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This paper presents a hydrodynamic investigation carried out on the “Wave Attenuator” device, which is a new type of floating breakwater anchored with piles and equipped with a linear Power Take Off (PTO) mechanism, which is typical for wave energy converters. The device is tested in the wave flume, under regular waves, in slightly non-linear conditions. The PTO mechanism, that restrains one of the two degrees of freedom, is simulated through an actuator and a programmable logic controller with preassigned strategy. The paper presents the system identification procedure followed in the laboratory, supported by a numerical investigation essential to set up a credible control strategy aiming at maximizing the wave energy harvesting. The maximum power conversion efficiency under the optimal PTO control strategy is found: it is of order 50–70% when the incident wave frequency is lower than the resonance one, and only of order 20% for higher frequencies. This type of experimental investigation is essential to evaluate the actual efficiency limitations imposed by device geometry.

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This paper investigates the impact of climate change on coastal dynamics along the Adriatic Italian coast, with reference to the period 2021–2050 considering the IPCC RCP 4.5 and 8.5 scenarios. The wave datasets are obtained by forcing a spectral wave model with ERA5 wind fields corrected with a procedure that makes them suitable for the investigated semi-enclosed basin where local meteorological events occur at scales of a few kilometers. The wave climate changes between the historic run (1981–2010) and the future scenarios are studied in terms of mean values, percentile and extreme waves in 120 virtual buoys along the coasts. Moreover, a morphological equivalent wave is computed for all the datasets to highlight the consequences of climate change on coastal sediment transport. Along the Adriatic Italian coast, a small decrease in the significant wave heights is found, both for mean and extreme values, and the sediment transport is reduced. However, significant deviations along the coast are highlighted and the longshore sediment transport even reverses its direction in some locations for the future scenarios.

Background The breast is innervated by the intercostal nerves and the brachial plexus. We propose a technique to perform breast surgery without general anesthesia using the erector spinae plane (ESP) block and selective block of four nerves that arise from the brachial plexus innervate the breast and the axilla (SBP block). Case A 77-year-old man with breast cancer was scheduled for radical mastectomy and axillary clearance. He had a previous history of myocardial infarction with dilated cardiomyopathy and severely impaired ejection fraction. The surgery was performed under regional anesthesia with combined ESP and SBP block. The patient did not require opioids or other supplemental analgesics intra- or postoperatively and was discharged uneventfully. Conclusions SBP is a novel block that selectively blocks branches of the brachial plexus that innervate the breast.

This paper highlights the issue of the model consistency for wave hindcasts in enclosed basins, such as lakes and lagoons. For these applications, the wind input mechanism is essential and the differences in the model approaches and available settings make it critical and difficult for the users to comprehensively understand each of the model’s capabilities and limitations. Therefore, three freely accessible regional scale spectral wave models (SWAN, STWAVE, and CMS-Wave), using the Half and Full plane modes where available, are used for wave hindcast purposes in two locations of the Garda Lake (IT). Results achieved with default settings are compared and discussed. Significant differences are found showing that, unfortunately, specific calibration, which is, however, not possible in many practical cases, is essential for applications in enclosed basins.

Over the last decades, the evaluation of hazards and risks associated with coastal flooding has become increasingly more important in order to protect population and assets. The general purpose of this research was to assess reliable coastal flooding hazard maps due to overflow and wave overtopping. This paper addresses the problem of defining credible joint statistics of significant wave heights Hs and water levels ζ, focusing on the selection of the sample pair that characterizes each sea storm, to evaluate the occurrence probability of extreme events. The pair is selected maximizing a spatial structure variable, i.e., a linear combination of Hs and ζ, specific to each point of the area at risk. The structure variable is defined by the sensitivity of the flooding process to Hs and ζ, as found by analyzing a set of inundation maps produced through a Simplified Shallow-Water numerical model (SSW). The proposed methodology is applied to a coastal stretch in the Venetian littoral (Italy), by means of a 30 year-long time series recorded at the “Acqua Alta” oceanographic research tower, located in the Northern Adriatic Sea in front of the Venetian lagoon. The critical combination of Hs and ζ forming the structure variable is presented in a map, and it can be related to the topography and the presence of mitigation measures. The return period associated with the two recent large storms that occurred in this area in 2018 and 2019 is also investigated. The proposed procedure gives credible occurrence probabilities for these events, whereas other approaches would consider them extremely unlikely.

