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Geosynthetic-reinforced earth (GRE) retaining walls show a better performance than conventionally-designed walls during destructive earthquakes, due to their capability of redistributing seismic-induced deformations within the reinforced zone. In this paper, a recently-proposed method to design GRE walls is first recalled, where the wall is designed to trigger an internal plastic mechanism in the presence of strong earthquakes. Following a pseudo-static approach, the seismic coefficient k is therefore assumed equal to the internal seismic resistance of the wall k c int. The seismic coefficient is then calibrated against given seismic wall performance, expressed in terms of limit values of earthquake-induced displacements. Permanent displacements are evaluated through empirical relationships that were previously developed on the basis of a parametric integration of an updated Italian seismic database. Effectiveness of the proposed procedure is then demonstrated by assessing, through Finite Difference nonlinear dynamic analyses, the seismic performance of two walls, namely a GRE and a conventional gravity wall, characterised by the same seismic resistance but triggering an internal and external plastic mechanism, respectively. They are both subjected to a real strong motion, capable of activating a plastic mechanism. Results showed that lower permanent displacements are accumulated in the GRE wall where internal mechanisms are triggered.

A retrospective survey was conducted over a 10-year period (1990-99) among 52 haematology divisions in order to evaluate the clinical and laboratory characteristics and outcome of patients with proven Pneumocystis carinii pneumonia (PCP) complicating haematological diseases. The study included 55 patients (18 with non-Hodgkin's lymphoma, 10 with acute lymphoblastic leukaemia, eight with acute myeloid leukaemia, five with chronic myeloid leukaemia, four with chronic lymphocytic leukaemia, four with multiple myeloma, three with myelodys-plastic syndrome, two with myelofibrosis and one with thalassemia) who developed PCP. Among these, 18 (33%) underwent stem cell transplantation; only two received an oral prophylaxis with trimethroprim/sulphamethoxazole. Twelve patients (22%) developed PCP despite protective isolation in a laminar airflow room. The most frequent symptoms were: fever (86%), dyspnoea (78%), non-productive cough (71%), thoracic pain (14%) and chills (5%); a severe hypoxaemia was present in 39 patients (71%). Chest radiography or computerized tomography showed interstitial infiltrates in 34 patients (62%), alveolar infiltrates in 12 patients (22%), and alveolar-interstitial infiltrates in nine patients (16%). Bronchoalveolar lavage was diagnostic in 47/48 patients, induced sputum in 9/18 patients and lung biopsy in 3/8 patients. The diagnosis was made in two patients at autopsy. All patients except one started a specific treatment (52 patients trimethroprim/sulphamethoxazole, one pentamidine and one dapsone). Sixteen patients (29%) died of PCP within 30 d of diagnosis. Multivariate analysis showed that prolonged steroid treatment (P < 0.006) and a radiological picture of diffuse lung involvement (P < 0.003) were negative diagnostic factors.

A 10 Gb/s CMU has been fabricated in a commercial SiGe BiCMOS technology featuring multistandard compliance with SDH/SONET and 10 GbE specifications,dual reference clock frequency and output jitter below 80 mUIpp.The phase tracking loop uses a charge pump with low common mode current to minimize frequency ripple.Power supply is 2.5 and 3.3 V and the total power consumption is below 480 mW.

