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As a Covid Hub in Emilia Romagna, we have experienced an increasing number of tracheostomized patients, prompting us to develop a standardized decannulation protocol for COVID-19 ARDS patients. Currently, there are no guidelines or protocols for decannulation in this population, and few studies have investigated the early outcomes of tracheostomy in COVID-19 patients, with no detailed analysis of the decannulation process. We recognized the importance of mutual reliance among our team members and the significant achievements we made compared to previous decannulation methods. Through the optimization of the decannulation process, we identified a clear, safe, and repeatable method based on clinical best practice and literature evidence. We decided to implement an existing standardized decannulation protocol, which was originally designed for severe brain-damaged patients, due to the growing number of COVID-19 patients with tracheostomy. This protocol was designed for daily practice and aimed to provide a uniform approach to using devices like fenestrated cannulas, speaking valves, and capping. The results of our implementation include: expanding the applicability of the protocol beyond severe brain-damaged patients to different populations and settings (in this case, patients subjected to a long period of sedation and invasive ventilation) early activation of speech therapy to facilitate weaning from the cannula and recovery of physiological swallowing and phonation early activation of otolaryngologist evaluation to identify organic problems related to prolonged intubation, tracheostomy, and ventilation and address proper speech therapy treatment activation of more fluid and effective management paths for decannulation with a multiprofessional team.

The philosophy behind Space 2.0 is causing shifts in the paradigms at the basis of launch vehicle design. The pursue for maximum efficiency at all costs is no longer targeted, environmental concerns become predominant, and flexibility in launch rates and launch readiness is highly valued. The drivers for launch vehicle design are therefore vastly different with respect to few decades ago. Such change requires a radical re-thinking of the tools and approaches used throughout the entire product development. To this aim, RUAG has worked towards establishing a multi-disciplinary framework for the development of payload fairings. In addition to coupling the conventional disciplines of structural mechanics and aerothermodynamics, the framework considers additional aspects such as the costs of materials and labor associated with manufacturing, assembling, and refurbishing space structures. The inputs for the study are volumetric constraints, topology and structural concepts, and trajectory profiles. The associated design parameters span all disciplines: geometry, materials choice, structural sizing and refurbishment strategy. The computational complexity associated with coupling structural, thermal and fluid domains has been tackled by developing several multidisciplinary frameworks characterized by different levels of fidelity and computational costs. Two models were used to assess the aerothermodynamics: a simplified, semi-empirical approach using DKR formulas, and a steady-state RANS-based CFD simulation relying on Spalart-Allmaras turbulence model and ideal gas assumptions. The latter was also used in combination with a surrogate model developed on the basis of the CFD-generated aerothermal database. The impact of these simplifications has been validated with comparisons against reference simulations, permitting to estimate the introduced errors. Crucially, these models exhibit sufficient accuracy to capture the relevant phenomena and their limited computational cost permits executing global, multi-disciplinary optimizations in few hours. With this holistic approach, leveraging interactions between different disciplines, a global optimum can be reached. The possibility to execute such complex assessments in the early phases of a new product development, and of evaluating different scenarios in an accurate and unbiased manner, enables to effectively support critical decisions and identify truly optimal designs. As all disciplines are considered and evaluated, the goals can be expressed in a high-level manner: the fairing must exhibit the necessary strength and stiffness while requiring the lowest lifecycle costs possible within the chosen design space. These goals are conflicting hence a multi-objective optimization has been employed, permitting to quantify the impact of the tradeoffs. In this respect, reusability opens new financial scenarios once different strategies for reuse/refurbishment are considered. Notably, the optimizer does not prioritize only low weight solutions as more traditional engineering practices tend to do. In fact, the identified extremes are heavier designs, surviving numerous flights with minimum refurbishments between launches (thus having lower lifecycle costs) and lighter structures requiring significant refurbishment after each flight. Ultimately, this information will be crucial for the Launcher Prime to identify, based on the specific cadence and cost-per-kg information, the ideal solution for their specific business case. Further, this framework allows the analysis of the effects of market trends on the overall costs and performance of the fairings.

ObjectiveThis study aimed to assess the olfactory recovery rates and patterns in a cohort of coronavirus disease 2019 positive patients, and to investigate the clinical predictors of poor long-term olfactory restoration.MethodsAn observational retrospective study was conducted on 146 patients between September 2020 and January 2021 at a tertiary referral hospital. Coronavirus disease 2019 positive patients with olfactory dysfunction were sent a modified version of the COVID-19 Anosmia Reporting Tool for Clinicians via e-mail.ResultsThe difference in median recovery time between complete recovery and incomplete or no recovery was statistically significant. On multivariate analysis, the only significant factor associated with incomplete or no recovery was anosmia duration.ConclusionAfter a mean time of 5.6 months from severe acute respiratory syndrome coronavirus-2 infection, persistent olfactory disorders were self-reported in 36.7 per cent of patients. Complete recovery was more likely to occur within 15 days. Given the high prevalence of coronavirus disease 2019, a large number of patients are expected to suffer from long-term olfactory morbidity.

The Covid-19 pandemic affected large part of Italy since February 2020; we, therefore, aimed to assess the impact of 2020 SARS-CoV-2 outbreak on telemedicine management of cardiovascular disease (CVD) in Italy. We analyzed data from three telemedicine dispatch centers, one located in Genoa, serving private clients (pharmacies, general practitioners), one in Brescia, serving pharmacies, and one in Bari, serving regional public STEMI network and emergency medical service in Apulia (4 million inhabitants). Demographic data and principal electrocardiogram diagnosis were collected and analyzed. Records from the time interval March 1, 2020 and April 1, 2020 were compared with the corresponding period in 2019. The comparative analysis of data shows a 54% reduction of telemedicine electrocardiogram transmission in Genoa telemedicine center (from 364 to 166), 68% in Brescia (from 5.745 to 1.905), 24% in Bari (from 15.825 to 11.716); relative reduction according to electrocardiogram diagnosis was 38% for acute coronary syndrome, 40% for other acute CVD in Genoa center, 24% for acute coronary syndrome, and 38% for other acute CVD in Bari. Male/female ratio remained substantially unchanged. A dramatic reduction of telemedicine access for CVD was observed during Covid-19 outbreak in March 2020 in Italy. The reduction was substantially consistent for all electrocardiogram findings, ACS, other acute CVD and normal.

BackgroundThe aim of this study was to assess by a census supported by the Italian Society of Cardiology (Società Italiana di Cardiologia, SIC) the present implementation of telemedicine in the field of cardiovascular disease in Italy.MethodsA dedicated questionnaire was sent by email to all the members of the SIC: data on telemedicine providers, service provided, reimbursement, funding and organisational solutions were collected and analysed.ResultsReported telemedicine activities were mostly stable and public hospital based, focused on acute cardiovascular disease and prehospital triage of suspected acute myocardial infarction (prehospital ECG, always interpreted by a cardiologist and not automatically reported by computerised algorithms). Private companies delivering telemedicine services in cardiology (ECGs, ambulatory ECG monitoring) were also present. In 16% of cases, ECGs were also delivered through pharmacies or general practitioners. ICD/CRT-D remote control was performed in 42% of cases, heart failure patient remote monitoring in 37% (21% vital parameters monitoring, 32% nurse telephone monitoring). Telemedicine service was public in 74% of cases, paid by the patient in 26%. About half of telemedicine service received no funding, 17% received State and/or European Union funding.ConclusionsSeveral telemedicine activities have been reported for the management of acute and chronic cardiovascular disease in Italy. The whole continuum of cardiovascular disease is covered by telemedicine solutions. A periodic census may be useful to assess the implementation of guidelines recommendations on telemedicine.

Summary In this report, we concisely describe recent innovations in the field of telemedicine applied to cardiovascular disease management achieved across Italy. Several networks based on pre-hospital triage of acute myocardial infarction by telemedicine electrocardiograms have been currently activated. Telemedicine support was also used for cardiovascular risk prevention and pre-participating screening of young non-competitive athletes, according to recent innovation in the legislative framework of sport medicine. Telemonitoring and telerehabilitation have been used for patients with chronic heart failure and even reimbursed in some regions.

The electronic Health Bubble, from now on eHB, was conceived 24 months ago as an eHealth information and communication technology system whose aim is to help the telehealth and tele-caregiving services dedicated to elders or to patients affected by a chronic disease Thanks to our cooperation with experts of health services and consultants for other NHSs, the eHB field of intervention has been enlarged by including all the tools, equipment, medical processes and a new social approach to cope with the second phase of the COVID-19 pandemia, after the lockdown © 2020 The Authors

"To quantify the costs for each situation at risk of sudden death identified by ECG screening using a Telecardiology system. ECGs received at the Telecardiology Center (Telemedico Srl, Genoa) for non-competitive sports, in the September-November 2018 period were analyzed. A total of 4360 non- competive athletes (2113 women, 48.5%) were evaluated between the ages of 3 and 40 years (mean ± SD: 17.3 ± 10.6). The average cost per ECG was € 9.2. An ECG pattern at risk of sudden death has been identified in 319 (7.3%) subjects, respectively 259 (5.9%) at low risk and 60 (1.4%) at medium-high risk. The cost of ECG screening to identify a risk situation was € 125.74 and rose to € 668.53 in the identification of a medium-high risk situation of sudden death. The low costs of the ECG performed by Telecardiology justifies its use in the screening of heart disease at risk of sudden death even in subjects practicing noncompetitive sports."

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Among the wide range of medical specialties in which telemedicine has been successfully applied, cardiology can be considered as one of the most important fields of application. Through the transmission of clinical data and the electrocardiogram, telecardiology allows access to a real-time assessment (teleconsultation) without any need to travel for both patient and cardiologist. This review discusses the impact of telecardiology in different clinical settings of application. Pre-hospital telecardiology has proved to be useful either in the clinical management of remote patients with acute coronary syndrome or in supporting the decision-making process of general practitioners. In the setting of in-hospital telecardiology, most of the applications refer to real-time echocardiography transmissions between rural small hospitals and tertiary care centres, particularly for the diagnosis or exclusion of congenital heart disease in newborns. Finally, many trials show that post-hospital telecardiology improves outcomes and reduces re-admissions or outpatient contacts in patients with heart failure, arrhythmias or implantable devices.

