Analysis of Fluid-structure Interaction for a Submerged Floating Tunnel

Abstract The behavior of a submerged floating tunnel (SFT) exposed to a water current of variable velocity is investigated through complex numerical analyses based on the Computational Fluid Dynamics (CFD) and the Finite Element Method (FEM) implemented in the ABAQUS code. An accurate modelling of turbulent phenomena is made, based on both Implicit Large Eddy Simulation and the RANS-based Spalart-Allmaras model, followed by a co-simulation procedure in which the fluid dynamics and the structural analysis are carried out separately and interfaced with each other. Circular and elliptical cross sections are considered, each of them fitted for combined railway and motorway services. The analysis is carried out in both static and dynamic way, by varying the current velocity with a given value of the residual buoyancy of the tunnel. The results emphasize the effect of the main parameters investigated, evidencing the great potentials of the adopted calculation tool for carrying out further investigations aimed at achieving useful elements for the design and optimization of the SFT

Raising Healthy Children: Promoting the Multiple Benefits of Green Open Spaces through Biophilic Design

Several studies have indicated that children who grow up in green environments enjoy beneficial impacts on their development. However, to date, very little attention has been paid to the types and characteristics of dedicated public open green space for children. In addition, studies on biophilic design that could help landscape architects to design open spaces for children are limited. In order to fill this gap, this perspective examines the scientific literature on the relationship between open spaces and children. The authors specifically discuss and analyze the following points: (1) pathways to and effects on children’s health and well-being; (2) types and characteristics of open spaces for child-dedicated facilities (e.g., schools, hospitals, fitness camps, playgrounds, etc.), as well as for child-friendly urban open spaces. Finally, the authors provide inspiring examples and case studies of biophilic design for children’s health and well-being. Conclusions from this perspective show that biophilic design could benefit both the physical and mental health of children, as well as improve children’s overall resilience to pandemics and other diseases. This perspective provides, for the first time, new insights for designing biophilic and child-friendly cities, and explores areas of future research

Role of age in dynamics of autoantibodies in pediatric celiac disease

Background. Celiac disease (CD) is characterized by elevated serum titers of autoantibodies IgA anti-tissue transglutaminase 2 (TGA-IgA) and IgA anti-endomysial (EMA), with small bowel mucosa atrophy. We evaluated age differences between CD children exhibiting variable antibody titers at diagnosis.MethodsCD children diagnosed between January 2014 and June 2019, according to 2012 ESPGHAN guidelines were studied. All had EMA and TGA-IgA measurements, while a proportion of them underwent esophagogastroduodenoscopy (EGD). Patients were grouped based on serum TGA-IgA titers normalized to the upper limit of normal (ULN) and differences in median age (years) assessed by analysis of variance (ANOVA) and creation of orthogonal contrasts.ResultsCD was diagnosed in 295 subjects (median age: 4.4 [IQR: 2.60-8.52]) with a biopsy sparing protocol (high titer: >= 10xULN) and in 204 by EGD biopsy. Of the latter, 142 (median age: 8.5 [IQR: 5.81-11.06]) and 62 (median age: 9.5 [IQR: 6.26-12.76]) had a low (< 5xULN) and a moderate (>= 5 < 10xULN) TGA-IgA titer, respectively. Potential CD was diagnosed in 20 patients (median age: 3.6 [IQR: 2.47-6.91]). The median age was significantly lower in the no-biopsy group (ANOVA: F-(3,F- 516) = 25.98, p < .001) than in low- and moderate titer groups (p < 0.0001), while there was no statistical difference between biopsy-sparing and potential CD groups.ConclusionCD patients with greatly elevated antibody titers (>= 10xULN) were diagnosed at an earlier age than those with lower titers. This may indicate that an increase in TGA-IgA is independent of age and suggests a polarization of autoimmunity in younger individuals with higher serum antibody levels

Designing Urban Green Blue Infrastructure for Mental Health and Elderly Wellbeing

The main objective of this essay is to illustrate the state-of-the-art on ‘mental health-sensitive’ open space design in the built environment. Urban Green Blue Infrastructure can contribute to urbanites’ mental health and wellbeing as well as healthy aging, while providing co-benefits balancing the negative impacts of climate change, through the provision of integrated ecosystem services. There are a number of ways that exposure to and affiliation with Nature have shown to support mental health, but we are still missing the necessary evidence of the actual benefits achieved, as well as the key performance indicators and metrics to monitor and adapt our open space to the growing urban challenges. After introducing the key concepts of degenerative mental disorders as they are growing in the urban environment, and the emerging green blue infrastructure design approach, the authors present international case studies describing how evidence-based design and Nature-based Solutions have been found to be beneficial, especially to those diagnosed with mental disorders. Subsequently, in a comparative critical analysis, the authors look closer at a number of design solutions capable, at different scales, to support healthy aging through exposure to, and affiliation with, biodiversity

Left ventricular remodeling in hypertrophic cardiomyopathy: an overview of current knowledge

