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In the transportation engineering field, the turbulent boundary layer over a structure is one of the most relevant sources of structural vibration and emitted noise. Wind tunnels are still one of the best options for vibroacoustic experimental analyses for this specific problem. However, it is also true that this experimental method is not always affordable, due to several limitations—settings hard to control, time and money consumption, discrepancies among laboratories—that wind tunnel facilities present. It has already developed different methodologies to address this necessity, most of them based on the use of loudspeakers or shakers. In this work, an existing numerical method, called the pseudo-equivalent deterministic excitation method (PEDEM), is further developed for the experimental purpose of reproducing the experimental structural response of a panel subjected to a turbulent boundary layer (TBL) excitation, by using an equivalent rain-on-the-roof excitation instead; different formulations are used for the application of this approximated TBL excitation. The experimental application of PEDEM, here called X-PEDEM, is validated by comparison with experimental results of two different panels analysed in two different wind tunnel facilities.

Background MicroRNAs (miRNAs, miR) are essential gene expression regulators involved in numerous biological processes and diseases including type 2 diabetes (DM). Purpose We aimed to determine the predictive value of selected circulating miRNAs for cardiovascular and all-cause mortality and their potential usefulness as biomarkers in DM patients. Method Two hundred fifty-two patients with diabetes were enrolled in the study. Among the patients included, 26 (10.3%) patients died during a median follow-up of 71 months (5.9 years). Plasma miR-191 and miR-16 expressions were assessed by quantitative real-time PCR and compared between the patients who survived and those who died. Results Patients who died from cardiovascular-related death had significantly higher expression of miR-191 and miR-16 as compared with patients who survived (p=0.003, p=0.001, respectively). The study population was divided into two subgroups by using ROC curve analysis for each miRNA, i.e., low or high value of single miRNAs. Kaplan Meier and Cox regression were performed for survival analysis. High expression levels of miRNAs were associated with cardiovascular mortality, when the models included one single miRNA and other covariates: miR-191 (HR = 4.793, 95% CI: 1.48–15.579; p=0.009) and miR-16 (HR = 4.66, 95% CI: 1.48–14.75; p=0.009). Furthermore, miRNAs expression between clopidogrel and the whole acetylsalicylic acid groups (i.e., 75 mg +150 mg), miR-191 expressions was significantly higher in the clopidogrel subgroup (p=0.010), whereas miR-16 did not differ (p=0.127). Conclusion To conclude, miR-191 and miR-16 expression are strong and independent predictors of cardiovascular and all-cause mortality in patients with T2DM. Moreover, miR-191 and miR-16 present significant interactions with antiplatelet treatment regimens and clinical outcomes. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Warsaw

This paper outlines the main findings of the project “DEvelopment and applications of a VIrtual hybrid platform for multiscale analysis of advanced StructUres of aircraft” (DEVISU), which deals with failure of composite structures and noise/vibration reduction, along with investigation of new materials for aerospace applications.

In the wind tunnel facility, a test structure is often used for measuring its vibrational response to the aerodynamic excitation. A support is needed to sustaining the structure and it is mandatory that this support does not influence the vibrational energy to be measured. To this aim, the maximum amount of energy decoupling between the structure and the support is desired. This work is focused around a quick method to estimate this decoupling by using simplified models for the Turbulent Boundary Layer (TBL) excitation and for the structural response. Specifically, the Equivalent Rain-on-the-roof excitation is invoked with a Statistical Energy Analysis model for the structure. Some simple design rules are proposed and based on little information leading to foresee the difference of vibrational velocity levels between the two structural systems. A simplified test-case is used for the first investigations and a complex structure is finally conceived thinking to vibroacoustic measurements in a large wind tunnel facility. Although some results are largely expected, the global approach is promising.

An investigation is carried out on structure-borne vibrations of tyre models at low frequencies. The idea is to use embedded resonant meta-materials to damp the tyres’ vibrations and thus reduce the transferred energy to the main attached structures. A simplified tyre model is used, being the investigation of the effects of the embedded substructures the main target of the work; internal pressure and tyre rotation effects are neglected at this stage. Different configurations are tested targeting different natural modes of the tyre, while mechanical excitation is assumed on one section of the tyres. The results show how the proposed designs open new possible and feasible solutions for the vibration control.

Aims The implementation of the 2013 European Society of Cardiology (ESC) Core Curriculum guidelines for acute cardiovascular care (acc) training among European countries is unknown. We aimed to evaluate the current status of acc training among cardiology trainees and young cardiologists ( Methods and results The survey (March–July 2019) asked about details of cardiology training, self-confidence in acc technical and non-technical skills, access to training opportunities, and needs for further training in the field. Overall 614 young doctors, 31 (26–43) years old, 55% males were surveyed. Place and duration of acc training differed between countries and between centres in the same country. Although the majority of the respondents (91%) had completed their acc training, the average self-confidence to perform invasive procedures and to manage acc clinical scenarios was low—44% (27.3–70.4). The opportunities for simulation-based learning were scarce—18% (5.8–51.3), as it was previous leadership training (32%) and knowledge about key teamwork principles was poor (48%). The need for further acc training was high—81% (61.9–94.3). Male gender, higher level of training centres, professional qualifications of respondents, longer duration of acc/intensive care training, debriefings, and previous leadership training as well as knowledge about teamwork were related to higher self-confidence in all investigated aspects. Conclusions The current cardiology training program is burdened by deficits in acc technical/non-technical skills, substantial variability in programs across ESC countries, and a clear gender-related disparity in outcomes. The forthcoming ESC Core Curriculum for General Cardiology is expected to address these deficiencies.

Background The existence of a close association between disease of the biliary tract and heart‘s disease is known from the mists of time. Acute acalculous cholecystitis (AAC) is a challenging diagnosis. The atypical clinical onset associated to a paucity and similarity of symptoms and to laboratory data mimicking cardiovascular disease (CVD) often results in under and misdiagnosed cases. Moreover, AAC is often associated with gangrene, perforation and empyema as well as considerable morbidity and mortality(up 50%). Early diagnosis is crucial to increase survivability. Even today, there is still a lot of confusion regarding the relationship and consequently the clinical management AAC and CVD. Aim The aim of this review was to provide evidence regarding epidemiology, pathophysiology, clinical presentation and treatment of the complex association between AAC and CVD. Methods we searched for publications addressing Acalculous cholecystitis and cardiovascular disease, consulting Medline and Scopus databases. Any retrospective or prospective study design or systematic review focusing on the aforementioned topic was accepted. This study was conducted in accordance with the PRISMA and AMSTAR Guidelines. Our search rendered 1422 hits (995 from Medline and 427 from Scopus). After progressive screening, 268 full texts were assessed for eligibility and 135 studies were included in qualitative synthesis. Results According to the literature, 11 cases of AAC were reported after cardiopulmonary bypass surgery. Similarly, in 6 of 7 patients following aortic reconstruction. Small vessel occlusion has shown to be the predominant phenomenon in AAC. Histological analysis suggest involvement of ischaemia and reperfusion mediated injury. The most common ECG alterations noted in AAC are changes in T waves in significant leads, slurring and notching of the QRS complex and elevation or depression of the S–T segment, hypothesizing a vagally reflex mechanism, due to the distention of the common bile duct, with a reduced coronary blood flow. Finally it was reported a resolution of ECG changes due to AAC after cholecystectomy or antibiotic treatment within a few days. Conclusion AAC should be suspected after each general disease leading to hypoperfusion such as cardiovascular diseases and major heart or aortic surgery. ECG changes in absence of significant laboratory data for IMA could be related to a misdiagnosed AAC.

Few studies have reported the implications and adverse events of performing endotracheal intubation for critically ill COVID-19 patients admitted to intensive care units. The aim of the present study was to determine the adverse events related to tracheal intubation in COVID-19 patients, defined as the onset of hemodynamic instability, severe hypoxemia, and cardiac arrest.Tertiary care medical hospitals, dual-centre study performed in Northern Italy from November 2020 to May 2021.Adult patients with positive SARS-CoV-2 PCR test, admitted for respiratory failure and need of advanced invasive airways management.Endotracheal Intubation Adverse Events.The primary endpoint was to determine the occurrence of at least 1 of the following events within 30 minutes from the start of the intubation procedure and to describe the types of major adverse peri-intubation events: severe hypoxemia defined as an oxygen saturation as measured by pulse-oximetry80%; hemodynamic instability defined as a SBP 65 mmHg recoded at least once or SBP 90 mmHg for 30 minutes, a new requirement or increase of vasopressors, fluid bolus15 mL/kg to maintain the target blood pressure; cardiac arrest.Among 142 patients, 73.94% experienced at least one major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 65.49% of all patients undergoing emergency intubation, followed by severe hypoxemia (43.54%). 2.82% of the patients had a cardiac arrest.In this study of intubation practices in critically ill patients with COVID-19, major adverse peri-intubation events were frequent.www.gov identifier: NCT04909476.

Up to now, similitude methods have been used in order to overcome the typical drawbacks of experimental testing and numerical simulations by reconstructing the full-scale model behavior from that of the scaled model. The novelty of this work is the application of similitude theory not as a tool for predicting the prototype dynamic response, but for supporting, and eventually validating, experimental measurements polluted by noise. Two Aluminium Foam Sandwich (AFS) plates are analyzed with Digital Image Correlation (DIC) cameras. First, an algorithm for blind source separation problems is used to extract information about the excitation; then, SAMSARA (Similitude and Asymptotic Models for Structural-Acoustic Research Applications) similitude method is applied to both the force spectra and velocity responses of prototype and model. The reconstruction of force and velocity curves demonstrates that the similitude results are coherent with the quality of the experimental measurements: when the spatial pattern in resonance is recognizable, then the curves overlap. Instead, when the displacement field of just one model is not well identified, the reconstruction exhibits discrepancies. Therefore, similitude methods reveal to be an interesting tool for understanding if a set of measurements is reliable or not and their application should not be underestimated, especially in the light of the expanding range of approaches which can extract important information from noisy observations.

Background Stroke is the second-most common cause of death worldwide. Circulating levels of selected microRNAs (miRNAs) were found to be modulated both in animal experimental models and in patients with stroke, opening up new avenues for the identification of more effective and specific biomarkers to identify and risk-stratify stroke patients. Aim of the present study is to identify all circulating miRNAs that are modulated in patients with stroke, to select specific miRNAs to be used as disease biomarkers to improve prognosis. Methods 48 patients with stroke- ESUS were involved in the study. We have divided the patient groups based on patients who had a second stroke or TIA and did not have (safety vs safety control). Total RNA was extracted from plasma samples quality of extracted material was assessed using a fluorometric electrophoretic assay. MiRNA profiling was performed using the Affymetrix platform using. Statistical analysis was performed in TAC software. Additional analyses were performed in and R using Signal information obtained from the TAC output. We performed the following tests using log2 transformed data and all comparison groups (A-F). We performed additional FDR correction, logistic regression, Mann-whitney test t-test depending if variances were equal or differing. We calculated Area under the curve using ROCp R package. Scores were ranging from 0–1. Co-expression analysis to identify genes authentically expressed was performed using Spearman correlation (cutoff=0.9, Rpval=0.05). In order to identify the targets of DE miRNAs we used our wizbionet R package and previously developed pipelines [1,2]. We performed target screening using multimiR package, selecting top 20% predictions from all available databases. Results MiR-4786, miR-1205, miR-548ar-3p and miR-518e-3p were found the most differentially expressed miRNAs between the groups. So far, miR-4786 was studied only in patients with acute leukemia [3]. Several studies showed the importance of miR-1205 in cell carcinoma and ovarian cancer progression [4]. Moreover, so far only one study showed the regulation of miR-548ar-3p in breast cancer [5]. Finally only one study showed the alteration of miR-518e-3p in Parkinsons disease patients [6]. Besides, our enrichment analysis showed Interleukin-2 signaling pathway, Lipid and lipoprotein metabolism, BDNF signaling pathway, MAPK signaling pathway, Intellectual Disability, Alzheimer's Disease are significantly related to ESUS- patients. Conclusions Any of those miRNAs were never studied in stroke before, our results identified several novel circulating prognostic biomarkers miRNAs that are down- of up-regulated in ESUS-stroke patients (who had only one vs multiple stroke). Among those several miRNAs were identified that are known to play a role in the pathophysiology of neurovascular diseases, paving the way to a new class of smart pathophysiology-based biomarkers in stroke. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Polish National Science Center OPUS Figure 1Figure 2

