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The integration of metals and polymers in the same component to couple the best properties and advantages of both these classes of materials can be useful for engineering applications. In this scenario, the aim of this paper is to integrate additive manufacturing of composites with cold spray deposition of metal particles: in particular, 3D-printed carbon fibre-reinforced plastics (CFRP) panels were coated with aluminium particles to couple the lightweight and high mechanical properties of CFRP with high wear resistance and hardness of metals. CFRP panels have been produced by using the Fused Filament Fabrication (FFF) technology, then the panels have been coated with aluminium particles by using a low pressure cold spray facility. Panels with various stratification sequences have been produced to investigate the feasibility of the process and to highlight the influence of the lay-up strategy on the whole process; the parameters of the cold spray process have been also optimized to ensure an effective deposition. Adhesion tests, distortion measurements, cross-section observations and surface coverage measurements have been chosen as response outputs to evaluate the effectiveness of the process and to assess the influence of the process parameters. The integration between FFF of CFRPs and cold spray deposition of aluminium particles has been proved, values of surface coverage close to 100% and good values of adhesion strength (close to 4 MPa) have been achieved; moreover, the presence of the fibres, giving a higher stiffness to the substrate, avoids the occurrence of distortion phenomena during the deposition. It was also proved that the printing parameters influence the deposition: an increase in the infill density from 30% to 50% leads to an increase in the adhesion strength up to 40%. In summary, the results obtained proved the feasibility of the process and allowed to enucleate directions of future research.

Ensuring drug safety for pregnant women through prescription drug monitoring is essential. The aim of this study was to describe the prescription pattern of medicines among pregnant immigrant women from countries with high migratory pressure (HMPCs) compared to pregnant Italian women. The prevalence of drug prescriptions among the two study populations was analysed through record linkage procedures applied to the administrative databases of eight Italian regions, from 2016 to 2018. The overall prevalence of drug prescription was calculated considering all women who received at least one prescription during the study period. Immigrants had a lower prevalence of drug prescriptions before (51.0% vs. 58.6%) and after pregnancy (55.1% vs. 60. 3%). Conversely, during pregnancy, they obtained a slightly higher number of prescriptions (74.9% vs. 72.8%). The most prescribed class of drugs was the blood and haematopoietic organs category (category ATC B) (56.4% vs. 45.9%, immigrants compared to Italians), followed by antimicrobials (31.3% vs. 33.7%). Most prescriptions were appropriate, while folic acid administration 3 months before conception was low for both study groups (3.9% immigrants and 6.2% Italians). Progesterone seemingly was prescribed against early pregnancy loss, more frequently among Italians (16.5% vs. 8.1% immigrants). Few inappropriate medications were prescribed among antihypertensives, statins and anti-inflammatory drugs in both study groups.

Purpose To analyse the drug use pattern in women with psoriasis before, during and after pregnancy. Methods All children born (2009-2016) in a central Italian region (Lazio) to mothers with a diagnosis of psoriasis were identified. Drug use patterns (biologicals, systemic, and topical), and discontinuation and switching of drug therapies before, during, and after pregnancy were studied. Findings were compared with data from a population exposed to similar drug therapies (eg, antirheumatic drugs). Results Among 3499 deliveries by women affected by psoriasis, 1876 (53.6%) were diagnosed with this condition before the Last Menstrual Period (LMP). Of these, 525 (27.9%) had at least one drug prescription for psoriasis therapy during 6 months before LMP. For each class of drugs considered, there was a general decrease in its use during pregnancy. Considering the two trimesters preceding LMP and the three trimesters of pregnancy, the following percentages of prescriptions were observed: from 10.5% to 0% for biologicals, 7.2% to 2.5% for the conventional systemic drugs, and 51.1% to 9.4% for the topical treatments. After delivery, previous treatments were resumed. Similar results were observed for rheumatoid arthritis, a chronic condition. Conclusions Majority of drugs come with warnings regarding potential embryo-fetotoxicity, which might play a role in the decision to continue treatments during pregnancy. According to our study pregnancy appears to have a significant influence on drug prescriptions of different pharmacological treatments for psoriasis.

Background: There is growing interest both in testing IgE in nasal secretions (NS) and in molecular diagnosis of seasonal allergic rhinitis (SAR). Yet, the reliability of nasal IgE detection with the newest molecular assays has never been assessed in a large cohort of pollen allergic patients. Objective: To investigate with microarray technology and compare the repertoires of specific IgE (sIgE) antibodies in NS and sera of a large population of children and adults with SAR. Methods: Nasal secretions were collected with an absorbent device (Merocel 2000��, Medtronic) and a minimal dilution procedure from 90 children and 71 adults with SAR. Total IgE (tIgE) (ImmunoCAP, Thermo Fisher Scientific (TFS)) and sIgE antibodies against 112 allergen molecules (ISAC-112, TFS) were measured in NS and serum. Results: Nasal sIgE was detectable in 68.3% of the patients. The detected nasal sIgE antibodies recognized airborne (88%), vegetable (10%), and animal food or other (

