Managing rare and undetectable events in risk assessment: the case of a satellite system launch project

Assessing the wide diversity of risk types in large and complex projects using the traditional hyperbolic iso-risks curves may seem a simplistic and reductive approach, and evaluating the risk factor through the multiplication of likelihood and severity parameters results in defining as dangerous those risks that are associated either with rare but devastating consequences or with probable but minor effects. In this work, the authors aimed at focusing on those risks that, despite their low occurrence probability, may significantly compromise a project result. To this extent, a different formula has been used to compute the risk factor, keeping into account risk detectability and evaluating the potential consequences in four different domains (cost, time, performance, reputation). This approach has been validated on the case of a large industrial project related to the launch of an innovative mobile telecommunications system, collecting the experts' opinions in a primary Italian firm in aerospace industry

From business continuity to design of critical infrastructures: ensuring the proper resilience level to datacentres

Since a few years, companies that runs business critical applications are increasing their focus on their support infrastructures. Indeed, it is clearly useless to pursue higher systems reliability, when the infrastructure is vulnerable. Aim of this paper is to explore the value of business continuity within the scope of the design of resilient system. The publication of the fifth revision of ANSI/TIA/EIA 942 standard provides operation managers and risk managers with a framework to plan and design resilient infrastructures. It will be shown how to use the aforementioned standard to analyse the gap between the current and the desired resilience level of a system, and suggest the proper steps to reach it, accordingly to the business continuity requirements. This approach was adopted on the case of the power system infrastructure of a primary Italian Application Service Provider, granting 24/7 mission critical services to its customers

Cooled tip radiofrequency ablation of benign thyroid nodules: preliminary experience with two different devices

Background: Thyroid nodules are very common in general population. Even if benign, they may require a treatment in case of symptoms or cosmetic concerns. In the last years, minimally invasive treatments alternative to surgery have been developed, in particular ultrasound (US) guided radiofrequency ablation (RFA). Methods: Twenty-four patients (9 males; 15 females; mean age 57.9 years) were treated and divided in two groups (A and B) according to the RFA needle used (18 gauge needle, AMICA; 17 gauge needle, COVIDIEN). Nodules and patients characteristics, together with procedural data were registered pretreatment and at 1-month follow-up. US visibility of the needle, volume of the nodules, symptoms and cosmetic concerns, complications were registered. Results: Visibility of the needle was not significantly different in the two groups (P=0.0787). At 1 month the mean volume of the nodules dropped from 37.1 to 25 mL in group A and from 23.2 to 15.4 mL in group B; shrinkage rate (36.9% and 39.5%, respectively) was not significantly different (P=0.3137). Symptoms decreased from 3.1 to 1.4 in group A and from 4 to 1.6 in group B: no significant differences in reductions were observed (P=0.3305). Cosmetic score decreased from 3.7 to 3.4 in group A and from 3.9 to 3.6 in group B: no significant differences in reductions were observed (P=0.96). Total complication rate (18.2% in group A vs. 23.1% in group B) did not showed significant differences (P=0.5049). Conclusions: The two systems used in our study resulted equivalent in terms of US needle visibility, efficacy, symptom/cosmetic relief, safety. More patients and a longer follow-up are necessary to confirm our results

Maternal and infant NR3C1 and SLC6A4 epigenetic signatures of the COVID-19 pandemic lockdown: when timing matters