Background and aim Characterized by prolonged, highly dynamic exercise that is low-to-high power in nature, endurance training has proven beneficial in cardiovascular disease prevention. Several miRNAs have been reported to be regulated in response to exercise in healthy humans. Our aim was to determine the miRNA expression changes before and after an ultramarathon run in elite runners [1]. Method We performed bioinformatic analyses - tissue-specific/CV process-specific. Each bioinformatic analysis included 55 miRNAs (figure 1). The multiMiR 1.4 R package was used to identify the targets of miRNAs while a screening of the gene ontology terms for the presence of keywords with the biomaRt interface was used to identify genes associated with angiogenesis, cardiac muscle function, muscle hypertrophy, coagulation, inflammation, and fibrosis. Cardiac tissue-specific targets were identified in Tissue 2.0 database using expression confidence score >2. Gene-gene interaction data were retrieved from the STRING app for Cytoscape. Enrichment analyses of biological processes and reactome and KEGG pathways were also conducted on the STRING app. miR-1-3p, miR-126, miR-223, miR-125a-5p, miR-106a, and miR-15a/b were chosen, based on bioinformatic analysis for qRT-PCR validation, among those related to inflammation, fibrosis and cardiac function [2]. Total RNA was extracted from plasma samples using the MirVana PARIS Kit (ABI, California, USA) and quality was assessed using fluorometric assay. qRT-PCR was performed using the TaqMan Advance (ABI, Foster City, California) protocol on a high throughput thermal cycler. The Wilcoxon test was used for paired comparison – before vs after ultramarathon running – and Spearman's Correlation was used for database analysis of miRNA expressions, p Results MiR-1-3p, miR-126, miR-223, miR-125a-5p, miR-106a, and miR-15a/b expressions were measured in 22 endurance athletes before and after an ultramarathon wherein athletes ran to completion (100 km) or exhaustion (52–91 km, median 74 km). We found that the expressions of miR-125a-5p, miR-126, miR-223 were significantly increased after the ultramarathon (p=0.018; p=0.001; p=0.014, respectively), whereas miR-15b was significantly decreased (p=0.028). No significant difference was observed for miR-1-3p and miR-15a, while miR-106a was not detectable in the circulating plasma (figure 2). Additionally, miR-1-3p expression post-run showed negative correlation with hsCRP levels post-run (r=−0.631, p=0.005). miR-125a-5p expression post-run showed negative correlation with max lactate levels during run (r=−0.759, p=0.004). Conclusion Extreme physical activity, as exemplified by an ultramarathon, may have an impact on the expression alterations of miRNAs associated with inflammation, fibrosis, and cardiac muscle function. Further studies will clarify the long-term impact of these observations. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Warsaw Figure 1Figure 2. Differences in miRNA expression pre- and post-ultramarathon

Background Assessment of intracardiac flows and turbulence has acquired rising significance in the past few years, due to the development and introduction of technologies for non-invasive cardiovascular imaging. Recent studies have shown that alterations in intracardiac fluid dynamics can be helpful to identify abnormalities in cardiac function. Purpose This study investigates the additional information provided by the quantitative assessment of intracardiac flow dynamics for the evaluation of patients with aortic stenosis (AS), by using an advanced echocardiography vortex-based approach. Methods Sixty-one patients with severe AS (33 females) and 38 healthy sex- and BSA-matched controls (CTRL) (15 females) were prospectively included and underwent echocardiographic assessment of intracardiac flow dynamics. Echocardiographic measurements were performed on apical three chamber views. The HyperDoppler software adapted to the echo-scanner without contrast injection was used to assess intracardiac vortex properties. The following parameters were obtained: vortex area (VA) (the ratio between the total vortex area and the left ventricular (LV) area); vortex length (VL) (the longitudinal length of the vortex relative to the total LV length; vortex depth (VD) (the distance of the vortex center from the LV base relative to the total LV long axis). Inter-rater variability was measured using intraclass correlation coefficients (ICCs) between two independent operators. Results Patients with severe AS (mean gradient: 47,5±13,9 mmHg; aortic valve area: 0.7±0.2 cm2; ejection fraction: 53±7%) had increased LV wall thickness (p0.001, respectively) were significantly higher in AS patients compared with CTRL. Among those who underwent TAVR, we observed a significant difference in the delta values of VA and VL pre-postTAVR in patients with and without significant paravalvular leak (p Conclusions The newly defined VA, VL and VD, quantitative indices of vortical flow, were significantly increased in the LV cavity of patients with severe AS compared to normal subjects. These indices, whose measurement was feasible and reliable, might provide complementary information to standard echocardiography, useful for the further diagnostic and prognostic characterization of the heterogeneous population of patients with severe AS. Funding Acknowledgement Type of funding sources: None.

Background Over the last decades growing evidence have demonstrated the promising role of intracardiac flow dynamic analysis in evaluating cardiac performance. Diastolic forces contribute to the formation of vortices, complex structures capable of kinetic energy storage and responsible of a smoother transition of blood from left ventricular (LV) inlet to outlet. Change in shape and location of these structures has been related with cardiovascular disease and prognosis. Purpose To investigate quantitative changes in vortices parameters in patients with different ventricular geometry. Methods We enrolled 72 consecutive patients (age 66±11 years, 49 male, 68%) with LV concentric hypertrophy (CH, n=15), eccentric hypertrophy (EH, n=13), concentric remodeling (CR, n=15) and normal LV geometry (CTRL, n=29). Each patient underwent a complete echocardiographic examination and a non-invasive intracardiac fluid dynamic analysis by Color Vector Flow Mapping. A 3-chamber apical view with a frame rate between 22 and 25 Hz has been acquired and subsequently analyzed offline by a semi-automatic software obtaining the following parameters: vortex area (VA) (the ratio between the total vortex area and the left ventricular (LV) area); vortex length (VL) (the longitudinal length of the vortex relative to the total LV length; vortex depth (VD) (the distance of the vortex center from the LV base relative to the total LV long axis). Bland Altman Plot has been used to assess intra and inter-observer variability. Results Mean VD was higher in CR, CH and EH compared to CTRL (p=0.013, p=0.001 and p=0.022, respectively). Moreover, CH showed higher VL (p=0.006) and larger VA (p=0.012) compared to CTRL. A similar trend was noticed in EH patients, despite did not reach statistical significance (p=0.21 and p=0.07 for VA and VL respectively). No significative differences in vortices parameters have been observed between CH and EH. Conclusion(s) This is the first study providing quantitative echocardiographic parameters of vortex location and morphology in different LV geometries. Higher values of VD were found in CR, CH and EG. Quantitative intra dynamic fluid assessment was feasible and reliable in the whole population and could provide additional information to the standard echocardiographic examination. Funding Acknowledgement Type of funding sources: None.