The objective of this study was to derive normal electrocardiographic values and to report the abnormal findings in a large contemporary European cohort of physically active children and young adolescents. In a 3-month period, data derived from subjects aged between 3 and 14 years and referred to the Telecardiology Centre (Genoa, Italy) for electrocardiogram (ECG) evaluation as pre-participation screening for non-competitive sports were analyzed. A total of 2060 ECGs were recorded. Of those, 1962 did not show any morphological abnormality and were used to derive normality ranges for heart rate, PR interval, QRS duration, corrected QT interval, and voltage of R wave as measured in V1 according to age and sex. Findings and clinical implications of the 98 ECGs with abnormal findings were also reported. Abnormal ECG findings were not as uncommon as expected in this population, being manifest in about 5 % of subjects. However, major ECG anomalies (diffuse negative T-waves, pre-excitation) were present in just ten subjects (0.5 %). Lower mean heart rate values (from 90–100 bpm at 3 years of age to 80–85 bpm at 14 years of age) and lower rates of the prevalence of negative T-waves in the V3 lead (from 55–60 % at 3 years of age to 8–10 % at 14 years of age) were observed with increasing age. This is the first work reporting derived normal limits and abnormal ECG findings in a large contemporary European cohort of children and adolescents aged 3–14 years practicing non-competitive sports. Clear pathological alterations are extremely uncommon, deserving, when encountered, additional examinations. Even in a physically active population, the common features of an adult athlete’s ECG are absent.

Genotoxic effects of ivermectin (IVM) and its commercial formulation ivomec® (IVM 1.0%) were studied on Aedes albopictus larvae (CCL-126™) cells by sister chromatid exchange (SCE) and single cell gel electrophoresis (SCGE) while cytotoxicity was determined by cell-cycle progression (CCP), proliferative rate index (PRI), mitotic index (MI), 3(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), and neutral red (NR) endpoints within a 1–250 µg mL−1 concentration range. While IVM and ivomec® did not markedly affect SCE frequencies, these agents induced DNA-strand breaks enhancing both slightly damaged and damaged cells at 25–50 and 5–50 µg mL−1 IVM and ivomec®, respectively. Both compounds exerted a delay in CCP and reduction of PRI at 10 µg mL−1. Cytotoxicity was observed at concentrations higher than 25 µg mL−1. A marked reduction of about 98% and 94% of MI compared to controls was noted with 25 µg mL−1 of IVM and ivomec®, respectively. NR and MTT assays revealed that both compounds induced a c...

The effects of ivermectin (IVM) and its commercial formulation ivomec (IVM 1.0%) were studied on Chinese hamster ovary (CHO(K1)) cells by several genotoxicity [sister chromatid exchange (SCE) and single cell gel electrophoresis (SCGE)] and cytotoxicity [cell-cycle progression (CCP), mitotic index (MI), proliferative replication index (PRI), 3(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), and neutral red (NR)] bioassays within the 1.0-250 microg/ml concentration-range. While IVM and ivomec did not modified SCE frequencies, they induced DNA-strand breaks revealed by SCGE. An enhancement of slightly damaged cells and a decrease in undamaged cells were observed in IVM-treated cultures with 5.0-50.0 microg/ml. In ivomec((R))-treated cells, while an increase in slightly damaged cells was induced with 5.0-50.0 microg/ml, the damaged and undamaged cells increased and decreased only with 50.0 microg/ml. Both compounds exerted a delay in CCP and a reduction in PRI when 25.0 microg/ml was employed whereas cytotoxicity was observed at higher concentration than 50.0 microg/ml. No MI alteration was observed with 1.0-10.0 and 1.0-5.0 microg/ml of IVM and ivomec, respectively. A concentration-related trend to an increase in MI was achieved within 1.0-10.0 microg/ml. An increase in the MI was induced in 10.0 microg/ml ivomec-treated cultures. A marked reduction of about 89% and 62% in regard to controls was observed with 25.0 microg/ml of IVM and ivomec, respectively. NR and MTT assays revealed a cell growth inhibition when 0.25-250.0 microg/ml of both compounds was employed. The results highlighted that IVM and ivomec exert both genotoxicity and cytotoxicity in mammalian cells in vitro, at least in CHO(K1) cells.

The in vitro geno- and cytotoxicity exerted by the N-methylcarbamate pesticide carbofuran (CF) and its commercial formulation furadan (F) were studied in Chinese hamster ovary (CHO(K1)) cells by several bioassays for both genotoxicity (e.g., the sister chromatid exchange (SCE) and micronuclei (MNi) frequencies), and cytotoxicity (e.g., cell-cycle progression, mitotic index (MI), 3(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), and neutral red (NR)). Both CF and F activities were tested within the range of 5-100 microg/ml. CF within a 10-100 microg/ml concentration-range induced a significant dependent increase of SCE frequency and MNi over control values. At the same concentration-range, F increased significantly the SCE frequencies over control values although in a non-dependent manner while only an enhanced frequency of MNi was found in those 50 microg/ml-treated cultures. No binucleated cytokinesis-block cells were found in 100 microg/ml F-treated cultures. The NDI index revealed a delay in the onset of cell-division with 50 and 100 microg/ml of CF and F, respectively. The delayed rate of nuclear division induced by 100 microg/ml of F was higher than that induced by an equal concentration of CF. CF and F induced both a significant concentration-dependent delay in cell-cycle progression and a decrease in the proliferative replication index within 5-100 microg/ml and 50-100 microg/ml concentration-range, respectively. Decreased cell viability was found in up to 26% and 47% in 100 microg/ml CF- and F-treated cultures, respectively. The NR and MTT assays revealed a clear cell growth inhibition when concentrations of 50 and 100 microg/ml of either CF or F were employed. Accordingly, the results highlight that CF by itself and F, even in a greater extend exerts both genotoxicity and cytotoxicity in mammalian cells in culture, at least in CHOK1 cells.

