Requirements for acquiring a high-quality house dust mite extract for allergen immunotherapy

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A survey on features of allergic rhinitis in children

Objective: A number of epidemiologic studies evaluated the prevalence of allergic rhinitis (AR), but few data are available on its different clinical presentations. We addressed this survey to assess the features of AR in children and adolescents. Methods: Thirty-five centers in Italy included 2623 pediatric patients with rhinitis, of whom 2319 suffered from AR, while 304 had other kinds of rhinitis. For each patient a standardized questionnaire was filled in, including ARIA classification, the duration of symptoms, the allergen identified as clinically relevant, the co-morbidities, the kind of treatment, the response to treatment, the satisfaction with the treatment, and the feasibility of allergen immunotherapy (AIT). Results: Of the 2319 patients, 597 (25.7%) had mild intermittent, 701 (30.2%) mild persistent, 174 (7.5%) moderate-severe intermittent, and 773 (33.3%) moderate-severe persistent AR. The allergens most relevant were grass pollen and dust mites. The most frequently used drugs were oral antihistamines (83.1%) and topical corticosteroids (63.5%). The response to treatment was judged as excellent in 13.5%, good in 45.1%, fair in 30.8%, poor in 10%, and very bad in 0.6% of cases. The satisfaction with treatment was judged as very satisfactory in 15.2%, satisfactory in 61.8%, unsatisfactory in 22.4%, and very unsatisfactory in 0.5% of cases. AIT was considered indicated in 53.1% of patients with mild intermittent, 79.2% of moderate-severe intermittent, 72.6% of mild persistent, and 82.7% of moderate-severe persistent AR. Conclusions: The limitation of this study is that the population was not unselected and this prevents epidemiological significance. These results offer confirmation of the adequacy of ARIA guidelines in classifying patients with AR and of the association of severe phenotype with lack of success of drug treatment. \ua9 2013 Informa UK Ltd All rights reserved

Flow-dynamics assessment of mitral-valve regurgitation by vector flow mapping

Background. Heart valve diseases and, in particular, mitral regurgitation are a group of pathologies that in the last two decades have undergone profound changes in terms of epidemiology, diagnosis, prognosis, and therapy. Echocardiography has progressively gained importance, enabling to obtain an early recognition of these pathologies, to provide a more accurate selection of patients, and to identify the optimal treatment timing. In this subset, researchers focused on the study and characterization of parameters that could provide information on the severity of mitral insufficiency and left ventricle function. In the first group of parameters, we include: 1) qualitative parameters, as valve morphology, regurgitation jet color Doppler signal, and regurgitation jet continuous wave (CW) doppler signal; 2) semi-quantitative parameters, as vena contracta and inflow and upstream venous flow; 3) quantitative parameters, as EROA, RVol, and heart chambers dilatation. The second group includes the left ventricle ejection fraction (LVEF) and the left ventricle stroke volume (SV). Although these parameters are widely used, new ones emerged in recent years, to achieve a comprehensive understanding of the pathology and its possible therapeutic implications. Among these, speckle-tracking echocardiography with Strain and Strain rate calculation gained particular importance. Another important derived parameter is the coupling that describes the relationship between cardiac function and the arterial system, expressing ventricular performance. Finally, vector flow mapping (VFM) has been also used to assess the left ventricle. Purpose of study. Analyze and describe the key role of the mitral valve on the generation of physiologic flow dynamics in control patients and basics aspects of vortex behavior in the left ventricle. Examine 1) how mitral regurgitation determines inefficient non-physiological flow within the left ventricle, resulting in abnormal vortex formation and energy loss (EL), 2) how its treatment can influence the distribution of flow inside the left ventricle, 3) how this could have a potential clinical impact. Materials and methods. From the Cardio-Thoracic Department of Pisa, two populations of patients, one represented by patients with mitral regurgitation (n:30) and one control (n:20), were recruited. They were evaluated, using Vector Flow mapping, in terms of 1) vortices patterns in early diastole, late diastole, and systole, 2) number of vortices in early diastole, mid diastole, and late diastole, 3) energy loss, calculated in a complete cycle, in isolated systole, in isolated diastole, and as a percentage ratio between diastolic data and the total. To visualize the interventricular flow were used vectors and flow streamlines. From the MR population, 18 patients undergoing the main treatment options (repair and replacement) were selected, and their flow dynamics were analyzed, and energy loss was calculated. Results. In the formation of the LV vortex, a primary role is played by the physiological eccentric position of the valve and by the difference between the anterior longer leaflet and the posterior shorter leaflet of the mitral valve, which leads to a pair of counter-rotating vortices. Normally, the anterior vortex rotates clockwise, and the posterior vortex rotates counterclockwise. In patients with Mitral Regurgitation, different patterns of interventricular flow were visualized. Those patterns are associated with an increase of EL, from 112 (91-158) J/(m3 ∙ s), in control patients, to 230 (165-299) J/(m3 ∙ s) in patients with mitral regurgitation (p-value <0.0001). Especially, Diastolic EL (p-value <0.0001) and Diastolic/total % (p-value = 0.007), presented a statistically significant increase in MR population. There is also a substantial difference, in terms of interventricular flows, between mitral valve repair and replacement: Mitral Valve repair tends not to alter the direction of the vortex and does not increase EL, in contrast, Mitral Valve replacement alters the direction of the intraventricular vortex and increases EL. In addition, there are important differences between the two types of treatment: the use of tri-leaflets bioprosthetic valves seem to cause multiple separated vortexes in the LV chamber, while the mechanical valve replacement (in anatomical position) would lead to a single large vortex. In contrast to these, Tendyne replacement appears to have the potential to generate physiological vortex patterns. These results were also confirmed by EL calculations, which show that flows other than physiological flows lead to increased energy expenditure. This is a preliminary study realized on a small population. Therefore, larger cohorts will be needed in the future to verify changes in EL and vortices and analyze differences in different treatment options. Conclusions. VFM is an important tool for studying the dynamics of interventricular flows and related parameters (EL, vortex, WSS), under physiological, pathological, and therapeutic conditions

Leveraging the Grid for the Autonomic Management of Complex Infrastructures

Autonomic Management of complex IT infrastructures requires multiple different types of analysis to be performed on large data sets in order to promptly detect anomalies and attacks and take appropriate actions. The requirements in terms of computing power can be so high that new solutions must be devised in order to reduce reaction times. This paper describes how Grid technologies can be leveraged in the Autonomic Management of complex IT infrastructures, such as complex networks with tens of border firewalls. In particular, we show how an Autonomic Manager can benefit from the large computing power and storage space made available by the Grid. We designed the architecture of an Autonomic Manager which makes use of Grid resources to collect and store data and to perform analysis. We then implemented the core part of the system (LoGrid), which collects data in CBE standard format, processes them using Grid resources and feeds back the results in CBE format to the Autonomic Manager. We tested our implementation in a reference scenario and found that the use of the Grid for the Autonomic Management of complex IT infrastructure is feasible and convenient

Aquaponics: challenges and opportunities for commercial application

Aquaculture is the production, under controlled conditions, of freshwater or saltwater aquatic organisms for human consumption and non-food use. Worldwide aquaculture has increased remarkably in the last decades and now accounts for approximately half of the total production of aquatic animals. The expansion of aquaculture has several environmental impacts due to the production of feed ingredients, the disposal of aquafarm effluents, disease transmission, and the dispersal of invasive species. Among the aquaculture technologies, land-based recirculating aquaculture systems (RASs) have a much greater impact due to the massive use of energy, water, and other resources. Aquaponics is a system that couples fish production in RAS with soilless plant cultivation. Aquaponic systems can produce both plant and animal food with a much greater use efficiency of land and water and a minor environmental impact compared to conventional food production systems such as in-land aquafarming greenhouse horticulture. In this chapter, along with a brief description of hydroponic technologies and RASs, several issues concerning the application of aquaponics on a commercial scale are discussed, such as the selection of fish and crop species; the development of salt-water aquaponics systems; the system monitoring; the protection of fish and crop; animal health and welfare; economic and environmental sustainability. Finally, the concept of self-sufficient integrated multi-trophic aquaponic system is briefly introduced

The Paganico holes (Lucca plain, Tuscany) produced by indiscriminate water pumping in a fragile hydrogeological context

Paganico is a little village located in the south-eastern portion of the Lucca plain (north-western Tuscany, Italy). Since the sixties, it is interested by a rather unusual phenomenon: the opening of little holes and collapses in the ground surface. At the beginning, such phenomena were sporadic, but since the eighties their frequency and intensity increased. At present, many zones of the Paganico area are interested by holes and collapses. Their size sometimes reaches 2 m in diameter and depth. The opening of the holes mainly occurs at the end of the dry season, during or immediately after the first important and intense rainfall events, which normally characterize, in this area, the end of the summer and the beginning of the autumn. At present, the collapse phenomena are producing many problems to the population and agricultural activity of the area, but their causes are not so clear. For such reasons, this research provides a contribute in order to comprehend the triggering mechanism and evolution of the holes, with relation to the stratigraphic, hydrogeological and geotechnical features of the materials involved. It seems clear that the holes opening is directly linked to the strong pumping through an aquifer with particular hydro-structural conditions, as pointed out by the geological, hydrogeological and geotechnical surveys carried out in this area. The Paganico underground is in fact characterized by three horizons with different lithologic, hydrogeological and geotechnical features: a superficial silt-sandy horizon (1-3 m thick), which is particularly interested by the collapses; an intermediate silt-clayey horizon (1-3 m thick); a lower and thick gravel-pebbly horizon, interested by an important water circulation and heavy pumping. Since the seventies, such water pumping has considerably rose, due to the local demographic (well-field), and, above all, industrial development (paper manufacture). Therefore, this area is characterized by the presence of two water tables: a temporary one, located in the superficial silt-sandy horizon, and a second one, located in the lower gravel-pebbly horizon. Such water tables are separated by the less permeable silt-clayey horizon. The latter probably tends to fracture by desiccation during the dry season, originating water exchange between the two water tables during the first important autumnal rainfall events. The formation of fractures would interest also the superficial horizon. Thus, the water exchange would produce erosive phenomena in the superficial material, with removal of the fine fraction. This process could be at the base of the holes opening

Estimation of soil properties of shallow landslide source areas by dynamic penetration tests: first outcomes from Northern Tuscany (Italy)

In Northern Tuscany (Italy) rapid, shallow landslides often cause casualties and severe damage. Aimed at contributing to the characterisation of the source areas of rapid, shallow landslides, this paper deals with the geotechnical parameterisation of the mainly involved soil by means of dynamic penetration tests. The source areas are usually located in difficult access sites, where boring and undisturbed sampling are very hard and onerous. Therefore, the results of 177 dynamic penetration tests were analysed, including dynamic probing (DP) tests and standard penetration tests (SPT). The results of these tests were related to relative density D r and friction angle Φ′ of the soil by means of empirical equations. The distribution and variability of these parameters were analysed and related to soil type, test type and probing depth. The D r and Φ′ values coming from the DP and SPT tests were found to be comparable. The Φ′ values coming from DP tests and direct shear tests showed an acceptable correlation, confirming the utility of the DP tests. The DP test can thus be an effective tool in the estimation of the properties of potentially unstable soil slope covers

Dip. Informatica e

Autonomic Management of complex IT infrastructures requires multiple different types of analysis to be performed on large data sets in order to promptly detect anomalies and attacks and take appropriate actions. The requirements in terms of computing power can be so high that new solutions must be devised in order to reduce reaction times. This paper describes how Grid technologies can be leveraged in the Autonomic Management of complex IT infrastructures, such as complex networks with tens of border firewalls. In particular, we show how an Autonomic Manager can benefit from the large computing power and storage space made available by the Grid. We designed the architecture of an Autonomic Manager which makes use of Grid resources to collect and store data and to perform analysis. We then implemented the core part of the system (LoGrid), which collects data in CBE standard format, processes them using Grid resources and feeds back the results in CBE format to the Autonomic Manager. We tested our implementation in a reference scenario and found that the use of the Grid for the Autonomic Management of complex IT infrastructure is feasible and convenient

Diatoms in drowning cases in forensic veterinary context: a preliminary study.

In this preliminary study, a digestive method used in forensic context to extract diatoms has been applied in organs taken from ten wildlife animals belonging three species of mammals (a deer, a roe and five otters) and one species of birds (two magpies). Only four carcasses were recovered from aquatic environments (bath trough for animals, bathtub irrigation, river) and only in three cases out of ten that the cause of death was ruled out as drowning. In seven cases, the death was due to other causes: gunshot injuries for one otter, blunt trauma for a magpie, and traumatic injuries followed by motor vehicle collision in other four otters and a roe. Post-mortem examination was performed in all carcasses. The diatom test protocol was performed according to the Italian guidelines for analysis of benthic diatoms for ecological status assessment of inland waters. Five grams of lung, liver, and kidney was taken from all the animal carcasses. In some cases, additional tissue samples were also available among which brain, heart, spleen, and bone marrow. In all four cases found in water, the drowning medium was also available. Hydrogen peroxide (H2O2) digestion was performed, and identification of 21 genera of diatoms was obtained. The method proved to be suitable for the identification of diatoms in the organs of the animals drowned supporting the final diagnosis of drowning. Only in otters, all died for causes other than drowning, diatoms did not prove to be suitable for the diagnosis of drowning since their presence in the internal organs was mainly related to their main diet based on fishmeal. The authors believe that this first trial is very promising, and the results suggest that diatom test can be easily applied in forensic veterinary context

The prevalence of complications in chronic allergic rhinitis

Incidenza della rinite allergica in Italia. Studio multicentric