Cloud Capacity Spectrum Method: Accounting for record-to-record variability in fragility analysis using nonlinear static procedures

This paper investigates a number of computational issues related to the use of nonlinear static procedures in fragility analysis of structures. Such approaches can be used to complement nonlinear dynamic procedures, reducing the computational and modelling effort. Specifically, this study assesses the performance of the Capacity Spectrum Method (CSM) with real (i.e. recorded) ground motions (as opposed to code-based conventional spectra) to explicitly account for record-to-record variability in fragility analysis. The study focuses on single-degree-of-freedom systems, providing a basis for future multi-degree-of-freedom system applications. A case-study database of 2160 inelastic oscillators is defined through parametric backbones with different elastic periods, (yield) base shear coefficients, values of the ductility capacity, hardening ratios, residual strength values and hysteresis rules. These case studies are analysed using 100 real ground motions. An efficient algorithm to perform the CSM with real spectra is proposed, combined with a cloud-based approach (Cloud-CSM) to derive fragility relationships. Simple criteria to solve the issue of multiple CSM solutions (i.e. two or more points on the backbone satisfying the CSM procedure) are proposed and tested. It is demonstrated that the performance point selection can be carried out based on a particularly efficient intensity measure detected via optimal intensity measure analysis. The effectiveness of the proposed Cloud-CSM in fragility analysis is discussed through extensive comparisons with nonlinear time-history analyses, the code-based N2 method, and a simple method involving an intensity measure as a direct proxy for the performance displacement. The Cloud-CSM provides errors lower than ±20% in predicting the median of the fragility curves in most of the analysed cases and outperforms the other considered methodologies in calculating the fragility dispersion

Late recovery with cyclosporine-A of an auto-immune sudden sensorineural hearing loss

Sensorineural hearing loss of immune-mediated origin may be present as a symptom in systemic autoimmune diseases or may occur as a primary disorder without other organ involvement (auto-immune inner ear disease). The diagnosis of auto-immune inner ear disease is still predicated on clinical features and to date specific diagnostic tests are not available. We report a case of right-sided sudden hearing loss in a female patient in which the clinical manifestations, in addition to ANA positivity and hypocomplementaemia allowed us to hypothesize an auto-immune inner ear disease. The immunosuppressive treatment with cyclosporine-A was capable of a recovery of the hearing that, however, occurred progressively with normalization of the hearing function after 1 year of treatment. cyclosporine-A could be proposed as a therapeutic option in case of auto-immune inner ear disease allowing the suspension of corticosteroids that, at high dose, expose patients to potentially serious adverse events

The Employment of Leukotriene Antagonists in Cutaneous Diseases Belonging to Allergological Field

Leukotrienes (LTs) are potent biological proinflammatory mediators. LTC4, LTD4, and LTE4 are more frequently involved in chronic inflammatory responses and exert their actions binding to a cysteinyl-LT 1 (CysLT1) receptor and a cysteinyl-LT 2 (CysLT2) receptor. LTs receptor antagonists available for clinical use demonstrate high-affinity binding to the CysLT1 receptor. In this paper the employment of anti-LTs in allergic cutaneous diseases is analyzed showing that several studies have recently reported a beneficial effects of these agents (montelukast and zafirlukast as well as zileuton) for the treatment of some allergic cutaneous related diseases-like chronic urticaria and atopic eczema although their proper application remains to be established

Benralizumab improves patient reported outcomes and functional parameters in difficult-to-treat patients with severe asthma: Data from a real-life cohort

