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著者人数: 19名, 形態: カラー図版あり, Number of authors: 19, Physical characteristics: Original contains color illustrations, Accepted: 2021-01-14, 資料番号: PA2110015000

Hazards from the outer space environment either natural (space weather and asteroids) or artificial (space debris and the growing number of satellites launched to orbit) pose a rising risk to space flight activities. The awareness for space sustainability and space safety has seen a continuous increase in recent years and does not stop at the Earth's sphere of influence. The first spacefaring nations start thinking about sustainability in cislunar space and the Martian environment. This work deals with the issue of space debris in Martian orbits in the light of planetary protection. A Mars Sustainability Framework has been developed. This includes a study on the orbital and regulatory environment of Mars, long-term propagation of orbits of artificial objects and the two natural moons, and the analysis of objects evolution and first approaches for collision probability computation. With this work, the issue of space debris beyond Earth orbit is analysed at an early stage.

In recent years, several metrics have been proposed to quantify the impact of a mission on the space debris environment. In our previous work, we introduced the environmental capacity as the number and typology of missions that are compatible with the stable evolution of the debris environment. This concept enables the evaluation of the effectiveness of mitigation guidelines by looking at the use of environmental capacity due to existing missions. The current work will investigate how the same concept can also be applied as a tool during the design of a mission, facilitating the comparison of different mission architectures depending on their overall contribution to the debris environment. First, the paper will present the latest updates to the debris index used as a metric of the environment capacity, including the inclusion of a penalisation for objects with low trackability and an improved model for the break-up probability. Then, several application cases will be discussed to demonstrate its use as design driver. First, the relevance of adopting operational best practices (i.e. collision avoidance and disposal manoeuvres) will be studied for different spacecraft classes as a way of quantifying better than required behaviour. Then, the environmental impact of a mission will be analysed considering the case when the mission is realised through a single large satellite or through a constellation of smaller satellites. Finally, different end-of-life scenarios will be assessed to demonstrate the use of the method to discriminate between various technologies on a case-by-case basis. The adoption of passive de-orbiting systems will be compared to conventional disposal through de-orbit burns or operations at lower altitudes to gain insight into how two different options, both compliant to existing guidelines, differ in terms of the resulting environmental impact. Finally, a scenario with active-debris-removal will be considered, showing how the quantification of the impact on the debris environment can support the selection of parameters such as the rendez-vous altitude, based on the expected success rate of the capture and final disposal phase.

The current debris mitigation guidelines are formulated by considering single objects, so they cannot dynamically account for variations in the space traffic, or for the actual current level of implementation and success of post-mission disposal manoeuvres. To address this limitation, the concept of space traffic management based on the environment capacity was proposed. Following this approach, a mission (single or multiple satellites and launch vehicles) is evaluated, before its launch, not only with respect to existing mitigation guidelines, but also with respect to what can be accommodated by the environment (e.g. not exceeding a defined risk level), considering objects already in orbits and other planned future missions. In this way, similarly to the approach used for frequency allocation in GEO, each mission can use a share of the environment capacity through a process that may define, for example, a maximum capacity consumption per year. In order to implement such a scheme, a measure of the debris environment criticality is required. Different formulations for such a metric have been proposed and, in the present work, the ECOB index (Environmental Consequences of Orbital Breakups) is applied. This work will give a brief overview of the most recent changes in the formulation of the index and will discuss examples of applications to the current environment. Different Post-Mission Disposal success rates and future launch traffic scenarios will be analysed. In this context, the evaluation provided by the debris index will be compared to other formulations available in literature and to the one from other indicators such as number of objects and catastrophic collisions. A comparison with operational data from ESA's collision avoidance service will be also presented. Finally, it will be analysed how such an index can be connected to the concept of the environment capacity and a concept for its inclusion within a space traffic management process will be formulated.

