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A 85–year–old female was transferred to our ICCU for acute heart failure from one of our spoke hospitals. The patient had a long history of chronic myelofibrosis, treated with fedratinib as a second–line agent after ruxolitinib failure. During a recent hospital admission, transthoracic echocardiography already showed signs of severe pulmonary hypertension (PH) with right ventricular (RV) dysfunction, so diuretic was started. On admission the patient presented showed consistent with acute on chronic kidney injury (serum Cr 3.2 mg/dl), stable anemia (Hb 9.2 mg/dl) and markedly elevated Nt–proBNP. A pulmonary CT–scan excluded acute pulmonary embolism and lung parenchymal alterations, with a clear dilation of main pulmonary artery. Transthoracic echocardiography (figure 1) confirmed precapillary PH phenotype diagnosis. Electrocardiogram (figure 2) showed sinus rhythm; incomplete RBBB, T wave inversion in V2 to V4. The patient was initially treated with high dose furosemide, low flow oxygen; but later she needed multiple cycles of inotropes, vasopressors and combined diuretic therapy (metolazone and acetazolamide) to stabilize the clinical setting. The patient also experienced episodes of paroxysmal high ventricular rate atrial flutter. After resolution of volume overload, a right heart catheterization was performed and findings were consistent with severe precapillary pulmonary hypertension: PA pressure 90/58/40 mmHg, normal PCWP, high PVR, mild cardiac index reduction. Due to critical clinical situation, Sildenafil 20 mg was started as an off–label therapy for PH (group 5). Subsequently, the patient experienced gradual but constant hemodynamic and clinical improvement and was discharged in NYHA class II. At 1 month control, patient was stable, echocardiogram revealed improvement in right ventricle dimension, systolic function and right atrial enlargement. At three months, patient is still in an intermediate risk class for PH, so we are evaluating a combination therapy (either endothelin receptor antagonist or prostanoids), taking into account anemia and thrombocytopenia. Take home message: PH can be a complication of hematological disorders as myelofibrosis, included in “mixed” forms (group 5) of PH. In our patient, after a challenging management for acute right heart failure, an off–label PDE–5 inhibitor stabilized the clinical scenario: more data are needed on PH drugs use in this setting where up to now therapeutic strategies are lacking.

Vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) are potentially severe and complex disease in its management among the various allergic eye diseases. In this regard, studies clarified the etiopathogenetic mechanisms. The workup should be multidisciplinary. The treatment includes topical and systemic medications with anti-inflammatory and immunosuppressant activity. However, a definition of nationally- and internationally-shared diagnostic protocols would also be needed and validated access to therapeutic options of proven safety and efficacy to avoid the use of galenic preparations, up to now still essential in the management of moderate-severe VKC. Finally, recognizing VKC and AKC, among rare diseases, at a national and international level would be an essential step to allow the management of VKC with adequate timings and settings within the National Health System.

The paper discusses the possibility of detecting local damages in complex structures typical of civil engineering, as multispan beams and trusses. Namely, it describes a procedure to identify localised cracks in structures in the elastic range of behaviour using only the values of natural frequencies in the intact configuration and in the damaged one evaluated by means of dynamic tests. The error minimisation procedure described in the paper selects the solution within a set of finite element models that simulate a range of positions and levels of damage, by identifying the damaged configuration as the one whose modal frequencies minimise the least-square difference with the measured data. The accuracy of the method is first investigated by applying it to the damage detection of a two-span steel beam, whose modal frequencies were obtained by means of experimental tests. To explore the accuracy of the proposed procedure, numerically simulated data with random noise were also generated for several positions and levels of damage and for different values of the random noise. The procedure was then extended, by means of numerical simulations, to the case of a beam with two localised damages. Finally, the procedure proposed for multispan beams is adapted to the damage identification of plane truss structures.

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The present paper deals with the evaluation of the seismic vulnerability of slender historical buildings; these structures, in fact, may manifest a high risk with respect to seismic actions as usually they have been designed to resist to gravitational loads only, and are characterized by a high flexibility. To evaluate this behavior, the bell tower of the Trani’s Cathedral is investigated. The tower is 57 m tall and is characterized by an unusual building typology, i.e., the walls are composed of a concrete core coupled with external masonry stones. The dynamic parameters and the mechanical properties of the tower have been evaluated on the basis of an extensive experimental campaign that made use of ambient vibration tests and ground penetrating radar tests. Such data have been utilized to calibrate a numerical model of the examined tower. A linear static analysis, a dynamic analysis and a nonlinear static analysis have been carried out on such model to evaluate the displacement capacity of the tower and the seismic risk assessment in accordance with the Italian guidelines.

