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The paper describes a study on the liquefaction potential of flood defences along the rivers running through the delta area of the Netherlands. The study concentrates on an area south of Rotterdam. The dykes used as primary flood defences protect an urban, rural, and industrial area of 102,400 ha. In this paper the data from more than 4200 Cone Penetration Tests, CPT traces are used to assess more than 200 km of dykes. The pore pressure, u2 data is analysed, then used to separate the material response into contractive and dilative zones. Using the separation of liquefaction susceptible soils, and geometry of the riverbed a regional hazard map is generated. The choices for the data visualisation and their effect on the generated map are discussed and presented. The final liquefaction susceptibility map is used by the water governing authority Waterschap Hollandse Delta as a decision-making tool to improve the efficacy of liquefaction hazard assessment such as the location and return period of bathymetry measurements, and the scale of site-and laboratory investigation.

Understanding how soil varies spatially is necessary in order to accurately quantify the reliability of geotechnical infrastructure. For long linear infrastructure such as flood embankments, incorporating vertical and horizontal scales of fluctuation can have a significant impact on stability assessments. This paper presents preliminary results and discussion from a field test designed to determine the vertical and horizontal scales of fluctuation of a Croatian flood embankment. A series of 15 CPTUs were carried out over a 200m length of the embankment with a Multi-channel Analysis of Surface Waves (MASW) survey done on the same section. CPT spacing was designed specifically to determine horizontal variation with multiple CPTs carried out in close proximity to each other. There was significant variation in soil stratigraphy over the embankment section with pockets of increased strength and stiffness showing up in the MASW and CPT results. This paper discusses dealing with horizontal correlation in challenging deposits and presents initial findings from the underlying sand layer.

On October 24, 2018 the Italian Constitutional Court held that the absolute ban on assisted suicide provided for by Art. 580 of the Italian criminal code is unconstitutional under certain conditions. On the one hand, this Article «serves the purpose of protecting interests that are worthy of protection by the legal system» (p. 6), such as life and the protection of weak and vulnerable people. On the other hand, in specific situations like the one in the DJ Fabo's case, the assistance to die «may seem to the sick person to be the only way out of being kept alive by artificial methods that are no longer desired, and which he or she has the right to refuse» (p. 8). In particular the Court has set four conditions under which the absolute prohibition of suicide assistance can turn to be unconstitutional, and namely in those cases in which «assisted persons are (a) affected by an illness that is incurable and (b) causes physical or psychological suffering, which they find absolutely intolerable, and who are (c) kept alive by means of life support treatments, but remain (d) capable of making free and informed decisions» (p. 8). In such a situation the absolute ban on suicide assistance obliges the patient to «undergo a slower process, in a scenario that corresponds less well to the patient's vision of a dignified death and which is marked by more pain and suffering for the people close to the patient» (p. 9). Being aware of the impact and scope of its remarks and of the values at stake, the Court decided not to immediately declare the unconstitutionality of art. 580 of the criminal code, but rather to postpone the official discussion of the questions of constitutionality to the hearing on September 24, 2019. In a «“collaborative” and “dialogical”» perspective, the Court thus called upon the Parliament to regulate a subject which is at the «intersection between values of primary importance, the balancing of which presupposes, in a direct and immediate way, choices that the legislator is, first of all, authorized to make» (p. 11). As already known, the Parliament has not passed a law on assisted suicide so far; the Court will therefore decide at the hearing on September 24 how to amend what has already defined as a «unconstitutional regulatory scheme» (p. 11). Against this background and considering the reasoning of the Court in December 2018, the Authors of this Document - legal scholars and professionals with long-standing experience in these topics - decided to open an interdisciplinary discussion on the main legal end-of-life issues. Starting from the Order but without limiting the analysis to it, the Working Group met on a monthly basis at the University of Trento and with the support of the Jean Monnet BioTell Project, addressing and studying in depth the large number of tricky issues raised by the Order of the Constitutional Court and linked to a possible Parliament decision. The results of these discussions have been gathered and developed in the Document together with some operational proposals, offering a “constitutionally oriented” and scientific grounded understanding of end-of-life issues. The Working Group thus aimed to contribute to the public debate suggested by the Court, which must be truly informed and plural due to the impact on institutional choices. On September 25, the Constitutional Court ruled the impunity of those who foster the suicide under the conditions expressed in the Court press release reporting the Court's judgment.

Background: Childhood-onset dystonia is often genetically determined. Recently, KMT2B variants have been recognized as an important cause of childhood-onset dystonia. \ud Objective: To define the frequency of KMT2B mutations in a cohort of dystonic patients aged less than 18 years at onset, the associated clinical and radiological phenotype, and the natural history of disease. \ud Methods: Whole-exome sequencing or customized gene panels were used to screen a cohort of sixty-five patients who had previously tested negative for all other known dystonia-associated genes.\ud Results: We identified fourteen patients (21.5%) carrying KMT2B variants, of which one was classified as a Variant of Unknown Significance (VUS). We also identified two additional patients carrying pathogenic mutations in GNAO1 and ATM. Overall, we established a definitive genetic diagnosis in 23% of cases. We observed a spectrum of clinical manifestations in KMT2B variant carriers, ranging from generalized dystonia to short stature or intellectual disability alone, even within the same family. In 78.5% of cases, dystonia involved the lower limbs at onset, with later caudo-cranial generalization. Eight patients underwent pallidal Deep Brain Stimulation with a median decrease of BFMDRS-M score of 38.5% in the long term. We also report four asymptomatic carriers, suggesting that some KMT2B mutations may be associated with incomplete disease penetrance. \ud Conclusions: KMT2B mutations are frequent in childhood-onset dystonia and cause a complex neurodevelopmental syndrome often featuring growth retardation and intellectual disability as additional phenotypic features. A dramatic and long-lasting response to Deep Brain Stimulation is characteristic of DYT-KMT2B dystonia.

