Diplomacy in the Time of Cholera

Turning everyday ordinary happenings into struggling moments for existence—from breathing to socializing—is how the Covid-19 pandemic will mark history. What we ask here is not how the ordinary becomes abnormal but how it becomes political and diplomatic. We argue that the spread of the Covid-19 virus, which is measured through virologic and epidemiological models, overlaps with feverous diplomatic and political activities taking place among big geopolitical powers. Yet, this is not new in history of health. The first encounters between diplomats and health professionals were elicited by the social and economic challenges caused, on a global scale, by the cholera epidemics of the nineteenth century. Indeed, health sciences and diplomacy have been historically co-produced. Such a historical perspective on science and health diplomacy facilitates our understanding of international institutions such as the World Health Organization as highly political and diplomatic endeavors. The Diplomatic Studies of Science, a new interdisciplinary research field underpinned by a historical perspective on science diplomacy, sheds light on the multiple factors contributing to the worsening of the global COVID-19 crisis we are facing nowadays

A detailed study of rainfall in the Roman area in the decade 1992–2001

A study of the rainfall regime in the Roman area over the decade 1992-2001 has been undertaken on using tipping pluviometers data, coming from 23 climatic stations located in Rome and in its surroundings. The time response of the instruments and the automatic acquisition system ensure a resolution of less than 1 minute, thus offering the possibility of an accurate evaluation of intense and extreme events. The mean yearly rainfall over the whole decade has been determined for each station, obtaining values between 682 and 870mm/year, with a geographical average of 771 and a standard deviation of 47. A study of the rainfall distribution within the 48 half-hours of the day has been carried out in order to ascertain whether preferred times for rain events exist. The analysis has evidenced that this is the case, with high rainfall rates mostly occurring in the late morning and low rates in the late night. Typical values of the maximum 30-min rainfall ever recorded at any given station oscillate between 25 and almost 60 mm. A separate analysis of rainy and dry days has been carried out on studying the statistics of the time delays between two successive tips of the pluviometer. This allowed a characterization of the intense rains as well as of the droughts: the resulting histograms show the existence of a bimodal distribution explained in terms of two kinds of rain events, intense summer showers and drizzles distributed over the rest of the year. As for the droughts, the longest durations appear to range from one to about seven months. On confining the analysis to the rainy days only, the rain intensity data for each station has been plotted and fitted with a Weibull distribution. The corresponding Weibull parameters, while gathering around common mean values, do not show any recognizable pattern when regressed, for instance, versus the altitude of the station or the distance from the coastline. Last, the likelihood that a day of the year, taken at random, be a rainy day or not has been computed for each station yielding probability values ranging from 0.18 to 0.22

Oncological and functional outcome of conservative surgery for primary supraglottic cancer

The aim of this study was to verify the oncological and functional outcome of conservative surgical treatment of primary supraglottic squamous cell carcinoma (SGSCC) and related neck disease in order to verify the effectiveness of supraglottic laryngectomy (SL) and the validity of an "observation" policy in the control of clinically negative (NO) necks. Of a total of 252 consecutive patients affected by primary SGSCC seen between 1975 and 1990 at the Department of Otolaryngology of the University of Perugia (1975-1987) and the Catholic University of the Sacred Heart of Rome (1988-1990), a subset of 132 patients treated with classical SL was evaluated after presenting sufficient clinicopathological data and a follow-up period of at least 5 years. Tumors were staged according to the 1992 UICC TNM classification and grouped into stages I-II (n = 94) and III-IV (n = 38). Comprehensive neck dissections were performed only in the clinically positive (N+) necks (25/132 cases), while in the clinically NO ones (107/132 cases) an "observation" policy under strict follow-up conditions was adopted. After primary surgery, the 5-year relapse-free survival (RFS) was 74%. The RFS was 80% for T1-2 disease and 65% for T3. The RFS was 80% for stages I-II tumors and 71% for stages III-IV. The actual 5-year overall survival (OS) was 89% for T1-T2 tumors and 67% for T3 disease or 93% for stages I-II and 69% for stages III-IV. The OS was 89% for NO neck and 73% for N+. The 5-year-metastasis-free survival (MFS) was 83% for NO patients, 74% for N+, 84% for T1-T2 NO, 71% for T1-T2 N+, 81% for T3 NO and 68% for T3 N+. In all, SL was found to be highly effective in the management of primary SGSCC. In the presence of clinically NO neck "observation" under strict follow-up with therapeutic comprehensive neck dissection for delayed nodal recurrence, SL was suitable for controlling the neck cancer, as well as for salvaging recurrent disease. Bilateral elective, selective or functional neck dissection in every instance of supraglottic cancer was best performed only in those SGSCC patients who were more likely to have occult nodal disease on the basis of biological factors and imaging data

The burden of calcific aortic stenosis. what's behind

In Western countries, calcific aortic valve stenosis (CAS) is widely common, representing the third cause of death among cardiovascular diseases (CVD). The burden of CAS is high, with an increasing prevalence rate related to age. An efficient medical treatment, according to guidelines, lacks to prevent the development and to reduce the progression of CAS. In this context, due to the aging population and the lack of effective medical management, the prevalence is expected to double-triple within the next decades. In our review, we aim to provide an overview of the underlying mechanisms of pathogenesis and the current state of the art regarding pathophysiological insights and novel potential therapeutic targets

Functional Tricuspid Regurgitation: Behind the Scenes of a Long-Time Neglected Disease

Severe tricuspid valve regurgitation has been for a long time a neglected valve disease, which has only recently attracted an increasing interest due to the notable negative impact on the prognosis of patients with cardiovascular disease. It is estimated that around 90% of tricuspid regurgitation is diagnosed as "functional" and mostly secondary to a primary left-sided heart disease and, therefore, has been usually interpreted as a benign condition that did not require a surgical management. Nevertheless, the persistence of severe tricuspid regurgitation after left-sided surgical correction of a valve disease, particularly mitral valve surgery, has been associated to adverse outcomes, worsening of the quality of life, and a significant increase in mortality rate. Similar results have been found when the impact of isolated severe tricuspid regurgitation has been studied. Current knowledge is shifting the "functional" categorization toward a more complex and detailed pathophysiological classification, identifying various phenotypes with completely different etiology, natural history and, potentially, an invasive management. The aim of this review is to offer a comprehensive guide for clinicians and surgeons with a systematic description of "functional" tricuspid regurgitation subtypes, an analysis centered on the effectiveness of existing surgical techniques and a focus on the emergent percutaneous procedures. This latter may be an attractive alternative to a standard surgical approach in patients with high-operative risk or isolated tricuspid regurgitation.Copyright © 2022 Vinciguerra, Sitges, Luis Pomar, Romiti, Domenech-Ximenos, D'Abramo, Wretschko, Miraldi and Greco

HV-CMOS design and characterization of a smart rotor coil driver for automotive alternators

n/