The cold spray deposition process has gained interest as a promising technique for producing metallic coatings on polymers and composite materials thank to its low working temperatures. However, poor adhesion of metallic particles on polymeric substrates and the brittle nature of these materials lead to generation of cracks under the impact of the sprayed particles, limiting its application to polymeric matrix composite. The interposition of an intermediate metallic layer over the thermoset composite to be coated has been claimed to improve the adhesion of the sprayed particles and the formation of a stable link between the metal coating and the underlying polymer panel. The present work discusses a methodology that integrates the manufacturing of glass reinforced epoxy panels having functionalized surface and the subsequent production of a dense metallic layer by cold spray. Pure copper and titanium metallic powders, having spherical and irregular shape respectively, were placed on the top of the stack of dry glass fiber fabrics. Resin infusion process was then applied to impregnate the glass fabrics providing the simultaneous functionalization of the composite panel. In order to assess the effectiveness of the produced substrate, and of the proposed procedure, metallic coatings have been finally deposited on manufactured composite panels by means of a low-pressure cold spray facility. Regardless the spraying condition (namely gas temperature, stand-off distance, sprayed particles), copper samples showed a remarkable erosion of functionalized layer after cold spray process with pronounced damages of the composite substrate. On the other hand, effective depositions have been observed on titanium samples under specific combination of process parameters.

Cold spray (CS) is an emerging coating technology that makes use of a converging/diverging nozzle, a high pressure and a heated gas source to create a high‐velocity gas flow. Coating deposition occurs at relatively low temperatures compared to other spray technologies, therefore the sprayed particles remaining in the solid-state. The process can produce dense coatings when the process parameters are optimized. Despite the incredible advantages of CS and the established knowledge of CS considering metal substrates, some questions like the bonding mechanism and the adhesion/cohesion strength of the coating with polymeric substrates remain an open research topic. In this paper, a metal coating (AlSi10Mg) was deposited on a plate in polypropylene by cold spray in order to increase the properties of the surface. Metallic particles, in the range of 20-40 µm, were injected into gas flow and propelled to supersonic velocities. Polymers require a deposition technique in which the substrate remains at relatively low temperatures during the whole process in order to avoid plastic deformation or degradation. Determination of the mechanical properties of thin films on substrates by indentation has always been difficult because of the influence of the substrate on the measured properties. In order to evaluate the local properties of the deposited coating, microindentation tests and DMA were carried out. In particular hardness values by microindentation tests and values of elastic modulus by DMA were calculated.

Polymer matrix composites (PMCs) are the most used in aerospace fields due to their special mechanical properties coupled with reduced weight. Metallic structures can be manufactured on the surface of PMCs producing hybrid constructions with intriguing characteristics. The cold spray technology (CS) seems to be the best solution for the manufacturing of metallic coatings on polymer-based substrates. However, the last researches on PMCs metallization through CS were carried out without taking into account a proper manufacturing of the substrates. Therefore, the customized manufacturing of PMCs used as substrates for CS deposition represents a crucial aspect to be considered, the target surface should be designed and manufactured to fit better the CS requirements. In this scenario, the Fused Filament Fabrication method (FFF) is the best solution for tailored composites manufacturing. Therefore, this work aims to develop a novel manufacturing route to produce innovative composite structures by using the FFF technology for the 3D-printed polymer-based substrate and the cold spray technology for the 3D-printed metal deposition. The novelty is that, for the first time, the polymer-based substrates will be designed and manufactured “ad hoc” for the cold spray metallization by using the rapid prototyping 3D-printing process successfully integrated with CS technology.

Cold spray deposition, which can be framed in the wider family of additive manufacturing, is a manufacturing technique that is able to produce coatings on diverse types of substrates through the deposition of feedstock powder. As a low-temperature process, cold spray represents a potential solution for the metallization of temperature-sensitive materials, i.e. polymers and polymer matrix composites. The study of the cold spray technology for the metallization of polymers is still in its early stage, and the deposition mechanisms of metals on polymer-based materials are not thoroughly understood yet. On these premises, a review on this topic is needed to systematically depict the actual state of the art and to provide a reliable and well-organized overview discussing all the theories arisen in these years. In summary, this review aims: i) to collect all the available literature and enucleate the most discussed and interesting points (the most prevailing theories regarding the bonding mechanisms, the influence of the different process parameters and the main characteristics of cold-sprayed coating), providing a reliable and well-organized state of the art; ii) to define the open questions and to delineate the directions of future work.

Cold spray (CS) is a low-temperature process that can be used for the metallization of temperature-sensitive materials, such as polymers or polymer matrix composites, so coupling the lightweight of polymers with the wear resistance, physical properties and hardness of metals. The study of the cold spray of metal particles applied to polymers is still in its early stage and the deposition mechanisms underlying the process are not thoroughly understood yet. Moreover, numerical studies of cold spray of metal-to-polymer are almost completely absent in literature. Therefore, aiming to fulfill this gap of knowledge, the scope of this work is to develop a numerical FE model capable of predicting the impact and the adhesion of a micron size metallic particle onto a polymeric substrate. The results from the model were compared with the experimental outcomes found in literature to establish the effectiveness of the model that was used as a powerful tool to better understand the bonding mechanisms and all the related phenomena ruling the CS process of metal-to-polymer.

Background The Dermatophagoides pteronyssinus molecule Der p 23 is a major allergen whose clinical relevance has been shown in cross‐sectional studies. We longitudinally analysed the trajectory of Der p 23‐specific IgE antibody (sIgE) levels throughout childhood and youth, their early‐life determinants and their clinical relevance for allergic rhinitis and asthma. Methods We obtained sera and clinical data of 191 participants of the German Multicentre Allergy Study, a prospective birth cohort. Serum samples from birth to 20 years of age with sIgE reactivity to Der p 23 in a customised semiquantitative microarray were newly analysed with a singleplex quantitative assay. Early mite exposure was assessed by measuring the average content of Der p 1 in house dust at 6 and 18 months. Results Der p 23‐sIgE levels were detected at least once in 97/191 participants (51%). Prevalence of Der p 23 sensitisation and mean sIgE levels increased until age 10 years, plateaued until age 13 years and were lowest at age 20 years. Asthma, allergic rhinitis (AR) and atopic dermatitis (AD) were more prevalent in Der p 23‐sensitised children, including those with monomolecular but persistent sensitisation (11/97, 11%). A higher exposure to mites in infancy and occurrence of AD before 5 years of age preceded the onset of Der p 23 sensitisation, which in turn preceded a higher incidence of asthma. Conclusions Der p 23 sensitisation peaks in late childhood and then decreases. It is preceded by early mite exposure and AD. Asthma and AR can occur in patients persistently sensitised to Der p 23 as the only mite allergen, suggesting the inclusion of molecular testing of Der p 23‐sIgE for subjects with clinical suspicion of HDM allergy but without sIgE to other major D.pt. allergens.

The Atlas of social inequalities in the use of medicines for the treatment of the major chronic diseases is the first national report published on social inequalities in the context of pharmaceutical care in Italy. The results highlighted how the socioeconomic position was strongly correlated with the use of medicines: for many therapeutic categories, the highest per capita consumption rates were recorded in the areas with a higher socioeconomic deprivation index. On the other hand, no correlations emerged between the level of deprivation and adherence and persistence to pharmacological treatment.

The results of the OsMed reports of the Italian Medicines Agency (AIFA) on consumption and expenditure related to biosimilar medicines show a high heterogeneity at the regional level, with great differences in terms of both consumption and price. In light of the potential savings and the growing number of biological medicines whose patents have expired or are about to expire, it is therefore desirable that the regions with the lowest levels of consumption take action to increase the awareness of health professionals on efficacy and safety of such treatments and the potential advantages in terms of sustainability of the national health system.

BACKGROUND Mobile health technologies enable allergists to monitor disease trends by collecting daily patient-reported outcomes of allergic rhinitis. To this end, patients with allergies are usually required to enter their symptoms and medication repetitively over long time periods, which may present a risk to data completeness and quality in the case of insufficient effort reporting. Completeness of patient’s recording is easily measured. In contrast, the intrinsic quality and accuracy of the data entered by the patients are more elusive. OBJECTIVE The aim of this study was to explore the association of adherence to digital symptom recording with a predefined set of parameters of the patient-generated symptom and medication scores and to identify parameters that may serve as proxy measure of the quality and reliability of the information recorded by the patient. METHODS The @IT.2020 project investigates the diagnostic synergy of mobile health and molecular allergology in patients with seasonal allergic rhinitis. In its pilot phase, 101 children with seasonal allergic rhinitis were recruited in Rome and instructed to record their symptoms, medication intake, and general conditions daily via a mobile app (AllergyMonitor) during the relevant pollen season. We measured adherence to daily recording as the percentage of days with data recording in the observation period. We examined the patient’s trajectories of 3 disease indices (Rhinoconjunctivitis Total Symptom Score [RTSS], Combined Symptom and Medication Score [CSMS], and Visual Analogue Scale [VAS]) as putative proxies of data quality with the following 4 parameters: (1) intravariation index, (2) percentage of zero values, (3) coefficient of variation, and (4) percentage of changes in trend. Lastly, we examined the relationship between adherence to recording and each of the 4 proxy measures. RESULTS Adherence to recording ranged from 20% (11/56) to 100% (56/56), with 64.4% (65/101) and 35.6% (36/101) of the patients’ values above (highly adherent patients) or below (low adherent patients) the threshold of 80%, respectively. The percentage of zero values, the coefficient of variation, and the intravariation index did not significantly change with the adherence to recording. By contrast, the proportion of changes in trend was significantly higher among highly adherent patients, independently from the analyzed score (RTSS, CSMS, and VAS). CONCLUSIONS The percentage of changes in the trend of RTSS, CSMS, and VAS is a valuable candidate to validate the quality and accuracy of the data recorded by patients with allergic rhinitis during the pollen season. The performance of this parameter must be further investigated in real-life conditions before it can be recommended for routine use in apps and electronic diaries devoted to the management of patients with allergic rhinitis.

In this research activity, the manufacturing of metallic coatings on polymer-based panels through the low pressure cold spray technique was studied. Aluminium particles were sprayed for the metallization and carbon fibre composite materials with thermoplastic matrix (PP, PA66) were used as substrates. Different deposition parameter combinations have been set to investigate the feasibility of the process; SEM analyses were carried out to study the coating surface morphology and the interface interaction between particle and substrate. The results showed that the CS process is an effective technique to create aluminium coatings on polymeric matrix composite materials: compact coatings can be obtained if the process parameters are properly set.

In this work, the manufacturing through cold gas dynamic spray (cold spray or CS) of metallic composite coatings of Al-Al2O3 on organic composite substrates with thermoplastic PLA matrix and hemp fibers was studied. Alumina powders, with a mean diameter of 50 μm, were used blended with aluminum powders in three different weight concentration percentages (0, 15, 20, and 45%) as feedstock material in order to highlight and discuss the variations of the coating surface properties depending on the alumina percentage. The coatings were produced by using a low-pressure cold spray equipment. A detailed experimental campaign, including microstructural observations and confocal microscopy, was carried out to study the structure of the coatings. Moreover, the tribological behavior of the coatings was studied through both scratch test and pin-on-disk test. The experiments showed that a small addition of alumina improves the compactness of the coating and its resistance to scratch and wear behavior.

International audience; Composite materials are widely used as main parts and structural components in different fields, especially for automotive and military applications. Although these materials supply different advantages comparing to the metals, their implementation in engineering applications is limited due to low electrical and thermal properties and low resistance to erosion. To enhance these above-mentioned properties, the metallization of composite materials by creating a thin metal film on their surface can be achieved. Among different coating deposition techniques, Cold Spray appears to be the most suitable one for the metallization of temperature-sensitive materials such as polymers and composites with a thermoplastic matrix. This process relies on kinetic energy for the formation of the coating rather than on thermal energy and consequent erosion and degradation of the polymer-based composite can be avoided. In the last years, a new method to produce composite materials, as known as Fused Filament Fabrication (FFF), has been developed for industrial applications. This technique consists of a 3D printing process that involves the thermal extrusion of thermoplastic polymer and fibers in the form of filaments from a heated mobile nozzle. The implementation of this new technique is leading to the manufacturing of customized composite materials for the cold spray application. In the presented experimental campaign, Onyx material is used as a substrate. This material is made of Nylon, a thermoplastic matrix, and chopped carbon fibers randomly dispersed in it. Aluminum powders were cold sprayed on the Onyx substrate with a low-pressure cold spray (LPCS) system. This study aims to investigate the possibility of the metalizing 3D-printed composite material by cold spray technology. For this purpose, optical and microscopical analyses are carried out. Based on the results, the feasibility of the process and the influence of the morphology of the substrate are discussed, and optimal spraying conditions are proposed.

Polymer matrix composites are finding never-ending widespread uses in the last decades, one recent tendency is to metallize their surface to further widen their field of application. Cold-spray deposition is one of the most promising techniques that can be adopted to this aim. Cold-spray deposition on polymers is in its early stage and more experimental work is required to fully understand the phenomena ruling the deposition. In this paper, the results of nanoindentation measurements on cold-spray coatings on various substrates will be presented and discussed. Polypropylene was used as matrix while carbon and glass fibers have been used as reinforcement, both steel and aluminum have been used as feedstock material for the cold-spray deposition. Nanoindentations tests have been then carried out on all the different samples, the influence of the fibers and of the powders sprayed on the behavior of the coatings is discussed in light of the experimental outcomes.

Cold spray deposition of aluminum powders on polyethylene reinforced with glass fibers has been studied. Different processing conditions, including different stratifications of the fiber-reinforced polymer used as a substrate, have been investigated to better understand the deposition mechanism. The experimental campaign has been conceived and tailored to highlight the influence of several process parameters on the deposition of the first layer of particles. The results obtained allowed to highlight and clarify the influence of standoff distance and gas pressure and also gave some insights concerning the effect of the substrate stratification. Guidelines regarding the design of the manufacturing process have been also released.

Metallization is a common strategy employed to enhance the electrical and thermal conductivity of polymer matrix composite materials. Nevertheless, metallic deposition on polymer-based materials is challenging due to the inherent limitations related to high temperature exposure of the substrate. In this article, a new technique for the manufacturing of composite laminates and the subsequent metallization by cold spraying of metallic powder is presented. The composite manufacturing route is based on the production of thermoplastic-thermoset hybrid substrates and consisted of two main stages: in the first stage the partial impregnation of a reinforcement textile by a thermoplastic film was promoted by hot pressing compaction. Afterwards, the prepared lamina was vacuum bagged with other reinforcing layers and impregnated by the thermoset catalyzed resin by a vacuum infusion process. Finally, the thermoset and thermoplastic layers were co-cured to increase the adhesion of the substrate with the thermoplastic film. The metallization of composite laminate was obtained through the cold spraying technique, depositing powders on the thermoplastic surface layer. The effect of processing parameters on the coating deposition, quality and microstructure was reported and discussed.

Background: Allergen immunotherapy (AIT) is the only disease-modifying treatment in patients with seasonal allergic rhinoconjunctivitis (SAR). Its efficacy depends on the precise identification of the triggering allergen. However, diagnostics based on retrospective clinical history and sensitization to whole extracts (SWE) often leads to equivocal results. Objectives: To assess the usability and impact of a recently established algorithm for a clinical decision support system (@IT2020-CDSS) for SAR and its diagnostic steps [anamnesis, SWE (skin prick test or serum IgE), component resolved diagnosis, CRD, and real-time digital symptom recording, eDiary] on doctor's AIT prescription decisions. Methods: After educational training on the @IT2020-CDSS algorithm, 46 doctors (18 allergy specialists, AS, and 28 general practitioners, GP) expressed their hypothetical AIT prescription for 10 clinical index cases. Decisions were recorded repeatedly based on different steps of the algorithm. The usability and perceived impact of the algorithm were evaluated. Results: The combined use of CRD and an eDiary increased the hypothetical AIT prescriptions, both among AS and GP (p < .01). AIT prescription for pollen and Alternaria allergy based on anamnesis and SWE was heterogeneous but converged towards a consensus by integrating CRD and eDiary information. Doctors considered the algorithm useful and recognized its potential in enhancing traditional diagnostics. Conclusions and clinical implications: The implementation of CRD and eDiary in the @IT2020-CDSS algorithm improved consensus on AIT prescription for SAR among AS and GP. The potential usefulness of a CDSS for aetiological diagnosis of SAR and AIT prescription in real-world clinical practice deserves further investigation.

The deposition of steel powders on glass fiber reinforced polymer (GFRP) with the Cold Spray technique is investigated. Metallization of composite materials is still challenging when high-strength and dense powders, such as steel, are used due to excessive erosion of the polymer or disruption of the fibers during the deposition. To overcome these issues, low-pressure cold spray equipment has been used for the experimental campaign shown in this paper. Different coatings were obtained by using nitrogen as the carrier gas and different sets of pressure and standoff distance. Optimization of the process parameters, including the stratification of the laminate, has been carried out. Results of an initial study of the feasibility of the process and the influence of the different chosen spray conditions are exposed. In particular, the bonding mechanisms of steel powders and their morphology are discussed.

Background: Allergen immunotherapy(AIT) is the only disease-modifying treatment with long-term effects in patients with seasonal allergic rhinoconjunctivitis(SAR). Its efficacy depends on the precise identification of the pollen triggering symptoms. However, a diagnostic approach based on retrospective clinical history and sensitization to extracts often does not lead to unequivocal results. Objectives: To assess the usability and impact of a recently established algorithm for a potential clinical decision support system (@IT.2020-DSS) for pollen allergy and its diagnostic steps (including anamnesis, SPT, component resolved diagnosis, CRD, and real-time digital symptom recording, eDiary) on doctor’s AIT prescription decisions. Methods: After a concise educational training on the @IT.2020-DSS algorithm, 46 doctors (18allergy specialists, AS, and 28general practitioners, GP) expressed their hypothetical AIT prescription for 10 clinical index cases. Decisions were recorded repeatedly based on different steps of the support algorithm. The usability and perceived impact of the algorithm on individual clinical performance were evaluated. Results: The combined use of CRD and an eDiary increased the hypothetical AIT prescriptions, both among AS and GP (p

