Time-optimal trajectories to circumsolar space using solar electric propulsion

The aim of this paper is to explore the capabilities of a solar electric propelled spacecraft on a mission towards circumsolar space. Using an indirect approach, the paper investigates minimum time of transfer (direct) trajectories from an initial heliocentric parking orbit to a desired final heliocentric target orbit, with a low perihelion radius and a high orbital inclination. The simulation results are then collected into graphs and tables for a trade-off analysis of the main mission parameters. Finally, a comparison of the performance between a solar electric and a (photonic) solar sail based spacecraft is discussed

Designing optimal low-thrust gravity-assist trajectories using space-pruning and a multi-objective approach

A multi-objective problem is addressed consisting of finding optimal low-thrust gravity-assist trajectories for interplanetary and orbital transfers. For this, recently developed pruning techniques for incremental search space reduction - which will be extended for the current situation - in combination with subdivision techniques for the approximation of the entire solution set, the so-called Pareto set, are used. Subdivision techniques are particularly promising for the numerical treatment of these multi-objective design problems since they are characterized (amongst others) by highly disconnected feasible domains, which can easily be handled by these set oriented methods. The complexity of the novel pruning techniques is analysed, and finally the usefulness of the novel approach is demonstrated by showing some numerical results for two realistic cases

Computing the set of Epsilon-efficient solutions in multiobjective space mission design

In this work, we consider multiobjective space mission design problems. We will start from the need, from a practical point of view, to consider in addition to the (Pareto) optimal solutions also nearly optimal ones. In fact, extending the set of solutions for a given mission to those nearly optimal significantly increases the number of options for the decision maker and gives a measure of the size of the launch windows corresponding to each optimal solution, i.e., a measure of its robustness. Whereas the possible loss of such approximate solutions compared to optimal—and possibly even ‘better’—ones is dispensable. For this, we will examine several typical problems in space trajectory design—a biimpulsive transfer from the Earth to the asteroid Apophis and two low-thrust multigravity assist transfers—and demonstrate the possible benefit of the novel approach. Further, we will present a multiobjective evolutionary algorithm which is designed for this purpose

A digital repository with an extensible data model for biobanking and genomic analysis management

Motivation: Molecular biology laboratories require extensive metadata to improve data collection and analysis. The heterogeneity of the collected metadata grows as research is evolving in to international multi-disciplinary collaborations and increasing data sharing among institutions. Single standardization is not feasible and it becomes crucial to develop digital repositories with flexible and extensible data models, as in the case of modern integrated biobanks management. Results: We developed a novel data model in JSON format to describe heterogeneous data in a generic biomedical science scenario. The model is built on two hierarchical entities: processes and events, roughly corresponding to research studies and analysis steps within a single study. A number of sequential events can be grouped in a process building up a hierarchical structure to track patient and sample history. Each event can produce new data. Data is described by a set of user-defined metadata, and may have one or more associated files. We integrated the model in a web based digital repository with a data grid storage to manage large data sets located in geographically distinct areas. We built a graphical interface that allows authorized users to define new data types dynamically, according to their requirements. Operators compose queries on metadata fields using a flexible search interface and run them on the database and on the grid. We applied the digital repository to the integrated management of samples, patients and medical history in the BIT-Gaslini biobank. The platform currently manages 1800 samples of over 900 patients. Microarray data from 150 analyses are stored on the grid storage and replicated on two physical resources for preservation. The system is equipped with data integration capabilities with other biobanks for worldwide information sharing. Conclusions: Our data model enables users to continuously define flexible, ad hoc, and loosely structured metadata, for information sharing in specific research projects and purposes. This approach can improve sensitively interdisciplinary research collaboration and allows to track patients' clinical records, sample management information, and genomic data. The web interface allows the operators to easily manage, query, and annotate the files, without dealing with the technicalities of the data grid.Peer reviewe

