Bilateral Remote Ischemic Conditioning in Children:a two-center, double-blind, randomized controlled trial in young children undergoing cardiac surgery

Objective: The study objective was to determine whether adequately delivered bilateral remote ischemic preconditioning is cardioprotective in young children undergoing surgery for 2 common congenital heart defects with or without cyanosis.Methods: We performed a prospective, double-blind, randomized controlled trial at 2 centers in the United Kingdom. Children aged 3 to 36 months undergoing tetralogy of Fallot repair or ventricular septal defect closure were randomized 1:1 to receive bilateral preconditioning or sham intervention. Participants were followed up until hospital discharge or 30 days. The primary outcome was area under the curve for high-sensitivity troponin-T in the first 24 hours after surgery, analyzed by intention-to-treat. Right atrial biopsies were obtained in selected participants.Results: Between October 2016 and December 2020, 120 eligible children were randomized to receive bilateral preconditioning (n = 60) or sham intervention (n = 60). The primary outcome, area under the curve for high-sensitivity troponin-T, was higher in the preconditioning group (mean: 70.0 ± 50.9 μg/L/h, n = 56) than in controls (mean: 55.6 ± 30.1 μg/L/h, n = 58) (mean difference, 13.2 μg/L/h; 95% CI, 0.5-25.8; P = .04). Subgroup analyses did not show a differential treatment effect by oxygen saturations (pinteraction = .25), but there was evidence of a differential effect by underlying defect (pinteraction = .04). Secondary outcomes and myocardial metabolism, quantified in atrial biopsies, were not different between randomized groups.Conclusions: Bilateral remote ischemic preconditioning does not attenuate myocardial injury in children undergoing surgical repair for congenital heart defects, and there was evidence of potential harm in unstented tetralogy of Fallot. The routine use of remote ischemic preconditioning cannot be recommended for myocardial protection during pediatric cardiac surgery

Realtime Feedback in Coding Games

Visual feedback in the space of interactive media can give users more insight into the execution of a program. This paper discusses the implications and results of incorporating visual annotations into both programming environments and computer games and how it affects the user experience. We combined both of these spaces and developed a coding-based resource-management game and used playtesting feedback to analyze the impact of the visuals on a user’s performance in the game. The collected data shows that in general, the introduction of visuals assists players in making more well-informed decisions within a time limit. Based on these gathered results, there is clearly a lot of undiscovered potential for visual annotations in both coding and gaming to provide more informative experiences

Methods to Minimize Commercial Vessel-Generated Marine Acoustic Pollution

Acoustic pollution is endangering marine life both physically and psychologically. Of the many sources of marine acoustic pollution, our team focused on the constant noise from commercial shipping. - In collaboration with the United States Coast Guard, we reviewed professional and academic literature and interviewed experts in acoustic pollution. We identified and analyzed 33 methods that have the potential to reduce vessel noise based on six criteria: cost, noise reduction effectiveness, availability, implementation, maintainability, and efficiency. We determined that most methods were designed for efficiency, but also had the potential to reduce noise. To optimize these methods, they must be considered in the early design stages of new vessels

Unusual underwater flowering of Utricularia australis populations: a botanical enigma?

The free-floating aquatic plant Utricularia australis has typically subsurface shoots and subaerial showy in- florescences. To find it growing with large populations among benthic Chara stands at 4–6 m depth in two Central Italian lakes, is a phenomenon that was never previously reported. Production of showy chasmogamous flowers at this depth makes such finding yet increasingly intriguing. Here we make quantitative-qualitative comparisons of morphological characters among subaerial and underwater flowers taken from diverse sites in Central Italy. Environmental data were used to delineate differences between superficial and underwater habitats where flowering U. australis populations were found, and to help explain these extraordinary findings. Although similar, the subaerial and underwater flowers did show some differences, the most important being the length of the floral scape. Underwater scapes were around three times longer than those emerged. This might be a typical phototropic-response or a failed attempt to get flowers above water surface for allowing entomophilous polli- nation, or a redundant morpho-physiological trait as a result of a recent ecological move. Underwater flowers were generally smaller, but they did have longer styles, nectar signalling was less obvious, thinner petals, mucous-coated pollen (subaerial pollen is dry and grainy). Both types of flower were sterile, producing abortive fruits. Possibility of underwater ecological conditions causing stress-induced flowering is also proposed. A lack of water movement is an important ecological requirement for U. australis growth and could explain why large populations have been found in deep water far from its typical habitat

Unusual underwater flowering of Utricularia australis populations: a botanical enigma?

The free-floating aquatic plant Utricularia australis has typically subsurface shoots and subaerial showy inflorescences. To find it growing with large populations among benthic Chara stands at 4–6 m depth in two Central Italian lakes, is a phenomenon that was never previously reported. Production of showy chasmogamous flowers at this depth makes such finding yet increasingly intriguing. Here we make quantitative-qualitative comparisons of morphological characters among subaerial and underwater flowers taken from diverse sites in Central Italy. Environmental data were used to delineate differences between superficial and underwater habitats where flowering U. australis populations were found, and to help explain these extraordinary findings. Although similar, the subaerial and underwater flowers did show some differences, the most important being the length of the floral scape. Underwater scapes were around three times longer than those emerged. This might be a typical phototropic-response or a failed attempt to get flowers above water surface for allowing entomophilous pollination, or a redundant morpho-physiological trait as a result of a recent ecological move. Underwater flowers were generally smaller, but they did have longer styles, nectar signalling was less obvious, thinner petals, mucous-coated pollen (subaerial pollen is dry and grainy). Both types of flower were sterile, producing abortive fruits. Possibility of underwater ecological conditions causing stress-induced flowering is also proposed. A lack of water movement is an important ecological requirement for U. australis growth and could explain why large populations have been found in deep water far from its typical habitat

