Search

Background Functional outcomes after ileoanal pouch creation have been studied; however, there is great variability in how relevant outcomes are defined and reported. More importantly, the perspective of patients has not been represented in deciding which outcomes should be the focus of research. Objective The primary aim was to create a patient-centered definition of core symptoms that should be included in future studies of pouch function. Design This was a Delphi consensus study. Setting Three rounds of surveys were used to select high-priority items. Survey voting was followed by a series of online patient consultation meetings used to clarify voting trends. A final online consensus meeting with representation from all 3 expert panels was held to finalize a consensus statement. Patients Expert stakeholders were chosen to correlate with the clinical scenario of the multidisciplinary team that cares for pouch patients, including patients, colorectal surgeons, and gastroenterologists or other clinicians. Main outcome measures A consensus statement was the main outcome. Results patients, 62 colorectal surgeons, and 48 gastroenterologists or nurse specialists completed all 3 Delphi rounds. Fifty-three patients participated in online focus groups. One hundred sixty-one stakeholders participated in the final consensus meeting. On conclusion of the consensus meeting, 7 bowel symptoms and 7 consequences of undergoing ileoanal pouch surgery were included in the final consensus statement. Limitations The study was limited by online recruitment bias. Conclusions This study is the first to identify key functional outcomes after pouch surgery with direct input from a large panel of ileoanal pouch patients. The inclusion of patients in all stages of the consensus process allowed for a true patient-centered approach in defining the core domains that should be focused on in future studies of pouch function. See Video Abstract at http://links.lww.com/DCR/B571. Los pacientes sometidos a ciruga de reservorio ileoanal experimentan una constelacin de sntomas y consecuencias que representan un sndrome unico Un Informe de los Resultados Reportados por los Pacientes Posterior a la Cirugia de Reservorio (PROPS) Estudio de Consenso DelphiANTECEDENTES:Los resultados funcionales despues de la creacion del reservorio ileoanal han sido estudiados; sin embargo, existe una gran variabilidad en la forma en que se definen y reportan los resultados relevantes. Mas importante aun, la perspectiva de los pacientes no se ha representado a la hora de decidir que resultados deberian ser el foco de investigacion.OBJETIVO:El objetivo principal era crear en el paciente una definicion centrada de los sintomas principales que deberia incluirse en los estudios futuros de la funcion del reservorio.DISENO:Estudio de consenso Delphi.ENTORNO CLINICO:Se emplearon tres rondas de encuestas para seleccionar elementos de alta prioridad. La votacion de la encuesta fue seguida por una serie de reuniones de consulta de pacientes en linea que se utilizan para aclarar las tendencias de votacion. Se realizo una reunion de consenso final en linea con representacion de los tres paneles de expertos para finalizar una declaracion de consenso.PACIENTES:Se eligieron partes interesadas expertas para correlacionar con el escenario clinico del equipo multidisciplinario que atiende a los pacientes con reservorio: pacientes, cirujanos colorrectales, gastroenterologos / otros medicos.PRINCIPALES MEDIDAS DE VALORACION:Declaracion de consenso.RESULTADOS:Ciento noventa y cinco pacientes, 62 cirujanos colorrectales y 48 gastroenterologos / enfermeras especialistas completaron las tres rondas Delphi. 53 pacientes participaron en grupos focales en linea. 161 interesados participaron en la reunion de consenso final. Al concluir la reunion de consenso, siete sintomas intestinales y siete consecuencias de someterse a una cirugia de reservorio ileoanal se incluyeron en la declaracion de consenso final.LIMITACIONES:Sesgo de reclutamiento en linea.CONCLUSIONES:Este estudio es el primero en identificar resultados funcionales claves despues de la cirugia de reservorio con informacion directa de un gran panel de pacientes con reservorio ileoanal. La inclusion de pacientes en todas las etapas del proceso de consenso permitio un verdadero enfoque centrado en el paciente para definir los dominios principales en los que deberia centrarse los estudios futuros de la funcion del reservorio. Consulte Video Resumen en http://links.lww.com/DCR/B571.

While fecal incontinence and constipation can be measured through physiological testing, the subjective experience of severity and impact on health-related quality of life lead to both being most effectively captured through patient-reported measures. Patient-reported measures of severity and impact help to determine baseline symptoms, guide clinical decision making, and compare various treatments. Here, we take pause to review the psychometric qualities that make effective instruments, and discuss some of the most commonly used instruments along with the reasons behind their use. In addition, we highlight the benefits of a standardized instrument designed to evaluate the major symptoms of patients presenting with pelvic floor disorders (including fecal incontinence and constipation). Ultimately, we aim to provide guidance in choosing appropriate instruments for clinical and research use.

