Implementing Air Pollution and Health Damage Costs in Urban Multi-Energy Systems Modelling

The growing global urbanization rate implies that the sustainability challenges are increasingly concentrated in cities. At today, around 75% of global energy is consumed in urban areas, so efforts must be addressed to transform existing urban energy systems into more sustainable systems. In this perspective, a key aspect to evolve toward a cleaner and affordable energy system is the development of Multi-Energy Systems (MES) modelling, whereby heat, electricity, fuels, transport, and other energy carriers closely interact with each other at various scales. MES can optimize technical, economic and environmental performance with respect to “traditional” independent energy systems, at both the operational and the planning stage. This paper presents a development of the existing MESsi modelling platform, consisting in the implementation of a model estimating the impacts on air quality and human health. MESsi is a novel distributed infrastructure for modelling and co-simulating Multi-Energy-Systems. It exploits modern software design patterns (i.e. microservices) to guarantee scalability, extendibility and easy maintenance of the system. Thus, MESsi is flexible in modelling and co-simulating different energy flows in a single solution made of different interoperable modules that can be deployed in a plug-and-play fashion. The module to be implemented in MESsi infrastructure is the DIATI integrated dispersion and externalities model (DIDEM). The DIDEM model is based on the impact pathway approach, linking the simulation of pollutants dispersion to the concentration-exposure-response functions provided by latest WHO recommendations. An overview of the potential integration steps in the modelling infrastructure is described in this paper. A discussion on possible application scenarios that have different spatio-temporal resolutions is also reported. The integration of DIDEM model in MESsi platform allows the inter-connection of a detailed impact assessment to a high-level energy system simulation

Mantle-Derived Corundum-Bearing Felsic Dykes May Survive Only within the Lower (Refractory/Inert) Crust: Evidence from Zircon Geochemistry and Geochronology (Ivrea–Verbano Zone, Southern Alps, Italy)

Corundum-rich (up to 55 vol.%) felsic dykes formed with albite, +/- K-feldspar, +/- hercynite and +/- biotite-siderophyllite cut the lower crustal rocks exposed in the Ivrea–Verbano Zone (NW Italy). Zircon is an abundant accessory mineral and its investigation through laser ablation-inductively coupled plasma (multi-collector)-mass spectrometer (LA-ICP-(MC)MS) has allowed results to directly constrain the timing of emplacement, as well as petrology and geochemistry of parental melts. Zircons are characterized by very large concentration in rare earth elements (REE), Th, U, Nb and Ta, and negative Eu anomaly. U–Pb analysis points to Norian emplacement ages (223 +/- 7 Ma and 224 +/- 6 Ma), whereas large positive EHf(t) values (+13 on average) indicate a derivation from depleted to mildly enriched mantle source. The mantle signature and the corundum oversaturation were preserved thanks to limited crustal contamination of the host, high-temperature refractory granulites and mafic intrusives. According to the geochemical data and to the evidence of the development of violent explosions into the conduits, it is proposed that dykes segregated from peraluminous melts produced by exsolution processes affecting volatile-rich differentiates during alkaline magmatism. This work provides robust evidence about the transition of the geochemical affinity of Southern Alps magmatism from orogenic-like to anorogenic during Norian time, linked to a regional uprising of the asthenosphere and change of tectonic regime

Nanoscale electro-structural characterisation of ohmic contacts formed on p-type implanted 4H-SiC

This work reports a nanoscale electro-structural characterisation of Ti/Al ohmic contacts formed on p-type Al-implanted silicon carbide (4H-SiC). The morphological and the electrical properties of the Al-implanted layer, annealed at 1700°C with or without a protective capping layer, and of the ohmic contacts were studied using atomic force microscopy [AFM], transmission line model measurements and local current measurements performed with conductive AFM

Effect of Immuno-Nutrition on Malnutrition, Inflammatory Response and Clinical Course of Semi-Critically Ill COVID-19 Patients: A Pilot Perspective Study

