective but safe for fetus. Corticosteroids and some immunosuppressive drugs can be used in pregnancy to control maternal disease. A prolonged fetal exposure to dexamethasone was reported to impair cerebral development, but we recently studied 6 children, born to patients treated with dexamathasone because of CHB, showing a normal intelligence quotient. The last 10-year experience shows that fetal exposure to antimalarial drugs should not be regarded as an important risk factor for gestational nor neonatal complications. However, information about long-term outcome of children exposed to immunosuppressive drugs "in utero" are still lacking and more efforts are needed in this research area.

Objectives: To describe the natural history of pyelectasis from its detection in the second trimester to delivery, its capability to predict renal pathology and whether prenatal development of pelvic dilatation is correlated to its postnatal evolution. Study design: A retrospective analysis involving 375 fetuses with a complete urological follow-up. Prenatal ultrasound was correlated with the results of postnatal investigation and frequency of postnatal surgery was established. Results: Two-hundred and eighty cases underwent at least two examinations before birth. 73.1% were male fetuses. 57.4% had a bilateral pyelectasis. Prenatal evolution of pelvic dilatation was the following:18.6% of the cases normalized, in 34.6% of the cases the dilatation reduced but did not disappear, in 30.7% it remained unchanged, while it worsened in 16.4%. One case from the first group, three cases from the second, seven cases from the third and 11 cases from the fourth needed surgical treatment. 1.9, 7.2, 18.6, 23.9% of cases respectively worsened after birth in the four groups (trend: P = 0.001). Conclusions: Prenatal diagnosis of pyelectasis improves the outcome of these children due to a surgical approach that avoids renal damage. There is a good correlation between prenatal evolution and postnatal outcome, although a postnatal follow-up is opportune in those cases that normalized before birth.

To correlate umbilical artery Doppler velocimetry with perinatal outcome in a group of growth-restricted fetuses.The study was a retrospective analysis of 578 singleton pregnancies with diagnosis of intrauterine growth restriction (IUGR), delivered in a single obstetric unit, at the Spedali Civili, Brescia, Italy, a university and teaching hospital with 3500 deliveries a year and neonatal intensive care unit (NICU).During 1991-99 we studied 578 pregnancies with a diagnosis of IUGR referred for Doppler velocimetry. From this population, four subsets were formed: normal umbilical artery pulsatility index (NUAPI; 334 fetuses); increased pulsatility index but with telediastolic flow (abnormal umbilical artery pulsatility index AUAPI; 137 fetuses); absent end-diastolic flow (AEDF; 70 fetuses); reverse telediastolic flow (RF; 37 fetuses). Fetal biometry, amniotic fluid and fetal-maternal Doppler velocimetry were evaluated in all patients, with biophysical profile and routine non-stress test, when indicated. The following outcomes were examined: mean gestational age at delivery, number of preterm deliveries (34 weeks), mean neonatal weight, Apgar score at 5 min7, prenatal and neonatal deaths (within the first 28 days of life), admission to the NICU and number of days spent after birth in hospital. Neonatal morbidity was analyzed, including respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH, grade 2-3), necrotizing enterocolitis (NEC) and retinopathy of prematurity. Long-term neurological follow-up is still ongoing and will not be presented in this paper.Out of 578 fetuses with IUGR, 547 were born alive. There were 26 neonatal deaths. The mean gestational age at delivery was 35.6 +/- 4 weeks and mean birth weight 1844 +/- 612 g. There were 28 intrauterine deaths and three elective terminations of pregnancy. A total of 60 cases (11%) were complicated by RDS, 13 cases (2.4%) by retinopathy of prematurity, IVH was present in nine cases (1.6%) and NEC in seven cases (1.3%). Total perinatal mortality was 9.8%; in the 26 cases of neonatal death, the mean week at delivery was 29.6 +/- 4 with a mean weight of 840 +/- 425 g. Patients with NUAPI had a mean week at delivery of 37 +/- 3, those with AUAPI delivered at 34 +/- 3.2, those with AEDF delivered at 31 +/- 3 and those with RF delivered at 29 +/- 2 weeks. In progressively worsening umbilical velocimetry, we observed an increase of incidence of low Apgar score. Days of admission to the NICU and incidence of perinatal mortality increased with the worsening of Doppler velocimetry.Our study underlines the existence of a strict correlation between umbilical Doppler velocimetry and an increased incidence of perinatal complications in IUGR fetuses.

Asset and liability management (ALM) models represent an important tool for banks and finance companies to measure the volatility of expected revenues. These models – usually static and deterministic to fit conventional computer resources – may be much more useful if a dynamic stochastic simulation is adopted. This makes it possible to increase the precision of risk estimation. In this paper the parallelization strategy adopted to implement such a stochastic ALM code is described, together with porting and code performance issues. The very good timings obtained on a 128-proc Cray T3E are reported. Anyway the code is easily portable on other, possibly heterogeneous, high-performance computing platforms.

The objective of this study was to describe the normal blood flow velocity waveforms in the main branches of the right and left pulmonary arteries in the human fetus and to establish reference ranges for different Doppler parameters during the second half of pregnancy. Cross-sectional data were collected from 86 healthy human singleton fetuses between 18 and 38 weeks of gestation. With advancing gestation a significant increase (p < 0.001) in the peak systolic velocity, time averaged velocity and time velocity integral was observed. The pulsatility index decreased significantly (p < 0.05) in the same period, suggesting a decrease in the pulmonary arterial vascular resistance. The acceleration time (AT) and the ratio of AT to ejection time (AT/ET), described in postnatal cardiology as having an inverse correlation with mean arterial pressure, increased significantly (p < 0.001). This is possibly the result of decreased pulmonary arterial pressure. The data show that Doppler examination of blood flow in the main stem of both the right and the left pulmonary arteries of the fetus is feasible, and increases insight into the lung perfusion of the human fetus. The observed changes throughout gestation are in accordance with animal experiments showing an increase in perfusion as well as a decrease in the vascular resistance and pressure.

Durum wheat is one of the most important cereal crops used in the Mediterranean-type temperate zones whose consumption might reduce the risk of developing chronic diseases, such as cardiovascular diseases, type-2 diabetes, and certain types of cancer. These health benefits have been partly attributed to the occurrence of phytochemicals with antioxidant activity, which include phenolic acids (PAs) belonging to hydroxycinnamic acids and hydroxybenzoic acids derivatives. They occur as soluble free acids, soluble conjugates PAs that are esterified to sugars and other low molecular mass compounds, and as insoluble bound PAs that are mostly ester-linked to cell wall polymers such as polysaccharides and lignin. This communication reports the results of a study performed to identifying and quantifying PAs occurring as soluble free, soluble conjugated and insoluble bound compounds, which were separately extracted from wholemeal of durum wheat of different genotypes cultivated in three different Italian regions over three consecutive crop years. The three forms of PAs were independently identified and quantified by HPLC, using a narrow bore reversed phase column and a semimicro photodiode array detector (PDA) cell, in conjunction with a single quadrupole mass spectrometer, equipped with an electrospray ionization source (ESI-MS). The method was validated in terms of linearity of calibration graphs, limits of detection, limits of quantification, repeatability and accuracy, which was evaluated by a recovery study. Our study has evidenced that RP-HPLC on a semimicro separation scale offers both economical and environmental benefits, while maintaining separation performance and reliability of traditional HPLC methods, allowing the accurate estimation of the individual PAs occurring as soluble free, soluble conjugated and insoluble bound compounds in wholemeal of durum wheat. The variations in the content of the three forms of PAs in durum wheat as a function of genotype, cultivation region and crop year are discussed.

Phenolic acids (PAs) represent the most common form of phenolic compounds occurring in whole grain cereals as soluble free acids, soluble conjugates and as insoluble bound forms and mainly concentrated in the outermost layers of the kernels. These bioactive compounds are important for their antioxidant properties, in particular it has been demonstrated that they can act as scavengers of free radicals, which can lead to aging processes and many chronic diseases. Studies in literature have shown that the content of these compounds may have a wide range of variability, conceivably due to several factors which can influence the occurrence of grain antioxidants. Despite this, few studies focused on durum wheat. This communication reports the results of a study performed to determine the effects of genetic, environmental and technological factors on the content of free, conjugated and bound PAs in durum wheat and derived products (milling fractions and pasta). The impact of genetic effects on the profile and the content of PAs was evaluated analyzing the content in 10 different genotypes of durum wheat grown in an experimental field across 3 crop years. In order to elucidate effects of growing locations, 3 of the selected genotype, grown in 2 additional locations in the same crop years, were analyzed for their PAs content. Finally, impact of technological factors was evaluated by the studying effects of milling and pastamaking process on PAs occurrence, comparing products obtained by the traditional process with the ones made by wholemeal. For all samples, free, conjugated and bound PAs were extracted following a method developed by Li et al (1) with some modifications (2,3) and determined by HPLC method. Results show that genotype, growing location but most of all crop year affect the content of the three PAs forms. As regards the technological aspects, traditional milling appears the process mainly influencing the occurrence of PAs, causing a drastic reduction of PAs content in semolina and pasta with respect to the intact kernel. On the contrary, products obtained using wholemeal preserve most of these antioxidants and therefore it results a more interesting process to obtain durum wheat derived products with high nutritional value. In conclusion, our results suggest that genetic, environmental and technological factors affect the occurrence of PAs in durum wheat and derived products; moreover they support the importance of knowledge of their impact on the occurrence of bioactives for the production of durum wheat derived food rich in bioactive compounds.

Because of its minor environmental impact, electricity generation using wind power is getting remarkable. The further growth of the wind industry depends on technological solutions to the challenges in production and construction of the turbines. Wind turbine tower vibrations, which limit power generation efficiency and cause fatigue problems with high maintenance costs, count as one of the main structural difficulties in the wind energy sector. To mitigate tower vibrations auxiliary measures are necessary. The effectiveness of tuned mass damper is verified by means of a numeric study on a 5 MW onshore reference wind turbine. Hereby, also seismic-induced vibrations and soil–structure interaction are considered. Acquired results show that tuned mass damper can effectively reduce resonant tower vibrations and improve the fatigue life of wind turbines. This chapter is also concerned with tuned liquid column damper and a semiactive application of it. Due to its geometric versatility and low prime costs, tuned liquid column dampers are a good alternative to other damping measures, in particular for slender structures like wind turbines.

I cereali integrali costituiscono un'importante fonte di composti bioattivi presenti soprattutto negli strati più esterni della cariosside. Tra questi meritano particolare interesse, grazie alla loro relativa abbondanza e alla spiccata attività antiossidante, gli acidi fenolici (PAs) che si ritrovano nei cereali in 3 diverse forme: libera, coniugata e legata. Purtroppo negli strati più esterni della cariosside possono anche accumularsi eventuali contaminanti, tra cui pesticidi, micotossine e metalli pesanti, che influiscono negativamente sulla qualità igienico-sanitaria dei cereali. Il processo di macinazione tradizionale riduce drasticamente il contenuto di contaminanti, ma anche di composti bioattivi che rimangono concentrati negli strati cruscali. Vi è quindi un crescente interesse nella messa a punto e nell'ottimizzazione di processi innovativi che consentano di ottenere prodotti che presentino un'elevata qualità tecnologica, nutrizionale ed igienico-sanitaria. Tra questi, particolarmente interessante è il processo di decorticazione, che consiste nell'abrasione e frizione delle cariossidi. Nel presente lavoro è stato valutato l'effetto del processo di decorticazione sul contenuto di PAs negli scarti di decorticazione (DF) e nelle granelle decorticate (DK), nonché l'impatto dell'uso di DK e di DF nel processo di pastificazione. In particolare, al fine di valutare l'effetto dell'utilizzo di DK e dell'arricchimento di semole con DF per la produzione di paste speciali, le paste sono state analizzate, comparandole con la pasta tradizionale, prodotta con l'utilizzo di semola derivante dal processo di macinazione tradizionale. In tutti i campioni, i PAs sono stati estratti con il metodo proposto da Li et al. (2008) con alcune modifiche (2) ed analizzati mediante HPLC, con l'utilizzo di una colonna narrow-bore C18 a fase inversa accoppiata ad un rivelatore UV a serie di fotodiodi e ad uno spettrometro di massa con sorgente di ioni per elettrovaporizzazione. L'analisi quantitativa è stata basata sul rapporto Area acido fenolico/Area standard interno e mediante l'utilizzo di rette di calibrazione costruite con standard che hanno subito lo stesso procedimento previsto per la determinazione degli acidi fenolici liberi, coniugati e legati. Nella presente comunicazione vengono mostrati i principali risultati dello studio, evidenziando le prospettive future nell'utilizzo di questo processo.