Spacecraft collision avoidance procedures have become an essential part of satellite operations. Complex and constantly updated estimates of the collision risk between orbiting objects inform the various operators who can then plan risk mitigation measures. Such measures could be aided by the development of suitable machine learning models predicting, for example, the evolution of the collision risk in time. In an attempt to study this opportunity, the European Space Agency released, in October 2019, a large curated dataset containing information about close approach events, in the form of Conjunction Data Messages (CDMs), collected from 2015 to 2019. This dataset was used in the Spacecraft Collision Avoidance Challenge, a machine learning competition where participants had to build models to predict the final collision risk between orbiting objects. This paper describes the design and results of the competition and discusses the challenges and lessons learned when applying machine learning methods to this problem domain., Pre-print

Studies have concluded that active debris removal (ADR) of the existing in-orbit mass is necessary. However, the quest for an optimal solution does not have a unique answer and the available data often lacks coherence. To improve this situation, modern knowledge representation techniques, that have been shaping the World Wide Web, medicine and pharmacy, should be employed. Prior efforts in the domain of space debris have only focused onto space situational awareness, neglecting ADR. To bridge this gap we present a domain-ontology of intact derelict objects, i.e. payloads and rocket bodies, for ADR capture methods selection. The ontology is defined on a minimal set of physical, dynamical and statistical parameters of a target object. The practicality and validity of the ontology are demonstrated by applying it onto a database of 30 representative objects, built by combining structured and unstructured data from publicly available sources. The analysis of results proves the ontology capable of inferring the most suited ADR capture methods for considered objects. Furthermore, it confirms its ability to handle the input data from different sources transparently, minimizing user input. The developed ontology provides an initial step towards a more comprehensive knowledge representation framework meant to improve data management and knowledge discovery in the domain of space debris. Furthermore, it provides a tool that should make the initial planning of future ADR missions simpler yet more systematic., Comment: 32 pages, 7 figures and 6 tables

The use of GnRH antagonists (GnRHant) is increasing in the ovarian stimulation protocol. Among several other benefits, GnRHant should prevent a premature luteinization and premature ovulation, the first described either as a 'reassuringly rare event' or 'frequent event', while the second as occurring more frequently in women with decreased ovarian reserve, advanced age and poor ovarian response. Two cases of associated premature luteinization and premature ovulation, during treatment with gonadotropins and GnRHant in IVF cycles, are here reported. In both cases, premature luteinization occurred and ovulation took place during ovarian stimulation protocols with exogenous gonadotropins and GnRHant, before reaching the criteria of hCG administration, regardless of the age of the patients and their ovarian reserve. Ovulation was documented by the disappearance of most of the developing follicles, by the transformation of endometrium from a triple line picture into a uniform hyper-echogenic image, by the presence of fluid in the pouch of Douglas, by the increase of progesterone plasma levels and the simultaneous reduction of estradiol plasma levels. This evidence can be important for a correct counseling with infertile patients in preparation for an IVF cycle.

Background Posthysterectomy vaginal vault prolapse repair is a challenge for pelvic floor surgeons. Native-tissue repair procedures imply lower costs and reduced morbidity. Our study aims to evaluate operative data, complications, objective, subjective and functional outcomes of transvaginal native-tissue repair for posthysterectomy vaginal vault prolapse. We also investigated differences among available techniques. Methods Retrospective study including patients with symptomatic vaginal vault prolapse (≥stage 2), previously treated with transvaginal vault suspension through native-tissue repair. Objective recurrence was defined as the descent of at least one compartment ≥II stage according to Pelvic Organ Prolapse Quantification (POP-Q) system or need of reoperation. Subjective recurrence was defined as the presence of bulging symptoms. Patients satisfaction was evaluated with PGI-I Score. Results The study included 111 patients. Apical suspension was achieved either by uterosacral ligament suspension (16), levator myorrhaphy (17), iliococcygeus fascia fixation (65) or sacrospinous ligament fixation (13). No intraoperative complications were observed. Perioperative/postoperative complications occurred in 8 patients (7.2%). Mean follow-up was 24.5±12.1 months. Objective recurrence was observed in 28 patients (25.2%). Reintervention was required by 3 patients (2.7%). Subjective recurrence was referred by 6 patients (5.4%). Mean satisfaction evaluated with PGI-I Score was 1.2±0.6. No differences in terms of operative data, overall complications, objective, subjective cure rate and perceived satisfaction were found among different techniques. Conclusions Transvaginal repair with native-tissue procedures is safe and effective in correcting posthysterectomy vaginal vault prolapse and represents a valid alternative to prosthetic procedures for vaginal vault prolapse treatment.