The aim of this paper is to discuss the current evidence regarding short and long-term health respiratory effects of nutrients and dietary patterns during the first 1000 days from conception. Population of interest included children from birth to two years and their mothers (during pregnancy and lactation). Studies were searched on MEDLINE® and Cochrane database, inserting individually and using the Boolean ANDs and ORs, ‘nutrients’, ‘micronutrients’, ‘LC-PUFA’, ‘Mediterranean Diet’, ‘human milk’, ‘complementary food’, ‘pregnancy’, ‘respiratory disease’, ‘pulmonary disease’, ‘asthma’, ‘epigenetics’, ‘first 1000 days’, ‘maternal diet’ and ‘respiratory health’. All sources were retrieved between 01-09-2015 and 07-12-2016. While unhealthy maternal dietary patterns (high fat intake) during pregnancy can result in alteration of foetal lung development, with increased risk of respiratory disorders, Mediterranean diet has been associated with a lower risk of allergic sensitisation and allergic rhinitis. Breastfeeding has beneficial effects on respiratory infections while evidences about its protective effect on allergic disorders are unclear. During complementary feeding there is no evidence to avoid or encourage exposition to ‘highly allergenic’ foods to have modification of tolerance development. In children from birth to two years of age, Mediterranean diet has been associated with a lower risk of atopy, wheezing and asthma. Micronutrients, antioxidant and LCPUFA supplementation is not recommended and a whole food approach should be preferred, except for Vitamin D.

Aims.We study the efficiency and reliability of cluster mass estimators that are based on the projected phase-space distribution of galaxies in a cluster region.

The detection of an excess of soft X-ray or Extreme Ultraviolet (EUV) radiation, above the thermal contribution from the hot intracluster medium (ICM), has been a controversial subject ever since the initial discovery of this phenomenon. We use a large-scale hydrodynamical simulation of a concordance ΛCDM model, to investigate the possible thermal origin of such an excess in a set of 20 simulated clusters having temperatures in the range 1-7 keV. Simulated clusters are analysed by mimicking the observational procedure applied to ROSAT-PSPC data, which for the first time showed evidence for the soft X-ray excess: we compare the low-energy (e.g. [ 0.2-1]  keV) part of the spectrum of each cluster with that predicted for a plasma having temperature and metallicity as computed after weighting by the emissivity in a harder band (e.g., [ 1-2]  keV). For distances to the cluster center $0.4< R/R_{\rm vir}< 0.7$we detect a significant excess in most of the simulated clusters, whose relative amount changes from cluster to cluster and, for the same cluster, by changing the projection direction. In about 30 per cent of the cases the soft X-ray flux is measured to be at least 50 per cent larger than predicted by the one-temperature plasma model. We find that this excess is generated in most cases within the virialized regions of the cluster. It mainly comes from low-entropy and high-density gas associated with merging sub-halos, rather than from diffuse warm gas. Only in a few cases does the excess arise from fore/background groups observed in projection, while no evidence is found for a significant contribution from gas lying within large-scale filaments. We compute the distribution of the relative soft excess, as a function of the distance to the cluster center , and compare it with the observational result by Bonamente et al. ([CITE]) for the Coma cluster. As in the observations, we find that the relative excess increases with the distance from the cluster center, with no significant excess detected for $R<0.4R_{\rm vir}$. However, an excess as large as that reported for the Coma cluster at scales $0.4\la R/R_{\rm vir}\la 0.7$is found to be rather unusual in our set of simulated clusters.