Abstract Background Nodal skip metastasis is a prognostic factor in some sites of malignancies, but its role in esophageal cancer is still unclear. The present study aimed to investigate occurrence and effect of nodal skip metastases in thoracic esophageal squamous cell carcinoma. Methods All 578 patients undergoing esophagectomy for thoracic esophageal squamous cell carcinoma at the Center for Esophageal Diseases located in Padova between January 1992 and December 2010 were retrospectively evaluated. Selection criteria were R0 resection, pathological M0 stage and pathological lymph node involvement. Patients receiving neoadjuvant therapy were excluded. Results The selection identified 88 patients with lymph node involvement confirmed by pathological evaluation. Sixteen patients (18.2%) had nodal skip metastasis. Adjusting for the number of lymph node metastases, patient with nodal skip metastasis had similar 5-year overall survival (14% vs. 13%, p = 0.93) and 5-year disease free survival (14% vs. 9%, p = 0.48) compared to patients with both peritumoral and distant lymph node metastases. The risk difference of nodal skip metastasis was: −24.1% (95% C.I. -43.1% to −5.2%) in patients with more than one lymph node metastasis compared to those with one lymph node metastasis; −2.3% (95% C.I. -29.8% to 25.2%) in middle thoracic esophagus and −23.0% (95% C.I. -47.8% to 1.8%) in lower thoracic esophagus compared to upper thoracic esophagus; 18.1% (95% C.I. 3.2% to 33.0%) in clinical N0 stage vs. clinical N+ stage. Conclusions Nodal skip metastasis is a common pattern of metastatic lymph involvement in thoracic esophageal squamous cell carcinoma. However, neither overall survival nor disease free survival are associated with nodal skip metastasis occurrence.

Esophageal cancer (EC) is a very aggressive tumor, and no reliable prognostic markers exist especially for resectable advanced neoplasia. The principal aim of this study was to investigate the association of germline polymorphisms in nucleotide excision repair (NER) pathway genes with the overall survival (OS) of patients with advanced EC. As a second aim, we also studied the association of NER gene variants with response to cisplatin-based chemotherapy. Among the EC patients referred to our Institution between 2004 and 2012, we selected a cohort of 180 patients diagnosed with a clinical tumor stage ranging from IIB and IVA. Patients were genotyped for four NER variants, two in the ERCC1 (rs11615 and rs3212986) and two in the ERCC2/XPD (rs1799793 and rs13181) genes. Kaplan–Meier analyses and Cox proportional hazards model were used to evaluate the associations of the selected variants with OS; association with response to neoadjuvant therapy was investigated using logistic regression. Results showed that the ERCC1 rs3212986 and the ERCC2/XPD rs1799793 were significantly associated with shorter OS. On the contrary, response association analysis displayed that, while rs11615 and rs3212986 in ERCC1 were associated with response, both ERCC2/XPD variants were not. By creating survival prediction models, we showed that the rs3212986 and the rs1799793 have a better predictability of the tumor stage alone. Furthermore, they were able to improve the power of the clinical model (AUC = 0.660 vs. AUC = 0.548, p = 0.004). In conclusion, our results indicate that the ERCC1 rs3212986 and the ERCC2/XPD rs1799793 could be used as surrogate markers for a better stratification of EC patients with advanced resectable tumor.

The aim of this work is to show that a significant increase of the efficiency of a Wave Energy Converter (WEC) can be achieved already at an early design stage, through the choice of a turbine and control regulation, by means of an accurate Wave-to-Wire (W2W) modeling that couples the hydrodynamic response calibrated in a wave flume to a Hardware-In-the-Loop (HIL) test bench with sizes and rates not matching those of the system under development. Information on this procedure is relevant to save time, because the acquisition, the installation, and the setup of a test rig are not quick and easy. Moreover, power electronics and electric machines to emulate turbines and electric generators matching the real systems are not low-cost equipment. The use of HIL is important in the development of WECs also because it allows the carrying out of tests in a controlled environment, and this is again time- and money-saving if compared to tests done on a real system installed at the sea. Furthermore, W2W modeling can be applied to several Power Take-Off (PTO) configurations to experiment different control strategies. The method here proposed, concerning a specific HIL for testing power electronics and control laws for a specific WECs, may have a more general validity.

This paper aims at evaluating the wave overtopping discharge over the pavement of “Piazza S. Marco” (Venice) in order to select the best option to mitigate the risk of flooding of the Piazza and to protect the monuments and historic buildings, e.g., the “Basilica S. Marco”. In fact, the MO.S.E. (MOdulo Sperimentale Elettromeccanico) system is designed to keep the water level below a certain value, for the safety of the lagoon, but it does not guarantee the defence of the Piazza, where flooding is still possible, being its pavement locally much lower than the maximum expected water level. To completely defend the Piazza, specific additional works are planned to prevent the back-flow through the natural drainage system (now the primary pathway) or by filtration or by overtopping. This paper investigates on the overtopping mechanism, under conditions compatible with a fully operational MO.S.E. system, through 2-D experiments. The pavement of the Piazza is gently sloping towards the masonry quay which, in some parts is formed by 5 descending steps, and in some other parts, is just a vertical wall. Close to the “Marciana” Library, a critical part is present, with a slightly lower crest freeboard. In total, three cross-sections were examined in the 36 m long wave flume of the Padova University. The test programme includes 10 irregular wave attacks and three different water levels. The test results differ considerably from the results of the available formulas, since the investigated cross-sections by far exceed their range of applicability. The presence of the steps affects only the reflection coefficient rather than the overtopping discharges. In general, if the waves incident to the Piazza are higher than 40 cm, which is a possible scenario, some other adaptation works must be considered, such as the pavement rise, temporary barriers or the reduction of the waves impacting the quay through, for instance, floating breakwaters.

This paper investigates on a Wave Energy Converter (WEC) named Energy & Protection, 4th generation (EP4). The WEC couples the energy harvesting function with the purpose of protecting the coast from erosion. It is formed by a flap rolling with a single degree of freedom around a lower hinge. Small-scale tests were carried out in the wave flume of the maritime group of Padua University, aiming at the evaluation of the device efficiency. The test peculiarity is represented by the system used to simulate the Power Take Off (PTO). Such dummy PTO permits a free rotation of two degrees before engaging the shaft, allowing the flap to gain some inertia, and then applying a constant resistive moment. The EP4 was observed to reach a 35% efficiency, under short regular waves. The effects, in terms of coastal protection, are small but not negligible, at least for the shortest waves.

In recent years, marine flooding and its impacts have become a question of growing interest, since coastal areas are the most heavily populated and developed land zones in the world. This paper presents a rapid tool for mapping at regional scale the hazard associated with coastal flooding due to overflow. The tool merges a recently developed numerical model that solves a simplified form of the Shallow-Water Equations and is suited for Graphic Processing Unit (GPU) acceleration, with a Level II reliability method that allows producing hazard maps of inland flooding propagation. The procedure was applied to two stretches of the Venetian littoral, i.e., Valle Vecchia and Caorle, located in the northern Adriatic Sea. The application includes the site descriptions and the resulting hazard maps that show the probability of failure in each point of the coast for a given inland inundation level.

This note presents the Seabreath wave energy converter, basically a multi-chamber floating oscillating water column device, and the lumped model used to size its chambers, the ducts and the turbine. The model is based on extensive testing carried out in the wave flume of the University of Padova using fixed and floating models with a dummy power take off and indirect measurement of the produced power. A map with the available energy in the Mediterranean Sea is also proposed, showing possible ideal application sites. The Seabreath is finally dimensioned for a quarter scale test application in the Adriatic Sea, with a 3 kW turbine, and a capacity factor of 40%.

Esophageal cancer represents the 6th cause of cancer mortality in the World. New treatments led to outcome improvements, but patient selection and prognostic stratification is a critical aspect to gain maximum benefit from therapies. Today, patients are stratified into 9 prognostic groups, according to a staging system developed by the American Joint Committee on Cancer. Recently, trying to better select patients with curing possibilities several authors are reconsidering tumor length as a valuable prognostic parameter. Specifically, endoscopic tumor length can be easily measured with an esophageal endoscopy and, if its utility in esophageal cancer staging is demonstrated, it may represent a simple method to identify high risk patients and an easy-to-obtain variable in prognostic stratification. In this study we retrospectively analyzed 662 patients treated for esophageal cancer, stratified according to cancer histology and current staging system, to assess the possible role of endoscopic tumor length. We found a significant correlation between endoscopic tumor length, current staging parameters and 5-year survival, proving that endoscopic tumor length may be used as a simple risk stratification tool. Our results suggest a possible indication for preoperative therapy in early stage squamocellular carcinoma patients without lymph nodes involvement, who are currently treated with surgery alone.

This paper discusses the key aspects of the recent Coastal Plan of the Veneto Region (IT). Its aim is to propose a single mitigation strategy for coastal erosion that is valid for the whole Veneto Region, and possibly elsewhere, as well as a method to assign a priority level to any action. The suggested mitigation action against erosion depends on urbanization level, beach width, as well as cross-shore and long-shore sediment transport. The criterion used to give a priority level to mitigation actions is based on a vulnerability index that takes into account erosive tendency, existing coastal flooding hazards, coast value, environmental relevance, tourist pressure, urbanization level, the presence of production activities, and cultural heritage. A sample case featuring the littoral of Rosolina is also provided and includes a site description, the sediment budget, critical issues and possible mitigation measures.

Neonates with congenital diaphragmatic hernia and large defects often require patch closure. Acellular collagen matrices (ACM) have been suggested as an alternative to synthetic durable patches as they are remodeled by the host or could also be used for tissue engineering purposes.2.0x1.0 cm diaphragmatic defects were created in 6-weeks old New-Zealand white rabbits. We compared reconstruction with a purpose-designed cross-linked ACM (Matricel) to 4-layer non-cross-linked small intestinal submucosa (SIS) and a 1-layer synthetic Dual Mesh (Gore-Tex). Unoperated animals or animals undergoing primary closure (4/0 polyglecaprone) served as age-matched controls. 60 (n = 25) resp. 90 (n = 17) days later, animals underwent chest x-ray and obduction for gross examination of explants, scoring of adhesion and inflammatory response. Also, uniaxial tensiometry was done, comparing explants to contralateral native diaphragmatic tissue.Overall weight nearly doubled from 1,554±242 g at surgery to 2,837±265 g at obduction (+84%). X-rays did show rare elevation of the left diaphragm (SIS = 1, Gore-Tex = 1, unoperated control = 1), but no herniation of abdominal organs. 56% of SIS and 10% of Matricel patches degraded with visceral bulging in four (SIS = 3, Matricel = 1). Adhesion scores were limited: 0.5 (Matricel) to 1 (SIS, Gore-Tex) to the left lung (p = 0.008) and 2.5 (Gore-Tex), 3 (SIS) and 4 (Matricel) to the liver (p

BACKGROUND: Development of novel therapeutic drugs and regimens for cancer treatment has led to improvements in patient long-term survival. This success has, however, been accompanied by the increased occurrence of second primary cancers. Indeed, patients who received regional radiotherapy for Hodgkin's Lymphoma (HL) or breast cancer may develop, many years later, a solid metachronous tumor in the irradiated field. Despite extensive epidemiological studies, little information is available on the genetic changes involved in the pathogenesis of these solid therapy-related neoplasms. METHODS: Using microsatellite markers located in 7 chromosomal regions frequently deleted in sporadic esophageal cancer, we investigated loss of heterozygosity (LOH) and microsatellite instability (MSI) in 46 paired (normal and tumor) samples. Twenty samples were of esophageal carcinoma developed in HL or breast cancer long-term survivors: 14 squamous cell carcinomas (ESCC) and 6 adenocarcinomas (EADC), while 26 samples, used as control, were of sporadic esophageal cancer (15 ESCC and 11 EADC). RESULTS: We found that, though the overall LOH frequency at the studied chromosomal regions was similar among metachronous and sporadic tumors, the latter exhibited a statistically different higher LOH frequency at 17q21.31 (p = 0.018). By stratifying for tumor histotype we observed that LOH at 3p24.1, 5q11.2 and 9p21.3 were more frequent in ESCC than in EADC suggesting a different role of the genetic determinants located nearby these regions in the development of the two esophageal cancer histotypes. CONCLUSIONS: Altogether, our results strengthen the genetic diversity among ESCC and EADC whether they occurred spontaneously or after therapeutic treatments. The presence of histotype-specific alterations in esophageal carcinoma arisen in HL or breast cancer long-term survivors suggests that their transformation process, though the putative different etiological origin, may retrace sporadic ESCC and EADC carcinogenesis.

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