La regolazione a rotatoria delle intersezioni stradali

Il volume si pone come finalità generale di fornire al lettore le basi teoriche e gli strumenti operativi per affrontare le principali problematiche connesse con la regolazione delle inter-sezioni stradali a raso attraverso l’uso delle rotatorie. Lo studio fornisce in modo sufficientemente ampio la descrizione delle tematiche legate alle moderne rotatorie: da una esposizione generale del dispositivo di moderazione del traffico alle principali metodologie di calcolo della capacità degli ingressi in uso nei paesi occiden-tali (Europa, Stati Uniti e Australia), confrontando e integrando, in qualche caso con risultati di ricerche specifiche, le formule di capacità di derivazione sperimentale e quelle derivate dalla logica gap acceptance. Il testo dedica uno spazio particolare alle rotatorie innovative, note come turborotatorie, nonché a un aspetto sinora poco approfondito, quello degli apprestamenti per gli utenti non motorizzati, pedoni e ciclisti. Lo studio è completato, infine, da un’analisi dei più interes-santi aspetti della geometria dell’intersezione, seguendo e interpretando anche in modo in-novativo le linee guida della Federal highway administration. L’opera, derivata dall’esperienza didattica, di ricerca e professionale degli autori, è mirata alla formazione dell’ingegnere trasportista, ma costituisce, anche, un supporto utile per spe-cifiche ricerche della materia

The “dica” endoscopic classification for diverticular disease of the colon shows a significant interobserver agreement among community endoscopists

Background & Aim: An endoscopic classification of Diverticular Disease DD, called DICA Diverticular Inflammation and Complication Assessment is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement levels for this classification among an endoscopist community setting. Methods: A total of 66 endoscopists independently scored a set of DD endoscopic videos. The percentages of overall agreement on the DICA score and a free-marginal multirater kappa κ coefficient were reported as statistical measures of the inter-rater agreement. Results: The overall agreement levels were: 70.2% for DICA 1, 70.5% for DICA 2, 81.3% for DICA 3. The free marginal κ was: 0.553 for DICA 1, 0.558 for DICA 2, 0.719 for DICA 3. The agreement levels among the expert group were: 78.8% for DICA 1, 80.2% for DICA 2, 88.5% for DICA 3. The free marginal κ among the expert group were: 0.682 for DICA 1, 0.712 for DICA 2, 0.828 for DICA 3. The agreement of expert raters on the single item of the DICA classification was superior to the agreement of the overall group. Conclusions: The overall inter-rater agreement for DICA score in this study ranges from moderate to good, with a significant improvement in the expert subgroup of raters. Diverticular Inflammation and Complication Assessment is a simple and reproducible endoscopic scoring system

Risk factors and action thresholds for the novel coronavirus pandemic. Insights from the Italian Society of Nephrology COVID-19 Survey

Background and aim: Over 80% (365/454) of the nation’s centers participated in the Italian Society of Nephrology COVID-19 Survey. Out of 60,441 surveyed patients, 1368 were infected as of April 23rd, 2020. However, center-specific proportions showed substantial heterogeneity. We therefore undertook new analyses to identify explanatory factors, contextual effects, and decision rules for infection containment. Methods: We investigated fixed factors and contextual effects by multilevel modeling. Classification and Regression Tree (CART) analysis was used to develop decision rules. Results: Increased positivity among hemodialysis patients was predicted by center location [incidence rate ratio (IRR) 1.34, 95% confidence interval (CI) 1.20–1.51], positive healthcare workers (IRR 1.09, 95% CI 1.02–1.17), test-all policy (IRR 5.94, 95% CI 3.36–10.45), and infected proportion in the general population (IRR 1.002, 95% CI 1.001–1.003) (all p < 0.01). Conversely, lockdown duration exerted a protective effect (IRR 0.95, 95% CI 0.94–0.98) (p < 0.01). The province-contextual effects accounted for 10% of the total variability. Predictive factors for peritoneal dialysis and transplant cases were center location and infected proportion in the general population. Using recursive partitioning, we identified decision thresholds at general population incidence ≥ 229 per 100,000 and at ≥ 3 positive healthcare workers. Conclusions: Beyond fixed risk factors, shared with the general population, the increased and heterogeneous proportion of positive patients is related to the center’s testing policy, the number of positive patients and healthcare workers, and to contextual effects at the province level. Nephrology centers may adopt simple decision rules to strengthen containment measures timely