1,084 research outputs found

    Children with special health care needs attending emergency department in Italy: analysis of 3479 cases

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    Application of the GeoUML Tools for the Production and Validation of Inspire Datasets

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    The structure of INSPIRE datasets is oriented to the exchange of data, not to its storage and manipulation in a database. Therefore data transformation is required. This paper analyses the possibility of using in this context the tools developed by SpatialDBGroup at Politecnico di Milano in order to create and validate spatial databases. The considered scenario is the following one: - an organisation (data provider) is willing to provide WFS and GML conformant to INSPIRE specifications (services and data); - this organisation is hosting geodata related to one or more INSPIRE themes on a spatial relational database, called here Source Database - in order to facilitate the implementation of INSPIRE compliant GML data, the organisation implements a new "INSPIRE-structured" spatial database, called here INSPIRE Database - a Transformation Procedure is created which extracts the data from the Source Database and loads it into the INSPIRE Database - the INSPIRE Database is "validated" also using topological operators, in order to identify also topological constraints gaps. We assume that both the Source Database and the INSPIRE Database are SQL based and that their physical schemas have been generated by the GeoUML Catalogue tool from the corresponding conceptual schemas, called SCSOURCE and SCINSPIRE. In this scenario the availability of the conceptual schemas suggests different areas where the tools can provide a great benefit: 1. Creation of the GeoUML specification SCINSPIRE, automatic generation of the corresponding physical SQL structure and Validation of the INSPIRE Database with respect to the specification 2. (Semi)automatic generation of the Transformation Procedure using a set of correspondence rules between elements of SCSOURCE and SCINSPIRE 3. Automatic generation of the WFS configuration from the SCINSPIRE In this paper we describe the work which has already been done and the research directions which we are following in order to deal with these points

    Geochemical constraints on the origin of enigmatic cemented chalks, Norfolk, UK

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    Very hard cemented chalk stacks and crusts found locally in the upper part of the Cretaceous Chalk of north Norfolk, UK, are related to solution features. The solution features, mainly pipes and caves, formed after deposition of the overlying Middle Pleistocene Wroxham Crag, probably by routing of sub-glacial, or glacial, melt-waters derived from late Pleistocene glaciers. New geochemical (particularly stable isotope) data shows that cementation of the chalks, although related spatially to the solution features, was not caused by glacier-derived waters. The carbon isotope composition of the chalk cements is typically around -9.5‰, indicative of biologically active soils. Moreover, the oxygen isotope compositions of the cements, around -5‰, are incompatible with water d18O values much below -9 to -10‰ (which probably precludes isotopically negative glacier-derived water), as resulting palaeo-temperatures are below zero. Taken together, the isotope data suggest chalk cementation occurred under interglacial conditions similar to the present. Dissolved calcium carbonate for cementation came from dissolution of reworked chalk in overlying MIS 12 glacial tills

    Investigating marine shallow waters dynamics to explore the role of turbidity on ecological responses

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    The ecological tangible effect of the complex interaction between sediments and water column in shallow waters is represented by turbidity which is a common feature of most aquatic ecosystems: it varies both temporally and spatially; it can cover a huge area and persist for a long period or it can be very localized and temporary. Among many factors able to generate turbidity, wind generated wave action and water mass movements due to tides seem important in causing resuspension of sediments. Although there is much research spent in last decades on this topic and many models to explain the complexity of the wind-water-sediment interaction, some interactive aspects are too site specific and then still poor understood. On the other hand, this interaction involves many physical, chemical and trophic aspects like water flow velocity, turbulence, boundary layer thickness, environmental stresses and, in turn, resuspension, transport, and deposition of particulate matter, mechanical limits to size, larval dispersion, food availability. To get further knowledge on these aspects, we carried out in March 2007 a 5-day-experiment in a Mediterranean shallow area (The Stagnone di Marsala, Western Sicily) by collecting data on wind and water velocities, their directions and the contextual response of the water column in term of turbidity, chlorophyll-a and suspended solids (by ignition). To analyse the interaction, we proceeded step by step. Firstly, we studied data from the two current meters (an acoustic doppler velocimeter 40 ± 2 cm deep, and an electromagnetic current meter 20 ± 2 cm deep). From this data, the water column had the following features: i) during the big semidiurnal tidal transitional phase, the flow field followed a behaviour leading us to hypothesize a logarithmic layer defined by the law of the wall and to obtain friction velocity values with linear regression in good agreement with calculated ones with covariance and TKE method, while ii) during the small tidal transition and at high and low tides, a not-well defined gradient was present (i.e., the mean deviation of the direction of the two water velocities was more than 30° and the flow magnitude at 40 cm was less than that measured at 20 cm implying high values of turbulence intensity). The second step analysed data from multiprobe, ADV, meteorological station and considered turbidity (NTU) as proxy of food availability for consumers. NTU followed a one-day-period and the lower the turbidity, the higher the turbulence (both at 20 and 40 cm)

    Functionalized Enzyme-Responsive Biomaterials to Model Tissue Stiffening in vitro