The structural behavior of modern wind turbines has reached a very high complexity and many factors are involved: slenderness of the structure, excitation environment and operational controls. Moreover, if a project is located at sites with relevant seismic hazard, the wind unit must be designed considering a reasonable likelihood of earthquake occurrence during the operational state or an emergency shutdown. The influence of the subsoil on the seismic response of a wind turbine can be crucial during the seismic design phase and need to be properly included into the computational model. Norms and guidelines need to keep up with technological developments and structural peculiarities. However the dynamic soilstructure interaction is often neglected or roughly mentioned. It is usually suggested to represent the soil through springs. The proposed investigation estimates the seismic response of a soil-turbine system and involves a 1.5-MW, 3- blade wind turbine, grounded on a layered half space. The wind turbine system is modeled by means of Finite Element Method (FEM). The effects of the layering are investigated. The soil is simply idealized as a generalized spring, according to the majority of standard codes. In parallel, the same investigation is performed with a more accurate method, a coupling between finite element and Boundary Element Method (BEM). This allows assessing the applicability and accuracy of the simplified soil representation.

The objective of this study was to describe blood flow velocity waveforms of fetal peripheral pulmonary arteries in normally grown and growth-retarded fetuses. Doppler studies were performed in 182 normally grown fetuses (gestational age 18-40 weeks) and in 61 growth-retarded fetuses (gestational age 24-36 weeks) that were free from structural and chromosomal abnormalities and whose umbilical and middle cerebral artery Doppler findings suggested uteroplacental insufficiency as the most likely etiology of the growth defect. The pulsatility index was used to quantify the velocity waveforms. Successful recordings were obtained in 90.1% of the normally grown and 93.4% of the growth-retarded fetuses. In normally grown fetuses the pulsatility index values significantly decreased with advancing gestation. In growth-retarded fetuses the pulsatility index values were significantly elevated compared to those of normal fetuses. A significant relationship was observed between the severity of hypoxia and pulsatility index values from the peripheral pulmonary arteries in 29 fetuses in which Doppler recordings were obtained immediately before cordocentesis. In conclusion, these data show that in normal fetuses the Doppler-measured impedance to flow in the peripheral pulmonary circulation decreases with advancing gestation. Impedance to flow in the lungs is elevated in the presence of growth retardation and this increase is related to the severity of fetal hypoxia.

Il consumo di alimenti integrali in questi ultimi anni è in crescente aumento essendo oramai noti, anche al consumatore, gli aspetti salutistici degli alimenti a base di cereali contenenti frazioni cruscali ricche di composti bioattivi. Per contro, le frazioni cruscali, principalmente costituite dagli strati più esterni della cariosside (tegumenti), in particolare gli strati più superficiali dei tegumenti, possono contenere alcuni contaminanti (micotossine, metalli pesanti, pesticidi ecc.) che abbassano la qualità igienico-sanitaria degli alimenti integrali. Il processo della decorticazione, tradizionalmente utilizzato per svestire dalle glume fortemente adese le cariossidi di cereali come orzo ed avena, può essere applicato anche alle cariossidi nude al fine sia di ridurre le eventuali sostanze contaminanti presenti in superficie sia preservare il contenuto di composti bioattivi. In questo studio sono state eseguite sulle cariossidi di frumento duro decorticazioni in successione di 15 secondi ciascuna, raccogliendo ad ogni tempo tutte le frazioni (lo scarto di decorticazione e una quota di granella decorticata). Per tutte le frazioni raccolte è stata valutata la capacità antiossidante totale mediante il metodo diretto di Serpen et al. ed il contenuto in acidi fenolici liberi, coniugati e legati estratti adattando la procedura precedentemente descritta alle matrici in esame. La separazione, quantificazione e identificazione degli acidi fenolici è stata eseguita mediante cromatografia liquida ad elevate prestazioni in fase inversa (RP-HPLC) con rivelatore a serie di fotodiodi (PDA), accoppiata alla spettrometria di massa con sorgente di ioni per elettrovaporizzazione (ESI-MS) per confermare l'identificazione. La quantificazione è stata eseguita con il metodo dello standard interno, sottoponendo gli standard di acidi fenolici e lo standard interno alle stesse procedure di estrazione effettuate per le tre forme degli acidi fenolici. I risultati hanno dimostrato che il processo di decorticazione può essere utilizzato con successo prima del processo di macinazione tradizionale per ottenere prodotti trasformati ricchi in composti bioattivi ed allo stesso tempo con un'elevata qualità igienico-sanitaria.