Introduction Volume depletion can trigger atrial fibrillation through the alteration of the balance of autonomic tone. Hemodynamic response to crystalloid infusion has never been investigated in Paroxysmal AF patients. In this pilot study we have evaluated volume expansion response using Doppler echocardiogaphy in a group of patients coming to our Emergency Department because of symptomatic paroxysmal AF. Methods In a group of consecutive Paroxysmal AF patients we performed a comprehensive echocardiographic examination including Vena Cava diameters and inspiratory collapse rate (from bidimensional subxiphoid view) and including Left Ventricular Outflow time–velocity integral (as mean value of 10 consecutive cardiac cycles). Those with mitral, aortic or tricuspid regrgitation of grade higher than 2+/4+, mitral stenosis, prosthethic mitral valve, FE Results Fluid challenge showed positive response in 7/13 patients. From ROC curve analysis an inspiratory diameter of 9,5 mm or a respiratory collapse of 52% or more both had a 75% sensitivity for volume challenge responsiveness. Conclusion Accounting for small sample size this preliminary work suggests that non invasive bedside parameters easy to evaluate can guide Paroxysmal AF management with crysalloid infusion on top of standard therapy. 1. Preau S et al Crit Care Med 2016; 45: e290–7 2. Bortolotti P et al Ann Intensive Care 2018; 8: 79

The most promising probe to establish the Majorana or Dirac nature of the neutrino is the neutrinoless double beta decay and the effective neutrino mass would be evaluated by the knowledge of the corresponding nuclear matrix elements. Also measurements of the Double Charge Exchange (DCE) interactions of heavy ion beams can get information on them. The NUMEN experiment based on the pre-existing large acceptance MAGNEX spectrometer and integrated with new challenging components aims at measuring DCE cross sections using ion beams of unprecedented intensity (1013 pps) on specific isotopes at INFN-LNS in Catania. Expected rate on the sensitive area of about 0.15 m2 reaches up to about 5 Mpps, demanding for adequate detectors in measuring position, direction, energy, mass and charge of the ions produced by interactions. Gamma detectors surround a scattering chamber containing the target.

In this contribution, we present first experimental results for the deuteron pickup transfer in the 16O+28Si system at E lab. = 240 MeV. This reaction populates states in the 26Al target-like nucleus. In the same experimental campaign we have also measured the one-proton transfer 28Si(16O,17F)27Al and one-neutron transfer 27Al(16O,17O)26Al at the same beam energy. Comparison between the energy spectrum of these transfer reactions indicate that: i) the one-proton and one-neutron transfers favor the population of the low-lying states; ii) deuteron transfer to the ground state in 26Al is highly suppressed; iii) the cross-sections for deuteron transfer that populates low-lying states in 26Al are roughly 3 times less than the one-neutron transfer.

This work is part of the NUMEN Project (NUclear Matrix Elements for Neutrinoless double beta decay), which, among other goals, aims to measure cross-section of double charge exchange reactions (DCE). In the experiments to be carried out at the Laboratori Nazionali del Sud, in Catania, Italy, a target deposited on a carefully chosen backing (substrate) will be irradiated with a high energy ion beam and, importantly, neither the target nor the substrate will be allowed to overheat as this would affect their structures and its properties, which are special for the experiment. Within this context, highly oriented pyrolytic graphite (HOPG) was chosen as a substrate for the deposition of target elements that will be irradiated by ions such as 12C, 18O and 20Ne, with energies ranging from 15 MeV/u to 60 MeV/u. HOPG is considered a semimetal structured in layers, being composed of a stack of graphene sheets with a small and very subtle disorientation (less than 1°), which makes it to approach to a single crystal. With its specific flat hexagonal molecular structure, consisting only of carbon atoms, HOPG has good thermal conductivity in these sheets, making it an excellent candidate as a heat sink. However, for the HOPG to act with thermal energy dissipation functionality during the experiments proposed by the NUMEN project, it is necessary to verify whether possible changes caused by exposure to the radiation beam have a direct or indirect influence on its mechanical and thermal properties. Regarding the thermal conductivity, vacancies produced during irradiation is one of the factors that considerably decrease such property. As the production of vacancies during irradiation is one of the factors that considerably decrease thermal conductivity, in this work it was used the SRIM/TRIM code simulations to investigate the mechanisms of vacancy production in the target plus HOPG backing system. In the simulations, it was considered different types and doses of incident ion beams as well as different target thickness. From the results it was possible to estimated how long a target-HOPG system can be irradiated before the HOPG high heat conductivity property is lost.

Transfer is an excellent tool to get insights into the short-range correlations on nucleons in a nuclear state. Within the context of direct reactions, the double charge exchange reactions have recently gained attention once their matrix elements might be associated with the double-beta decay rates. This class of reaction can occur from two completely distinctive mechanisms. They can take place by nucleons exchange or driven by mesons exchange between the projectile and target nuclei. Once the double charge exchange driven by multi-nucleon or mesons exchanges can compete with each other, it is crucial to analyze the contribution of the multi-nucleon transfer in this type of reaction to verify its relevance on the measured cross sections.

