A causal statistical family of dissipative divergence type fluids

In this paper we investigate some properties, including causality, of a particular class of relativistic dissipative fluid theories of divergence type. This set is defined as those theories coming from a statistical description of matter, in the sense that the three tensor fields appearing in the theory can be expressed as the three first momenta of a suitable distribution function. In this set of theories the causality condition for the resulting system of hyperbolic partial differential equations is very simple and allow to identify a subclass of manifestly causal theories, which are so for all states outside equilibrium for which the theory preserves this statistical interpretation condition. This subclass includes the usual equilibrium distributions, namely Boltzmann, Bose or Fermi distributions, according to the statistics used, suitably generalized outside equilibrium. Therefore this gives a simple proof that they are causal in a neighborhood of equilibrium. We also find a bigger set of dissipative divergence type theories which are only pseudo-statistical, in the sense that the third rank tensor of the fluid theory has the symmetry and trace properties of a third momentum of an statistical distribution, but the energy-momentum tensor, while having the form of a second momentum distribution, it is so for a different distribution function. This set also contains a subclass (including the one already mentioned) of manifestly causal theories.Comment: LaTex, documentstyle{article

Role of perfusion CT in the evaluation of metastatic nodal tumor response after radiochemotherapy in head and neck cancer: preliminary findings

OBJECTIVE: To assess changes of CT perfusion parameters (ΔPCTp) of cervical lymph node metastases from head and neck cancer (HNC) before and after radiochemotherapy (RT-CT) and their association with nodal tumor persistence. PATIENTS AND METHODS: Eligibility criteria included HNC (Stage III-IV) candidates for RT-CT. Patients underwent perfusion CT (PCT) at baseline 3 weeks and 3 months after RT-CT. Blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability surface (PS) were calculated. PET/CT examination was also performed at baseline and 3 months after treatment for metabolic assessment. RESULTS: Between July 2012 and May 2016, 27 patients were evaluated. Overall, only 3 patients (11%) experienced tumor persistence in the largest metastatic lymph node. A significant reduction of all PCTp values (p<0.0001), except MTT (from 6.3 to 5.7 s; p=0.089), was observed at 3 weeks post-RT-CT compared to baseline. All PCTp values including MTT were significantly lower at 3-month follow-up compared to baseline (p<0.05). Moreover, a statistical significant association was observed between nodal tumor persistence and high BF values (p=0.045) at 3 months after treatment that did not occur for the other parameters. CONCLUSIONS: Our preliminary findings show that all PCTp except MTT are significantly reduced after RT-CT. High BF values at 3 months post-RTCT are predictive of nodal tumor persistence

Clinical Evidence of Type 2 Inflammation in Non-allergic Rhinitis with Eosinophilia Syndrome: a Systematic Review

Purpose of Review: Non-allergic rhinitis (NAR) includes different subtypes, among which NAR with eosinophilia syndrome (NARES) is the most important because of severity of symptoms and the high risk of comorbidities. Its pathophysiology is still object of debate, but a crucial role of chronic eosinophilic inflammation has been recognized. The aim of this review is to critically analyze the current evidence regarding the hypothesis that NARES may be considered a type 2 inflammatory disorder. Recent Findings: The definition and diagnostic criteria for NARES are not universally shared and adopted, thus generating difficulties in reproducing the results. At present, there is extreme heterogeneity in sampling methods and disagreement in the cut-off of local eosinophilic count to determine a diagnosis of NARES. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standard was applied to identify English-language experimental and clinical articles regarding NARES. The search was performed in April 2021. Twenty-six articles were included. Summary: Our data suggest a particular heterogeneity regarding sampling and specific cut-offs adopted for diagnosis of NARES and consensus should be reached. We suggest that eosinophil count should be reported as an absolute value for at least 10 observed rich fields in order to increase the level of standardization. Consensus among authors on this topic should be reached with particular attention to the cut-off for diagnosis. In the future, this limitation may be overcome by the identification of repeatable biomarkers to refine diagnosis and prognosis of NARES. Furthermore, our data strongly suggest that NARES have numerous similarities with clinical features of the most common type 2 diseases such as eosinophilic asthma and chronic rhinosinusitis with nasal polyps (CRSwNP): late onset, association with type 2 comorbidities, selective eosinophilic tissue infiltration, remarkable response to oral and intranasal corticosteroids, and progression in a type 2 CRSwNP

Mepolizumab Improves Outcomes of Chronic Rhinosinusitis with Nasal Polyps in Severe Asthmatic Patients: A Multicentric Real-Life Study