While most patients with hypertrophic cardiomyopathy (HCM) show a relatively stable morphologic and clinical phenotype, in some others, progressive changes in the left ventricular (LV) wall thickness, cavity size, and function, defined, overall, as "LV remodeling", may occur. The interplay of multiple pathophysiologic mechanisms, from genetic background to myocardial ischemia and fibrosis, is implicated in this process. Different patterns of LV remodeling have been recognized and are associated with a specific impact on the clinical course and management of the disease. These findings underline the need for and the importance of serial multimodal clinical and instrumental evaluations to identify and further characterize the LV remodeling phenomenon. A more complete definition of the stages of the disease may present a chance to improve the management of HCM patients

Risk stratification in transthyretin-related cardiac amyloidosis

Transthyretin related cardiac amyloidosis (TTR-CA) is an infiltrative cardiomyopathy that cause heart failure with preserved ejection fraction, mainly in aging people. Due to the introduction of a non invasive diagnostic algorithm, this disease, previously considered to be rare, is increasingly recognized. The natural history of TTR-CA includes two different stages: a presymptomatic and a symptomatic stage. Due to the availability of new disease-modifying therapies, the need to reach a diagnosis in the first stage has become impelling. While in variant TTR-CA an early identification of the disease may be obtained with a genetic screening in proband's relatives, in the wild-type form it represents a challenging issue. Once the diagnosis has been made, in order to identifying patients with a higher risk of cardiovascular events and death it is necessary to focus on risk stratification. Two prognostic scores have been proposed both based on biomarkers and laboratory findings. However, a multiparametric approach combining information from electrocardiogram, echocardiogram, cardiopulmonary exercise test and cardiac magnetic resonance may be warranted for a more comprehensive risk prediction. In this review, we aim at evaluating a step by step risk stratification, providing a clinical diagnostic and prognostic approach for the management of patients with TTR-CA

Role of Arterial Hypertension and Hypertension-Mediated Organ Damage in Cardiotoxicity of Anticancer Therapies

Purpose of the review: Arterial hypertension (AH) is the most common cardiovascular (CV) risk factor in the community and in oncologic patients. It also represents the most important CV condition predisposing to anticancer treatment-related cardiotoxicity. This risk is heightened in the presence of cardiac AH-mediated organ damage (HMOD). Influence of AH and HMOD on the development of cardiotoxicity will be reviewed, with a focus on specific scenarios and implications for management of oncologic patients. Recent findings: Not adequately controlled AH before or during anticancer treatments and/or development of AH during or after completion of such therapies have detrimental effects on the clinical course of oncologic patients, particularly if HMOD is present. As overlooking CV health can jeopardize the success of anticancer treatments, the goal for clinicians caring for the oncologic patient should include the treatment of AH and HMOD

The current benefit of genome sequencing compared to exome sequencing in patients with developmental or epileptic encephalopathies

Background: As the technology of next generation sequencing rapidly develops and costs are constantly reduced, the clinical availability of whole genome sequencing (WGS) increases. Thereby, it remains unclear what exact advantage WGS offers in comparison to whole exome sequencing (WES) for the diagnosis of genetic diseases using current technologies. Methods: Trio-WGS was conducted for 20 patients with developmental or epileptic encephalopathies who remained undiagnosed after WES and chromosomal microarray analysis. Results: A diagnosis was reached for four patients (20%). However, retrospectively all pathogenic variants could have been detected in a WES analysis conducted with today's methods and knowledge. Conclusion: The additional diagnostic yield of WGS versus WES is currently largely explained by new scientific insights and the general technological progress. Nevertheless, it is noteworthy that whole genome sequencing has greater potential for the analysis of small copy number and copy number neutral variants not seen with WES as well as variants in noncoding regions, especially as potentially more knowledge of the function of noncoding regions arises. We, therefore, conclude that even though today the added value of WGS versus WES seems to be limited, it may increase substantially in the future

Insight into Hypoxia Stemness Control

Recently, the research on stemness and multilineage differentiation mechanisms has greatly increased its value due to the potential therapeutic impact of stem cell-based approaches. Stem cells modulate their self-renewing and differentiation capacities in response to endogenous and/or extrin- sic factors that can control stem cell fate. One key factor controlling stem cell phenotype is oxygen (O2). Several pieces of evidence demonstrated that the complexity of reproducing O2 physiological tensions and gradients in culture is responsible for defective stem cell behavior in vitro and after transplantation. This evidence is still worsened by considering that stem cells are conventionally incubated under non-physiological air O2 tension (21%). Therefore, the study of mechanisms and signaling activated at lower O2 tension, such as those existing under native microenvironments (referred to as hypoxia), represent an effective strategy to define if O2 is essential in preserving naïve stemness potential as well as in modulating their differentiation. Starting from this premise, the goal of the present review is to report the status of the art about the link existing between hypoxia and stemness providing insight into the factors/molecules involved, to design targeted strategies that, recapitulating naïve O2 signals, enable towards the therapeutic use of stem cell for tissue engineering and regenerative medicine