Open Renal Transplantation in Obese Patients: A Correlation Study between BMI and Early and Late Complications with Implementation of a Prognostic Risk Score

Background: Obesity is a global epidemic that affects millions worldwide and can be a deterrent to surgical procedures in the population waiting for kidney transplantation. However, the literature on the topic is controversial. This study evaluates the impact of body mass index (BMI) on complications after renal transplantation, and identifies factors associated with major complications to develop a prognostic risk score. Methods: A correlation analysis between BMI and early and late complications was first performed, followed by a univariate and multivariate logistic regression analysis. The 302 included patients were divided into obese (BMI >= 30 kg/m2) and non-obese (BMI <= 30 kg/m2) groups. Correlation analysis showed that delayed graft function (DGF) was the only obesity-associated complication (p = 0.044). Logistic regression analysis identified female sex, age >= 57 years, BMI >= 25 and >= 30 kg/m2, previous abdominal and/or urinary system surgery, and Charlson morbidity Score >= 3 as risk factors for significant complications. Based on the analyzed data, we developed a nomogram and a prognostic risk score. Results: The model's area (AUC) was 0.6457 (95% IC: 0.57; 0.72). The percentage of cases correctly identified by this model retrospectively applied to the entire cohort was 73.61%. Conclusions: A high BMI seems to be associated with an increased risk of DGF, but it does not appear to be a risk factor for other complications. Using an easy-to-use model, identification, and stratification of individualized risk factors could help to identify the need for interventions and, thus, improve patient eligibility and transplant outcomes. This could also contribute to maintaining an approach with high ethical standards

Il doppio volto del concordato preventivo nella riforma tributaria, tra imposizione e collaborazione

Il decreto sull’accertamento (re)introduce la possibilità, per autonomi e imprese minori, di determinare, in accordo con l’amministrazione, una parte dell’imponibile da assoggettare a tassazione nel biennio successivo, con irrilevanza dei redditi prodotti, preclusione degli accertamenti e alcune semplificazioni. L’istituto avrebbe le potenzialità per riorientare il rapporto amministrazione-contribuenti a criteri di collaborazione, rispetto a un contesto che ha a lungo concepito il concorso alle spese pubbliche come imposizione dall’alto di un dovere, più che consapevole osservanza dal basso. Ma il testo delinea un istituto “doppio”, che coarta – nemmeno tanto implicitamente – la condotta dei contribuenti. L’intento di recuperare alla contribuzione chi vi si sottrae trova sostegno in un’implementazione massiva delle nuove tecnologie, con un duplice, e negativo, effetto: di concorso secondo un criterio che non si conserva uguale per tutti, e che va come tale giustificato, e di indebolimento delle garanzie del contribuente.The decree on tax assessment (re)introduces the possibility, for self-employed persons and minor enterprises, to determine in agreement with the tax authorities a part of the income to be taxed in the following two years, with irrelevance of the income produced, preclusion of further assessments and some simplifications. This institute would have the potential to reorient the administration-taxpayer relationship to criteria of cooperation, compared to a context that has long conceived the contribution to public expenditure as the imposition from above of a duty, rather than a true compliance. But the legal discipline outlines a “double” institute, which – not even so implicitly – constrains the conduct of taxpayers. The intention of recovering those who are less compliant finds support in a massive implementation of new technologies, with a double, and negative, effect: a public contribution according to a criterion that is not the same for everyone, and which must be justified as such, and a weakening in the taxpayer’s rights

La morte di Plinio il Vecchio: una ricognizione iconografica

The figurative representation of the episode of the death of Pliny the Elder, killed by the eruption of Vesuvius in 79 A.D., enjoyed a remarkable success during the 19th century, following the wake of interest generated by archaeological excavations of the Bourbon era, which brought to light new sites of the ancient cities destroyed by the cataclysm. The combination of the romantic conception of history, the affirmation of the aesthetics of the “sublime” and the proliferation of reproductions and descriptions of the active Neapolitan volcano, contributed, especially in France, to fueling the success of the historiated landscape genre, also used to describe, in a way that was not always faithful to the sources, the last moments of the Como naturalist’s life, poorly explored by artistic historiography

Limits of Current Design Approaches in the Analysis of Wind Turbine Foundations

The design of massive structures such as the shallow foundations of wind turbines is not a trivial task also in light of the fact that this structural typology is not specifically covered in technical Standards. The structural modelling of onshore wind turbine shallow foundations deals with combined complex phenomena, such as material nonlinearities, soil-structure interaction and local stress concentration in both reinforced concrete foundation and soil. The design practice basically adopts two methods: (i) an elastic approach where wind tower foundations are usually designed by modelling the foundation as a slab with variable thickness using shell finite elements and by introducing very simplified assumptions for the soil behaviour (i.e. Winkler model), and (ii) an approach where wind tower foundations are designed by using limit analysis. The paper aims to highlight the limits and the safety margins of the current design practice by comparing the aforementioned methods (i) and (ii) with nonlinear numerical simulations fully accounting for soil-structure interaction based on three-dimensional elements for both concrete foundation and soil, contact surfaces for their interface, and beam elements for reinforcing bars

Ten questions concerning statistical data analysis in human-centric buildings research: A focus on thermal comfort investigations

Given the large amount of time we spend indoors, designing and operating buildings that are safe, comfortable, and conducive to productivity and well-being is essential. To achieve this goal, in the past decades, research has been conducted to investigate the influence of the indoor environment on occupants. Thermal comfort has been the subject of most investigations in this field. However, despite being a consolidated research topic since the 1920s, statistical practices for analysing thermal comfort data often rely on simplified premises, which may be due to several possible factors (e.g., limited computational capabilities and lack of training). Consequently, important aspects of data analysis are often absent or overlooked. Recent statistics and statistical software advances have provided more options for effectively modelling complex issues. However, properly using these tools requires a solid understanding of statistical analysis, increasing the risk of misuse in practice. This paper presents ten questions highlighting the most critical issues regarding statistical analysis for thermal comfort research and practice. The first four questions provide general perspectives concerning statistical data analysis, while the remaining ones address specific problems related to thermal comfort research, but that can extend to all human-centric research in the built environment. Additionally, the last five questions demonstrate the practical significance of analysis pitfalls (i.e., sampling variability, selection bias, variable selection, clustered/nested observations, and measurement error) through examples with synthetic data. This study provides insights into the current statistical ‘habits’ in thermal comfort research and, more importantly, help researchers better define and conduct their statistical analyses