Robustness of the Vesuvian roofs under the combined overload and high temperatures due to air falls

During an explosive eruption, a construction is hit by several actions, always associated to elevated temperatures, causing fires, possible explosions and reduction of the mechanical properties of the structural materials. In this paper, the attention is focused on the analysis of a specific volcanic event, the so-called air fall deposits, generally falling from the eruptive column due to gravity. In particular the robustness against the air fall deposit of the most common roofing structures, typically made of timber, steel and reinforced concrete, in the Vesuvian areais evaluated. Consequently, some protection systems for mitigating the effects of the combination of overloading and high temperaturesare identified

Epidemiology of gastroenteropancreatic neuroendocrine tumours.

Gastroenteropancreatic neuroendocrine tumours are a heterogeneous group of tumours arising from diffuse endocrine cells, causing unique clinical syndromes. These tumours, formerly named carcinoid, can involve any part of the gastrointestinal tract and the endocrine pancreas and have a wide range of malignant potential: from benign to poorly differentiated tumours. In this review we will summarize the data available on the epidemiology of gastroenteropancreatic tumours as it is reported from around the world. This includes annual incidence rates at the various anatomic sites, and trends in incidence rates with time. In addition age and stage at presentation, gender and racial differences and finally prognosis and survival were collected when reported

Familial hypercholesterolemia in cardiac rehabilitation: a new field of interest

Familial hypercholesterolemia (FH) is a frequently undiagnosed genetic disease characterized by substantial elevations of low-density lipoprotein cholesterol (LDL-C). The prevalence of heterozygous FH (HeFH) in the general population is 1:500 inhabitants, while the prevalence of homozygous FH (HoFH) is 1:1,000,000. If FH is not identified and aggressively treated at an early age, affected individuals have a 20-fold increased lifetime risk of coronary heart disease compared with the general population. This narrative review provide a concise overview of recommendations for diagnosis and treatment of adults and children with FH, and discuss the utility of considering FH as a comorbidity at the entry of cardiac rehabilitation programme

Analysis of Fluid-structure Interaction for a Submerged Floating Tunnel

Abstract The behavior of a submerged floating tunnel (SFT) exposed to a water current of variable velocity is investigated through complex numerical analyses based on the Computational Fluid Dynamics (CFD) and the Finite Element Method (FEM) implemented in the ABAQUS code. An accurate modelling of turbulent phenomena is made, based on both Implicit Large Eddy Simulation and the RANS-based Spalart-Allmaras model, followed by a co-simulation procedure in which the fluid dynamics and the structural analysis are carried out separately and interfaced with each other. Circular and elliptical cross sections are considered, each of them fitted for combined railway and motorway services. The analysis is carried out in both static and dynamic way, by varying the current velocity with a given value of the residual buoyancy of the tunnel. The results emphasize the effect of the main parameters investigated, evidencing the great potentials of the adopted calculation tool for carrying out further investigations aimed at achieving useful elements for the design and optimization of the SFT

Monotonic tests on beam-to-column joint with steel link for timber seismic resistant structures

For the design of dissipative heavy timber frame structures, in the context of modern seismic design approach based on the mechanical triad of strength, stiffness and ductility, brittle timber failure modes can be avoided by integrating modern timber connection technology into hybrid timber-steel system. The overall seismic performance can be improved, entrusting the dissipation function to ad hoc conceived devices, as an alternative to connections. Steel links located at the ends of the beams are very promising solutions, which can develop plastic hinges, thus providing a ductile behaviour, with a significant dissipative capacity. Besides timber members, as well as connections, to be designed with an adequate over-strength, can remain in elastic field. In this perspective, the paper illustrates the mechanical characterisation through monotonic tests of two different configurations of timber beam-to-column joint with steel link for heavy timber frames, consisting of a timber element connected to a steel link by means of a steel end-plate and glued-in steel rods. The experimental results indicate a satisfactory agreement with the theoretical ones, therefore the suitability of the system and of the design criteria.The research project DPC–ReLUIS 2019-2021 and 2022-2024 - WP13 Contribution to standards for timber structures, and the Department of Civil Engineering (DECivil) laboratory of the Minho University, in Guimaraes (Portugal) are acknowledged

Preoperative cardiac risks in noncardiac surgery: The role of coronary angiography