Enhanced Recovery after Surgery (ERAS) protocols have been demonstrated to improve hospital length of stay and outcomes in patients undergoing colorectal surgery. This article presents the specific components of an ERAS protocol implemented at the authors' institution. In particular, details of both surgical and anesthetic ERAS pathways are provided with explanation of all aspects of preoperative, perioperative, and postoperative care. Evidence supporting inclusion of various aspects within the ERAS protocol is briefly reviewed. The ERAS protocol described has significantly benefitted postoperative outcomes in colorectal patients and can be employed at other institutions wishing to develop an ERAS pathway for colorectal patients. A checklist is provided for clinicians to easily reference and facilitate implementation of a standardized protocol.

BACKGROUND The influence of microsatellite instability on prognosis in high-risk stage II colon cancer is unknown. OBJECTIVE This study aimed to investigate the relationship between microsatellite instability and overall survival in high-risk stage II colon cancer. DESIGN This is a retrospective review of the National Cancer Database from 2010 to 2016. SETTINGS This study included national cancer epidemiology data from the American College of Surgeons Commission on Cancer. PATIENTS Included were 16,788 patients with stage II colon adenocarcinoma and known microsatellite status (1709 microsatellite unstable). MAIN OUTCOME MEASURES The primary outcome measured was overall survival. RESULTS Microsatellite unstable cancers with high-risk features had significantly better overall survival than microsatellite stable cancers with high-risk features (5-year survival 80% vs 72%, p = 0.01), and had survival equivalent to microsatellite stable cancers with low-risk features (5-year survival, 80%). When stratified by specific high-risk features, patients with lymphovascular invasion, perineural invasion, or high-grade histology had overall survival similar to patients without these features, only in microsatellite unstable cancers. However, patients with high-risk features of T4 stage, positive margins, and

The use of driving-simulator is increasing wide-spreading in the whole automotive sector. The adoption of driving simulator indeed allows evaluating the design choices directly during the design stage thought the man-machine interaction, where “man” means the driver while “machine” means the mathematical model of the car traduced to the driver thought a different machine: the driving simulator. In this research activity a questionnaire was developed to evaluate the performances of a driving simulator focusing on two main aspects. The first one regards the ability of the driving simulator to accurately reproduce the driving feelings without inducing motion sickness sensations. The second instead regards the ability of the driver to objectively judge the vehicle performances throughout a set of parameters. All these aspects were firstly numerically investigated implementing different models showing different dynamics characteristics and successively verified by experimental test at the driving simulator. The drivers scores, about both the accuracy of the mathematical model and the driving simulator, were analysed in order to understand if their feelings match the real behaviour imposed to the car.

Severe burn injury induces gut barrier dysfunction and subsequently a profound systemic inflammatory response. In the present study, we examined the role of the small intestinal brush border enzyme, intestinal alkaline phosphatase (IAP), in preserving gut barrier function and preventing systemic inflammation after burn wound infection in mice. Mice were subjected to a 30% total body surface area dorsal burn with or without intradermal injection of Pseudomonas aeruginosa. Mice were gavaged with 2000 units of IAP or vehicle at 3 and 12 hours after the insult. We found that both endogenously produced and exogenously supplemented IAP significantly reduced gut barrier damage, decreased bacterial translocation to the systemic organs, attenuated systemic inflammation, and improved survival in this burn wound infection model. IAP attenuated liver inflammation and reduced the proinflammatory characteristics of portal serum. Furthermore, we found that intestinal luminal contents of burn wound–infected mice negatively impacted the intestinal epithelial integrity compared with luminal contents of control mice and that IAP supplementation preserved monolayer integrity. These results indicate that oral IAP therapy may represent an approach to preserving gut barrier function, blocking proinflammatory triggers from entering the portal system, preventing gut-induced systemic inflammation, and improving survival after severe burn injuries., Oral intestinal alkaline phosphatase therapy preserves gut barrier function in mice following burn injury, blocking pro-inflammatory triggers from entering the portal system, preventing gut-induced systemic inflammation, and improving survival.