a grid enabled web platform for integrated digital biobanking in paediatrics

Motivation and Objectives A solid and integrated biobanking framework is an absolute requirement for high quality investigation in paediatric tumours. The overall goal of our activity is to design and develop a centralized Digital Biobank prototype able to integrate and interconnect an increasing number of local biobanks situated in various centres across Europe. As a first step, we are designing a web-based repository to store all tissue and genomic data from paediatric tumours collected by the G. Gaslini Children's Hospital, in Genoa. The repository satisfies flexibility and extensibility criteria, and is being deployed on a data Grid architecture (Bote-Lorenzo et al., 2004). Methods The repository is designed to contain data from all the tissue and blood samples obtained from infants and children affected by paediatric tumours, such as primary bone tumour and neuroblastoma. Many samples may be extracted from the same patient in a single visit or surgical operation; moreover from a single sample, nucleic acids (i.e. DNA and RNA) may be extracted for further analysis. These extractions could happen more than once, even at a distance of months or even years, if required. In order to satisfy the strict requirements above and ensure the extensibility of the repository, we have adopted a process/event model, already used for designing data and image repositories in Neuroscience (Corradi et al., 2012). The process/event model is a multipurpose taxonomic schema composed by two main generic objects: processes and events. An event can be any 'atomic' operation that is performed on patients or samples, or any processing of data or everything else related to the repository administration and management. A process is defined as a group of sequential events or sub-processes related to an activity, allowing the creation of a sort of hierarchical structure. As an example, the storage of a DNA sample in a specified location within a -80°C freezer and a post-processing step (such as differential expression, survival or correlation/anti-correlation analysis on microarray data) are single events, pertaining respectively to the more general 'Nucleic Acid Extraction' and 'Data Mining' processes. Platform Architecture The repository has a client-server architecture and it is composed by three main components, as shown in Figure 1: Repository portal Database Grid storage The repository portal is designed to make the storage and the navigation of data and information easy, through a simple and transparent web interface. It is a Java Enterprise Edition web application based on several existing open source tools for the development of web applications. The basis of the portal consists in a framework that relies on an Apache Tomcat web application container. It incorporates a database interface layer built through MyBatis, a persistence framework that automates the mapping between SQL databases and objects in Java. To provide users with highly interactive interfaces, some components are designed using the Asynchronous Javascript and XML (AJAX) programming technique. Wherever possible information is exchanged in XML or JavaScript Object Notation (JSON) format. The web portal represents the main access point to all the functionalities available through the overall integration platform, and exposes both user and administrator interfaces. T he repository itself is based on a MySQL database. The database design is fundamental in order to make the repository highly flexible and easily extensible. The core of the database is formed by the two previously described entities: processes and events and their relationships to data and metadata. Existing processes and events are contained in two homonymous tables. Each element in the event table refers to an element in the data table. The information inside the latter represents all the data inserted in the repository. These data can be associated with one or more files accordingly to their data type. The file table contains the logical path of all the stored files. The repository can be configured to store the metadata totally or partially within the database. In this latter case, the metadata are stored as XML descriptions inside the data table, to display the data in a rapid and dynamic way using XSL Transformations, and as records of specific metadata tables, to perform complex queries in an easier way. All data files are contained in the Grid storage, so the database doesn't really have to deal with hundreds of GB of data. Moreover, the number of operators should be quite small, thus making MySQL a reasonable choice as a database. The storage subsystem has been built around the iRODS data grid software (Rajasketar et al., 2010), chosen among others because it allows building a federated and distributed data storage system without the need of central components. Being able to deal with a huge amount of metadata, iRODS is widely used by the research community, also for Next Generation Sequencing Projects (Chiang et al., 2011). Careful attention has been given to security and privacy issues. All data are anonymised and cannot be linked in any way to patients' names, since the connection between clinical and personal data is done using unique identifiers managed exclusively by clinicians. Administrators are able to control users' access by creating groups and their association with pages and functions, define processes, events and all their relationships, define new data types and related metadata, associate them with the related events and manage available ontologies. Normal users, according to their assigned permissions, can insert new data, retrieve patients' information and view all the related data, download stored information, explore processes together with all the related events, data and metadata to have a global picture. The integrated system we envision at a European level will take advantage of the data Grid features provided by iRODS. Each hospital or biobank involved in the virtual community may have a local database and a dedicated separated iRODS system (called iRODS zone) where its own metadata and files can be saved. All the iRODS zones in the community will be federated. Federated iRODS zones are administered separately, but the users in the multiple zones, if given permission, will be able to access data stored in the other zones. If more hospital or research groups are working on the same project or using the same data structure, they may share a single iRODS zone and database. To provide access to the various local databases, federated database systems will be taken into account. Results and Discussion A first prototype of the repository is currently being tested at the Giannina Gaslini Institute, in Genoa. Information on over 1300 tissue samples, with their related DNA and RNA purified samples, have been stored together with administrative and clinical data from more than 700 patients. Three kinds of genomic analyses (i.e. event types) are currently provided, two for DNA samples - Comparative Genomic Hybridization (CGH) array and Multiplex Ligation-dependent Probe Amplification (MLPA) - and one for RNA - microarray analysis. For each analysis it is possible to store one or more files and user customized metadata. New data types can be configured via administrator interface, without additional programming, when new types of analyses or processing are required. The extensibility of our data model with user-defined data types and metadata is a crucial aspect of our implementation. As mentioned before, future developments will comprise the integration of our local biobank at the Gaslini Institute, with similar digital structures located across Europe. We are currently testing a distributed storage configuration, implementing data management policies expressed as rules that are interpreted by the iRODS Rule Engine. Acknowledgements Our research activity is performed in the framework of the 'European Network for Cancer Research in Children and Adolescents' (ENCCA) European project. References Bote-Lorenzo ML, Dimitriadis YA and Gomez-Sanchez E (2004) Grid characteristics and uses: a grid definition, Proceedings of the First European Across Grids Conference, ACG'03, Springer-Verlag, LNCS 2970, 291-298. doi:10.1007/978-3-540-24689-3_36 Chiang GT, Clapham P, Qi G, Sale K and Coates G (2011) Implementing a genomic data management system using iRODS in the Wellcome Trust Sanger Institute BMC Bioinformatics 2011, 12:361. doi:10.1186/1471-2105-12-361 Corradi L, Porro I, Schenone A, Momeni P, Ferrari , Nobili F, Ferrara M, Arnulfo G and Fato MM (2012) A repository based on a dynamically extensible data model supporting multidisciplinary research in neuroscience, BMC Medical Informatics and Decision Making (in press). JSON (JavaScript Object Notation), [online], http://www.json.org/. MyBatis, [online], http://www.mybatis.org. Rajasketar A, Moore R, Hou C et al. (2010) iRODS Primer: Integrated Rule-Oriented Data Systems. Morgan & Claypool. doi:10.2200/S00233ED1V01Y200912ICR012 XSL Transformations [online], http://www.w3.org/TR/xslt. Note: Figures and tables are available in PDF version only

