A Port Accessibility Index for Mediterranean container terminals

Using the Mediterranean as an application case, this study defines a Port Accessibility Index (PAI) useful to measure the accessibility of Mediterranean container ports. Traditionally, accessibility is measured as the quality of maritime links that connect ports together, without considering the port’s characteristics. Differently from previous studies, this paper also focuses on the internal accessibility of the port. In so doing, the PAI will combine the Liner Shipping Connectivity Index with other factors, such as, time at port of container ships, maximum quay depth and number of containers per quay crane (QC) or per yard area. The application considers the 34 main Mediterranean container ports in terms of TEUs handled in the last decade. The results can contribute to highlight and identify the potential elements that could improve the accessibility of Mediterranean container ports, providing decision-makers with a useful wealth of knowledge when carrying out management strategies. Future studies may concern the extension of the research to other geographical areas with the inclusion of additional indicators (e.g., road and/or rail accessibility)

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Gastric Cancer Following Bariatric Surgery: a Review

Background Bariatric procedures can induce a massive weight loss, that lasts more than 15 years after surgery; in addition they achieve important metabolic effects including diabetes resolution in the majority of morbidly obese patients. However some bariatric interventions may cause gastroesophageal reflux disease and other serious complications. The aim of our study is to evaluate the risk of cancer after bariatric surgery. Methods We performed a review of literature about the cases of gastric cancer arising after any bariatric procedure, including a case of adenocarcinoma incidentally discovered by the authors six months after Laparoscopic Adjustable Gastric Banding. Results Globally 17 case reports describing 18 patients were retrieved, including the case of the authors. The diagnosis of tumor was at mean of 8,6 years after bariatric surgery, respectively 9,3 after RYGB and 8,1 after restrictive procedures. The adenocarcinoma represented most cases (15 patients - 83%). In the patients with RYGB the adenocarcinoma was localized in the excluded stomach in 5 (83%) and in the pouch in 1 (17%). After a restrictive procedure the cancer was localized in the pouch in 5 patients (62,5%), in the pylorus in 2 patients (25%) and in lesser curvature only in 1 (12,5%). Conclusion Nowadays there is a lack of evidence about a connection between the late occurrence of gastric adenocarcinoma and the bariatric surgery. For this reason while the preoperative upper endoscopy is still mandatory, there is no need for a regular endoscopic evaluation of patients after surgery

ChAracterization of ItaliaN severe uncontrolled Asthmatic patieNts Key features when receiving Benralizumab in a real-life setting: the observational rEtrospective ANANKE study

Background: Data from phase 3 trials have demonstrated the efficacy and safety of benralizumab in patients with severe eosinophilic asthma (SEA). We conducted a real-world study examining the baseline characteristics of a large SEA population treated with benralizumab in clinical practice and assessed therapy effectiveness. Methods: ANANKE is an Italian multi-center, retrospective cohort study including consecutive SEA patients who had started benralizumab therapy ≥ 3 months before enrolment (between December 2019 and July 2020), in a real-world setting. Data collection covered (1) key patient features at baseline, including blood eosinophil count (BEC), number and severity of exacerbations and oral corticosteroid (OCS) use; (2) clinical outcomes during benralizumab therapy. We also conducted two post-hoc analyses in patients grouped by body mass index and allergic status. Analyses were descriptive only. Results: Of 218 patients with SEA enrolled in 21 Centers, 205 were evaluable (mean age, 55.8 ± 13.3 years, 61.5% females). At treatment start, the median BEC was 580 cells/mm3 (interquartile range [IQR]: 400-850); all patients were on high-dose inhaled controller therapy and 25.9% were on chronic OCS (median dose: 10 mg/die prednisone-equivalent [IQR: 5-25]); 92.9% experienced ≥ 1 exacerbation within the past 12 months (annualized exacerbation rate [AER] 4.03) and 40.3% reported ≥ 1 severe exacerbation (AER 1.10). During treatment (median duration: 9.8 months [IQR 6.1-13.9]; ≥ 12 months for 34.2% of patients), complete eosinophil depletion was observed; exacerbation-free patients increased to 81% and only 24.3% reported ≥ 1 severe event. AER decreased markedly to 0.27 for exacerbations of any severity (- 93.3%) and to 0.06 for severe exacerbations (- 94.5%). OCS therapy was interrupted in 43.2% of cases and the dose reduced by 56% (median: 4.4 mg/die prednisone-equivalent [IQR: 0.0-10.0]). Lung function and asthma control also improved. The effectiveness of benralizumab was independent of allergic status and body mass index. Conclusions: We described the set of characteristics of a large cohort of patients with uncontrolled SEA receiving benralizumab in clinical practice, with a dramatic reduction in exacerbations and significant sparing of OCS. These findings support benralizumab as a key phenotype-specific therapeutic strategy that could help physicians in decision-making when prescribing biologics in patients with SEA. Trial registration ClinicalTrials.gov Identifier: NCT04272463