Libration Point Orbits (LPOs) and Highly Elliptical Orbits (HEOs) are often selected for astrophysics and solar terrestrial missions. No guidelines currently exist for their end-of-life disposal. However, as current and future missions are planned to be placed on these orbits, it is a critical aspect to clear these regions at the end of operations to avoid damage to other spacecraft and ensure on-ground safety. This paper presents an analysis of possible disposal strategies for LPO and HEO missions as a result of a European Space Agency study. The dynamical models and the design approach are presented for each disposal option. Five current missions are selected as test cases Herschel, Gaia, SOHO as LPOs, and INTEGRAL and XMM-Newton as HEOs. A trade-off on the disposal options is made considering technical feasibility, as well as the sustainability context.

To evaluate the prevalence and prenatal ultrasound detection of clubfoot in Tuscany during a period of 20 years.This is a descriptive analysis on data from the Tuscan register of congenital defects, covering a 20-year period from 1992 to 2011. The Tuscan registry of congenital defects is a population-based register for the epidemiologic surveillance of congenital anomalies. The study included all cases of pre- or postnatally diagnosed clubfoot (isolated clubfoot and cases associated with other congenital defects). Overall prevalence and pre-natal detection rates were calculated.Among the 549,931 deliveries recorded in Tuscany between 1992 and 2011, 858 cases of clubfoot were registered, with a prevalence of 1.56/1000. Seventy-eight percent of cases were isolated. The detection rate was higher when the defect was associated with other anomalies compared to isolated forms. Over the study period, there was a substantial improvement in the prenatal detection of clubfoot (from 11 to 31% overall). For isolated forms, detection rate improved from 4 to 16%, and for cases associated with other congenital defects, it increased from 43 to 73%.Prevalence of clubfoot in Tuscany is 1.56 per 1000 births, in agreement with the incidence reported in epidemiological studies in Europe. Prenatal detection of clubfoot improved over time. The detection rate was higher in cases associated with other anomalies.

Study objectives To investigate behavioral aspects and quality of life in children and adolescents with type 1 narcolepsy (NT1). Methods We performed a case-control study comparing 29 patients with NT1 versus sex- and age-matched patients with idiopathic epilepsy (n = 39) and healthy controls (n = 39). Behavior and quality of life were evaluated by self-administered questionnaires (Child Behavior Checklist, Pediatric Quality of Life Inventory). Patient groups were contrasted and scale results were correlated with clinical and polysomnographic parameters, and cerebrospinal fluid hypocretin-1 levels. Results Young patients with NT1 showed increased internalizing problems associated with aggressive behavior. Emotional profile in patients with NT1 positively correlated with age at onset, diagnostic delay, and subjective sleepiness, whereas treatment and disease duration were associated with fewer behavioral problems (attention problems, aggressive behavior, and attention deficit/hyperactivity disorder). Psychosocial health domains of pediatric NT1 were worse than in healthy controls, whereas the physical health domains were comparable. Conclusions Young NT1 patients show a discrete pattern of altered behavioral, thought, and mood profile in comparison with healthy controls and with idiopathic epilepsy patients thus suggesting a direct link with sleepiness. Further studies investigating behavior in patients with idiopathic hypersomnia or type 2 narcolepsy are needed to disentangle the role of REM sleep dysfunction and hypocretin deficiency in psychiatric disorders. Symptoms of withdrawal, depression, somatic complaints, thought problems, and aggressiveness were common, NT1 children perceived lower school competencies than healthy children, and their parents also reported worse psychosocial health. Our data suggest that early effective treatment and disease self-awareness should be promoted in NT1 children for their positive effect on behavior and psychosocial health.

