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Introduction The transmastoid approach is the most recommended technique to Bonebridge surgery, while in patients with bad anatomy or in the canal wall down technique, retrosigmoid or Middle Fossa Approaches are the alternative surgical options. Objective To describe a novel alternative approach called inverted middle fossa approach (IMFA) and its technique and audiological outcomes. Methods Seven patients submitted to the IMFA were included. All patients presented conductive and mixed hearing loss with bone thresholds of the audiogram > 40 dB. The audiological test was conducted pre- and postoperatively. Results A total of 5 males and 2 females, aged 13,8 years old (range 6–25 years old) were studied. The average follow-up was of 20 months (12 to 32 months). All patients presented aural atresia, except one with severe osseous-fibrous dysplasia of the temporal bone. Two patients showed bilateral compromise, three patients had associated Goldenhar and Treacher Collins syndrome. On the preoperative audiograms, air conduction (AC) thresholds showed a PTA4 (0.5, 1, 2 and 4 kHz) of 66.7 dB (standard deviation [SD] = ± 7.8), while the bone conduction thresholds reached an average of 11.2 dB (SD = ± 6.9). The postoperative thresholds did not change, and additional sensorineural damage was not observed before activation. Four weeks after surgery, all the patients were fitted with the external processor. The postoperative audiological aided exam showed AC PTA 4 thresholds of 18.9 dB (SD = ± 5.9). Conclusion The IMFA allows the nearest position of the microphone to the external auditory canal. The technique is a suitable option to the 3 classical approaches with similar rate of audiological results. More investigation is needed to determine the benefit of the novel approach compared with the others.

The stability of embankment dams without an impermeable core depends on the characteristics of the face slab that prevents internal erosion, piping and eventual collapse of the structure. Under a Mediterranean climate, the impermeable asphaltic face slab is subjected to high solar radiation and consequent temperature changes, which can generate the creation of cracks and joints. The Medau Zirimilis Dam, located in the Casteddu River (Sardinia), is an embankment dam that has undergone seepage and continuous repairs in its asphalt face slab. These reparations have been conducted because of the occurrence of cracks and relative movement of different segments of the slab. To evaluate if seepage endangers the integrity of the dam, GPR was used, with different antennas (100, 250 and 500 MHz), along its crest and upstream and downstream faces, and the data were integrated with infrared thermographic images. Although geophysical data do not show structural changes affecting the main dam structure, deformation structures at shallow levels and in particular in the upstream face and along the crest of the dam have been identified. Such deformation affects the road atop the crest, the face slab and underlying levels, resulting in landslides that include material from several meters below the surface. The analysis permitted the identification of the origin of surficial cracks and their effects on the face slab. These sectors, independent of current movement, define the most unstable areas against water level changes that can affect the dam integrity. GPR analysis at the embankments usually has the handicap of high clay content that precludes electromagnetic wave penetration; however, in this case, the obtained resolution and extent of penetration using the different antennas was sufficient, due to the absence of an inner waterproof unit, and permitted the evaluation of the inner structure of the dam and the application of GPR for construction quality surveillance, internal structural characterization and dam monitoring.

Introduction His bundle pacing (HBP) allows physiological ventricular activation and prevents the electrical and mechanical desynchronization generally induced by myocardial stimulation, which can increase the risk of atrial fibrillation and heart failure. On the other hand, reliable HBP capture often requires higher energy than conventional myocardial pacing. This reduces the expected life of the stimulator and might limit the diffusion of HBP in the clinical practice. Purpose Decreasing HBP current drain by careful management of stimulation safety margin and pulse duration. Methods In 28 patients undergoing DDD pacing with HBP, a third lead was implanted in RV apex to provide back-up pacing on demand. HBP and apical leads were connected, respectively, to the V1 and V2 channels of a 3-chamber stimulator. When HBP was effective, apical sensing occurred within the VV delay and prevented V2 stimulation. In contrast, in case of HBP failure, V2 sensing was missing and apical back-up pacing was promptly delivered at the end of the VV delay. The availability of a back-up pulse on demand allowed reducing the HBP safety margin with no risk. Furthermore, the individual HBP strength-duration curve was derived in the aim of optimizing the Hisian pulse parameters, which are the major determinants of the device current drain. Results Correct back-up inhibition by successful HBP and stimulation in the event of capture loss was achieved in all the patients. The latency from Hisian pacing to apical sensing averaged 96±14 ms. According to the pacemaker counters, no back-up pulse was delivered in daily life in 59% of patients. In the remaining, the prevalence of back-up stimulation never exceeded 15% of paced ventricular cycles. The high HBP threshold was essentially due to an increased rheobase (1.2±0.6 V), while the chronaxie ranged from 0.30 to 0.53 ms in 71% of patients (median 0.44 ms), exceeding 0.6 ms only in 29% of the cases. An average current saving of 5.4±3.0 μA was obtained at the expense of a mild reduction in HBP safety margin (from 1.6±0.2 to 1.4±0.1 times). HBP and apical back-up Conclusions Back-up stimulation on demand is a reliable option to decrease HBP current drain and prolong the stimulator service life with full safety. In most of the cases, significant saving can be achieved by pulse shortening, as the chronaxie time is in the same range as with myocardial stimulation and longer pulses are not required. A pulse duration exceeding 0.6 ms is indicated in less than 1/3 of the implants.