We examined the interaction between ephrins and metabotropic glutamate (mGlu) receptors in the developing brain and cultured neurons. EphrinB2 coimmunoprecipitated with mGlu1a receptors, in all of the brain regions examined, and with mGlu5 receptors in the corpus striatum. In striatal slices, activation of ephrinB2 by a clustered form of its target receptor, EphB1, amplified the mGlu receptor-mediated stimulation of polyphosphoinositide (PI) hydrolysis. This effect was abolished in slices treated with mGlu1 or NMDA receptor antagonists but was not affected by pharmacological blockade of mGlu5 receptors. An interaction among ephrinB2, mGlu1 receptor, and NMDA was supported by the following observations: (1) the NR1 subunit of NMDA receptors coimmunoprecipitated with mGlu1a receptors and ephrinB2 in striatal lysates; (2) clustered EphB1 amplified excitatory amino acid-stimulated PI hydrolysis in cultured granule cells grown under conditions that favored the expression of mGlu1a receptors; and (3) clustered EphB1 amplified the enhancing effect of mGlu receptor agonists on NMDA toxicity in cortical cultures, and its action was sensitive to mGlu1 receptor antagonists. Finally, fluorescence resonance energy transfer and coclustering analysis in human embryonic kidney 293 cells excluded a physical interaction between ephrinB2 and mGlu1a (or mGlu5 receptors). A functional interaction between ephrinB and mGlu1 receptors, which likely involves adaptor or scaffolding proteins, might have an important role in the regulation of developmental plasticity.

Objective: To assess the feasibility of using contrast enhanced colour Doppler echocardiography to determine left ventricular (LV) mass and to compare its accuracy with LV mass obtained by magnetic resonance imaging (MRI). Methods: Images were acquired in the short axis plane of the heart, derived from coronal and sagittal scout views and double oblique angulation. The LV mass was calculated by two methods: Simpson’s rule and the area–length method. Levovist (Schering AG, Berlin, Germany) 2.5 g was given by slow intravenous bolus or infusion over about 45 seconds for contrast imaging. LV images were captured in the apical two chamber, four chamber, and three chamber views. Each contrast harmonic colour Doppler image was converted to a cavity-only image by simple image mathematics. Results: 27 (77.1%) of the patients (mean (SD) age 66.2 (8.9) years) were men. There was a mean (SD) interval of 6.6 (8.6) days (range 0–27 days) between echocardiography and MRI. The mean (SD) LV mass determined by MRI Simpson’s rule method was 171.0 (52.4) g (range 105.1–318.7 g). The mean LV mass (SD) determined by the echocardiographic Simpson’s rule method was 178.2 (47.0) g (range 112.6–307.6 g). The mean (SD) MRI area–length LV mass was 187.3 (64.5) g (range 109.0–393.6 g). The linear regression correlation between LV mass determined by MRI Simpson’s and echocardiographic Simpson’s methods was excellent (y = 1.022x, R 2 = 0.986) with a mean (SD) difference of 7.20 (20.9) g. The linear regression correlation between the MRI area–length LV mass and MRI Simpson’s LV mass was excellent (y = 1.101x, R 2 = 0.989) with a mean (SD) difference of 16.3 (22.3) g. Conclusions: LV mass may be obtained reliably by contrast enhanced colour Doppler and two dimensional echocardiography. The contrast Doppler method accurately determines LV mass with excellent agreement with the MRI technique.

In the present paper, five different resin systems (epoxy, vinylester, ortophtalic, isoneophentilic and polyester) were evaluated in order to assess their proprieties in the manufacturing of a rib hull by means of infusion process. Their performances were also compared to the current system (polyester for hand lay-up). Laminates were produced under monitored conditions (vapor emissions, polymerization periods and polymerization temperatures) and then characterized by means of flexural and interlaminar shear tests. Cinque sistemi di resina (epossidico, vinilestere, poliestere, poliestere ortoftalico e poliestere isoneopentilico) sono stati utilizzati nella produzione tramite la tecnologia ad infusione di un laminato rinforzato con fibre di vetro rappresentativo dello scafo di un gommone. I laminati così ottenuti sono stati caratterizzati meccanicamente tramite prove di flessione e taglio interlaminare e i relativi risultati confrontati con quelli ottenuti da un laminato di riferimento ottenuto per stratificazione manuale di resina poliestere e identico tessuto di rinforzo. Tutti i laminati sono stati prodotti in condizioni monitorate registrando l’emissione dei gas volatili e i tempi richiesti dal processo.

