La lesione intestinale nella malattia ciliaca: possibile ruolo dei macrofagi e dell'ossido nitrico

Dottorato di ricerca in scienze gastroenterologiche pediatriche. 8. ciclo. A.a. 1994-95. Coordinatore e tutore N. Ansaldi BaloccoConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - P.za Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

A high-Q InP resonant angular velocity sensor for a monolithically integrated optical gyroscope

\u3cp\u3eThe design, fabrication, and optical characterization of the sensing element of a photonic InP-based gyroscope intended for applications in the field of aerospace and defense are reported in this paper. The sensing element is a spiral resonator coupled to a straight bus waveguide through a multimode interference coupler and exhibits a Q factor of approximately 600000 with a footprint of approximately 10 mm\u3csup\u3e2\u3c/sup\u3e. The design of each component of the sensor is based on some well-established numerical methods such as the Finite Element Method, the beam propagation method, and the film mode matching method. The spiral cavity was designed using the standard transfer matrix method. The selected fabrication process, which is an enhanced version of the standard COBRA process, allows the monolithic integration of the sensing element with the other active components of the gyroscope, e.g., lasers, photodiodes, and modulators. Each component of the fabricated sensing element was optically characterized using an appropriate setup, which was also used for the optical characterization of the whole sensor. Based on the results of the characterization, the gyro performance was evaluated, and a way to improve both the resolution and the bias drift, i.e., down to 10 °/h and 1 °/h, respectively, was also clearly identified. The achieved results demonstrate, for the first time, the actual feasibility of a photonic gyro-on-chip through a well-established InP-based generic integration process.\u3c/p\u3

High-Flow Nasal Oxygen for Severe Hypoxemia: Oxygenation Response and Outcome in Patients with COVID-19

Rationale: The "Berlin definition" of acute respiratory distress syndrome (ARDS) does not allow inclusion of patients receiving high-flow nasal oxygen (HFNO). However, several articles have proposed that criteria for defining ARDS should be broadened to allow inclusion of patients receiving HFNO. Objectives: To compare the proportion of patients fulfilling ARDS criteria during HFNO and soon after intubation, and 28-day mortality between patients treated exclusively with HFNO and patients transitioned from HFNO to invasive mechanical ventilation (IMV). Methods: From previously published studies, we analyzed patients with coronavirus disease (COVID-19) who had PaO2/FiO2 of ⩽300 while treated with ⩾40 L/min HFNO, or noninvasive ventilation (NIV) with positive end-expiratory pressure of ⩾5 cm H2O (comparator). In patients transitioned from HFNO/NIV to invasive mechanical ventilation (IMV), we compared ARDS severity during HFNO/NIV and soon after IMV. We compared 28-day mortality in patients treated exclusively with HFNO/NIV versus patients transitioned to IMV. Measurements and Main Results: We analyzed 184 and 131 patients receiving HFNO or NIV, respectively. A total of 112 HFNO and 69 NIV patients transitioned to IMV. Of those, 104 (92.9%) patients on HFNO and 66 (95.7%) on NIV continued to have PaO2/FiO2 ⩽300 under IMV. Twenty-eight-day mortality in patients who remained on HFNO was 4.2% (3/72), whereas in patients transitioned from HFNO to IMV, it was 28.6% (32/112) (P < 0.001). Twenty-eight-day mortality in patients who remained on NIV was 1.6% (1/62), whereas in patients who transitioned from NIV to IMV, it was 44.9% (31/69) (P < 0.001). Overall mortality was 19.0% (35/184) and 24.4% (32/131) for HFNO and NIV, respectively (P = 0.2479). Conclusions: Broadening the ARDS definition to include patients on HFNO with PaO2/FiO2 ⩽300 may identify patients at earlier stages of disease but with lower mortality

Synergistic Effect of Static Compliance and D-dimers to Predict Outcome of Patients with COVID-19-ARDS: A Prospective Multicenter Study