In the last decade, an increasing number of randomized controlled trials (RCTs) on biologic therapy in patients with severe asthma have included patient-reported outcomes (PROs) as secondary efficacy measures. The majority of these RCTs showed a benefit in symptoms and quality of life. However, the magnitude of this benefit remains uncertain, because it rarely exceeded the minimal important difference (MID), owing to a significant improvement in the control group (placebo effect). Real-life studies on biologic therapies assessing PRO are scarce. They may support and integrate RCT results through their different experimental design. This real-life retrospective study provides data on 15 patients with difficult-to-treat severe eosinophilic asthma treated with benralizumab up to 6 months. Asthma quality of life questionnaire (AQLQ) and asthma control test (ACT) were assessed and administered at each visit to minimize the Hawthorne effect. Changes in general accepted efficacy measures, such as forced expiratory volume in 1 s (FEV1), peak expiratory flux (PEF), exacerbation rate and blood eosinophils, from baseline were also assessed. AQLQ and ACT improved from 3.9 ± 0.4 to 5.2 ± 0.4 and from15.6 ± 5.7 to 18.1 ± 5.6, respectively. FEV1 increased of about 250 ml (+14%). PEF increased from 288 ± 107 to 333 ± 133 l/min. The number of exacerbations requiring OCS courses decreased from 2.8 ± 2.2 to 0.5 ± 0.8. Eosinophil counts dropped to 25.6 ± 15 cells/microliter. In conclusion, most patients reported improvements in AQLQ and ACT greater than MID, suggesting that these outcome represent a sensitive tool in real-life effectiveness studies. Our approach reduced the limitations of transition questions and the Hawthorne effect, increasing findings reliability

Once daily levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria

Levocetirizine is the pharmacologically active enantiomer of cetirizine. It is a potent histamine H-1 receptor antagonist with anti-inflammatory and antiallergic properties. The review analyses the levocetirizine’s properties in terms of safety and efficacy both in allergic rhinitis and urticarioid syndromes

Acquired angioedema with C1 inhibitor deficiency associated with anticardiolipin antibodies.

Acquired angioedema (AAE) with C1 inhibitor deficiency is often associated to B cell lymphoproliferative disorders or autoimmune diseases. We report a case of AAE associated with IgM anti-cardiolipin antibodies, with frequent edematous attacks, that disappeared completely after a slight immunosuppression and danazol therapy

Design and Analysis of CFD Experiments for the Development of Bulk-Flow Model for Staggered Labyrinth Seal

Nowadays, bulk-flow models are the most time-efficient approaches to estimate the rotor dynamic coefficients of labyrinth seals. Dealing with the one-control volume bulk-flow model developed by Iwatsubo and improved by Childs, the “leakage correlation” allows the leakage mass-flow rate to be estimated, which directly affects the calculation of the rotor dynamic coefficients. This paper aims at filling the lack of the numerical modelling for staggered labyrinth seals: a one-control volume bulk-flow model has been developed and, furthermore, a new leakage correlation has been defined using CFD analysis. Design and analysis of computer experiments have been performed to investigate the leakage mass-flow rate, static pressure, circumferential velocity, and temperature distribution along the seal cavities. Four design factors have been chosen, which are the geometry, pressure drop, inlet preswirl, and rotor peripheral speed. Finally, dynamic forces, estimated by the bulk-flow model, are compared with experimental measurements available in the literature

Safety of measles, mumps, and rubella vaccine in egg allergy: in vivo and in vitro management

Background: Egg allergy is the second most prevalent form of food allergy in childhood. In spite of the evidence accumulated, inoculating egg allergy children with attenuated vaccines grown on chick embryo cell cultures, such as the measles, mumps, and rubella (MMR) vaccine, is regarded (erroneously) as potentially dangerous or even anaphylactogenic, by many. An issue perceived as particularly conflicting also by Health Professionals. Case presentation: A 15-year-old boy, with a history of severe egg allergy in early infancy, who was still sensitized to egg allergens, including baked egg, had never received MMR vaccination, in fear of possible anaphylaxis, in spite of the fact that this vaccination is mandatory in the first year of life, in Italy. Because of that, he was not allowed to attend school, longer, and was referred to us in order to assess the potential risk of MMR vaccination. Upon thorough allergologic workup, sensitization to MMR vaccine components was excluded by an in vivo approach, consisting in skin prick tests, intradermal tests, and subcutaneous injection test, corroborated by vaccine-specific B-lymphocyte proliferation assay, ex vivo. T-cell proliferation in response to MMR vaccine was also excluded. Eventually, the boy was inoculated with MMR vaccine and was readmitted to school. Conclusions: The diagnostic strategy adopted appears feasible and easy-to-perform and may be adopted in controversial cases (as the one reported), characterized by previous severe allergic reactions to egg. The B-lymphocyte proliferation assay we developed may represent a useful and reliable tool not only in research but also in clinical practice