Evaluating the improvements of the BOLAM model of the ISPRA Sistema Idro-Meteo-Mare on the December 2008 flood event in Rome

The Sistema Idro-Meteo-Mare is an integrated meteo-marine forecasting chain for the Mediterranean basin. The recent update of the meteorological segment, based on the hydrostatic BOlogna Limited Area Model (BOLAM), gives the opportunity for a comparative verification study on a Mediterranean cyclone. The 10–12 December 2008 flood event in Rome has been chosen as case study. This disastrous event was claimed to be an extreme one by mass-media; however, its return time is shown here to be about 5 years. The Mediterranean cyclone responsible for the flood offers a tough case study in order to verify the model's ability in reproducing the evolution of meso-synoptic features in the Mediterranean environment. A qualitative comparison, employing satellite data and derived products, is performed. Results suggest that the upgraded model provides a more realistic representation of the cyclone warm sector – where the main rainfall peak took place – whereas the error in the cyclone trajectory and shape evolution is less affected by the BOLAM improvement

A Light Calibration System for the ProtoDUNE-DP Detector

A LED-based fiber calibration system for the ProtoDUNE-Dual Phase (DP) photon detection system (PDS) has been designed and validated. ProtoDUNE-DP is a 6x6x6 m3 liquid argon time-projection-chamber currently being installed at the Neutrino Platform at CERN. The PDS is based on 36 8-inch photomultiplier tubes (PMTs) and will allow triggering on cosmic rays. The system serves as prototype for the PDS of the final DUNE DP far detector in which the PDS also has the function to allow the 3D event reconstruction on non-beam physics. For this purpose an equalized PMT response is desirable to allow using the same threshold definition for all PMT groups, simplifying the determination of the trigger efficiency. The light calibration system described in this paper is developed to provide this and to monitor the PMT performance in-situ.Comment: 15 pages, 5 figure

Clinical Management of Neuroendocrine Neoplasms in Clinical Practice: A Formal Consensus Exercise

Many treatment approaches are now available for neuroendocrine neoplasms (NENs). While several societies have issued guidelines for diagnosis and treatment of NENs, there are still areas of controversy for which there is limited guidance. Expert opinion can thus be of support where firm recommendations are lacking. A group of experts met to formulate 14 statements relative to diagnosis and treatment of NENs and presented herein. The nominal group and estimate-talk-estimate techniques were used. The statements covered a broad range of topics from tools for diagnosis to follow-up, evaluation of response, treatment efficacy, therapeutic sequence, and watchful waiting. Initial prognostic characterization should be based on clinical information as well as histopathological analysis and morphological and functional imaging. It is also crucial to optimize RLT for patients with a NEN starting from accurate characterization of the patient and disease. Follow-up should be patient/tumor tailored with a shared plan about timing and type of imaging procedures to use to avoid safety issues. It is also stressed that patient-reported outcomes should receive greater attention, and that a multidisciplinary approach should be mandatory. Due to the clinical heterogeneity and relative lack of definitive evidence for NENs, personalization of diagnostic–therapeutic work-up is crucial

Is the patella apprehension test a valid diagnostic test for patellar instability? A systematic review

Introduction Patellar instability can arise from a traumatic event with anatomical predisposing factors increasing the risk of dislocation. Accurate diagnosis is required to initiate appropriate treatment. We aimed to evaluate the patella apprehension test (PAT) as a method to diagnose patellar instability. Methods The PRISMA diagnostic test accuracy checklist was followed. The review protocol was registered on PROSPERO with registration number CRD42022357898. Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. A narrative synthesis evaluated the validity of the PAT as a method of diagnosing patellar instability. Results A total of 4867 records were screened in the initial search. Of these, 34 articles satisfied the inclusion criteria, assessing 1139 knees of 1046 patients. The PAT was found to have a high sensitivity and specificity. Its intra and inter-rater reliability was highly variable among studies. Studies reporting patellar instability correction following surgery also found a decrease in the number of patients exhibiting a positive PAT. Conclusion Current evidence suggests that the PAT has a high sensitivity and specificity. The intra- and inter-rater validities of the PAT are widely variable due to its subjective nature. Thus, though the PAT can be used to provide a provisional clinical diagnosis of patellar instability, formal functional assessment and imaging should be performed to confirm the diagnosis. Further research should explore the association between a positive PAT and anatomical parameters. In addition, studies comparing the accuracy of the PAT and radiological investigations should be performed

Patho-morphology of patellar instability in children and adolescents: A systematic review and meta-analysis.