Background Evaluation of left atrial (LA) function is an emerging biomarker of cardiovascular disease (CVD). LA strain by 2D speckle tracking echocardiography (LA strain, LAS) is feasible and reliable, and has been recently associated with adverse long-term outcomes in CVD, including aortic stenosis (AS). Purpose To evaluate the changes in left atrial strain (LAS) after correction of severe AS with transcatheter aortic valve replacement (TAVR) and assess its prognostic impact. Methods One hundred consecutive patients with severe symptomatic AS who underwent TAVR at the Magna Graecia University of Catanzaro have been enrolled. Echocardiographic examination before and after TAVR was performed using Vivid E95 system and analysed using the EchoPAC 112.99 workstation (GE Healthcare). Patients underwent clinical follow up visits regularly. The primary study outcome was the difference in ΔLAS (postTAVR-preTAVR) between patients that met the main clinical endpoint (a composite of cardiovascular mortality and heart failure hospitalization) and those not meeting the endpoint. Statistical analyses were performed using JASP (version 0.14.1) and KMWin (version 1.52). Continuous variables were presented as mean and standard deviation and were compared through the unpaired Student's t test or the Mann-Whitney U test in case of a non-normal distribution. Differences between categorical variables were tested with the chi-square test. Multiple logistic regression analysis was performed to identify independent correlates of ΔLAS and to calculate Hazard Ratios (HR) with 95% CI. Kaplan-Meier was used to assess adverse event. Results During a median follow-up of 31 months, 35 patients (35%) met the composite clinical endpoint. The difference between LAS post-TAVR and LAS pre-TAVR (ΔLAS) was significantly larger in patients who met the combined endpoint (HR=0.76 [0.67–0.86]; p Conclusions A lower reduction in ΔLAS after TAVR was an independent predictor of the primary composite outcome of cardiovascular death and hospitalization for HF. Funding Acknowledgement Type of funding sources: None.

The dynamic behavior of structures can be investigated using concepts of complete (exact) and incomplete (distorted) similitudes.The incompleteness is much more of interest since the complete similitudes are difficult to be achieved and the experiments are often executed using distorted models as test articles. In this work, beams in similitude have been investigated using machine learning to establish degrees of correlation between similar systems, without invoking governing equations and/or solution schemes. Machine learning is based on algorithms that derive models from sample inputs providing data-driven predictions. The absence of an explicit algorithm, being the process totally data-driven, confers to the approach a high versatility which allows its application even in the vibroacoustic research fields and problems. In view to validate the machine learning predictions, numerical investigation of beams in similitude has been performed. The good predictions obtained with machine learning highlight the potentialities of these algorithms and open the way to analyses with more complex structures.

The increasing attention towards the possibility of scaling structures and, therefore, systems in similitude in engineering field has led to plenty of methods which allow to reconstruct the response of a system, starting from that of a reference one. In fact, this approach would help to overcome the obstacles associated with full-scale testing, such as cost and setup. However, the associated predictions may not be fully reliable, due to some intrinsic limitations characterizing the traditional similitude methods (based on the definition of similitude conditions and scaling laws), such as: size effects, rate sensitivity phenomena, distorted similitudes. For this reason, a new method, called VOODOO (Versatile Offset Operator for the Discrete Observation of Objects), has been proposed; such a method is based on the definition of a transformation matrix which links the outputs between two sets of points belonging to a linear systems. The applications of VOODOO to plates and systems of plates demonstrate that an exact estimation of the frequency response is obtained when the degrees of freedom involved in the definition of the transformation are considered. Therefore, this work aims at investigating, by means of a sensitivity analysis, the method’s strengths and limitations when other degrees of freedom are considered, in order to identify the direction for further developments.

This work aims at determining the location of low speed impact events on thin aluminium panels, specifically designed to be used on typical aircraft fuselage and wing panels, by processing the acoustic emission signals. The detection principle is based on the propagation of the first antisymmetric lamb wave (A0 mode) in the panel on which four PZT sensors are bonded to receive the signals. The impact location is assessed with the use of a supervised machine learning algorithm that is based on linear regression, appropriately designated to post-process the acquired signals. Some experimental cases are reported in order to investigate the optimal kind and amount of training data to improve the performance of the algorithm and therefore the accuracy of the impact location estimation.

The control of the response to tonal excitations or to broadband stochastic disturbances of a stiffened cylinder is investigated through the use of a Tuned Vibrating Absorber (TVA). In particular, the study considered both a purely passive device (Mechanical) and a semi-active one with shunt circuit (Electro-Mechanical) to evaluate the efficiencies and differences.

PERIODICITY AND QUASI-PERIODICITY EFFECTS ON VIBRATION BAND GAPS: NUMERICAL INVESTIGATIONS ON ONE-DIMENSIONAL STRUCTURES

Presence of teeth in a newborn represents a rare finding and a disturbance of biological chronology of teeth. The aim of this paper is to report two cases with neonatal teeth histologically examined.In this paper two cases of patients with neonatal teeth are reported and histological examinations of three extracted teeth are described. We report an exceptional finding in one of the neonatal teeth microscopically examined: a massive inflammatory infiltration in the pulp tissue similar to that in pulpitis.The management of natal and neonatal teeth usually includes the extraction in case of ulceration on the tongue or severe tooth mobility to prevent accidental inhalation or feeding disturbances. The presence of an inflammatory infiltration of pulp tissue in one of teeth histologically examined suggests to review the indications for extraction considered to date.The management of natal and neonatal teeth should consider the presence of an inflammatory infiltration of pulp tissue. An anamnestic interview is advisable in ordert to deeply investigate about possible behaviours of the child due to pain or discomfort.

Background Recent reports evidenced gender differences in the knowledge, perception and awareness of cardiovascular risk factors and cardiovascular diseases. Purposes To evaluate trends in awareness of cardiovascular risk, as well as knowledge of symptoms and preventive behaviors related to cardiovascular disease (CVD). Methods As part of Vivi con il Cuore (campaign with the goal of raising awareness about women's heart disease) a nationwide survey was conducted. Standardized questions on awareness of CVD risk, as well as prevention behaviors and barriers, were provided through a computer-assisted web interviewing platform to a large sample of Italians citizens ranging from 40 to 70 years old. The sample was representative of the population by age, sex, and area of geographical residence. Results A total of 1,000 subjects were included in this survey, of which 511 (51%) female. About 60% of women indicated cancer as the leading cause of death among female sex, while only 22% indicated cardiovascular disease. Similarly, when the same question was asked to men, 44% indicated cancer and 21% cardiovascular disease, observations that were consistent across age categories. Although a well sizable part of the population (90% of the interviewees) have consulted the general practitioner in the last year, only 45% of women and 56% of men declared to receive information about CVD risk. Almost 84% among men and women, recognized the importance of knowing how to understand the symptoms of a heart attack due to the possibility of survival. An additional survey was conducted among young cardiologists under 40 years old, including a total of 200 young cardiologists, similarly distributed among men and women (47% and 53% respectively). About 24% of young cardiologists indicated breast cancer as the leading cause of death in women, while only 70% reported cardiovascular diseases. Furthermore, 35% of participants reported that they did not have adequate training on the risks of heart disease in women. Conclusions In this survey, only 22% of women were aware that cardiovascular disease is the number one killer of women. Likewise, a well sizable part of young cardiologists (30%) does not recognize cardiovascular disease as the leading cause of death in women. These data should inform public health campaigns to focus on evidence-based strategies to prevent CVD and to help target messages that resonate and motivate women to take action. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Abbott

Background Smartwatches are increasingly popular and used for digital health information. A new smart watch introduced an integrated ECG tool, which allows recording a single-lead ECG that has been used for atrial fibrillation detection. The aim of the present study was to prospectively investigate the feasibility and the accuracy of the Apple Watch in patients admitted in the CCU with the diagnosis of Acute Coronary Syndrome compared with a standard 12-lead ECG. Methods A commercially available smart watch series 4 was used and the posterior sensor of the watch was positioned in different standardized body positions to obtain nine bipolar ECGs (corresponding to Einthoven leads I, II and III and Precordial leads V1-V6) that were compared with a simultaneous standard 12-lead ECG. One hundred subjects were included in the study. Fifty-five patients had a STEMI, twenty-seven patients had an NSTEMI all treated with percutaneous coronary revascularization. Eighteen age-matched subjects were included as controls. Results A very good agreement was found between Smartwatch ECG and Standard ECG for the identification of normal ECG, ST segment elevation and NSTE alterations (Cohen's kappa 0.90 [95% CI 0.78 to 1], 0.88 [95% CI 0.78 to 0,97], 0.85 [95% CI 0.74 to 0.96]), respectively. The sensitivity and specificity of Smartwatch ECG for the diagnosis of normal ECG were 84% (95% CI 60 to 97) and 100% (95% CI 95 to 100), STE deviation were 93% (95% CI 82 to 99) and 95% (95% CI 85 to 99), NSTE ECG alterations were 94% (95% CI 81 to 99) and 92% (95% CI 83 to 97), respectively. No significant differences between Smartwatch ECG and Standard ECG for the amplitude of ST changes were reported for each lead (see Figure). Conclusions The Smart Ami Trial demonstrated a very good agreement between the Smartwatch ECG and Standard ECG for the identification of ST-segment elevation and ST depression in patients with acute coronary syndromes opening the possibility of using this tool when a standard ECG is not available. Figure 1 Funding Acknowledgement Type of funding source: None

Background Cardiovacular diseases (CVD) are the leading cause of death worldwide. Platelet play a key role in the pathophysiology of multiple CVD. LincRNAs are long non-coding RNAs transcribed from intergenic DNA segments. Some members of this class were recently associated with human disease. Linc-223 is co-transcribed together with mir-223 and was recently shown to bind to miR-125. Both miR-223 and miR-125 are highly expressed in platelets. Purpose In light of the capability of Linc-223 to bind to miR-125, we aimed to investigate whether their reciprocal expression levels might reflect the degree of platelet activity. Methods RNA was extracted using miRVANA. MiRNAs and lncRNAs were measured by means of quantitative Real Time RT-PCR. Results We found a significant reduction of Linc-223 levels (p Conclusions We identify a reciprocal modulation of Linc-223 and miR-125, its ligand upon different levels of platelet aggregations. These results are compatible with previous evidence from patients with Acute Myeloid Leukemia, that Linc-223 might bind to and sponge miR-125, inhibiting its effect. These results suggest that plasma levels of Linc-223, miR-125 and miR-223 might be used a biomarkers of platelet finction in a clinical context, for risk stratification of patients or to assess the responsiveness to antiplatelet treatments. Funding Acknowledgement Type of funding source: None

In transportation engineering, there is the need of having quick and reliable tools for estimating the acoustic power radiated by a given elastic surfaces. Normally, the computational and experimental tools, or their combination, are based on CPU time-consuming matrix methods. This collaborative activity started some years ago as a way to share this central question, i.e. is it possible to build on digital methods that can easily and quickly reproduce (vibro)acoustic fields without using conventional CPU time-consuming matrix methods? In all the present numerical methods, the matrix central to the full computational process is not universal, i.e., repetitive computations are required for each new set of design iterations. The aim of this paper is the definition of a universal acoustic impedance matrix that accommodates any form of surface radiator, regardless of its geometry or boundary condition using a digitized, acoustic-space concept. Plane wave superposition is used on a map on which the points and the wave numbers are simply related by integers. This new concept for re-imagining acoustic space is expected to have several features: 1) the space is mapped in terms of a grid-work of evenly-spaced integer points, 2) each grid is insonified with a collection of plane waves chosen to generate the Greens functions comprising the impedance matrix and 3) the acoustic impedance matrix (derived via the plane waves superposition and the digitized method) leads to orthogonality and consequently no inversion operation is required. Some of these steps are now ready and shown in the present work. The final goal is still to be achieved but the paper presents the first successful test cases and the definition of the main points of the expected procedure.

aeronautical industries since they introduce frequency stop-bands (frequency ranges where wave cannot freely propagates). In this investigation 2D periodic and quasi-periodic pattern: instead of strictly repeating a pattern, a certain degree of irregularity is introduced. Quasi-periodic PCs in this paper are defined as assemblies of two different elements in two direction by using Thue-Morse and semi-Sierpinski carpet which results in asymmetry in both directions. Numerical studies on periodic and quasi-periodic lattices are performed. The spectral analysis in periodic waveguide is validated with the dispersion diagram of a reference model and vibration transmission of the lattices are studied. The wave characteristics in quasi-periodic super-cell configuration increases the wide of band-gaps about 22% compared to the reference model. Nevertheless, the associated level of vibration in the forced response of quasi-periodic lattices are predicted.

An investigation is carried out on alternative periodic designs of sandwich panels, for vibroacoustic purposes; a mechanically-linked double-wall panel and a rectangular core sandwich panel are considered. The elastic bending waves’ propagation versus the acoustic wavenumbers is trimmed using folded and corrugated core walls, trying to keep the same mass and compression stiffness of the original configurations. Standard and proposed configurations are 3D-printed and the sound transmission loss measurements carried out. The experimental evidence of reduced acoustic radiation of the panels, in a large frequency band, is achieved with measurements on the printed solutions.

The periodic structures exhibit a considerable amount of scattering in material properties during the manufacturing process and mechanical properties evaluations. Due to imprecision and nonavailability of the information about the parameter, the uncertainty is modelled as fuzzy variable. In this paper wave finite element method in conjunction with fuzzy logic and algebra defined as fuzzy wave finite e lement method h as b een a pplied f or f ree wave p ropagation i n t he two-dimensional periodic structure. The formulation is derived for the direct form where frequency is imposed, and wavenumber dispersion is obtained. The dispersion curves for the out of plane flexural waves with fuzzy parameters have been used to illustrate the proposed approach. In the numerical simulation, target is to look for the possibility to find the variation of the frequency band gap (frequency region, where waves cannot propagate). The validation of the presented method is carried out for the free wave propagation for the periodic plate by comparison with WFEM MCS results.

