The journey of Italian emergency medicine

The Emergency Medicine school in Italy is relatively young. It was founded in 2008, and the first specialists were trained 5 years later, in 2013. The school was created to give relevance to the role of the emergency doctor and try to obtain highly specialized and trained figures in managing, quickly and effectively, the various situations that can occur in an emergency department. Before the creation of the school, many colleagues believed that anyone could go to work in an emergency room (ER), even without a specific traineeship for that. In reality, the school was created to try to equate the level of training of Italian first aid doctors to the standards of other western countries, in which the school of emergency medicine had already been established. After a somewhat sluggish start, over the years the emergency and urgency medicine (MEU) school has gained its importance and more and more people have enrolled in what is the most adrenaline-filled and varied training school of all. With the neospecialists there has been a gradual filling of the ERs with highly trained figures in the management of various medical emergencies and equipped with various diagnostic-therapeutic skills. Unfortunately, the situation has changed in recent years. In fact, since 2020 our national health system (SSN, Servizio Sanitario Nazionale) has deteriorated significantly in terms of services and quality. Even before the 2020 various critical issues could have been noticed, such as the lack of staff in many departments, the overcrowding of hospitals, the lack of an effective territorial health support system, it is with the COVID-19 epidemic that our public SNN has really started to falter. Italy, as some may already know, was one of the European countries to suffer the most from the pandemic especially due to the large number of elderly people in Italy. Hospitals, and ERs in particular, were always under pressure and those who worked there were subjected to exhausting shifts. Unluckily, among the consequences of the emergency situation there has been an important departure of doctors from the national health system towards either the free profession or even abroad. Needless to say, among the most abandoned departments in recent times, there are the critical area and intensive care departments and the ER. This led to a major health crisis to which a real solution has not yet been found. Almost all Italian ERs are now understaffed and the doctors who work there have to face exhausting working days and take on many responsibilities. Waiting times in most Italian ERs are getting longer and longer, and episodes of physical and verbal aggression carried out by patients against doctors and healthcare staff are now very so much common. Sadly, the prospect of a life of so many sacrifices has led to a slump in enrollment in graduate school of emergency medicine, with more than 60% of the places available each year vacant. Various ERs have closed and others will be closed if the situation does not improve. In this moment, no effective proposals to solve the problem have been presented by the Italian government. However, there are many doctors who claim their rights and who work with passion every day in often difficult environments. More and more demonstrations and protests are being organized which demand an improvement in working conditions, a higher wage in line with European standards, a reduction in working hours and an increase in annual days off. It goes without saying that emergency medicine doctors are at the forefront of all of this. There are those who say that only by improving the working conditions in the Italian ERs could it be possible to recover the Italian public health system from its serious crisis which forces the Italian government to hire doctors from other foreign states and conversely, Italian doctors to emigrate to other countries that guarantee greater attention to the rights of health professionals, that I cannot be agree with those

ACAES systems to enhance the self-consumption rate of renewable electricity in sustainable energy communities

This paper aims to evaluate the optimal configuration of an Adiabatic Compressed Air Energy Storage (ACAES) system designed to achieve the best matching between power production from non-programmable Renewable Energy Sources (RES) power plants and power demand from final users. The electrical energy demand of a small town, with a maximum power load of about 10 MW, has been considered as case study. The electrical energy can be supplied by both a photovoltaic (PV) power plant and the grid. For the ACAES system, different sizes for compressor, turbine, thermal energy storage (TES) system and air storage reservoir have been evaluated by varying the air mass flow rate of turbomachines and the charging and discharging duration times, to enhance the share of the PV energy supplied to the end user. The best performance is achieved with a PV power plant rated at about 35 MW and an ACAES section characterized by a compressor/turbine rated power of about 25-35% of the maximum power load of the end user, with a charging time of about 10 hours and a discharging time of about 20 hours. The average round-trip efficiency of the ACAES system is around 70%. On the overall, the integrated PV-ACAES system allows to cover 66% of the yearly electrical energy demand

Modulation of Hyperpolarization-Activated Cation Currents (Ih) by Ethanol in Rat Hippocampal CA3 Pyramidal Neurons