The preoperative evaluation of patients candidates to noncardiac surgery requires a knowledge of factors related both to type of surgery and to features of the single patient, potentially responsible for perioperative cardiovascular complications, fatal and nonfatal. The assessment of symptoms and/or noninvasive testing indicating the presence of coronary artery disease may suggest the need for medical therapy optimization and, eventually, coronary arteriography before the scheduled timing of noncardiac surgery. There is no evidence favoring a prophylactic myocardial revascularization (percutaneous or surgical) and more studies are needed to define the role of coronary artery disease diagnosis and treatment before high-risk non cardiac surgery

Natural History and Management of Familial Paraganglioma Syndrome Type 1: Long-Term Data from a Large Family

Head and neck paragangliomas are the most common clinical features of familial paraganglioma syndrome type 1 caused by succinate dehydrogenase complex subunit D (SDHD) mutation. The clinical management of this syndrome is still unclear. In this study we propose a diagnostic algorithm for SDHD mutation carriers based on our family case series and literature review. After genetic diagnosis, first evaluation should include biochemical examination and whole-body imaging. In case of lesion detection, nuclear medicine examination is required for staging and tumor characterization. The study summarizes the diagnostic accuracy of different functional imaging techniques in SDHD mutation carriers. 18F-3,4-dihydroxyphenylalanine (18F-DOPA) positron emission tomography (PET)-computed tomography (CT) is considered the gold standard. If it is not available, 123I-Metaiodobenzylguanidine (MIBG) could be used also for predicting response to radiometabolic therapy. 18F-fluoro-2-deoxy-D-glucose (18F-FDG) PET-CT has a prognostic role since high uptake identifies more aggressive cases. Finally, 68Ga-peptides PET-CT is a promising diagnostic technique, demonstrating the best diagnostic accuracy in our and in other published case series, even if this finding still needs to be confirmed in larger studies. Periodic follow-up should consist of annual biochemical and ultrasonographic screening and biannual magnetic resonance examination to identify biochemical silent tumors early

Capecitabine and Temozolomide (CAPTEM) in advanced neuroendocrine neoplasms (NENs): a systematic review and pooled analysis

Background Retrospective studies and single center experiences suggest a role of capecitabine combined with temozolomide (CAPTEM) in neuroendocrine tumors (NENs). Methods We performed a systematic review to assess the efficacy and safety of CAPTEM in patients affected with NENs, with the aim to better clarify the role of this regimen in the therapeutic algorithm of NENs. Results A total of 42 articles and 1818 patients were included in our review. The overall disease control rate was 77% (range 43.5%-100%). The median progression free survival ranged from 4 to 38.5 months, while the median overall survival ranged from 8 to 103 months. Safety analysis showed an occurrence of G3-G4 toxicities in 16.4% of the entire population. The most common toxicities were hematological (27.2%), gastrointestinal (8.3%,) and cutaneous (3.2%). Conclusion This systematic review demonstrated that CAPTEM was an effective and relatively safe treatment for patients with advanced well-moderate differentiated NENs of gastroenteropancreatic, lung and unknown origin

Thyroid nodules treated with percutaneous radiofrequency thermal ablation: a comparative study

Percutaneous radiofrequency thermal ablation (RTA) was reported as an effective tool for the management of thyroid nodules (TNs). The aim of this study was to investigate the effects of RTA and to establish whether they were treatment-related by comparison with a matched, untreated control group

An Expert Opinion on the Role of the Rosuvastatin/Amlodipine Single Pill Fixed Dose Combination in Cardiovascular Prevention

Current cardiovascular disease prevention strategies are based on the management of cardiovascular risk as a continuum, redefining the therapeutic goals for each individual based on the estimated global risk profile. Given the frequent clustering of the principal cardiovascular risk factors, such as hypertension, diabetes and dyslipidaemia, in the same individual, patients are required to take multiple drugs to achieve therapeutic targets. The adoption of single pill fixed dose combinations may contribute to achieve better control of blood pressure and cholesterol compared to the separate administration of the individual drugs, mostly due to better adherence related to therapeutic simplicities. This paper reports the outcomes of an Expert multidisciplinary Roundtable. In particular, the rational and potential clinical use of the single pill fixed dose combination "Rosuvastatin-Amlodipine" for the management of concomitant hypertension/hypercholesterolemia in different clinical fields are discussed. This Expert Opinion also illustrates the importance of an early and effective management of total cardiovascular risk, highlights the substantial benefits of combining blood pressure and lipid-lowering treatments in a single-pill fixed dose combination and attempts to identify and overcome the barriers to the implementation in clinical practice of the fixed dose combinations with dual targets. This Expert Panel identifies and proposes the categories of patients who may benefit the most from this fixed dose combination