Real time monitoring of hadrontherapy beam intensity and profile is a critical issue for the optimisation of dose delivery to carcinogenic tissue, patient safety and operation of the accelerator complex. For this purpose an innovative beam monitor, SLIM (secondary electron emission for low interception monitoring) is being developed in the framework of the EC-funded SUCIMA (silicon ultra-fast cameras for electrons and gamma sources in medical application) project The detector system is based on the secondary emission of electrons by a non-perturbative, sub-micron thick Al foil placed directly in the extracted beam path. The secondary electrons, accelerated by an electrostatic focusing system, are detected by a monolithic silicon position-sensitive sensor, which provides the beam intensity and its position with a precision of 1 mm at a 10 kHz frame rate. The results of the laboratory tests of the first system prototype with thermoionic electrons emitted from a hot Tungsten wire are presented together with the measurements performed on a low intensity hadron beam at the Cyclotron of the Joint Research Centre in Ispra.

In this paper the Fokker-Planck equation, which takes into account the medium absorption and the Maxwellian behavior of the field particles at low energy for Coulomb interactions is obtained. The analytical solution of the stationary distribution function is obtained in both angle and velocity variables. In particular the electron distribution for electron-ion collisions has been obtained using this diffusion approximation for beam and isotropic sources. If the absorption is neglected the solution recovers the classical stationary Maxwell distribution. For low absorption rates the solution shows a typical slowing down spectrum for high energy and a Maxwellian-like distribution at thermal energy. For moderate and high absorption rates the test particles do not reach the thermal equilibrium and the Maxwell distribution at low energies does not appear.

Adhesively bonded stiffened panels can provide the best damage tolerance proprieties if compared to the conventional integral and riveted panels. Bonded panels can, indeed, take big advantage by the long fatigue crack propagation periods through the skin underneath the bonded stiffeners. To exploit the aforementioned benefit of bonded panels for safe and weight effective structures, reliable prediction models taking into account the fatigue crack propagation under the bonded stiffeners have to be provided. A well known analytical literature model, developed for the damage tolerance characterization of patch repairs, was implemented and subsequently validated by fatigue crack propagation test results concerning wide stiffened panels. The implemented model confirmed to be a reliable and effective method for the damage tolerance design optimization of thin-walled bonded structures.

STREAM is the acronym of a new concept of mass transit system designed and developed by Ansaldo Trasporti S.p.A. to provide an efficient solution to rubber‐tyred transportation problems in urban areas. One of STREAM's most distinctive feature is the power supply system, which uses a magnetic lift contact line embedded in the road surface to deliver traction power and to provide operating and control information. In this paper the field and the current flow analyses of this buried feeding track are presented and discussed. Analyses are aimed at determining the highest values of accessible voltages on the ground under different environmental and operating conditions. Results provided by a numerical simulation of the 3D model representing the feeding track allow us to identify the most critical conditions and to verify the safety and reliability of the system.

The Large Hadron Collider (LHC) nominal luminosity is 10 34 cm −2 s −1 , but special runs at 10 28 cm −2 s −1 are also foreseen. In order to cover a luminosity dynamic range of six orders of magnitude, we have studied a new concept of luminosity monitor based on a double mode detector, working as a secondary emission counter at the highest luminosity and as an ionisation chamber at lower levels. We present the description of the device and the results obtained during tests at the CERN PS and SPS beams.

Cor triatriatum sinistrum is a rare congenital heart disease usually diagnosed in symptomatic children. Symptoms depend on the degree of obstruction to pulmonary venous return with pulmonary hypertension and other associated abnormalities. Persistent left superior vena cava is quite a common congenital heart disease (about 0.5% in healthy populations). It should be suspected every time a dilated coronary sinus is detected at the echo examination. Transthoracic and transoesophageal examinations visualize the site and the size of the fibrous membrane as well as the degree of obstruction, and allow the evaluation of pulmonary pressures that are very important clues for prognosis and therapy. This case report describes the clinical signs and the diagnostic ultrasound findings evaluated in comparison with magnetic resonance imaging, a well-defined gold standard in heart disease of this uncommon congenital association.

Telemedicine is the provision of health care services, through the use of information and communication technology, in situations where the health care professional and the patient, or 2 health care professionals, are not in the same location. It involves the secure transmission of medical data and information, through text, sound, images, or other forms needed for the prevention, diagnosis, treatment, and follow-up of a patient. First data on implementation of telemedicine for the diagnosis and treatment of acute myocardial infarction date from more than 10 years ago. Telemedicine has a potential broad application to the cardiovascular disease continuum and in many branches of cardiology, at least including heart failure, ischemic heart disease and arrhythmias. Telemedicine might have an important role as part of a strategy for the delivery of effective health care for patients with cardiovascular disease. In this document the Working Group on Telecardiology and Informatics of the Italian Society of Cardiology intends to remark some key-points regarding potential benefit achievable with the implementation of telemedicine support in the continuum of cardiovascular disease.

