Pregnancy-Associated Plasma Protein A as Predictor of Outcome in Patients With Suspected Acute Coronary Syndromes

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Uva, nocciola e frumento: nuovi ingredienti per l’architettura e il design?

The circular economy represents a sustainable development model and an opportunity to innovate production processes by eliminating the concept of waste. In line with the growing interest of public and private actors on this issue, the article intends to illustrate the developments of the research activities carried out by the circular design team from the Department of Architecture and Design of the Politecnico di Torino. In particular, the paper describes an experience based on two close- ly related activities: CIBUS’ research project (CIrcular economy in the BUilding Sector from agri-food waste) and the innovative educational course Progettare e sviluppare l’economia circolare. The two activities, conducted in collaboration with companies in the Piedmont region, focus on the study of waste from the grape, hazel- nut, and wheat sectors to outline new “ingredients” for architecture and design. By exploring the current (linear) production model, the annual quan- tities of residues were identified and, subsequently, the potential for valorizing agricultural by-products was outlined. The results of the researches are encouraging and show how it is pos- sible to design new scenarios of cross-sectoral collaboration between agriculture and architecture

Design and Construction of a New Metering Hot Box for the In Situ Hygrothermal Measurement in Dynamic Conditions of Historic Masonries

The main purpose of the HeLLo project is to contribute to data available on the literature on the real hygrothermal behavior of historic walls and the suitability of insulation technologies. Furthermore, it also aims at minimizing the energy simulation errors at the design phase and at improving their conservation features. In this framework, one of the preliminary activities of the study is the creation of a real in situ hot box to measure and analyze different insulation technologies applied to a real historic wall, to quantify the hygrothermal performance of a masonry building. Inside this box, ‘traditional’ experiments can be carried out: recording heat flux, surface temperature, and air temperatures, as well as relative humidity values through the use of a new sensing system (composed of thermocouples and temperature/relative humidity combined sensors). Within this paper, the process of development, construction, and validation of this new metering box is exhibited. The new hot box, specifically studied for historic case studies, when compared to other boxes, presents other advantages compared to previous examples, widely exemplified

Evaluation on prognostic efficacy of lymph nodes ratio (LNR) and log odds of positive lymph nodes (LODDS) in complicated colon cancer: The first study in emergency surgery

Background: Lymph node involvement is one of the most important prognostic factors in colon cancer. Twelve is considered the minimum number of lymph nodes necessary to retain reliable tumour staging, but several factors can potentially influence the lymph node harvesting. Emergent surgery for complicated colon cancer (perforation, occlusion, bleeding) could represent an obstacle to reach the benchmark of 12 nodes with an accurate lymphadenectomy. So, an efficient classification system of lymphatic involvement is crucial to define the prognosis, the indication to adjuvant therapy and the follow-up. This is the first study with the aim to evaluate the efficacy of lymph nodes ratio (LNR) and log odds of positive lymph nodes (LODDS) in the prognostic assessment of patients who undergo to urgent surgery for complicated colonic cancer. Methods: This is a retrospective study carried out on patients who underwent urgent colonic resection for complicated cancer (occlusion, perforation, bleeding, sepsis). We collected clinical, pathological and follow-up data of 320 patients. Two hundred two patients met the inclusion criteria and were distributed into three groups according to parameter N of TNM, LNR and LODDS. Survival analysis was performed by Kaplan-Meier curves, investigating both overall survival (OS) and disease-free survival (DFS). Results: The median number of harvested lymph nodes was 17. In 78.71% (n = 159) of cases, at least 12 lymph nodes were examined. Regarding OS, significant differences from survival curves emerged for ASA score, surgical indication, tumour grading, T parameter, tumour stage, N parameter, LNR and LODDS. In multivariate analysis, only LODDS was found to be an independent prognostic factor. Concerning DFS, we found significant differences between survival curves of sex, surgical indication, T parameter, tumour stage, N parameter, LNR and LODDS, but none of these confirmed its prognostic power in multivariate analysis. Conclusions: We found that N, LNR and LODDS are all related to 5-year OS and DFS with statistical significance, but only LODDS was found to be an independent prognostic factor for OS in multivariate analysis

Applied Research of the Hygrothermal Behaviour of an Internally Insulated Historic Wall without Vapour Barrier: In Situ Measurements and Dynamic Simulations

The hygrothermal behaviour of an internally insulated historic wall is still hard to predict, mainly because the physical characteristics of the materials composing the historic wall are unknown. In this study, the hygrothermal assessment of an internally thermal insulated masonry wall of an historic palace located in Ferrara, in Italy, is shown. In situ non-destructive monitoring method is combined with a hygrothermal simulation tool, aiming to better analyse and discuss future refurbishment scenarios. In this context, the original U-value of the wall (not refurbished) is decreased from 1.44 W/m2K to 0.26 W/m2K (10 cm stone wool). Under the site specific conditions of this wall, not reached by the sun or rain, it was verified that even in the absence of vapour barrier, no frost damage is likely to occur and the condensation risk is very limited. Authors proposed further discussion based on simulation. The results showed that the introduction of a second gypsum board to the studied technology compensated such absence, while the reduction of the insulation material thickness provides a reduction of RH peaks in the interstitial area by 1%; this second solution proved to be more efficient, providing a 3% RH reduction and the avoidance of further thermal losses

Applied Research of the Hygrothermal Behaviour of an Internally Insulated Historic Wall without Vapour Barrier: In Situ Measurements and Dynamic Simulations

The hygrothermal behaviour of an internally insulated historic wall is still hard to predict, mainly because the physical characteristics of the materials composing the historic wall are unknown. In this study, the hygrothermal assessment of an internally thermal insulated masonry wall of an historic palace located in Ferrara, in Italy, is shown. In situ non-destructive monitoring method is combined with a hygrothermal simulation tool, aiming to better analyse and discuss future refurbishment scenarios. In this context, the original U-value of the wall (not refurbished) is decreased from 1.44 W/m2K to 0.26 W/m2K (10 cm stone wool). Under the site specific conditions of this wall, not reached by the sun or rain, it was verified that even in the absence of vapour barrier, no frost damage is likely to occur and the condensation risk is very limited. Authors proposed further discussion based on simulation. The results showed that the introduction of a second gypsum board to the studied technology compensated such absence, while the reduction of the insulation material thickness provides a reduction of RH peaks in the interstitial area by 1%; this second solution proved to be more efficient, providing a 3% RH reduction and the avoidance of further thermal losses

Root growth of corn seedlings as affected by soil resistance to penetration

A resistência do solo à penetração é relacionada com a textura, compactação e umidade do solo. No presente trabalho se estudou o efeito da interação desses fatores sobre o crescimento de raízes de milho. Materiais de solo com 22, 30, 34, 41 e 48% de argila foram acondicionados em tubos de PVC de 10 cm com 4,3 cm de diâmetro interno, nas densidades globais de 1,07, 1,18, 1,36 e 1,53 g cm-3, em três tensões de água: -0,034, -0,106 e -0,640 MPa. Plântulas de milho foram cultivadas nos tubos por 48 horas. Quando a densidade do solo é baixa, a textura tem papel preponderante no crescimento radicular. Esse efeito é menor à medida que aumenta a densidade global. O aumento da resistência do solo à penetração causa diminuição no comprimento e número de raízes seminais adventícias; a raiz seminal primária mostra menor capacidade de penetração do que as raízes seminais adventícias. Resistências do solo à penetração da ordem de 1,3 MPa reduzem à metade o crescimento das raízes seminais adventícias do milho.The soil resistance to penetration is affected by soil texture, compaction and moisture content. In this paper, the effects of the interaction of these factors on corn root growth was studied. Soil materials with 22, 30, 34, 41 and 48% of clay were packed in PVC tubes 10 cm high, with 4.3 cm of internal diameter to reach bulk densities of 1.07, 1.18, 1.36 and 1.53 g cm-3. Water was added to reach water potentials of -0.034, -0.106 and -0.640 MPa. Corn seedlings were grown in the tubes for 48 hours. When the soil bulk density was low, root growth was affected mainly by soil texture. As soil bulk density increased, there was a decrease in the effect of soil texture on root growth. The increase in soil strength caused a decrease in root length and in the number of seminal adventitious roots. The primary roots showed a lower penetration ability when compared to seminal adventitious roots. A soil resitance of 1.3 MPa caused a 50% decrease in seminal adventitious corn roots

