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Objective: This study aims to evaluate long-term functional, sexual, and cosmetic outcomes in adult patients who underwent hypospadias repair during childhood at a national highly specialized pediatric hospital. Methods: Medical records of pediatric patients who had undergone surgical repair of hypospadias between 1993 and 2004 at Meyer Children Hospital of Florence were reviewed. Adult patients were contacted by telephone between July and August 2021 and invited to participate. Long-term surgical outcomes were assessed focusing on complications and reinterventions, and 3 validated questionnaires on urinary function, erectile function, and penile cosmetic appearance were administered. Results: From January 1993 to December 2004, a total of 799 patients with hypospadias underwent repair surgery. Two hundred thirty-nine patients gave consent to be included in the study. Follow-ups occurred between 17 and 28 years after the first surgery. Most patients had anterior localization of hypospadias (210/239) and associated penile curvature (132/239). The most frequent surgery for hypospadias repair was meatal advancement and glanduloplasty incorporated (MAGPI) (88/239), and the most used surgical treatment for penile curvature was the Nesbit technique (49/132). The complication rate was 27% (65/239) in an average time of 4.7 years, and 48 surgical procedures have been performed to treat them. At follow-up, the mean IPSS was 0.96 ± 1.97, the mean IIEF-5 score was 24.10 ± 1.02, and the mean HOSE score was 15.47 ± 0.45. Patients who underwent reintervention reported a lower IPSS than those who underwent only 1 surgery (0.29 vs. 1.16). Conclusion: Hypospadias repair during childhood leads to rather normal urinary and sexual function and penile cosmetic appearance in adolescence and adulthood.

Polycarbonate (PC) is a thermoplastic polymer used in many engineering applications such as safety devices and aerospace components. However, the unique behavior of PC under tensile load and its effects on the estimation of its constitutive curve are often overlooked in the literature, neglecting to consider crucial aspects of the characterization process. This work carries out a comprehensive analysis of the mechanical behavior of PC to understand the key points for accurate constitutive modeling and simulation of its static tensile performance, including its unconventional deformation mechanisms. The work starts from the accurate analysis of a representative experimental static tensile test on a rectangular section PC specimen and the evaluation of its true stress-strain curve. This analysis, carried out considering the classic length-based approach and the more accurate area-based approach, makes it possible to evaluate in detail the peculiar tensile behavior of this material. The mathematical form of the PC true stress-strain curve is then justified and the coincidence of the obtained length-based and area-based estimates of the same is demonstrated. Then, based on the in-depth understanding of the dynamics underlying the mechanical behavior of PC and making use of FEM simulations, the key points for obtaining its constitutive curve are defined. It is demonstrated that the constitutive curve is able to completely determine the behavior of PC, including its peculiar deformation mechanism. It is also highlighted which specific characteristics of the constitutive curve are critical in affecting various aspects of the material's behavior. The final constitutive curve of PC at hand is then obtained with an inverse approach, capable of accurately simulating all aspects of its tensile behavior. The validity of the proposed modelling key points is then confirmed, effectively explaining the underlying phenomena controlling the tensile behavior of PC and massively reducing uncertainty in the estimation of its constitutive curve starting from its area-based true curve.

Equivalent viscous damping plays a central role in displacement-based design procedures. In this paper, approaches for estimating the equivalent viscous damping of RC frame buildings are proposed. At first, the analytical formulation of Blandon and Priestley was analysed, and then a calibration of the coefficients of this formulation was performed. Compared with the work of Blandon and Priestley, a larger set of synthetic accelerograms, related to different types of soil and different intensities, and a wider range of the effective periods were considered. In particular, two different sets of parameters are proposed: the first is usable in the case of spectra obtained numerically (approach 1), and the second is usable in the case of code-based spectra and damping modification factor (approach 2). To test the performed calibration and to compare the considered formulations (i.e., the proposed and literature equations), the direct displacement-based design procedure has been applied to three case studies of reinforced concrete frame structures, and then pushover and nonlinear time-history analyses have been performed. The results show that the use of the calibrated parameters (for both the considered approaches) has determined more conservative results, in terms of design base shear and maximum drift from NLTH. Moreover, the average displacement profiles and the inter-storey drifts obtained from time-history analyses for the frames designed with the calibrated parameters match better the design profile.

