Evaluation of the use of blast furnace slag as an additive in mortars

Abstract Clinker is the raw material used in the manufacture of cement. However, this material is very harmful to the environment, since it is estimated that for every ton of clinker produced, about 1.0 ton of CO2 is released into the atmosphere. For this reason, alternatives were sought for the use of other materials that are less harmful to the environment. This has led to the use of industrial by-products with the aim of increasing their use and thus reducing the amount of carbon released into the atmosphere. Blast furnace slag is a by-product used in the manufacture of some cementitious products. The aim of this research is to conduct a study on the use of slag as an additive for cement or concrete. The mortar samples were tested according to Brazilian, American and European technical standards. Physical, chemical and compressive strength tests were carried out which confirmed the possibility of using the slag without chemical or thermal activation

AVALIAÇÃO DA INCORPORAÇÃO DE RESÍDUO DE CORTE DE MÁRMORE E GRANITO EM CONCRETO PARA PRODUÇÃO DE PISOS INTERTRAVADOS PARA PAVIMENTAÇÃO

A indústria da construção civil é uma atividade que consome elevado volume de recursos naturais e no cenário atual é imprescindível se preocupar com o desenvolvimento sustentável e encontrar alternativas de reaproveitamento de resíduos sólidos. Nesse contexto, a reinserção do resíduo de corte de mármore e granito (RCMG) na cadeia produtiva é uma alternativa para amenizar um sério problema ambiental, pois o consumo de rochas ornamentais vem crescendo e elevando a quantidade de resíduo produzido. Devido ao grande volume de resíduos de corte de granito produzido e não reutilizado, este artigo técnico avalia a viabilidade técnica da sua utilização como adição em concretos e produção de blocos intertravados com resistência à compressão mínima de 35 MPa e a absorção d'água de 6% no máximo. As matérias primas foram caracterizadas quanto à massa específica, massa unitária, distribuição do tamanho de partículas, materiais pulverulentos e composição química (FRX). Em seguida, os corpos de prova foram moldados de acordo com as prescrições da norma técnica NBR 9781:2013 e foram realizadas análises de desempenho mecânico (resistência à compressão) e absorção d'água. Em suma, a partir dos resultados obtidos no programa experimental, o uso do resíduo de corte de mármore e granito como adição em concretos para produção de pisos de pavimentação é viável tecnicamente para tráfego de pedestres, veículos leves e veículos comerciais de linha

Head and neck radiotherapy amid the COVID‑19 pandemic: practice recommendations of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Abstract Management of patients with head and neck cancers (HNCs) is challenging for the Radiation Oncologist, especially in the COVID-19 era. The Italian Society of Radiotherapy and Clinical Oncology (AIRO) identified the need of practice recommendations on logistic issues, treatment delivery and healthcare personnel’s protection in a time of limited resources. A panel of 15 national experts on HNCs completed a modified Delphi process. A five-point Likert scale was used; the chosen cut-offs for strong agreement and agreement were 75% and 66%, respectively. Items were organized into two sections: (1) general recommendations (10 items) and (2) special recommendations (45 items), detailing a set of procedures to be applied to all specific phases of the Radiation Oncology workflow. The distribution of facilities across the country was as follows: 47% Northern, 33% Central and 20% Southern regions. There was agreement or strong agreement across the majority (93%) of proposed items including treatment strategies, use of personal protection devices, set-up modifications and follow-up re-scheduling. Guaranteeing treatment delivery for HNC patients is well-recognized in Radiation Oncology. Our recommendations provide a flexible tool for management both in the pandemic and post-pandemic phase of the COVID-19 outbreak