In Italy, chronic pain affects more than a quarter of the population, whereas the average European prevalence is 21%. This high prevalence might be due to the high percentage of Italian people who do not receive treatment, even after the passing of law 38/2010 (the right to access pain management in Italy), which created a regional network for the diagnosis and treatment of noncancer chronic pain. Italian epidemiologic studies on chronic pain are scanty, and this observational, multicenter, cross-sectional study is the first to investigate the clinical characteristics of patients who attended the pain management clinics in the Latium Region, Italy, for the management of their noncancer chronic pain. A total of 1,606 patients (mean age 56.8 years, standard deviation ± 11.4), 67% women, were analyzed. Severe pain was present in 54% of the sample. Women experienced pain and had it in two or more sites more often than men (57% vs. 50%, p = .02; and 55.2% vs. 45.9%, p .001, respectively). Chronic pain was musculoskeletal (45%), mixed (34%), and neuropathic (21%). In more than 60% of the cases, chronic pain was continuous, and in 20% it had lasted for more than 48 months; long-lasting pain was often neuropathic. Low back (33.4%) and lower limbs (28.2%) were the main locations. Severe intensity of pain was statistically significantly associated with female gender (odds ratio [OR] 1.39; 95% confidence interval [CI] 1.06-1.84); with International Classification of Diseases, Ninth Revision, codes for chronic pain syndrome (OR 2.14; 95% CI 1.55-2.95); and with continuous pain (OR 2.02; 95% CI 1.54-2.66). Neuropathic pain and mixed pain were significantly associated with number of sites, and a trend seemed to be present (OR 2.11 and 3.02 for 2 and 3 + sites; 95% CI 1.59-2.79 and 2.00-4.55, respectively).

Knowledge of the fines content is necessary for all soil classification systems and an important factor in the evaluation of soil strength in liquefaction and seismic settlement analysis. This paper presents the application of cone penetration test, CPT data for estimating the soil fines content. The correlation can be used either as a first estimate of fines content (for example in the offshore environment) or to provide statistical information on the variation of fines content within a given area of interest (e.g. for a regional liquefaction study). The paper shows how field and laboratory test data were used with a neural network to correlate the CPT results and the fines content. Data from five site investigation locations across Northern Croatia were utilised. Verification of the approach is performed using field and lab test data from the Veliki vrh landslide.

The evaluation of soil parameters for design is best undertaken through comprehensive laboratory test programmes. However, due to sampling difficulty, time and cost constraints correlations between in-situ tests and physical-mechanical properties of soils are routinely applied in practice. This paper presents data collected from five sites in Northern Croatia at which Cone Penetration Tests (CPT) and comprehensive laboratory test data was available. One of the advantages of using CPT data in preference to other types of in-situ tests for establishing correlations, is the large volume of high-quality data available at each probe location allows for the application of advanced statistical approaches. In this paper, the use of neural networks in developing such correlations is demonstrated. Using a database of 216 data pairs, obtained from the five sites, a correlation between CPT qc and soil unit weight is established. A validation exercise was performed in which the correlation was tested against data from the recent Veliki vrh landslide that occurred in the same geographical region as the database sites. In addition, by using the soil behaviour type index, Ic, normalised cone tip resistance, Qtn, and normalised sleeve friction, Fr, the results can be compared to correlations developed for soils from geotechnical diverse regions to check for consistency in the derived correlations.

BACKGROUND: We present a group of patients affected by a paediatric onset genetic encephalopathy with cerebral calcification of unknown aetiology studied with Next Generation Sequencing (NGS) genetic analyses. METHODS: We collected all clinical and radiological data. DNA samples were tested by means of a customized gene panel including fifty-nine genes associated with known genetic diseases with cerebral calcification. RESULTS: We collected a series of fifty patients. All patients displayed complex and heterogeneous phenotypes mostly including developmental delay and pyramidal signs and less frequently movement disorder and epilepsy. Signs of cerebellar and peripheral nervous system involvement were occasionally present. The most frequent MRI abnormality, beside calcification, was the presence of white matter alterations; calcification was localized in basal ganglia and cerebral white matter in the majority of cases. Sixteen out of fifty patients tested positive for mutations in one of the fifty-nine genes analyzed. In fourteen cases the analyses led to a definite genetic diagnosis while results were controversial in the remaining two. CONCLUSIONS: Genetic encephalopathies with cerebral calcification are usually associated to complex phenotypes. In our series, a molecular diagnosis was achieved in 32% of cases, suggesting that the molecular bases of a large number of disorders are still to be elucidated. Our results confirm that cerebral calcification is a good criterion to collect homogeneous groups of patients to be studied by exome or whole genome sequencing; only a very close collaboration between clinicians, neuroradiologists and geneticists can provide better results from these new generation molecular techniques.