It is well established that ethanol (EtOH), through the interaction with several membrane proteins, as well as intracellular pathways, is capable to modulate many neuronal function. Recent reports show that EtOH increases the firing rate of hippocampal GABAergic interneurons through the positive modulation of the hyperpolarization-activated cyclic nucleotide-gated (HCN) cation channels. This effect might be consistent with the increase of GABA release from presynaptic terminals observed in both CA1 and CA3 inhibitory synapses that leads the enhancement of the GABAergic system induced by EtOH. The activation of HCN produced an inward currents that are commonly called Ih. Ih play an important role for generating specific neuronal activities in different brain regions, including specific sub-regions of the hippocampal formation, such as CA1 and CA3 pyramidal neurons and hippocampal GABAergic interneurons. The main physiologic effect mediated by HCN-induced Ih is directed to the control of the neuronal resting membrane potential and action potential (AP) discharge as well as dampen synaptic integration. Since robust Ih are also present in CA3 glutamatergic neurons, I here investigated whether the action of EtOH in the control of CA3 excitability can be correlated with its possible direct interaction with these cation channels. For this purpose, patch-clamp experiments were performed in CA3 pyramidal neurons from hippocampal coronal slices obtained from male Sprague-Dawley rats. The data obtained demonstrated that EtOH is able to modulate Ih in biphasic manner depending on the concentrations used. Low EtOH concentrations enhanced Ih amplitude, while high reversibly reduced them. This biphasic action induced by EtOH reflects on firing rate and synaptic integration. In addition, in this reports it has been shown that EtOH modulates the function of HCN channels through interfering with the cAMP/AC/PKA intracellular pathways, an effect that is mimicked also by other endogenous compounds such as dopamine through D1 receptors activation. These data suggest that the HCN-mediated Ih currents in CA3 pyramidal neurons are sensitive to EtOH action, which at low or relevant concentrations is able to increase or reduce their function respectively. Altogether these data suggest a potential new mechanism of EtOH actions on hippocampal formation and may help to better understand the depressant central activity showed by this drug of abus

ANSwER-Sistema informativo ambientale basato su ontologia e logica Fuzzy

2006/2007Le fonti dati rilevanti per il monitoraggio dell’avifauna delle lagune friulane, previsto dal progetto ANSER (Programma INTERREG IIIA Transfrontaliero Adriatico), sono alimentate da tre diverse metodologie di censimento, una metodologia di cattura/marcatura e una metodologia di tracciamento radio telemetrico. L’ampio spettro di informazioni a riguardo è confluito in un sistema informativo ambientale che 1) traduce tutti i dati in Ecological Metadata Language (EML) seguendo un unico modello sintattico orientato agli oggetti, 2) lo arricchisce semanticamente con una ontologia di dominio basata sulla Logica Descrittiva, 3) ne analizza le performance predittive, validando, attraverso un sistema inferenziale fuzzy, il modello teorico rispetto ai dati raccolti su campo. I risultati più importanti sono descrivibili così: 1) l’eliminazione completa di eterogeneità tra dataset ha permesso di atomizzare le tuple, reificando in un’unica super-classe di eventi nel tempo, i contatti tra operatore e animale in un determinato luogo; 2) l’ontologia OWL-DL ha determinato in maniera consistente l’appartenenza delle specie alle guild considerate e la relativa attrazione verso i diversi habitat disponibili; 3) il modello fuzzy ha rivelato che le informazioni sull’habitat e sulla profondità delle acque nel punto di monitoraggio, influiscono differentemente sulla predizione di abbondanza delle diverse guild esaminate.XX Ciclo196

Bi-directional Modulation of Hyperpolarization-Activated Cation Currents (Ih) by Ethanol in Rat Hippocampal CA3 Pyramidal Neurons

It is widely acknowledged that ethanol (EtOH) can alter many neuronal functions, including synaptic signaling, firing discharge, and membrane excitability, through its interaction with multiple membrane proteins and intracellular pathways. Previous work has demonstrated that EtOH enhances the firing rate of hippocampal GABAergic interneurons and thus the presynaptic GABA release at CA1 and CA3 inhibitory synapses through a positive modulation of the hyperpolarization-activated cyclic nucleotide-gated cation (HCN) channels. Activation of HCN channels produce an inward current, commonly called Ih, which plays an essential role in generating/regulating specific neuronal activities in GABAergic interneurons and principal glutamatergic pyramidal neurons such as those in the CA3 subregion. Since the direct effect of EtOH on HCN channels expressed in CA3 pyramidal neurons was not thoroughly elucidated, we investigated the possible interaction between EtOH and HCN channels and the impact on excitability and postsynaptic integration of these neurons. Patch-clamp recordings were performed in single CA3 pyramidal neurons from acute male rat coronal hippocampal slices. Our results show that EtOH modulates HCN-mediated Ih in a concentration-dependent and bi-directional manner, with a positive modulation at lower (20 mM) and an inhibitory action at higher (60-80 mM) concentrations. The modulation of Ih by EtOH was mimicked by forskolin, antagonized by different drugs that selectively interfere with the AC/cAMP/PKA intracellular pathway, as well as by the selective HCN inhibitor ZD7288. Altogether, these data further support the evidence that HCN channels may represent an important molecular target through which EtOH may regulate neuronal activity

