Morphing shell structures:A generalised modelling approach

AbstractMorphing shells are nonlinear structures that have the ability to change shape and adopt multiple stable states. By exploiting the concept of morphing, designers may devise adaptable structures, capable of accommodating a wide range of service conditions, minimising design complexity and cost. At present, models predicting shell multistability are often characterised by a compromise between computational efficiency and result accuracy. This paper addresses the main challenges of describing the multistable behaviour of thin composite shells, such as bifurcation points and snap-through loads, through the development of an accurate and computationally efficient energy-based method. The membrane and the bending components of the total strain energy are decoupled by using the semi-inverse formulation of the constitutive equations. Transverse displacements are approximated by using Legendre polynomials and the membrane problem is solved in isolation by combining compatibility conditions and equilibrium equations. This approach provides the strain energy as a function of curvature only, which is of particular interest, as this decoupled representation facilitates efficient solution. The minima of the energy with respect to the curvature components give the multiple stable configurations of the shell. The accurate evaluation of the membrane energy is a key step in order to correctly capture the multiple configurations of the structure. Here, the membrane problem is solved by adopting the Differential Quadrature Method (DQM), which provides accurate results at a relatively small computational cost. The model is benchmarked against three exemplar case studies taken from the literature

A novel mutation in calcium-sensing receptor gene associated to hypercalcemia and hypercalciuria.

Background: Familial Hyperparathyroidism (HPT) and Familial benign Hypocalciuric Hypercalcemia (FHH) are the most common causes of hereditary hypercalcemia. FHH has been demonstrated to be caused by inactivating mutations of calcium-sensing receptor (CaSR) gene, involved in PTH regulation as well as in renal calcium excretion.Case presentation: In two individuals, father and son, we found a novel heterozygous mutation in CaSR gene. The hypercalcemia was present only in father, which, by contrast to the classic form of FHH showed hypercalciuria (from 300 to 600 mg/24 h in different evaluations) and a Calcium/Creatinine ratio of 0.031, instead of low or normal calciuria (<0.01 typical finding in FHH). His son showed the same mutation in CaSR gene, but no clinical signs or hypercalcemia although serum ionized calcium levels were close to the upper limit of normal values (1.30 mmol/L: normal range: 1.12-1.31 mmol/L). Sequence analysis revealed a point mutation at codon 972 of CaSR gene (chromosome 3q), located within cytoplasmic domain of the CaSR, that changes Threonine with Methionine. The father was treated with Cinacalcet 90 mg/day, with a decrease of total serum calcemia from an average value of 12.2 mg/dl to 10.9 mg/dl.Conclusion: This is a case of a novel inactivating point mutation of CaSR gene that determines an atypical clinical presentation of FHH, characterized by hypercalcemia, hypercalciuria and inadequate normal PTH levels. Functional assay demonstrated that the 972 M variant influenced the maturation of the protein, in terms of the post-translational glycosylation. The impairment of the receptor activity is in keeping with the specific localization of the 972 residue in the C-terminal tail, assigned to the intracellular signalling, that on the basis of the our findings appears to be differently modulated in parathyroid gland and in kidne

Ultrasound-guided laser ablation after excisional vacuum-assisted breast biopsy for small malignant breast lesions: Preliminary results

Background: The purpose of this preliminary study is to evaluate the feasibility of the excisional ultrasound (US) guided vacuum-assisted breast biopsy (VAE), followed by US-guided Laser Interstitial Thermal Therapy (LITT) in the treatment of unifocal ductal breast carcinomas ≤ 1 cm and estimate the ablation rate analyzing the final histopathological results after subsequent surgical excision. Methods: In a single session 11 female patients with unifocal less than a centimeter breast cancer underwent 2 different minimally invasive percutaneous US-guided techniques: a VAE breast biopsy with an 8 G needle to remove the lesion and, immediately after, a LITT ablation in the biopsy site. Four weeks later, all patients underwent radiological follow-up. Afterward, a systematic surgery was performed, the ablation rate was calculated, and iconographic and histological features were correlated. Results: Average maximum diameter of the lesions was 7.6 mm (5-10 mm). No patient reported pain or discomfort during procedure. 1/11 patient (9.1%) reported an early minor complication (a small superficial skin burn). After surgical excision, the histopathological evaluation reported in 10/11 cases (90.9%) complete ablation of the target lesion. In only one case (9.1%) residual cancer was detected. The necrotic-hemorrhagic cavities showed a mean maximum diameter of 27.3 mm (20-35 mm). Conclusions: Laser ablation performed after excisional biopsy could be considered a valid alternative to surgical excision for the treatment of lesions ≤ 1 cm, if carried out by expert radiologists. The association of these minimally invasive percutaneous methods has proven to be reliable, fast, and safe with an ablation rate of 90.9% and excellent aesthetic results. RM and CESM are potentially able to quantifying treatment results and to follow-up the ablation effects

A Serum Resistin and Multicytokine Inflammatory Pathway Is Linked With and Helps Predict All-cause Death in Diabetes

Context: Type 2 diabetes (T2D) shows a high mortality rate, partly mediated by atherosclerotic plaque instability. Discovering novel biomarkers may help identify high-risk patients who would benefit from more aggressive and specific managements. We recently described a serum resistin and multicytokine inflammatory pathway (REMAP), including resistin, interleukin (IL)-1 beta, IL-6, IL-8, and TNF-alpha, that is associated with cardiovascular disease.Objective: We investigated whether REMAP is associated with and improves the prediction of mortality in T2D.Methods: A REMAP score was investigated in 3 cohorts comprising 1528 patients with T2D (409 incident deaths) and in 59 patients who underwent carotid endarterectomy (CEA; 24 deaths). Plaques were classified as unstable/stable according to the modified American Heart Association atherosclerosis classification.Results: REMAP was associated with all-cause mortality in each cohort and in all 1528 individuals (fully adjusted hazard ratio [HR] for 1 SD increase=1.34, P&lt;.001). In CEA patients, REMAP was associated with mortality (HR=1.64, P=.04) and a modest change was observed when plaque stability was taken into account (HR=1.58; P=.07). REMAP improved discrimination and reclassification measures of both Estimation of Mortality Risk in Type 2 Diabetic Patients and Risk Equations for Complications of Type 2 Diabetes, well-established prediction models of mortality in T2D (P&lt;.05-&lt;.001).Conclusion: REMAP is independently associated with and improves predict all-cause mortality in T2D; it can therefore be used to identify high-risk individuals to be targeted with more aggressive management. Whether REMAP can also identify patients who are more responsive to IL-6 and IL-1 beta monoclonal antibodies that reduce cardiovascular burden and total mortality is an intriguing possibility to be tested

The Effect of coronavirus (COVID-19) on breast cancer teamwork: A multicentric survey

Background/Aim: Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs). Patients and Methods: In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated. Results: A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP. Conclusion: Working in a COVID-19-hospital represents a factor that negatively affects psychosocial wellbeing. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP

Metabolic Syndrome Predicts New Onset of Chronic Kidney Disease in 5,829 Patients With Type 2 Diabetes: A 5-year prospective analysis of the Hong Kong Diabetes Registry

OBJECTIVE—Type 2 diabetes is the leading cause of end-stage renal disease worldwide. Aside from hyperglycemia and hypertension, other metabolic factors may determine renal outcome. We examined risk associations of metabolic syndrome with new onset of chronic kidney disease (CKD) in 5,829 Chinese patients with type 2 diabetes enrolled between 1995 and 2005

Forward Secrecy of SPAKE2

Currently, the Simple Password-Based Encrypted Key Exchange (SPAKE2) protocol of Abdalla and Pointcheval (CT-RSA 2005) is being considered by the IETF for standardization and integration in TLS 1.3. Although it has been proven secure in the Find-then-Guess model of Bellare, Pointcheval and Rogaway (EUROCRYPT 2000), whether it satisfies some notion of forward secrecy remains an open question. In this work, we prove that the SPAKE2 protocol satisfies the so-called weak forward secrecy introduced by Krawczyk (CRYPTO 2005). Furthermore, we demonstrate that the incorporation of key-confirmation codes in SPAKE2 results in a protocol that provably satisfies the stronger notion of perfect forward secrecy. As forward secrecy is an explicit requirement for cipher suites supported in the TLS handshake, we believe this work could fill the gap in the literature and facilitate the adoption of SPAKE2 in the recently approved TLS 1.3

On the Relation Between SIM and IND-RoR Security Models for PAKEs with Forward Secrecy

Password-based Authenticated Key-Exchange (PAKE) protocols allow the establishment of secure communication entirely based on the knowledge of a shared password. Over the last two decades, we have witnessed the debut of a number of prominent security models for PAKE protocols, whose aim is to capture the desired security properties that such protocols must satisfy when executed in the presence of an active adversary. These models are usually classified into (i) indistinguishability-based (IND-based) or (ii) simulation-based (SIM-based). However, the relation between these two security notions is unclear and mentioned as a gap in the literature. In this work, we prove that SIM-BMP security from Boyko et al. (EUROCRYPT 2000) implies IND-RoR security from Abdalla et al. (PKC 2005) and that IND-RoR security is equivalent to a slightly modified version of SIM-BMP security. We also investigate whether IND-RoR security implies (unmodified) SIM-BMP security. The results obtained also hold when forward secrecy is incorporated into the security models in question