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Highlights: [•] A Hammerstein–Windkessel model to represent the central blood pressure system. [•] A Kalman filter estimated the time varying Fourier series representing the Windkessel model's output signal. [•] The Fourier coefficients of this modeled oscillometry is then used in a next step to drive a logistic regression analysis. [•] A logistic regression analysis based on the signal features of the oscillometry can detect hyper- and hypotension and correct the blood pressures accordingly. [Copyright &y& Elsevier]

Abstract: A dynamic model of a palladium membrane reactor for the Water Gas Shift (WGS) reaction has been developed by using the ISAAC Dynamic© platform. The mono-dimensional, time depending model has been developed by coupling the simple models of WGS reaction and Pd-membrane, e.g. considering that separation and reaction occur simultaneously in a single cell. The model of the composite Pd-membrane includes the presence of defects in the palladium film and a multilayered support, while in the WGS model kinetics of the reaction is considered. Membrane model has been first validated by comparison with permeation measurements, in the 300-445°C temperature range, of two Pd-membranes 12 and 29μm thick, respectively, obtained by electroless plating on a macroporous stainless steel support. The whole model has been then validated by using results of WGS tests performed at RSE at 410°C in a tubular palladium membrane reactor fed with a syngas mixture with a 7.6% CO concentration and H2O/CO ratio in the 2.7-3.6 range. Model results fit quite well experimental data; the model, however, slightly overestimates CO conversion at high H2 recovery (up to the 10%), mainly due to the fact that concentration polarization effects are not considered. [Copyright &y& Elsevier]

Abstract: Pd-based membranes have been studied for pure hydrogen separation from syngas: in particular, a mathematical model of a Pd membrane for hydrogen separation has been developed. This model can be used in process and assessment studies of the parameters which characterize the mass transfer phenomena (such as: hydrogen permeability, surface coverage and limiting step). By coupling the permeation and water gas shift reaction kinetics, it can also be used to evaluate the performances of the membrane reactor. Further, it can be helpful to evaluate the best assembly and sizing of a H2/CO2 separation system. The model takes into account the kinetics of H2 adsorption/desorption on Pd surface, the H2 permeation into the palladium bulk and in the porous layer, and the kinetics of CO, CO2, H2O, O2, H2S competitive adsorption/desorption on Pd surface. It is also comprehensive of flux equations and bulk mass, momentum and energy balance. The results released by the model were compared to the experimental data during both the transient phase and the steady state conditions. A satisfactory agreement between model and experimental data was found. [Copyright &y& Elsevier]

Presents a personal narrative which explores the author's vocational experiences and her identification with the character Dorthea Brooke from the novel "Middlemarch," by George Eliot.

Abstract: Converting coppices into high forests with continuous cover has often been established during the last decades as a management goal in hilly and mountainous Mediterranean areas to attenuate the negative effects that frequent clearcutting may have on soil, landscape and biodiversity conservation. The silvicultural tool usually adopted for this purpose is the gradual thinning of sprouts during the long span of time required to complete the conversion, that also allows the owner to keep harvesting some wood. This research compared the effects of various thinning intensities (three treatments plus control) on the stand growth and structure of a beech coppice with standards. The optimal density after thinning was assessed by expressing mean tree spacing as a function of main stand attributes like stand height and stand dbh. This system was preferred to the empirical evaluation of the percentage of basal area to be removed in order to give forest managers general reference guidelines to adapt to the varying environments of the Mediterranean mountains. Results confirmed that the positive effects of thinning on mean stem volume is due more to the higher diameter increment than to different height growth. The acceleration of crown growth in the thinned plots allowed canopy closure to be achieved 13 years after thinning. This reduced the negative effects of the opening of the stand overlayer and the elimination of most suppressed trees on soil protection. Under the conditions examined, the best thinning intensity proved to be a stand density 20% lower than normal prescribed by the yield tables elaborated for beech high forests in Central and Southern Italy. [Copyright &y& Elsevier]

An essay is presented on auricular confessions during the Victorian period in Great Britain. Confessions under the Roman Catholic church were done to absolve people of their grave sins. Protestants and anti-Catholic groups during the era saw confessions as a tool to destroy family bonds. Women's writings about confession featured mixed reactions. The essay examines two stories, "Villette," by Charlotte Bronte and "Ellen Middleton" by Lady Georgiana Fullerton. The portrayal of women in relation to confessions are examined in the works as well as views on Roman Catholicism.

The article presents a discussion about the architecture and design program for the Italian home by Italian modernist architect and designer Giovanni Ponti. Also a writer, Ponti expressed his modern Italian aesthetic in architecture and design through his writings. In 1934, he was given the Premio Mussolini or Mussolini Prize by the Royal Academy of Italy. It was noted that the program of Ponti focused on emphasis of Italian Rationalists on machine age. shifting from Neoclassical forms by Milanese Novecento.

EUS-guided biopsy sampling is the method of choice for obtaining pancreatic tissue. Next-generation sequencing (NGS) has been applied to EUS-guided biopsy sampling and may classify patients based on specific molecular profiles. Our study aimed to compare side-by-side the diagnostic yield achievable by genetic identification of somatic mutations detected with NGS versus histologic and cytologic typing in locally advanced pancreatic carcinoma (LAPC) in samples acquired under EUS guidance. We conducted a prospective comparative pilot study at Humanitas Research Hospital. The study included 33 patients referred for LAPC who underwent EUS-guided tissue acquisition using a 22-gauge Franseen needle. Material was obtained for both pathologic diagnosis and DNA extraction and targeted NGS analysis with the AmpliSeq Comprehensive Panel v3 (Illumina Inc, San Diego, Calif, USA). Twenty-one genes were prioritized for somatic mutation detection. The final diagnosis was pancreatic ductal adenocarcinoma (PDAC) in all patients (100%). A macroscopic core was obtained in 30 patients (91%). In 3 lesions no cores adequate for histologic analysis were obtained, but cytologic analysis revealed tumoral cells from PDAC. DNA was extracted from 32 of 33 samples (97%), most of which (27/32) carried at least 2 clearly pathogenic mutations in different genes. Detection of K-ras mutation allowed for molecular diagnosis of PDAC in most of the patients (30/32). In our study we demonstrated that proper tissue specimens obtained under EUS guidance allowed DNA sample extraction and subsequent NGS analysis in 97% of cases. These results support the potential role of NGS as a complementary diagnostic test to be implemented in association with standard diagnostic modalities. (Clinical trial registration number: NCT03578939.) [ABSTRACT FROM AUTHOR]

• Analysis of cross-commodity linkages for palm, rapeseed, soy, and sunflower oils • High responsiveness of sunflower and soy oils; substitutability of domestic oils • Land use effects relevant in northern EU countries, greater producers of rapeseed • Biofuel policies would favour EU production of emissions saving oils (soy, sunflower) • Side-effects of palm oil expansion: indirect land use change, transports emissions Vegetable oil market is becoming of increasing interest in the global biofuel industry. This phenomenon has also interested the European Union (EU), where the growing expansion of biofuel production is affected by political interventions promoting fuel security and environmental goals. Yet, empirical evidence on the impacts that changes in price of one commodity may have on the supply of another commodity are rather scant. We investigate these dynamics for the major sources of biodiesel in the EU and conclude on cross-commodity linkages for palm, rapeseed, soy, and sunflower oils. We also examine the acreage response of domestically produced feedstocks to changes in prices of vegetable oils. Our findings suggest strong and diversified path dependencies among vegetable oils that should be considered in planning sustainable biofuel policies. In particular, the empirical analysis reveals the great relevance of sunflower and soy oils, which show a high price responsiveness, and the high competition in end uses of domestically produced vegetable oils (i.e. rapeseed, soy, and sunflower oils), that tend to be net substitutes in supply. In terms of land use effects, we find that an increase in the price of imported palm oil results in a displacement effect in land devoted to rapeseed cultivation, whereas a surge in the price of sunflower oil decreases the use of land for rapeseed. Land use effects would be relevant in northern EU countries where the production of rapeseed is the most intense. A policy measure in the EU, incentivising the production of renewable and environmental-friendly fuel from sustainable feedstocks, would be positive for the domestic market to the extent that it stimulates the production of vegetable oils (soy and sunflower oils) with the highest direct and indirect emissions saving. However, the expansion of oil palm plantations in extra-EU producing countries and of imports to the EU would determine important impacts in terms of indirect land use change emissions and direct emissions due to increased transports. [ABSTRACT FROM AUTHOR]