Objective: The upcoming introduction of mepolizumab represents a promising treatment for chronic rhinosinusitis with nasal polyps (CRSwNP). The present study aimed to evaluate the effectiveness of mepolizumab on sinonasal outcomes of comorbid CRSwNP and severe asthma in a real-life setting. The primary endpoint was to evaluate changes in the SinoNasal Outcome Test (SNOT)-22 score, Nasal Polyp (NP) score, and blood eosinophil count during a 12-month treatment with mepolizumab. Secondary endpoints were to quantify mepolizumab's effects on the mentioned parameters, identify clinical variables influencing the degree of response to treatment, and portray responder and nonresponder patients. Methods: A multicentric retrospective no-profit observational study on severe asthmatic patients, treated with mepolizumab, and comorbid CRSwNP was conducted. All patients were followed for at least 12 months. SNOT-22 score, NP score, and blood eosinophil count (and other CRS-specific variables) were collected at baseline and after 12 months. Results: Forty-three patients were included. A statistically significant reduction was observed for SNOT-22 score (mean t0 SNOT-22 54.8 +/- 25.9; mean t12 SNOT-22 31.5 +/- 21.3, p &lt; 0.0001), NP score (median t0 NPS 3 (IQR 3); median t12 NPS 2 (IQR 4), p &lt; 0.0001), and blood eosinophil count (mean t0 blood eosinophils 804.7 +/- 461.5 cell/mu L; mean t12 blood eosinophils 107.5 +/- 104.6 cell/mu L, p &lt; 0.0001) after 12 months of treatment. Twenty patients (47%) gained improvement both in clinical and endoscopic outcome. Mepolizumab responder patients presented a t0 SNOT-22 significantly higher than nonresponders (p = 0.0011). Conclusions: Mepolizumab improved CRSwNP outcomes in a population of severe asthmatic patients. No clinical feature emerged to outline the profile of a "typical" responder patient, except for baseline SNOT-22 score, which seemed to affect the response to treatment. Further studies would be necessary to supplement these preliminary evaluations

Secondary cytomegalovirus infections: How much do we still not know? Comparison of children with symptomatic congenital cytomegalovirus born to mothers with primary and secondary infection

congenital cytomegalovirus (cCMV) infection can follow primary and secondary maternal infection. growing evidence indicate that secondary maternal infections contribute to a much greater proportion of symptomatic cCMV than was previously thought. We performed a monocentric retrospective study of babies with cCMV evaluated from august 2004 to february 2021; we compared data of symptomatic children born to mothers with primary or secondary infection, both at birth and during follow up. among the 145 babies with available data about maternal infection, 53 were classified as having symptomatic cCMV and were included in the study: 40 babies were born to mothers with primary infection and 13 babies were born to mothers with secondary infection. Analyzing data at birth, we found no statistical differences in the rate of clinical findings in the two groups, except for unilateral sensorineural hearing loss (SNHL) which was significantly more frequent in patients born to mother with secondary infection than in those born to mother with primary infection (46.2 vs. 17.5%, P = 0.037). during follow up, we found a higher rate of many sequelae (tetraparesis, epilepsy, motor and speech delay, and unilateral SNHL) in the group of children born to mothers with secondary infection, with a statistical difference for tetraparesis and unilateral SNHL. otherwise, only children born to mothers with primary infection presented bilateral SNHL both at birth and follow up. Our data suggest that the risk of symptomatic cCMV and long-term sequelae is similar in children born to mother with primary and secondary CMV infection; it is important to pay appropriate attention to seropositive mothers in order to prevent reinfection and to detect and possibly treat infected babies

Contouring of emerging organs-at-risk (OARS) of the female pelvis and interobserver variability. A study by the Italian association of radiotherapy and clinical oncology (AIRO)