BACKGROUND: Recent genetic studies identified common mutations between diverticular disease and connective tissue disorders, some of which are associated with abdominal wall hernias. Scarce data exists, however, shedding light on the potential clinical implications of this shared etiology, particularly in the era of laparoscopic surgery. METHODS: The New York Statewide Planning and Research Cooperative System database was used to identify adult patients undergoing elective sigmoid and left hemicolectomies (open or laparoscopic) from 1/1/2010 to 12/31/2016 for diverticulitis or descending/sigmoid colon cancer. The incidences of incisional hernia diagnosis and repair were compared using competing-risks regression models, clustered by surgeon and adjusted for a host of demographic/clinical variables. Subsequent abdominal surgery and death were considered competing risks. RESULTS: Among 8,279 patients included in the study cohort, 6,811 (82.2%) underwent colectomy for diverticulitis and 1,468 (17.8%) for colon cancer. The overall 5-year risk of incisional hernia was 3.5% among patients with colon cancer, regardless of colectomy route, which was significantly lower than that among diverticulitis patients after both open (10.7%; p

Rationale: Liver fibrosis is frequently associated with gut barrier dysfunction, and the lipopolysaccharides (LPS) -TLR4 pathway is common to the development of both. Intestinal alkaline phosphatase (IAP) has the ability to detoxify LPS, as well as maintain intestinal tight junction proteins and gut barrier integrity. Therefore, we hypothesized that IAP may function as a novel therapy to prevent liver fibrosis. Methods: Stool IAP activity from cirrhotic patients were determined. Common bile duct ligation (CBDL) and Carbon Tetrachloride-4 (CCl4)-induced liver fibrosis models were used in WT, IAP knockout (KO), and TLR4 KO mice supplemented with or without exogenous IAP in their drinking water. The gut barrier function and liver fibrosis markers were tested. Results: Human stool IAP activity was decreased in the setting of liver cirrhosis. In mice, IAP activity and genes expression decreased after CBDL and CCl4 exposure. Intestinal tight junction related genes and gut barrier function were impaired in both models of liver fibrosis. Oral IAP supplementation attenuated the decrease in small intestine tight junction protein gene expression and gut barrier function. Liver fibrosis markers were significantly higher in IAP KO compared to WT mice in both models, while oral IAP rescued liver fibrosis in both WT and IAP KO mice. In contrast, IAP supplementation did not attenuate fibrosis in TLR4 KO mice in either model. Conclusions: Endogenous IAP is decreased during liver fibrosis, perhaps contributing to the gut barrier dysfunction and worsening fibrosis. Oral IAP protects the gut barrier and further prevents the development of liver fibrosis via a TLR4-mediated mechanism.

Diminished integrity of the intestinal epithelial barrier with advanced age is believed to contribute to aging-associated dysfunction and pathologies in animals. In mammals, diminished gut integrity contributes to inflammaging, the increase in inflammatory processes observed in old age. Recent work suggests that expression of intestinal alkaline phosphatase (IAP) plays a key role in maintaining gut integrity. IAP expression decreases with increasing age in mice and humans. Absence of IAP leads to liver inflammation and shortened life-spans in mice lacking the IAP gene. In normal mice, exogenous supplemental IAP reverses age-induced barrier dysfunction, improves aging-associated metabolic dysfunction, prevents microbiome dysbiosis (imbalance), and extends life-span. Consistent with IAP playing a conserved role in maintaining gut integrity, increased dietary IAP increases aging-diminished physical performance in flies. IAP helps maintain gut integrity in part by supporting the expression of tight junction proteins that maintain the intestinal epithelial barrier and by inactivating bacterial pro-inflammatory factors such as lipopolysaccharides (LPS) by dephosphorylation. Recombinant IAP is in late clinical trials for sepsis-associated acute kidney injury, suggesting it may soon become available as a therapeutic. Taken together, these reports support the idea that directly increasing IAP levels by supplemental recombinant IAP or by indirectly increasing IAP levels using dietary means to induce endogenous IAP may slow the development of aging-associated pathologies.

There are little data on risk factors for increased inpatient opioid use and its relationship with persistent opioid use after colorectal surgery.We identified colorectal surgery patients across five collaborating institutions. Patient comorbidities, surgery data, and outcomes were captured in the American College of Surgeons National Surgical Quality Improvement Program. We recorded preoperative opioid exposure, inpatient opioid use, and persistent use 90-180 days after surgery.1646 patients were analyzed. Patients receiving ≥250 MMEs (top quartile) were included in the high use group. On multivariable analysis, age65, emergent surgery, inflammatory bowel disease, and postoperative complications, but not prior opioid exposure, were predictive of high opioid use. Patients in the top quartile of use had an increased risk of persistent opioid use (19.8% vs. 9.7%, p 0.001), which persisted on multivariable analysis (OR 1.48; p = 0.037).We identified risk factors for high inpatient use that can be used to identify patients that may benefit from opioid sparing strategies. Furthermore, high postoperative inpatient use was associated with an increased risk of persistent opioid use.

The breakup of 9Be is studied via an inelastic scattering experiment on a proton target at 5.6 A MeV in inverse kinematics. Two of the three cluster constituents (α and α) as well as the proton target recoil were recorded in a triple coincidence mode allowing a full kinematics approach analysis. In this respect relative α - α and α - n, Q-value and 9Be excitation spectra, energy spectra for all fragments as well as the energy spectrum of the recoil proton were reconstructed. A clear signature of the two breakup sequential modes (5He + 4He and 8Be + n) was identified via the recoiling proton reconstructed spectra together with the direct breakup decay. A strong 5He + 4He mode was observed compatible with previous beta decay experiments.