We report the results of a pilot survey in diagnostic medical sonographers. Aim of the study was to evaluate the frequency of musculoskeletal disorders in sonologists and the relationship of these symptoms to ergonomic factors.340 sonographers (258 male, 82 female doctors; mean age 41.5 +/- 7.2 years) were given a questionnaire to fill out. The questionnaire asked questions about the sonologist's age, gender, technique of ultrasound procedure, physical activity, and work-related musculoskeletal complaints. Two symptom lists regarded carpal tunnel syndrome (CTS) symptoms (8 items) and other work-related musculoskeletal symptoms (13 items). The categorized response variables "have now" or "in the past" were provided. The symptoms experienced were categorized into three levels as no symptoms, few symptoms (1-4 symptoms), and many symptoms (5 symptoms).One third of the respondents reported having at least one or more work-related symptoms in the upper extremities. The most frequent symptoms were tingling (17.6%), numbness or finger pain (13.5%). Carpal tunnel syndrome had been diagnosed in 5 cases (1.5%). More than 60% of all respondents have experienced one or more musculoskeletal symptoms in the cervical or lumbar spine. The commonest symptom was neck and low back pain (67%). The pain was generally intermittent and occurred at the end of the workday. Motion impairment in the neck and/or back was present in 23.5% of cases. Twenty-five percent of respondents had received treatments for their symptoms and 10% reported having stopped work because of their symptoms. Data analysis showed that muscular efforts such as gripping the transducer, applying sustained pressure, and scanning with a correlated flexed or hyperextended wrist were significantly correlated with increasing severity of symptoms in the hand, wrist, and forearm area. On the other hand, low back pain appeared to be negatively correlated with correct position of the body.Several physical risk factors (e.g., repetitive work and force exertion, twisting of the body and poorly-adjustable chairs) have been identified for work-related upper extremity and spine disorders. Ergonomic redesign of the workstation configuration as well as allowing sufficient recovery time to body and arm muscles appear to be the main goals to achieve prevention of musculoskeletal disorders in sonographers.

Background. Efficacy of Thalidomide-dexamethasone (TD) as induction therapy in preparation for autologous stem cell transplantation (ASCT) in multiple myeloma provided the basis for the design of the phase II “Bologna 2002”study incorporating TD into double autotransplantation as up-front therapy for younger patients (pts) with newly diagnosed disease. Aim. We performed a molecular study aimed at identifying a gene expression profile (GEP) signature predictive of attainment of at least near complete response (nCR) to TD and subsequent autotransplantation. Methods. For this purpose, we analyzed bone marrow samples obtained at diagnosis from 112 pts who received TD before double ASCT. The differential gene expression of CD138+ enriched plasma cells was evaluated by means of expression microarray using the Affymetrix platform. Significant expression results were validated by Real-time PCR. Results. Two subsequent study phases were planned. Firstly, a GEP supervised analysis was performed on a training set of 32 pts, allowing to identify 157 probe sets differentially expressed (P

Introduction: Within the framework of the GIMEMA Study Group, the characteristics of acute lymphoid leukemia and acute myeloid leukemia occurring in patients who have suAered a previous malignancy were studied. Assessment was also made of the clinical course, laboratory features and overall outcome of these conditions. Materials and methods: A four-year, multi-center retrospective study was conducted to evaluate the eAect of treatment for previous hematological malignancy on the development of secondary leukemia. The study collected in the GIMEMA Archive of Adult Acute Leukemia 3934 new cases of acute leukemia (2964 AML, 901 ALL, 60 acute biphenotypic leukemia). Among these cases, data were evaluated from patients with a personal history of a previous malignancy, and included inquiring into demographic data, history of neoplastic diseases in the 1st degree relatives, type and treatment of the previous malignancy, latency until the development of a secondary acute leukemia diagnosis, laboratory features, treatment and outcome at the onset of secondary acute leukemia. Results: Approximately 200 (5.1%) patients presented a previous malignancy. Twenty-one were aAected by ALL and 179 by AML. The proportion of patients with secondary AML was higher than that of patients with secondary ALL (179/2964 vs 21/901, O.R. 2.69‐95% C.I. 1.66‐4.39, P50.001). The median latency, from the onset of the previous malignancy to the development of secondary ALL was 27 months and to the development of secondary AML was 52 months (P50.05). Furthermore, of patients who previously received chemotherapy more developed a second AML (66/127 sAML vs 5/21 sALL; O.R. 3.46‐ 95% C.I. 1.10‐11.56, P50.01). Conclusion: In most cases, chemotherapy treatment for a previous malignancy can play a role in the development of secondary AML. In almost all cases of secondary ALL, the role of previous drugs does not appear to be relevant. On the basis of our analysis, performed systematically for the first time on a large adult series of acute leukemia, we conclude that in these patients a biological predisposition to cancer may be suspected. The Hematology Journal (2000) 1, 329‐332