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    The mechanical properties of the cellular microenvironment play a crucial role in modulating cell function, and many pathophysiological processes are accompanied by variations in extracellular matrix (ECM) stiffness. Lysyl oxidase (LOx) is one of the enzymes involved in several ECM-stiffening processes. Here, we engineered poly(ethylene glycol) (PEG)-based hydrogels with controlled mechanical properties in the range typical of soft tissues. These hydrogels were functionalized featuring free primary amines, which allows an additional chemical LOx-responsive behavior with increase in crosslinks and hydrogel elastic modulus, mimicking biological ECM-stiffening mechanisms. Hydrogels with elastic moduli in the range of 0.5–4 kPa were obtained after a first photopolymerization step. The increase in elastic modulus of the functionalized and enzyme-responsive hydrogels was also characterized after the second-step enzymatic reaction, recording an increase in hydrogel stiffness up to 0.5 kPa after incubation with LOx. Finally, hydrogel precursors containing HepG2 (bioinks) were used to form three-dimensional (3D) in vitro models to mimic hepatic tissue and test PEG-based hydrogel biocompatibility. Hepatic functional markers were measured up to 7 days of culture, suggesting further use of such 3D models to study cell mechanobiology and response to dynamic variation of hydrogels stiffness. The results show that the functionalized hydrogels presented in this work match the mechanical properties of soft tissues, allow dynamic variations of hydrogel stiffness, and can be used to mimic changes in the microenvironment properties of soft tissues typical of inflammation and pathological changes at early stages (e.g., fibrosis, cancer)

    Qualità della didattica universitaria e sviluppo della capacità decisionale. Il modello ADVP per garantire i passaggi da L-19 a LM-85bis.

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    Il presente contributo intende offrire una riflessione sulle competenze attese individuate attraverso la formulazione dei descrittori di Dublino dei CdS in Scienze dell’Educazione (L-19) e Scienze della Formazione Primaria (LM-85bis) istituiti presso l’Ateneo di Palermo e nello stesso tempo proporre un modello per lo sviluppo della maturità professional e necessaria a garantire scelte consapevoli, mature e responsabili. L’analisi condotta ci ha permesso, in una seconda fase di individuare gli obiettivi formativi finali scelti seguendo il modello proposto dalle Linee Guida dell ’Anvur, e di scegliere il modello dell’Activaction du Developpement Vocationnel et Personnel quale strumento per lo sviluppo della capacità decisionale che permetta un passaggio consapevole e responsabile degli studenti dal corso L-19 al corso LM-85bis salvaguardando le competenze professionali specifiche che devono acquisire i giovani che intendono dedicarsi all’insegnamento nella scuola primaria e dell’infanzia

    Spatial variations in snowpack chemistry, isotopic composition of NO3− and nitrogen deposition from the ice sheet margin to the coast of western Greenland

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    The relative roles of anthropogenic nitrogen (N) deposition and climate change in causing ecological change in remote Arctic ecosystems, especially lakes, have been the subject of debate over the last decade. Some palaeoecological studies have cited isotopic signals (δ(15N)) preserved in lake sediments as evidence linking N deposition with ecological change, but a key limitation has been the lack of co-located data on both deposition input fluxes and isotopic composition of deposited nitrate (NO3−). In Arctic lakes, including those in western Greenland, previous palaeolimnological studies have indicated a spatial variation in δ(15N) trends in lake sediments but data are lacking for deposition chemistry, input fluxes and stable isotope composition of NO3−. In the present study, snowpack chemistry, NO3− stable isotopes and net deposition fluxes for the largest ice-free region in Greenland were investigated to determine whether there are spatial gradients from the ice sheet margin to the coast linked to a gradient in precipitation. Late-season snowpack was sampled in March 2011 at eight locations within three lake catchments in each of three regions (ice sheet margin in the east, the central area near Kelly Ville and the coastal zone to the west). At the coast, snowpack accumulation averaged 181 mm snow water equivalent (SWE) compared with 36 mm SWE by the ice sheet. Coastal snowpack showed significantly greater concentrations of marine salts (Na+, Cl−, other major cations), ammonium (NH4+; regional means 1.4–2.7 µmol L−1), total and non-sea-salt sulfate (SO42−; total 1.8–7.7, non-sea-salt 1.0–1.8 µmol L−1) than the two inland regions. Nitrate (1.5–2.4 µmol L−1) showed significantly lower concentrations at the coast. Despite lower concentrations, higher precipitation at the coast results in greater net deposition for NO3− as well as NH4+ and non-sea-salt sulfate (nss-SO42−) relative to the inland regions (lowest at Kelly Ville 6, 4 and 3; highest at coast 9, 17 and 11 mol ha−1 a−1 of NO3−, NH4+ and nss-SO42− respectively). The δ(15N) of snowpack NO3− shows a significant decrease from inland regions (−5.7 ‰ at Kelly Ville) to the coast (−11.3 ‰). We attribute the spatial patterns of δ(15N) in western Greenland to post-depositional processing rather than differing sources because of (1) spatial relationships with precipitation and sublimation, (2) within-catchment isotopic differences between terrestrial snowpack and lake ice snowpack, and (3) similarities between fresh snow (rather than accumulated snowpack) at Kelly Ville and the coast. Hence the δ(15N) of coastal snowpack is most representative of snowfall in western Greenland, but after deposition the effects of photolysis, volatilization and sublimation lead to enrichment of the remaining snowpack with the greatest effect in inland areas of low precipitation and high sublimation losses