Benralizumab in Patients With Severe Eosinophilic Asthma With and Without Chronic Rhinosinusitis With Nasal Polyps: An ANANKE Study post-hoc Analysis

Background: Severe eosinophilic asthma (SEA) in the presence of chronic rhinosinusitis with nasal polyps (CRSwNP) indicates the presence of a more extensive eosinophilic inflammation. Post-hoc analyses from a pivotal clinical trial have demonstrated the enhanced efficacy of benralizumab on asthma outcomes in patients with CRSwNP as a comorbidity. Methods: This is a post-hoc analysis from the Italian multi-center observational retrospective ANANKE study. Patients were divided into two groups based on self-reported CRSwNP. Baseline clinical and laboratory features in the 12 months prior to benralizumab prescription were collected. Data of change over time of blood eosinophils, annualized exacerbations rates (AER), asthma control, lung function, oral corticosteroids (OCS) use, and benralizumab discontinuation were collected during the observation period. Results: At baseline, the 110 patients with CRSwNP were less frequently female (50.9% vs 74.2%) and obese (9.1% vs. 22.6%) with higher eosinophils (605 vs. 500 cells/mm3) and OCS use when compared to patients without CRSwNP. Similar reductions of AER were seen (-95.8% vs. -91.5% for any exacerbation and -99.1% vs. -92.2% for severe exacerbations in patients with and without CRSwNP, respectively). During benralizumab treatment, comorbid SEA+CRSwNP was associated with a lower risk of any exacerbation (p = 0.0017) and severe exacerbations (p = 0.025). After a mean ± SD exposure of 10.3 ± 5.0 months, half of the SEA+CRSwNP patients eliminated OCS use. No discontinuation for safety reasons was recorded. Conclusions: This study helped to confirm the baseline clinical features that distinguish patients with and without CRSwNP being prescribed benralizumab. Numerically enhanced OCS reduction and lower exacerbation risk were observed in patients with SEA and comorbid CRSwNP treated with benralizumab

A Computable Model of Amartya Sen’s Social Choice Function in the Framework of the Category Theory Logic

A significant part of the short history of the mathematical theory of social, political, and economical sciences, specifically in the context of welfare politics and economy, is related with the development of the notion and the theory of the so-called “social welfare function (SWF)”. This theory started with the pioneering contributions of A. Bergson and of the Nobel Prize P. Samuelson leading to the “Bergson-Samuelson SWF” [1,2], but received a substantial improvement by the contribution of another Nobel Prize, K. Arrow [3]. Arrow’s SWF is intended as a function ranking social states as less, more, or indifferently desirable, for every pair of them, with respect to individual welfare measures and/or preferences. One of the main uses of SWF is aimed, indeed, at representing coherent patterns (effectively, structures) of collective and social choices/preferences as to alternative social states. The essential limitation of SWF’s is that they are defined in the framework of an approach to the study of social and economic systems stable at equilibrium like in statistical mechanics. They are all inspired, indeed, by Samuelson’s general approach to mathematical economics in his seminal handbook [2], based on Gibbs’ statistical thermodynamics of gases, to which the first two chapters of the book are significantly dedicated, because naturally consistent with the liberal individualistic vision of economy and society. Unfortunately, a fundamental unexpected and undesired consequence of Arrow’s mathematical theory is the famous “Arrow’s impossibility theorem”, demonstrating the mathematical inconsistency for democratic systems of social choices based on the majority decisions. The main contribution of A. Sen’s theory of social choice functions (SCF) [4], for which he was awarded with the Nobel Prize in Economics in 1998, was the formal demonstration that the only way for avoiding Arrow’s impossibility results is introducing in the model the interpersonal comparison of utilities — and generally the information exchange among persons constituting homogeneous groups, on the contrary considered as irrelevant in the classical economic theory. This allows also to introduce into the mathematical modeling of SCF Theory 215 Handbook of the 6th World Congress and School on Universal Logic distributive principles of social and economical justice, such as, for instance, the famous J. Rawl’s maxmin principle, which gives priority to the interests of worst-off persons. This transforms SCF Theory into a normative theory of social choices. On this regard, Sen demonstrated that an effective mathematical modeling of ethical constraints in economy cannot be based on abstract and not-computable optimal choices defined on the complete (total) ordering of social/economical states in a society, but on concrete criteria of maximal choices relative to the different contexts, and then defined on partial orderings, not necessarily satisfying a transitive relation among the different social aggregates (sets) of persons so defined, and between groups and the whole society. All this means that the physical paradigm underlying Sen’s mathematical theory of economy and society is no longer the gas thermodynamics stable at equilibrium of the liberalism mathematical models, but the fluid thermodynamics of condensed matter systems, stable in far from equilibrium conditions, characterizing a “liquid society” such as ours. The real-time information exchange among communication agents determines the fast aggregation/dissolution of interest groups in a worldwide environment — think, for instance, at the stock-exchange market and at the infinite flow of data streams it produces. Unfortunately, this condition makes unrealistic a SCF/SWF Theory based on finite [5], and then Turing-computable sets, because, on infinite sets, Sen’s maximal partial orders correspond to as many ultrafilters requiring higher order functions to be calculated [6]. We propose in this contribution an original solution of this problem in the formal framework of the Category Theory, based on the categorical dual equivalence (anti-isomorphism) between co-algebras (environment) and algebras (system), originally applied to the mathematical modelling of condensed matter thermodynamic systems, stable in far from equilibrium conditions, in the context of quantum field theory of dissipative systems, human brains included [7,8,9]. The same categorical duality co-algebras/algebras is used also in theoretical computer science, for formalizing the effectiveness of dynamic computations on infinite data streams with always changing inner correlations — i.e., on infinite data sets just it is the case of Sen’s SCFs. This approach is inside the paradigm of the Algebraic/Co-algebraic Universality in computations [10,11], which is wider than the classic Turing Universality, “probabilistic”, “quantum” Turing Machines included

Quantum field theory and coalgebraic logic in theoretical computer science

We suggest that in the framework of the Category Theory it is possible to demonstrate the mathematical and logical dual equivalence between the category of the q-deformed Hopf Coalgebras and the category of the q-deformed Hopf Algebras in quantum field theory (QFT), interpreted as a thermal field theory. Each pair algebra-coalgebra characterizes a QFT system and its mirroring thermal bath, respectively, so to model dissipative quantum systems in far-from-equilibrium conditions, with an evident significance also for biological sciences. Our study is in fact inspired by applications to neuroscience where the brain memory capacity, for instance, has been modeled by using the QFT unitarily inequivalent representations. The q-deformed Hopf Coalgebras and the q-deformed Hopf Algebras constitute two dual categories because characterized by the same functor T, related with the Bogoliubov transform, and by its contravariant application Top, respectively. The q-deformation parameter is related to the Bogoliubov angle, and it is effectively a thermal parameter. Therefore, the different values of q identify univocally, and label the vacua appearing in the foliation process of the quantum vacuum. This means that, in the framework of Universal Coalgebra, as general theory of dynamic and computing systems (“labelled state-transition systems”), the so labelled infinitely many quantum vacua can be interpreted as the Final Coalgebra of an “Infinite State Black-Box Machine”. All this opens the way to the possibility of designing a new class of universal quantum computing architectures based on this coalgebraic QFT formulation, as its ability of naturally generating a Fibonacci progression demonstrates