The aim of this chapter is to bring together, summarize and explain the latest development in the field of the cold spray deposition on polymeric and composite substrates. Although the deposition on metallic substrates has been widely studied and there are interesting books reporting the phenomena occurring and describing the process in detail, the deposition on polymeric substrates is a relatively new branch of cold spraying and to date there are no review papers or books focused on this topic. Several original research papers dealing with this topic have been published in the last years so it can be assumed that the available material is enough to allow the writing of a book chapter that summarizes what was done and highlights what more needs to be done. First it is worth to notice why this topic is of interest. Polymer matrix composites (PMCs) are widely used in the aerospace industry and in the military because of their low density, high specific strength and stiffness, and other unique properties such as ease formation and machining, well size stability. At the same time the use of polymeric components in aircraft, automobile, and power sector has gradually increased due to the development of new polymers with enhanced mechanical and physical properties. Some special characteristics such as electrical conductivity, thermal conductivity, electromagnetic shielding, erosion and radiation protection have to be improved to further widen the fields of application of these materials. Therefore, the surface metallization of a PMC or polymeric substrate is considered to be an effective technique to enhance the above-mentioned surface properties. To date there are several conventional techniques for the polymer metallization. The most common metallization techniques include vapor phase deposition, thermal spray deposition, electro deposition, electroforming and electroless deposition. However, these techniques have disadvantages. High equipment and processing costs, size limitations of workpiece produced by vapor phase deposition-based techniques (deposition in atomic dimension and workpiece should be placed in a limited cavity). Low adhesive force, poor stability in the electroplating case and the consequent pollution it generates, long production cycle and high cost of the mold for electroforming, distortion of the substrate surface resulting from the molten particles, and high-temperature flames in thermal spraying (TS). Recently, the cold spray technique, with suitable modification, has been increasingly used for the metallization of polymers and PMCs, especially for the advance polymer composite such as carbon fiber-reinforced polymer (CFRP). Compared to the techniques mentioned in the previous indent the cold spray offers some intriguing advantages when spraying metallic particles on polymeric substrates: (i) the deposition is made possible by the significant plastic deformation of the particles and of the substrate, some polymers (the thermoplastic ones) can experience an huge amount of plastic deformation so this type of interaction easily occurs; (ii) no chemical reaction are required to take place between the particles and the substrate, so it is not a problem the fact that due to their different chemical nature it would be almost impossible to observe a chemical bonding between a metal and a polymer; (iii) compared with thermal spray processes a less heat input is required in cold spray, therefore, heat effects such as surface distortion, oxides, void, phase transformation, and residual stresses are considerably reduced in the coatings; on this premise cold spray appears to be a suitable technique to process temperature-sensitive materials, such as polymers; (iv) in addition, CS has a technical advantage (similar to the TS)—the spraying gun can be held by a robot arm or the workpiece can be installed onto a numerical control working platform to prepare large-sized or complex surface parts with flexibility and compatibility, and this can be a big competitive advantage in the realm of additive manufacturing. In this chapter it will be provided a comprehensive overview of the deposition of metallic coatings on polymeric substrates through cold spray. The deposition behavior of the coatings and the adhesion mechanisms between the substrate and the particles will have discussed to set a foundation for the practical application of cold spray on polymers. The microstructure and the properties of the coatings will be as well reported to provide a useful guideline for practical applications. Moreover, a section will be devoted to the study of the tailored design of the PMCs substrates and to the study of proper chemical formulations of the polymers to facilitate the cold spray deposition. The main topics that are covered in this chapter are below reported: Different experimental set up adopted; Various substrate/coating configurations that can be produced; Mechanisms that rule the adhesion between the particles and the substrate; Deposition behavior and influence of the primary process parameters; Mechanical, tribological, and physical properties of the coatings, including microstructure; Modeling of the process; Tailored design and production of the PMCs to facilitate the deposition; Tailored chemical composition of the polymers to facilitate the deposition; and Direction of further investigation.

Background In early childhood, the allergen-specific IgG repertoire is mainly directed to animal and vegetable food molecules and infrequently to airborne molecules. It is unknown whether this early pattern is maintained throughout childhood. Objective To investigate the evolution of IgG and IgE responses to a broad panel of allergenic molecules from birth to age 10yrs. Methods We examined the sera collected between birth and age 10yrs from participants in the German Multicentre Allergy Study, a birth cohort born in 1990. The IgE (cut-off ≥0.30 ISU) and IgG (cut-off ≥0.10 ISU) responses to 35 genuine allergenic molecules were measured with a multiplex microarray approach (ImmunoCAP ISAC™). Results IgE responses were mostly directed against a restricted group of airborne molecules, with a sequence and prevalence hierarchy (Phl p 1 > Bet v 1 > Fel d 1 > Phl p 5 > Der p 2 > Der p 1) largely maintained over time. Conversely, the IgG repertoire was much broader, starting with animal foodborne, then spreading to vegetable foodborne and finally to airborne molecules. A strong and persistent IgG response to a given airborne molecule almost invariably preceded or accompanied an IgE response to that molecule. Conclusions The evolution of IgG and IgE responses throughout childhood differs widely at population level. IgG responses are mostly directed to animal food allergens while IgE responses are dominated by airborne allergens. However, a strong IgG response almost invariably precedes or accompanies the appearance of IgE to the same molecule in specifically sensitized subjects. This article is protected by copyright. All rights reserved.