International audience; The periodic structures have various applications in vibroacoustic engineering fields since they introduce frequency band effects due to the periodic discontinuities in the geometrical or material configurations: this can lead to increased performances. This paper is focused on the analysis of quasi-periodic structures: instead of using strictly repeated patterns, a certain degree of irregularity is introduced. Quasi-periodic lattices are defined as assemblies of two different elements in two directions. The assembly follows a Thue-Morse Morphism sequence which results in asymmetry in both directions. Numerical studies and experimental measurements on two-dimensional periodic and quasi-periodic lattices are thus performed. First validations are carried out by comparing the quasi-periodic lattice modelled by using finite element model with a prototype manufactured by laser machine. The wave characteristics in quasi-periodic lattice introduce elements of novelty for designing wider frequency stop bands in low frequency ranges.; Les structures périodiques ont diverses applications dans les domaines de l'ingénierie vibroacoustique car elles introduisent des effets de bande de fréquence dus aux discontinuités périodiques dans les configurations géométriques ou matérielles: cela peut conduire à des performances accrues. Cet article se concentre sur l'analyse des structures quasi-périodiques: au lieu d'utiliser des motifs strictement répétés, un certain degré d'irrégularité est introduit. Les réseaux quasi-périodiques sont définis comme des assemblages de deux éléments différents dans deux directions. L'assemblage suit une séquence de morphisme de Thue-Morse qui se traduit par une asymétrie dans les deux sens. Des études numériques et des mesures expérimentales sur des réseaux bidimensionnels périodiques et quasi-périodiques sont ainsi réalisées. Les premières validations sont réalisées en comparant le réseau quasi-périodique modélisé en utilisant le modèle par éléments finis avec un prototype fabriqué par machine laser. Les caractéristiques des ondes dans un réseau quasi-périodique introduisent des éléments de nouveauté pour la conception de bandes d'arrêt de fréquence plus larges dans les gammes de basses fréquences.

An investigation is carried out on structure-borne vibration and noise propagation of tyres’ models at low frequencies. The idea is to use embedded resonant meta-materials to damp the tyres’ vibrations and thus reduce the transferred energy to the main attached structures. A simplified tyre model is used, being the investigation of the effects of the embedded substructures the main target of the work; internal pressure and tyre rotation effects are neglected at this stage. Different configurations are tested targeting different natural modes of the tyre, while mechanical excitation is assumed on one section of the tyres. The results show how the proposed designs are a feasible solution for vibration control.

Graphitic electrodes in ion batteries and graphite electrochemical exfoliation for graphene production are technological processes based on the anion intercalation mechanism in the stratified crystal structure upon immersion in acid solutions. To the detriment of the graphite mother-crystal, decomposition of the electrolyte solution or production of unexpected graphite intercalation compounds (GICs) is a side effect related to the anion intercalation mechanism. In this work, we studied the surface of highly oriented pyrolytic graphite (HOPG) samples treated with electrolyte solutions of 2 M HClO4 and 1 M H2SO4 in order to identify elemental and molecular species involved in the intercalation processes and, at the same time, find local surface defects through which solvated ions easily reach the HOPG subsurface. Results from cyclic voltammetry, X-ray photoelectron spectroscopy (XPS), and time-of-flight secondary ion mass spectrometry (ToF-SIMS) are described and discussed. Large blister formation and more general HOPG surface damage induced by treatment with acid solutions were revealed and mapped. In both HOPG samples, oxidized in 2 M HClO4 and 1 M H2SO4, the surface distribution of perchlorate and hydrogen sulfate ions gives direct evidence that the anion intercalation happens via surface defects among HOPG crystallites. These results pave the way for a complex intercalation process where more than one molecular species could be responsible for blister formation and carbon detriment.

For the analysis of the vibrational response of structures subjected to aerodynamic excitations, wind tunnel facilities are equipped with ”test bench” structures. Clearly, for the sake of the measurements’ purity, it is important that the test bench does not transmit part of its vibrational energy to the test structure. For this reason, it is important to define design rules with which it is possible to project ”smartly” a test bench which ensures an energy transmission decoupling. This work has been carried out focusing in the high frequency domain (HF), exploiting the possibility to assume an aerodynamic excitation as the Turbulent Boundary Layer (TBL) approximated to an Equivalent Rain-on-the-roof excitation. The method invoked here was based on Statistical Energy Analysis (SEA). For the analysis of vibrational response, a simplified model was conceived: it is wanted to determine the effective design rules for the structure and material properties; this means that it is wanted to guarantee the possibility of different material choices for a test bench project and, at the same time, to ensure a test bench versatility.

Background The respective ischemic and bleeding risks of early aspirin discontinuation following an acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) remains uncertain. Objectives To evaluate the safety and efficacy of early aspirin discontinuation in ACS or PCI patients treated with P2Y12 inhibitors with or without anticoagulants. Methods We performed a review of randomized controlled trials (RCTs) comparing a P2Y12 inhibitor-based single antiplatelet strategy following early aspirin discontinuation to a strategy of sustained dual antiplatelet therapy (DAPT) in ACS or PCI patients requiring or not anticoagulation for another indication. The primary safety endpoint was major bleeding while non-major bleeding and all bleeding were secondary safety endpoints. The primary efficacy endpoint was all-cause mortality while secondary efficacy endpoints included major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction (MI), definite stent thrombosis (ST) or any stroke. We estimated risk ratios (RR) and 95% confidence intervals (CI) using random effect models. The study is registered in PROSPERO (CRD42019139576). Results We included 9 RCTs comprising 40,621 patients.Compared to prolonged DAPT, major bleeding (2.2% vs. 2.8%; RR 0.68; 95% CI: 0.54 to 0.87; p=0.002; I2: 63%), non-major bleeding (5.0% vs. 6.1%; RR: 0.66; 95% CI: 0.47 to 0.94; p=0.02; I2:87%) and all bleeding (7.4% vs. 9.9%; RR: 0.65; 95% CI: 0.53 to 0.79; p Conclusions In patients on DAPT after an ACS or a PCI, early aspirin discontinuation prevents bleeding events with no effect on the ischemic risk or mortality. Figure 1. Central illustration Funding Acknowledgement Type of funding source: None

Today there are several new and interesting Nano-particle materials on the market providing good electrical conductivity. Examples are carbon Nano-tubes and different versions of graphene derivatives, often provided as powder. In particular, the materials available were Multi-Walled Carbon Nanotubes in Epoxy matrix and Reduced Graphene Oxide (rGOH). An initial literature survey underlined the lack of measurements and information about the conductivity of these materials during heating up or curing. This work is part of a larger project aiming at producing ”sensing structural composite material”, i.e. a composite material with integrated Nanoparticles, as eg. Carbonnano-tubes or graphene, working as sensors reporting the status of the material during heating up, curing and/or tensioning. The principal results concerns the evaluation of the specific conductivity during heating for both materials (rGOH and MWCNT in Epoxy Matrix) with the realization of an experimental model for the gradient of the specific conductivity with temperature. The linearity underlines the possibility of using the properties of these materials to create sensors, not only for strain (with the advantage of high Gauge Factors), but also for temperature.

