National variations in perioperative assessment and surgical management of Crohn's disease: a multicentre study

Aim: Crohn's disease (CD) requires a multidisciplinary approach and surgery should be undertaken by dedicated colorectal surgeons with audited outcomes. We present a national, multicentre study, with the aim to collect benchmark data on key performance indicators in CD surgery, to highlight areas where standards of CD surgery excel and to facilitate targeted quality improvement where indicated. Methods: All patients undergoing ileocaecal or redo ileocolic resection in the participating centres for primary and recurrent CD from June 2018 to May 2019 were included. The main objective was to collect national data on hospital volume and practice variations. Postoperative morbidity was the primary outcome. Laparoscopic surgery and stoma rate were the secondary outcomes. Results: In all, 715 patients were included: 457 primary CD and 258 recurrent CD with a postoperative morbidity of 21.6% and 34.7%, respectively. Laparoscopy was used in 83.8% of primary CD compared to 31% of recurrent CD. Twenty-five hospitals participated and the total number of patients per hospital ranged from 2 to 169. Hospitals performing more than 10 primary CD procedures per year showed a higher adoption of laparoscopy and bowel sparing surgery. Conclusions: There is significant heterogeneity in the number of CD surgeries performed per year nationally in Italy. Our data suggest that high-volume hospitals perform more complex procedures, with a higher adoption of bowel sparing surgery. The rate of laparoscopy in high-volume hospitals is higher for primary CD but not for recurrent CD compared with low-volume hospitals

Vortex pinning and flux flow microwave studies of coated conductors

Demanding microwave applications in a magnetic field require the material optimization not only in zero-field but, more important, in the in-field flux motion dominated regime. However, the effect of artificial pinning centers (APC) remains unclear at high frequency. Moreover, in coated conductors the evaluation of the high frequency material properties is difficult due to the complicated electromagnetic problem of a thin superconducting film on a buffered metal substrate. In this paper we present an experimental study at 48 GHz of 150-200 nm YBa$_2$Cu$_3$O$_{7-x}$ coated conductors, with and without APCs, on buffered Ni-5at%W tapes. By properly addressing the electromagnetic problem of the extraction of the superconductor parameters from the measured overall surface impedance $Z$, we are able to extract and to comment on the London penetration depth, the flux flow resistivity and the pinning constant, highlighting the effect of artificial pinning centers in these samples.Comment: 5 pages, IEEE Trans. Appl. Supercond., accepted for publication (2019

The High Voltage Regulator Board for the BDX Experiment

In this note we describe the design and construction of SiPM High Voltage (HV) Regulator board for the BDX experiment. The board is used to provide bias voltage to the Silicon PhotoMultipliers (SiPMs) used in the BDX detector. It hosts four independent channels, each with a selectable output voltage in the range 37 V to 80 V: each channel is individually regulated by means of a variable resistor. In the note, after a brief introduction to the BDX experiment, we present the design of the board, discussing in particular the critical aspects that we identified during the circuit implementation phase. We also show the results obtained from the characterization of a first sample of 10 boards

Photoluminescence properties of C60 films deposited on silicon substrate

Photoluminescence (PL) spectra of C-60 films deposited on Si substrates have been measured from 10 to 300 K and as a function of laser excitation intensity. Recombination of self-trapped excitons and their phonon replicas, as well as X-trap-related emissions, are the main features of the PL spectra. The influence of the deposition parameters, namely deposition rate and substrate temperature, on the luminescence efficiency of the C-60 films have been investigated. Low substrate temperature produces a lowering of the PL efficiency, whereas an increase of the deposition rate causes an increase of the X-trap emission

Stereoselective Reaction of 2-Carboxythioesters-1,3-dithiane with Nitroalkenes: An Organocatalytic Strategy for the Asymmetric Addition of a Glyoxylate Anion Equivalent.

Under mild reaction conditions γ-nitro-β-aryl-α-keto esters with up to 92% ee were obtained, realizing a formal catalytic stereoselective conjugate addition of the glyoxylate anion synthon

Magnetic resonance arthrography in patients with multidirectional instability: could inferior capsulsar width be considered the cornerstone in the diagnosis of non-traumatic shoulder instability?

