Impact of megaships on the performance of port container terminals

Following the advent of megaships, the performance requirements of container terminals have increased significantly, highlighting necessary changes in their layout, infrastructure, and equipment. We focus on the impact of megaships on a terminal within the port network of the Italian Region of Liguria, in terms of its ability to manage the flow of imports from arrival to inland destinations. We use discrete event simulation techniques to analyze the operations of a terminal and evaluate the relevant performance indices in different scenarios, which vary as a function of the \u201ccall size\u201d of the larger containerships. The possibility of guaranteeing a more balanced modal split (favoring rail transport) for the inland distribution of containers is also evaluated. Dwell times at the yard and turnaround times at the berth are considered, with the objective of achieving a modal split of inland transport consisting of no less than 40% rail. Our results show that this objective can be achieved if a higher dwell time for outgoing containers is allowed

The elderly and urban mobility: cost sensitivity of elderly people in the “oldest” Italian city

The world is facing a series of changes that will modify the way we envisage transport planning in our cities. Demographic ageing as a consequence of higher life expectancy and lower fertility rates is a world-wide phenomenon. While ageing is indeed a triumph of scientific progress and increasing longevity is perceived as one of humanity’s greatest achievements, the transition in society needs to be managed. In the urban context, any increase in age, health, and economic conditions determines one’s ability to enjoy the urban milieu and the so-called economies of urbanisation (advantages gained from an urban location, e.g., proximity to a market, labour supply, good communications, and financial and commercial services) longer. As there are more and more elderly people in cities, urban mobility becomes crucial in making the urban environment more inclusive. In order to provide suitable policy guidelines, it is, therefore, necessary to investigate and understand senior traveller behaviour.  In this study, we investigate urban travel characteristics of people aged 65 years and over living in the city of Genoa (one of the cities with the largest population of the elderly in the EU). By utilising a structured questionnaire, the paper explores the satisfaction and motivations of approx. 600 elderly public transport users in the city. In particular, exploratory factor analysis has been used to determine the key dimensions of the satisfaction and mobility motivations, and subsequently to use them to investigate the cost sensitivity of elderly people

Galilean symmetry in the effective theory of inflation: new shapes of non-Gaussianity

We study the consequences of imposing an approximate Galilean symmetry on the Effective Theory of Inflation, the theory of small perturbations around the inflationary background. This approach allows us to study the effect of operators with two derivatives on each field, which can be the leading interactions due to non-renormalization properties of the Galilean Lagrangian. In this case cubic non-Gaussianities are given by three independent operators, containing up to six derivatives, two with a shape close to equilateral and one peaking on flattened isosceles triangles. The four-point function is larger than in models with small speed of sound and potentially observable with the Planck satellite.Comment: 23 pages, 6 figures. v2: minor changes to match JCAP published versio

Anti-PD1 Consolidation in Patients with Hodgkin Lymphoma at High Risk of Relapse after Autologous Stem Cell Transplantation: A Multicenter Real-Life Study

(1) Background: Consolidation therapy is an emerging strategy for patients with relapsed/refractory (RR) Hodgkin Lymphoma (HL) at high risk of failing salvage autologous stem cell transplantation (ASCT). (2) Objectives: To assess the safety and effectiveness of PD1-blockade consolidation for these high-risk patients. (3) Design: Multi-center retrospective analysis. (4) Methods: We identified 26 patients given anti-PD1 consolidation, from June 2016 to May 2020. (5) Results: Patients displayed the following risk factors: refractory disease (69%), relapse 3, occurred in 12 patients (46.15%) and mainly included skin rashes (41.7%), transaminitis (33.3%), and thyroid hypofunction (25%). Patients completed a median of 13 courses (range 6–30). At a median follow-up of 25.8 months post-ASCT, the median progression-free (PFS) was 42.6 months, with a 2-year PFS and overall survival rates of 79% and 87%, respectively. (6) Conclusions: Post-ASCT consolidation with anti-PD1 is feasible and effective. Further studies are warranted to define the optimal treatment length and patients’ subsets more likely to benefit from this approach

Final results of the tests on the resistive plate chambers for the ALICE muon arm