In recent years, polymeric materials have gained prominence as a competitive option for gear manufacturing. Nevertheless, the absence of comprehensive literature addressing the wear due to the coupling of these materials presents a real challenge in response to this innovative trend. Wear of plastic gearwheels represents, in fact, a key issue, traditionally assessed using standard formulations under optimal dry operating conditions. These calculations often rely on coefficients derived from specialized gear tests, but their applicability is constrained to specific polymer–metal combinations. This research was dedicated to the development of a test bench tailored to evaluate the wear of glass fiber-reinforced self-lubricating polymer gearwheels under different operating conditions. This study commenced with a comprehensive exploration of wear phenomena in thermoplastic gearwheels and the inherent challenges associated with utilizing existing standards and the scientific literature for wear analysis. This was followed by a careful evaluation of the operational needs of the test bench, which, starting from a basic solution already implemented, improved its use in various aspects. Finally, this study introduced an optical-based methodology for average linear wear control. This research strived to establish a testing approach that minimizes uncertainties when assessing the wear of thermoplastic gears.

The study presented in this paper was undertaken in response to two instances of unexpected blade breakage in the cutting blade used in a Carton Wrap machine (CW). Failure of the Al7075 alloy blade occurred at an indentation during typical operational loading conditions. Subsequent metallographic examinations of the fractured samples confirmed that both cases were attributed to fatigue failure. The main objective of this study is to investigate potential causes of fatigue failure in the CW blade using simplified linear elastic static numerical simulations through Finite Element Analysis (FEA). In this research, we employed the well-established Theory of Critical Distance (TCD), and this case study provided a contextualization at an industrial level. Furthermore, the analysis focused on a second key aspect: proposing a new blade geometry aimed at mitigating the identified issues and eliminating possible causes of failure. In this context, the actual stress concentration at the indentation was determined using the TCD with Line Method (LM). The results from the numerical simulations indicated that the new blade geometry significantly reduced stress concentration, resulting in a risk factor reduction of approximately four compared to the original blade design, even under non-optimal operating conditions. Overall, in conjunction with simple linear static FEA, the proposed numerical approach provided substantial support for designers, especially in fault analysis and when comparing different industrial solutions.

This paper focuses on the effect of rapid annealing on Non-Grain Oriented Electrical Steel (NGO) in terms of microstructure, mechanical properties, and magnetic properties. The Ultra-Fast Heating (UFH) tests were performed by a transversal induction heater on NGO electrical steel samples (cold rolled down to 0.5 mm), varying the heating power (80 kW and 90 kW) and the speed of the strip through the induction heater. This allowed us to exploit heating rates (HR) in the range of 200–300 °C/s and targeting peak temperature (Tpeak) up to a maximum of 1250 °C. The comparison between the microstructure as obtained by conventional annealing and the ultra-fast heating process highlights a clear effect in terms of grain size refinement provided by the UFH. In particular, the average grain size as obtained by UFH ranges two/three times lower than by a conventional process. The results show the possibility of applying UFH to NGO steels, targeting mechanical properties such as those obtained by the standard process, combined with the benefits from this innovative heat treatment in terms of green energy and the minimization of CO2 emissions. Magnetic characterization performed by a single sheet tester (30 × 90 mm) showed that the values of core losses are comparable with conventional NGO grades.

One of the most important factors that influence people’s daily lives and their well-being at work is the so-called “worker safety”. Different literature works demonstrated the positive effects on worker mood and well-being brought by the awareness of being in a safe environment and, consequently, less prone to accidents. Every working environment should guarantee safety protection to employees and operators both in normal operations and extraordinary duties (e.g., maintenance operations), however, the industrial domain is the one that is more exposed to risks for workers. Different technologies already accomplished such requirements in “normal” operations, nonetheless, the literature still lacks solutions to also monitor and guide operators during exceptional and dangerous operations (e.g., maintenance). The combination of IoT and Industry 4.0 can guide the research toward the resolution of the maintenance-related exposed problems. This paper proposes an IoT-aware architecture for the industrial domain to support maintenance operators. It was designed to guide them step by step while real-time monitoring plant, machinery, and other employees working in the same area. During the maintenance procedure, the operator is guided in the proper execution of every single step required by maintenance and an autonomous IoT system monitors the status of the different parts of the plants and machinery to, then, authorize and show, the next steps foreseen in the maintenance process. To test the feasibility and usefulness of the proposed system, a prototype was developed and functionally tested through the exploitation of a machinery simulator and a real lathe machine.