A Novel Combination of High-Load Omega-3 Lysine Complex (AvailOm®) and Anthocyanins Exerts Beneficial Cardiovascular Effects

Omega-3 fatty acids have been shown to exert several beneficial effects in the prevention of cardiovascular and cerebrovascular diseases. The objective of the present study was to analyze the effects of a novel high-load omega-3 lysine complex, AvailOm®, its related constituents and a novel mixture of AvailOm® with specific vasoactive anthocyanins on vascular function in mice resistance artery. Pressure myograph was used to perform vascular reactivity studies. Nitric oxide and oxidative stress were assessed by difluorofluorescein diacetate and dihydroethidium, respectively. Increasing doses of AvailOm® exerted a dose-response vasorelaxation via AMPK-eNOS-mediated signaling. Omega-3 Ethyl Ester was identified as the main bioactive derivative of AvailOm®, being capable of inducing vasorelaxant action to the same extent of entire product. The combination of AvailOm® with a mix of potent vasoactive anthocyanins (C3-glu + DP3-glu + Mal3-glu + Mal3-gal + PEO3-gal), strongly protected mesenteric arteries from vascular dysfunction and oxidative stress evoked by oxidized-LDL. These data demonstrate for the first time the direct effects of AvailOm® on resistance arteries. The evidence that the combination of specific vasoactive anthocyanins and AvailOm® further enhanced the vasculoprotective properties of these compounds, may offer new promising perspectives for preventing the onset of cardiovascular and cerebrovascular events

Outcomes of pregnancies after kidney transplantation: lessons learned from CKD. A comparison of transplanted, nontransplanted chronic kidney disease patients and low-risk pregnancies: a multicenter nationwide analysis.

BACKGROUND: Kidney transplantation (KT) may restore fertility in CKD. The reasons why materno-foetal outcomes are still inferior to the overall population are only partially known. Comparison with the CKD population may offer some useful insights for management and counselling.Aim of this study was to analyse the outcomes of pregnancy after KT, compared with a large population of non-transplanted CKD patients and with low-risk control pregnancies, observed in Italy the new millennium. METHODS: We selected 121 live-born singletons after KT (Italian study group of kidney in pregnancy, national coverage about 75%), 610 live-born singletons in CKD and 1418 low-risk controls recruited in 2 large Italian Units, in the same period (2000-2014). The following outcomes were considered: maternal and foetal death; malformations; preterm delivery; small for gestational age baby (SGA); need for the neonatal intensive care unit (NICU); doubling of serum creatinine or increase in CKD stage. Data were analysed according to kidney diseases, renal function (staging according to CKD-EPI), hypertension, maternal age, partity, ethnicity. RESULTS: Materno-foetal outcomes are less favourable in CKD and KT as compared with the low-risk population. CKD stage and hypertension are important determinants of results. KT patients with e-GFR >90 have worse outcomes compared with CKD stage 1 patients; the differences level off when only CKD patients affected by glomerulonephritis or systemic diseases ('progressive CKD') are compared with KT. In the multivariate analysis, risk for preterm and early-preterm delivery was linked to CKD stage (2-5 versus 1: RR 3.42 and 3.78) and hypertension (RR 3.68 and 3.16) while no difference was associated with being a KT or a CKD patient. CONCLUSIONS: The materno-foetal outcomes in patients with kidney transplantation are comparable with those of nontransplanted CKD patients with similar levels of kidney function impairment and progressive and/or immunologic kidney diseas

“Gli aspetti innovativi dell’informativa finanziaria nelle “entità” del settore pubblico: gli IPSAS 5, 15, 18, 19 e 21”

Per il citato lavoro, che rappresenta un contributo alla ricerca della Scuola Superiore della Pubblica Amministrazione “Principi e metodi di contabilità economico-patrimoniale per lo Stato e le Pubbliche Amministrazioni nel quadro teorico ed operativo internazionale” (coordinatore Prof. L. Anselmi, anni 2007/2008), sono stati assolti gli obblighi di pubblicazione direttamente dall’autore, ai sensi della Legge 15.4.2006 n. 106 e del D.P.R. 03.05.2006, n. 252

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management