Background The identification of the primary sensitizing pollen is difficult in Southern European patients with Seasonal Allergic Rhinitis (SAR) if sensitized to various pollen sources with overlapping seasonality. A more precise diagnosis is obtained by IgE assays to allergen molecules, currently available as singleplex or microarrays. Objectives To test the analytical performance of a multi-parameter immunoblot molecular "Pollen Test" specifically designed to test IgE antibodies to pollen extracts and molecules clinically relevant in Southern Europe. Methods Sera were obtained from 101 children and 98 adults with SAR and tested with a customized multiplex immunoblot assay (EUROLINE Southern European Pollen Profile [ESEP]; EUROIMMUN AG, Luebeck, Germany) containing a comprehensive panel of allergen extracts and molecules. ESEP's outcomes were then compared in selected sera (ESEP positive to negative = 2:1) with those of singleplex IgE assays (ImmunoCAP; ThermoFisher Scientific, Uppsala, Sweden). For each of the examined reagents, qualitative (sensitivity, specificity, accuracy), semi-quantitative (classes) and quantitative (Spearman's rank correlation, Bland-Altmann plots) comparisons were performed. Results Compared to ImmunoCAP, cumulative ESEP's sensitivity and specificity were 87% (95% CI 84%-90%) and 88% (83%-93%) for extracts and 99% (98%-100%) and 87% (83%-91%) for molecules. Cohen's kappa coefficients (κC ) ranged for extracts from 0.18 (Pellitory) to 0.50 (Cypress) and for molecules from 0.21 (Ole e 1) to 0.68 (Phl p 7). The quantitative outcomes of the two diagnostic tests were highly correlated, with Spearman's rank correlation coefficients always exceeding 0.80. Bland-Altmann plots showed a tendency of ESEP to overestimate serum specific IgE levels, when compared to ImmunoCAP. Conclusions and clinical relevance Sensitivity and specificity of ESEP in testing serum IgE antibodies against pollen allergen extracts and molecules, in Italian patients with SAR, both exceeded 85%. The advantages and limitations of a multiplex customized immunoblot assay, in the routine clinical use of molecular diagnostics in Southern European pollen allergic patients, deserve to be tested.

Recently, the growing attraction to the development of new eco-sustainable composite materials is driving the research interest toward the replacement of synthetic reinforcing fibres with natural ones and exploiting the inherent recyclability of thermoplastic resins even for uses in which thermosetting matrices are well consolidated (e.g. naval and aeronautical fields). Among the natural fibres, a growing interest of the research is addressed to basalt fibres. Focusing the attention on thermoplastic composites, many experimental findings already available in literature highlight the outstanding mechanical properties of composite materials including basalt fibres and their potentiality concerning glass ones. On the other hand, some issues are related to the surface properties of the bio-laminates: in particular, the wear ones, the flame resistance and the aesthetic appearance have to be improved to extend the application fields of these materials. Aiming to these goals, this paper deals with the study of the deposition ofaluminium coating through cold spray process on polypropylene/basalt fabric composite laminates. The specimens were obtained by film stacking, and compression moulding technology and their performances were studied in terms of low-velocity impact behaviour, considering the influence of the surface modification with the aluminium coating. The results obtained from the reference laminates and the coated ones are compared in terms of impact parameters: the aluminium deposition seems to affect the damage mechanism propagation even if the impact response seems to be similar in both conditions.

In this activity, customized panels for the CS deposition have been produced and aluminium has been deposited using air as a carrier gas. The custom-made panels were made with different matrix thicknesses on the surface in order to point out the influence of the fibres in the deposition and to study the feasibility and the growth of the coating. The polymer chosen for the matrix is polypropylene, widely used in the automotive sector, while for the reinforcements glass fibres have been used. Different process parameters have been examined in order to point out the influence of temperature, stand-off distance and pressure chosen, on the compaction and densification of the coating produced. In addition, morphological investigations were performed to further characterize the coatings deposited. It has been noticed that aluminium powders can be effectively deposited on polypropylene panels, leading to significantly better results when the thickness of the matrix is ​​sufficient to prevent the powders bouncing elastically on the fibres, while benefiting from the stiffening effect of the latter.

Background: Pollen-related seasonal allergic rhinoconjunctivitis (SAR) is a very frequent pediatric disease in Westernized countries. Risk factors and disease phenotypes have been thoroughly examined in several cross-sectional studies. By contrast, only a few studies have examined disease evolution in patient cohorts. We investigated predictive biomarkers of disease evolution in a large cohort of children with SAR. Methods: During 2015-2017 (follow-up), we re-examined 401 patients from those enrolled in 2009-2011 (baseline) by the “Panallergens in Pediatrics” study, a large multicenter survey of Italian children with SAR. Information on clinical history (standard questionnaire, AllergyCARD®; TPS, Italy) and skin prick tests for inhalant and foods extracts (ALK-Abelló, Hørsholm, Denmark) was acquired as at baseline visit. Evolution in clinical and sensitization data of patients was analyzed over time, as well as their association with the main baseline characteristics and atopy risk factors. Results: The average age of participants was 10.4±3.4years at baseline and 16.2±3.6years at follow-up. SAR persisted in 93.3% of patients at follow-up and became more frequently associated with asthma (from 36.7% at baseline to 48.6% at follow-up) and oral allergy syndrome (OAS, from 23.4% to 37.7%). Compared to baseline, the prevalence of skin sensitization to some pollens (Phleum pratense, Corylus avellana, Platanus acerifolia, Artemisia vulgaris) and vegetables (hazelnut, wheat, and apple) significantly decreased at follow-up. Earlier onset of SAR and polysensitization at baseline were associated with incident asthma at follow-up. The presence at baseline of serum IgE to the following allergen molecules was identified as biomarkers of clinical evolution: (a) Phl p 1, for persistence of SAR; (b) Phl p 5, for persistence of both rhinitis and asthma; (c) Pru p 3, for new onset of asthma; (d) Bet v 1, for persistence of OAS. Conclusions: Seasonal allergic rhinoconjunctivitis is clinically heterogeneous in its evolution from childhood to adolescence. The detection of serum IgE to specific molecules (Phl p 1, Phl p 5, Bet v 1, Pru p 3) may be useful as biomarkers to predict SAR persistence and future onset of comorbidities, such as asthma and/or OAS.

