Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT.

Despite advances in patient and graft management, biliary complications (BC) still represent a challenge both in the early and delayed period after orthotopic liver transplantation (OLT). Because of unspecific clinical presentation, imaging is often mandatory in order to diagnose BC. Among imaging modalities, magnetic resonance cholangiography (MRC) has gained widespread acceptance as a tool to represent the reconstructed biliary tree noninvasively, using both the conventional technique (based on heavily T2-weighted sequences) and contrast-enhanced MRC (based on the acquisition of T1-weighted sequences after the administration of hepatobiliary contrast agents). On this basis, MRC is generally indicated to: (1) avoid unnecessary procedures of direct cholangiography in patients with a negative examination and/or identify alternative complications; and (2) provide a road map for interventional procedures or surgery. As illustrated in the review, MRC is accurate in the diagnosis of different types of biliary complications, including anastomotic strictures, non-anastomotic strictures, leakage and stones

Variation of genetic and behavioural traits in the sandhopper Talitrus saltator (Crustacea Amphipoda) along a dynamic sand beach

In an attempt to unravel the possible relationships among coastal stability, genetic variability and orientation behaviour in the sandhopper Talitrus saltator, we have screened four subpopulations of this species. Sandhoppers along 3 km of a dynamic sand beach were studied for orientation performance (i.e. adherence to the seaward theoretical escape direction (TED)) and sequence variation for a fragment of the mitochondrial (mt) gene encoding for the cytochrome oxidase Subunit I (COI). The sampling sites differed in the stability of the shoreline (from severely eroded to accreting). Analysis of molecular variance (AMOVA) revealed significant subdivisions among the four locations. The subpopulation sampled at the most eroded point showed no haplotype diversity and had the highest scatter in orientation. Genetic diversity increased with decreasing erosion. Orientation performances were best where the beach is in dynamic equilibrium, and were progressively more scattered at the accreting points. Multiple linear regression analyses demonstrated that the variables and factors that affected orientation significantly were daytime, global solar radiation, sex of individuals and haplotype diversity. Environmental factors are likely to influence sandhopper behaviour on a short and medium time scale (i.e. from single individual life span to a few generations). The data also suggest that temporal stability of the shoreline has a positive effect on the genetic variability of the resident sandhopper populations

Volcanic hazard assessment at the Campi Flegrei caldera

Previous and new results from probabilistic approaches based on available volcanological data from real eruptions of Campi Flegrei, are assembled in a comprehensive assessment of volcanic hazards at the Campi Flegrei caldera, in order to compare the volcanic hazards related to the different types of events. Hazard maps based on a very wide set of numerical simulations, produced using field and laboratory data as input parameters relative to the whole range of fallout and pyroclastic-flow events and their relative occurrence, are presented. The results allow us to quantitatively evaluate and compare the hazard related to pyroclastic fallout and density currents (PDCs) in the Campi Flegrei area and its surroundings, including the city of Naples. Due to the dominant wind directions, the hazard from fallout mostly affects the area east of the caldera, and the caldera itself, with the level of probability and expected thickness decreasing with distance from the caldera and outside the eastern sectors. The hazard from PDCs decrease roughly radially with distance from the caldera centre and is strongly controlled by the topographic relief, which produces an effective barrier to propagation of PDCs to the east and northeast, areas which include metropolitan Naples. The main result is that the metropolitan area of Naples would be directly exposed to both fallout and PDCs. Moreover, the level of probability for critical tephra accumulation by fallout is relatively high, even for moderate-scale events, while, due to the presence of topographic barriers, the hazard from PDCs is only moderate and mostly associated with the largest events

A Fuzzy Inference System for the Assessment of Indoor Air Quality in an Operating Room to Prevent Surgical Site Infection

Indoor air quality in hospital operating rooms is of great concern for the prevention of surgical site infections (SSI). A wide range of relevant medical and engineering literature has shown that the reduction in air contamination can be achieved by introducing a more efficient set of controls of HVAC systems and exploiting alarms and monitoring systems that allow having a clear report of the internal air status level. In this paper, an operating room air quality monitoring system based on a fuzzy decision support system has been proposed in order to help hospital staff responsible to guarantee a safe environment. The goal of the work is to reduce the airborne contamination in order to optimize the surgical environment, thus preventing the occurrence of SSI and reducing the related mortality rate. The advantage of FIS is that the evaluation of the air quality is based on easy-to-find input data established on the best combination of parameters and level of alert. Compared to other literature works, the proposed approach based on the FIS has been designed to take into account also the movement of clinicians in the operating room in order to monitor unauthorized paths. The test of the proposed strategy has been executed by exploiting data collected by ad-hoc sensors placed inside a real operating block during the experimental activities of the “Bacterial Infections Post Surgery” Project (BIPS). Results show that the system is capable to return risk values with extreme precision