The gasification of biomass and waste is a potentially high efficiency process for energy generation. However, the appropriate cleaning of the produced fuel gas is a major issue, in particular for tar removal. This study investigates the performance of three new-generation activated carbons, which are able to adsorb a wide spectrum of tars at high temperature, from 750°C up to 900°C. For this purpose, a laboratory scale hot gas filtration apparatus was designed and set-up. Experimental tests were carried out with naphthalene as the reference tar compound. The selected activated carbons were tested under different conditions of temperature, test duration and naphthalene concentration. The procedure allows evaluating the contributions of adsorption and cracking phenomena on the overall tar removal efficiency. Complete naphthalene removal was obtained with two of the selected activated carbons, at 850 °C and 900 °C, respectively. Simultaneously, a partial reforming of adsorbed naphthalene was observed, and molecular hydrogen was detected in the gas phase. Results were correlated to the differences in porosimetry and chemical surface of the selected activated carbons, as well as to those highlighted by Scanning Electronic Microscopy and X-ray analyses. Finally, a procedure for activated carbon regeneration by carbon dioxide is reported, together with results from preliminary tests. The gasification of biomass and waste is a potentially high efficiency process for energy generation. However, the appropriate cleaning of the produced fuel gas is a major issue, in particular for tar removal. This study investigates the performance of three new-generation activated carbons, which are able to adsorb a wide spectrum of tars at high temperature, from 750 degrees C up to 900 degrees C. For this purpose, a laboratory-scale hot gas filtration apparatus was designed and set-up. Experimental tests were carried out with naphthalene as the reference tar compound. The selected activated carbons were tested under different conditions of temperature, test duration and naphthalene concentration. The procedure allows evaluating the contributions of adsorption and cracking phenomena on the overall tar removal efficiency. Complete naphthalene removal was obtained with two of the selected activated carbons, at 850 degrees C and 900 degrees C respectively. Simultaneously, a partial reforming of adsorbed naphthalene was observed, and molecular hydrogen was detected in the gas phase. Results were correlated to the differences in porosimetry and chemical surface of the selected activated carbons, as well as to those highlighted by Scanning Electronic Microscopy and X-ray analyses. Finally, a procedure for activated carbon regeneration by carbon dioxide is reported, together with results from preliminary tests. (C) 2016 Elsevier B.V. All rights reserved.

Flexible plastic packagings are rapidly gaining market share since they offer significant functional benefits. However, they also pose a challenge from a recycling perspective. In fact, due to the presence of different polymeric fractions and to contamination by organic substances and out-of-target materials, such as paper and metals, the mechanical properties of the recycled material are relatively poor. Addition of nanoparticles to plastic waste can offer the combinations of improved properties and processing, and reduce operational cost. Moreover, in recent studies it was demonstrated that they can also act as blend compatibilizers. The aim of this study is the upgrading of Fil-s (acronym for film-small), a fraction of mixed plastic waste stream obtained by the separation and mechanical recycling of post-consumer packaging films of small size. Physical, chemical and rheological characterization evidenced that Fil-s stream is mainly composed of polyethylene and a smaller fraction of polypropylene. With the purpose to improve the performances of Fil-s, lamellar and acicular organoclays were melt compounded with the recycled material in a twin-screw extruder. Moreover, in order to enhance the compatibility between the polyolefin components and the nanofiller dispersion in the mixed polymer matrix, the functionalization of Fil-s with maleic anhydride (MAH) was realized by reactive extrusion. Morphological, thermal, rheological and mechanical properties of the functionalized materials and the nanocomposite systems were extensively discussed. The positive effect of the MAH-grafting on the compatibilization between the two polyolefin components of Fil-s was pointed out and an interesting improvement in ductility of Fil-s was obtained. The further addition of the nanoclays also significantly increased the stiffness of the systems.