The increased life expectancy, the importance of the prevention in younger age and the role of the pelvic floor dysfunction not only in the disease of the third age, but also in the childbearing age, as the influence on the type of delivery, underline the importance of the evaluation of the pelvic floor. The evaluation of pelvic floor is generally clinical, but in the last 2 decades, the use of ultrasound has become a mainstream diagnostic tool in the investigation of female pelvic organ prolapse, urinary and fecal incontinence and defecation disorders, providing an immediate objective confirmation of findings obtained on clinical examination and filling some of the gaps of the urogynecological exam. The use of transabdominal ultrasound was the first developed, while the use of translabial, transrectal and transvaginal techniques started later. This review will focus on the use of transperineal ultrasound, including two-dimensional (2D), three-dimensional (3D) and 4D imaging, as a valuable and objective method in the urogynecological evaluation, allowing the assessment of the pelvic floor anatomy and its functions and dysfunctions, the choice of the right type of treatment and the analysis of the changes after surgical treatment and its complications. The ultrasound approach has become an important instrument for the prevention, but also for the analysis of the disease, and to understand the importance of the pelvic floor function in different period of life of a woman.

Upper-stage motors used in small launchers constitute an application where hybrid rocket motors may be competitive. A coupled optimization of motor design and trajectory is needed for such an application due to mission characteristics and motor features. The present article presents a cooperative evolutionary method nested with an indirect approach to perform the coupled optimization of hybrid rocket motor and trajectory for an upper stage. The evolutionary method optimizes the parameters that affect the motor design (e.g., grain geometry) and feed system, whereas the indirect method optimizes the trajectory (i.e., thrust direction and motor switching times) for a given motor and mission. A mission profile based on the Vega launcher is considered and the performance index is the payload inserted into the final orbit. The hybrid rocket motor powers the third and last stage and has a pressurizing feed system that is partially regulated. The characteristics of the first and second solid rocket motor stages a...

To assess prognosis of gestational trophoblastic neoplasia (GTN) and obstetric outcome after chemotherapy.Sixty-six patients had diagnosis of hydatiform mole on curettage and 18 developed GTN. Two patients were referred with pathological diagnosis of GTN. Chemotherapy was tailored according to International Federation of Gynecology and Obstetrics risk scoring system.All patients with GTN but one, were recovered by chemotherapy and had no evidence of disease after a median follow-up of 80 months. Only the patient with epithelioid trophoblastic tumor died of disease. Seven out of the eight women who tried to conceive after chemotherapy became pregnant. Ten conceptions occurred, resulting in no molar pregnancy, three miscarriages and seven term-live healthy births (70.0%). All seven babies showed normal development and growth after a median follow-up of 38 months.The prognosis of women with GTN is very good, and obstetric outcomes of those who conceive after chemotherapy are similar to those of the general population.

In the past years, several methods have been proposed to rank spacecraft and space debris objects depending on their effect on the space environment. The interest in this kind of indices is primarily motivated by the need of prioritising potential candidates of active debris removal missions and to decide on the required reliability for disposal actions during the design phase. The index proposed in this work measures the effect of the catastrophic fragmentation of the analysed spacecraft in terms of the resulting collision probability for operational spacecraft. The propagation of the debris cloud generated by the fragmentation and the estimation of the collision probability are obtained by applying an analytical approach based on the study of the density of the fragment cloud. The dependence of the proposed severity index on the mass of the spacecraft and on its semi-major axis and inclination is investigated. The index was computed for the objects in the DISCOS database and its results were compared to other formulations proposed in literature. A discussion on the results and on the comparison is presented.

As the debris population increases, the probability of collisions in space grows. Because of the high level of released energy, even collisions with small objects may produce thousands of fragments. Propagating the trajectories of all the objects produced by a breakup could be computationally expensive. Therefore, in this work, debris clouds are modeled as a fluid, whose spatial density varies with time under the effect of atmospheric drag. By introducing some simplifying assumptions, such as an exponential model of the atmosphere, an analytical expression for the cloud density evolution in time is derived. The proposed approach enables the analysis of many potential fragmentation scenarios that would be time limited with current numerical methods that rely on the integration of all the fragments’ trajectories. In particular, the proposed analytical method is applied to evaluate the consequences of some recent breakups on a list of target objects. In addition, collision scenarios with different initial conditions are simulated to identify which parameters have the largest effect on the resulting collision probability. Finally, the proposed model is used to study the mutual influence among a set of high-risk targets, analyzing how a fragmentation starting from one spacecraft affects the collision probability of the others.