Stress exposure during pregnancy is critically linked with maternal mental health and child development. The effects might involve altered patterns of DNA methylation in specific stress-related genes (i.e., glucocorticoid receptor gene, NR3C1, and serotonin transporter gene, SLC6A4) and might be moderated by the gestational timing of stress exposure. In this study, we report on NR3C1 and SLC6A4 methylation status in Italian mothers and infants who were exposed to the COVID-19 pandemic lockdown during different trimesters of pregnancy. From May 2020 to February 2021, 283 mother–infant dyads were enrolled at delivery. Within 24 h from delivery, buccal cells were collected to assess NR3C1 (44 CpG sites) and SLC6A4 (13 CpG sites) methylation status. Principal component (PC) analyses were used to reduce methylation data dimension to one PC per maternal and infant gene methylation. Mother–infant dyads were split into three groups based on the pregnancy trimester (first, second, third), during which they were exposed to the COVID-19 lockdown. Mothers and infants who were exposed to the lockdown during the first trimester of pregnancy had lower NR3C1 and SLC6A4 methylation when compared to counterparts exposed during the second or third trimesters. The effect remained significant after controlling for confounders. Women who were pregnant during the pandemic and their infants might present altered epigenetic biomarkers of stress-related genes. As these epigenetic marks have been previously linked with a heightened risk of maternal psychiatric problems and less-than-optimal child development, mothers and infants should be adequately monitored for psychological health during and after the pandemic

Is Brain-Derived Neurotropic Factor Methylation Involved in the Association Between Prenatal Stress and Maternal Postnatal Anxiety During the COVID-19 Pandemic?

BackgroundThe COVID-19 pandemic is a collective trauma that may expose susceptible individuals to high levels of stress. Pregnant women represent a high-risk population, considering that pregnancy is a period of heightened neuroplasticity and susceptibility to stress through epigenetic mechanisms. Previous studies showed that the methylation status of the BDNF gene is linked with prenatal stress exposure. The goals of this study were (a) to assess the association between pandemic-related stress and postnatal anxiety and (b) to investigate the potential role of maternal BDNF methylation as a significant mediator of this association. MethodsIn the present study, we report data on the association among pandemic-related stress during pregnancy, maternal BDNF methylation, and postnatal anxiety symptoms. Pandemic-related stress and postnatal anxiety were assessed through self-report instruments. BDNF methylation was estimated in 11 CpG sites in DNA from mothers' buccal cells. Complete data were available from 108 mothers. ResultsResults showed that pandemic-related stress was associated with an increased risk of postnatal anxiety, r = 0.20, p < 0.05. CpG-specific BDNF methylation was significantly associated with both prenatal pandemic-related stress, r = 0.21, p < 0.05, and postnatal maternal anxious symptoms, r = 0.25, p = 0.01. Moreover, a complete mediation by the BDNF CpG6 methylation emerged between pandemic-related stress during pregnancy and postnatal maternal anxiety, ACME = 0.66, p < 0.05. ConclusionThese findings suggest that BDNF epigenetic regulation by pandemic-related stress might contribute to increase the risk of anxiety in mothers. Policymakers should prioritize the promotion of health and wellbeing in pregnant women and mothers during the present healthcare emergency

Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day\u201317.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered

From business continuity to design of critical infrastructures: ensuring the proper resilience level to datacentres

Since a few years, companies that runs business critical applications are increasing their focus on their support infrastructures. Indeed, it is clearly useless to pursue higher systems reliability, when the infrastructure is vulnerable. Aim of this paper is to explore the value of business continuity within the scope of the design of resilient system. The publication of the fifth revision of ANSI/TIA/EIA 942 standard provides operation managers and risk managers with a framework to plan and design resilient infrastructures. It will be shown how to use the aforementioned standard to analyse the gap between the current and the desired resilience level of a system, and suggest the proper steps to reach it, accordingly to the business continuity requirements. This approach was adopted on the case of the power system infrastructure of a primary Italian Application Service Provider, granting 24/7 mission critical services to its customers

Is hemoccult a good test for colorectal polyps detection ?

Parmi 45 patients, 17,7 % d'entre eux porteurs de polypes isolés ou multiples présentaient un test d'hémoccult II positif. Les polypes ont été les seules lésions mises en évidence après explorations radiologique et endoscopique du côlon. La majorité des polypes ont été réséqués par voie endoscopique. Le degré de positivité du test s'élève à 25 % lorsque les polypes dépassent un diamètre d'un centimètre. Les polypes localisés entre la marge anale et 15 cm en amont ont toujours un test négatif. 20 % seulement des polypes associés à une dégénérescence débutante présentaient un test positif. La recherche de sang occulte par test hémoccult s'avère une méthode insuffisamment sensible pour la détection des polypes recto-coliques