False positive (FP) results by computer-aided detection (CADe) hamper the efficiency of colonoscopy by extending examination time. Our aim was to develop a classification of the causes and clinical relevance of CADe FPs, and to assess the relative distribution of FPs in a real-life setting. In a post-hoc analysis of a randomized trial comparing colonoscopy with and without CADe (NCT: 04079478), we extracted 40 CADe colonoscopy videos. Using a modified Delphi process, 4 expert endoscopists identified the main domains for the reasons and clinical relevance of FPs. Then, 2 expert endoscopists manually examined each FP and classified it according to the proposed domains. The analysis was limited to the withdrawal phase. The 2 main domains for the causes of CADe FPs were identified as artifacts due to either the mucosal wall or bowel content, and clinical relevance was defined as the time spent on FPs and the FP rate per minute. The mean number of FPs per colonoscopy was 27.3 ± 13.1, of which 24 ± 12 (88%) and 3.2 ± 2.6 (12%) were due to artifacts in the bowel wall and bowel content, respectively. Of the 27.3 FPs per colonoscopy, 1.6 (5.7%) required additional exploration time of 4.8 ± 6.2 seconds per FP (ie, 0.7% of the mean withdrawal time). In detail, 15 (24.2%), 33 (53.2%), and 14 (22.6%) FPs were classified as being of mild, moderate, or severe clinical relevance. The rate of FPs per minute of withdrawal time was 2.4 ± 1.2, and was higher for FPs due to artifacts from the bowel wall than for those from bowel content (2.4 ± 0.6 vs 0.3 ± 0.2, P <.001). FPs by CADe are primarily due to artifacts from the bowel wall. Despite a high frequency, FPs result in a negligible 1% increase in the total withdrawal time because most of them are immediately discarded by the endoscopist. [ABSTRACT FROM AUTHOR]

One-fourth of colorectal neoplasias are missed during screening colonoscopies; these can develop into colorectal cancer (CRC). Deep learning systems allow for real-time computer-aided detection (CADe) of polyps with high accuracy. We performed a multicenter, randomized trial to assess the safety and efficacy of a CADe system in detection of colorectal neoplasias during real-time colonoscopy. We analyzed data from 685 subjects (61.32 ± 10.2 years old; 337 men) undergoing screening colonoscopies for CRC, post-polypectomy surveillance, or workup due to positive results from a fecal immunochemical test or signs or symptoms of CRC, at 3 centers in Italy from September through November 2019. Patients were randomly assigned (1:1) to groups who underwent high-definition colonoscopies with the CADe system or without (controls). The CADe system included an artificial intelligence–based medical device (GI-Genius, Medtronic) trained to process colonoscopy images and superimpose them, in real time, on the endoscopy display a green box over suspected lesions. A minimum withdrawal time of 6 minutes was required. Lesions were collected and histopathology findings were used as the reference standard. The primary outcome was adenoma detection rate (ADR, the percentage of patients with at least 1 histologically proven adenoma or carcinoma). Secondary outcomes were adenomas detected per colonoscopy, non-neoplastic resection rate, and withdrawal time. The ADR was significantly higher in the CADe group (54.8%) than in the control group (40.4%) (relative risk [RR], 1.30; 95% confidence interval [CI], 1.14–1.45). Adenomas detected per colonoscopy were significantly higher in the CADe group (mean, 1.07 ±1.54) than in the control group (mean 0.71 ± 1.20) (incidence rate ratio, 1.46; 95% CI, 1.15–1.86). Adenomas 5 mm or smaller were detected in a significantly higher proportion of subjects in the CADe group (33.7%) than in the control group (26.5%; RR, 1.26; 95% CI, 1.01–1.52), as were adenomas of 6 to 9 mm (detected in 10.6% of subjects in the CADe group vs 5.8% in the control group; RR, 1.78; 95% CI, 1.09–2.86), regardless of morphology or location. There was no significant difference between groups in withdrawal time (417 ± 101 seconds for the CADe group vs 435 ± 149 for controls; P =.1) or proportion of subjects with resection of non-neoplastic lesions (26.0% in the CADe group vs 28.7% of controls; RR, 1.00; 95% CI, 0.90–1.12). In a multicenter, randomized trial, we found that including CADe in real-time colonoscopy significantly increases ADR and adenomas detected per colonoscopy without increasing withdrawal time. ClinicalTrials.gov no: 04079478 [ABSTRACT FROM AUTHOR]

