Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Performance of LoRa for bike-sharing systems

Today bike sharing systems are becoming popular in many cities as short-distance transit vehicles. More than 18million bicycles are available worldwide for public use and one of the main problems that afflicts such sharing systems is the loss of bikes, which can be stolen or simply left in unknown locations. Thus, many bikes are docked or tracked using GPS and costly cellular connections. In this paper, we consider the emerging Long Range (LoRa) technology for use in bike sharing systems. LoRa exploits free ISM bands and has been conceived for low power and low data rate applications. Additionally, LoRa is characterized by large cells and heterogeneous application domains, which may lead to extremely high numbers of devices coexisting in the same cell. Thus, in this paper we study the scalability limits of a typical LoRa cell, showing that the performance of LoRa in crowded scenarios can be quite limited when using high spreading factors (SFs). Then, we design and realize a prototype of LoRa tracker module that can be embedded in a bike and we test its use in a large area of Palermo city, Italy. According to our knowledge, this is the first paper that study the performance of LoRa for bike sharing systems

ABCs of hemodiafiltration prescription: The Pisa style

In end-stage kidney disease patients, hemodiafiltration, a mixed diffusive-convective technique, has shown beneficial effects in terms of improvement of anemia, inflammation, mineral bone disorders, malnutrition and cardiovascular stability. Greater convective volume exchange was also associated with improved overall and cardiovascular survival. However, absolute target threshold volume would be difficult to define and achieve in daily clinical practice, mainly because of differences in patient size. Convective volumes standardized for body surface area would appear to be the simplest approach in clinical practice. Several factors can affect achievement of optimal convective volume, with vascular access being the main limiting factor. Based on our own clinical experience, hemodiafiltration is a more effective and preferable dialysis technique but only when a target convective volume greater than 20 L can be achieved. Conversely, standard high flux hemodialysis or expanded hemodialysis may be helpful and valuable alternative dialysis techniques

Impact of Spreading Factor Imperfect Orthogonality in LoRa Communications

In this paper we study the impact of imperfect-orthogonality in LoRa spreading factors (SFs) in simulation and real-world experiments. First, we analyze LoRa modulation numerically and show that collisions between packets of different SFs can indeed cause packet loss if the interference power received is strong enough. Second, we validate such findings using commercial devices, confirming our numerical results. Third, we modified and extended LoRaSim, an open-source LoRa simulator, to measure the impact of inter-SF collisions and fading (which was not taken into account previously in the simulator). Our results show that non-orthogonality of the SFs can deteriorate significantly the performance especially of higher SFs (10 to 12) and that fading has virtually no impact when multiple gateways are available in space diversity

Volcano eruptions

Union Civil Protection Mechanism Decision No 1313/2013/EU requires EU Member States and UCPM participating states to report to the Commission on their disaster risk management activities to support formulating an EU risk management policy that would complement and enhance the national ones. The aim of this report is to support the use of the new “Reporting Guidelines on Disaster Risk Management, Art. 6(1)d of Decision No.1313/2013/EU,” (2019/C 428/07) by relevant national authorities. This report is the second in the series of reports “Recommendations for National Risk Assessment for Disaster Risk Management”. The aim of this series of reports is to build-up a network of experts involved in the different aspects of the national risk assessment process. The European Commission Joint Research Centre joins national, regional and global efforts to acquire better risk governance structure through evidences, science and knowledge management. Risk governance facilitates policy cycle for the implementation of integrated disaster risk management. Risk Assessment is positioned at the heart of the policy cycle and provides evidence for DRM planning and the implementation of prevention and preparedness measures. This report explains the purpose and objective of each step of the reporting to give meaning and motivation to demanding risk governance processes. It collects the contributions of fourteen expert teams that prepared short step by step description of disaster risk assessment approaches specific for the chosen hazard/asset usable in the context of a national risk assessment exercise and addressed national risk assessment capability to be further developed in order to bring the evidence to next level A special focus is dedicated to capability needed to tackle climate change. The risks covered are of natural, anthropogenic and socio-natural origin: floods, droughts, wildfires, biodiversity loss, earthquakes, volcano eruptions, biological disasters, Natech accidents, chemical accidents, nuclear accidents, terrorist attacks, critical infrastructure disruptions, cybersecurity and hybrid threats

impact of different luminous efficacy models on the calculation of lighting energy uses in non residential buildings

Abstract Artificial lighting has a relevant impact on the electricity uses in non-residential buildings. The calculation method introduced in the relevant EN standards takes into account, only to some extent, the daylighting role on the lighting performances of buildings. An alternative method is under development for the Italian territory, which introduces a climate based approach to properly estimate the day light contribution. The method requires the implementation outdoor global and diffuse illuminance Typical Meteorogical Years (TMY), which calculated starting from solar irradiation data and luminous efficacy models. Different models can be used for this purpose, consequently these differences may lead to different estimates of daylight availability in buildings during the year. This paper explores the impact of different luminous efficacy models on the lighting energy uses in non-residential buildings. A typical office building is used for the study and calculations are carried out for three localities of the Italian territory. The outdoor luminous environment, the reference indoor visual task and the building daylight characteristics are taken into account. Results allow to compare the energy lighting performance of the building applying the different luminous efficacy models and, as a consequence, to select the most suitable model to be used in a climate based artificial lighting calculation method

Impact of Different Illuminance Typical Years Models on a Climate Based Method for the Calculation of Artificial Lighting Energy Use in Office Buildings

Artificial lighting has a relevant impact on the electricity uses in not residential buildings. The method to assess such uses is based on standards, which hardly take into account the daylighting contribution and the time evolution of the outdoor illuminance conditions. Different models were adopted to build diffuse illuminance reference years, starting from satellite images. These models lead to different daylight availability during the year. The paper explores the impact that these models have on the artificial lighting energy uses by hourly monthly mean calculations. The test was carried out with a climate based method, which takes into account: the outdoor luminous environment, the reference indoor visual task and the building daylight characteristics. A typical office building was used for the test in Rome, Italy. Results allowed to compare the impact of each model and to select the most suitable one to be implemented in the climate based method to predict artificial lighting use in buildings

An Alternative Method for the Assessment of the Typical Lighting Energy Numeric Indicator for Different Outdoor Illuminance Conditions.

The contribution of daylight plays a key role in the evaluation of the Lighting Energy Numeric Indicator (LENI), which refers to the annual lighting energy consumption per square meter: the higher the contribution, the lower the energy consumption. Calculation of energy need for artificial lighting is defined in European Standard EN 15193-1:2017; the daylight availability is assessed by using the Daylight Factor. This parameter is easy to use and commonly applied by designers and technicians, but it has several limitations. The estimation of daylight contribution proposed in the first version of the EN 15193:2008 was discussed in literature and alternative methodologies and models have been suggested, since it was noticed that it underestimated the daylight contribution. Starting from these considerations, this study will focus on the analysis of a parameter which represents a middle way between static and climate-based variables. This new variable is the Daylight Factor Target, reference parameter of the new EN 17037. The D target will be used in the alternative methodology of LENI calculation developed in previous studies and the results will be compared with the ones obtained by applying the EN 15193-1:2017 procedure. Results showed that the Daylight Factor Target allows to assess in the first building design phase the LENI of any building which complies with the EN 17037, independently from its characteristics, just choosing the operative working hours and the lighting power installed. The LENI target resulted to be 50% lower than the values obtained using EN 15193-1:2017