Field Emission from Graphene Layers

We report the field emission characterization of graphene flakes deposited on SiO2/Si substrates. Electrical measurements are performed inside a scanning electron microscope provided of nano-manipulated metallic probes exploited as electrodes either to contact the flakes or as anode to collect electrons in field emission configuration. We demonstrate that local electric field as high as few hundreds V/µm allows to extract a current from the top of the flake. We also demonstrate a horizontal field emission device in which the electrons are extracted from the edge of the flake

A3MMM3R2

Obiettivo è valorizzare i quattro ambiti dʼintervento – Stupinigi, interramento ferrovia, sponda Sangone, ex Viberti – collocandoli in un sistema di relazioni spazio-funzionali di livello territoriale ed eliminando le barriere esistenti – ferrovia, autostrada e, in modo diverso, fiume. I quattro ambiti sono sub-sistemi di un sistema territoriale comunale (e oltre) che si offre quale volano di uno sviluppo armonico e sostenibile dellʼintero territorio comunale di Nichelino e, soprattutto, della sua comunità di uomini e donne. Lo sviluppo sostenibile è considerato nelle tre dimensioni ambientale, sociale ed economica. La proposta è di intervenire nei quattro ambiti attraverso un progetto unitario di sviluppo sostenibile territoriale che consideri lʼambiente, la società, lʼeconomia di Nichelino e del suo comprensorio. La strategia è mettere a sistema gli interventi previsti. La tutela ambientale è interpretata attraverso due canali. Il primo riguarda lʼimpatto sullʼambiente naturale di tutti gli interventi previsti. Il secondo è relativo alIa valorizzazione del Parco di Stupinigi, delle sponde del fiume Sangone e di tutte le altre aree verdi esistenti e che si realizzeranno. La promozione sociale è interpretata in termini di fruizione di luoghi, nuovi o rinnovati, che si offrono alla comunità dei cittadini per favorire gli incontri, lʼaggregazione, lʼinclusione e il godimento del patrimonio naturale e culturale di Nichelino. La crescita economica è interpretata come produzione di ricchezza attraverso interventi il cui ritorno sia superiore alle risorse investite per la capacità di mettere in moto attività produttive in campo turistico, artigianale, agricolo, culturale e commerciale. Lʼidea-progetto è il collegamento fisico, funzionale e simbolico dei quattro ambiti attraverso soluzioni osmotiche che realizzino il passaggio da un ambito allʼaltro. Il collegamento fisico si esplica nella possibilità di spostarsi agevolmente tra gli ambiti a piedi, in bicicletta e con piccoli bus elettrici dedicati. Per lʼinterramento della ferrovia e la ricucitura: la sistemazione della nuova area di sedime, il ponte piastra con i nuovi edifici soprastanti, lʼhousing sociale e i servizi pertinenti, il parcheggio multipiano e il polo per lo spettacolo e il pubblico intrattenimento, la nuova stazione e il polo di scambio intermodale, il recupero della vecchia stazione, i percorsi attrezzati con pensiline, il miglio solare con la passeggiate e i pannelli fotovoltaici, le aree verdi e gli spazi pubblici. Per lʼarea dismessa della ex fabbrica Viberti: lʼarea si proietta verso il parco di Stupinigi e verso lʼinterramento della ferrovia segnando il territorio, il taglio della tangenziale è ricomposto dal ponte piastra, le nuove funzioni dialogano con gli altri ambiti, con la città di Nichelino e il territorio, il recupero degli edifici esistenti con le funzioni innovative, le nuove costruzioni con le pertinenze, gli impianti a rete e la centrale fotovoltaica, la nuova viabilità, gli spazi pubblici e le aree verdi. Per il Parco di Stupinigi e i Poderi Juvarriani: la rinnovata fruizione del parco a piedi e in bicicletta, parcheggi di interscambio con i minibus elettrici, il recupero degli edifici storici e le nuove funzioni, il viale dellʼarte, le cascine della memoria, il borgo creativo, le cascine per la coltivazione, lʼosservatorio e cabina di regia, la costruzione dei nuovi parcheggi in duna, lʼadeguamento paesaggistico-funzionale dei vecchi parcheggi, lʼadeguamento delle strade e la riorganizzazione della mobilità, la pedonalizzazione del parco e del nuovo viale dellʼarte, la rinaturalizzazione del parco. Per lʼarea sensibile del torrente Sangone: la tutela dellʼecosistema, la valorizzazione ecologica, la fruizione sostenibile, le aree attrezzate, il nuovo elemento ponte che proietta il verde di Nichelino verso il territorio al di là del fiume, la trasformazione del torrente Sangone da elemento di divisione in raccordo tra le due sponde, la sistemazione delle rive e del canale fluviale, la costruzione del ponte bio-architettonico, gli interventi di rinaturalizzazione, la costruzione degli ingressi al Boschetto con i parcheggi di attestamento, le aree ludiche e per lo sport