• ddPCR is a highly sensitive and accurate screening tool for CRISPR/Cas9 engineering. • Dopaminergic differentiation results in faithful co-expression of TH and reporter. • Endogenous fluorescence detectable in dopaminergic neurons by flow cytometry. Human induced pluripotent stem cells (hiPSCs) have become indispensable for disease modelling. They are an important resource to access patient cells harbouring disease-causing mutations. Derivation of midbrain dopaminergic (DAergic) neurons from hiPSCs of PD patients represents the only option to model physiological processes in a cell type that is not otherwise accessible from human patients. However, differentiation does not produce a homogenous population of DA neurons and contaminant cell types may interfere with the readout of the in vitro system. Here, we use CRISPR/Cas9 to generate novel knock-in reporter lines for DA neurons, engineered with an endogenous fluorescent tyrosine hydroxylase – enhanced green fluorescent protein (TH-eGFP) reporter. We present a reproducible knock-in strategy combined with a highly specific homologous directed repair (HDR) screening approach using digital droplet PCR (ddPCR). The knock-in cell lines that we created show a functioning fluorescent reporter system for DA neurons that are identifiable by flow cytometry. [ABSTRACT FROM AUTHOR]

Underwater EMR is an alternative way to have nonpedunculated colorectal lesions lifted before being resected. The endoscopist takes advantage of the behavior of mucosal lesions floating away from the muscular layer, once immersed in liquid. We performed a systematic review with meta-analysis to evaluate the efficacy and safety of this technique. Electronic databases (Medline, Scopus, EMBASE) were searched up to May 2018. Full articles including patients with colorectal lesions resected by the underwater EMR technique were eligible. The complete resection (primary outcome), en bloc resection, recurrence, and adverse event rates were pooled by means of a random or fixed-effect model. Ten studies were eligible, providing data on 508 lesions removed from 433 patients (male/female = 239/194; mean age range 62.2-75.0 years). Six studies were performed in the United States and the other in Europe; 7 studies were prospective. The specific indications for performing underwater EMR varied widely across studies. The complete resection rate was 96.36% (95% confidence interval [CI], 91.77-98.44), with a rate of en bloc resection of 57.07% (95% CI, 43.20%-69.91%). The recurrence rate was 8.82% (95% CI, 5.78-13.25) in a mean endoscopy surveillance period of 7.7 months (range 4-15 months). The postprocedural bleeding rate was 2.85% (95% CI, 1.64-4.90). Bleeding during the procedure was always mild and was considered as part of the procedure in all series. The overall adverse event rate was 3.31% (95% CI, 1.97%-5.52%). No cases of perforation were reported. According to the results of this systematic review, underwater EMR appears to be an effective and extremely safe technique for resecting nonpolypoid colorectal lesions. [ABSTRACT FROM AUTHOR]