A terahertz quantum cascade laser has been realized from an isotropic disordered hyperuniform design. Such a system presents a photonic band-gap (PBG) although it is characterized by an efficient depletion of long range order, which is counterintuitive. In this work, a hyperuniform distribution pattern, which is characterized by the total suppression of density fluctuations for long wavelengths [1] was investigated. The statistical properties of the distribution are globally isotropic while locally the system is anisotropic. Hyperuniform disordered patterns allow greater versatility in engineering band gaps in comparison to standard photonic-crystal and quasi-crystal designs. In fact, these PBGs can be tuned by acting a priori on an order parameter which regulates the degree of disorder in the system. The procedure for the realization of a 2D hyperuniform pattern has been done according to Ref. [1] and is based on a 2D scatterers distribution. The final design consists of a hyperuniform distribution of disks arranged in a hexagonal tile. This pattern was transferred in a finite element method solver (Comsol Multiphysics v4.2), where the eigenmodes are computed using the effective index approximation, in order to simulate the real device. The system presents a PBG as large as 17%. The highest Q-factor modes lies at the lower edge of the PBG and are localized, as shown in Fig. 1 a). The device fabrication is similar to the process described in [2] for the fabrication of photonic crystal THz QCL. An active region design with center emission frequency around at 3.1 THz, was processed into a disordered hyperuniform distribution of pillars, whose size have been scaled in order for the lower edge of the PBG to match the gain profile of the active region.

Funder: Dipartimento della Protezione Civile, Presidenza del Consiglio dei Ministri; doi: http://dx.doi.org/10.13039/100012783; Grant(s): ReLUIS research project - Working Pachage 16: Geotechnical Engineering - Task Group 2: Slope stability, Seismic performance of slopes can be assessed through displacement-based procedures where earthquake-induced displacements are usually computed following Newmark-type calculations. These can be adopted to perform a parametric integration of earthquake records to evaluate permanent displacements for different slope characteristics and seismic input properties. Several semi-empirical relationships can be obtained for different purposes: obtaining site-specific displacement hazard curves following a fully-probabilistic approach, to assess the seismic risk associated with the slope; providing semi-empirical models within a deterministic framework, where the seismic-induced permanent displacement is compared with threshold values related to different levels of seismic performance; calibrating the seismic coefficient to be used in pseudo-static calculations, where a safety factor against limit conditions is computed. In this paper, semi-empirical relationships are obtained as a result of a parametric integration of an updated version of the Italian strong-motion database, that, in turn, is described and compared to older versions of the database and to well-known ground motion prediction equations. Permanent displacement is expressed as a function of either ground motion parameters, for a given yield seismic coefficient of the slope, or of both ground motion parameters and the seismic coefficient. The first are meant to be used as a tool to develop site-specific displacement hazard curves, while the last can be used to evaluate earthquake-induced slope displacements, as well as to calibrate the seismic coefficient to be used in a pseudo-static analysis. Influence of the vertical component of seismic motion on these semi-empirical relationships is also assessed.

Background During recent years, interest on Sleep Disordered Breathing (SDB) in pediatric age has increased, due to the impact on quality of life, psycho-physical attitude and other serious morbidities if undiagnosed and untreated. Methods Italian Pediatric Respiratory Diseases Society (SIMRI) SDB-Working Group carried out an exploratory survey in Italy, from January to December 2016, to assess the diagnostic and therapeutic pathways, perception and relevance of SDB in Italian Hospitals. Results A questionnaire was sent to 180 Pediatric Units (PUs) distributed throughout the Italy; 102 Pediatric Units (PUs; 56.6%) answered and among them 57% dealt with SDB, and 94% recognized SDB as a major problem. Instrumental tests performed by the PUs were saturimetry (66%), nocturnal polygraphy with complete cardio-respiratory monitoring (46%) and full polysomnography (23%). In addition, hospital pediatricians reported that 54% of parents were unaware of the SDB and 84% did not know their complications. In the Northern Italy, the diagnosis was frequently performed with instrumental tools and the treatment was often surgical. In the Southern Italy the diagnosis was clinical, and the treatment was usually with drugs. Conclusions The results of our study showed a heterogeneity in the diagnosis and treatment of SDB throughout Italy. Parents know little about SDB and their complications. The operator satisfaction was associated with the availability of tools for diagnosing SDB. Electronic supplementary material The online version of this article (10.1186/s13052-019-0658-2) contains supplementary material, which is available to authorized users.