A Risk-Based Methodology and Tool Combining Threat Analysis and Power System Security Assessment

A thorough investigation of power system security requires the analysis of the vulnerabilities to natural and man-related threats which potentially trigger multiple contingencies. In particular, extreme weather events are becoming more and more frequent due to climate changes and often cause large load disruptions on the system, thus the support for security enhancement gets tricky. Exploiting data coming from forecasting systems in a security assessment environment can help assess the risk of operating power systems subject to the disturbances provoked by the weather event itself. In this context, the paper proposes a security assessment methodology, based on an updated definition of risk suitable for power system risk evaluations. Big data analytics can be useful to get an accurate model for weather-related threats. The relevant software (SW) platform integrates the security assessment methodology with prediction systems which provide short term forecasts of the threats affecting the system. The application results on a real wet snow threat scenario in the Italian High Voltage grid demonstrate the effectiveness of the proposed approach with respect to conventional security approaches, by complementing the conventional "N - 1" security criterion and exploiting big data to link the security assessment phase to the analysis of incumbent threat

Wet snow hazard for power lines: a forecast and alert system applied in Italy

Wet snow icing accretion on power lines is a real problem in Italy, causing failures on high and medium voltage power supplies during the cold season. The phenomenon is a process in which many large and local scale variables contribute in a complex way and not completely understood. A numerical weather forecast can be used to select areas where wet snow accretion has an high probability of occurring, but a specific accretion model must also be used to estimate the load of an ice sleeve and its hazard. All the information must be carefully selected and shown to the electric grid operator in order to warn him promptly. <br><br> The authors describe a prototype of forecast and alert system, WOLF (<b>W</b>et snow <b>O</b>verload a<b>L</b>ert and <b>F</b>orecast), developed and applied in Italy. The prototype elaborates the output of a numerical weather prediction model, as temperature, precipitation, wind intensity and direction, to determine the areas of potential risk for the power lines. Then an accretion model computes the ice sleeves' load for different conductor diameters. The highest values are selected and displayed on a WEB-GIS application principally devoted to the electric operator, but also to more expert users. Some experimental field campaigns have been conducted to better parameterize the accretion model. Comparisons between real accidents and forecasted icing conditions are presented and discussed

high resolution study of epigenetic processes new insights into methylation and demethylation

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Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Influence of extrusion process conditions on the properties of buckwheat products

Extrusion has an important role as a manufacturing process in the food industry; it is used to obtain a great variety of products such as baby foods, breakfast cereals, snack foods, pasta, instant powders, modified starches, etc. However, as regards cereals, few studies have examined the application of the extrusion process on less common materials, such as minor cereals and pseudocereals, of interest for their nutritional value. Buckwheat, for instance, is rich in antioxidants, contains rutin, and has a good amino acid profile; moreover, it does not contain gluten proteins, therefore being suitable for the diet of people with celiac disease. The aim of this research was to investigate the influence of different extrusion process conditions (barrel temperature, screw speed, feed moisture) on the chemical-physical characteristics of extruded products obtained from buckwheat. A high fiber buckwheat flour and broken kernels of dehulled buckwheat were used, in order to evaluate the effect of both the fiber content and the particle size of the raw materials on the extrudates' properties. A 3-factor, 3-level Box-Behnken Experimental Design was applied for finding out the relationships between the chemical-physical properties of the extruded samples and the process variables. The barrel temperature and the screw speed each positively influenced the starch damage content and the expansion ratio of the products and negatively influenced their texture, while the feed moisture negatively influenced the expansion of the extrudates. Moreover, for all experimental conditions, good results could be obtained from broken kernels, indicating that starting materials do not necessarily need to be in powder form (e.g., flour)

Delayed Rupture of a Normal Appearing Spleen After Trauma: Is Our Knowledge Enough? Two Case Reports

BACKGROUND Non-operative management is considered the gold standard for hemodynamically stable patients with splenic injuries. Delayed splenic rupture is a well-known complication of non-operative management in splenic trauma, with a relevant impact on mortality and morbidity. Most of the reported cases of delayed splenic rupture presented splenic injury at admission imaging or no imaging investigations were performed. We report 2 cases of delayed splenic rupture after blunt trauma, in which multidetector computed tomography (CT) scan at admission did not show any splenic injury.   CASE REPORT Two patients were admitted to our emergency surgery unit after abdominal trauma with left rib fractures, but no solid organ injuries were detected at CT scan. Some days after the trauma, both patients suddenly developed hemorrhagic shock due to splenic rupture and required emergency splenectomy. CONCLUSIONS Trauma patients' management and follow-up remains challenging for surgeons, because of sudden clinical changes that can occur. Delayed splenic rupture with inconspicuous admission CT scan is a rare event. In some cases, it seems to be related to a poor CT quality, but this explanation cannot be adopted in all cases. Moreover, there is no standardization for imaging follow-up in the case of a normal CT scan at admission, in order to prevent delayed hemorrhage. In this context, every element that can identify patients with higher risk of delayed splenic rupture is of great importance. We suggest that lower left rib fractures can be associated with delayed splenic rupture, and we propose some explaining hypothesis

Modeling the effect of COVID-19 lockdown on mobility and NO2 concentration in the Lombardy region

Recent observation and modeling-based studies have shown how air quality has been positively affected by the containment measures enforced due to the COVID-19 outbreak. This work aims to analyze Lombardy’s NO2 atmospheric concentration during the spring lockdown. The region of Lombardy is known for having the largest number of residents in Italy and high levels of pollution. It is also the region where the first European confinement measures were imposed by the Italian government. The modeling suite composed of CAMx (Comprehensive Air Quality Model with Extensions) and WRF (Weather Research and Forecasting model) provides the setting to compare the atmospheric NO2 concentration from mid-February to the end of March with a business as usual situation. The main interest in this work is to investigate the response of NO2 atmospheric concentration to increasingly reduced road traffic. We can simulate, for the first time, a real circumstance of progressively reduced mobility, as well as validating it with measured air quality data. Focusing on the city of Milan, we found that the decrease in NO2 concentration reflects progressively reduced traffic contraction. In the case of a large traffic abatement (71%), the concentration level is reduced by one third. We also find that industrial activities have a relevant impact on NO2 atmospheric concentration, especially in the provinces of Brescia and Bergamo. This study provides an overview of how incisive policies must be implemented to achieve the set environmental targets and protect human health

Impact of Covid-19 on surgical activities and personnel: lessons for the future

Covid-19 pandemic has impacted professional, economic and social activities. In the surgical field, it has brought changes to operating activities, the organization of workforces, the protection measures for patients and personnel against possible intraoperative transmissions as well as training young surgeons. This study intends to assess the extent of this impact in our institution

The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

Background: The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods: Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results: A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. Conclusions: The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands. Graphical abstract: [Figure not available: see fulltext.