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The Path of Fertile Family (FFP) is a service for couples experiencing infertility, aimed to obtain natural conception, as an alternative to assisted reproductive techniques, developed in 2018 and provided by the Counseling Centre of Centro della Famiglia Foundation, an institute of culture and pastoral care of the Diocese of Treviso, in cooperation with the local socio-health unit. FFP offers to infertile couples a specific multidisciplinary path of care, including the involvement of specific gynecological, andrological, endocrinological, and psycho-relational competences, together with fertility awareness. It represents an “experiential laboratory” for the multidisciplinary diagnosis and treatment of infertility, for understanding relational processes, for the development of operational strategies and above all for the verification of the goodness of a lifestyle that is able to harmonize the couple’s project and the family’s project, couple satisfaction and parental openness. The setting of the service draws inspiration and reference from three paradigms from which significant ethical choices derive: the ecological perspective of fertility, the relational intimacy of the couple and a multidisciplinary approach. From the three founding paradigms, FFP model has been developed and progressively implemented in order to define a specific FFP Quality of Care Path (QCP) for couple infertility. Although further studies are needed to better clarify the role of each studied variable in a complex monitoring system, we identified for the first time a QCP Path based on 7 variables we present here two illustrative cases: the first one in which a natural conception has been obtained and the second one, in which the focus has been moved from natural conception to the reconstruction of relational competence. Further studies will demonstrate, on large scale, the efficacy of our protocol and of the analyzed variables. Summary: This paper provides an overview of the conceptual and methodological process of implementing the monitoring of the path of infertile couples towards natural conception in harmony with their relational life project. A multi-professional team accompanies couples in overcoming the obstacles to fertility and in the progressive awareness that parenting is not only biological. The result is a range of goals to strive for. The reference paradigms of the service justify the ethical choices of the couple and the team. The operating protocol supports the couple commitment and guides professionals in their effective action if competent and concerted. The variables identified are the monitoring tool that gradually indicates the degree of the path progress.

Traffic monitoring agencies collect traffic data samples to estimate annual average daily traffic (AADT) at short duration count sites. The steps to estimate AADT from sample data introduce error that manifests as uncertainty in the AADT statistic and its applications. Past research suggests that the assignment of a short duration count site to a traffic pattern group (TPG), characterized by known traffic periodicities, represents a significant but poorly quantified source of error. This paper presents an approach to quantify the range of errors arising from such assignments and to mitigate these errors using a novel data-driven assignment method. The approach uses simulated 48-hour short duration counts sampled from continuous count sites with known AADT to develop a benchmark of the total error expected when AADT is estimated from such samples. Likewise, the analysis produces a set of AADT estimates using temporal factors from pre-defined TPGs to quantify the range of assignment errors. The data-driven assignment method aims to mitigate these errors by minimizing the absolute mean deviation in AADT estimates produced from multiple short duration counts in a single year. The approach is applied to traffic data collected in Manitoba, Canada, as a case study. The results indicate that the mean absolute error from 48-hour short duration counts is 6.40% of the true AADT and that improper assignment can lead to a range in mean absolute errors of 9%. When applied to previously unassigned sites, the data-driven assignment method reduced mean absolute errors from 10.32%, using a conventional assignment method, to 7.86%.

Male accessory gland infection (MAGI) represents a frequent disease, commonly treated with antibiotics alone. However, in approximately 40% to 50% of patients, persistent infection is detected. Intestinal dysbiosis is involved in the pathogenesis of prostatitis. We aimed to evaluate the efficacy of antibiotic treatment in association with a specific probiotic supplementation. A total of 104 infertile patients, with microbiological analysis on semen and/or prostatic secretions positive for Gram-negative bacteria, have been enrolled. All patients received antibiotic treatment with fluoroquinolones. In total, 84 patients received a commercial association of Enterococcus faecium and Saccharomyces boulardii during antibiotic treatment, followed by treatment with Lactobacilli. After the treatment, a complete microbiological analysis was repeated. Polymicrobial infections have been observed in 11% of patients, while infections due to a single germ were reported in 89% of the patients. After the treatment was performed, a complete eradication with negative semen culture and microbiological analysis on prostatic secretion was observed in 64 of 84 patients (76.2%), while only 10 of 20 patients receiving antibiotics alone (50%; p < .05) reported negative microbiological analysis. Persistent infections have been observed only in patients with infections due to Enterococcus faecalis and Escherichia coli. This study represents the first approach demonstrating the efficacy of a specific probiotic treatment in reducing the rate of persistent infections in patients with MAGI.

Traffic volume, often measured in relation to annual average daily traffic (AADT), is a fundamental output of traffic monitoring programs. At continuous count sites, unusual events or counter malfunctions periodically cause data loss, which influences AADT accuracy and precision. This paper evaluates five methods used to calculate AADT values from continuous count data, including the use of a simple average, the commonly adopted method developed by AASHTO (the AASHTO method), and methods that incorporate adjustments to the AASHTO method. The evaluation imposes data removal scenarios designed to simulate real-life causes of data loss to quantify the accuracy and precision improvements provided by these adjustments. Truck traffic data are used to reveal issues arising when volumes are low or when they exhibit unusual temporal patterns. Unlike the AASHTO method, which incorporates a weighted average and an hourly base time period, the FHWA method provides the most accurate and precise results in all data removal scenarios, according to the evaluation. Specifically, when up to 15 days of data are randomly removed, application of the FHWA method can be expected to produce errors within approximately é1.4% of the true AADT value, 95% of the time. Results also demonstrate that including a weighted average improves AADT accuracy primarily, whereas the use of hourly rather than daily count data influences precision. If possible, practitioners contemplating the adoption of the FHWA method should assess its relative advantages within their local context.

The use of rail profile measurements for the planning and specification of rail-grinding activities normally involves comparing the existing and desired rail profiles within a rail segment. In current practice, a somewhat subjective approach is used to select a measured profile—usually located near the midpoint of the segment—that represents the profiles throughout the rail segment. Industry-standard rail profile data were used to develop an automated procedure for calculating a representative average (mean) rail profile for a rail segment. The procedure was verified by comparing the calculated average with an expected profile. Then, it was validated by comparing the calculated average profiles of 42 in-service rail segments (10 tangents and 32 curved segments) with the Corresponding median rail profiles for each segment, chosen subjectively. Validation results indicated that the coordinates comprising the mean and median profiles differed by less than 1%, on average. Agreement was stronger for tangent rail segments than for curved rail segments, as expected. Therefore, validation demonstrated that the procedure yields results comparable with current practice while it improves the objectivity and repeatability of the decisions that support rail-grinding activities. The procedure also offers the opportunity for integration with existing software tools to help automate the specification of grinding activities that minimize metal removal and prolong rail life.