EXPERIMENTAL ANALYSIS OF THE THREE DIMENSIONAL FLOW IN A WELLS TURBINE ROTOR

An experimental investigation of the local flow field in a Wells turbine has been conducted, in order to produce a detailed analysis of the aerodynamic characteristics of the rotor and support the search for optimized solutions. The measurements have been conducted with a hot-wire anemometer (HWA) probe, reconstructing the local three-dimensional flow field both upstream and downstream of a small-scale Wells turbine. The multi-rotation technique has been applied to measure the three velocity components of the flow field for a fixed operating condition. The results of the investigation show the local flow structures along a blade pitch, highlighting the location and radial extension of the vortices which interact with the clean flow, thus degrading the turbine’s overall performance. Some peculiarities of this turbine have also been shown, and need to be considered in order to propose modified solutions to improve its performance

Flux vacua with approximate flat directions

We present a novel method to obtain type IIB flux vacua with flat directions at tree level. We perform appropriate choices of flux quanta that induce relations between the flux superpotential and its derivatives. This method is implemented in toroidal and Calabi-Yau compactifications in the large complex structure limit. Explicit solutions are obtained and classified on the basis of duality equivalences. In the toroidal case we present solutions with N = 1 and N = 2 supersymmetry and arbitrarily weak coupling. In Calabi-Yaus we find novel perturbatively flat vacua, as well as solutions with non-zero flux superpotential and an axionic flat direction which represent a promising starting point for de Sitter constructions from non-zero F-terms in the complex structure sector. The higher order (perturbative and non-perturbative) effects that can lift these flat directions are discussed. We also outline applications in a wide variety of settings involving the classical Regge growth conjecture, inflation and quintessence, supersymmetry breaking and F-term de Sitter uplifting

Self-Propagating High-Temperature Synthesis Reactions for ISRU and ISFR Applications

In the framework of ISRU (In-Situ Resource Utilization) and ISFR (In-Situ Fabrication and Repair) applications, a novel recently patented process based on the occurrence of Self-propagating High temperature Synthesis (SHS) reactions potentially exploitable for the in-situ fabrication of construction materials in Lunar and Martian environments is described in this work. Specifically, the SHS process involves thermite reactions type between Lunar or Martian regolith simulants and aluminum as reducing agent. To overcome the fact that the original content of ilmenite (FeTiO3) and ferric oxide (Fe2O3) on Moon and Mars soils, respectively, is not enough to make the SHS process possible, suitable amounts of these species have to be added to the starting mixtures. The dependence of the most important processing parameters, particularly the composition of the starting mixture, evacuation level, and gravity conditions, on SHS process behaviour and product characteristics is specifically examined for the case of Lunar regolith. All the obtained findings allows us to conclude that the optimized results obtained under terrestrial conditions are valid for in-situ applications in Lunar environment. In particular, parabolic flight experiments evidenced that neither SHS process dynamics nor product characteristics are significantly influenced in both Lunar and Martian systems when passing from Earth to low gravity conditions. Finally, the complete scheme involving all stages required for the fabrication of physical assets to be used as protection against solar rays, solar wind and meteoroids, etc., is reported.</p

Pumps as turbines for pumped hydro energy storage systems - A small-size case study

Pumped Hydro Energy Storage (PHES) technology has been used since early 1890s and is, nowadays, a consolidated and commercially mature technology. PHES systems allow energy to be stored by pumping water from a lower-to a higher-level reservoir. Subsequently, this energy can be released through a turbine placed in a penstock, which connects the two reservoirs, to produce energy. Although these plants have historically been employed at large power scales (in the order of hundreds of MW), in recent years, micro- and small-scale plants are becoming more interesting, due to their possibility of being integrated with renewable energy systems (RES) used in autonomous island grids. Capital costs associated with hydraulic machines used in PHES systems represent the most critical economic factor, which can be mitigated by using commercial centrifugal pumps in reverse mode (Pumps as Turbines, PATs) in place of small hydro turbines. These expected economic benefits must be weighed in each specific case study, with some drawbacks related to the use of PATs, mainly associated to a lower round-trip efficiency with respect to specifically designed pumps and turbines. In this work, a small-scale PHES plant has been studied coupled to an existent photovoltaic system for the integration in the electric grid of a small island in Southern Italy. Two different PHES outlines have been compared based on techno-economic considerations. The former is a typical PHES system composed of both pumps and a turbine, while the latter uses only an array of parallel pumps which work also in reverse mode. The analysis demonstrates the feasibility of integrating a photovoltaic and PHES plant, which results in a lower cost of electricity production, while PHES performance in the PAT-based outline results penalized by the lower efficiency of PATs with respect to the hydraulic turbine