An 80-year-old man with idiopathic cold agglutinin disease presented with acute cholecystitis. We describe operating room and anaesthetic considerations for patients with cold agglutinin disease and measures that can be taken to prevent disease exacerbation in this case report. Multidisciplinary collaboration and planning between the operative room staff, anaesthesia team and surgical team are needed to ensure safe surgery and optimal patient outcomes.

International audience; Despite the recent drastic reversal of decarbonization effort by the current Presidential administration, the majority of U.S. states continue policies aimed at reducing greenhouse gas (GHG) emissions and increasing renewable energy technology (RET) deployment. Although electrical power utilities are required and/or encouraged to comply with these policies, their executives lack direct incentives to do so. In this study, a novel incentive mechanism is evaluated for specifically aligning electric utility executive compensation with RET declining costs, renewable portfolio standards adopted by the majority of U.S. states, and global environmental goals. First, an overview is provided on chief executive officer (CEO) pay and the GHG emissions. The relationship between GHG emissions, renewable energy diversification, and CEO pay is examined using the case study of three of the large electric utilities in Michigan. The results show that the regulated utility market is not consistently rewarding CEOs with higher compensation for decreasing GHG emissions and that both an approach incentivizing RETs adoption and an approach encouraging GHG emissions have deficiencies. A combined approach is then analyzed that results in a compensation equation allowing for utility executives to receive incentive pay for reducing overall emissions and increasing renewable generation. The results indicate that by careful calibration of the proposed incentive equations the harmful effects of emissions can be prevented through CEO incentive pay.

The so-called Hoyle state in 12C (7.654 MeV, 0+) is an excited state of 12C characterized by a well-pronounced 3α cluster nature. Many possible cluster configurations, such as a linear-chain arrangement of 3α particles, bentarm, triangular or gas-like structures were theoretically conjectured within the previous decades, but, also due to the existence of ambiguities in experimental data, it is still impossible to draw a firm conclusion. Its direct α-decay partial width is accurately predicted by models but requires better experimental constraints. We performed a high-precision and high-selectivity investigation of its α-decay by using the 14N(d, α2)12C- reaction at 10.5 MeV incident energy with the aim of distinguishing between sequential and direct decay patterns. We are able to significantly improve the state of the art upper limit for direct 3α decays by placing the new limit at 0.043%. Such a low limit allows to give fundamental constraints to theoretical models attempting to describe the structure of the Hoyle state.

An intense activity in the field of experimental, as well as theoretical, nuclear structure is ongoing at the INFN-LNS laboratory in Catania. A short overview of the main recent results is reported.

Despite the drastic reversal of decarbonization effort by the Trump administration, the majority of U.S. states continue policies aimed at reducing greenhouse gas (GHG) emissions and increasing renewable energy technology (RET) deployment. Although electrical power utilities are required and/or encouraged to comply with these policies, their executives lack direct incentives to do so. In this study, a novel incentive mechanism is evaluated for aligning utility executive compensation with such policies. First, an overview is provided on chief executive officer (CEO) pay and the GHG emissions of utilities. The relationship between GHG emissions, renewable energy diversification, and CEO pay is examined using the case study of three of the largest electric utilities in Michigan. The results show that the regulated utility market is not consistently rewarding CEOs with higher compensation for decreasing GHG emissions and that both an approach incentivizing RETs adoption and an approach encouraging GHG emissions have deficiencies. A combined approach is then analyzed that results in a compensation equation allowing for utility executives to receive incentive pay for reducing overall emissions and increasing renewable generation. The results indicate that by careful calibration of the proposed incentive equations the harmful effects of emissions can be prevented through CEO incentive pay.

International audience; The ${0}_{2}^{+}$ state in(12)C (7.654MeV, the Hoyle state) is important for the understanding of clustering phenomena in nuclei. The pronounced cluster nature of this state allows the triple-α process in stars with a reaction rate regulated by its structure properties. To precisely estimate the direct component in the 3α decay mechanism of the Hoyle state, we developed a new experiment using the(14)N(d,α)(12)C reaction at 10.5MeV. An anti-coincidence telescope was used to identify the α ejectiles leading the residual(12)C in the Hoyle state, while its decays in 3α were studied by means of a new hodoscope of silicon detectors, superOSCAR, placed in kinematical coincidence to fully reconstruct the events. Details of the experiment and preliminary results are discussed in the text.