A comparison between the most promising design configurations for the industrial application of gasification based, plastics-to-energy cogenerators in the 2–6 MWe range is presented. A pilot scale bubbling fluidized bed air gasifier, having a feeding capacity of 100 kg/h, provided experimental data: the syngas complete composition, the characterization of the bed material, the entrained fines collected at the cyclone and the purge material from the scrubber. Mass and energy balances and material and substance flow analyses have been therefore drawn to assess and compare design solutions utilizing two mixed plastic wastes (MPW) obtained from separate collection of plastic packaging, after different levels of pre-treatments. The related techno-economic performances have been finally estimated on the basis of the manufacturer’s specifications. The study concludes that the MPW obtained after a very simple pre-treatment and fed to a gasifier coupled with a steam turbine is the solution that currently offers the higher reliability and provides the higher internal rate of return for the investigated range of electrical energy production.

Biomass has great potential as a clean and renewable feedstock for producing modern energy carriers. This paper focuses on the process of biomass gasification, wherein the synthesis gas is subsequently used to produce electricity. A comparison between the most promising design configurations for the industrial application of gasification based, biomass-to-energy cogenerators in the 100-600. kWe range is presented. Mass and energy balances and material and substance flow analyses drawn for each design solutions are based on the experimental data obtained from a pilot scale bubbling fluidized bed air gasifier, having a feeding capacity of 100. kg/h and operated with a commercially available, natural biomass. Measurements taken during the experimental tests include the syngas complete composition as well as the characterization of the bed material, the entrained fines collected at the cyclone and the purge material from the scrubber. The techno-economic performances of two energy generation devices, a gas engine and an externally-fired gas turbine, have been estimated on the basis of the manufacturer's specifications. The study concludes that the internal combustion engine layout is the solution that currently offers the higher reliability and provides the higher internal rate of return for the investigated range of electrical energy production. © 2010 Elsevier B.V.

Dispersion of pollutants from mining areas can result in risks to human health. The dynamic interaction of geological processes can generate complex situations that favor enrichment in toxic elements by sedimentary and diagenetic mechanisms. In order to explore the distribution of iron-rich minerals in coastal and river sediments, a geophysical campaign was performed along the outlet of the Piscinas and Naracauli Rivers that drain two abandoned mining areas in SW Sardinia. Both rivers flow into the Mediterranean Sea, a bay where fluvial, marine, and eolian processes interact. The geophysical campaign comprised magnetometry and ground-penetrating radar surveys. Magnetic properties were controlled by means of magnetic susceptibility measurements along the beach and dune areas, through sampling of surface sediments, natural outcrops and trenches, and considering different grain size intervals. Results indicate enrichment in ferromagnetic minerals at the leeside of dunes and berms. Sedimentological interpretation is supported by means of ground-penetrating radar. Due to both sedimentary and diagenetic processes, the 100- to 300-μm fraction of fine sands exhibits high susceptibility. Implied tenors of toxic elements in the magnetite may represent a serious hazard to environmental and health security. The results inferred from magnetic anomalies support the applicability of the geophysical approach in order to locate high concentrations of iron-rich particles both at surface and below ground and the usefulness of joint evaluation of magnetic susceptibility and ground-penetrating radar in order to characterize the sedimentary and geomorphology-controlled magnetite distribution.

Aim Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Despite its extremely favorable prognosis, cervical lymph node metastases are a common feature of PTC and a known independent risk factor for local recurrence. However, the role of prophylactic central neck dissection (PCND) remains a matter of debate in patients with clinically node-negative (cN0) PTC. To better clarify the current role of PCND in the surgical treatment of PTC, evaluating advantages and disadvantages of PCND and outcome of cN0 PTC patients who have been treated with either total thyroidectomy alone or in combination with PCND. A review of recent literature data is performed. Methods Between January 2000 and December 2015, 186 consecutive patients with cN0 PTC were identified to be included in the present study. 74 of these underwent total thyroidectomy associated with PCND, while 112 patients underwent total thyroidectomy alone. The epidemiological and clinical-pathological data of all patients included were collected at diagnosis and during follow-up. Results Overall complication rate was significantly higher in the group of patients undergoing PCND (39.2% vs. 17.8%, p = 0.0006). To be specific, they presented a considerably increased risk of temporary recurrent laryngeal nerve injury ( p = 0.009) and of permanent hypothyroidism ( p = 0.016). Overall survival and recurrence rates did not differ between those undergoing PCND and those undergoing total thyroidectomy alone ( p = 1.000 and p = 0.715, respectively). Conclusions The results of the present study do not support the routine use of PCND in the treatment of cN0 PTC patients.

The superior horizontal pancreatic artery was described in 1910, and after a few years, it was forgot by most investigators. This research is aimed to revive the description of this artery, describing course, pattern of branching and frequency. More than 1,000 of angiographies including studies of the superior mesenteric artery, celiac trunk and its branches, were selected from the angiographic archives of the ex-institutes of Radiology of Siena, Rome (University of Sacro Cuore) and Perugia, and the arterial anatomy of the pancreas was studied. A pancreatic branch of the splenic artery running along the superior border of the pancreatic body and tail was observed in 25.93 % of cases. This branch matched the description of the superior horizontal pancreatic artery and, when existing, replaced the pancreatica magna artery. For this reason, we considered the superior horizontal pancreatic artery as a variant of the pancreatica magna artery. Variable in caliber and importance, in most cases the superior horizontal pancreatic artery gave off descending branches that anastomosed with the inferior pancreatic artery. A superior horizontal pancreatic artery could be visualized more easily by selective angiography of the splenic artery. When coupled with the inferior pancreatic artery, the presence of the superior horizontal pancreatic artery outlined a longitudinally arranged pattern of blood supply of the distal pancreas that should be known. In particular circumstances, extended resections of the gland cutting both longitudinal arteries might jeopardize the surviving of the pancreas remnant.

Reliable single-lead VDD pacing requires stable atrial sensing performance. The intracavitary P-wave amplitude was measured in supine and upright body position. Amplitude range and mean were determined over 4 consecutive cycles and a variability index was derived as percentage of the former to the

Well faceted palladium nanoparticles (rods, cubes, tetrahedrons, polyhedrons) supported on alumina were synthesized by a seed-mediated growth technique. The quantification of the different exposed crystallographic planes of these supported palladium nanoparticles was firstly done by TEM analysis. To get more information about the exposed crystallographic planes, the amount of defects and the accessibility of palladium sites, infrared spectroscopy measurements of an adsorbed probe molecule (CO) were also performed and enabled to improve and complete the first TEM analysis. In fact, infrared measurements allowed to evidence, and likely to quantify, the presence of crystallographic planes and defects not seen by TEM. Finally, the preferential adsorption of CTAB (cetyltrimethylammonium bromide) on low coordinative crystallographic planes was also experimentally demonstrated.

Tungstated zirconia catalysts with loadings ranging from near monolayer (6 wt% W) to multilayer coverages (30 wt% W) were prepared by wet impregnation with ammonium metatungstate as precursor, characterized by X-ray diffraction, temperature-programmed reduction, and in situ X-ray photoelectron spectroscopy and compared for surface reducibility. Two catalyst preparation methods were used. On the one hand, the ammonium metatungstate precursor was deposited directly on commercial monoclinic ZrO 2 , or it was deposited on amorphous ZrO x (OH) 4−2 x hydroxide, according to the Hino and Arata procedure and leading to tetragonal ZrO 2 . The degree of reducibility of the WO 3 /ZrO 2 systems and consequently the catalytic behavior (forthcoming Part II) strongly depend on the initial WO 3 content but not at all on the monoclinic or tetragonal structure of ZrO 2 . Whatever the preparation method, the surface of the near-saturation monolayer catalyst is mainly constituted of amorphous tungstate species in which tungsten atoms (W 6+ and W 5+ ) are in tetrahedral coordination, in direct interaction with the support and thus difficult to reduce. The increase in tungsten content yields a progressive formation of tungstate species in which tungsten is octahedrally coordinated, more easy to reduce, and giving W 4+ surface species. Increasing the WO 3 content above 15 wt% W leads to the formation of bulk-like WO 3 crystallites, whose reduction leads to the appearance of metallic tungsten.

In the framework of several projects sustained by the Regional Sardinian Government Laws no. 43 (28/09/1990) and no. 19 (11/04/1996), research groups of the University of Cagliari (Sardinia, Italy) and of the University Mohamed V-Agdal of Rabat (Morocco) have started a series of preliminary geo-environmental studies in the basin of the Oued Sebou. An area of almost 1000 square km around the famous city of Fes has been studied, using satellite images and two ground surveying campaigns. These surveys aim to define the geological and structural settings, the vegetation and land use, in order to define the landscape units and to select the areas of major hydrogeological and geo-environmental risk. The satellite data used are the LANDSAT TM5 images taken on the 9th of October 1997. These images have been analysed to obtain the different bases for further thematic mapping, resulting in the geo-environmental map of the area around Fes that constitutes an up-to-date representation of the geological and environmental state of the territory and a useful instrument for further risk assessment and urban and territorial planning.

Atrial contraction timing should be considered in AV-delay setting, to avoid AV-valve closure before the end of active filling. Tricuspid and mitral flows were assessed by echo-Doppler in 22 pacemaker patients, measuring the latency between P-wave onset and A-wave onset and end (P-Aon; P-Aend).

Efficient myocardial stimulation ensures reliable pacing with restricted energy expense. We assessed the ventricular stimulation performance of a single-pass lead for VDD pacing (Phymos 4, Medico) in the chronic follow-up (28±14 months) of 29 implants. This lead is tined, non-steroid eluting and

Hisian pacing might entail a higher threshold than conventional pacing methods. Back-up stimulation on demand allows managing the risk of capture loss with the lowest energy cost. His-bundle and apical back-up leads were connected, respectively, to the V1 and V2 channels of a suitable three-chamber

The hematologic disorder beta-thalassemia major is relatively common in Southern Italy. Stroke is a well described, though infrequently reported, complication of this disorder. We now report our experience regarding 300 children with beta-thalassemia major examined at the University of Catania, Italy, over a 20-year period. We encountered 9 patients (3%; 3 males, 6 females) with beta-thalassemia major who had hemorrhagic stroke. Two groups of patients can be identified: group 1 (2 patients 22%) with early-onset post-transfusion hemorrhage and group 2 (7 patients 77%) with delayed post-transfusion hemorrhage. In the first group, the hemorrhage occurred within 48 hours following blood transfusion. In the second group, hemorrhage occurred 7-15 days from last transfusion. In 5 patients out of 7 of this second group the first transfusion and ictal event both occurred after age five, suggesting prolonged chronic anemia might play a role in the hemorrhage.

Atrial electrode position was determined by radiographic analysis in 160 patients paced in single-lead VDD for second- or third-degree A-V block, implanted > 1 year with Phymos single pass leads and Phymos 3D pacemakers. The packing lead features an atrial dipole with a 30-mm electrode interspace. In 44% of patients, the upper atrial electrode was positioned within a band of 20 mm centered at the level of the superior vena caval insertion (junctional area) and was in the inferior vena cava or in the atrium in 35% and 21% of cases, respectively. In spite of these different dipole locations, all patients had stable atrium-driven pacing at routine follow-up visits. With the electrode in the junctional area, unipolar stimulation of up to 5 V for 1 ms resulted in stable atrial capture in 63% and 59% of the patients in supine and upright positions, respectively. With the electrode in the atrium, corresponding success rates were 45% and 54%. In the atrium, however, the prevalence of diaphragmatic stimulation was significantly lower than at the junction (10% vs 42% in supine position; 21% vs 47% upright). Though atrial sensing function proved adequate in a wide range of positions, these results suggest that the Phymos lead atrial dipole should be positioned within the atrium, as close as possible to the atrial wall, to maximize the number of VDD patients who might benefit from single-lead DDD pacing.