As the debris spatial density increases due to recent collisions and inoperative spacecraft, the probability of collisions in space grows. Even a collision involving small objects may produce thousands of fragments due to the high orbital velocity and the high energy released. The propagation of the trajectories of all the objects produced by a breakup would be prohibitive in terms of computational time; therefore, simplified models are needed to describe the consequences of a collision with a reasonable computational effort. The continuity approach can be applied to this purpose as it allows switching the point of view from the analysis of each single fragment to the study of the evolution of the debris cloud globally. Previous formulations of the continuity equation approach focussed on the representation of the drag effect on the fragment spatial density. This work proposes how the continuity equation approach can be extended to multiple dimensions in the phase space defined by the relevant orbital parameters. This novel approach allows including in the propagation also the effect of the Earth’s oblateness and improving the description of the drag effect by considering the distribution of area-to-mass ratio and eccentricity among the fragments. Results for these three applications are shown and discussed in terms of accuracy compared to the numerical propagation and to the one-dimensional approach.

Around the Earth there are more than ten million objects larger than 1 mm that can interfere with other orbiting spacecraft. In particular, objects larger than 1 cm are considered massive enough to seriously damage or even destroy a satellite in case of collision. The traditional piece-by-piece approach to study the evolution of debris objects cannot be applied to small fragments their number is so large that the computational time would be prohibitive. This work proposes an alternative method based on the computation of the fragment density, whose evolution in time under the effect of atmospheric drag can be obtained with the continuity equation. The fragment density can then be used to evaluate the resulting collision probability. In particular, the proposed method is here applied to evaluate the consequence of some reference breakups on a list of target objects. In addition, the low computational time allows simulating many collision scenarios with different collision conditions to understand which parameters have the largest effect on the risk for other spacecraft.

Current debris evolutionary models usually neglect fragments smaller than 10 cm because of the high computational effort they add to the simulation. However, small-debris objects can also be dangerous to operational satellites. This work proposes an analytical approach to describe the evolution of a cloud of small fragments generated by a collision in low Earth orbit. The proposed approach considers the cloud globally and derives its evolution analytically, in terms of the change in the spatial density under the effect of atmospheric drag. As a result, the analytical approach allows the representation of small fragments and noticeably reduces the computational time under 10% compared to the numerical propagation of all the fragment trajectories. For altitudes above 800 km, the relative error compared to the numerical method is lower than 10%.

Narcolepsy type 1 (NT1) is a rare central disorder of hypersomnolence characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, hallucinations, and fragmented nocturnal sleep usually arising in adolescence or young adulthood. Recently, the childhood NT1 diagnoses have increased for improved disease awareness and for several cases occurring after the H1N1 pandemic influenza or vaccination. As in adults, the occurrence of NT1 in individuals with a genetic predisposition of the immune system (e.g., human leukocyte antigen, HLA-DQB1*0602) together with the role of environmental triggers (e.g., H1N1 influenza virus, streptococcus β hemolyticus) further supports the autoimmune pathogenesis. Children with NT1 close to disease onset show a peculiar cataplexy phenotype characterized by persistent hypotonia with prominent facial involvement (cataplectic facies) and by a complex mosaic of hyperkinetic movement abnormalities that increase during emotional stimulation. This phenotype progressively vanishes along the disease course leading to the typical picture of cataplexy (i.e., muscle weakness exclusively evoked by strong emotions). This possibly explains in part the misdiagnoses and diagnostic delay. Childhood NT1 also shows behavioral abnormalities and psychiatric disorders, encompassing depressive feelings, hyperactive/aggressive behavior, up to psychotic features. The association with obesity and precocious puberty strikingly suggests that NT1 arising in prepubertal children may reflect a wide hypothalamic derangement secondary to hypocretin neuronal loss. The complexity of the childhood NT1 phenotype claims a multidisciplinary assessment and management, taking behavioral and endocrinological features into account. NT1 indeed is a lifelong disorder with a devastating impact on quality of life, especially when arising across developmental age, and targeted school programs, medicolegal and psychological supports are essential for patients care. Controlled studies are mandatory to assess safety and efficacy of the current symptomatic off-label medications on which also relies the treatment for children with NT1, and hopefully future pathogenetic evidences will pave the way to better disease prevention and therapies to modify the disease course.