The existence of a wide reinforced concrete (r.c.) building stock, which is reaching the end of its service life, has focused the attention on its vulnerability assessment. The first step of this analysis is the estimation of the concrete compressive strength. In this field, many codes allow to supplement the classical destructive tests with nondestructive ones, because of their versality and of the possibility of reducing the time spent for tests. It is worth noting that the spread of these tests is strictly connected to the accuracy of the conversion models, which correlate the nondestructive measurements to the concrete strength. The present paper deals with this issue by examining the results of the experimental investigations, which made use of destructive and ultrasonic pulse velocity tests, on three r.c. buildings in Bari (Italy). The data are analyzed and rearranged to define several testing conditions, for each one of which a conversion model is calibrated. Moreover, the variability of the parameters of the identified models is discussed with respect to the number of data considered in the calibration process, to the chosen model, and to the accuracy of the assessed strength.

In this paper, the experimental modal identification analysis of the public building “San Giacomo” in Corfu (Greece) is illustrated. It represents the unique example of a structure built utilising carves stones inside the city of Corfu. The building has a rectangular plan shape with dimensions 24.75 x 14 m, and height 9 m; all the floors are made by wood. The monitoring system consists of several elements properly connected: the units of acquisitions or piezoelectric accelerometers (in total 18 installed on the different walls) with a sensitivity of 1000 mV/g; the data acquisition system or DAQs positioned at each monitored level; the laptop with an acquisition software; the cables that connect all elements to each other. The paper describes the phases of the investigations, the technical details of the performed in-situ tests, the first identified frequencies of the building by means of the classical methods of Operational Modal Analysis (OMA) and the comments about the acquired data.

The present paper is centered on the static and dynamic analysis of the fortified tower of San Felice sul Panaro (Italy) citadel. The examined tower, that dated back to the XIV century, is particularly vulnerable to seismic forces, as the recent Emilia Romagna earthquake (2012) has demonstrated, and can be considered representative of a wide class of masonry towers located in the north of Italy. In order to evaluate the structural behavior, detailed numerical models of the tower with different level of complexity have been defined. In particular, the present paper shows the preliminary results of the static and dynamic analysis performed on such models and the influence of some parameters on the tower dynamic behavior.

Background: To investigate endothelial dysfunction and morphological vascular changes in childhood obesity.Methods: 93 overweight/obese children (body mass index 26 ± 5 kg/m2; median 26 kg/m2; interquartile range 22–28 kg/m2), mean age 10.9 ± 2.7 years, underwent a check-up of total, high-density lipoprotein- and low-density lipoprotein-cholesterol, triglycerides, C-reactive protein, erythrocyte sedimentation rate, and white blood cell count, together with ultrasound measures of flow-mediated dilatation, carotid intima-media thickness, and anterior-posterior diameter of the abdominal aorta.Results: The body mass index of overweight/obese children had a statistically significant linear relationship (p < 0.05) with triglycerides, erythrocyte sedimentation rate, carotid intima-media thickness, anterior-posterior diameter of the abdominal aorta, and flow-mediated dilatation values.Conclusions: Overweight/obese children have an initial endothelial dysfunction and vascular damage, i.e., the first stage in the development of atherosclerosis.

The study of the broadband emission of GHzPeakedSpectrum GPS radio galaxies is a powerful tool to investigate the physical processes taking place in the central, kpcsized region of their active hosts, where the jets propagate and the lobes expand, interacting with the surrounding interstellar medium ISM. We recently developed a new dynamicalradiative model to describe the evolution of the GPS phenomenon Stawarz et al. 2008: as the relativistic jets propagate through the ISM, gradually engulfing narrowline emitting gas clouds along their way, the electron population of the expanding lobes evolves, emitting synchrotron light, as well as inverseCompton radiation via upscattering of the photon fields from the host galaxy and its active nucleus. The model, which successfully reproduces the key features of the GPS radio sources as a class, provides a description of the evolution of their spectral energy distribution SED with the lobes expansion, predicting significant and complex Xray to γray emission.We apply here the model to the broadband SEDs of a sample of known, Xray emitting GPS galaxies, and show that i the freefree absorption mechanism enables us to reproduce the radio continuum at frequencies below the turnover; ii the lobes nonthermal, inverseCompton emission can account for the observed Xray spectra, providing a viable alternative to the thermal, accretiondominated scenario. We also show that, in our sample, the relationship between the Xray and radio hydrogen column densities, NHand NHI, is suggestive of a positive correlation, which, if confirmed, would support the scenario of highenergy emitting lobes © 2009 WILEYVCH Verlag GmbH & Co. KGaA, Weinheim

We present a new determination of the cluster mass function and velocity dispersion function in a volume ~107 h3 Mpc-3 using data from the Fourth Data Release of the Sloan Digital Sky Survey (SDSS) to determine virial masses. We use the caustic technique to remove foreground and background galaxies. The cluster virial mass function agrees well with recent estimates from both X-ray observations and cluster richnesses. Our determination of the mass function lies between those predicted by the 1 and 3 year WMAP data. We constrain the cosmological parameters Om and s8 and find good agreement with WMAP and constraints from other techniques. With the CIRS mass function alone, we estimate Om = 0.24img1.gif and s8 = 0.92img2.gif, or s8 = 0.84 +-0.03 when holding Om = 0.3 fixed. We also use the WMAP parameters as priors and constrain velocity segregation in clusters. Using the 1 and 3 year results, we infer velocity segregation of sgxy/sDM [?] 0.94 +- 0.05 or 1.28 +- 0.06, respectively. The good agreement of various estimates of the cluster mass function shows that it is a useful independent constraint on estimates of cosmological parameters. We compare the velocity dispersion function of clusters to that of early-type galaxies and conclude that clusters comprise the high-velocity end of the velocity dispersion function of dark matter halos. Future studies of galaxy groups are needed to study the transition between dark matter halos containing individual galaxies and those containing systems of galaxies. The evolution of cluster abundances provides constraints on dark energy models; the mass function presented here offers an important low-redshift calibration benchmark.

In hierarchical clustering, galaxy clusters accrete mass through the aggregation of smaller systems. Thus, the velocity field of the infall regions of clusters contains significant random motion superposed on radial infall. Because the purely spherical infall model does not predict the amplitude of the velocity field correctly, methods estimating the cosmological density parameter O0 based on this model yield unreliable biased results. In fact, the amplitude of the velocity field depends on local dynamics and only very weakly on the global properties of the universe. We use N-body simulations of flat and open universes to show that the amplitude of the velocity field of the infall regions of dark matter halos is a direct measure of the escape velocity within these regions. We can use this amplitude to estimate the mass of dark matter halos within a few megaparsecs from the halo center. In this region dynamical equilibrium assumptions do not hold. The method yields a mass estimate with better than 30% accuracy. If galaxies trace the velocity field of the infall regions of clusters reliably, this method provides a straightforward way to estimate the amount of mass surrounding rich galaxy clusters from redshift data alone.

Using high‐resolution cosmological N‐body simulations, we investigate the survival of dark matter satellites falling into larger haloes. Satellites preserve their identity for some time after merging. We compute their loss of mass, energy and angular momentum as they are dissolved by dynamical friction, tidal forces and collisions with other satellites. We also analyse the evolution of their internal structure. Satellites with less than a few per cent of the mass of the main halo may survive for several billion years, whereas larger satellites rapidly sink into the centre of the main halo potential well and lose their identity. Penetrating encounters between satellites are frequent and may lead to significant mass loss and disruption. Only a minor fraction of cluster mass (10–15 per cent on average) is bound to substructure at most redshifts of interest. We discuss the application of these results to the survival and extent of dark matter haloes associated with galaxies in clusters, and to their interactions. We find that a minor fraction of galaxy‐size dark matter haloes are disrupted by redshift z= 0. The fraction of satellites undergoing close encounters is similar to the observed fraction of interacting or merging galaxies in clusters at moderate redshift.

We examine the systematics affecting the X-ray mass estimators applied to Chandra-like long exposures images of five simulated clusters.

Using the caustic method, we identify the member stars of five dwarf spheroidal (dSph) galaxies of the Milky Way, the smallest dark matter (DM) dominated systems in the Universe. After our interloper rejection, we compute line-of-sight velocity dispersion profiles that are substantially smoother than previous results. Moreover, two dSphs have line-of-sight velocity dispersions 20% smaller than previous calculations suggested. Our Jeans modelling confirms that the DM content interior to 300 pc is roughly constant with satellite luminosity. Finally, if we assume that MOND provides the true law of gravity, our identification of interlopers implies that four dSphs have mass-to-light ratios in agreement with stellar population synthesis models, whereas Carina still has a mass-to-light ratio a factor of two too large and remains a problem for MOND.