    TEVAR and periscope graft technique to treatment of huge aneurysm of aortic isthmus: Case report

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    Introduction: Thoracic endovascular aortic repair (TEVAR) has revolutionized the treatment of thoracic aortic aneurysms. Innovative techniques as chimney and periscope grafts can improve the outcomes of procedure. Herein, we report a case in emergency of huge Thoracic aortic aneurism. Presentation of case: An 86-year-old male with hypertension, diabetes mellitus, was referred to our hospital for chest pain. CT-angiography showed a huge aneurysm of aortic isthmus with signs of rupture. The patient was considered unfit for open surgery and an endovascular approach was chosen. This patient underwent endovascular repair with TEVAR, using the periscope graft technique to preserve patency in left subclavian artery (LSA). Discussion: Symptomatic ischemia from LSA coverage has been reported to occur in only a modest 6–10% of patients and is often sacrificed with impunity given coverage rates between 10 and 50%. In this case reported the lack of revascularization of LSA increased the risk of neurological manifestations or stroke. Periscope technique is feasible and safe to maintain perfusion to the subclavian artery, with a 93% primary patency at 2 years. Conclusions: Our experience using TEVAR with periscope graft technique as solution to address thoracic aneurysm of aortic isthmus was feasible and safe

    Staged acute mesenteric and peripheral ischemia treatment in COVID-19 patient: Case report

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    Introduction: COVID-19 is an infectious disease that has been associated not only with respiratory complications. The COVID-19 disease includes, also damage to other organ systems as well as coagulopathy. The present report describes a case of COVID-19 presenting with acute mesenteric ischemia (AMI) and subsequent acute limb ischemia (ALI). Presentation of case: An 84-years old hospitalized female patient presenting diabetes and recent COVID-19 reported acute onset of abdominal pain and typical findings of AMI. The CT-angiography confirmed the AMI secondary to a superior mesenteric artery (SMA) occlusion. The patient was managed through an endovascular approach using a SMA mechanical thrombectomy and stenting with a good result. Discussion: Treatment of this life-threatening condition includes surgical resection of the necrotic bowel, restoration of blood flow to the ischemic intestine and supportive measure - gastrointestinal decompression, fluid resuscitation, hemodynamic support. Endovascular management of AMI is preferred over the standard surgical approach due to a reduced mortality and morbidity rates. Imaging findings of intestinal necrosis, however, represent an indication for AMI surgical treatment with explorative laparotomy. Different endovascular solutions have been employed to address AMI including mechanical thrombectomy, local thrombolysis, and PTA-stenting. Conclusion: COVID-19 clinical presentation can be atypical, including gastrointestinal symptoms. If a first embolic event occurs, an aggressive anticoagulation treatment could be inefficient to reduce the risk of subsequent embolization events. The limited life expectancy of such revascularization procedures should orientate towards less invasive treatments

    How adenomyosis changes throughout pregnancy: A retrospective cohort study

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    Objective To study how adenomyosis changes during pregnancy and to possibly correlate these changes to maternal and fetal outcomes. Methods Retrospective exploratory cohort study including 254 women with a pre-conceptional/first-trimester scan to document adenomyosis and known obstetric outcome. If visible, adenomyosis signs were documented in each trimester and postpartum. Mann-Whitney U tests or chi(2) tests were used for continuous and categorical variables, respectively. Results A globular uterus was reported in 79% (n = 52) of women with adenomyosis in the first trimester, in 38% (n = 20) and 2% (n = 1) of women in the second and third trimesters, respectively, and postpartum in 77% (n = 34) of women. Asymmetrical thickening (n = 20, 30%) and cysts (n = 15, 23%) were only visible in 1st trimester. Adenomyosis was associated with miscarriage (odds ratio [OR] 5.9, 95% confidence interval [CI] 2.4-14.9, P < 0.001) also in normal conception only (OR 5.1, 95% CI 1.8-14.2, P = 0.002) or adjusting for maternal age (adjusted OR 5.9, 95% CI 2.3-15.2, P < 0.001). Gestational age at delivery was lower in adenomyosis (P = 0.004); the cesarean section rate was higher than in controls (OR 2.5, 95% CI 1.3-4.8, P = 0.007) also adjusting for age (adjusted OR 2.07, 95% CI 1.06-4.08, P = 0.035). Conclusions Signs of adenomyosis were visible but progressively disappeared in pregnancy; adenomyosis was associated with an increased risk of early miscarriage. Prospective studies are needed to confirm our results
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