I cereali rivestono interesse crescente nel panorama scientifico grazie al loro elevato contenuto di composti bioattivi (fibre e antiossidanti); tra questi, di particolare interesse sono gli acidi fenolici (PAs) presenti nei cereali in 3 diverse forme: libera, coniugata e legata. Scopo di questo studio è stato mettere a punto un metodo per l'estrazione e l'analisi di PAs liberi, coniugati e legati da applicare alla valutazione dei fattori genetici (cultivar) e ambientali (luogo e anno di coltivazione) che influenzano il contenuto di acidi fenolici nel grano duro, cereale di particolare importanza nei Paesi dell'area mediterranea. È stato inoltre valutato l'effetto dei principali processi di trasformazione del grano duro (macinazione e pastificazione) sul contenuto e sulla distribuzione delle 3 forme di PAs. L'estrazione degli acidi fenolici è stata effettuata con il metodo di Li et al. (2008) modificato ed ottimizzato per l'analisi di PAs in matrici con diverse caratteristiche chimico-fisiche (es. crusca e semola). Questi composti sono stati poi separati mediante RP-HPLC, utilizzando una colonna narrow-bore associata ad un rivelatore UV a serie di fotodiodi e ad uno spettrometro di massa con sorgente di ioni per elettrovaporizzazione (ESI-MS). Il metodo è stato validato in termini di linearità delle rette di calibrazione, ripetibilità ed accuratezza, valutata mediante analisi del recupero. I risultati mostrano che il genotipo, l'ambiente e l'anno di coltivazione influenzano il contenuto di acidi fenolici, ma non la distribuzione percentuale degli stessi nelle 3 forme. La maggiore fonte di variabilità è però rappresentata dal processo di macinazione tradizionale che comporta una drastica riduzione del contenuto di acidi fenolici, accumulati negli scarti di lavorazione (crusca). Al contrario, la macinazione integrale consente di preservare questi composti nella pasta, ottenendo prodotti finiti ricchi in composti bioattivi, di maggiore interesse nutrizionale rispetto ai prodotti raffinati.

Increasing evidence from clinical and epidemiological studies suggests that the regular consumption of whole grain and whole-grain derivatives might reduce the risk of developing chronic illnesses such as cardiovascular diseases, type-2 diabetes, and certain types of cancer. These health benefits have been partly attributed to the occurrence in wheat, as well as in other cereals of phytochemicals with antioxidant activity, which include phenolic acids (PAs) belonging to hydroxycinnamic acids and hydroxybenzoic acids derivatives, such as ferulic, p-coumaric, p-hydroxibenzoic, vanillic and siringic acids. The content of these compounds may have a wide range of variability and their occurrence has been related to the health-promoting effects of whole grains as regards the antioxidant activity. In addition, with the increasing popularity of functional foods, it is crucial to understand the distribution of phenolic compounds in different milling extractions which may have important implications in ensuring their health benefits. We report the results of a study carried out to evaluate the impact of growing environmental and different genotypes of durum wheat, cultivated in different regions, on the total antioxidant capacity (TAC) and on the occurrence and content of phenolic acids as soluble free, soluble conjugated and insoluble bound acids. The phenolic acids (free, conjugated and bound forms) were extracted following a method developed by Li et al with some modifications and determined by a RP-HPLC method developed in our laboratory. TAC levels were determined following the direct method described by Serpen et al using ABTS radical and expressing data as millimol Trolox equivalent antioxidant capacity per kg (mmol TEAC/kg).

Pulsed Doppler velocimetry of the fetal aortic and pulmonary valves derived in the five-chamber-view and short-axis view were performed in 88 uncomplicated pregnancies between the 20th and 40th week of gestation. The maximal and mean velocities were assessed for both semilunar valves. Considering the valve diameters and heart rate the stroke volume and cardiac output for both ventricles were calculated. Furthermore, the common stroke volume, common cardiac output and the ratio of right to left cardiac output were calculated. Normal ranges for all these parameters were constructed and correlated with gestational age. The maximal velocities were higher in the aorta than in the pulmonary trunk, but no differences were found in the mean velocities. The stroke volume and cardiac output of the right ventricle were in higher ratio 1.3:1 than that of the left ventricle as an expression of the right ventricular dominance in the fetus. Intracardiac Doppler flow velocimetry gives an insight into the physiology of fetal circulation and is a basis for the analysis of blood flow under pathological conditions.

Congenital heart defects (CHD) are the most frequent malformation in the human fetus and are the leading cause of mortality due to malformations in the first year of life. Despite its clinical importance screening performed by ultrasonographic examination during the second trimester of pregnancy has shown disappointingly low detection rates mainly due to the difficulties in obtaining an adequate examination of the fetal heart. Four-dimensional (4D) ultrasound of the fetal heart has been recently suggested as a tool to improve the detection rate of CHD by decreasing the dependency on operator skills required in two-dimensional ultrasound scans but up to now no practical manuals are available in describing its application in clinical practice for the study of fetal heart. The objective of this Ebook is to explain the role of 4D during second trimester examination and in fetuses with CHD. The technique of obtaining 4D volume of the fetal heart, how to navigate in the volume to obtain diagnostic planes and how to use semiautomatic and automatic software of analysis are described. We believe that after reading this book the standard fetal cardiac anatomy survey can be performed in the second trimester fetus by 4D in both normal and abnormal hearts. This approach may reduce the operator dependency in diagnosis CHD. This Ebook should prove to be a valuable resource for obstetricians, sonographers and pediatric cardiologists.

Objective To evaluate the initial experience at our centre in the treatment of monochorionic twin pregnancies complicated by twin reversed arterial perfusion sequence (TRAP), using radiofrequency ablation (RFA) with expandable needles, and to review the existing literature on the subject. Study design Between July 2007 and October 2010, 11 monochorionic twin pregnancies complicated by TRAP were referred to our centre. Seven patients underwent intrafetal ablation of the acardiac twin with RFA using LeVeen™ expandable needle electrodes. Data on the procedures and the obstetric outcome were reviewed, and subsequently we performed a review of the literature on the use of RFA in TRAP. Results Median gestational age at the intervention was 17 +3 weeks (range 14 +1 –23 +1 weeks). Technical success was obtained in all cases. Preterm premature rupture of membranes (PPROMs) occurred in 4/7 (57%) patients. Intrauterine death of the pump twin occurred in one patient at 21 +5 weeks, and one patient opted for termination of pregnancy because of PPROM at 21 +4 weeks. Five fetuses were delivered alive at a median gestational age of 33 +0 weeks (range 31 +0 –39 +5 weeks). All five infants (71%) were alive and had a normal examination at 6 months of age. The review identified 6 studies, for a total of 78 pregnancies (either monochorionc twins or triplets with a monochorionic component). Including our data, overall neonatal survival was 75/88 (85%). Conclusion RFA appears to be a relatively safe and reliable technique in the treatment of TRAP sequence pregnancies. Further research is needed to define the best timing of the procedure.

Objectives Ex utero Intrapartum Treatment (EXIT) is a technique to secure the fetal airway while oxygenation is maintained through utero-placental circulation. The aim of the study is to present three cases of fetal lymphatic malformation of the head and neck that required EXIT and to summarize EXIT details. Methods The cases were studied before the delivery and EXIT was planned with a multidisciplinary team. The key factors of EXIT are considered and the type, stage and clinical score of the three lymphatic malformations are defined. Results In the three cases of EXIT the time working on placental support to secure the airway was 9, 7, and 9 min, respectively (from the hysterotomy to clamping the umbilical cord). Procedures performed on the airway were laryngo–tracheo–bronchoscopy in the first case, laryngoscopy and intubation in the second one, laryngoscopy, drainage of the lymphatic macro-cyst, and intubation in the third case. A sketching to detail the EXIT steps are presented: EXIT-Team Time Procedure list (EXIT-TTP list). Lymphatic malformations were classified as mixed (micro/macro-cystic) in two cases, and macro-cystic in one. de Serres Stage was IV, V and II. Therapy varied in the three neonates (surgery alone, surgery + Picibanil® + Nd-YAG, or Picibanil® alone). Conclusions In case of prenatal suspicion of airway obstruction, EXIT should be planned with a multidisciplinary team. The EXIT-Team Time Procedure list (EXIT-TTP list), reviews the most critical phases of the procedure when different teams are working together. The type of lymphatic malformation, the anatomic location and the clinical score predict the outcome.

We report a case of monochorionic twin pregnancy complicated by twin-twin transfusion syndrome (TTTS) diagnosed in the late second trimester and treated with two amnioreductions. Three days after the first amniodrainage, the recipient twin developed intracranial ventriculomegaly and, similarly, after a few days, the donor showed signs of brain damage at MRI. We discuss the possible mechanism of brain damage of amnioreductions performed after 26 weeks of gestation in a monochorionic pregnancy with TTTS as a result of a placental ‘steal’ phenomenon.