Natural frequencies have always been one of the most intuitive and widely used features for damage identification in civil structures. Even with the recent rapid technological and theoretical developments, frequency-based identification methods are of great interest for applications through low-cost sensing systems. Although most techniques for frequency identification assume a linear structural behavior, in real applications, variations in the amplitude of input excitation can lead to short-term frequency fluctuations due to the inherent nonlinearities of civil structures. This paper proposes a procedure for damage detection in nonlinear systems based on instantaneous resonant frequency and amplitude estimates. A statistical model was fitted to identified data, and a synthetic indicator was proposed to obtain robust damage detection, even when frequency shifts due to variations in the input excitation are comparable to those due to actual damage. The proposed method was applied to a dataset recorded from a reinforced concrete building with strongly nonlinear behavior.

Ballistic penetration of machine guards is a topic of great significance for ensuring safety and avoiding projection of objects out of the working space of machines. Although standardized tests are performed according to EU Directive 2006/42/EC, they have some limitations because they are carried out using a given penetrator that perpendicularly impacts a given surface of about 500 × 500 mm. Nevertheless, the withstanding capacity of those guards depends on a lot of different design parameters and physical quantities that have not been fully investigated. This paper is focused on the study of the influence of the machine guard size on the withstanding capacity to ballistic penetration throughout theoretical models and experimental tests based on an innovative method involving the use of 3D optical scanners for inspection. The experimental analyses described in this work, compared to theoretical results, demonstrate that a maximum plastic deformation area can be defined, independently of the plate size, given the same material, thickness, and penetrator. This result allows to set proper new ranges for standardized tests, overcoming the limitation of using specific sample sizes.

The main purpose of this work is to investigate the usability of easily obtainable parameters instead of the modal traditional ones, in the context of a flexibility-based damage detection procedure, under the assumption of unknown structural masses. To this aim, a comparison is made between two different approaches: the first involves the calculation of the flexibility matrix by using traditional modal parameters, such as natural frequencies and modal vectors, normalized to unitary values, while the second involves the use of singular vectors, obtained through a simple matrix factorization. The modal parameters and the singular vectors necessary for the implementation of the damage detection procedure are evaluated through two different techniques: the Eigensystem Realization Algorithm and a wavelet-based procedure, for which a variant is proposed by introducing the energy reassignment concept into the original algorithm. Through the latter approach, in particular, it is possible to obtain a high number of singular vectors even in the case of reduced availability of sensors. The study is performed under the assumption of nonstationary excitation, in order to achieve general results, and the effectiveness of the procedures is evaluated through simulated tests regarding different structural schemes.

In this paper, the mechanical behavior of concrete twin-shaft mixers is analyzed in terms of power consumption and exchanged forces between the mixture and the mixing organs during the mixing cycle. The mixing cycle is divided into two macro phases, named transient and regime phase, where the behavior of the mixture is modeled in two different ways. A force estimation and power consumption prediction model are presented for both the studied phases and they are validated by experimental campaigns. From the application of this model to different machines and by varying different design parameters, the optimization of the power consumption of the concrete twin-shaft mixers is analyzed. Results of this work can be used to increase productivity and profitability of concrete mixers and reduce energy waste in the industries which involve mixing processes.

Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy.

Abstract The purpose of this study was to investigate the effect of diabetic retinopathy (DR) on longitudinal morphological changes in AMD-associated type 1 macular neovascularization using optical coherence tomography angiography (OCTA). We enrolled fifty treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV. Twenty of 50 eyes were affected by mild DR. En face OCT angiography were examined for the MNV lesion area (mm2), the MNV flow area (mm2), the central macular thickness (CMT) and the BCVA. The OCTA acquisition was performed at the following visits: (i) before the loading phase (LP) of intravitreal injection of aflibercept (T1), and (ii) 1 month after the last intravitreal injection of loading phase comprising 3 monthly injections (T2). All morpho-functional parameters showed a significantly change at T2 compared to T1 values in both groups. Furthermore, we found a greater MNV area reduction after LP in eyes without DR (P = 0.023). With regard to the remaining parameters, no significant changes were found between two groups (P > 0.05). Our analysis revealed a less MNV area reduction after loading dose of anti-VEGF therapy in eyes affected by diabetic retinopathy.

IntroductionInverted Internal Limiting Membrane (ILM)-flap technique demonstrated its effectiveness, in terms of anatomical closure rate and visual acuity recovery for high myopic macular holes. We evaluated macular function after a successful inverted ILM-flap for macular holes in high myopic eyes (hMMH) using microperimetry to predict visual prognosis.MethodsA retrospective study on 23 eyes of 23 patients after surgical closure of hMMH, was performed. All patients underwent inverted ILM-flap and gas tamponade. Cataract surgery was performed in phakic eyes. Study outcomes including best-corrected visual acuity (BCVA), retinal sensitivity (RS) at central 12°, central retinal sensitivity (CRS) at central 4° and mean deviation (MD), and fixation behavior as bivariate contour ellipse area (BCEA, degrees2) measured by microperimetry, were evaluated over 6 months. A mixed-effects model was used to evaluate and compare the repeated measurements of outcomes between phakic and pseudophakic eyes. A regression model was performed to assess the relationship between BCVA at 6 months and independent variables.ResultsOverall mean BCVA improved from 0.98 ± 0.21 logMAR at baseline to 0.47 ± 0.31 logMAR at the last follow-up (p

