Multiorgan paradoxical embolism consequent to acute pulmonary thromboembolism with patent foramen ovale: a case report

Paradoxical embolism is defined as a systemic arterial embolism requiring the passage of a venous thrombus into the arterial circulatory system through a right-to-left shunt. It is a relatively rare phenomenon, representing about 2% of all cases of arterial embolism. We report a case of a 79-years-old woman admitted to hospital because of dyspnea and lower left limb pain. CT scan revealed multiple thrombi to kidney, lower limb and superior mesenteric artery during acute pulmonary embolism. Echocardiogram documented a patent foramen ovale with a right-to-left shunt. The patient was treated with thrombolytic therapy and heparin with progressive improvement of symptoms and resolution of pulmonary embolism and peripheral thrombosis. Patent foramen ovale closure was not performed because a life-long anticoagulation therapy was necessary, a tunnel-type patent foramen ovale may increases difficulty in realizing device implantation and there are no clear evidence-based guidelines to date addressing treatment in presence of a patent foramen ovale

Validation of the Wiedemann-Franz Law in solid and molten tungsten above 2000 K through thermal conductivity measurements via steady state temperature differential radiometry

We measure the thermal conductivity of solid and molten tungsten using Steady State Temperature Differential Radiometry. We demonstrate that the thermal conductivity can be well described by application of Wiedemann-Franz Law to electrical resistivity data, thus suggesting the validity of Wiedemann-Franz Law to capture the electronic thermal conductivity of metals in their molten phase. We further support this conclusion using ab initio molecular dynamics simulations with a machine-learned potential. Our results show that at these high temperatures, the vibrational contribution to thermal conductivity is negligible compared to the electronic component

Transcranial Doppler as a screening test to exclude intracranial hypertension in brain-injured patients: the IMPRESSIT-2 prospective multicenter international study

Background: Alternative noninvasive methods capable of excluding intracranial hypertension through use of transcranial Doppler (ICPtcd) in situations where invasive methods cannot be used or are not available would be useful during the management of acutely brain-injured patients. The objective of this study was to determine whether ICPtcd can be considered a reliable screening test compared to the reference standard method, invasive ICP monitoring (ICPi), in excluding the presence of intracranial hypertension. Methods: This was a prospective, international, multicenter, unblinded, diagnostic accuracy study comparing the index test (ICPtcd) with a reference standard (ICPi), defined as the best available method for establishing the presence or absence of the condition of interest (i.e., intracranial hypertension). Acute brain-injured patients pertaining to one of four categories: traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH) or ischemic stroke (IS) requiring ICPi monitoring, were enrolled in 16 international intensive care units. ICPi measurements (reference test) were compared to simultaneous ICPtcd measurements (index test) at three different timepoints: before, immediately after and 2 to 3 h following ICPi catheter insertion. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were calculated at three different ICPi thresholds (> 20, > 22 and > 25 mmHg) to assess ICPtcd as a bedside real-practice screening method. A receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was used to evaluate the discriminative accuracy and predictive capability of ICPtcd. Results: Two hundred and sixty-two patients were recruited for final analysis. Intracranial hypertension (> 22 mmHg) occurred in 87 patients (33.2%). The total number of paired comparisons between ICPtcd and ICPi was 687. The NPV was elevated (ICP > 20 mmHg = 91.3%, > 22 mmHg = 95.6%, > 25 mmHg = 98.6%), indicating high discriminant accuracy of ICPtcd in excluding intracranial hypertension. Concordance correlation between ICPtcd and ICPi was 33.3% (95% CI 25.6-40.5%), and Bland-Altman showed a mean bias of -3.3 mmHg. The optimal ICPtcd threshold for ruling out intracranial hypertension was 20.5 mmHg, corresponding to a sensitivity of 70% (95% CI 40.7-92.6%) and a specificity of 72% (95% CI 51.9-94.0%) with an AUC of 76% (95% CI 65.6-85.5%). Conclusions and relevance: ICPtcd has a high NPV in ruling out intracranial hypertension and may be useful to clinicians in situations where invasive methods cannot be used or not available. Trial registration: NCT02322970