The low-velocity impact behaviour of novel composite structures, made of a polymer matrix composite with a superficial 3D printed metallic layer, was studied. The metallic layer was produced through cold spray deposition which is a relatively new additive coating technique allowing for the deposition of metallic coatings on thermal-sensitive substrates, such as the polymeric materials. Micron-sized aluminium particles were used to metallise the surface of basalt-nylon 6 (PA6) laminates manufactured by the compression moulding technique. Three different energy levels (10 J, 20 J, 30 J) were set for the impact tests. The results obtained pointed out the beneficial contributions of the metallic coating on the energy absorbing modes of the polymeric substrates; the positive effects on the damage mechanisms as well as the crack propagation were detected by plastic deformation analyses and ultrasonic damage controls.

Background The impact of proper aspiration of nasal secretions during upper respiratory infection on the frequency and severity of symptoms of lower airways has never been investigated. The study was aimed at testing if cleaning the nasal cavities of children with recurrent wheezing using an automatic nasal aspirator improves the upper and lower respiratory symptoms during the cold season. Methods Parents of wheezing children (age 3-72 mo.) answered questionnaires and learned using a nebulizer equipped (cases) or not equipped (controls) with an automatic nasal aspirator (DuoBaby, OMRON, Japan). During a 90-days monitoring period parents filled an electronic diary (BreathMonitor, TPS, Rome, Italy) on their child’s symptoms of the upper and lower airways. Results Eighty-nine/91 patients (43 cases, 46 controls) completed the study. Less days with upper (25.0% vs 46.4%, p = 0.004) or lower (21.8% vs 32.8%, p = 0.022) airways symptoms and less days with salbutamol inhalation (12.2% vs 16.9%, p

Background Grass pollen–related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. Methods We examined 1120 children (age 4–18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD™). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA. Results The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by higher serum total IgE, higher grass-specific serum IgE and higher number and degree of sensitization to pollens. The most frequent IgE sensitization profile was the monomolecular Phl p 1. Sensitization to Phl p 7 was a reliable biomarker of asthma, whereas Phl p 12 of oral allergy syndrome. Sensitization to Phl p 7 was associated with a higher severity of SAR, and complex profiles were associated with longer disease duration. Conclusions In a large pediatric population, the complexity of IgE sensitization profiles against Phleum pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7 and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response. This article is protected by copyright. All rights reserved.

Background Upper and lower airways diseases share in part their pathogenic mechanisms and frequently occur simultaneously as “United Airway Disease.” Local treatment with nebulizers delivers anti-symptomatic drugs in either the upper or the lower airways, according to the particle size generated by the nebulizer. To our knowledge, no nebulizer combines both application ways. The aim of this study is to test the efficacy and usability of a new nebulizer (OMRON A3 complete), generating aerosols with particles diameters of 2-4.5 μm, 4.5-7.5 μm or >7.5 μm, according to the user’s choice. Methods Seventy-seven patients between 5 and 17 years of age with a diagnosis of rhinitis or asthma were examined. Oxymetazoline or Salbutamol were prescribed according to best clinical practice guidelines. Both drugs were administered through the OMRON A3 Complete nebulizer, with a particle dimension of >7.5 μm to treat nasal obstruction and 2-4.5 μm for bronchial obstruction. The efficacy of treatment was assessed by total nasal inspiratory airflow and FEV-1, Tiffeneau index (FEV1/FVC) and MMEF 25/75 respectively, 10 min before and after treatment. Symptom improvement and usability were measured by patients’ and doctors’ questionnaires. Results Overall, 77 patients seeking care for acute respiratory symptoms were assigned to the upper (n = 39) or lower (n = 38) airways disease group. For symptoms of the upper airways, 92% (95% CI, 77-97%) of the patients reported subjective improvement, while 87% (95% CI, 73-94%) did so for the lower airways. The average total nasal inspiratory airflow improved significantly (p = 0.030) among the patients with upper airways symptoms, from 275 ml/s (95% CI, 207-342 ml/s) to 359 ml/s (95% CI, 300-419 ml/s) after Oxymetazoline administration. All selected lung function parameters (FEV1, Tiffeneau Index and MMEF25-75) significantly improved among the patients with lower airways symptoms after inhalation of Salbutamol (p < 0.001). The nebulizer was assessed as “easy to use” by over 95% of participants in both groups. Conclusions The OMRON A3 efficiently delivers anti-symptomatic drugs in both upper and lower airways in a user-friendly way. This device may be useful to facilitate adherence to a complete treatment of respiratory symptoms in patients with symptoms of the so-called United Airway Disease.