The Convective Urca Process with Implicit Two-Dimensional Hydrodynamics

Consideration of the role of the convective flux in the thermodymics of the convective Urca neutrino loss process in degenerate, convective, quasi-static, carbon-burning cores shows that the convective Urca process slows down the convective current around the Urca-shell, but, unlike the "thermal" Urca process, does not reduce the entropy or temperature for a given convective volume. Here we demonstrate these effects with two-dimensional numerical hydrodynamical calculations. These two-dimensional implicit hydrodynamics calculations invoke an artificial speeding up of the nuclear and weak rates. They should thus be regarded as indicative, but still qualitative. We find that, compared to a case with no Urca-active nuclei, the case with Urca effects leads to a higher entropy in the convective core because the energy released by nuclear burning is confined to a smaller volume by the effective boundary at the Urca shell. All else being equal, this will tend to accelerate the progression to dynamical runaway. We discuss the open issues regarding the impact of the convective Urca process on the evolution to the "smoldering phase" and then to dynamical runaway.Comment: 22 pages, 11 figures, accepted for publication in the Astrophysical Journa

Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2)

BACKGROUND: Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure. METHODS: The survey was conducted in 2002 in 12 centers in Northern, Center and Southern Italy, different in size, climate, latitude and level of urbanization. Standardized questionnaires filled in by parents were used to collect information on health outcomes and exposure to traffic among 33,632 6-7 and 13-14 years old children and adolescents. Three questions on traffic exposure were asked: the traffic in the zone of residence, the frequency of truck and of car traffic in the street of residence. The presence of a possible response bias for the self-reported traffic was evaluated using external validation (comparison with measurements of traffic flow in the city of Turin) and internal validations (matching by census block, in the cities of Turin, Milan and Rome). RESULTS: Overall traffic density was weakly associated with asthma symptoms but there was a stronger association with cough or phlegm (high traffic density OR = 1.24; 95% CI: 1.04, 1.49). Car and truck traffic were independently associated with cough or phlegm. The results of the external validation did not support the existence of a reporting bias for the observed associations, for all the self-reported traffic indicators examined. The internal validations showed that the observed association between traffic density in the zone of residence and respiratory symptoms did not appear to be explained by an over reporting of traffic by parents of symptomatic subjects. CONCLUSION: Children living in zones with intense traffic are at higher risk for respiratory effects. Since population characteristics are specific, the results of validation of studies on self-reported traffic exposure can not be generalized

Bronchoalveolar lavage diagnosis of bronchiolo-alveolar carcinoma.

Differentiation between diffuse lung tumours and interstitial pulmonary diseases often requires open lung biopsy. We report two cases of bronchiolo-alveolar carcinoma presenting as diffuse pulmonary disease, in which the diagnosis was made by cytological examination of bronchoalveolar lavage. Bronchoalveolar lavage can, thus, differentiate between diffuse lung tumours and interstitial pulmonary diseases

On a case of "Macrodystrophia lipomatosa".

Macrodistrophia Lipomatosa is a congenital malformation of rare finding and unknown pathogenic mechanism. The pathology is mainly characterized by the interest of lower extremities and peculiar macroscopic feature is the presence of hyperthrophic fibro-adipose tissue. In our experience the localization to the upper extremities and the presence of uncommon clinical signs show the importance of instrumental investigation: MRI and CT for an accurate examination and to exclude other types of localized gygantism

Evoluzione dell'abitudine al fumo nei locali dell'Azienda Ospedaliera Universitaria Senese dal 1998 al 2003

Obiettivi: l’ospedale dovrebbe rappresentare un modello per la promozione della salute, tuttavia, nonostante i divieti di legge, l’abitudine di fumare in ospedale è ancora diffusa. Obiettivo dello studio è rilevare l’abitudine al fumo di personale sanitario, pazienti e visitatori, nei locali dell’AOUS. Metodi: alcuni studenti universitari, durante le loro attività curricolari, hanno percorso i locali del policlinico in orari diversi, contando il numero di persone incontrate, operatori sanitari e pazienti/visitatori, e indicando il numero di coloro che stavano fumando, in entrambe le categorie. Questo studio è stato ripetuto negli anni 1998, 1999 e 2003. Risultati: la prevalenza di persone che stavano fumando è risultata del 6,4% nel 1998, del 3,8% nel 1999 e dell’1,1% nel 2003. La prevalenza di operatori sanitari che fumavano rispetto al totale dei fumatori è risultata rispettivamente del 25%, del 26% e del 23,8%. Nei due anni passati, nell’atrio, nel bar e nelle zone antistanti i reparti c’era una maggiore presenza di persone che fumavano; mentre nell’ultima indagine sono stati riscontrati più fumatori, oltre che nell’atrio, nei corridoi del piano didattico, zona non indagata in precedenza. Nell’ultima rilevazione, non sono stati individuati fumatori nei due bar del policlinico; mentre sono sempre stati rilevati, in numero esiguo, operatori sanitari che fumano all’interno delle corsie di degenza. Conclusioni: la diminuzione costante del numero di fumatori in ospedale, mostra come ci sia stato negli ultimi anni un rispetto sempre maggiore del divieto di fumo nei luoghi di cura. Il coinvolgimento di futuri medici permette di promuovere il problema fumo in ospedale

[Asthma attacks at school in Italian adolescents]

We evaluated the occurrence of asthma attacks at school in a sample of 13,266 adolescents (13-14 year old) from 12 centers across Italy (SIDRIA-2 study). 23.8% of asthmatic subjects reported at least one wheezing attack at school in the previous 12 months. The attacks occurred in the gymnasium (55.4%), in the classroom (42.6%), outside (28.7%), in the bathroom (4.5%) and in other school environments (4%). During the attacks, self-administration of a bronchodilator was reported by 66% of the subjects. Educational programs and specific guidelines to deal with asthmatic schoolchildren are warranted

Organizational appropriateness of recoveries: results of the evaluation of recoveries by AEP/PRUO at the Careggi Hospital in Florence in 1995-1998

The organizational appropriateness of hospital stays is an expression of a hospital's efficiency and aim of the management control. The AEP (American Version)/PRUO (Italian Version) protocol is specific for measuring the organizational appropriateness of hospital stays. The aim of this study is the comparative analysis of the organizational appropriateness of hospital stays in Careggi Hospital of Florence and in all hospital Departments in 1995 and 1998. In 1998 the AEP/PRUO protocol was applied to 2148 samples of hospital stays out of 38,968 eligible hospitalizations, and in 1995 a sample of 1989 hospital stays out of 35,108. In 1998 2,148 admissions and 15,338 days of hospitalization were tested. In 1995, 1989 admission days and 12,264 days of hospitalization were tested, 63 departments were studied. In 1995 the first edition of the protocol was applied, in 1998 the second. A sample of 218 of the 1998 hospital stays was tested with both editions to evaluate the impact of differences. In 1998, with the second edition of the protocol, the inappropriateness rate of admission days and hospitalization days and the rate of in-patients inappropriate hospital stays was respectively 38.0%, 43.8% and 18.5%. Compared with 1995 results, the rates increased +6.2%, 6% and +7.5% respectively. Instead, with the first edition of the protocol, the rates were 29.7%, 37.6% and 10.7% and, compared with 1995, they were reduced -2.1%, -0.6% and -0.3%. The longitudinal multilevel analysis has allowed the evaluation of the performance of each department

Differences in parental- and self-report of asthma, rhinitis and eczema among Italian adolescents. SIDRIA collaborative group. Studi Italiani sui Disordini Respiratori dell' Infanzia e l'Ambiente.

Epidemiological and clinical information on respiratory and allergic disorders in adolescents has been collected from the adolescents themselves or from their parents, but little is known about the differences between these two sources of information. This study compared the responses to 10 identically worded questions from the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire on asthma, rhinitis and eczema between written self- and parent-completed questionnaires in a large sample of 21,068 adolescent Italians aged 13-14 yrs. The effects of sex, latitude of residence, urbanization, socioeconomic status, previous diagnosis of asthma, family history of allergic diseases and adolescent's smoking habits on the prevalence estimates obtained with the two questionnaires were analysed using multiple logistic regression. Prevalence of self-reported symptoms was significantly higher in self-reported for all questions except for lifetime eczema, which was higher in parental report. Agreement between the two sources of information was poor, although it was slightly better for questions relative to clinical diagnosis of asthma, hay fever or eczema than for related symptoms, and for respiratory with respect to cutaneous disorders. When compared with self-reported, parent-reported was consistently higher in males and was more affected by socioeconomic level and by a diagnosis of asthma or family history of allergic diseases, whereas self-reported was more sensitive to the effect of the adolescent's smoking habits. It is concluded that, in adolescents, parent- and self-reported respiratory and allergic symptoms differ significantly and are differently affected by several constitutional and environmental factors. Obtaining direct information from adolescents may be essential for a correct evaluation of respiratory symptoms