Optimal Planning of Door-to-Door Multiple Materials Separated Waste Collection

none3noSeparated collection is an important part of waste management, because it allows material recovery. In order to organize separate collection operations, complex decisions need to be taken on the basis of a large amount of data. In this paper, the problem of planning the door-to-door waste collection of multiple materials for a municipality is considered. A few contributions are available in the literature for this problem. A new mixed integer linear programming model is formalized and solved. A multiobjective optimization model is proposed, aiming at minimizing both operational costs and possible inefficiencies of the recycling logistic system causing negative environmental impacts. The model is applied to a real case study and a mixed integer programming heuristic algorithm is used for its solution. The obtained results are discussed and conclusions are drawn.Anghinolfi, Davide; Paolucci, Massimo; Robba, MichelaAnghinolfi, Davide; Paolucci, Massimo; Robba, Michel

An optimal dynamic decision model for forest biomass exploitation

A decision support system for forest biomass exploitation for energy supply is presented. The system allows supporting decisions on a finite time horizon, concerning the localization, sizing, and setting of a number of biomass-to-energy conversion plants in a small-medium region. The system is based on the formalization of an optimal decision problem stated with reference to a dynamic biomass model. In the proposed approach, geographic information system based techniques are integrated with mathematical programming methods yielding a comprehensive system which allows formalizing the problem, taking decisions, and evaluating their effects. The application to a real case study is considered

Sintering behaviour of Nanograined ThO2 Powder using Spark Plasma Sintering

Thorium dioxide is a refractory ceramic material and is difficult to sinter to high density. Commercial powder starts to sinter in SPS above 1000°C and compaction is not finished at 1600°C. In contrast, a 13 nm nanopowder synthesised via low temperature decomposition of thorium oxalate starts to sinter at ~ 500°C; the onset of sintering shifts to higher temperatures for powders with larger grains. The initial grain size solely affects the onset of sintering, whereas the final stage of sintering is independent of the initial crystallite size for the powders used in this study. Pellets with density well above 95% of the theoretical density were prepared using SPS at sintering temperature of 1600°C with a 10 minute dwell time.JRC.E.4-Nuclear Fuel Safet

Data-Driven Photovoltaic Power Production Nowcasting and Forecasting for Polygeneration Microgrids

In this paper, we deal with the problem of nowcasting and forecasting the photovoltaic power production (PvPP) on the basis of real data available for the Savona Campus and coming from the energy management systems (EMSs) of the smart polygeneration microgrid that feeds buildings in the University area. In this paper, we show how PvPP nowcast and forecast problems can be solved with the state-of-the-art data-driven techniques, which use the historical data collected by the EMS. In particular, we compare the performance of the kernelized regularized least squares, the extreme learning machines, and the random forests. In the machine learning field, these algorithms are the best choice in three different families of techniques: kernel methods, neural networks, and ensemble methods. Results show that our proposal can improve of almost one order of magnitude to the actual prediction system used in the EMS of the Savona Campus, which is based on the knowledge of the physical problem. Finally, by using the EMS installed at the Savona Campus, it has been possible to quantify the saving in costs and CO 2 emissions due to the new nowcasting and forecasting models

Measurement of the Melting Temperature of ZrB₂ as Determined by Laser Heating and Spectrometric Analysis

The melting temperatures of two different ZrB2 ceramics were studied using laser induced melting. ZrB2 having a low Hf content, produced by reaction hot pressing, had a melting temperature of 3546 K and a commercial grade ZrB2 had a melting temperature of 3553 K. Uncertainty of the temperature measurements was 1% of the absolute temperature, or ~35 K for both materials based upon 2-sigma and a 95% confidence interval. While these values were consistent with the previously reported ZrB2 melting temperature of 3518 K, this study was able to measure Tm with less uncertainty than previous studies (± 45 K). Furthermore, this study assessed the effect of Hf content on melting temperature, finding that melting temperature did not change significantly for hafnium contents of 1.75 to 0.01 at%. This study also measured a normal spectral emissivity of 0.34 for ZrB2 at 3000 K. The emissivity decreased to 0.28 at the melting temperature, then, stabilized at 0.30 in a liquid phase

Laser-heating and Radiance Spectrometry for the Study of Nuclear Materials in Conditions Simulating a Nuclear Power Plant Accident

We present experiments in which real nuclear fuel, cladding and containment materials are laser-heated to temperatures beyond 3000 K, while their behavior is studied by radiance spectroscopy and thermal analysis. These experiments simulate on a laboratory scale the typical formation of a lava-phase (corium) following a nuclear reactor core meltdown.JRC.G.I.3-Nuclear Fuel Safet