Daily diaries are a useful way of measuring fluctuations in pain-related symptoms. However, traditional diaries do not assure the gathering of data in real time, not solving the problem of retrospective assessment. Ecological momentary assessment (EMA) by means of electronic diaries helps to improve repeated assessment. However, it is important to test its feasibility in specific populations in order to reach a wider number of people who could benefit from these procedures.The present study compares the compliance and acceptability of an electronic diary running on a smartphone using a crossover design for a sample with a specific pain condition, fibromyalgia and low familiarity with technology. Forty-seven participants were randomly assigned to one of two conditions: (1) paper diary - smartphone diary and (2) smartphone diary - paper diary, using each assessment method for 1 week.The findings of this study showed that the smartphone diary made it possible to gather more accurate and complete ratings. Besides, this method was well accepted by a sample of patients with fibromyalgia referred by a public hospital, with an important proportion of participants with low level of education and low familiarity with technology.The findings of this study support the use of smartphones for EMA even in specific populations with a specific pain condition, fibromyalgia and with low familiarity with technology. These methods could help clinicians and researchers to gather more accurate ratings of relevant pain-related variables even in populations with low familiarity with technology.

OBJECTIVES The purpose of this study was to verify in a long-term follow-up whether frequent monomorphic right ventricle extrasystoles may progress to arrhythmogenic right ventricular dysplasia (ARVD). BACKGROUND Frequent monomorphic right ventricle extrasystoles are generally considered benign. However, in patients with this pattern, cardiac magnetic resonance (MR) has recently shown anatomical and functional abnormalities of the right ventricle. METHODS Sixty-one patients who had been classified by noninvasive examinations as having frequent idiopathic right ventricle ectopy were contacted after 15 ± 2 years (12 to 20) and submitted to clinical examination, electrocardiogram (ECG), Holter monitoring, stress test, signal averaged ECG, echocardiography and, in 11 patients, cardiac MR. The primary end point was to ascertain the presence of cases of sudden death or progression to ARVD. RESULTS At the end of the follow-up, 55 patients were alive; six died, none of sudden death; eight stated to be well but refused further examinations. The 47 patients examined had normal ECG; in 24 patients (51%), extrasystoles were no longer present at Holter monitoring; late potentials were present in up to 15% of the patients; the right ventricle was normal at echocardiography. In 8 of 11 patients (73%), cardiac MR showed focal fatty replacement and other abnormalities of the right ventricle. CONCLUSIONS In this long-term follow-up study, no patient died of sudden death nor developed ARVD; two-thirds of the patients were asymptomatic, and, in half of the patients, ectopy had disappeared. Focal fatty replacement in the right ventricle was present in most.

Aim of our work was to validate magnetic resonance angiography (MRA) in detecting occlusion/patency of coronary artery bypass grafts. Twenty patients with previous history of bypass surgery and recurrent episodes of chest pain were enrolled. Two patients could not be studied (claustrophobia, erratic breathing). Thus, 18 patients with 51 bypasses were examined using a navigator echo sequence: 21 arterial grafts (six sequential) and 30 saphenous vein grafts (five sequential). All patients had undergone contrast conventional angiography 3-15 days before MRA. The magnetic resonance (MR) data set was analyzed by two independent readers blinded to the results of conventional angiography (occlusion of 12 of 51 grafts). At magnetic resonance, two bypasses of the posterior descending artery, patent at conventional angiography, could not be visualized because of imaging slab malpositioning. Interobserver concordance was 96% (47/49). Magnetic resonance and conventional angiography provided identical answers in 47 out of 49 (96%) of the examined grafts. Eleven out of 12 occluded grafts and 36 out of 37 patent grafts were correctly identified with MR. As far as occlusion is concerned, the sensitivity of MR was 91%, the specificity 97%. To summarize, a 30 min outpatient MR examination is highly reliable in determining occlusion/patency of arterial and venous, single and sequential bypasses.

We reevaluated the magnetic resonance (MR) examinations of 38 healthy volunteers (control group, CG) and of 124 patients with RV arrhythmia with left bundle branch block (LBBB) morphology: 45 with episodes of RV sustained tachycardia and of polymorphic RV premature beats (RVST-PPB group); 36 with only RV outflow tract sustained or not sustained tachycardia (RVOTT group); 43 with RV monomorphic premature beats (RVMPB group). All the examinations were reevaluated in a blinded fashion for detecting myocardial adipose replacement (AR) and wall bulges or aneurysms. In RVST-PPB patients, no AR was observed in 9%; 1 RV region involvement, 0%; 2 regions, 4%; ≥ 3 regions, 87%; left ventricle (LV), 15%. RVOTT patients: 28%, 53%, 14%, 5%, and 0%, respectively. RVMPB patients: 33%, 46%, 19%, 2%, and 0%, respectively. In CG, AR was observed in 11% (in RV outflow tract). RV bulges were detected in 75% of RVST-PPB , 39% of RVOTT, and 14% of RVMPB patients, none of the CG; RV aneurysms in 33% of RVST-PPB patients, none of RVOTT patients, RVMBP patients, and CG. A significant difference among groups for RV and LV AR as well as RV bulges and aneurysms was found (p < 0.0001). In the direct comparisons, significant differences were found for: disease duration (RVST-PPB vs. RVMPB, p = 0.0396); RV AR (all the patients groups vs. CG, RVST-PPB vs. RVOTT or RVMPB, p < 0.0001); RV aneurysms (RVST-PPB vs. CG. RVST-PPB vs. RVOTT or RVMPB, p < 0.0002); bulges (all comparisons, p < 0.0174). AR is confirmed as a structural substrate in RV arrhythmias. Number and extension of MR abnormalities are correlated to different degrees of RV arrhythmias.