ORal anticoagulants In fraGile patients with percutAneous endoscopic gastrostoMy and atrIal fibrillation: the (ORIGAMI) study

BACKGROUND: Randomized trials support the safety and efficacy of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients with nonvalvular atrial fibrillation, leading to increased use of these compounds. Crushed forms of DOACs have been shown to be reliable, but evidence supporting percutaneous endoscopic gastrostomy (PEG) delivery is lacking. PEG is a long-term option for enteral food and drug delivery in patients unable to maintain oral intake, bypassing the risks and disadvantages of parenteral nutrition.AIMS: The ORal anticoagulants In fraGile patients with percutAneous endoscopic gastrostoMy and atrIal fibrillation (ORIGAMI) study investigates the safety and efficacy of Edoxaban administered via PEG in patients with atrial fibrillation and a clinical indication for a long-term anticoagulation.DESIGN: In this prospective, single-centre observational study, 12 PEG-treated patients with indication to anticoagulation will receive edoxaban via PEG and will be followed up to 6 months. Plasma antifactor Xa activity and edoxaban concentrations will be assessed. Thromboembolic (ischaemic stroke, systemic embolism, venous thromboembolism) and bleeding events (Bleeding Academic Research Consortium and Thrombolysis in Myocardial Infarction) will be recorded at 1 and 6 months.PRELIMINARY CASES: A retrospective analysis of five atrial fibrillation cases undergoing PEG implantation at our Institution who received edoxaban via PEG showed plasma anti-FXa levels at a steady state of 146 ± 15 ng/ml, without major adverse event at a mean follow-up of 6 months.CONCLUSION: ORIGAMI prospectively investigates PEG-administration of edoxaban in PEG-treated patients requiring long-term anticoagulation. Our preliminary retrospective data support this route of DOAC administration. CLINICALTRIALS.GOV IDENTIFIER: NCT04271293

The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients

Abstract Background Pancreatic cancer (PC) patients have multiple risk factors for sarcopenia and loss of skeletal muscle mass (LSMM), which may cause greater treatment toxicities, reduced response to cancer therapy, prolonged hospitalization, impaired quality of life, and worse prognosis. Methods This is a retrospective study on advanced PC patients treated at the Department of Oncology of Udine, Italy, from January 2012 to November 2017. Among 162 patients who received chemotherapy, 94 consecutive patients with an available computed tomography (CT) scan were retrospectively analyzed. The primary objective of our study was to explore if an early LSMM ≥ 10% (measured at first radiological evaluation and compared with baseline) and/or baseline sarcopenia may impact prognosis. Baseline sarcopenia was defined according to Prado's criteria. Skeletal muscle area was measured as cross‐sectional areas (cm2) using CT scan data through the Picture archiving and communication system (PACS) image system. Results In the whole cohort, 48% of patients were ≤70 years old, and 50% had metastatic disease. At baseline, 73% of patients had sarcopenia, and 16% presented a visceral fat area ≥ 44 cm2/m2. Overall, 21% experienced an early LSMM ≥ 10%. Approximately 33% of sarcopenic patients at baseline and ~35% of patients with early LSMM ≥ 10% had a body mass index > 25 kg/m2. Of note, 71% of patients were evaluated by a nutritionist, and 56% received a dietary supplementation (oral and/or parenteral). After a median follow‐up of 30.44 months, median overall survival (OS) was 11.28 months, whereas median progression‐free survival (PFS) was 5.72 months. By multivariate analysis, early LSMM ≥ 10% was significantly associated with worse OS [hazard ratio (HR): 2.16; 95% confidence interval (CI) 1.23–3.78; P = 0.007] and PFS (HR: 2.31; 95% CI 1.30–4.09; P = 0.004). Moreover, an exploratory analysis showed that inflammatory indexes, such as neutrophil–lymphocyte ratio variation, impact early LSMM ≥ 10% (odds ratio 1.31, 95% CI 1.06–1.61, P = 0.010). Conclusions Early LSMM ≥ 10% has a negative prognostic role in advanced PC patients. Further prospective investigations are needed to confirm these preliminary data