A method to compute the non-linear behaviour of piles under horizontal loading

The empirical evidence for vertical piles under horizontal or lateral loading is firstly reviewed. The load–deflection relationship is nonlinear from the early stages of loading, while the load–moment relationship is nearly linear. Moving from the available experimental evidence, typical design issues are addressed and a validation of the widespread Broms’ method is then carried out. To predict the pile–soil interaction, a computer code, NAPHOL, based on a hybrid BEM approach, is fully presented and discussed. A limiting pressure profile, coupled with a cut-off procedure, allows the method to cope with the nonlinear behaviour. Simple guidelines and equations, to calibrate the model parameters, are derived on the basis of the back-analysis of a significant number of case histories. The program is finally used to throw light on the mechanism of the pile–soil interaction under horizontal loading

Monitoring a deep excavation in the historical center of Napoli: Università Station

The completion of the downtown stretch of Line 1 of the Napoli (Italy) underground involved the construction of many stations in the historic centre of the city, including the Università station. The name of the station is derived from the closeness to the historical buildings of the administrative offices of the Università Federico II. This station consists of two shafts excavated with the protection of reinforced concrete diaphragms, and two platform tunnels. The main and deeper shaft reaches the line tunnels excavated with TBMs in the formation of the Neapolitan Yellow Tuff, at a depth of more than 36 m below ground level and more than 33 m below the groundwater table; excavations of the shaft involved loose materials for a depth of 23 m, and the Neapolitan Yellow Tuff formation for the remaining. A secondary and shallower shaft was excavated to realize the mezzanine dedicated to ticket machines and checks. The two platform tunnels, each of them consisting in two separate stretches about 50 m long, were excavated from the main shaft using the Artificial Ground Freezing, AGF, technique to guarantee excavation stability and hydraulic seal. For space reason the paper presents the results of the monitoring carried out along the partial construction process with reference to the deep shafts for a total duration of about four years; the presented data consists of: measurements of pore water pressures inside and outside the excavations; measurements of displacement of retaining structures and ground-anchors forces; measurements of subsidence of surrounding buildings. The overall case history is a very complete one and valuable lessons are learnt on the effectiveness of the construction techniques further than on the design methodologies adopted. Qualitative and quantitative relationships among the various sets of measurements are also outlined, such an aspect representing a valuable feature of the presented case history. Keywords: Deep excavation, Settlement, Horizontal displacement, Artificial Ground Freezin

High thermal conductivity concrete for energy piles

Research is increasingly focusing on thermal properties of concrete with the aim of reducing the heat exchange between buildings and environment. On the other hand, concretes with high thermal conductivity could have interesting applications in the field of thermo-active ground structures as Geothermal Energy Piles (GEPs). This kind of foundations represent an environmentally friendly technology that allows exploiting the heat of the shallow earth surface to supply renewable energy for the air conditioning of buildings. GEPs are needed for structural and geotechnical reasons and allow recovering the installation costs connected to vertical boreholes. Concrete drilled or driven piles are equipped with a Primary Circuit (PC) of high-density polyethylene plastic pipes attached to the reinforcement cages. Thermal energy is extracted from or injected into the ground thought a carrier fluid that flows into the pipes of the PC. To improve the heat exchange between the pile and soil the thermal properties of the concrete should be considered as design parameters. Concrete thermal conductivity, contrary to what happens for the buildings, should be increased to optimise the thermal performance of the GEPs. Different solutions that modify the mix design of concrete are proposed to the aim of increasing the thermal performance of GEPs

Molecular evidence of Plasmodium vivax infection in Duffy negative symptomatic individuals from Dschang, West Cameroon

Background: Plasmodium vivax infection is known to be rare in West/Central Africa, the most accepted explanation being the lack of expression of erythroid Duffy antigen in the local human populations. Duffy negativity prevents the parasite to exploit the entry mechanism on the red blood cell surface. However, there are a growing number of reported vivax infections in Duffy-negative individuals. Data on P. vivax circulation in Cameroon are limited. The aim of the study was to evaluate the P. vivax presence, and its association with the Duffy genotype in West Cameroon. Results: Overall, 484 blood samples were collected consecutively from febrile outpatients attending the Dschang’s Hospital (West Cameroon) during a 3-months period. Plasmodium vivax infection was detected by PCR in 5.6% (n = 27/484) of the cases, representing 38.6% (n = 27/70) of all Plasmodium infections detected. All P. vivax infected individuals showed a Duffy-negative genotype, and the frequency of Duffy-positive individuals in the whole tested population was 1.7%. Conclusions: The results of this study confirm the circulation of P. vivax in Cameroon, as well as that the lack of expression of Duffy-antigen does not confer full protection against vivax malaria acquisition

A Markov-model simulation of IVF programs for PCOS patients indicates that coupling myo-Inositol with rFSH is cost-effective for the Italian Health System