The prediction capabilities of artificial neural networks in similitude field are investigated. They have been applied to plates in similitude with two objectives: prediction of natural frequencies and model identification. The results show that the method is able to give accurate predictions and that an experimental training set can be created if the models are well characterized.

The analysis of sound radiation from rotating elastic discs, e.g. saw blades, is an interesting research topic. Especially for people who work in the vicinity of such machines, health related issues with respect to noise exposure levels gain more and more awareness. Therefore, the industry is faced with the challenge of developing quieter products in order to improve the working environment and to extend the time a worker can use these tools before a harmful situation arises. Moreover, less noise emission means less energy consumption and therefore a higher productivity. In this paper, the authors investigate the sound radiation from a rotating disc where the sound power is used as a global measure for the acoustic performance. Different methods for calculating the sound power of a spinning saw blade are compared. These are a fully coupled finite element approach, a hybrid finite element/boundary element approach, a simplified form of the Rayleigh integral known as the lumped parameter model, and the equivalent radiated sound power. The results show good agreement between the costly full models and those utilizing approximation methods which can save remarkable computational costs. The proposed frame can be used in optimization procedures for developing quieter saw blades and other rotating discs. Furthermore, the paper discusses mode splitting which is a well-known phenomenon for rotating machinery. For this, the results of sound radiation are investigated with respect to the question whether mode splitting is actually audible.

International audience; Periodic structures found a big interest in engineering applications because they introduce frequency band effects, due to the impedance mismatch generated by periodic discontinuities in the geometry, material or boundary conditions, that can improve the vibroacoustic performances. However, the presence of defects or irregularity in the structure, leads to a partial lost of regular periodicity (called quasi-periodic structure) that can have a noticeable impact on the vibrational and/or acoustic behaviour of the elastic structure. The irregularity can be tailored to have impact on dynamical behaviour. In the present paper numerical studies on the vibrational analysis of one-dimensional finite, periodic and quasi-periodic structures are presented. The contents deal with the finite element models of beams focused on the spectral analysis and the damped forced responses. The quasi-periodicity is defined by invoking the Fibonacci sequence for building the assigned variations (geometry and material) along the span of finite element model. Similarly, the same span is used as a super unit cell with Floquet-Bloch conditions waves for analysing the infinite periodic systems. Considering both longitudinal and flexural elastic waves, the frequency ranges corresponding to band gaps are investigated. The wave characteristics in quasi-periodic beams, present some elements of novelty and could be considered for designing structural filters and controlling the properties of elastic waves. Prepared using sagej.cls; Les structures périodiques ont trouvé un grand intérêt dans les applications d'ingénierie car elles introduisent des effets de bande de fréquence, en raison de l'inadéquation d'impédance générée par les discontinuités périodiques dans la géométrie, le matériau ou les conditions aux limites, qui peuvent améliorer les performances vibroacoustiques. Cependant, la présence de défauts ou d'irrégularités dans la structure, conduit à une perte partielle de périodicité régulière (appelée structure quasi-périodique) qui peut avoir un impact notable sur le comportement vibratoire et / ou acoustique de la structure élastique. L'irrégularité peut être adaptée pour avoir un impact sur le comportement dynamique. Dans le présent article, des études numériques sur l'analyse vibrationnelle des structures finies unidimensionnelles, périodiques et quasi-périodiques sont présentées. Le contenu traite des modèles d'éléments finis de faisceaux focalisés sur l'analyse spectrale et les réponses forcées amorties. La quasi-périodicité est définie en invoquant la séquence de Fibonacci pour construire les variations attribuées (géométrie et matériau) le long de la durée du modèle par éléments finis. De même, la même plage est utilisée comme super-cellule unitaire avec des conditions de Floquet-Bloch pour analyser les systèmes périodiques infinis. En considérant les ondes élastiques longitudinales et flexionnelles, les gammes de fréquences correspondant aux bandes interdites sont étudiées. Les caractéristiques des ondes dans les faisceaux quasi-périodiques présentent certains éléments de nouveauté et pourraient être prises en compte pour la conception de filtres structuraux et le contrôle des propriétés des ondes élastiques.

International audience; Periodic structures have properties of controlling mechanical waves. These solutions are used in aircraft, trains, submarines, space structures where high level of robustness has to be ensured in presence of uncertainty in the numerical models. The paper presents a stochastic formulation for the Bloch analysis of periodic structures, based on the quadratic 1D and 2D forms of the Wave Finite Element method. In 1D case, numerical examples of periodic rod and metamaterial rod systems are considered; for the 2D case, homogeneous and periodic plates considered. In both cases, the effect of uncertainties on wavenumber variation is studied. The accuracy and performance of the developed method is compared with Monte Carlo simulation (MCS) results. It is found that the uncertainties affects the wavenumber scattering. Maximum variation of wavenumber occurs at the band gap edge frequencies and trends are increasing in higher frequency. In terms of computational cost, the presented formulation offers computational advantages over MCS. The computational cost savings can be a good point for the optimization and reliability study under uncertainties of complex structures. Highlights • A stochastic quadratic eigenvalue formulation for the periodic media is presented. • The longitudinal and flexural waves in the 1D and 2D periodic media are simulated. • In the case of flexural wave, only out of plane flexural wave are generated. • The formulation offers computational advantages over the Monte Carlo simulation.