Purpose: To provide straightforward instructions for daily practice in delineating emerging organs-at-risk (OARs) of the female pelvis and to discuss the interobserver variability in a two-step multicenter study.Methods and materials: A contouring atlas with anatomical boundaries for each emerging OAR was realized by radiation oncologists and radiologists who are experts in pelvic imaging, as per their knowledge and clinical practice. These contours were identified as quality benchmarks for the analysis subsequently carried out. Radiation oncologists not involved in setting the custom-built contouring atlas and interested in the treatment of gynecological cancer were invited to participate in this 2-step trial. In the first step all participants were supplied with a selected clinical case of locally advanced cervical cancer and had to identify emerging OARs (Levator ani muscle; Puborectalis muscle; Internal anal sphincter; External anal sphincter; Bladder base and trigone; Bladder neck; Iliac Bone Marrow; Lower Pelvis Bone Marrow; Lumbosacral Bone Marrow) based on their own personal knowledge of pelvic anatomy and experience. The suggested OARs and the contouring process were then presented at a subsequent webinar meeting with a contouring laboratory. Finally, in the second step, after the webinar meeting, each participant who had joined the study but was not involved in setting the benchmark received the custom-built contouring atlas with anatomical boundaries and was requested to delineate again the OARs using the tool provided. The Dice Similarity Coefficient (DSC) and the Jaccard Similarity Coefficient (JSC) were used to evaluate the spatial overlap accuracy of the different volume delineations and compared with the benchmark; the Hausdorff distance (HD) and the mean distance to agreement (MDA) to explore the distance between contours. All the results were reported as sample mean and standard deviation (SD). Results: Fifteen radiation oncologists from different Institutions joined the study. The participants had a high agreement degree for pelvic bones sub-structures delineation according to DICE (IBM: 0.9 +/- 0.02; LPBM: 0.91 +/- 0.01). A moderate degree according to DICE was showed for ovaries (Right: 0.61 +/- 0.16, Left: 0.72 +/- 0.05), vagina (0.575 +/- 0.13), bladder sub-structures (0.515 +/- 0.08) and EAS (0.605 +/- 0.05), whereas a low degree for the other sub-structures of the anal-rectal sphincter complex (LAM: 0.345 +/- 0.07, PRM: 0.41 +/- 0.10, and IAS: 0.4 +/- 0.07).Conclusion: This study found a moderate to low level of agreement in the delineation of the female pelvis emerging OARs, with a high degree of variability among observers. The development of delineation tools should be encouraged to improve the routine contouring of these OARs and increase the quality and consistency of radiotherapy planning

Il consolidamento degli apparati decorativi mediante dispositivi a memoria di forma: il progetto di ricerca sui dipinti murali di via dell’Abbondanza a Pompei

Il progetto di ricerca, iniziato durante il cantiere di restauro, recentemente concluso, ha riguardato gli interventi di consolidamento, conservazione e restauro su alcune facciate delle antiche botteghe di via dell'Abbondanza (Regio IX, Insulae 7 e 11) nel sito archeolo-gico di Pompei. Questi fronti sono caratterizzati da alcuni dei dipinti murali più importanti e le iscrizioni elettorali. Il progetto denominato “Da Asellina a Verecundus: ricerca, restauro e monitoraggio sulle pitture di alcune celebri botteghe di via dell'Abbondanza a Pompei (Regio IX, Insulae 7 e 11)” nato dalla collaborazione fra la Soprintendenza Ar-cheologica di Pompei, la Facoltà di Architettura Valle Giulia dell’Università di Roma La Sapienza, la Facoltà di Architettura e il Centro DIAPReM dell’Università di Ferrara e la II Facoltà di Ingegneria (sede di Forlì) dell’Università di Bologna, con l’obiettivo della salva-guardia di alcune strutture architettoniche e degli apparati pittorici e decorativi fra i più importanti di tutta la città. L’intervento di restauro, in particolare, ha riguardato alcune botteghe poste sul braccio del decumano massimo compreso fra il Foro e Porta Sarno. Tali facciate, riportate alla luce durante gli scavi condotti nel 1912 da Vittorio Spinazzola, appartengono all’officina coactiliaria (Regio IX, VII, 7-5); ad una casa privata (Regio IX, VII, 3); all’officina infectoria (Regio IX, VII, 2); all’officina coactiliaria (Regio IX, VII,1); al compitum (Regio IX, XI, 1); al thermopolium di Asellina, rivendita di bevande calde (Regio IX, XI, 2). Una sezione del progetto di ricerca ha riguardato la sperimentazione di nuovi dispositivi tecnologici finalizzati al restauro di pitture murali e basati su leghe a memoria di forma (SMA) per risolvere i problemi di consolidamento altrimenti risolto per mezzo di non-reversibile o invadente metodologie. Una delle applicazioni innovative di questi dispositivi riguarda il movimento delle lastre in policarbonato in grado di proteggere le pit-ture murali. Il particolare contesto del progetto di ricerca è collocato sul confine tra l'area scavata e l'area ancora sepolta, così, è stato particolarmente interessante mettere a fuoco le ricerche sul consolidamento delle decorazioni e pitture murali, anche attraverso lo studio delle interventi di Vittorio Spinazzola durante i lavori di scavo, all'inizio del XX secolo

The 2009 L’Aquila (central Italy) MW6.3 earthquake: Main shock

A MW 6.3 earthquake struck on April 6, 2009 the Abruzzi region (central Italy) producing vast damage in the L’Aquila town and surroundings. In this paper we present the location and geometry of the fault system as obtained by the analysis of main shock and aftershocks recorded by permanent and temporary networks. The distribution of aftershocks, 712 selected events with ML 2.3 and 20 with ML 4.0, defines a complex, 40 km long, NW trending extensional structure. The main shock fault segment extends for 15–18 km and dips at 45 to theSW, between 10 and 2 km depth. The extent of aftershocks coincides with the surface trace of the Paganica fault, a poorly known normal fault that, after the event, has been quoted to accommodate the extension of the area.We observe a migration of seismicity to the north on an echelon fault that can rupture in future large earthquakes.PublishedL183083.1. Fisica dei terremotiJCR Journalreserve

Qual è l’effetto della radioterapia sulla funzionalità deglutitoria nei pazienti con tumore del rinofaringe e orofaringe? Risultati a breve termine di uno studio prospettico

In questo lavoro vengono riportati i risultati a breve termine di uno studio prospettico, finalizzato alla valutazione strumentale della funzionalità deglutitoria in pazienti affetti da tumore del rinofaringe e orofaringe sottoposti a trattamento radio o radiochemioterapico con tecnica ad intensità modulata (IMRT). L’ IMRT è stata finalizzata, oltre che al miglioramento della conformazione della dose radiante al volume tumorale, alla riduzione della stessa alle strutture responsabili della deglutizione (SWOARs). I criteri dello studio hanno previsto in tutti i pazienti la valutazione strumentale della deglutizione con Videofluoroscopia (VFS), Fibroscopia Endoscopica della deglutizione (FEES) e Scintigrafia Orofaringea (OPES) prima dell’inizio del trattamento e ad 1 mese dal termine dello stesso. Ogni esame è stato eseguito rispettivamente in seguito all’assunzione di un bolo liquido (L) e semiliquido (SL) e per ognuno sono stati calcolati i seguenti valori strumentali: presenza o meno di caduta pre-deglutitoria, presenza o meno di aspirazione, tempo di transito faringeo (PTT) ed indice di ritenzione ipofaringeo (HPRI). Dal Gennaio 2012 al Giugno 2013, un totale di 20 pazienti ha terminato il trattamento ed ha eseguito la valutazione strumentale a 1 mese dal termine della radioterapia. Il confronto tra i valori dell’HPRI prima e dopo il trattamento radiante ha mostrato un peggioramento significativo sia alla FEES-L (p = 0,021) e SL (p = 0,02) che alla VFS-L (p = 0,008) che SL (p = 0,005). Inoltre è stata riscontrata una significativa correlazione tra i valori dell’HPRI basale ed a 1 mese alla FEES-L e SL (p = 0,005) così come alla VFS-L e SL (p 0,2). Solo in pochi pazienti è stata riscontrata la comparsa di caduta pre-deglutitoria ( 1 paziente con tumore della base linguale alla FEES-L e SL) e la presenza di aspirazione (1 paziente con tumore del rinofaringe alla OPES-L e FEES-SL). Nel complesso i risultati iniziali del nostro studio mostrano che l’ IMRT, finalizzata al risparmio delle SWOARs, determina soltanto un significativo incremento della ritenzione di bolo a livello del distretto ipofaringeo. Un follow-up più lungo sarà necessario per valutare se tale incremento sia associato o meno ad un maggior rischio di sviluppare fenomeni di aspirazione tardivi

Post-supereruption recovery at Toba Caldera

Large calderas, or supervolcanoes, are sites of the most catastrophic and hazardous events on Earth, yet the temporal details of post-supereruption activity, or resurgence, remain largely unknown, limiting our ability to understand how supervolcanoes work and address their hazards. Toba Caldera, Indonesia, caused the greatest volcanic catastrophe of the last 100 kyr, climactically erupting ~74 ka. Since the supereruption, Toba has been in a state of resurgence but its magmatic and uplift history has remained unclear. Here we reveal that new 14 C, zircon U-Th crystallization and (U-Th)/He ages show resurgence commenced at 69.7±4.5 ka and continued until at least ~2.7 ka, progressing westward across the caldera, as reflected by post-caldera effusive lava eruptions and uplifted lake sediment. The major stratovolcano north of Toba, Sinabung, shows strong geochemical kinship with Toba, and zircons from recent eruption products suggest Toba's climactic magma reservoir extends beneath Sinabung and is being tapped during eruptions