Futurismo, cultura e politica

Nell’ambito della mostra “Futurismo e Futurismi”, curata da Palazzo Grassi a Venezia nel 1986, la Fondazione Giovanni Agnelli organizzò a Venezia, il 15 e 16 maggio 1986, il convegno “Futurismo, Cultura e Politica”, volto ad esplorare la dimensione politica e meta-politica del movimento e della cultura futurista, in Italia ed all’estero. Il volume raccoglie i saggi nati dalle relazioni presentate in quella occasione.- Indice #5- Introduzione di Renzo De Felice #9- Parte Prima. Gli aspetti generali del rapporto tra futurismo, cultura e politica #13- Futurismo e culture politiche in Europa: una prospettiva globale, George L. Mosse #15- Il ruolo di Marinetti nella costruzione del futurismo, Luciano De Maria #35- Il futurismo nel dibattito intellettuale italiano dalle origini al 1920, Alberto Asor Rosa #51- Futurismo e sinistra politica, Umberto Carpi #69- Macchine e rarimerletti. Alcune fonti del futurismo nell’ideologia e nella letteratura, Roberto Tessari #81- Parte Seconda. L’esperienza politica del futurismo italiano #105- II futurismo e la politica. Dal nazionalismo modernista al fascismo (1909-1920), Emilio Gentile #107- Futurismo e fascismo, Niccolò Zapponi #163- Settimelli e Carli dal futurismo al fascismo, Paolo Buchignani #179- Bottai: da intellettuale futurista a leader fascista, Giordano Bruno Guerri #223- La politica culturale del fascismo, le avanguardie e il problema del futurismo, Enrico Crispolti #249- Parte Terza. Futurismo, cultura e politica fuori d’Italia #287- Futurismo e culture politiche in Francia, Pasquale A. Jannini #289- Futurismo e rivoluzione conservatrice in Germania, Ferruccio Masini #307- Il futurismo italiano e l’avanguardia ungherese, Gianpiero Cavaglià #323- I contatti politico-culturali tra futuristi italiani e Russia, Cesare G. De Michelis #355- Il secondo futurismo russo: la dimensione politica, Halina Stephan #385- Futurismo, ultraismo e culture politiche nell’area ispanica, Jaime Brihuega #411- Futurismo, vorticismo e “mondomoderno”, William C. Wees #443- Interventi #459- Arti liberali e diritto dell’individuo in F. T. Marinetti, Leonardo Clerici #461- Futurismo e dibattito politico, Emilio R. Papa #483- Spettacolo politico e “18 BL”, Marco Verdone #48

Interpretable surface-based detection of focal cortical dysplasias:a Multi-centre Epilepsy Lesion Detection study

One outstanding challenge for machine learning in diagnostic biomedical imaging is algorithm interpretability. A key application is the identification of subtle epileptogenic focal cortical dysplasias (FCDs) from structural MRI. FCDs are difficult to visualize on structural MRI but are often amenable to surgical resection. We aimed to develop an open-source, interpretable, surface-based machine-learning algorithm to automatically identify FCDs on heterogeneous structural MRI data from epilepsy surgery centres worldwide. The Multi-centre Epilepsy Lesion Detection (MELD) Project collated and harmonized a retrospective MRI cohort of 1015 participants, 618 patients with focal FCD-related epilepsy and 397 controls, from 22 epilepsy centres worldwide. We created a neural network for FCD detection based on 33 surface-based features. The network was trained and cross-validated on 50% of the total cohort and tested on the remaining 50% as well as on 2 independent test sites. Multidimensional feature analysis and integrated gradient saliencies were used to interrogate network performance. Our pipeline outputs individual patient reports, which identify the location of predicted lesions, alongside their imaging features and relative saliency to the classifier. On a restricted 'gold-standard' subcohort of seizure-free patients with FCD type IIB who had T1 and fluid-attenuated inversion recovery MRI data, the MELD FCD surface-based algorithm had a sensitivity of 85%. Across the entire withheld test cohort the sensitivity was 59% and specificity was 54%. After including a border zone around lesions, to account for uncertainty around the borders of manually delineated lesion masks, the sensitivity was 67%. This multicentre, multinational study with open access protocols and code has developed a robust and interpretable machine-learning algorithm for automated detection of focal cortical dysplasias, giving physicians greater confidence in the identification of subtle MRI lesions in individuals with epilepsy

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population