Neoplasie neuroendocrine del pancreas serotonina positive: correlazione imaging – anatomia patologica

Analisi delle caratteristiche radiologiche delle neoplasie neuroendocrine pancreatiche serotonina positive

The clinical effectiveness of an integrated multidisciplinary evidence-based program to prevent intraoperative pressure injuries in high-risk children undergoing long-duration surgical procedures: a quality improvement study

The prevention of hospital-acquired pressure injuries (HAPIs) in children undergoing long-duration surgical procedures is of critical importance due to the potential for catastrophic sequelae of these generally preventable injuries for the child and their family. Long-duration surgical procedures in children have the potential to result in high rates of HAPI due to physiological factors and the difficulty or impossibility of repositioning these patients intraoperatively. We developed and implemented a multi-modal, multi-disciplinary translational HAPI prevention quality improvement program at a large European Paediatric University Teaching Hospital. The intervention comprised the establishment of wound prevention teams, modified HAPI risk assessment tools, specific education, and the use of prophylactic dressings and fluidized positioners during long-duration surgical procedures. As part of the evaluation of the effectiveness of the program in reducing intraoperative HAPI, we conducted a prospective cohort study of 200 children undergoing long-duration surgical procedures and compared their outcomes with a matched historical cohort of 200 children who had undergone similar surgery the previous year. The findings demonstrated a reduction in HAPI in the intervention cohort of 80% (p < 0.01) compared to the comparator group when controlling for age, pathology, comorbidity, and surgical duration. We believe that the findings demonstrate that it is possible to significantly decrease HAPI incidence in these highly vulnerable children by using an evidence-based, multi-modal, multidisciplinary HAPI prevention strategy

Living Heritage: The Digital Ecomuseums of the Terre di Siena Territory - theory and practice

Il progetto Ecomusei Digitali delle Terre di Siena, ideato e gestito dalla Fondazione Musei Senesi dal 2012 e tuttora in corso, nasce nell'ambito di un piano strategico di rilancio dei servizi museali del territorio senese. Il progetto, vincitore del Premio Federculture per la Cultura di Gestione 2011, mirava a consolidare la creazione di distretti culturali evoluti, integrando il vasto patrimonio materiale e immateriale del territorio, i beni conservati nei suoi musei, il patrimonio naturale, le industrie culturali e della conoscenza e prodotti e infrastrutture tradizionali locali. La piattaforma degli Ecomusei Digitali rappresenta uno strumento funzionale alla realizzazione dei distretti culturali territoriali, volti a rendere più efficace il processo di produzione e fruizione della cultura ampliando ulteriormente e aprendo la rete culturale ai cittadini, e offre la possibilità di vivere il territorio in maniera alternativa sia per le comunità locali sia per i visitatori, in linea con la visione della Fondazione: “Visita il museo e vivi il territorio”. Partendo dalla definizione di ecomuseo come “un patto con cui la comunità si prende cura di un territorio” (Maggi 2002), non è difficile immaginare che un luogo con un alto coefficiente identitario e un tale bagaglio storico possa facilmente costituire terreno fertile per un approccio volto alla valorizzazione del patrimonio attraverso gli ecomusei.The Digital Ecomuseums of the Terre di Siena project, conceived and managed by the Fondazione Musei Senesi since 2012 and still ongoing, was initiated as part of a strategic plan to relaunch museum services in the Terre di Siena area. The plan won the 2011 Federculture Cultural Management Prize, and aimed to consolidate the creation of evolved cultural districts, integrating the area’s extensive material and immaterial heritage, the items conserved in its museums, natural heritage, cultural and knowledge-based industries, and traditional local products and infrastructures. The Digital Ecomuseums project is a functional tool for the realisation of territorial cultural districts, intended to make the process of production and utilisation of culture more effective by further expanding and opening the cultural network to citizens. It offers ways of experiencing the territory for both local communities and visitors, in keeping with the Fondazione’s vision: Visit the museum and experience the territory. Based on the definition of the ecomuseum as ‘a pact with which the community takes care of a territory’ (Maggi 2002), it is not hard to imagine that a place with a high identity-determining coefficient and weighty historical baggage can easily constitute fertile terrain for an approach aimed at enhancing the value of heritage through ecomuseums

A Combined Electromagnetic and Mechanical Approach for EU-DEMO Toroidal Field Coils

The roadmap to fusion electricity of the European scientific program aims at the realization of the future DEMOnstration (DEMO) fusion power plant. In 2020, the pre-concept design phase of DEMO was completed, defining the concept and characteristics of the main magnets and structures of the machine. Sixteen toroidal D-shaped magnets, six poloidal annular coils and a central solenoid constitute the functioning system core. The reactor is subjected to huge mechanical loads, mainly due to the Lorentz force produced by the combination of the high magnetic fields and operative currents. As a consequence, the loading conditions are extremely demanding for the structural components, and it is crucial to complete a comprehensive static and fatigue assessment before proceeding with the next design iteration. This work focuses on the electromagnetic and structural analyses performed on the toroidal field coil system and its support structures to present the methodological approach developed. Exploiting the finite element method, a three-dimensional model has been defined to obtain the electromagnetic loads on the main time points of the reference plasma scenario and then transfer them to a related 3D structural model, corresponding to the discretization of the electromagnetic one. The structural model was used to obtain the displacement and stress fields at the various time points to perform the mechanical evaluation as well as the fatigue assessment

AC Loss Measurement of the DEMO TF React&Wind Conductor Prototype No. 2

The EUROfusion DEMO is being designed as the fusion machine to be built after ITER. During the preconceptual phase, several design options are investigated by theoretical analyses as well as tests on newly developed conductor prototypes. One design option for the toroidal field magnet (TF) and central solenoid (CS) is based on flat Nb3Sn forced-flow conductors made with react & wind technique. The usage of these conductors simplifies some steps in the conductor and coil manufacturing, and together with graded layer-winding allows approx. 50 & x0025; reduction of the required amount of Nb3Sn compared to ITER-like design based on wind-react-insulate pancake-winding. Two full-size prototype cables for DEMO TF coil were manufactured, jacketed and tested in several test campaigns in SULTAN test facility. The DC results for the second prototype, RW2, rated for 63 kA at 12.3 T, were presented and published in 2018. The AC loss data were collected over several test campaigns performed on various assemblies of RW2 at AC field parallel and perpendicular to the broad cable side. The measurements done at 4.5 K and 20 K allow us to decompose the AC loss contributions originating from the bundle of superconducting strands (hysteresis and coupling loss) and copper-matrix stabilizer located around the cable. The AC loss for sinusoidal and trapezoidal field variations are presented and discussed. The low AC loss of the flat cable makes the cable an attractive choice for the central solenoid operating in a pulse mode

A new test method of AC loss assessment for fusion conductors

The coupling currents loss for fusion conductors is frequently assessed applying a sinusoidal field sweep of fixed, small amplitude and variable frequency. From the initial slope of the loss curve, the coupling loss time constant is derived and applied in the loss calculation over the whole range of field transient. In this work, the traditional AC loss assessment is compared to an alternative experimental assessment made on a trapezoidal field change, which mimics the actual field change rate in the central solenoid of tokamaks during the plasma start-up. The comparative loss assessment is made using the test results of the Nb3Sn react&wind conductor developed at SPC and an ITER TF conductor. The proposed AC loss assessment allows an accurate estimate of the deposited energy during plasma start-up for the Central Solenoid

Experimental and Theoretical Analysis of Transverse Resistances in a Nb3Sn LMI-EM Strand

In Nb3Sn strands, hundreds or thousands of fine superconducting filaments are embedded in a metallic matrix for thermal and electrical stabilization. The transverse electrical resistivity between filaments plays a fundamental role in determining the ac losses, the thermal stability, and the current transfer length of the wire. The direct measurements of the transverse electrical resistances give useful information both for stability computations and to analyze the mechanical performance of the wire. In this paper, the interfilament resistances measured with a four-probe technique on a Nb3Sn wire produced by Europa Metalli have been interpreted through a simulation code. A 2-D finite element method model of the wire cross-section and of a 3-D electrical circuit model of the wire sample have been applied to derive qualitative and quantitative information about the transverse electrical resistance matrix. A comparison with measurements performed on a Nb3Sn wire with a different configuration shows the relevance of the wire layout in determining the interfilament resistance between filament bundles

Hypertrophic Pyloric Stenosis: 10 Years' Experience with Standard Open and Laparoscopic Approach

Purpose: Hypertrophic pyloric stenosis (HPS) is the most common cause of gastric obstruction in newborns. Extra-mucosal pyloromyotomy can be performed through a small laparotomy or laparoscopy. The aim of this study was to compare the two surgical techniques. We also analyzed the incidence of HPS in infants in the last 10 years in relation to the demographic trend of our province.Methods: We analyzed all the cases of HPS treated at our Unit between January 2010 and December 2019. The data were obtained from operating systems. Data about the demographic trends, in particular, the number of births and the population residing in the province of Verona from 2010 to 2019, were also retrieved.Results: During the study period, 60 patients were treated for HPS and met the inclusion criteria. Of these, 56 males and 4 females with an average age of 38 +/- 14 days at surgery were included. No differences were found in terms of the duration of surgery, post-operative complications, duration of hospitalization, and weight at the time of surgery. The only statistically significant data was the chlorine level in cases with and without post-operative vomiting (97 +/- 3.5 vs. 102 +/- 3.3 mmol/L, p<0.05). There was a lower incidence of HPS from 2014 to 2019; however, there was no significant evidence regarding the correlation between this and the reduced birth rate recorded in the province of Verona during the same period.Conclusion: Although laparoscopic pyloromyotomy is a highly complex procedure, it is a feasible alternative to the classic open technique

Coupled thermal and electromagnetic analysis of the NAFASSY magnet

The paper presents an analysis of the current distribution and electromagnetic losses in the NAFASSY magnet carried out with the THELMA code, thanks to a brand-new thermal module coupled with the pre-existing electromagnetic module. The non-linear thermal and electrical properties of both superconducting and copper strands, depending on the local temperature, current density and magnetic field, are taken into account. The model analyses a single turn of the magnet, located in the highest field zone, focusing on the current distribution in the cable, the coupling AC and DC losses during ramped waveforms. The results are then extrapolated to estimate the behaviour of the overall magnet. A description of the models is given, together with a parametric analysis of different boundary conditions and cable discretizations. The analysis shows that, in nominal working conditions, no thermal instability should take place. However, local current redistribution among the strands may occur, mainly driven by the interstrand contact pattern, the local magnetic field and the strand current density

Analysis of the effects of thermal anchors on the reduction of the parasitic load to the EU-DEMO TF coils

The design of the superconducting magnet system of the EU-DEMO tokamak reached the end of the preconceptual design phase, and a careful investigation of the parasitic heat load from the room-temperature environment is needed. A possible route for the parasitic heat to enter the toroidal field (TF) coils is by conduction through their Gravity Supports (GSs), which provide mechanical support to the TFs, the Vacuum Vessel (VV) and attached coils, acting as a thermal bridge to the TF casing. A thermal anchoring of the GS using Supercritical helium (SHe) at 4.5 K, re-routing a fraction of the coolant from the TF casing cooling loop, downstream of the casing, is addressed in this study. A 3D thermal model is developed for a plausible design of the EUDEMO GS, coupled to fluid lines that account for the active cooling by SHe. The effect of the location of the Thermal Anchor (TA) at different heights of the GS plates is investigated parametrically and the beneficial reduction of the parasitic heat load to the TF coil is demonstrated. The reduction of the static heat load to the TF winding pack, when the TA is enabled, is computed and discussed