An Integrated Accident & Consequence Analysis Approach for Accidental Releases through Multiple Leak Paths

This paper presents a consequence analysis for a postulated fire accident on a building containing plutonium when the resulting outside release is partly through the ventilation/filtration system and partly through other pathways such as building access doorways. When analyzing an accident scenario involving the release of radioactive powders inside a building, various pathways for the release to the outside environment can exist. This study is presented to guide the analyst on how the multiple building leak path factors (combination of filtered and unfiltered releases) can be evaluated in an integrated manner starting with the source term calculation and proceeding through the receptor consequence determination. The analysis is performed in a two-step process. The first step of the analysis is to calculate the leak path factor, which represents the fraction of respirable radioactive powder that is made airborne that leaves the building through the various pathways. The computer cod e of choice for this determination is MELCOR. The second step is to model the transport and dispersion of powder material released to the atmosphere and to estimate the resulting dose that is received by the downwind receptors of interest. The MACCS computer code is chosen for this part of the analysis. This work can be used as model for performing analyses for systems similar in nature where releases can propagate to the outside environment via filtered and unfiltered pathways. The methodology provides guidance to analysts outlining the essential steps needed to perform a sound and defensible consequence analysis

The influence of social support on the wellbeing of immigrants residing in Italy: Sources and functions as predictive factors for life satisfaction levels, sense of community and resilience

Moving from one country to another involves not only separation from the country of origin, but also the tiring process of integration into a new physical, institutional, and sociocultural context, which may expose migrants to acculturation stress. The loss of former support networks, or at the very least their transformation, presents immigrants with the need to rebuild their social support systems in the host country, involving an active search for support. Therefore, the aim of study is to analyze the structure of informal social support and its capacity to predict immigrants’ sense of community, resilience, and satisfaction with life. The results confirm that social support predicts satisfaction with life, sense of community, and resilience. Our findings highlight the way sources and frequency of support, and the satisfaction with which they are associated, have different degrees of predictive value on the dependent variables under investigation. In this study, it can be concluded that social support is an important factor in the well-being of migrants and their integration into the host community. The results have an important practical value in promoting interventions that improve immigrants’ support networks and, consequently, increase their satisfaction with life, sense of community, and resilience

Evidence that muscle cells do not express the histidine-rich glycoprotein associated with AMP deaminase but can internalise the plasma protein

Histidine-rich glycoprotein (HRG) is synthesized by liver and is present at relatively high concentration in the plasma of vertebrates. We have previously described the association of a HRG-like molecule to purified rabbit skeletal muscle AMP deaminase (AMPD). We also provided the first evidence for the presence of a HRG-like protein in human skeletal muscle where a positive correlation between HRG content and total determined AMPD activity has been shown. In the present paper we investigate the origin of skeletal muscle HRG. The screening of a human skeletal muscle cDNA expression library using an anti-HRG antibody failed to reveal any positive clone. The RT-PCR analysis, performed on human skeletal muscle RNA as well as on RNA from the rhabdomyosarcoma (RD) cell line, failed to show any mRNA specific for the plasma HRG or for the putative muscle variant. When the RD cells were incubated with human plasma HRG, a time-dependent increase of the HRG immunoreactivity was detected both at the plasma membrane level and intracellularly. The internalisation of HRG was inhibited by the addition of heparin. The above data strongly suggest that skeletal muscle cells do not synthesize the muscle variant of HRG but instead can actively internalise it from plasma

Visualization, navigation, augmentation. The ever-changing perspective of the neurosurgeon

Introduction: The evolution of neurosurgery coincides with the evolution of visualization and navigation. Augmented reality technologies, with their ability to bring digital information into the real environment, have the potential to provide a new, revolutionary perspective to the neurosurgeon. Research question: To provide an overview on the historical and technical aspects of visualization and navigation in neurosurgery, and to provide a systematic review on augmented reality (AR) applications in neurosurgery. Material and methods: We provided an overview on the main historical milestones and technical features of visualization and navigation tools in neurosurgery. We systematically searched PubMed and Scopus databases for AR applications in neurosurgery and specifically discussed their relationship with current visualization and navigation systems, as well as main limitations. Results: The evolution of visualization in neurosurgery is embodied by four magnification systems: surgical loupes, endoscope, surgical microscope and more recently the exoscope, each presenting independent features in terms of magnification capabilities, eye-hand coordination and the possibility to implement additional functions. In regard to navigation, two independent systems have been developed: the frame-based and the frame-less systems. The most frequent application setting for AR is brain surgery (71.6%), specifically neuro-oncology (36.2%) and microscope-based (29.2%), even though in the majority of cases AR applications presented their own visualization supports (66%). Discussion and conclusions: The evolution of visualization and navigation in neurosurgery allowed for the development of more precise instruments; the development and clinical validation of AR applications, have the potential to be the next breakthrough, making surgeries safer, as well as improving surgical experience and reducing costs

The progression of hemophilic arthropathy: The role of biomarkers

Background: Hemophilia A and B are X-linked congenital bleeding disorders characterized by recurrent hemarthroses leading to specific changes in the synovium and cartilage, which finally result in the destruction of the joint: this process is called hemophilic arthropathy (HA). This review highlights the most prominent molecular biomarkers found in the literature to discuss their potential use in the clinical practice to monitor bleeding, to assess the progression of the HA and the effectiveness of treatments. Methods: A review of the literature was performed on PubMed and Embase, from 3 to 7 August 2020. Study selection and data extraction were achieved independently by two authors and the following inclusion criteria were determined a priori: English language, available full text and articles published in peer-reviewed journal. In addition, further articles were identified by checking the bibliography of relevant articles and searching for the studies cited in all the articles examined. Results: Eligible studies obtained at the end of the search and screen process were seventy-three (73). Conclusions: Despite the surge of interest in the clinical use of biomarkers, current literature underlines the lack of their standardization and their potential use in the clinical practice preserving the role of physical examination and imaging in early diagnosis

Patients with Musculoskeletal Disorders Presenting to the Emergency Department: The COVID-19 Lesson

Background: Musculoskeletal disorders (MSKDs) are the most common class of complaints among patients presenting for care in the Emergency Department (ED). There is a non-urgent patient population with musculoskeletal complaints attending ED services that creates a burgeoning waiting list and contributes to overcrowding in Emergency Departments (EDs), which is a major concern worldwide. The recent (Coronavirus disease-19) COVID-19 pandemic is an unprecedented challenge that is revealing the structural and situational strengths and weaknesses of healthcare systems. Methods: This study retrospectively and prospectively assessed patients presenting to the Emergency Department before and after the COVID-19 outbreak (from 21 February 2019 to 3 May 2019 and from 21 February 2020 to 3 May 2020) with non-traumatic or low-severity musculoskeletal conditions to test the hypothesis that these patients should have access to care outside the ED and that the COVID-19 outbreak has changed patients’ care and health perception. Results: A total of 613 patients were identified, and 542 of them (87.56%) participated in a personalized survey. From this number, 81.73% of the total accesses took place in 2019, and only 18.27% of the accesses took place during the first outbreak and lockdown. More than 90% of patients admitted to the ED accessed care during the day shift in both periods. A total of 87.30% of patients presenting to the ED with a MSKD followed their general practitioner’s (GP) advice/referral in 2019, and 73.87% did so in 2020. The differences in the means of transport to the ED was statistically significant (p-value 0.002). Conclusions: The outbreak and lockdown period confirmed that there is an inappropriate use of the ED related to patients with MSKD. However, the ED appears to be the only available solution for these patients. New services and pathways are therefore needed to enhance MSKD management and reduce ED crowding. Additional observational studies shall be developed to confirm and compare our findings with those of various EDs. The main limit of the inferential part of the study is probably due to the small sample of patients in 2020

Unusual presentation of a solitary plasmocytoma of the jaw: a case report

Introduction. Plasma cell malignancies include two localized forms (e.g. Solitary Plasmocytoma of the Bone-SPB- and Extramedullary Plasmocytoma-EMP) and one more severe disseminated form (e.g. Multiple Myeloma-MM). SPB usually affected male during 6th decades, it occurs as a single uni- or multilocular osteolytic lesion, histopathological- ly characterized by an abnormal proliferation of plasma cell. In some patients SPB may progress to MM, character-ized by multiple osteolytic lesion in several bones, presence of abnormal plasma cells in the bone marrow biopsy, detection of amyloid deposit and abnormalities of immunoglobulin production. In both clinical forms, the maxillofacial area is rarely involved, the higher risk sites are the marrow-rich areas (ramus, angle and retromolar trigon of the mandible). Case presentation. A male patient of 60 years, anamnestically reporting diabetes and hypertensions, was observed at the Sector of Oral Medicine for the presence of pain and paraesthesia localized in right emimandibular area arisen from about 2 months after the extraction of 4.7 and 4.6. The patient denied previous therapy with bisphosphonates and/or angiogenesis inhibitory drugs. Clinical examination showed an area of osseous exposition in the site of right emimandibula. Rx exams (OPT and TC) showed a radiolucent unilocular area of osteolysis in the same region (2.1 x 1.2 x 1.8 cm) with infiltration of mandibular canal. Patients showed both local (e.g. pain, swelling, paraesthesia, infec- tion) and systemic symptoms/signs (abnormal protein electrophoresis, anaemia, thrombocytopenia, ESV/ PCR in- crease, weight loss and renal failure). Histopathological examination of the biopsy confirmed the diagnosis of SPB, complicated by bone exposition and bacterial superinfection after teeth extraction. The patient has bee referred to a haematologist for stadiation and therapy. Conclusions. Differential diagnosis of apparent spontaneous osteonecrosis of the jaw should be include haemato- logical disorders, such as SPB and MM

Cognitive disabilities and bioethical implications in down syndrome

Down syndrome is a genetic syndrome related to trisomy 21, and characterized by intellectual and adaptive deficiencies, facial deformities, cardiopathiacenitis and hypotonia that determine a specific cognitive behavioral phenotype. The behavioral and psychiatric cognitive phenotype and its evolutionary profile impose bioethical considerations in the down to promote better and personalized clinical and relief, diagnostic and therapeutic strategies to favor an adequate insertion of the down in the scholastic and work environment

The classification of isotrivially fibred surfaces with p_g=q=2

An isotrivially fibred surface is a smooth projective surface endowed with a morphism onto a curve such that all the smooth fibres are isomorphic to each other. The first goal of this paper is to classify the isotrivially fibred surfaces with $p_g=q=2$ completing and extending a result of Zucconi. As an important byproduct, we provide new examples of minimal surfaces of general type with $p_g=q=2$ and $K^2=4,5$ and a first example with $K^2=6$.Comment: Main paper by M.Penegini. Appendix by S.Rollenske. 31 pages, 6 Figures. v2 changed group relations in Theorem 5.2, changes in Theorem 5.7, new proof of Theorem 4.15, minor corrections of misprint