Thromboembolic (TE) events have been frequently reported in β-thalassemic patients in association with known risk factors such as diabetes, complex cardiopulmonary abnormalities, hypothyroidism, liver function anomalies, and postsplenectomy thrombocytosis. In a recent survey involving 9 Italian thalassemic centers, we identified 32 patients with TE episodes in a total of 735 subjects, of whom 683 had thalassemia major and 52 thalassemia intermedia, corresponding to 3.95 and 9.61%, respectively. There was a great variation in localization: the main one (16/32) was CNS, with a clinical picture of headache, seizures and hemiparesis. Other localizations were the pulmonary (3 patients), mesenteric (1 patient) and portal (2 patients) sites. There were 6 cases of deep venous thrombosis (2 in the upper limbs, 4 in the lower ones). Intracardiac thrombosis was found in 2 subjects and clinical and laboratory signs of DIC were observed in 2 others during pregnancy. Since our patients with TE events present a statistically significantly higher incidence of associated dysfunction (cardiomyopathy, diabetes, liver function anomalies, hypothyroidism) than those without TE events (50 vs. 13.8%), we suggest close monitoring of those patients who are at higher risk of developing TE events because of the presence of one or more of these predisposing factors.

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Si propone un itinerario geoturistico di notevole interesse didattico e scientifico, di grande attrazione e facile accesso, per scoprire dei siti naturali di importante valenza geologica, geomorfologica ed ecologica che ben si prestano alla conoscenza ed all'approfondimento in un'ottica ambientale, culturale e socio-economica. Il percorso si snoda attraverso il Plateau centrale del Medio Atlante (El Hajeb, Ifrane, Azrou, Ain Leuh, Kénifra) e il Massiccio Centrale del Marocco (Oulmes, Tarmilate, El-Archa), toccando paesaggi, geositi e geomorfositi di grande importanza per lo studio del patrimonio geologico e naturalistico, e nello stesso tempo di grande effetto scenico: le immense distese dei tavolati calcarei (causses) vegetati da foreste di querce e di cedri, gli sconfinati panorami d'Ito, le cavità criptocarsiche del Plateau d'Azrou, i paesaggi ruiniformi di Tidrine, i paesaggi vulcanici (Jbel Hebri, El Koudiat e Michliffen, ecc.), la sorgente carsica e le cascate di l'Oum-er-Rbia, la depressione carsica dell'Aguelmame Azigza, il bacino permiano di Kénifra ricco di siti fossiliferi (scoperti nel 1988), il massiccio granitico di Ment modellato dall'erosione plio-quaternaria associata ad un'attività vulcanica importante, i fenomeni di vulcanismo recente della valle dell'Oued Aguennour, il penepiano Permo-triassico d'Oulmes con le sue risorse minerarie e la sorgente termale Lalla Haya che sgorga al fondo della profonda valle dell'Oued Aguennour, incassata nel basamento paleozoico, dall'aspetto orrido e selvaggio. Nell'ottica di perseguire uno sviluppo sostenibile, emerge come il territorio marocchino, costituito da un variegato mosaico di siti geologici e geomorfologici di grande interesse, necessiti di una politica di valorizzazione e protezione delle sue grandi potenzialità naturali, ancora poco conosciute a livello internazionale.

This article is the third part of a comprehensive review on the pancreatic arterial blood supply and deals with the inferior pancreaticoduodenal a. The aim of this review is to summarise the anatomical studies, starting from Haller's reports, and to supply as far as possible, with original material, angiographic evidences for the classic anatomical notions. For this purpose, the overall research was carried out by picking out and studying 1015 selective angiographies (celiac trunk and its branches, superior mesenteric a.) taken from the angiographic archives of the Institutes of Radiology of Siena, Rome (Catholic University), and Perugia. Angiographically, the authors observed the inferior pancreaticoduodenal a., present in most instances, as arising from the superior mesenteric a., from the right accessory hepatic a., or from a common trunk with the first or the first two jejunal aa. Some variations of the course have been shown. The authors underline and discuss the discordant opinions still existing regarding the incidence of the different ways the inferior pancreaticoduodenal a. arises and the surgical importance of the variation of origin of this artery.

