CREATION OF A MULTIRESOLUTION AND MULTIACCURACY DTM: PROBLEMS AND SOLUTIONS FOR HELI-DEM CASE STUDY

The work is part of "HELI-DEM" (HELvetia-Italy Digital Elevation Model) project, funded by the European Regional Development Fund within the Italy-Switzerland cooperation program. The aim of the project is the creation of a unique DTM for the alpine and subalpine area between Italy (Piedmont, Lombardy) and Switzerland (Ticino and Grisons Cantons); at present, different DTMs, that are in different reference frames and have been obtained with different technologies, accuracies, and resolutions, have been acquired. The final DTM should be correctly georeferenced and produced validating and integrating the data that are available for the project. DTMs are fundamental in hydrogeological studies, especially in alpine areas where hydrogeological risks may exist. Moreover, when an event, like for example a landslide, happens at the border between countries, a unique and integrated DTM which covers the interest area is useful to analyze the scenario. In this sense, HELI-DEM project is helpful. To perform analyses along the borders between countries, transnational geographic information is needed: a transnational DTM can be obtained by merging regional low resolution DTMs. Moreover high resolution local DTMs should be used where they are available. To be merged, low and high resolution DTMs should be in the same three dimensional reference frame, should not present biases and should be consistent in the overlapping areas. Cross-validation between the different DTMs is therefore needed. Two different problems should be solved: the merging of regional, partly overlapping low and medium resolution DTMs into a unique low/medium resolution DTM and the merging with other local high resolution/high accuracy height data. This paper discusses the preliminary processing of the data for the fusion of low and high resolution DTMs in a study-case area within the Lombardy region: Valtellina valley. In this region the Lombardy regional low resolution DTM is available, with a horizontal resolution of 20 meters; in addition a LiDAR DTM with a horizontal resolution of 1 meter, which covers only the main hydrographic basins, is also available. The two DTMs have been transformed into the same reference frame. The cross-validation of the two datasets has been performed comparing the low resolution DTM with the local high resolution DTM. Then, where significant differences are present, GPS survey have been used as external validation. The results are presented. Moreover, a possible strategy for the future fusion of the data, is shortly summarized at the end of the paper

A semi-implicit, second-order-accurate numerical model for multiphase underexpanded volcanic jets

Abstract. An improved version of the PDAC (Pyroclastic Dispersal Analysis Code, Esposti Ongaro et al., 2007) numerical model for the simulation of multiphase volcanic flows is presented and validated for the simulation of multiphase volcanic jets in supersonic regimes. The present version of PDAC includes second-order time- and space discretizations and fully multidimensional advection discretizations in order to reduce numerical diffusion and enhance the accuracy of the original model. The model is tested on the problem of jet decompression in both two and three dimensions. For homogeneous jets, numerical results are consistent with experimental results at the laboratory scale (Lewis and Carlson, 1964). For nonequilibrium gas–particle jets, we consider monodisperse and bidisperse mixtures, and we quantify nonequilibrium effects in terms of the ratio between the particle relaxation time and a characteristic jet timescale. For coarse particles and low particle load, numerical simulations well reproduce laboratory experiments and numerical simulations carried out with an Eulerian–Lagrangian model (Sommerfeld, 1993). At the volcanic scale, we consider steady-state conditions associated with the development of Vulcanian and sub-Plinian eruptions. For the finest particles produced in these regimes, we demonstrate that the solid phase is in mechanical and thermal equilibrium with the gas phase and that the jet decompression structure is well described by a pseudogas model (Ogden et al., 2008). Coarse particles, on the other hand, display significant nonequilibrium effects, which associated with their larger relaxation time. Deviations from the equilibrium regime, with maximum velocity and temperature differences on the order of 150 m s−1 and 80 K across shock waves, occur especially during the rapid acceleration phases, and are able to modify substantially the jet dynamics with respect to the homogeneous case

Quaternary capable folds and seismic hazard in Lombardia (Northern Italy): the Castenedolo structure near Brescia.

We identify evidence of late Quaternary compressive tectonics in the Northern sector of the Central Po Plain through a systematic revision of the literature, new field mapping, and a new study of seismic reflection data obtained by ENI E&P. In particular, the reinterpretation of ca. 18.000 km of seismic profiles clearly shows a belt of segmented, 10 to 20 km long, fault propagation folds, controlled by the Plio-Quaternary growth of several out-of-sequence thrusts. As an example of this active structural style, in this paper we focus on a buried fold located just south of the Castenedolo Hill, a few km SE of Brescia. Although the Castenedolo anticline has long ago been described as a young compressional structure (e.g., DESIO, 1965), no detailed structural analysis of this feature has been performed until now. We calculated the uplift rates of this fold through the analysis of its syntectonic sedimentary record as imaged by the extremely high quality ENI E&P subsurface data available in the area. The evolution of this anticline was a discontinuous process characterized by several tectonic uplift pulses (with rates of ca. 0.1 mm/yr) of different duration, separated by periods of variable extent in which no fold growth occurred. The Quaternary growth history of this anticline and the presence of faulted and folded late Pleistocene to Holocene deposits at nearby sites (Ciliverghe and Monte Netto) demonstrate that the significant seismicity of this area (e.g., the December 25, 1222, Io = IX MCS Brescia earthquake, MAGRI & MOLIN, 1986; GUIDOBONI, 1986) must be related to active compressional structures within the Brescia piedmont belt. Our regional investigations show that the structural and paleoseismic setting illustrated near Castenedolo is typical of the whole Lombardia domain of the Southern Alps. This implies that the currently accepted seismotectonic model for this region, and related seismic hazard assessment, should be thoroughly and carefully re-evaluated