The elastic scattering excitation function for 15O on 4He was measured - for the first time - by using the Inverse Kinematic Thick Target scattering method. The obtained spectrum was analysed in an R-matrix framework providing spectroscopic information for several states in the excitation energy of the nucleus 19Ne from 4.8 to 9 MeV. Eight of them are newly observed states. The set-up and the experimental technique will be described in detail and the results will be shown and discussed. European Unions Horizon 2020 659744

Despite clinical and technical advances, acute aortic dissection carries high operative mortality. This study was designed to establish whether this is influenced by institution and surgeon volume.Outcomes of 5,184 patients (mean age, 60.3 years; 65.9% male) diagnosed with acute aortic dissection from the Nationwide Inpatient Sample from 2003 to 2008 were analyzed with risk-adjustment for preoperative comorbidity using multivariate logistic regression analysis.Overall operative mortality was 21.6%, with similar preoperative patient risk profile across institutions and individual surgeons. A strong inverse relationship was observed between operative mortality and both institution and surgeon volume: surgeons who averaged less than 1 aortic dissection repair annually had a mean operative mortality of 27.5%, compared with 17.0% for those averaging 5 or more annually (odds ratio, 1.78; 95% confidence interval, 1.39 to 2.29; p0.001). This was similar to the relationship seen between institution volume and mortality: operative mortality was 27.4% in institutions performing 3 or fewer acute aortic dissections a year, compared with 16.4% in those performing more than 13 annually (p 0.001). Nationally, operative mortality decreased steadily from 23% in 1998-2000 to 19% in 2005-2008, with no significant decrease in patient risk profile.Patients undergoing emergency repair of acute aortic dissection by lower-volume surgeons and centers have approximately double the risk-adjusted mortality of patients undergoing repair by the highest volume care providers. Routine involvement, whenever feasible, of teams experienced in acute aortic dissection repair may be a strategy to reduce operative mortality and major morbidity.

One of the most important tasks of urban and hazard planning is to mitigate the damages and minimize the costs of the recovery process after catastrophic events. In this context, the capability of urban systems and communities to recover from disasters is referred to as resilience. Despite the problem of resilience quantification having received a lot of attention, a mathematical definition of the resilience of an urban community, which takes into account the social aspects of an urban environment, has not yet been identified. In this article, we provide and test a methodology for the assessment of urban resilience to catastrophic events which aims at bridging the gap between the engineering and the ecosystem approaches to resilience. We propose to model an urban system by means of different hybrid social-physical complex networks, obtained by enriching the urban street network with additional information about the social and physical constituents of a city, namely citizens, residential buildings, and services. Then, we introduce a class of efficiency measures on these hybrid networks, inspired by the definition of global efficiency given in complex network theory, and we show that these measures can be effectively used to quantify the resilience of an urban system, by comparing their respective values before and after a catastrophic event and during the reconstruction process. As a case study, we consider simulated earthquakes in the city of Acerra, Italy, and we use these efficiency measures to compare the ability of different reconstruction strategies in restoring the original performance of the urban system

Background: For the deeply bound one-nucleon removal at intermediate energies using a $^{9}\text{Be}$ or $^{12}\text{C}$ target, a strong reduction of cross section was observed relative to the prediction of eikonal theoretical model. The large disagreement has not been explained and the systematic trend is inconsistent with results from transfer reactions. The recently observed asymmetric parallel momentum distribution of the knockout residue indicates the significant dissipative core-target interaction in the knockout reaction with a composite target, implying new reaction mechanisms beyond the eikonal reaction descriptions.Purpose: To investigate the reaction mechanism for deeply bound nucleon removal at intermediate energies.Method: Neutron removal from $^{14}\text{O}$ using a $^{12}\text{C}$ target at 60 MeV/nucleon was performed. Nucleon knockout cross sections were measured. The unbound excited states of $^{13}\text{O}$ were reconstructed by using the invariant mass method with the residues and the associated decay protons measured in coincidence. The measured cross sections are compared with an intra-nuclear cascade (INC) prediction.Results: The measured cross section of ($^{14}\text{O}$, $^{11}\text{C}$) is 60(9) mb, which is 3.5 times larger than that of ($^{14}\text{O}$, $^{13}\text{O}$) channel. This $2pn$-removal cross section is consistent with INC prediction, which is 66 mb with the main contribution being non-direct reaction processes. On the other hand, the upper limit of the cross section for one-neutron removal from $^{14}\text{O}$ followed by proton evaporation is 4.6(20) mb, integrated up to 6 MeV above the proton separation energy of $^{13}\text{O}$. The calculated total cross section for such reaction processes by the INC model is 2.5 mb, which is within the measured upper limit.Conclusions: The data provide the first constraint on the role of core excitation and evaporation processes in deeply bound nucleon removal from asymmetric nuclei. The experiment results suggest that non-direct reaction processes, which are not considered in the eikonal model, play an important role in deeply bound nucleon removal from asymmetric nuclei at intermediate energies.