Objectives To provide quantitative anatomical parameters in patients with and without non-traumatic multidirectional instability using MR arthrography (MR-a). Materials and methods One hundred and seventy-six MR-a performed from January 2020 to March 2021 were retrospectively evaluated. Patients were divided according to the presence of clinically diagnosed multidirectional shoulder instability (MDI). Each MR-a was performed immediately after intra-articular injection of 20 ml of gadolinium using the anterior approach. The width of the axillary recess, the width of the rotator interval, and the circumference of the glenoid were measured by three independent radiologists, choosing the average value of the measurements. The difference between the mean values of each of the three parameters between the two study groups was then assessed. Results Thirty-seven patients were included in the study (20 in the MDI group, 17 in the control group). The mean axillary recess width in the MDI group was significantly greater than in the control group (t(33) = 3.15, p = .003); rotator interval width and glenoid circumference measurements were not significantly different (t(35) = 1.75, p = .08 and t(30) = 0,51, p = .6, respectively). Conclusions Inferior capsular redundancy may be an important predisposing factor in MDI, while glenoid circumference is not related to MDI. The relationship between the width of the rotator interval and shoulder instability remains debated

Pareto-Optimization of HTS CICC for High-Current Applications in Self-Field

The ENEA superconductivity laboratory developed a novel design for Cable-in-Conduit Conductors (CICCs) comprised of stacks of 2nd-generation REBCO coated conductors. In its original version, the cable was made up of 150 HTS tapes distributed in five slots, twisted along an aluminum core. In this work, taking advantage of a 2D finite element model, able to estimate the cable's current distribution in the cross-section, a multiobjective optimization procedure was implemented. The aim of optimization was to simultaneously maximize both engineering current density and total current flowing inside the tapes when operating in self-field, by varying the cross-section layout. Since the optimization process involved both integer and real geometrical variables, the choice of an evolutionary search algorithm was strictly necessary. The use of an evolutionary algorithm in the frame of a multiple objective optimization made it an obliged choice to numerically approach the problem using a nonstandard fast-converging optimization algorithm. By means of this algorithm, the Pareto frontiers for the different configurations were calculated, providing a powerful tool for the designer to achieve the desired preliminary operating conditions in terms of engineering current density and/or total current, depending on the specific application field, that is, power transmission cable and bus bar systems

MOD derived pyrochlore films as buffer layer for all-chemical YBCO coated conductors

We report a detailed study performed on La2Zr2O7 (LZO) pyrochlore material grown by Metal-Organic Decomposition (MOD) method as buffer layers for YBa2Cu3O7-x (YBCO) coated conductors. High quality epitaxial LZO thin films have been obtained on single crystal (SC) and Ni-5%at.W substrates. In order to evaluate structural and morphological properties, films have been characterized by means of X-ray diffraction analyses (XRD), atomic force microscope (AFM) and scanning electron microscope (SEM). Precursors solutions and heat treatments have been studied by thermogravimetric analyses (TG-DTA-DTG) and infrared spectra (FT-IR) with the aim of optimizing the annealing process. Thin films of YBCO have been deposited by pulsed laser ablation (PLD) on this buffer layers. The best results obtained on SC showed YBCO films with critical temperature values above 90 K, high self field critical current density values (Jc > 1 MA/cm2) and high irreversibility field values (8.3 T) at 77 K together with a rather high depinning frequency vp (0.5 T, 77 K)>44 GHz as determined at microwaves. The best results on Ni-5%at.W has been obtained introducing in the heat treatment a pyrolysis process at low temperature in air in order to remove the residual organic part of the precursor solution

Retinal and Optic Disc Vascular Changes in Patients Using Long-Term Tadalafil: A Prospective Non-Randomized Matched-Pair Study

Retinal, choroidal and optic disc vascularity has never been evaluated in patients taking PDE5is long-term. The aim of our study was to evaluate the neurostructural and vascular changes after long-term use of tadalafil, using spectral domain (SD)-optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). In the present clinical trial, 27 patients who have been taking tadalafil 20 mg on alternate days (OAD) for at least 6 months (Group A) were enrolled. The matched group consisted of 27 healthy men (Group B). Both groups of patients underwent SD-OCT to study ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) and choroidal thickness and OCTA for the evaluation of superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) and radial peripapillary capillary (RPC). A reduction in SCP, DCP and RPC vessel density was found in patients using tadalafil long-term. Retinal and optic disc toxicity may be detected using modifications of capillary vessel density. Further studies are needed to investigate the possibility of a causal association