Management of the Diabetic Patient in the Diagnostic Care Pathway

Diabetes is a complex pathology both for the affected patients and for the medical specialists who follow them. Furthermore, since diabetes is a pathology with a high prevalence and incidence, it is essential to intervene effectively in therapeutic actions through the application of common guidelines. Therefore, in order to improve the management of the diabetic patient, the aim of the work is to define a Diagnostic Therapeutic Assistance Pathway (PDTA). A questionnaire-based approach is adopted for data collection from 136 patients at the Clinical Dermatology Unit of the University Hospital “Federico II”. In most cases (64%) the diagnosis was made by the General Practitioner, 15% of patients obtained the diagnosis at the ASL and 12% at the Polyclinic of Naples AOU “Federico II” and the remaining part from the diabetologist specialist. The second access is generally carried out at the “Federico II” AOU (66%), followed by the ASL (17%), by a doctor specialized in diabetology (12%) while no patient has turned to the General Practitioner for the treatment of diabetes. The final visit is carried out at the “Federico II” AOU in almost cases. The data obtained follow the Italian guidelines: the patients get the diagnosis from the Family Doctor and then they are addressed either to ASL or to diabetologists specialists. For the subsequent visits, most of them prefer to turn to the “Federico II” AOU, especially when they have complications associated with the diseases as they are followed in a more careful and satisfying manner

Low mass T Tauri and young brown dwarf candidates in the Chamaeleon II dark cloud found by DENIS

We define a sample designed to select low-mass T Tauri stars and young brown dwarfs using DENIS data in the Chamaeleon II molecular cloud. We use a star count method to construct an extinction map of the Chamaeleon II cloud. We select our low-mass T Tauri star and young brown dwarf candidates by their strong infrared colour excess in the I-J/J-K_s colour-colour dereddened diagram. We retain only objects with colours I-J>2, and spatially distributed in groups around the cloud cores. This provides a sample of 70 stars of which 4 are previously known T Tauri stars. We have carefully checked the reliability of all these objects by visual inspection on the DENIS images. Thanks to the association of the optical I-band to the infra-red J and K_s bands in DENIS, we can apply this selection method to all star formation regions observed in the southern hemisphere. We also identify six DENIS sources with X-ray sources detected by ROSAT. Assuming that they are reliable low-mass candidates and using the evolutionary models for low-mass stars, we estimate the age of these sources between 1 Myr and < 10 Myr.Comment: 7 Pages, including 3 PostScript figures. Accepted for publication in Astronomy & Astrophysic

Application of Vis/Nir spectroscopy to establish peach ripening as affected by rootstock

The objective of this paper was to monitor peach ripeness of “Chimarrita” and “Maciel” cultivars, grafted on different rootstocks, using the pulp firmness parameter, as an indicator of harvest time through equipment based on Vis/Nir spectroscopy. The orchard was installed in 2005, has a "V" conduction system with spacing of 5.0 x 1.5 m, and the cultivars are grafted on seven rootstocks: “Capdeboscq”, “Flordaguard”, “Nemaguard”, “Okinawa”, “Tsukuba”, “Umezeiro” and “Viamão”. After harvesting, the fruits were evaluated by the NIR CASE spectrophotometer, establishing categories of pulp firmness, between 40N and 60N for fruits consumed in a long term and <40N for immediate consumption. The analyzed rootstocks alter the peach ripeness of the “Chimarrita” and “Maciel” cultivars. The “Umezeiro” rootstock anticipates harvest for the “Chimarrita” cultivar. The “Nemaguard”/ “Maciel” combination provides fruits with a superior harvest period than the other ones evaluated. The Vis/Nir Spectroscopy is a useful tool to monitor the harvest of “Chimarrita” and “Maciel” cultivars

Product Differentiation Costs and Global Competition

The growing competitive intensity on the markets determines the emergence of competition costs that are expressed at a corporate level and have implicit repercussions for the supply system. This type of costs makes it possible to identify a close link between competition costs and supply differentiation costs. Classification by competitive intensity presupposes that the analysis performed identifies the classification of company costs as the discriminating element, in terms of the competitive pressure of the context in which the firm operates. The emergence of competition costs is linked to an attempt to squeeze them as an aspect of vertical, or more specifically, horizontal cooperation strategies.Product Differentiation; Differentiation Costs; Over-Supply; Global Competition; Marketing; Market-Driven Management; Global Corporations; Global Markets DOI:http://dx.doi.org/10.4468/2005.1.06garbelli