This paper gives an overview of some stochastic optimization strategies, namely, evolution strategies, genetic algorithms, and simulated annealing, and how these methods can be applied to problems in electrical engineering. Since these methods usually require a careful tuning of the parameters which control the behavior of the strategies (strategy parameters), significant features of the algorithms implemented by the authors are presented. An analytical comparison among them is performed. Finally, results are discussed on three optimization problems.

The increasing overexploitation of water resources is observed on a global scale in the previous decades; this trend involves the coastal regions of Mediterranean Basin (Van Beynen et alii, 2012). As an effect of increasing groundwater discharge from coastal aquifers, the phenomenon of seawater intrusion is becoming a serious problem for most of the coastal aquifers, especially in the Mediterranean area (COST, 2003; COST, 2005). The aim of this paper is to present the modeling of a coastal porous aquifer located in the complex plain of Sibari (Southern Italy), a plain deeply modified as an effect of reclamation works realized after thirties. The model was implemented using piezometric historical data (from thirties) to establish the effect of seawater intrusion when the well discharge was negligible (natural conditions), the modification in subsequent decades, to be used for forecasting purpose and for evaluate the evolution of groundwater resource. The area actually represents a landscape with anthropic equilibrium based on the works of a land reclamation project (1960s-1990s). Study area is about 365 km2 for a coastline of about 35 km, about which an hydrogeological conceptual model was defined. The area can be conceptualized into three hydrogeological complexes (from the top): sand complex, a clay complex and a sand and conglomerate complex, constituting the deep aquifer, the bottom of which is not well-defined. Shallow aquifer is predominantly fed by direct rainwater infiltration. Deep aquifer is fed by outflows of the mountainous aquifers as the case of limestone aquifer of Pollino Mount,and of shallow granitic aquifer of the Sila massif (Guerricchio and Melidoro, 1975). The maximum piezometric levels of the deep aquifer are equivalent to approximately 40 m asl, so in some areas it presents artesian feature. The computer codes selected for numerical groundwater modelling were MODFLOW (McDonald and Harbaugh, 1998) and SEAWAT (Guo and Langevin, 2002). This groundwater flow modelling is based on the concept of a equivalent homogeneous porous medium by which it is assumed that the real heterogeneous aquifer can be simulated as homogeneous porous media within cells or elements (Anderson, 2002). The modeled aquifer area was uniformly discretized, using Peclet number, into a finite difference grid of 97,735 cells of 240 m x 350 m. For the vertical discretization, model was divided into five layers of variable thicknesses, defined on the basis of a multi-methodological geological survey. Climatic, hydrological and agricultural data were processed to defines inputs for the numerical model based on the variable-density flow. An hydrological balance using monthly and annual of 13 thermo-pluviometric stations falling in the study area, in the time period 1930-1975, was done (Polemio and Casarano, 2008, Polemio et alii, 2013). The numerical model was calibrated with PEST code with a correlation coefficient equal to 0,90. Preliminary results of steady flow and of groundwater salinity spatial are now available and shows it is not sustainable in the case of shallow aquifer and it can be improved in the case of deep aquifer.

To prepare dense bunches of lead ions for the LHC it has been proposed to accumulate the 4.2 MeV/u linac beam in a storage ring with electron cooling. A series of experiments is being performed in the low-energy ring LEAR to test this technique. First results were already reported at the Beam Crystallisation Workshop in Erice in November 1995. Two more recent runs to complement these investigations were concerned with: further study of the beam lifetime; the dependence of the cooling time on optical settings of the storage ring and on neutralization of the electron beam; and tests in view of multiturn injection. New results obtained in these two runs in December 1995 and in April 1996 will be discussed in this contribution.

This report presents results of experiments performed between 1994 and 1996 by a CERN/JINR collaboration, aimed to study the problem of the generation of intense electron beams whose space charge is neutralised by the residual gas ions. The problem is related to the development of electron cooling methods. The large space charge potential for high density electron beams is a significant drawback for the cooling process. In order to reduce this effect, an electron beam neutralisation system has been implemented on the LEAR cooler and the JINR test bench. In this paper we briefly discuss the physics of the neutralisation process, technological aspects of neutralisation, the measurement techniques and the results.

A large space-charge is detrimental to the cooling process of a dense beam. Generation of a neutralised electron beam is restricted by beam-drift instability. To suppress this instability, active methods are used: a kicker with a transverse electric field (shaker) and longitudinal electrodes placed in the vacuum chamber and in the gun region expel secondary electrons. Results of experiments dedicated to the development of beam stabilisation on the JINR test bench and in the electron cooling system at LEAR are discussed.

A proposal for benchmark problems to test electromagnetic optimization methods, relevant to multiobjective optimization of a solenoidal superconducting magnetic energy storage with active and passive shielding is presented. The system has been optimized by means of different optimization procedures based on the global search algorithm, evolution strategies, simulated annealing and the conjugate gradient method, all coupled to integral or finite element codes. A comparison of results is performed and the features of the problem as a test of optimization procedures are discussed.

