Seismic Performance of Sheathed Cold-formed Shear Walls

The paper presents and discusses the results of a research on the seismic behaviour of cold-formed steel stud shear walls, sheathed with wood-based (oriented strand board) and gypsum-based (wallboard) panels. Within this activity, this paper provides the outcomes of the results of experimental (capacity evaluation) and theoretical (demand evaluation) phases of the research. Moreover, a contribution is given for the .evaluation of the strength reduction factor of this structural typology

Gigantomastia During Pregnancy Due to Burkitt Lymphoma

Gigantomastia is a rare complication of pregnancy usually associated with benign conditions and rarely with malignancies. This paper reports a non-Hodgkin lymphoma case associated with gigantomastia during pregnancy. The patient was a 30-year-old gravida one woman, with a history of rapidly enlarging right breast at 2 weeks prior to presentation. After the first diagnosis of benign gigantomastia, the continuous growth of the breast, despite the delivery and bromocriptine therapy, required further investigation of the case. The histological analysis revealed the presence of Burkitt lymphoma. Malignant causes of unilateral gigantomastia in pregnancy should be considered in the differential diagnosis of this condition

Achieving Isolation in Mixed-Criticality Industrial Edge Systems with Real-Time Containers Appendix

Real-time containers are a promising solution to reduce latencies in time-sensitive cloud systems. Recent efforts are emerging to extend their usage in industrial edge systems with mixed-criticality constraints. In these contexts, isolation becomes a major concern: a disturbance (such as timing faults or unexpected overloads) affecting a container must not impact the behavior of other containers deployed on the same hardware. In this paper, we propose a novel architectural solution to achieve isolation in real-time containers, based on real-time co-kernels, hierarchical scheduling, and time-division networking. The architecture has been implemented on Linux patched with the Xenomai co-kernel, extended with a new hierarchical scheduling policy, named SCHED_DS, and integrating the RTNet stack. Experimental results are promising in terms of overhead and latency compared to other Linux-based solutions. More importantly, the isolation of containers is guaranteed even in presence of severe co-located disturbances, such as faulty tasks (elapsing more time than declared) or high CPU, network, or I/O stress on the same machine

Oral progesterone for the prevention of recurrent preterm birth: systematic review and metaanalysis

Objective The purpose of this study was to perform a systematic review and metaanalysis of randomized controlled trials on oral progesterone compared with placebo or other interventions for preterm birth prevention in singleton pregnancies with previous spontaneous preterm birth. The primary outcome was preterm birth at <37 weeks gestation; the secondary outcomes included preterm birth rate at <34 weeks gestation, neonatal morbidity/death, and maternal side-effects. Study Searches were performed in PubMed, Scopus, ClinicalTrials.gov, PROSPERO, EMBASE, and the Cochrane Register with the use of a combination of words related to “preterm birth,” “preterm delivery,” “progesterone,” “progestogens,” and “oral” from inception of each database to April 2018. Additionally, systematic reviews on progesterone for preterm birth prevention that were identified in our search were also reviewed for additional studies. We included all randomized trials of asymptomatic singleton gestations with previous spontaneous singleton preterm birth that had been randomized to prophylactic treatment with oral progesterone vs placebo, no treatment, or other preterm birth intervention. Exclusion criteria included quasirandomized trials, trials that involved women with preterm labor/membrane rupture at the time of randomization or multiple gestations. Study Appraisal and Synthesis Methods The risk of bias and quality of evidence were assessed for each study. All analyses were done with an intention-to-treat approach. The primary outcome was incidence of preterm birth at 30% was used to identify heterogeneity. Results The search strategy identified 79 distinct studies. Three trials on oral progesterone vs placebo (involved 386 patients: 196 in oral progesterone and 190 in placebo) met the inclusion criteria; there were no studies on oral progesterone vs other intervention that met inclusion criteria. Metaanalysis demonstrated a significantly decreased risk of preterm birth at <37 weeks gestation (42% vs 63%; P=.0005; relative risk, 0.68; 95% confidence interval, 0.55–0.84), preterm birth at <34 weeks gestation (29% vs 53%; P<.00001; relative risk, 0.55; 95% confidence interval, 0.43–0.71), and increased gestational age of delivery (mean difference, 1.71 weeks; 95% confidence interval, 1.11–2.30) with oral progesterone compared with placebo. There was a significantly lower rate of perinatal death (5% vs 17%; P=.001; relative risk 0.32; 95% confidence interval, 0.16–0.63), neonatal intensive care admission (relative risk, 0.39; 95% confidence interval, 0.25–0.61), respiratory distress syndrome (relative risk, 0.21; 95% confidence interval, 0.05–0.93), and higher birthweight (mean difference, 435.06 g; 95% confidence interval, 324.59–545.52) with oral progesterone. There was a higher rate of maternal adverse effects with oral progesterone that included dizziness (relative risk, 2.95; 95% confidence interval, 1.47–5.90), somnolence (relative risk, 2.06; 95% confidence interval, 1.29–3.30), and vaginal dryness (relative risk, 2.37; 95% confidence interval, 1.10–5.11); no serious adverse effects were noted. Conclusion Oral progesterone appears to be effective for the prevention of recurrent preterm birth and a reduction in perinatal morbidity and mortality rates in asymptomatic singleton gestations with a history of previous spontaneous preterm birth compared with placebo. There were also increased adverse effects with oral progesterone therapy compared with placebo, although none were serious. Further randomized study on oral progesterone compared with other established therapies for the prevention of recurrent preterm birth are warranted