Background: The SARS-COV 2 pandemic has hit on our lives since early 2020. During different contagion waves, both malnutrition and overweight significantly correlated with patient mortality. Immune-nutrition (IN) has shown promising results in the clinical course of pediatric inflammatory bowel disease (IBD) and in both the rate of extubation and mortality of patients admitted to an intensive care unit (ICU). Thus, we wanted to assess the effects of IN on a clinical course of patients admitted to a semi-intensive COVID-19 Unit during the fourth wave of contagion that occurred at the end of 2021. Methods: we prospectively enrolled patients admitted to the semi-intensive COVID-19 Unit of San Benedetto General hospital. All patients had a biochemical, anthropometric, high-resolution tomography chest scan (HRCT) and complete nutritional assessments at the time of admission, after oral administration of immune-nutrition (IN) formula, and at 15 days interval follow-up. Results: we enrolled 34 consecutive patients (age 70.3 +/- 5.4 years, 6 F, BMI 27.0 +/- 0.5 kg/m(2)). Main comorbidities were diabetes (20%, type 2 90 %), hyperuricemia (15%), hypertension (38%), chronic ischemic heart disease (8 %), COPD (8%), anxiety syndrome (5%), and depression (5%). 58% of patients were affected as moderately-to-severely overweight; mini nutritional assessment (MNA) score (4.8 +/- 0.7) and phase angle (PA) values (3.8 +/- 0.5) suggestive of malnutrition were present in 15% of patients, mainly with a history of cancer. After 15 days upon admission, we recorded 3 deaths (mean age 75.7 +/- 5.1 years, BMI 26.3 +/- 0.7 kg/m(2)) and 4 patients were admitted to the ICU. Following IN formula administration, inflammatory markers significantly decreased (p < 0.05) while BMI and PA did not worsen. These latter findings were not observed in a historical control group that did not receive IN. Only one patient needed protein-rich formula administration. Conclusions: in this overweight COVID-19 population immune-nutrition prevented malnutrition development with a significant decrease of inflammatory markers

Effect of Whey Proteins on Malnutrition and Extubating Time of Critically Ill COVID-19 Patients

none13Abstract: The novel SARS-CoV-2 virus has led to a severe pandemic, starting from early 2020. Intensive care (ICU) management of the COVID-19 disease is difficult with high morbidity and mortality. Early nutritional support, especially with whey protein, seems to be crucial in this medical case. Thus, we aimed to assess the effects of an adequate nutritional protocol rich in whey protein on nutritional and inflammatory status, extubating time, and mortality of critically ill COVID-19 patients (CICP). Methods: A prospective single-center exploratory observational study was undertaken on 32 consecutive CICP admitted to the ICU of Santa Maria Hospital, Terni, Italy, and treated with whey protein-enriched formula. Patients’ demographics, nutritional status, indexes of inflammation, daily pre-albumin serum levels, duration of mechanical ventilation, and mortality were recorded. Results: Thirty-two patients were enrolled. Ninety-five percent of them showed a gradual reduction in C-reactive protein (CRP) values and increase in pre-albumin levels after the whey protein-enriched formula. Prealbumin levels were not correlated with a better nutritional status but with a shorter extubating time and better survival. Conclusions: An adequate administration of whey protein during COVID-19 patients’ ICU stays can provide fast achievement of protein targets, reducing the duration of mechanical ventilation, and improving inflammatory status and ICU survival. Further prospective and large-scale, controlled studies are needed to confirm these results.openScarcella, Marialaura; Scarpellini, Emidio; Ascani, Alessandra; Commissari, Rita; Scorcella, Claudia; Zanetti, Michela; Parisi, Amilcare; Monti, Riccardo; Milic, Natasa; Donati, Abele; Luzza, Francesco; De Robertis, Edoardo; Abenavoli, LudovicoScarcella, Marialaura; Scarpellini, Emidio; Ascani, Alessandra; Commissari, Rita; Scorcella, Claudia; Zanetti, Michela; Parisi, Amilcare; Monti, Riccardo; Milic, Natasa; Donati, Abele; Luzza, Francesco; De Robertis, Edoardo; Abenavoli, Ludovic

Diagnosis of calcium pyrophosphate crystal deposition disease by ultrasonography: how many and which sites should be scanned?

ObjectiveTo develop the optimal US scanning protocol for the diagnosis of CPPD disease.MethodsIn this cross-sectional study, consecutive patients with a crystal-proven diagnosis of CPPD disease, and age-, sex-matched disease controls and with a negative synovial fluid analysis were prospectively enrolled in two Italian Institutions. Four rheumatologists, blinded to patients’ clinical details, performed US examinations using a standardised scanning protocol including 20 joints (shoulders, elbows, wrists, metacarpophalangeal joints from 2nd to 5th fingers, hips, knees, ankles). CPPD was identified as presence/absence, according to the OMERACT definitions. Reduced US scanning protocols were developed by selecting the most informative joints to be imaged by US using the LASSO technique. Patients were randomly divided into training and validation sets. Their diagnostic accuracy was tested comparing the area under the ROC curves.Results204 participants were enrolled: 102 with CPPD disease and 102 disease controls [age (mean±standard deviation) 71.3 ± 12.0 vs 71.1 ± 13.5 years, female: 62.8% vs 57.8%].The median number of joints with US evidence of CPPD was 5 (IQR: 4–7) and 0 (IQR: 0–1) in patients with CPPD disease and controls, respectively (p< 0 01).The detection of CPPD in ≥ 2 joints using a reduced scanning protocol (bilateral assessment of knees, wrists, and hips) showed a sensitivity of 96.7% (95%CI: 82.8–99.9) and a specificity of 100 (95%CI: 88.8–100.0) for the diagnosis of CPPD disease and had good feasibility [(mean±standard deviation) 12.5 ± 5.3 min].ConclusionBilateral US assessment of knees, wrists, and hips had excellent accuracy and good feasibility for the diagnosis of CPPD disease

Current trends on subtotal petrosectomy with cochlear implantation in recalcitrant chronic middle ear disorders

Objective. To establish the safety and effectiveness of subtotal petrosectomy with cochlear implantation in patients affected by chronic middle ear disorders to refractory to previous surgical treatments. Methods. A multicentre, retrospective study was conducted on patients affected by recalcitrant chronic middle ear disorders who underwent cochlear implantation in combi-nation with subtotal petrosectomy. Patients’ details were collected from databases of 11 Italian tertiary referral centres. Additionally, a review of the most updated literature was carried out. Results. 55 patients were included with a mean follow-up time of 44 months. Cholestea-toma was the most common middle ear recurrent pathology and 50.9% of patients had an open cavity. 80% of patients underwent a single stage surgery. One case of explantation for device failure was reported among the 7 patients with post-operative complications. Conclusions. Subtotal petrosectomy with cochlear implantation is a benchmark for management of patients with recalcitrant chronic middle ear disorders. A single stage procedure is the most recommended strategy. Optimal follow-up is still debated. Further studies are required to investigate the role of this surgery in paediatric patients. © Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale

COVID-19 in rheumatic diseases in Italy: first results from the Italian registry of the Italian Society for Rheumatology (CONTROL-19)

OBJECTIVES: Italy was one of the first countries significantly affected by the coronavirus disease 2019 (COVID-19) epidemic. The Italian Society for Rheumatology promptly launched a retrospective and anonymised data collection to monitor COVID-19 in patients with rheumatic and musculoskeletal diseases (RMDs), the CONTROL-19 surveillance database, which is part of the COVID-19 Global Rheumatology Alliance. METHODS: CONTROL-19 includes patients with RMDs and proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) updated until May 3rd 2020. In this analysis, only molecular diagnoses were included. The data collection covered demographic data, medical history (general and RMD-related), treatments and COVID-19 related features, treatments, and outcome. In this paper, we report the first descriptive data from the CONTROL-19 registry. RESULTS: The population of the first 232 patients (36% males) consisted mainly of elderly patients (mean age 62.2 years), who used corticosteroids (51.7%), and suffered from multi-morbidity (median comorbidities 2). Rheumatoid arthritis was the most frequent disease (34.1%), followed by spondyloarthritis (26.3%), connective tissue disease (21.1%) and vasculitis (11.2%). Most cases had an active disease (69.4%). Clinical presentation of COVID-19 was typical, with systemic symptoms (fever and asthenia) and respiratory symptoms. The overall outcome was severe, with high frequencies of hospitalisation (69.8%), respiratory support oxygen (55.7%), non-invasive ventilation (20.9%) or mechanical ventilation (7.5%), and 19% of deaths. Male patients typically manifested a worse prognosis. Immunomodulatory treatments were not significantly associated with an increased risk of intensive care unit admission/mechanical ventilation/death. CONCLUSIONS: Although the report mainly includes the most severe cases, its temporal and spatial trend supports the validity of the national surveillance system. More complete data are being acquired in order to both test the hypothesis that RMD patients may have a different outcome from that of the general population and determine the safety of immunomodulatory treatments