Accumulating evidence suggests that oral supplementation with myo-Inositol (myo-Ins) is able to reduce the amount of gonadotropins and days of controlled ovarian hyperstimulation (COS) necessary to achieve adequate oocyte maturation in assisted reproduction technology (ART) protocols, particularly in women affected by polycystic ovary syndrome (PCOS). We used computational calculations based on simulation modellings. We simulated in vitro fertilization (IVF) procedures-with or without intracytoplasmic sperm injection (ICSI)-with 100,000 virtual patients, accounting for all the stages of the entire IVF procedure. A Monte Carlo technique was used to account for data uncertainty and to generate the outcome distribution at each stage. We considered virtual patients with PCOS undergoing IVF cycles to achieve pregnancy. Computational data were retrieved from clinical experience and published data. We investigated three parameters related to ART protocols: cost of single procedure; efficacy to achieve ongoing pregnancy at 12 gestational weeks; overall cost per single pregnancy. The administration of oral myo-Ins during COH protocols, compared to the standard COH with recombinant Follicle Stimulating Hormone (rFSH) only, may be considered a potential strategy to reduce costs of ART for the Italian Health System

Ketogal: A Derivative Ketorolac Molecule with Minor Ulcerogenic and Renal Toxicity

Ketorolac is a powerful non-steroidal anti-inflammatory drug (NSAID), with a great analgesic activity, present on the Italian market since 1991. Despite the excellent therapeutic activity, the chronic use of ketorolac has long been limited owing to the high incidence of gastrointestinal and kidney side events. In our previous study, we demonstrated that ketorolac–galactose conjugate (ketogal), synthesized and tested in a single-dose study, was able to reduce ulcerogenicity, while preserving the high pharmacological efficacy of its parent drug. In this paper, in order to verify the suitability of this compound, for repeated administration, ex vivo experiments on naïve mice were performed. Mice were treated for 5 or 7 days with the highest doses of two drugs (ketorolac 10 mg/kg and ketogal 16.3 mg/kg), and the expression of both gastric COX-1 and PGsyn was evaluated. Results showed that oral ketorolac treatment significantly reduced both enzymes; surprisingly, oral treatment with ketogal did not produce significant variation in the expression of the two constitutive enzymes. Moreover, histological experiments on stomach and kidneys clearly indicated that repeated administration of ketogal induced lower toxicity than ketorolac. At same time, in vivo results clearly showed that both ketorolac and ketogal had a similar therapeutic activity in a model of inflammation and in pain perception. These effects were accompanied by the reduction of enzyme expression such as COX-2 and iNOS, and by the modulation of levels of nuclear NF-kB and cytosolic IkB-a in the inflamed paws. These very encouraging results demonstrate for the first time that ketogal could represent a valid and novel therapeutic alternative to the ketorolac and might pave the way for clinical studies

Identifying priority areas for spatial management of mixed fisheries using ensemble of multi‐species distribution models

Spatial fisheries management is widely used to reduce overfishing, rebuild stocks, and protect biodiversity. However, the effectiveness and optimization of spatial measures depend on accurately identifying ecologically meaningful areas, which can be difficult in mixed fisheries. To apply a method generally to a range of target species, we devel- oped an ensemble of species distribution models (e-SDM) that combines general ad- ditive models, generalized linear mixed models, random forest, and gradient-boosting machine methods in a training and testing protocol. The e-SDM was used to integrate density indices from two scientific bottom trawl surveys with the geopositional data, relevant oceanographic variables from the three-dimensional physical-biogeochemi- cal operational model, and fishing effort from the vessel monitoring system. The de- termined best distributions for juveniles and adults are used to determine hot spots of aggregation based on single or multiple target species. We applied e-SDM to juvenile and adult stages of 10 marine demersal species representing 60% of the total demer- sal landings in the central areas of the Mediterranean Sea. Using the e-SDM results, hot spots of aggregation and grounds potentially more selective were identified for each species and for the target species group of otter trawl and beam trawl fisheries. The results confirm the ecological appropriateness of existing fishery restriction areas and support the identification of locations for new spatial management measures

Identifying priority areas for spatial management of mixed fisheries using ensemble of multi‐species distribution models

Spatial fisheries management is widely used to reduce overfishing, rebuild stocks, and protect biodiversity. However, the effectiveness and optimization of spatial measures depend on accurately identifying ecologically meaningful areas, which can be difficult in mixed fisheries. To apply a method generally to a range of target species, we developed an ensemble of species distribution models (e-SDM) that combines general additive models, generalized linear mixed models, random forest, and gradient-boosting machine methods in a training and testing protocol. The e-SDM was used to integrate density indices from two scientific bottom trawl surveys with the geopositional data, relevant oceanographic variables from the three-dimensional physical-biogeochemical operational model, and fishing effort from the vessel monitoring system. The determined best distributions for juveniles and adults are used to determine hot spots of aggregation based on single or multiple target species. We applied e-SDM to juvenile and adult stages of 10 marine demersal species representing 60% of the total demersal landings in the central areas of the Mediterranean Sea. Using the e-SDM results, hot spots of aggregation and grounds potentially more selective were identified for each species and for the target species group of otter trawl and beam trawl fisheries. The results confirm the ecological appropriateness of existing fishery restriction areas and support the identification of locations for new spatial management measures

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication