Estimating the hydrodynamic and morphodynamic characteristics using Entropy theory at the confluence of Negro and Solimões Rivers

When two mega rivers merge the mixing of two flows results in a highly complex threedimensional flow structure in an area known as the confluence hydrodynamic zone

Australia-modified Karnofsky Performance Scale and physical activity in COPD and lung cancer: an exploratory pooled data analysis

Objectives: Patient-relevant measures of functional status are required in chronic obstructive pulmonary disease (COPD) and lung cancer in clinical practice and research. We explored the relationship between the Australia-modified Karnofsky Performance Scale (AKPS) and measures of functional capacity and physical activity in these patient groups. Methods: Pooled clinical trial data were analysed to explore the relationship between AKPS and average daily steps (ADS), 6 min walk distance (6MWD), and body mass index, airflow obstruction, dyspnoea and exercise score (COPD group). Receiver operator characteristic curves were produced to compare sensitivity and specificity of cut-offs (no dependency >70, high dependency 70, the optimal ADS cut-points were COPD, 3342 steps (AUC 0.88, 95% CI 0.79 to 0.97, sensitivity 82%, specificity 76%), and lung cancer, 3380 steps (AUC 0.72, 95% CI 0.64 to 0.81, sensitivity 61%, specificity 74%), and for 6MWD (COPD only) 242 m (AUC 0.72, 95% CI 0.63 to 0.81, sensitivity 73%, specificity 34%). Conclusions: An AKPS score is strongly related to ADS in people with COPD and lung cancer. The AKPS may be useful in clinical practice and research to indicate levels of physical activity where ADS and 6 min walk test are not possible. Longitudinal data are needed to confirm these findings

Patrimoni e scopi. Per un'analisi economica delle fondazioni

Il volume raccoglie i contributi presentati al Primo Workshop sulle Fondazioni organizzato nel 2007 dal Dipartimento di Scienze Economiche e Finanziarie "G. Prato", presso la Facoltà di Economia dell'Università degli Studi di Torino. Il lavoro il tema delle fondazioni viene affrontato in chiave evolutiva, proponendo una classificazione che mette in luce la pluralità di esperienze, ovvero di patrimoni (ingenti e non) associati a differenti scopi.- Indice #7- Prefazione, Giovanni Zanetti #11- Introduzione Dalla «fondazione» alle «fondazioni»: un percorso di lettura, Gilberto Turati, Massimiliano Piacenza, Giovanna Segre #17- Parte prima Aspetti generali #31- Cap.I Fondazioni italiane: per una introduzione a beneficio degli inesperti curiosi, Marco Demarie #33- Cap.II Le fondazioni di origine bancaria: dalla nascita per caso all'esercizio dell'innovazione sociale, Gian Paolo Barbetta #59- Cap.III Quale valutazione per le fondazioni grant-making, Alberto Martini, Barbara Romano #87- Cap.IV Complementarità e/o sostituibilità tra le erogazioni delle fondazioni di origine bancaria e le politiche di spesa degli enti locali: il caso del Piemonte, Stefano Piperno, Federica Givone #107- Cap.V L'evoluzione della legislazione in materia di fondazioni di origine bancaria, Maura Leddi #135- Parte seconda Le esperienze #143- Cap.VI Una valutazione complessiva delle attività di erogazione delle fondazioni grant-making piemontesi, Angelo Miglietta #145- Cap.VII L'attività di una fondazione grant-making: l'esperienza della Compagnia di San Paolo, Flavio Brugnoli #159- Cap.VIII L'attività di una fondazione operativa nella cultura: la Fondazione Teatro Regio di Torino, Carlo Carrà #167- Cap.IX L'attività di una fondazione operativa nel sociale: la Fondazione Banco Alimentare Onlus, Roberto Cena #17

The role of immune suppression in COVID-19 hospitalization: clinical and epidemiological trends over three years of SARS-CoV-2 epidemic

Specific immune suppression types have been associated with a greater risk of severe COVID-19 disease and death. We analyzed data from patients >17 years that were hospitalized for COVID-19 at the “Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico” in Milan (Lombardy, Northern Italy). The study included 1727 SARS-CoV-2-positive patients (1,131 males, median age of 65 years) hospitalized between February 2020 and November 2022. Of these, 321 (18.6%, CI: 16.8–20.4%) had at least one condition defining immune suppression. Immune suppressed subjects were more likely to have other co-morbidities (80.4% vs. 69.8%, p < 0.001) and be vaccinated (37% vs. 12.7%, p < 0.001). We evaluated the contribution of immune suppression to hospitalization during the various stages of the epidemic and investigated whether immune suppression contributed to severe outcomes and death, also considering the vaccination status of the patients. The proportion of immune suppressed patients among all hospitalizations (initially stable at <20%) started to increase around December 2021, and remained high (30–50%). This change coincided with an increase in the proportions of older patients and patients with co-morbidities and with a decrease in the proportion of patients with severe outcomes. Vaccinated patients showed a lower proportion of severe outcomes; among non-vaccinated patients, severe outcomes were more common in immune suppressed individuals. Immune suppression was a significant predictor of severe outcomes, after adjusting for age, sex, co-morbidities, period of hospitalization, and vaccination status (OR: 1.64; 95% CI: 1.23–2.19), while vaccination was a protective factor (OR: 0.31; 95% IC: 0.20–0.47). However, after November 2021, differences in disease outcomes between vaccinated and non-vaccinated groups (for both immune suppressed and immune competent subjects) disappeared. Since December 2021, the spread of the less virulent Omicron variant and an overall higher level of induced and/or natural immunity likely contributed to the observed shift in hospitalized patient characteristics. Nonetheless, vaccination against SARS-CoV-2, likely in combination with naturally acquired immunity, effectively reduced severe outcomes in both immune competent (73.9% vs. 48.2%, p < 0.001) and immune suppressed (66.4% vs. 35.2%, p < 0.001) patients, confirming previous observations about the value of the vaccine in preventing serious disease

Small airways dysfunction: is there any involvement in patients with atopy?

atopy and asthm

Retrograde instillation of methylene blue in the difficult diagnosis of BPF

We report two cases in which we were able to diagnose bronchopleural fistula through retrograde methylene blue instillation during bronchoscopy. In the first case, methylene blue was injected through an abdominal drain, followed by air instillation and detected in the left bronchial tree, demonstrating the presence of a fistula in the lingula’s bronchus. In the second case, methylene blue was injected into a pleural drain, through a breach on a surgical suture and detected in the right bronchial tree, demonstrating the presence of a fistula in the right inferior bronchus. The retrograde instillation of methylene blue, through a drain in the abdomen or the thoracic wall, is a safe, cheap, and practical method that allows the bronchoscopist to identify the presence of a fistula and, more importantly, to identify the exact point on the bronchial tree where a fistula is located. This provides the possibility of sealing the fistula with a variety of devices. It is our opinion that this procedure should be considered a primary method of diagnosis when a bronchopleural fistula is suspected and a drain on the thoracic or abdominal wall is positioned such that effusions are able to drain

Esophageal ultrasound with ultrasound bronchoscope (EUS-B) guided left adrenal biopsy: Case report with review of literature

A 45-year old man, chronic smoker with a pancoast tumor due to squamous cell carcinoma has been described. The initial diagnosis of lung carcinoma was based on a scant tissue so the exact cell typing was not possible. The initial treatment consisted of platinum based chemotherapy and radiotherapy. He developed a left adrenal lesion on treatment. There was a possibility of metachronous primary. Also, a large tissue sample was required for tumor markers. The lung mass was difficult to access and was static on treatment. A left adrenal biopsy was considered to be more appropriate. A novel approach for left adrenal lesion with esophageal ultrasound using ultrasound bronchoscope (EUS-B) was successfully performed. This article is aimed at describing the use of EUS-B for transdiaphragmatic structures. Keywords: EUS-B, Left adrenal, Transdiaphragmatic, FNA

Origine e problemi di governance delle fondazioni

The paper explains the existence of philantropic intermediaries and foundations as a result of the information asymmetries existing between donors and beneficiries and transaction costs in the market of donation

Management of chronic breathlessness: non-pharmacological and pharmacological interventions

Effective interventions for chronic breathlessness exist and are distinct from interventions directed at the pathophysiology of the medical condition causing the breathlessness. Some, like pulmonary rehabilitation, have been accepted by the clinical community and are integrated into respiratory care, at least in part and for people with COPD. Others, such as breathlessness clinics, are less well recognised but have strong evidence to support their use. A better understanding of the ways that can be used to integrate breathlessness management systematically alongside disease management should drive further implementation research. Low-dose, steady-state oral morphine has a developing evidence base in support of a net benefit. However, not all people tolerate opioids and further research into alternative drug options is needed to help this distressing symptom

Preparation and characterization of bio-based protective coatings for the indoor preservation of bronze works of art

The corrosion of metals involves irreversible electrochemical processes, which are promoted by the presence of water, oxygen and acidic species: long-term exposure of metallic objects to these environmental agents results in the formation of layers of corrosion patina, ultimately leading to the pulverization and deterioration of the material. The main products commercially available since decades to prevent metal corrosion are based on acrylic resins containing inhibitors such as benzotriazole and its derivatives, but their toxicity addressed the efforts of the scientific community in the field of cultural heritage preservation to the development of new green multi-functional formulations, based on biomaterials and nanoparticles. In this work, we investigate the use of three different bio-based polymers (i.e. alginate, chitosan, carboxymethyl cellulose) for the development of multifunctional coatings to provide long-term protection to bronze works of art from humidity and corrosion agents. As required in the field of art preservation, the composition of these formulations have been optimized to maintain the original appearance of the artworks, by producing adhesive, homogeneous and transparent films, and they are easy-to-use and removable using safe procedures. The characterization of the coatings’ morphology, thermal behavior and the properties of the substrate/coating interface is performed via Optical, Metallurgical and Scanning Electron Microscopy, UV-Vis spectrophotometry, colorimetry and vibrational spectroscopies (Fourier transform infrared and Raman), ageing under controlled humidity and temperature, removal tests. The efficacy of the coatings is assessed on bronze disks and mockups by means of accelerated corrosion tests with HCl vapors on bare and coated specimens