The 13 C( 18 O, 16 O) 15 C reaction has been studied at 84 MeV incident energy. The ejectiles have been momentum analized by the MAGNEX spectrometer and 15 C excitation energy spectra have been obtained up to about 20 MeV. In the region above the two-neutron separation energy, a bump has been observed at 13.7 MeV. The extracted cross section angular distribution for this structure, obtained by using different models for background, displays a clear oscillating pattern, typical of resonant state of the residual nucleus.

In this contribution we will present the future activities that our collaboration will carry out at ELI-NP (Extreme Light Infrastructure Nuclear Physics), the new multi peta-watt Laser facility, currently under construction at Bucharest (Romania). The activities concerns the study of nuclear reactions in laser plasmas. In this framework we proposed the construction of a new, general-purpose experimental set-up able to detect and identify neutrons and charged particles.

Radial and longitudinal strain assessment in the carotid artery wall using speckle tracking

The 12C(18O,16O)14C two-neutron transfer reaction has been studied at an incident energy of 275 MeV and the ejectiles have been momentum analysed at forward angles by the MAGNEX spectrometer. The identification of the 16O ejectiles was obtained by combining a standard ΔE-E technique with the simultaneous measurement of the angle and the position at the focal plane. The 14C excitation energy spectra have been obtained and several known bound and resonant states of the residual nuclei have been identified. The results have been compared to a previous measurement of the same reaction at 84 MeV incident energy.

The knowledge of the nuclear matrix elements for the neutrinoless double beta decay is fundamental for neutrino physics. In this paper, an innovative technique to extract information on the nuclear matrix elements by measuring the cross section of a double charge exchange nuclear reaction is proposed. The basic point is that the initial and final state wave functions in the two processes are the same and the transition operators are similar. The double charge exchange cross sections can be factorized in a nuclear structure term containing the matrix elements and a nuclear reaction factor. First pioneering experimental results for the 40Ca(18O,18Ne)40Ar reaction at 270 MeV incident energy show that such cross section factorization reasonably holds for the crucial 0+ --> 0+ transition to 40Args, at least at very forward angles.

The lateral line system, formed of both superficial (pit organs) and canal neuromasts, is one of the major mechanosensory systems in fish. It has always been assumed that this system depends on neurotrophins and their cognate Trk receptors for development and maintenance, as has been shown in other mechanosensitive systems of vertebrates. However, until now this issue has not been specifically addressed. In this study we used immunohistochemistry to investigate the occurrence and localization both of neurotrophins (NGF-, BDNF- and NT-3-like) and of Trk-like proteins (TrkA-, TrkB-, TrkC-like) in alevins of Salmo salar and S. trutta. All cells in the pit organs of S. salar displayed strong immunoreactivity for TrkB-like and BDNF-like, whereas they were restricted to the hair cells in S. trutta. The hair, supporting and mantle cells of S. salar, and the mantle cells of S. trutta, also expressed TrkA-like immunoreactivity. In the canal neuromasts BDNF-, TrkA- and TrkB-like proteins were present in all cells, without differences between species. NGF-, NT-3- and TrkC-like immunoreactivity were never detected. The present results suggest that mechanoreceptive hair cells, as well as supporting cells, in the lateral line system are under the control of the BDNF–TrkB-like complex, and probably of ligands of TrkA-like receptors.

Study on clustering of nucleons in nuclei is recently focusing on unstable nuclei where new kinds of structures, namely molecular structures with excess nucleons, are predicted. The Coulomb shift of energy in the mirror system is suggested to reflect the size of these structures. Although the missing mass spectroscopy is expected to give access to these structures even beyond particle decay thresholds without any biases in excitation energy spectra but the detection of very low energy particles is challenging. To satisfy the requirement, a new active target system MAIKo has been developed at RCNP. The detector was commissioned using a 13C beam under the same kinematical condition as that of RI beam experiments.

ABCA12 mutations disrupt the skin barrier and cause harlequin ichthyosis. We previously showed Abca12(-/-) skin has increased glucosylceramide (GlcCer) and correspondingly lower amounts of ceramide (Cer). To examine why loss of ABCA12 leads to accumulation of GlcCer, de novo sphingolipid synthesis was assayed using [(14)C]serine labeling in ex vivo skin cultures. A defect was found in β-glucocerebrosidase (GCase) processing of newly synthesized GlcCer species. This was not due to a decline in GCase function. Abca12(-/-) epidermis had 5-fold more GCase protein (n = 4, P < 0.01), and a 5-fold increase in GCase activity (n = 3, P < 0.05). As with Abca12(+/+) epidermis, immunostaining in null skin showed a typical interstitial distribution of the GCase protein in the Abca12(-/-) stratum corneum. Hence, we tested whether the block in GlcCer conversion could be circumvented by topically providing GlcCer. This approach restored up to 15% of the lost Cer products of GCase activity in the Abca12(-/-) epidermis. However, this level of barrier ceramide replacement did not significantly reduce trans-epidermal water loss function. Our results indicate loss of ABCA12 function results in a failure of precursor GlcCer substrate to productively interact with an intact GCase enzyme, and they support a model of ABCA12 function that is critical for transporting GlcCer into lamellar bodies.