Internal Iliac Artery Embolization within EVAR Procedure: Safety, Feasibility, and Outcome

Background: This study is focused on Internal Iliac Artery (IIA) embolization in patients undergoing Endovascular Aneurysm Repair (EVAR). Our aims were: to establish the feasibility of the procedure; to assess the presence of endoleak (EL) and increase in the size of the sac at follow-up; to define the need for reintervention; and to evaluate mortality rate. Methods: In this retrospective single-center study, EVAR-treated patients with an embolization of IIA were chosen. Coils and vascular plug were used as embolizing agents. Results: A total of 49 participants were enrolled in the study (48 men and one woman) with a median age of 76 +/- 12 years. Patients had no early EL in 87.75% of cases, 8.16% had type 1a EL, 2.04% type 1b EL, and 2.04% type 2 EL, with a comprehensive technical success of 95.91%. In the follow-up, at 1 month 72.22% remained without EL, at 6 months 70.97%, and at 1 year 81.48%. In the same period, the trend of type 1 EL was 5.56% (1 month), 3.23% (6 months), and 0% (1 year). For EL type 2: 22.22% at 1 month, 25.81% at 6 months, and 16.7% at 1 year. The overall mortality was 35.58% and the re-intervention rate was 16.33%. Conclusions: IIA embolization is a feasible and safe procedure. The presence of EL is not superior to EVAR procedures that do not involve embolization

Interventional Radiological Management and Prevention of Complications after Pancreatic Surgery: Drainage, Embolization and Islet Auto-Transplantation

Pancreatic surgery still remains burdened by high levels of morbidity and mortality with a relevant incidence of complications, even in high volume centers. This review highlights the interventional radiological management of complications after pancreatic surgery. The current literature regarding the percutaneous drainage of fluid collections due to pancreatic fistulas, percutaneous transhepatic biliary drainage due to biliary leaks and transcatheter embolization (or stent–graft) due to arterial bleeding is analyzed. Moreover, also, percutaneous intra-portal islet auto-transplantation for the prevention of pancreatogenic diabetes in case of extended pancreatic resection is also examined. Moreover, a topic not usually treated in other similar reviewsas percutaneous intra-portal islet auto-transplantation for the prevention of pancreatogenic diabetes in case of extended pancreatic resection is also one of our areas of focus. In islet auto-transplantation, the patient is simultaneously donor and recipient. Differently from islet allo-transplantation, it does not require immunosuppression, has no risk of rejection and is usually efficient with a small number of transplanted islets

Multifocality and multicentricity are not contraindications for sentinel lymph node biopsy in breast cancer surgery

BACKGROUND: After the availability of the results of validation studies, the sentinel lymph node biopsy (SLNB) has replaced routine axillary dissection (AD) as the new standard of care in early unifocal breast cancers. Multifocal (MF) and multicentric (MC) tumors have been considered a contraindication for this technique due to the possible incidence of a higher false-negative rate. This prospective study evaluates the lymphatic drainage from different tumoral foci of the breast and assesses the accuracy of SLNB in MF-MC breast cancer. PATIENTS AND METHODS: Patients with preoperative diagnosis of MF or MC infiltrating and clinically node-negative (cN0) breast carcinoma were enrolled in this study. Two consecutive groups of patients underwent SLN mapping using a different site of injection of the radioisotope tracer: a) "2ID" Group received two intradermal (ID) injections over the site of the two dominant neoplastic nodules. A lymphoscintigraphic study was performed after each injection to evaluate the route of lymphatic spreading from different sites of the breast. b) "A" Group had periareolar (A) injection followed by a conventional lymphoscintigraphy. At surgery, both radioguided SLNB (with frozen section exam) and subsequent AD were planned, regardless the SLN status. RESULTS: A total 31 patients with MF (n = 12) or MC (n = 19) invasive, cN0 cancer of the breast fulfil the selection criteria. In 2 ID Group (n = 15) the lymphoscintigraphic study showed the lymphatic pathways from two different sites of the breast which converged into one major lymphatic trunk affering to the same SLN(s) in 14 (93.3%) cases. In one (6.7%) MC cancer two different pathways were found, each of them affering to a different SLN. In A Group (n = 16) lymphoscintigraphy showed one (93.7%) or two (6.3%) lymphatic channels, each connecting areola with one or more SLN(s). Identification rate of SLN was 100% in both Groups. Accuracy of frozen section exam on SLN was 96.8% (1 case of micrometastasis was missed). SLN was positive in 13 (41.9%) of 31 patients, including 4 cases (30.7%) of micrometastasis. In 7 of 13 (53.8%) patients the SLN was the only site of axillary metastasis. SLNB accuracy was 96.8% (30 of 31), sensitivity 92.8 (13 of 14), and false-negative rate 7.1% (1 of 14). Since the case of skip metastasis was identified by the surgeon intraoperatively, it would have been no impact in the clinical practice. CONCLUSION: Our lymphoscintigraphic study shows that axillary SLN represents the whole breast regardless of tumor location within the parenchyma. The high accuracy of SLNB in MF and MC breast cancer demonstrates, according with the results of other series published in the literature, that both MF and MC tumors do not represent a contraindication for SLNB anymore

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

La sfida del lusso negli Emirati Arabi Uniti

Dalla fine degli anni novanta i principali marchi del lusso hanno costituito proprie filiali negli Emirati Arabi Uniti e, da Dubai, hanno gestito il Medio Oriente e talvolta il subcontinente indiano. Finora l’esperienza acquisita nei mercati più evoluti è stata utile, ma in futuro occorreranno strategie più innovative