A systematic review of microsurgical reconstruction of the jaws using vascularized fibula flap technique in patients with bisphosphonate-related osteonecrosis

OBJECTIVE: The aim of this systematic review was to assess the role of microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis, and biological complications after an observation period of at least 12 months. Material and methods: An electronic MEDLINE search supplemented by manual searching was conducted to identify studies reporting data of at least 12 months observation on the microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis. RESULTS: Four studies resulted eligible for the analysis yielded. Three out of five studies were free of complications, with a success rate of 100% as no recurrence of osteonecrosis was registered. CONCLUSIONS: Microsurgical reconstruction of the jaws represents a valid treatment modality in patients with bisphosphonate-related osteonecrosis at 3rd stage of the disease

Coronavirus disease 2019: the second wave in Italy

PurposeThis paper describes how Italy addressed the first Coronavirus disease 2019 (COVID-19) wave and analyzes the possible causes of the current second wave.Design/methodology/approachDescriptive analysis of critical points and differences in the containment strategies between the first and the second waves in Italy.FindingsItaly's strict lockdown has been credited with getting the initial major outbreak under control. Furthermore, the way Italy handled the first wave was considered a lesson for other countries. On the contrary, a decentralized and highly bureaucratic political system with low coordination and political conflicts between government, regions and stakeholders led to a relaxation of individual health behaviors, poor and conflicting communication to the general public, poor management of the public transport and the reopening of schools and companies after the summer, that in turn generated the second wave, which is showing signs of becoming worse than the first.Originality/valueThis is a commentary piece

A Modal Choice Model for Evaluating the Impact of Increasing Automation in Container Terminals

The aim of this paper is to define a model for the modal choice between road and rail transport taking into account the increase of rail attractiveness resulting from the increasing of the number of container terminals equipped with automated handling systems. The considered automated handling system is the automated multilevel handling system developed within the RCMS EU project, that is, a multistory storage building, equipped with electric AGVs, remote controlled elevators and remote controlled ceiling cranes. This automated system makes possible to access to a specific container without the necessity of reshuffling and to load/unload containers to/from trucks and trains directly under the storage structure, allowing a significant reduction of the loading/unloading time. In order to define the modal choice model, the systematic utility and the perceived utility are provided and the flows of freight delivered via rail or via road are determined with a binomial Logit model. Moreover, the threshold distance between seaport and inland terminals beyond which automation has a significant impact on modal split is evaluated. As a case study, a European port hinterland network is considered and some scenarios are analyzed, assuming that an increasing number of terminals introduces automation. The paper shows that the introduction of automation in container terminals has significant consequences on modal split. In particular, as the number of automated terminals increases, the rail mode becomes more competitive and the threshold distance between seaport and inland terminals, at which the modal split is equally distributed between road and rail modes, significantly decreases

Proper Respirators Use Is Crucial for Protecting Both Emergency First Aid Responder and Casualty from COVID-19 and Airborne-Transmitted Infections

We read with great interest the paper by Barycka et al. [...

Traffic management system for smart road networks reserved for self-driving cars

A model of a smart road network consisting of unsignalised intersections and smart roads connecting them is considered in this work with the aim of presenting a traffic management system for self-driving cars (or, more generally, autonomous vehicles) which travel the network. The proposed system repeatedly solves a set of mathematical programming problems (each of them relative to a single intersection or to a single road stretch of the network) within a decentralised control scheme in which each local intersection controller and each local road controller communicates with the fully autonomous vehicles in order to receive travel data from vehicles and to provide speed profiles to them once determined the optimal solution of the problem. In order to reduce the computational effort required to provide the optimal solution, a discrete-time approach is adopted so that, in each time interval, a limited number of vehicles are taken into consideration; in this way, solutions can be determined in a very short time thus making the proposed model compatible with a practical application to real traffic systems. The proposed model is general enough, and can be adapted to different scenarios of smart road networks reserved for self-driving cars

Assessing the risks of "infodemics" in response to COVID-19 epidemics

Our society is built on a complex web of interdependencies whose effects become manifest during extraordinary events such as the COVID-19 pandemic, with shocks in one system propagating to the others to an exceptional extent. We analyzed more than 100 millions Twitter messages posted worldwide in 64 languages during the epidemic emergency due to SARS-CoV-2 and classified the reliability of news diffused. We found that waves of unreliable and low-quality information anticipate the epidemic ones, exposing entire countries to irrational social behavior and serious threats for public health. When the epidemics hit the same area, reliable information is quickly inoculated, like antibodies, and the system shifts focus towards certified informational sources. Contrary to mainstream beliefs, we show that human response to falsehood exhibits early-warning signals that might be mitigated with adequate communication strategies.Comment: The dataset analyzed in this paper can be interactively visualized and accessed at https://covid19obs.fbk.eu

Usefulness and safety of double endoscopy in children with gastroesophageal reflux and respiratory symptoms

SummaryBackgroundManagement of children with gastroesophageal reflux disease (GORD) and difficult-to-treat (D-T-T) respiratory symptoms may include double fiberoptic, airway and oesophago-gastro-duodenoscopies (DE). A study was performed to evaluate the usefulness and safety of DE in children with severe GORD and D-T-T respiratory symptoms.MethodsA 3-year retrospective review of records of children who underwent DE under general anaesthesia was performed: the relevant clinical information obtained and the occurrence of complications in the 72h following the DE.ResultsInflammatory changes of the airways were found at bronchoscopy in 40 out of the 60 children: bronchoalveolar lavage (BAL) demonstrated positive lipid-laden alveolar macrophages (LLAM), neutrophilic inflammation or both, respectively in 9, 12 and 16 patients. BAL bacterial cultures were positive in 2 patients with elevated airway neutrophilia. Structural airway abnormalities, explaining not GOR-related D-T-T respiratory symptoms were identified in 11 patients. Oesophagoscopic findings supporting GORD were detected in 32/60 children and confirmed by consistent histological changes in oesophageal mucosal biopsies (OEB) in 27.The frequency of complications, all minor, was low during the procedure and in the following 72h. They included mild desaturation, stridor or bronchospasm, vomiting, dysphagia and hyperthermia requiring antibiotic treatment in 1 patient. No “new onset” complication was observed after 48h following DE. The time-dependent hazard of complications was significantly higher for patients with a history of onset of respiratory symptoms early in life (≤2 years of age) (p=0.038).ConclusionDE can be useful in the clinical evaluation of children with D-T-T respiratory symptoms and GORD and is associated with low frequency of mild complications when performed by appropriately trained and experienced personnel

A comparison of the differences in public risk perception and public health policies between the first and the second wave of COVID-19 pandemic in Italy

The paper presents the information on COVID-19 policy response in Italy inin the second half of 2020, when the second wave of the pandemic occurred. It builds on the authors previous report (1) that addressed the first wave of the COVID-19 pandemic. In Italy, from October till December, the number of SARS-CoV-2 infections increased significantly. However, the Italian government, unlike many other European governments, refrained from introducing a second nationwide lockdown. The pandemic was managed through a system of localized interventions (on a regional and / or provincial basis) which significantly varied across the regions. At the end of December 2020, a national plan for vaccination against COVID-19 was approved. In February 2021, together with the change of government, a new public policy against the COVID-19 pandemic was formulated

On analyzing the vulnerabilities of a railway network with Petri nets

Petri nets are used in this paper to estimate the indirect consequences of accidents in a railway network, which belongs to the class of the so-called transportation Critical Infrastructures (CIs), that is, those assets consisting of systems, resources and/or processes whose total or partial destruction, or even temporarily unavailability, has the effect of significantly weakening the functioning of the system. In the proposed methodology, a timed Petri ne<t represents the railway network and the trains travelling over the rail lines; such a net also includes some places and some stochastically-timed transitions that are used to model the occurrence of unexpected events (accidents, disruptions, and so on) that make some resources of the network (tracks, blocks, crossovers, overhead line, electric power supply, etc.) temporarily unavailable. The overall Petri net is a live and bounded Generalized Stochastic Petri Net (GSPN) that can be analyzed by exploiting the steady-state probabilities of a continuous-time Markov chain (CTMC) that can be derived from the reachability graph of the GSPN. The final target of such an analysis is to determine and rank the levels of criticality of transportation facilities and assess the vulnerability of the whole railway network