Background Alirocumab and evolocumab, two proprotein convertase subtilisin–kexin type 9 inhibitors, have both been associated with improved outcomes in patients with atherosclerotic cardiovascular disease in addition to standard lipid-lowering therapies. However, their comparative safety and efficacy profiles are unknown. Purpose To compare the safety and efficacy of alirocumab versus evolocumab. Methods We conducted a systematic review and network meta-analysis of placebo-controlled randomized trials available up to November 2018 evaluating the safety and efficacy of alirocumab and evolocumab. We estimated risk ratio and 95% confidence intervals using fixed effect model in a frequentist pairwise and network metanalytic approach. The primary safety endpoints were any adverse events leading to treatment-discontinuation, injection site reaction, systemic allergic reaction, neurocognitive events, ophthalmologic events and new-onset of diabetes mellitus (DM) or worsening of pre-existing DM. The primary efficacy endpoints were all-cause and cardiovascular (CV) death, myocardial infarction (MI) and stroke. This study was registered in PROSPERO (CRD42018090768). Results A total of 30 trials, enrolling 59,026 patients were included in this analysis, of whom 13,607 received alirocumab and 17,931 received evolocumab. Mean weighted follow-up time was 2.5 years, with an exposure time of 144,907 patients-years. Eligibility criteria varied significantly across trials evaluating alirocumab and evolocumab. There were no significant differences between alirocumab and evolocumab in terms of safety endpoints, except for injection site reaction with a 27% increased risk of injection site reaction with alirocumab compared to evolocumab (Figure). Compared with evolocumab, alirocumab was associated with a reduction of all-cause death but not CV death. There were no significant differences in MI or stroke between alirocumab and evolocumab. Conclusion Alirocumab and evolocumab share a similar safety profile. No significant differences were observed across the efficacy endpoints, except for all-cause death, which may be related to heterogeneity of the studied populations between the two drugs.

Aims The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI. Methods and results Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission. Conclusion The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

International audience; The main advantage of designing sound packages with periodic arrangements is that they can provide a combination of absorption effects, resonance effects and wave interferences effects. This offers different applications in transportation (aeronautics, space, automotive, railway), energy and civil engineering sectors, where both weight and space, as well as vibroacoustic quality of performance and comfort, still remain as critical issues. The application of shift cell technique is presented and discussed for periodic porous media described with equivalent fluid models: it consists in a reformulation of classical Floquet-Bloch (F-B) conditions, whose major advantage stands in allowing the introduction of any frequency dependence of porous material behavior, through the resolution a quadratic eigenvalue problem, providing an efficient way to compute the dispersion curves of a porous material modelled as an equivalent fluid. The central part of this work shows the results, in terms of absorption coefficient and transmission loss curves, obtained through a numerical test campaign involving different melamine and polyurethane foams. The 48 test cases involve a cubic unit cell of porous material with a cylindrical inclusion. Furthermore, some absorption coefficient and transmission loss comparisons are shown, between a homogeneous unit cell and a unit cell with a perfectly rigid inclusion; the comparisons are carried out at fixed dimensions, then at fixed mass and then at fixed performance in the periodicity peak range. The results clearly point out the advantage of designing foam layer with periodic inclusion patterns in order to improve the performances in a specific range of frequencies, allowing a save both in terms of thickness and, most of all, mass, respect to a classical homogeneous foam layer.

The need of reducing the vibration levels is one of the most important points in many engineering fields. Therefore, the knowledge of the vibrational field can be a useful and efficient tool in problems regarding acoustic and mechanical insulation. This paper is focused on the experimental measurements and numerical predictions of the structural intensity fields in rectangular plates. The method is applied by simulating finite plates and the effects of constraints, load conditions, damping, thickness and fibres orientation are investigated. Experimental measurements are carried out on both aluminium sandwich and composite (orthotropic) panels; the results are compared through a mixed numerical/experimental approach with purely numerical predictions. The mixed approach based on both experimental and numerical information is proposed since it can give good indications of the structural intensity fields, can offer information about the energy transmission paths and can fruitfully use the numerical generated information.

International audience; Two types of sandwich panels are designed by using the periodic structure theory. A double-wall panel with mechanical links and a sandwich panel with rectangular core are studied. An oriented optimization of the elastic bending waves' propagation versus the acoustic wavenumbers is achieved by using shifted core walls and by keeping the mass and stiffness of the system constant. Standard and optimized configurations are 3D-printed and sound transmission measurements are carried out by using a facility with an uncoupled reverberant-anechoic configuration. The experimental evidences of enlarged bending band-gaps and deformation mechanisms are proved using a reverse approach based on the acoustic radiation of the panels.

Similarity theory is a branch of engineering science that deals with establishing conditions of similarity among phenomena and is applied to various fields, such as structural engineering problems, vibration and impact. Tests and numerical simulation of scaled models are still a valuable design tool, whose purpose is to accurately predict the behaviour of large or small prototypes through scaling laws applied to the experimental and numerical results. The aim of this paper is to predict the behaviour of the complete and incomplete similarity of stiffened cylinders by applying distorted scaling laws of the models in similitude. The investigation is performed using models based on the finite element method within commercial software. Two classes of cylinders scaled, with different laws, and, hence, reproducing replicas (exact similitude) and avatars (distorted similitude) are investigated.

Patients with chronic kidney disease (CKD) are at high risk for critical illness and for admission into an intensive care unit (ICU). “Critically ill CKD patients” frequently develop an acute worsening of renal function (i.e., acute-on-chronic, AoC) that contributes to a long-term kidney dysfunction, potentially leading to end-stage kidney disease (ESKD). An integrated multidisciplinary effort is thus necessary to manage adequately the multiorgan damage of those kidney patients and contemporaneously reduce the progression of kidney dysfunction during their critical illness. The aim of this chapter is to describe (1) the pathophysiologic mechanisms underlying the development of AoC kidney dysfunction and its role in the progression toward ESKD; (2) the most common clinical presentations of critical illness among CKD/ESKD patients; and (3) the continuum of care for CKD/ESKD patients from maintenance hemodialysis/peritoneal dialysis to acute renal replacement therapy performed in ICU and, vice versa, for AoC patients who develop ESKD.

Experimental vibroacoustic measurements are very common for the study of emitted noise reduction and vibration energy isolation of structures. The most important case is when structures are subjected to an aerodynamic excitation as Turbulent Boundary Layer (TBL). In this paper, a preliminary study is performed on the energy transmission between subsystems of a structure subjected to TBL. A numerical test is developed on a three-plates-in-row system at high frequencies, through the application of Statistical Energy Analysis (SEA). Parameters such as surface dimensions, thickness and damping loss factor are evaluated in different configurations for a first design of a testbench used for vibroacoustic measurements in a wind tunnel.

Coronary arteries are medium-small caliber vessels, in which low shear rate values are encountered, where non-Newtonian blood effects cannot be neglected. This work aims to study a comparison between Newtonian and non-Newtonian blood behaviors in a cohort offorty-eight 3D patient-specific stenotic vessels (right (RCA), left (LAD) and circumflex (LCX) coronary artery) at different grades of stenosis. Numerical simulation was carried out by means of Computational Fluid Dynamics (CFD) Analysis to investigate the blood velocity and distribution of the shear stress indices at different times of the cardiac cycle. A statistical analysis was performed to have a prediction ofincrement or decrement ofthe various hemodynamic parameters. The results show that the non-Newtonian effects are mostly important in shear stress indices distributions.