Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

The GAPS Programme at TNG. XXVIII. A pair of hot-Neptunes orbiting the young star TOI-942

Context. Young stars and multi-planet systems are two types of primary objects that allow us to study, understand, and constrain planetary formation and evolution theories. Aims: We validate the physical nature of two Neptune-sized planets transiting TOI-942 (TYC 5909-319-1), a previously unacknowledged young star (50-20+30 Myr) observed by the TESS space mission in Sector 5. Methods: Thanks to a comprehensive stellar characterization, TESS light curve modeling and precise radial-velocity measurements, we validated the planetary nature of the TESS candidate and detected an additional transiting planet in the system on a larger orbit. Results: From photometric and spectroscopic observations we performed an exhaustive stellar characterization and derived the main stellar parameters. TOI-942 is a relatively active K2.5V star (log R'HK = -4.17 ± 0.01) with rotation period Prot = 3.39 ± 0.01 days, a projected rotation velocity v sin i⋆ = 13.8 ± 0.5 km s-1, and a radius of ~0.9 R⊙. We found that the inner planet, TOI-942 b, has an orbital period Pb = 4.3263 ± 0.0011 days, a radius Rb = 4.242-0.313+0.376 R⊕, and a mass upper limit of 16 M⊕ at 1σ confidence level. The outer planet, TOI-942 c, has an orbital period Pc = 10.1605-0.0053+0.0056 days, a radius Rc = 4.793-0.351+0.410 R⊕, and a mass upper limit of 37 M⊕ at 1σ confidence level. Based on observations made with the Italian Telescopio Nazionale Galileo (TNG) operated by the Fundación Galileo Galilei (FGG) of the Istituto Nazionale di Astrofisica (INAF) at the Observatorio del Roque de los Muchachos (La Palma, Canary Islands, Spain). The authors became aware of a parallel effort on the characterization of TOI-942 by Zhou et al. (2021) in the late stages of the manuscript preparations. The submissions are coordinated, and no analyses or results were shared prior to submission

Numerical Analysis of the Dynamic Response of a 5-Conductor Expanded Bundle Subjected to Turbulent Wind

The paper describes a numerical model, i.e. a design tool, to determine the dynamic response of bundle conductors to turbulent wind excitation. The structure is modeled by means of finite element method and the force field exerted on each cable, as function of cable's relative position and velocity, which was derived by experimental measurement at Politecnico di Milano Wind Tunnel. The proposed methodology has been applied to a real case to define the spacers number and position along the span to avoid large conductors displacements

Automatic Compliance of Privacy Policies in Federated Digital Identity Management

Privacy in the digital world is an important problem which is becoming even more pressing as new collaborative applications are developed. The lack of privacy preserving mechanisms is particularly problematic in federated identity management contexts. In such a context, users can seamlessly interact with a variety of federated web services, through theuse of single-sign-on mechanisms and the capability of sharing personal data among these web services. We argue that comprehensive privacy policies should be stated by federated service providers and proactively checked by these providers, before disclosing users’ data to federated partners. To address such requirements, we introduce mechanisms and algorithms for policy compliance checking between federated service providers, based on an innovative policy subsumption approach. We formally introduce and analyze our approach

Transcutaneous monitoring of partial pressure of carbon dioxide in the elderly patient: a prospective, clinical comparison with end-tidal monitoring.