Premature ovarian insufficiency (POI) represents a condition characterized by the absence of normal ovarian function due to an incipient (by 3-10 years) ovarian aging. In most of the women affected there are no signs or symptoms that precede the interruption of menstruation and the onset of POI and the majority of women have a normal history of menarche, regular menstrual cycles and normal fertility. The possible genetic role in the development of POI has been largely demonstrated and many genes have been involved; on the other hand, ovary is not protected immunologically and the detection of autoantibodies directed against various ovarian targets strongly support the hypothesis of an autoimmune etiology. In approximately 5-10% of women with a diagnosis of POI with a normal karyotype, a spontaneous pregnancy could occur even if the recovery of ovarian function is temporary and poorly predictable. Embryo donation and adoption are other alternatives that should be considered. POI and subsequent loss of reproductive capacity is a devastating condition and a difficult diagnosis for women to accept so it requires an individualized and a multidisciplinary approach. Hormonal replacement therapy (HRT) should be commenced as soon as possible to prevent and to contrast the onset of the symptoms related to hypoestrogenism and to improve the quality of life for these women.

This article presents the design of the end-of-life disposal of spacecraft in Highly Elliptical Orbits through Earth re-entry. The effect of luni-solar perturbations can be enhanced through impulsive maneuvers to move the spacecraft on a trajectory that will naturally evolve in the long-term towards Earth re-entry. The dynamics is propagated through semi-analytical averaging techniques, implemented in the PlanODyn suite. Moreover, the analytical approach to describe third-body perturbation by Kozai is used to validate the solution for optimal disposal maneuvers obtained through global optimization. For INTEGRAL mission, re-entry is possible with the available ?v onboard, provided that the orbital dynamics is wisely exploited to enhance the effects of the maneuver.

The aim of this study was to investigate the rate of the different histological chorioamnionitis (HCA) grade in relation to the gestational age in term and preterm delivery.Three hundred and ninety-two women with singleton pregnancy with spontaneous onset of labor either prematurely or at term, with histologic diagnosis of HCA, were enrolled. Placentas were classified as: deciduitis and/or histologic chorioamnionitis within the membranes (HCA1); amnionitis or inflammation of the chorionic plate without funisitis (HCA2); and histologic chorioamnionitis with funisitis (HCA3). Microbiological culture was performed on both placental and fetal membrane samples.HCA1 was more frequent in women delivering at term than in preterm (p 0.001). HCA2 was more represented in women delivering between 32 and 36 weeks (p 0.001) and HCA3 occurred more frequently in those delivering within 32 weeks (p 0.001). The positive bacterial culture was higher (p = 0.008) in presence of HCA3 in comparison with HCA1 and HCA2.This study showed a significantly different distribution of HCA grades in relation to gestational age at delivery. HCA may represent the expression of different subtending etiologies and may also reflect specific immune competence of gestational tissues at different gestational ages, strengthening as pregnancy advances.

Preterm birth is defined as birth before 37 weeks’ gestational age. With an incidence of 7% to 11%, it is one of the major causes of perinatal mortality and morbidity. Preterm birth is considered a clinical syndrome, which arises from different pathological processes that activate prematurely one or more components of the mechanisms leading to parturition. The premature activation of labor may be caused by multiple pathological conditions; in particular a deregulation of the immune system and an exaggeration of inflammatory processes represent common central mechanisms. The complex pathogenesis, the main risk factors and the different therapeutic options will be described in the present review. Since its incidence is still increasing in the last decades, the goal is to improve the primary and secondary prevention.

Preterm delivery, preeclampsia and intrauterine growth restriction are the major diseases of pregnancy. A key role in their pathogenesis is played by the placenta, which is the source of hormones and other important regulatory molecules providing the metabolic and endocrine homeostasis of the fetal-placental unit. Since obstetric syndromes are characterized by important maternal and neonatal morbidity and mortality worldwide, numerous efforts have been made over the years to prevent and treat them. Due to their complex pathogenesis, however, the therapy is poor and not very effective. Therefore, great emphasis is currently given to the prevention of these diseases through the identification of biochemical and biophysical markers, among which placental factors play a crucial role. The increasing knowledge of the role of placental molecules can indeed lead to the development of new therapeutic and diagnostic tools.

To determine delivery outcome in women undergoing induction of labor for postdate pregnancy in relation to fetal gender.A total of 365 nulliparous and 127 multiparous women carrying singleton postdate pregnancies with unfavorable cervix were enrolled. Clinical characteristics and delivery outcome were analyzed in relation to fetal gender.Women carrying male fetuses showed higher rate of caesarean section than those carrying females, in both nulliparous and multiparous women. Moreover, women carrying male fetuses presented more frequently with (i) interval between induction of labor and delivery24 hours (P.0002); (ii) augmentation of labor after cervical ripening (P.0391); (iii) meconium-stained liquor (P.0126); and (iv) higher neonatal weight (P.0011) than those carrying females.Male fetuses are more likely to be associated with higher rates of cesarean section. In maternal fetal medicine, gender differences may add prognostic information on the delivery outcome in women induced for postdate pregnancy.

The aim of the present study was to evaluate: i) the rate of histologic chorioamnionitis in relation to the onset of labor and mode of delivery; ii) influence of clinical parameters on the risk of histologic chorioamnionitis in laboring women; iii) neonatal outcome in relation to histologic chorioamnionitis.A cohort study was conducted on 395 healthy women at term, with singleton uneventful pregnancy, of which 195 with spontaneous onset of labor and 200 with elective cesarean section. All placentas, collected after delivery, were examined for the diagnosis of histologic chorioamnionitis. Mode of delivery, presence of bacterial infection of placenta and membranes, maternal clinical parameters and neonatal outcome were recorded.The rate of histologic chorioamnionitis in women with spontaneous onset of labor was significantly higher than in those experiencing elective cesarean section (28.7% vs. 11.5%). Nulliparity and the duration of labor were independent variables associated with acute histologic chorioamnionitis. The presence of histologic chorioamnionitis did not affect neonatal outcome.The present study showed a highest rate of histological chorionamniositis in women delivering after spontaneous onset of term labor, although the mode of delivery either vaginally or by emergency cesarean section was not influenced by the presence of this pathological condition.

A new method is developed for preliminary design of hybrid rocket motors. A cooperative evolutionary method is used with an indirect approach to perform the coupled optimization of hybrid rocket motor and trajectory for a sounding rocket. Different propellant combinations are considered for a sounding rocket application (microgravity platform). The motor grain is cylindrical with a single circular port: blowdown and self-pressurized feeding systems are used. The eects of throat erosion are discussed, taking into account recent CFD evaluation of throat regression rate in nozzles of hybrid rocket motors. The method shows to be very promising with respect to other procedures and can be applied to complex applications such as launcher upper stages or landers. Due to the peculiarity of the present problem also a purely evolutionary approach is used to perform optimization. Even if the nested evolutionary/indirect method is able to find a better solution, the purely evolutionary method is able to find a near-optimal solution with a CPU time which is one order of magnitude lower

Preterm delivery (PTD) and pre-eclampsia (PE) represent the main "obstetric syndromes," caused by multiple conditions, and characterized by complex pathogenesis. Nonetheless, recent evidences attest that deregulation of the immune system and exaggeration of inflammatory processes, taking place in the feto-placental unit, represent common central mechanisms occurring in both diseases. Tertiary prevention represents the only intervention to prevent PTD, but its incidence is still increasing. Advances in secondary prevention, focusing on risk factors and possible markers, are necessary.