A multidisciplinary approach to evaluate the effectiveness of natural attenuation at a contaminated site

This study evaluates the natural attenuation of chlorinated hydrocarbons as remediation action in a contaminated site downtown the city of Parma (Italy). To achieve this goal, a combination of new investigation methods (bio-molecular analysis, compound specific isotope analysis, phytoscreening) has been proposed. The approach (named circular multi step) allows to: fully understand the phenomena that occur at the study site, design new investigation activities, and manage best practices. Consequently, each step of the approach improves the conceptual and numerical models with new knowledge. The activities carried out at the study site allowed to detect a contamination of perchloroethylene in a large part of the city of Parma and, of main importance, underneath a kindergarten. The results of the study did not show significant natural attenuation of chlorinated hydrocarbons and that the detected contamination could refer to the same unknown contaminant source. Furthermore, the innovative phytoscreening technique was applied to assess the presence of chlorinated hydrocarbons at the ground level. The plume spread was estimated through numerical modeling starting from potential contaminant sources. This study enhances the knowledge of groundwater flow and contamination in Parma and allows authorities to design new investigation/reclamation activities through management actions

PS-318 Are Antenatal Corticosteroids Less Effective In Twins Than In Singletons? A Cohort Study In The Italian Neonatal Network

n/

A quasilinear differential inclusion for viscous and rate-independent damage systems in non-smooth domains

This paper focuses on (incomplete) rate-independent damage in elastic bodies. Since the driving energy is nonconvex, solutions may have jumps as a function of time, and in this situation it is known that the classical concept of energetic solutions for rate-independent systems may fail to accurately describe the behavior of the system at jumps. Therefore we resort to the (by now well-established) "vanishing-viscosity" approach to rate-independent processes, and approximate the model by its viscous regularization. In fact, the analysis of the latter PDE system presents remarkable difficulties, due to its highly nonlinear character. We tackle it by combining a variational approach to a class of abstract doubly nonlinear evolution equations, with careful regularity estimates tailored to this specific system, relying on a q-Laplacian type gradient regularization of the damage variable. Hence for the viscous problem we conclude the existence of weak solutions, satisfying a suitable energy-dissipation inequality that is the starting point for the vanishing-viscosity analysis. The latter leads to the notion of (weak) parameterized solution to our rate-independent system, which encompasses the influence of viscosity in the description of the jump regime

High-speed and high-resolution 2D and 3D elemental imaging of corroded ancient glass by laser ablation-ICP-MS

In this work, laser ablation-inductively coupled plasma-mass spectrometry was used to investigate for the first time glass weathering mechanisms using high-resolution 2D and 3D elemental maps of altered layers of ancient glass. Roman archaeological glass shards, displaying several corrosion indicators, were studied using multiple raster-scanning ablation with high depth and lateral resolution. The concentration gradients of different elements were captured (in their variations from the surface to the bulk of pristine glass) by multiple ablations on degraded regions of interest to observe the dissolution of the glass network due to the hydration and leaching processes that occur during its alteration. The results indicated an enrichment of silicon and a depletion of alkaline/alkaline earth element concentration in the first few microns of depth under the surface area suggesting that a de-alkalinisation phenomenon occurs on the glass surface when ancient items have been buried under soil for extended timeframes. The layer-by-layer elemental distribution revealed also how the composition of the archaeological glass changes from the bulk to the surface, shedding light on the leaching behaviour of glass constituents during the alteration process

Managerial features and outcome in neonatal intensive care units: results from a cluster analysis

Background: Healthcare organisations differ in performance even if they are located in the same country or region. Suitable managerial practices and organisational processes can lead to better health outcomes. As a result, hospitals are constantly looking for managerial arrangements that can improve outcomes and keep costs down. This study aims to identify different managerial models in neonatal intensive care units (NICUs) and their impact on a large number of outcomes. Methods: The research was conducted in Italy, within the SONAR project. SONAR’s aim was to identify the characteristics of NICUs, monitor outcomes and promote best practices. This study includes 51 of the 63 NICUs that took part in the SONAR project. Questionnaires on the activities and managerial features were administered to doctors and nurses working in NICUs. A total of 643 questionnaires were analysed from doctors and a total of 1601 from nurses. A cluster analysis was performed to identify managerial models of NICUs. Results: Three managerial models emerged from cluster analysis: traditional, collaborative and individualistic. In the “traditional” model the doctor is above the nurse in the hierarchy, and the nurse therefore has exclusively operational autonomy. The “collaborative” model has as key elements professional specialisation and functional coordination. The “individualistic” model considers only individual professional skills and does not concern the organisational conditions necessary to generate organisational effectiveness. The results also showed that there is an association between managerial model and neonatal outcomes. The collaborative model shows best results in almost all outcomes considered, and the traditional model has the worst. The individualistic model is in the middle, although its values are very close to those of traditional model. Conclusions: Health management needs to assess NICU strategically in order to develop models to improve outcomes. This study provides insights for management useful for designing managerial characteristics of NICUs in order to achieve better results. NICUs characterised by a collaborative model in fact show better neonatal outcomes

Language outcomes at 36 months in prematurely born children is associated with the quality of developmental care in NICUs

n/

Thyroid and pregnancy

A gravidez está associada com a necessidade aumentada de secreção hormonal pela tireóide desde as primeiras semanas após a concepção. Para que esta maior demanda ocorra, a gestação induz uma série de alterações fisiológicas que afetam a função tireoidiana e, portanto, os testes de avaliação da função glandular. Para as mulheres grávidas normais que vivem em áreas suficientes em iodo, este desafio em ajustar a liberação de hormônios tireoidianos para o novo estado de equilíbrio e manter até o término da gestação, geralmente, ocorre sem dificuldades. Entretanto, em mulheres com a capacidade funcional da tireóide prejudicada por alguma doença tireoidiana ou naquelas que residem em áreas de insuficiência iódica, isso não ocorre. O manejo de disfunções tireoidianas durante a gestação requer considerações especiais, pois tanto o hipotireoidismo quanto o hipertireoidismo podem levar a complicações maternas e fetais. Além disso, nódulos tireoidianos são detectados, com certa freqüência, em gestantes, o que pode gerar a necessidade do diagnóstico diferencial entre benignos e malignos ainda durante a gestação.Pregnancy is associated with an increased requirement of hormone secretion by the thyroid, within the first weeks after conception. To this greater demand to occurs, pregnancy induces a series of physiological changes that affect thyroid function and, consequently, the tests of glandular function. For normal pregnant women living in areas with a sufficient supply of iodine, this challenge regarding the adjustment of thyroid hormone releases to this new state of equilibrium and its maintenance until the end of pregnancy it meets no difficulties. However, among women with impaired thyroid function due to some thyroid disease or among women residing in areas with an insufficient iodine supply, this does not occur. The management of thyroid dysfunction during gestation requires special considerations, since both hypothyroidism and hyperthyroidism can lead to maternal and fetal complications. In addition, thyroid nodules are detected at reasonable frequency among pregnant women, a fact that requires a differential diagnosis between benign and malignant growths during the pregnancy itself