The aim of our study was to define cardiac morphological and functional abnormalities of right ventricular dysplasia by magnetic resonance imaging. Twenty-two healthy volunteers (age, 37.7 ± 14.2 years) free of cardiac or respiratory diseases (group I) and 12 patients (age, 41.9 ± 15.8 years) with clinical, electrophysiological and cineangiographic diagnosis of right ventricular dysplasia (group II) underwent magnetic resonance imaging at 0.2 Tesla. End-diastolic diameter, trabecular disarray and segmental wall motion abnormalities were evaluated for the right ventricle as were adipose replacement and fractional shortening for both ventricles. The right ventricular end-diastolic diameter was significantly enlarged in group II (P=0.0023). Right ventricular trabecular disarray was mild in two group I subjects, and moderate in seven and massive in five group II patients. Right ventricular systolic bulges were found in seven group II patients, aneurysms in five. Excellent agreement was found between magnetic resonance imaging and cineangiography for bulges, aneurysms and tricuspid regurgitation (P

The plasma generated in a spherical pinch device consists of a linear discharge along the diameter of a spherical vessel and of an implosion that compresses the linear plasma. Because the linear di...

Fil: Molinari, Gabriela Beatriz. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas; Argentina

The purpose of this study was to isolate new and potentially better polyhydroxyalkanoate (PHA)-producing bacteria, with a view to obtaining high yields from inexpensive substrates like glycerol, a major by-product of the biodiesel process.Eleven new plant original isolates of the genus Massilia, a poorly studied lineage within the Betaproteobacteria, were isolated and characterized. Two isolates, 2C4 and 4D3c, could not be assigned to a validated Massilia species and probably represent new species. Six isolates were found to produce poly-3-hydroxybutyrate (P3HB) when cultured with glucose or glycerol as carbon source. Isolate 4D6 accumulated up to 50 wt% of cell mass as polyhydroxybutyrate (PHB) when grown on glycerol.The phyllosphere may be a good source of bacteria unrelated or weakly related to human/animal pathogens for screening for new PHA producers for industrial application. Isolate 4D6 was capable of accumulating particularly high levels of PHB from glycerol.With the increase in biodiesel production, which generates increasing amounts of glycerol as a by-product, there is a major interest in exploiting this compound as feedstock for the synthesis of interesting products, like biopolymers, such as PHA. The new Massilia sp. 4D6 isolate described in this study may be a useful candidate as a cell factory for the industrial production of PHA from glycerol.

Abamectin and Ivermectin are 2 closely related members of the Avermectin family of 16-membered macrocyclic lactones derived from the actinomycete Streptomyces avermectinius which exhibit extraordinary anthelmintic activity. They are used worldwide in veterinary and human medicine as well as in agriculture. In the present review we summarized the results published so far for estimating the genotoxicity and cytotoxicity exerted by both compounds in several cellular systems. Although both compounds do not induce in vitro and in vivo gene mutations in either bacterial or mammalian cells, there is no concrete evidence of a clear clastogenic effect exerted both in vitro and in vivo in mammalian cells. However, reports indicating that both anthelmintic agents are able to induce single DNA-strand breaks in vitro and inhibit cell growth either in vitro or in in vivo bioassays, are scarce. Taking into account the similarity of the genotoxicity and cytotoxicity exerted by both antibiotics, and that only Abamectin has been classified so far as a class II toxicity pesticide by the EPA, the necessity of reconsideration for a further hazard evaluation of Ivermectin by an international regulatory agency(ies) is strongly recommended.

The magnetic spectrometer and charged particle tracking system used in Fermilab experiment 687 to study the photoproduction and decay of charm particles are described in detail. The photons are produced by a wideband electron beam which can operate at energies up to 600 GeV/ c . The spectrometer consists of a high resolution silicon microstrip detector, a large aperture dipole magnet, proportional chambers, a second large aperture dipole, and more proportional chambers. Three multi-cell threshold Cherenkov counters provide charged particle identification. The tracking system is capable of resolving the secondary decay vertices of charm and beauty mesons and baryons from the primary interaction vertex. It also determines the invariant mass of the multibody final states of particles containing heavy quarks with excellent resolution. The particle identification system allows one to identify kaons and protons present in these final states clearly. This collection of detectors produces very clean signals for charm particles and permits one to make many cross checks of the apparatus. The performance is illustrated for a variety of charm signals. Of particular interest is a description of the tracking through the silicon microstrip detector and its use in isolating downstream decay vertices. Two complementary approaches to the reconstruction of secondary decay vertices are presented and insight is gained by comparing their strengths and weaknesses.

The authors present a vector environment, built around a reconfigurable data structure and a library of solver routines, devised for an efficient exploitation of vector features of computers to speed up magnetic analysis codes. The tests performed for the definition of the environment are reported and commented on, and the final results showing significant speedups in real magnetic analysis cases on a selected vector machine are presented and discussed. It is concluded that the use of the vector environment defined by the ITPLUS storage and the APPEAL library of solver routines has proven practical and successful as a way to allow users to efficiently exploit vector architectures, while protecting them from the need of large recoding efforts and of deep knowledge in computer architecture features and performances. >

The present paper describes a direct method of obtaining are expression of the distribution function of charged particles which diffuse in a plasma. The distribution function in velocity, angle and time is presented starting from the Fokker-Planck equation. Temperature, average velocity and energy of charged particles (electron or ions) have also been calculated as functions of time. © 1992 Società Italiana di Fisica.