BACKGROUND: Children and adolescents have the highest incidence of patellar instability among the population. We aimed to identify patho-morphological and epidemiological factors associated with patellar instability, and to identify factors predisposing to recurrence in children and adolescents. METHODS: Published and unpublished literature databases, conference proceedings and the reference lists of included studies were searched to the 14th of March 2024. Studies were eligible if they compared history characteristics, examination features and radiological parameters between patients with and without instability, or evaluated risk factors for instability recurrence. A random-effects meta-analysis was performed. Included studies were appraised using tools respective of study design. RESULTS: The evidence was moderate to low in quality. Forty-five studies (including 9000 patients) were eligible. Tibial tubercle - tibial groove (TT-TG) distance (weighted mean difference [WMD] 5.96 mm, 95% Confidence Interval [CI]: 4.94 to 6.99 mm), sulcus angle (WMD: 13.93˚, 95% CI: 9.1˚ to 18.8˚), and Insall-Salvati index (WMD: 0.2, 95% CI: 0.16 to 0.23) were greater in patients with patellar instability. Risk factors for recurrent dislocation included age less than 18 years (Odds ratio [OR]: 2.56, 95% CI: 1.63 to 4.0), skeletal immaturity (OR: 1.79, 95% CI: 1.21 to 2.64) and presence of trochlear dysplasia (OR: 3.37, 95% CI: 1.85 to 6.15). CONCLUSION: Knowledge of patho-morphological factors associated with patellar instability could help explain its pathophysiological processes, allowing for the design of treatment approaches and the identification of patients at risk

Fertirrigação e agricultura de baixa emissão de carbono: resultados do projeto CNPq/REPENSA em São Gabriel do Oeste.

Este trabalho apresenta no âmbito do CNPq/REPENSA (Redes Nacionais de Pesquisa em Agrobiodiversidade e Sustentabilidade Agropecuária), Projeto número 562441/2010-7, ?Estruturação de rede de monitoramento e base compartilhada de dados de sistemas de produção integrada e intensiva sustentável (suinocultura-agrosilvipastoril) em assentamento de reforma agrária visando balanços favoráveis de água, energia e nutrientes?, informações norteadoras para projetos de fertirrigação para uma agricultura de baixa emissão de carbono. A fertirrigação vem se consolidando como atividade integradora de cadeias produtivas outrora dissociadas, sendo ferramenta importante de inclusão social no meio rural na borda do Pantanal (Bacia do Alto Taquari), transformando externalidades ambientais em fonte de renda e ganhos de produtividade agropecuária. Os resultados e indicadores aqui apresentados mostram que a fertirrigação com efluente de biodigestor de granjas de suínos, aqui convencionado de biofertilizante, gera impactos negativos e positivos. Os negativos recaem no potencial para eutrofização de corpos d?água por nitrogênio reativo na forma de nitratos (NO3); ambos os processos podem e devem ser substancialmente minimizados pelo uso controlado e eficiente do biofertilizante na agropecuária com doses adequadas de macro (especialmente N, P, K) e micronutrientes (Cu e Zn, entre outros) para diversasculturas, conforme discutido neste trabalho. Os impactos positivos são a manutenção do estoque de carbono no solo no longo prazo mediante manejo adequado da produção de forragem para gado (corte ou leite) ou na produção de grãos com tecnologias de conservação de solo, e o balanço favorável das emissões de gases de efeito estufa do agroecossistema como um todo pela substituição de diesel por biogás em motogeradores e motobombas, pela substituição da adubação mineral e de agrotóxicos (ambos não renováveis) e pela possibilidade de recomposição de mata proporcional à um terço dos ganhos de produtividade. Em termos de mecanismo de adaptação à mudança do clima, a restauração relativa de áreas de mata nativa favorece a recuperação e/ou manutenção de outros importantes serviços ambientais, como o aumento da agrobiodiversidade, a produção de água e incremento da polinização por insetos.bitstream/item/111107/1/BP116.pd