The synergic combination of D-dimer (as proxy of thrombotic/vascular injury) and static compliance (as proxy of parenchymal injury) in predicting mortality in COVID-19-ARDS has not been systematically evaluated. The objective is to determine whether the combination of elevated D-dimer and low static compliance can predict mortality in patients with COVID-19-ARDS. A "training sample" (March-June 2020) and a "testing sample" (September 2020-January 2021) of adult patients invasively ventilated for COVID-19-ARDS were collected in nine hospitals. D-dimer and compliance in the first 24 h were recorded. Study outcome was all-cause mortality at 28-days. Cut-offs for D-dimer and compliance were identified by receiver operating characteristic curve analysis. Mutually exclusive groups were selected using classification tree analysis with chi-square automatic interaction detection. Time to death in the resulting groups was estimated with Cox regression adjusted for SOFA, sex, age, PaO2/FiO(2) ratio, and sample (training/testing). "Training" and "testing" samples amounted to 347 and 296 patients, respectively. Three groups were identified: D-dimer 1880 ng/mL and compliance > 41 mL/cmH(2)O (LD-HC); D-dimer > 1880 ng/mL and compliance <= 41 mL/cmH(2)O (HD-LC). 28-days mortality progressively increased in the three groups (from 24% to 35% and 57% (training) and from 27% to 39% and 60% (testing), respectively; p < 0.01). Adjusted mortality was significantly higher in HD-LC group compared with LD (HR = 0.479, p < 0.001) and HD-HC (HR = 0.542, p < 0.01); no difference was found between LD and HD-HC. In conclusion, combination of high D-dimer and low static compliance identifies a clinical phenotype with high mortality in COVID-19-ARDS

Quality Control of Mass-Produced GEM Detectors for the CMS GE1/1 Muon Upgrade

The series of upgrades to the Large Hadron Collider, culminating in the High Luminosity Large Hadron Collider, will enable a significant expansion of the physics program of the CMS experiment. However, the accelerator upgrades will also make the experimental conditions more challenging, with implications for detector operations, triggering, and data analysis. The luminosity of the proton-proton collisions is expected to exceed $2-3\times10^{34}$~cm$^{-2}$s$^{-1}$ for Run 3 (starting in 2022), and it will be at least $5\times10^{34}$~cm$^{-2}$s$^{-1}$ when the High Luminosity Large Hadron Collider is completed for Run 4. These conditions will affect muon triggering, identification, and measurement, which are critical capabilities of the experiment. To address these challenges, additional muon detectors are being installed in the CMS endcaps, based on Gas Electron Multiplier technology. For this purpose, 161 large triple-Gas Electron Multiplier detectors have been constructed and tested. Installation of these devices began in 2019 with the GE1/1 station and will be followed by two additional stations, GE2/1 and ME0, to be installed in 2023 and 2026, respectively. The assembly and quality control of the GE1/1 detectors were distributed across several production sites around the world. We motivate and discuss the quality control procedures that were developed to standardize the performance of the detectors, and we present the final results of the production. Out of 161 detectors produced, 156 detectors passed all tests, and 144 detectors are now installed in the CMS experiment. The various visual inspections, gas tightness tests, intrinsic noise rate characterizations, and effective gas gain and response uniformity tests allowed the project to achieve this high success rate

Production and validation of industrially produced large-sized GEM foils for the Phase-2 upgrade of the CMS muon spectrometer

The upgrade of the CMS detector for the high luminosity LHC (HL-LHC) will include gas electron multiplier (GEM) detectors in the end-cap muon spectrometer. Due to the limited supply of large area GEM detectors, the Korean CMS (KCMS) collaboration had formed a consortium with Mecaro Co., Ltd. to serve as a supplier of GEM foils with area of approximately 0.6 m$^{2}$. The consortium has developed a double-mask etching technique for production of these large-sized GEM foils. This article describes the production, quality control, and quality assessment (QA/QC) procedures and the mass production status for the GEM foils. Validation procedures indicate that the structure of the Korean foils are in the designed range. Detectors employing the Korean foils satisfy the requirements of the HL-LHC in terms of the effective gain, response uniformity, rate capability, discharge probability, and hardness against discharges. No aging phenomena were observed with a charge collection of 82 mC/cm$^{2}$. Mass production of KCMS GEM foils is currently in progress