Wearable proximity sensors for monitoring a mass casualty incident exercise: a feasibility study

Over the past several decades, naturally occurring and man-made mass casualty incidents (MCI) have increased in frequency and number, worldwide. To test the impact of such event on medical resources, simulations can provide a safe, controlled setting while replicating the chaotic environment typical of an actual disaster. A standardised method to collect and analyse data from mass casualty exercises is needed, in order to assess preparedness and performance of the healthcare staff involved. We report on the use of wearable proximity sensors to measure proximity events during a MCI simulation. We investigated the interactions between medical staff and patients, to evaluate the time dedicated by the medical staff with respect to the severity of the injury of the victims depending on the roles. We estimated the presence of the patients in the different spaces of the field hospital, in order to study the patients' flow. Data were obtained and collected through the deployment of wearable proximity sensors during a mass casualty incident functional exercise. The scenario included two areas: the accident site and the Advanced Medical Post (AMP), and the exercise lasted 3 hours. A total of 238 participants simulating medical staff and victims were involved. Each participant wore a proximity sensor and 30 fixed devices were placed in the field hospital. The contact networks show a heterogeneous distribution of the cumulative time spent in proximity by participants. We obtained contact matrices based on cumulative time spent in proximity between victims and the rescuers. Our results showed that the time spent in proximity by the healthcare teams with the victims is related to the severity of the patient's injury. The analysis of patients' flow showed that the presence of patients in the rooms of the hospital is consistent with triage code and diagnosis, and no obvious bottlenecks were found

A case of 20-week abortion in a rare communicating rudimentary horn of a misinterpreted unicornuate uterus, incorrectly diagnosed as bicornuate: A serious hazard!

Female genital malformations, as the unicornuate uterus, are deviations from normal anatomy that could impair the reproductive potential of a woman or her health. We present a rare case of a 20-week spontaneous abortion in a 24 years old patient affected by a misunderstood unicornuate uterus with communicating rudimentary horn, previously diagnosed as bicornuate, and for this reason subjected to induction of abortive labor, using mifepristone and gemeprost. Following the ultrasound exam and MRI, performed due to the failure of the abortive procedure, revealed the diagnosis of unicornuate uterus with (not clear) communicating accessory horn pregnancy, then treated with laparotomy. 3D-ultrasonography, and above all MRI, should be performed in all those cases of suspected uterine anomalies, especially in presence of pregnancy or abortion, with the aim of avoiding wrong treatments, which leads to a high risk of uterine rupture. In this case, given the uncertainty of imaging exams performed in such an advanced second trimester of pregnancy, only the surgical approach was able to discover the real communication

Evaluation and treatment of the infertile women with Asherman syndrome: an updated review focusing on the role of hysteroscopy

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Laparoscopic gynecological surgery under minimally invasive anesthesia: a prospective cohort study

The purpose of this study is to assess the feasibility and the perioperative outcomes of laparoscopic gynecological surgery in regional anesthesia (RA) from the point of view of the surgeon, anesthesiologist and patient. This is a prospective cohort study comprising sixty-six women planned to undergo gynecologic laparoscopy surgery for benign pathology at tertiary care gynecolgical center of the University Federico II of Naples. Women were assigned, according to their preference, to either RA (Group A) or general anesthesia (GA) (Group B). Surgical, anesthesiologic and postoperative recovery data were recorded. Postoperative pain was considered as the primary outcome. Secondary outcomes included mobilization, length of hospital stay, global surgeons and patient satisfaction, intraoperative pain assessment in Group A. Immediate postoperative pain was significantly lower in Group A 0 vs 2 (p &lt; 0.001), with no significant differences at 24 h. The secondary outcome demonstrated early patient's mobilization (p &lt; 0.001) as well as early discharge (p &lt; 0.001) and greater patient's satisfaction for the Group A. In these patients, a maximum pain score of 3 points out of 5 was recorded through the entire surgery. RA showed to decrease the impact of surgical stress and to guarantee a quicker recovery without compromising surgical results. Although several surgical approaches can be employed to treat different conditions, RA technique could be a viable option for well-selected patients affected by gynecological diseases