Abstract The trigger for the ALICE muon spectrometer will be issued by single-gap, low resistivity bakelite resistive plate chambers (RPCs). The trigger system consists of four 5.5 × 6.5 m 2 RPC planes arranged in two stations, for a total of 72 detectors. One hundred and sixteen detectors have been assembled and tested in Torino. The tests have been performed with the streamer mixture developed for heavy ion data-taking. The tests include: the detection of gas leaks and parasitic currents; the measurement of the efficiency with cosmic rays, with particular regard to the uniformity of the efficiency throughout the whole active surface, with a granularity of about 2 × 2 cm 2 ; the measurement of the dark current and of the mean and localised noise rate. All the RPCs produced have been characterised. Among them, the detectors to be finally installed in ALICE and some spare have been selected; 17% of all the produced detectors have been discarded. A short description of the test set-up is given. The results of the tests are presented, with particular regard to the performance of the selected detectors

Safety of a 3-weekly schedule of carboplatin plus pegylated liposomal doxorubicin as first line chemotherapy in patients with ovarian cancer: preliminary results of the MITO-2 randomized trial

BACKGROUND: The MITO-2 (Multicentre Italian Trials in Ovarian cancer) study is a randomized phase III trial comparing carboplatin plus paclitaxel to carboplatin plus pegylated liposomal doxorubicin in first-line chemotherapy of patients with ovarian cancer. Due to the paucity of published phase I data on the 3-weekly experimental schedule used, an early safety analysis was planned. METHODS: Patients with ovarian cancer (stage Ic-IV), aged < 75 years, ECOG performance status ≤ 2, were randomized to carboplatin AUC 5 plus paclitaxel 175 mg/m(2), every 3 weeks or to carboplatin AUC 5 plus pegylated liposomal doxorubicin 30 mg/m(2), every 3 weeks. Treatment was planned for 6 cycles. Toxicity was coded according to the NCI-CTC version 2.0. RESULTS: The pre-planned safety analysis was performed in July 2004. Data from the first 50 patients treated with carboplatin plus pegylated liposomal doxorubicin were evaluated. Median age was 60 years (range 34–75). Forty-three patients (86%) completed 6 cycles. Two thirds of the patients had at least one cycle delayed due to toxicity, but 63% of the cycles were administered on time. In most cases the reason for chemotherapy delay was neutropenia or other hematological toxicity. No delay due to palmar-plantar erythrodysesthesia (PPE) was recorded. No toxic death was recorded. Reported hematological toxicities were: grade (G) 3 anemia 16%, G3/G4 neutropenia 36% and 10% respectively, G3/4 thrombocytopenia 22% and 4% respectively. Non-haematological toxicity was infrequent: pulmonary G1 6%, heart rhythm G1 4%, liver toxicity G1 6%, G2 4% and G3 2%. Complete hair loss was reported in 6% of patients, and G1 neuropathy in 2%. PPE was recorded in 14% of the cases (G1 10%, G2 2%, G3 2%). CONCLUSION: This safety analysis shows that the adopted schedule of carboplatin plus pegylated liposomal doxorubicin given every 3 weeks is feasible as first line treatment in ovarian cancer patients, although 37% of the cycles were delayed due to haematological toxicity. Toxicities that are common with standard combination of carboplatin plus paclitaxel (neurotoxicity and hair loss) are infrequent with this experimental schedule, and skin toxicity appears manageable

Association between preoperative evaluation with lung ultrasound and outcome in frail elderly patients undergoing orthopedic surgery for hip fractures: study protocol for an Italian multicenter observational prospective study (LUSHIP)

Hip fracture is one of the most common orthopedic causes of hospital admission in frail elderly patients. Hip fracture fixation in this class of patients is considered a high-risk procedure. Preoperative physical examination, plasma natriuretic peptide levels (BNP, Pro-BNP), and cardiovascular scoring systems (ASA-PS, RCRI, NSQIP-MICA) have all been demonstrated to underestimate the risk of postoperative complications. We designed a prospective multicenter observational study to assess whether preoperative lung ultrasound examination can predict better postoperative events thanks to the additional information they provide in the form of "indirect" and "direct" cardiac and pulmonary lung ultrasound signs

Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores. Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs. Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients