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Modularization is a current issue in the context of plant design. A modular system aims to reduce lead time and cost in design phases. An oil & gas plant consists of many Engineered-To-Order solutions to be submitted and approved during the negotiation phase. In this context, design tools and methods are necessary to support the design life cycle from the conceptual study to the detailed project. The paper proposes an approach to optimize the design of modularized oil & gas plants with a focus on the related steel structures. A test case shows the configuration workflow applied to a modular steel structure of about 400 tons. The modularized layout has been optimized using genetic algorithms. A Knowledge Base has been described to support the configuration phase related to the conceptual design. Design rules and metrics have been formalized from the analysis of past solutions.

The Italian population of the threatened European Lanner Falcon is mainly sedentary. Thanks to satellite telemetry, we recorded the first evidence on natal dispersal of a juvenile male (Falc36) outside Sicily. Falc36 was deployed with a GPS-GSM device in May 2017, after an initial phase of movements close to the natal cliff and of short wandering in Sicily crossed the Messina Strait in mid July and arrived in Apulia (south Italy). There we were able to follow his displacements and settling until the end of November when the transmitter broke up. Falc36 used mainly open habitats composed of arable field and heterogeneous agricultural areas firstly north of Altamura and Gravina, and from late August in the Cerignola-Ascoli Satriano-Candela area. He preferentially used single trees to spend the night in arable plots. We reviewed the existing information on species’ records at the main Italian migratory watch-points to put in context the Falc36’s dispersal.

We analysed variation in 10 polymorphic microsatellites and a variable portion of control region of mtDNA in 24 specimens from 3 populations of European Lanner Falcon Falco biarmicus feldeggii living in Sicily, continental Italy and the Balkan area to assess species' genetic diversity and population structure in the poorly investigated range of this threatened subspecies. We considered also a dataset of previously published mtDNA sequences of the other Lanner Falcon subspecies and of Hierofalco subgenus members (F. cherrug, F. rusticolus and F. jugger) to outline the genetic variation in the region on a wide-ranging basis. Regard with mtDNA we identified 6 haplotypes from our 24 European Lanner Falcon specimens, 3 of which were new and unique (1 Sicilian, 2 Balkans) and the 3 others already known and shared with other Hierofalcons. The 62.5% of our sample, including 14 of Sicilians and one Apulia specimen, belonged to haplotype H_24 shared with F. c. cherrug, F. rusticolus and F. jugger. MtDNA analyses of European Lanner Falcons showed a dispersed pattern of our specimens inside the main Hierofalco clades and haplo-groups in a way congruent to what found in recent literature. These analyses confirmed that none of the Hierofalcons form a monophyletic group, nonetheless the Lanner Falcons can be subdivided in two major Palaearctic (F. b. feldeggii, F. b. erlangeri and F. b. tanypterus) and sub-Sahara African (F. b. biarmicus and F. b. abyssinicus) clades. Microsatellites analysis yielded a first outline of population genetic structure, with genetic identity between continental Italy and Sicily and a moderate degree of differentiation of the Balkan area with Sicily and continental Italy. The 3 populations did not show significant departure from Hardy-Weinberg equilibrium, with low values of the inbreeding coefficients and had allele richness and haplotype diversity consistent with literature. Microsatellites analysis (Nm, frequency of private alleles) suggests a gene flow among the three examined populations and the connection of Sicilian population to those of mainland.

Cocaine abuse occasionally causes extensive destruction of the osteocartilaginous structures of the nose, sinuses and palate, which mimics the clinical picture of other diseases associated with necrotising midfacial lesions. The differentiation of cocaine-induced midline destructive lesions (CIMDL) and limited granulomatosis with polyangiitis (GPA) may be difficult, particularly if patients do not readily admit substance abuse. We studied 10 patients with CIMDL and palate perforation referred to our Unit between 2002 and 2015. All cases underwent nasal endoscopy, sinus CT or MRI and ANCA test. In 8 patients, a nasal biopsy was performed. The PubMed database was searched to review all cases of palate perforation described in patients affected by CIMDL or GPA. All 10 cases presented with septal perforation and inferior turbinate destruction. We found hard palate perforation in 7 patients, soft palate perforation in 2 patients, and perforation of both in one patient. ANCA testing was negative in 8 patients and positive in 2, with C-ANCA and P-ANCA specificity, respectively. A review of the English literature identified palate perforation in 5 patients with GPA and in 73 patients with CIMDL. The presence of palate perforation in patients with MDL may represent a clinical marker that strongly favors CIMDL over GPA.L’ abuso di cocaina può talvolta causare lesioni destruenti della struttura osteocartilaginea del naso, dei seni paranasali, del palato, con caratteristiche cliniche che ricordano altre patologie sistemiche associate a lesioni necrotizzanti centrofacciali. La diagnosi differenziale tra lesioni destruenti della linea mediana indotte da cocaina (CIMDL) e granulomatosi associata a poliangioite (GPA) può essere complessa, in particolare se il paziente non ammette l’abuso di sostanze. 10 pazienti con CIMDL e perforazione palatale sono stati trattati presso la nostra Unità Operativa tra il 2002 ed il 2015. Tutti i casi sono stati sottoposti ad endoscopia nasale, TC o RMN del massiccio facciale ed Anca test. In 8 casi è stata effettuata anche la biopsia nasale. Contestualmente è stata eseguita una revisione della letteratura presente su PubMed riguardante i casi di perforazione palatale in pazienti affetti da CIMDL e GPA. Tutti i 10 pazienti oggetto dello studio presentavano perforazione palatale e distruzione dei turbinati inferiori; inoltre 7 pazienti presentavano perforazione del palato duro , 2 pazienti perforazione del palato molle ed 1 paziente perforazione di entrambi. Gli Anca test erano negativi in 8 pazienti e positivi in 2, sia per C-Anca sia per P-Anca. La revisione della letteratura edita in lingua inglese ha evidenziato perforazioni palatali in 5 pazienti affetti da GPA e in 73 pazienti affetti da CIMDL. La presenza di perforazione palatale in pazienti con lesioni destruenti della linea mediana può rappresentare un nuovo marker clinico a favore delle CIMDL nella diagnosi differenziale con GPA.

Avian migration is naturally a plastic trait, and tracking migratory birds is problematic because of distances and areas involved. Electronic data loggers (e.g. light-level geolocators, GPS/GSM tags, etc) provide a means to directly follow several individuals and understand migration routes and geographic patterns of population displacements in overwintering areas. Thanks to the collaboration between different projects (PRIN, LIFE+ LIFE11/NAT/IT068), we tracked lesser kestrels equipped with GPS/UHF and GLS devices and we analyzed the migration data of more than 20 individuals breeding in different populations of Sicily (Gela Plain) and Southern Italy (Altamura, Gravina). The weights of complete backpacks (transmitter plus harness) was within 3% of individual body mass. We used both visual observation of QGIS maps and standardized method based on net displacement (ND) to classify onset and termination dates of migration, duration of migration and migration distances of all individuals. At the end of the breeding season, lesser kestrels moved from their southern breeding grounds to northern areas to spend the summer, thus confirming also for Italy the post-breeding behavior of most Western European populations. Migration departures data are concentrated in late September when the Italian Lesser Kestrels crossed the Mediterranean Sea and arrived straight to the Tunisian and Libyan coasts. All individuals overwintered in a large Sahel area, extending in longitude from Senegal to Chad. Individuals from different populations showed overlapping home ranges, and most of them showed small-scale winter movements, suggesting a progressive exploitation of winter foraging grounds. Spring migration started during the first weeks of March. The direction of return flight was similar to that of autumn migration, but occurred at a slower speed with more stopovers and with less time spent in nocturnal flight.

Quantitative information about natal dispersal is available for many species, usually focused on their long-distance migration. Basic information on non-migrant Peregrine falcons is virtually lacking, despite the amount of scientific data on this species, and the sensitivity of this stage in the Peregrines’ life history. Information on movements is crucial for the definition of young post-fledging areas, the behaviour of floaters and also gives key information about juvenile mortality. Thanks to satellite telemetry, we were able to provide data about the destiny, movement and habitat use during both the phase of post-fledging dependence by parents (PFDP) and the dispersal period of 14 Peregrine falcons in Sicily (Italy), by standardized net displacement (ND) and coefficient of variation (ΔCV) methods. In this preliminary contribution, we considered dispersal until the first winter of life, ended the 28 of February. PFDP extended on average 42±11 days, a phase in which young peregrines moved 3.0±1.6 km from the nest, and explored an area of 1.5 km2 on average. Dispersal started when young were about 80±11 days old, on average the 29th of June. Brothers from same nests (n=3) had similar PFDPs and dispersal behaviours. During their first winter, young Sicilian Peregrine falcons did exploration flights mixed to sedentary periods spent in localized territories. During exploration, the average maximum distance from the nest was 109.3±71.6 km and for 12 individuals corresponded to their first long flight, done immediately after the dispersal. Three falcons went outside Sicily and arrived to Aeolian islands and the southernmost Italian peninsula before to come back home after few days. 4 out 14 young falcons died few weeks (22±2 days) after the start of dispersal. Three others falcons showed a peak of increasing distance during the first days of the dispersal period, but after that, they came back in areas close (≤20 km) to their birth-place to spent the winter. The remaining 7 spent their first winter in localized territories far from the nest (>80 km). Only 7 out 14 individuals survived their first winter of life, and six of them have chosen the strategy of far dispersal from the birth-place. The average home range of the 7 overwintering falcons, calculated by kernel density estimation at 95% was 237.3±170.7 km2, home ranges were mainly composed of open cultivated areas, like cropland, plus limited extents of natural scrublands. At night the 14 falcons used to roost on cliffs (n=10) and power line pylons (n=4), when sedentary; but exploited arboreal roosts (eucalyptus, olive trees) during exploration trips.

The identification of suitable areas, by spatially explicit distribution models, is crucial for conservation of threatened species as the lanner falcon Falco biarmicus feldeggii. Monitoring and collecting data on lanner falcon during years has proven to be essential for better defining the areas of species environmental suitability. Recent research shows that breeding performances of this species are strongly influenced by bioclimatic factors, especially monthly temperature and rainfall, or linked to landscape morphology, such as the slope of territories. These environmental parameters combined with species productivity (number of fledged juveniles per checked pair) of geo-referenced breeding sites have been used to develop a predictive model (PM). A former PM, restricted to eastern Sicily, has been now extended to the whole Sicilian territory thanks to field records collected within the frame of the project: ‘Practical actions for preserving the main European population of Lanner falcon’ supported by the Nando & Elsa Peretti Foundation. Such a new PM contains the database of productivity and georeferenced breeding sitesof a representative sample of the known Sicilian lanner population. PM is composed by dynamic GIS-level of cartographic structures (as rainfall and temperature raster) and needs periodic implementation with annual data to improve its accuracy and long-term validity. The model was used during winter 2016-2017 to search new territories, with the noticeable discovery of 5 new sites. In addition, the comparison of the 2017 productivity data with the environmental quality value, as indicated by the PM, proved the good predictive performances of the model: the most productive were also the most suitable. A potential progress is to extend its application to continental Italy in order to explore the areas of environmental suitability of lanner falcon across the whole Italian species range. PM could be a valuable tool for monitoring the Italian population, defining attention areas of Lanner and concrete conservation actions in the view of global change.

Prey availability is a crucial factor for the reproductive success of apex predators and the analysis of their diets can provide meaningful information about the quality of their habitats. In Sicily the declining lanner falcon Falco biarmicus feldeggii and the increasing peregrine falcon Falco peregrines brookei share similar habitats and trophic needs. By studying their current and past diets, we have investigated whether the characteristics of their foraging ecology could explain these different demographic trends. In 2014-2016, we identified 805 peregrine and 250 lanner Vertebrate prey from 15 peregrine and 6 lanner nests, and compared our dataset with previous data from Sicily (Peregrine 1978-81; Lanner 1981-88). The average number of Vertebrate prey in peregrine nests (53,7 ± 28,7) was higher than in lanner nests (42,0 ± 25,6). Expectedly, peregrine preyed exclusively upon birds, while lanner upon birds (92,9%), small mammals (4%), and reptiles (2,4%). Orioles and common swifts were significant prey for the former, while the european rabbit was important for the latter in terms of biomass. Pigeons, starlings and magpies formed the majority of prey for both species, and collared dove, previously absent in Sicily, appears in their current diet. The average avian prey was smaller for peregrine (97,7 g) than for lanner (122,5 g). Over decades, the lanner richness of prey species (S) decreased (from 55 to 33) while the one of peregrine increased (from 38 to 63). Alfa-diversity index showed a similar figure, while dominance as expressed by the Simpson index (1-D) was lower in present lanner diet (0,83) than in past lanner, as well as in past and present peregrine diets (all indexes >0,90). Trophic niche overlap between the past and present datasets is medium according to Whittaker's index (0,44 peregrine; 0,48 lanner; 0,42 peregrine/lanner past; 0,48 peregrine/lanner present). Lanner preyed also on insects in both periods, with considerable differences (npast = 341 and ncurrent = 2) which can be attributed to different seasons of data collection. The two predators are responding to variations in habitats and prey populations; however the more aerial-hunting peregrine, demonstrates to be flexible and more successfully adapted to the alteration of traditional agro-ecosystems.

SUMMARY Radial forearm free flap surgery is a versatile technique that is widely adopted for microvascular reconstruction of the oral, oropharyngeal and hypopharyngeal lining. Nowadays, the technique for harvesting is standardized, while reconstruction of the forearm donor site defect is somewhat controversial. The authors describe a modified closure technique developed to reduce skin tension that provides subsequent improvement of the cosmetic appearance of the forearm donor site. A series of 43 patients undergoing radial forearm free flap (RFFF) reconstruction is presented, carried out by our ENT department between September 2007 and December 2010. The authors used a modification of the standard triangular full-thickness skin graft (FTSG) technique to close the forearm donor site on 23 patients with a new shape similar to a dagger. Using the Stony Brook Evaluation Scale, the authors analyzed the outcomes of 23 cases employing the dagger-shaped FTSG and compared these with a standard (triangular shaped) reconstructive graft used in 20 earlier patients. The new dagger-shaped graft decreases skin tension and reduces the need of multiple slits in the graft with improved aesthetic outcome; it is an effective method for repair of the forearm donor site with low tension and without the need to harvest the skin graft from the thigh. The technique is simple, reliable and requires no more time than a standard procedure.

Predators are highly sensitive to availability and changes of their prey, which are limiting factors for successful reproductive performances. We studied the diet of the increasing Peregrine falcon (F. p. brookei) and the declining Lanner falcon (F. b. feldeggii) populations in Sicily. The two species coexist in the same habitats of this large Mediterranean island and require similar feeding resources. We described the type and diversity of prey taken by both species in order to understand whether differences in foraging ecology could explain their diverse population status. During 2014-2016, we collected prey remains and pellets in 15 Peregrine and 6 Lanner nests and we compared the current diets with past data from Sicily (Peregrine: 1978-81; Lanner: 1981-88). We identified 805 Peregrine and 250 Lanner prey. Prey remains per Peregrine nest was on average higher (55.3±28.6) than per Lanner nest (42.0±25.6). Peregrine confirmed to be strictly ornitophagous (100% of prey) while Lanner preyed on birds (92.9%) and also on small mammals (4.0%) reptiles (2.4%) and arthropods (0.8%). The average avian prey of Peregrine is smaller (97.7 g) than that of Lanner (122.5 g). Columbidae, starlings, magpies formed the bulk of prey in both species; swifts and orioles were important prey in Peregrine, while rabbit gave a significant contribution to prey biomass in Lanner. Currently both species are preying upon the collared dove a taxon not present in past ’80 diets. The comparison of trophic diversity showed some striking differences, as Lanner in the past preyed upon much more taxa (Spast = 55 vs Scurrent = 33) while the reverse occurred in the Peregrine (Spast = 38 vs Scurrent = 63). A similar figure occurs also for the alpha-diversity index, while the Simpson (1-D) diversity dropped in the current Lanner diet (0.83) respect with the past Lanner, current and past Peregrine diets (all Simpson values > 0.90). The past/current diet overlap, as showed by the Whittaker index, was generally medium in both species (Peregrine = 0.44; Lanner = 0.48) and across species (past Peregrine/Lanner = 0.42; current Peregrine/Lanner = 0.48). Both species are responding to change of habitats and prey populations (e.g. more predation upon wood pigeon, collared dove, etc) with the more flexible and aerial-hunting Peregrine performing better than the Lanner in altered agro-ecosystems.

Background. Current knowledge of risk assessment in survivors of myocardial infarction is largely based on data gathered before the advent of thrombolysis. It must be determined whether and to what extent available information and proposed criteria of prognostication are applicable in the thrombolytic era. Methods and Results. We reassessed risk prediction in the 10 219 survivors of myocardial infarction with follow-up data available (ie, 98% of the total) who had been enrolled in the GISSI-2 trial, relying on a set of prespecified variables. The 3.5% 6-month all-cause mortality rate of these patients compared with the higher value of 4.6% found in the corresponding GISSI-1 cohort, originally allocated to streptokinase therapy, indicates a 24% reduction in postdischarge 6-month mortality. On multivariate analysis (Cox model), the following variables were predictors of 6-month all-cause mortality: ineligibility for exercise test for both cardiac (relative risk [RR], 3.30; 95% confidence interval [CI], 2.36-4.62) and noncardiac reasons (RR, 3.28; 95% CI, 2.23-4.72), early left ventricular failure (RR, 2.41; 95% Cl, 1.87-3.09), echocardiographic evidence of recovery phase left ventricular dysfunction (RR, 2.30; 95% CI, 1.78-2.98), advanced (more than 70 years) age (RR, 1.81; 95% Cl, 1.43 -2.30), electrical instability (ie, frequent and/or complex ventricular arrhythmias) (RR, 1.70; 95% Cl, 1.32-2.19), late left ventricular failure (RR, 1.54; 95% Cl, 1.17-2.03), previous myocardial infarction (RR, 1.47; 95% CI, 1.14-1.89), and a history of treated hypertension (RR, 1.32; 95% Cl, 1.05-1.65). Early post-myocardial infarction angina, a positive exercise test, female sex, history of angina, history of insulin-dependent diabetes, and anterior site of myocardial infarction were not risk predictors. On further multivariate analysis, performed on 8315 patients with the echocardiographic indicator of left ventricular dysfunction available, only previous myocardial infarction was not retained as an independent risk predictor. Conclusions. A decline in 6-month mortality of myocardial infarction survivors, seen within 6 hours of symptom onset, has been observed in recent years. Ineligibility for exercise test, early left ventricular failure, and recovery-phase left ventricular dysfunction are the most powerful (RR, >2) predictors of 6-month mortality among patients recovering from myocardial infarction after thrombolysis. Qualitative variables reflecting residual myocardial ischemia do not appear to be risk predictors. The lack of an independent adverse influence of early post-myocardial infarction angina on 6-month survival represents a major difference between this study and those of the prethrombolytic era.