BackgroundAge is a leading contributor to the liver fibrosis rate and a gradual deterioration of optical function, but this association in older populations is still under-explored. The present study aimed to explore the link between vascular and neural retinal characteristics and the risk of liver fibrosis in 731 older adults from the population-based Salus in Apulia study.MethodsRetinal features were obtained using optical coherence tomography (OCT) and OCT-angiography (OCT-A). Liver fibrosis risk was taken as the fibrosis-4 (FIB-4) score. Generalized linear models (logistic regression) were used to estimate the association effect between each unit increase of OCT and OCT-A parameters as independent variables and a FIB-4 ≥ 2.67 score as an outcome. Generalized additive models were used to assess the non-linear association between OCT-A features and the linear FIB-4 score.ResultsIncreased gangliar cell complex (GCC) thickness was inversely associated with a FIB-4 score above the cut-off in both the raw model (OR: 0.98; 95% CI: 0.96–0.99; SE: 0.01) and after adjustment for age, sex, education, hypertension, diabetes, total cholesterol, and triglycerides (OR: 0.98; 95% CI: 0.97–0.99; SE: 0.01).ConclusionOur findings add to the growing volume of scientific literature demonstrating that liver fibrosis is associated with retinal neurodegeneration. This study raises a number of new questions, including whether OCT-A may be used to track the progression of metabolic abnormalities and define exact thresholds for predicting and classifying liver disease.

The present study was conducted to investigate the potential of radiomics to develop an explainable AI-based system to be applied to ultra-widefield fundus retinographies (UWF-FRTs) with the objective of predicting the presence of the early signs of Age-related Macular Degeneration (AMD) and stratifying subjects with low- versus high-risk of AMD. The ultimate aim was to provide clinicians with an automatic classifier and a signature of objective quantitative image biomarkers of AMD. The use of Machine Learning (ML) and radiomics was based on intensity and texture analysis in the macular region, detected by a Deep Learning (DL)-based macular detector. Two-hundred and twenty six UWF-FRTs were retrospectively collected from two centres and manually annotated to train and test the algorithms. Notably, the combination of the ML-based radiomics model and the DL-based macular detector reported 93% sensitivity and 74% specificity when applied to the data of the centre used for external testing, capturing explainable features associated with drusen or pigmentary abnormalities. In comparison to the human operator’s annotations, the system yielded a 0.79 Cohen κ, demonstrating substantial concordance. To our knowledge, these results are the first provided by a radiomic approach for AMD supporting the suitability of an explainable feature extraction method combined with ML for UWF-FRT.

ObjectiveTo explore the linear association between inner retinal layers thickness and macular capillary density compared to variations of global cognition evaluated by psychometric measures in a cohort of Mediterranean subjects aged 65+ years.Materials and methodsWe performed a cross-sectional analysis of 574 participants aged 65 years+ drawn from a population-based Southern Italian study. All subjects underwent neurological evaluations, including global cognitive screening, the Mini-Mental State Examination (MMSE) and frontal assessment battery (FAB), together with an ophthalmic examination including optical coherence tomography (OCT) and OCT-Angiography. We assessed the average thickness of the ganglion cell complex (GCC) and the retinal nerve fiber layer (RNFL), the foveal avascular zone area, and vascular density (VD) of superficial (SVD) and deep (DVD) capillary plexi at the foveal and parafoveal area. Linear regression was applied to assess associations of ocular measurements with MMSE and FAB scores.ResultsIn the linear regression model, foveal DVD (beta = 0.01, 95% CI:0.004–0.052), whole DVD (beta = 0.04, 95% CI:0.02–0.08), and whole SVD (beta = 0.04, 95% CI:0.02–0.07) showed a positive association with MMSE. In addition, foveal SVD (beta = 0.01, 95% CI:0.003–0.05) and whole SVD (beta = 0.03, 95% CI:0.004–0.08) were positively associated with the FAB score. We found no further significant association between the MMSE score or the FAB score and the average thickness of the GCC and RNFL, and FAZ area.ConclusionA direct linear association between the VD of the macular capillary plexi with global and frontal cognitive functions was observed in elderly subjects.