One hundred and one donors who had received filgrastim (rhG-CSF) for the purpose of donating either granulocytes or peripheral blood stem cells (PBSC) for their relatives more than 3 years ago were contacted. All donors had received daily rhG-CSF at a median dose of 16 microg/kg/day (range 3-16) for a median of 6 days (range 3-15 days). All collection procedures were completed and short-term side-effects of rhG-CSF were mild in the majority of the donors. At a median time interval of 43.13 months (range 35-73), the donors were contacted to assess whether adverse effects related to rhG-CSF administration had occurred. Prior to rhG-CSF two donors had cancer, one had a myocardial infarction, one was hepatitis C virus positive, one had a history of sinusitis, one had Graves' disease and two had arterial hypertension. None worsened with the rhG-CSF administration but the donor with a history of infarction had an episode of angina following apheresis, and the donor with Graves' disease had a stroke 15 months after rhG-CSF. Two pregnancies occurred after the rhG-CSF administration and one donor was 2-3 weeks pregnant during rhG-CSF treatment. Three pregnancies resulted in two normal births and one in a spontaneous abortion of a pregnancy which occurred more than 2 years following rhG-CSF. In the time following rhG-CSF administration two donors developed cancer (breast and prostate cancer) at a follow-up of 70 and 11 months, respectively. One donor developed lymphadenopathy 38 months after the rhG-CSF, which spontaneously resolved. Blood counts were obtained in 70 donors at a median follow up of 40.4 months (range 16.8-70.8). Hematocrit was 43% (median, range 36.8-48), white blood cells were 5.7 x 109/l (median, range 3-14), granulocytes 3.71 x 109/l (median, range 1. 47-10.36), lymphocytes 1.67 x 109/l (median, range 0.90-3.96), monocytes 0.46 x 109/l (median, range 0.07-0.87) and platelet counts were 193.0 x 109/l (median, range 175.0-240.0). This study indicates that short-term administration of rhG-CSF to normal donors for the purpose of mobilizing the PBSC or granulocytes appears safe and without any obvious adverse effects more than 3 years after the donation. Bone Marrow Transplantation (2000) 25, 85-89.

The effect of peripartal supplementation with diet enriched with propylene glycol on some biochemical parameters was studied on 60 Maltese multiparous goats, from 10th day prepartum to 40th day postpartum. Goats were divided into two groups of 30, homogeneous for age (31 years), milk yield of the previous lactation (2±0.5kg/head/day) and body condition score (2.250.5) and raised in two multiple boxes. The groups, called “Glycol” and “Control”, received concentrate (0.7kg/head/day) and vetch hay (1.5kg/head/day). The hay of the Glycol group was integrated with 100mL/kg of the propylene glycol (Liqui-Beef®, San Marco-Italy). Blood samples were collected from 10th to 1st day prepartum and from 1st to 40th day postpartum for the determination of Glucose, Non Esterified Fatty Acids (NEFA), β-hydroxybutyrate (BHBA), Triglycerides, Total cholesterol, High Density Lipoprotein (HDL), Total protein, Urea and Creatinine, activities of Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) and Creatine Kinase (CK). Data were analysed as a two-factor ANOVA with diet (Control and Glycol) and period (pre- and postpartum) as the main effects. As regards the energetic metabolism, “Glycol” group showed significant lower levels only during the prepartum period; specifically for BHBA (Glycol 0.28 mmol/l vs. Control 0.33 mmol/l; P=0.047), Triglycerides (Glycol 0.36 mmol/l vs. Control 0.50; P=0.043), Total cholesterol (Glycol 1.50 mmol/l vs. Control 1.66 mmol/l; P=0.07) and HDL (Glycol 0.79 mmol/l vs. Control 0.93 mmol/l; P=0.004). The parameters concerning hepatic functionality (AST and ALT) were significantly lower in the Glycol group during the prepartum (AST: Glycol 51.43 U/l vs. Control 62.00 U/l; P=0.006. ALT: Glycol 11.55 U/l vs. Control 14.21 U/l; P=0.005) as well as postpartum period (AST: Glycol 69.00 U/l vs. Control 74.28 U/l; P=0.008. ALT: Glycol 12.02 U/l vs. Control 15.05 U/l; P=0.005). The same trend was observed for the CK values (prepartum: Glycol 42.79 U/l vs. Control 62.63 U/l, P=0.004; postpartum: Glycol 77.70 U/l vs. Control 89.60 U/l, P=0.02). Peripartal use of propylene glycol enriched diet, improving the metabolic-nutritional status of the animals and consequently the productive performances (as previously observed), represents an interesting nutritional strategy for the economic benefits of dairy farms