Role and Management of a Head and Neck Department during the COVID-19 Outbreak in Lombardy

The recent Italian outbreak of coronavirus disease 2019 led to an unprecedented burden on our health care system. Despite head and neck\u2013otolaryngology not being a front-line specialty in dealing with this disease, our department had to face several specific issues. Despite a massive reallocation of resources in the hospital, we managed to keep the service active, improving safety measures for our personnel, specifically during common otolaryngologic maneuvers known to produce aerosols. Furthermore, we strived to maintain our teaching role, giving residents an inclusive role in managing the response to the emergency state, and we progressively integrated our inactive specialists into other service rotations to relieve front-line colleagues\u2019 burden. Specific issues and management decisions are discussed in detail in the article

TOKES studies of the thermal quench heat load reduction in mitigated ITER disruptions

Disruption mitigation by massive gas injection (MGI) of Ne gas has been simulated using the 3D TOKES code that includes the injectors of the Disruption Mitigation System (DMS) as it will be implemented in ITER. The simulations have been done using a quasi-3D approach, which gives an upper limit for the radiation heat load (notwithstanding possible asymmetries in radial heat flux associated with MHD). The heating of the first wall from the radiation flash has been assessed with respect to injection quantity, the number of injectors, and their location for an H-mode ITER discharge with 280 MJ of thermal energy. Simulations for the maximum quantity of Ne (8 kPa m3) have shown that wall melting can be avoided by using solely the three injectors in the upper ports, whereas shallow melting occurred when the midplane injector had been added. With all four injectors, melting had been avoided for a smaller neon quantity of 250 Pa m3 that provides still a sufficient radiation level for thermal load mitigation

Bike Usage in Public Bike-Sharing: An Analysis of the “BikeMi” System in Milan

The constant increase of public shared bicycle systems (PSBSs) in western cities suggests that nowadays city councils consider public bike sharing systems a serious alternative to traditional public transportation in urban areas. PSBSs can represent a solution in the hands of citizens for short journeys in highly urbanized areas. In this paper we focus on the successful example of Milan\u2019s BikeMi PSBS which is giving very positive results in terms of satisfaction for all the actors involved, i.e. the service management, city council and users. From the available data it can be inferred that the bicycle overcome the car central areas in terms of speed, distance travelled daily, and choice of multiple itineraries, especially during peak periods and in proximity of the main railway stations. The main bicycle tracks and hotspots are also detected revealing an imbalance between the northern and the southern part of the city, with the northern part better covered by the service

Are they telling the truth? Revealing hidden traits of satisfaction with a public bike sharing service

Public bike-sharing systems are an emerging mode of transportation introduced by municipalities to solve congestion problems in metropolitan areas, especially when integrated with other types of transportation. In the last years, the number of public bike sharing services is constantly on the rise all over the world, and generally the overall satisfaction with them is high. However, satisfaction with public services is driven by mechanisms that can differ from those in the private sector. It is important to establish to what extent a high satisfaction is genuine or simply ephemeral. Even \u201cold\u201d public services (like public transportation) become \u201cgold\u201d when accompanied by the introduction of new technologies. In this paper we analyse this phenomenon using data from a satisfaction web-survey conducted among customers of the public bike sharing system \u2019BikeMi\u2019 in Milan, Italy, in a period when mobile technologies have been introduced to speed up the service. On simply analysing the responses to satisfaction questions, satisfaction resulted very high. However, our aim was to look for potential \u2019darker\u2019 sides of the service by detecting possible hidden satisfaction components. To this purpose, we used the Nonlinear Principal Components Analysis, which is particularly powerful in this sense. A simple textual analysis was also performed as a validating test.\u2028 Results from our analysis indicated that satisfaction is flawed by a set of factors like the mechanics of the bikes, the picking and dropping system, and the apps used to organize the service. Less concern was detected for more general aspects of the service

Adenoidal Disease and Chronic Rhinosinusitis in Children-Is there a Link?

Adenoid hypertrophy (AH) is an extremely common condition in the pediatric and adolescent populations that can lead to various medical conditions, including acute rhinosusitis, with a percentage of these progressing to chronic rhinosinusitis (CRS). The relationship between AH and pediatric CRS has been extensively studied over the past few years and clinical consensus on the treatment has now been reached, allowing this treatment to become the preferred clinical practice. The purpose of this study is to review existing literature and data on the relationship between AH and CRS and the options for treatment. A systematic literature review was performed using a search line for "(Adenoiditis or Adenoid Hypertrophy) and Sinusitis and (Pediatric or Children)". At the end of the evaluation, 36 complete texts were analyzed, 17 of which were considered eligible for the final study, dating from 1997 to 2018. The total population of children assessed in the various studies was of 2371. The studies were categorized as surgical-observational, microbiological, genetic-immunological, and radiological. The analysis of the studies confirms the relationship between AH and CRS and supports the existing consensus on medical and surgical therapy. Furthermore, these studies underline the necessity to adapt medical and surgical treatment considering age, comorbidities including asthma and, if present, the Computed Tomography (CT) score