In this study we have defined the spectrum of the beta-thalassemia mutations, the beta-thalassemia haplotypes, and the genotype-to-phenotype correlations in a large number of patients with different beta-thalassemia conditions. Seventeen different beta-thalassemia mutations were detected which included one chromosome each with Hb Dhonburi and Hb Lepore. Five alleles, namely, codon 39 (C-->T), IVS-I-110 (G-->A), IVS-I-6 (T-->C), IVS-II-745 (C-->G), and IVS-I-1 (G-->A), account for 90% of all beta-thalassemia mutations in 846 thalassemic chromosomes studied. Haplotyping for a large number of subjects showed that the five common mutations are linked to a few haplotypes. The presence of milder mutations, mainly IVS-I-6 (T C), in about 19% of our patients explains some of the clinical variables. Among the 37 patients with thalassemia of intermediate severity, only 6 were homozygous or compound heterozygous for two severe alleles. The type of beta-thalassemia is the main factor responsible for differences in the phenotypic expression of the disease in patients with Hb S-beta-thalassemia; patients with Hb S-beta(+)-thalassemia are less severely affected than those with Hb S-beta(0)-thalassemia. The five most frequent mutations have comparable distributions all over Sicily.

A comparison of possible solutions for small scale (0.2-1. MWe) waste-to-energy gasification-based industrial application is presented. A pilot scale bubbling fluidized bed air blown gasifier, having a capacity of 500. kWe, provided experimental data: the syngas complete composition as well as the characterization of the bed material and contaminants downstream of the cyclone and wet scrubber. Mass and energy balances and material and substance flow analyses have been drawn to assess and compare design solutions utilizing a packaging derived fuel (PDF) obtained as scrap by food industrial processes. The related environmental, energetic and economic performances have been estimated on the basis of the experimental data and manufacturer's specifications. In the scale range analyzed, the best solution is that of a power gasification coupled with an internal combustion engine, which provides high reliability and high internal rate of return. © 2012 Elsevier Ltd.

Besson, M. Descorme, C. Bernardi, M. Gallezot, P. di Gregorio, F. Grosjean, N. Minh, D. Pham Pintar, A. Sp. Iss. SI; International audience; This paper reviews some catalytic wet air oxidation (CWAO) investigations of industrial wastewaters over platinum and ruthenium catalysts supported on TiO2 and ZrO2 formulated to be active and resistant to leaching, with particular focus on the stability of the catalyst. Catalyst recycling experiments were performed in batch reactors and long-term stability tests were conducted in trickle-bed reactors. The catalyst did not leach upon treatment of Kraft bleaching plant and olive oil mill effluents, and could be either recycled or used for long periods of time in continuous reactors. Conversely, these catalysts were rapidly leached when used to treat effluents from the production of polymeric membranes containing N,N-dimethylformamide. The intermediate formation of amines, such as dimethylamine and methylamine with a high complexing capacity for the metal, was shown to be responsible for the metal leaching. These heterogeneous catalysts also deactivated upon CWAO of sewage sludges due to the adsorption of the solid organic matter. Pre-sonication of the sludge to disintegrate the flocs and improve solubility was inefficient.

Recent evidence strongly suggests that peroxidative modification of lipids may play a significant role in atherogenesis. In our present research, we investigated if the oxidative stress mediated by oxygen free radicals was a pathophysiologic condition that occurred in the early stages of human development. Thus the aim of this research was to examine lipid peroxidation in human fetal aortas. Human fetal aortas and proximal iliac arteries (n = 8) were obtained from fetuses aged 7 +/- 2 months, immediately after autopsy. Lipids from the initial fatty streak lesions (LFS) and the vessels uninvolved (LUV) were extracted by the chloroform/methanol method. Lipid peroxidation levels were measured by two different methods: determination of lipid conjugate dienes (the spectrum trend was recorded from 320 to 200 nm with a spectrophotometer) and malonyldialdehyde (MDA) content (TBA method). We observed that lipid conjugated dienes were present in LFS, but not in LUV, with a characteristic absorption peak at 233 nm. In addition, MDA levels were significantly higher when the LFS = 3.85 +/- 0.91 nmol than when the LUV = 0.41 +/- 0.12 nmol (p < 0.001 versus LUV). The presence of lipid peroxidation in our samples could be mediated by free radical production in the first stages of human development. Thus these data suggest that LFS peroxidation mediated by free radicals occurs in the vascular circulation in the early stages of human development. This could influence the progression of vascular damage and atherosclerotic disease.

1. Rat dorsal spinal roots were studied by the use of whole-nerve sucrose gap and intra-axonal recording techniques. A prominent time-dependent conductance increase as evidenced by a relaxation or "sag" in membrane potential toward resting potential was elicited in dorsal spinal roots by constant hyperpolarizing current pulses. The relaxation, or sag, indicative of inward rectification, reached a maximal level and then decayed during the current pulse. 2. The time-dependent sag elicited by hyperpolarization was reduced when Na+ or K+ was removed from the normal bath solution but was abolished with the removal of both Na+ and K+. Tetrodotoxin (TTX), tetraethylammonium (TEA), and 4-aminopyridine (4-AP) did not affect the depolarization sag, suggesting that conventional voltage-dependent sodium and potassium channels do not underlie the inward rectification. 3. Cs+ in low concentrations completely abolished the inward rectification, whereas Ba2+ induced a partial block. 4. Current-voltage curves indicate that the magnitude of the depolarizing sag increases monotonically with increasing hyperpolarization. The time required to reach peak hyperpolarization, maximal sag potential, and the time between peak hyperpolarization and sag membrane potentials decreases with increasing levels of hyperpolarization. 5. The inward rectification is refractory to further stimulation during its decay phase, as revealed by paired-pulse protocols. This decay in inward rectification is both time and voltage dependent and is observed on a single axon level by the use of intra-axonal recording techniques as well as from whole-root recordings in the sucrose gap. 6. It is concluded that rat dorsal root fibers display a prominent time-dependent conductance increase in response to hyperpolarization that depends on both Na+ and K+ permeability and is blocked by Cs+. This rectification displays a decay phase that has not been previously described for similar conductances. It is argued that the Na+ component of this conductance is primarily responsible for stabilizing membrane potential near resting potential during periods of hyperpolarization.

Cardiac rate adaptation to changes in metabolic demand for blood supply is essential for the optimisation of exercise capacity and general well-being, especially for people inclined to an active life-style. Since patients affected by sick sinus syndrome often present with different forms of chronotropic incompetence [1], dual-chamber rate-responsive pacing is usually indicated in the electrical treatment of this disease. Sensors of various kind are currently applied to regulate the pacing rate, but the ideal goal to precisely meet the physiological needs by an artificial control system has not yet been fully achieved [2]. Indeed, activity sensors, which are generally based on an accelerometer, are highly sensitive and quickly reactive during dynamic exercise, but they cannot detect conditions of isometric exercise, post-exercise recovery, or mental stress, which would normally entail cardiovascular compensation. In addition, the accelerometer indications are not specific, since the sensor can induce a rate increase even in response to passive movements. Sensors designed to record changes in physiological parameters indicating exercise or fatigue, such as minute ventilation, are more specific, but usually slow and less sensitive. Sensors of different manifestations of adrenergic tone, e.g. Q–T interval, pre-ejection interval, unipolar ventricular impedance, and peak endocardial acceleration (PEA), generally provide a good approximation of the expected rate regulation [3–6], but may require complex hardware [7], can be affected by positive feedback from the pacing rate itself [8], or may be unreliable under particular conditions [9].

In the present animal model study, the pacemaker Sophos 100 proved fully reliable in a 1 month follow-up period. TVI sensor operation did not interfere with conventional pacemaker functions, opening the way to its implantation in human beings.

The present study demonstrates that TVI data processing based on the inverse relationship with right ventricular volume provides an index of cardiac contractility that correlates closely with the simultaneous sinus rate modifications induced by adrenergic challenge. Similar progressive changes in the inotropic index are noticed even when the chronotropic adaptation is prevented. In contrast, a rate increase produced by overdrive pacing in the absence of contractility modifications does not affect the inotropic index [18].

In the present animal model study, TVI sensor operation did not interfere with conventional pacemaker functions of implanted Sophos pacemakers. These results look promising since this sensor could play an important part in haemodynamic monitoring: for physiological rate adaptation, for beat-tobeat capture confirmation, in patients with neurocardiogenic syncope, for the follow-up of patients with heart failure, to indicate the best interventricular delay in CRT, and to identify arrhythmias and their haemodynamic impact in implantable cardioverter-defibrillators [10-12].

Effective haemodynamic sensing would open the way to the autoregulation of a number of pacemaker functions, which could thus be integrated into a single control system. The TVI sensor can be proposed to play this crucial role, allowing the assessment of systolic and diastolic modifications in ventricular volume by means of conventional pacing leads.