To evaluate the accuracy and precision of estimation of partial pressure of carbon dioxide (Pa(CO2)) using end-tidal or transcutaneous CO2 (TcP(CO2)) measurements during mechanical ventilation in the elderly patient.A prospective, observational study was conducted.The study was done in the anesthesia department of a university hospital.Seventeen anesthetized, mechanically ventilated patients older than 60 years were studied.During standard sevoflurane anesthesia, and after proper calibration and an equilibration time of 30 minutes with stable hemodynamic and respiratory variables, arterial (Pa(CO2)), end-tidal (Pet(CO2)), and transcutaneous (TcP(CO2)) CO2 partial pressures were determined. In each patient, 1 to 5 sample sets (Pa(CO2), Pet(CO2), and TcP(CO2)) were obtained.A total of 45 sample sets were obtained from the patients studied. The Pa(CO2) values ranged between 21 and 58 mm Hg. The Pa(CO2) - Pet(CO2) tension gradient was 6 +/- 5 mmHg (95\% confidence interval, -3 to 16 mmHg), whereas the Pa(CO2) - TcP(CO2) tension gradient was 2 +/- 4 mmHg (95\% confidence interval, -6 to 9 mmHg) (P = 0.0005). The absolute value of the difference between Pa(CO2) and Pet(CO2) was 3 mm Hg or less in 7 of 45 sample sets (15\%), whereas the absolute value of the difference between Pa(CO2) and TcP(CO2) was 3 mm Hg or less in 21 of 45 sample sets (46\%) (P = 0.003). Linear regression analysis for TcP(CO2) versus Pa(CO2) showed a slope of 0.84 (r(2) = 0.73), whereas the linear regression analysis for Pet(CO2) versus Pa(CO2) showed a slope of 0.54 (r(2) = 0.50).Transcutaneous monitoring of CO(2) partial pressure gives a more accurate estimation of arterial CO(2) partial pressure than does Pet(CO2) monitoring

Forehead reflectance oximetry: a clinical comparison with conventional digit sensors during laparotomic and laparoscopic abdominal surgery.

This study compared the performance of forehead reflectance and conventional pulse oximetry (SpO(2)) in mechanically ventilated, anesthetized patients undergoing major abdominal surgery with either laparoscopic or laparotomic techniques.SpO(2) was continuously measured both with a forehead reflectance and a conventional digit sensor in 20 ASA physical status I-III, anesthetized patients undergoing either a laparotomic (group Laparotomy, n = 10) or laparoscopic (group Laparoscopy, n = 10) major abdominal surgery. SpO(2) values measured with the two sensors were continuously recorded at 10-second intervals during the entire procedure, and then analyzed for consistency.In group Laparotomy finger and forehead readings remained consistently similar during the study period; on the contrary, in group Laparoscopy forehead SpO(2) readings showed a much wider variability. The mean (95\% Confidence Intervals) difference between finger and forehead SpO(2) readings was 2.0\% (-1.3\% to +6.0\%) in group Laparotomy and 2.5\% (-3.5\% to +8.4\%) in group Laparoscopy (p = 0.001); however, in group Laparoscopy the mean difference between digit and forehead SpO(2) values increased from 0.2\% (CI(95): -2.1\% to +2.5\%) during the first hour to 4.5\% (CI(95): -2.5\% to +11-5\%) in the second hour (p = 0.0005), and 3.1\% (CI(95): -2.4\% to + 8.6\%) in the third hour of surgery (p = 0.0005). Clinically relevant desaturation (decrease of SpO(2) or =30 s) detected with the forehead sensor in the Laparoscopy group was significantly more frequent and longer lasting than with conventional digit sensor. No differences were observed in group Laparotomy.Forehead reflectance oximetry is as accurate as conventional digit based oximetry in mechanically ventilated patients undergoing laparotomic surgery in the supine position, but is significantly influenced by patient positioning and pneumoperitoneum during laparoscopic surgery

Optimal synthesis, design and operation of smart microgrids serving a cluster of buildings in a campus with centralized and decentralized hybrid renewable energy systems

Optimal design and operation of energy systems serving clusters of buildings interconnected by energy microgrids is a scientific challenge for the engineering community, with many interdisciplinary aspects involved. In the paper, the optimization problem is tackled in terms of simulation-based design of the energy system for a typical year of operation. The methodology has been applied to a Campus in Trieste, Italy, involving locally available renewable energy sources, a centralized cogeneration system, and decentralized heat pumps. The nominal powers of cogeneration plant, photovoltaic modules and wind turbine have been optimized by a population-based evolutionary optimization algorithm, previously proposed by the authors. We have also found the optimal scheduling of energy generators by means of a greedy approach. The solution with maximum Annualized Cost Saving Percentage is discussed, highlighting how a configuration involving decentralized heat pumps is cost effective, integrates more renewable energy sources, and reduces environmental impact and grid exchange compared to a benchmark solution, with fully centralized generators