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Today resilience paradigm is shared by both academic and political debates, and it is gradually being implemented into plans, programmes, and project's initiatives. In this context, wine regions, particularly those designated as UNESCO sites, show their robustness and vulnerabilities as Socio-Ecological Systems. The climate change impact is increasing the exposure of their aesthetic, cultural, economic, natural values to potential losses and therefore an effective response is required To build resilient strategies, Decision Makers are increasingly considering multidimensional models in planning and assessment processes. This paper continues a research work that develops an integrated evaluation framework constituted by Multicriteria Decision Analysis to calculate a Territorial Resilience Index, a dynamical model to predict future ecological scenarios and scenario building to define a resilient strategy for the Douro territory (Portugal). This paper focuses on scenario building which uses specific tools such as Social Network Analysis to identify and investigate the relationships between real actors and stakeholders, Wilson matrix to assess the degree of uncertainty and relevance of the strategies identified by a panel of specialists, and consistency matrix to evaluate the strategies consistency in achieving the Sustainable Development Goals and UNESCO requirements. The obtained protocol of guidelines and recommendations can support Decision Makers in the design of sustainable and resilient transformation, thereby assisting in the preservation of the UNESCO site.

The increasing attention on environmental problems is stimulating the development of integrated evaluation approaches to territorial transformations, where different facets have to be considered. The present paper focuses on the development of a novel integrated evaluation model for measuring the ecological states and the economic values of an environmental system employing both a system of indicators and a mathematical model of Lotka-Volterra. This integrated evaluation model aims at investigating the relations between the landscape ecology and economics, and at simulating possible and future transformation scenarios for the landscape planning and management. As case study, we consider an environmental system located in Piedmont (Italy), in the Monferrato Ovadese area. The present paper proposes a suitable support for local governments to visualize outcomes and possible future scenarios, aiding the decision-making process in the definition of territorial transformation policies and actions.

This paper aims to assess the territorial resilience of a socio-ecological system through an innovative integrated evaluation framework to aid the decision-making process in the planning of transformation scenarios. This framework employs a set of resilience indicators through a Multicriteria Decision Analysis (MCDA) coupled with a Lotka-Volterra mathematical model of cooperative type. The set of indicators aims to calculate a composite index of Territorial Resilience (TRI), whereas the mathematical model is an extension of an existing model, aimed to predict possible long-time scenarios. The proposed operational framework for rural and vineyard landscapes aims to bridge the existing gap between territorial resilience theory and practice, with an innovative Decision Support System able to assist Decision Makers and territory planners in the planning and management of resilient territorial systems. This integrated evaluation framework is applied to a famous wine region in Portugal, the Douro Valley, where Port-wine grows. Such framework, especially in a context of adaptive governance, proves to be a suitable support in the field of landscape and urban planning to evaluate the dynamics of socio-ecological systems and to envision long-term policies and actions., The research by A.J.S. has been partially supported by the Portuguese Funds FCT Projects UIDB/00013/2020 and UIDP/00013/2020.

Health equity in All Policies requires decision makers to face the health impact of their decisions and its distribution among different population groups. Since the evidence policy gap often preve...

Confocal Annular Josephson Tunnel Junctions (CAJTJs) which are the natural generalization of the circular annular Josephson tunnel junctions, have a rich nonlinear phenomenology due to the intrinsic non-uniformity of their planar tunnel barrier delimited by two closely spaced confocal ellipses. In the presence of a uniform magnetic field in the barrier plane, the periodically changing width of the elliptical annulus generates a asymmetric double-well for a Josephson vortex trapped in a long and narrow CAJTJ. The preparation and readout of the vortex pinned in one of the two potential minima, which are important for the possible realization of a vortex qubit, have been numerically and experimentally investigated for CAJTJs with the moderate aspect ratio 2:1. In this work we focus on the impact of the annulus eccentricity on the properties of the vortex potential profile and study the depinning mechanism of a fluxon in more eccentric samples with aspect ratio 4:1. We also discuss the effects of the temperature-dependent losses as well as the influence of the current and magnetic noise., Comment: arXiv admin note: text overlap with arXiv:1707.01672

Italy is in a dramatic situation owing to the spread of covid-19,1 but we could do more to protect medical doctors and all hospital workers, including nurses, therapists, technicians, and support staff. Beyond the personal risks that doctors and healthcare workers are facing directly—highlighted by the death of general practitioner and national delegate for continuous medical education Roberto Stella in Varese—hospitals and medical personnel are a potential vehicle for spread of covid-19.2 The New England Journal of Medicine has reported on the huge proportion of infected …

The social practices analyzed in this book suggest policies for the development of social networks, useful for promoting health and equity. They reinforce and specify many indications suggested by international literature [1]. Mainly, they help to better define the role that territorial actors could play in promoting health and equity. Moreover, these experiences explain more precisely the effect of local actions on social impact and therefore they propose guidelines for designing and evaluating intervention strategies. We will focus on the brief conclusions of the book on these issues.

We investigate the physics of planar annular Josephson tunnel junctions quenched through their transition temperature in the presence of an external magnetic field. Experiments carried out with long Nb/Al-AlOx/Nb annular junctions showed that the magnetic flux trapped in the high-quality doubly-connected superconducting electrodes forming the junction generates a persistent current whose associated magnetic field affects the both the static and dynamics properties of the junctions. More specifically, the field trapped in the hole of one electrode combined with a d.c. bias current induces a viscous flow of dense trains of Josephson vortices which manifests itself through the sequential appearance of displaced linear slopes, Fiske step staircases and Eck steps in the junction's current-voltage characteristic. Furthermore, a field shift is observed in the first lobe of the magnetic diffraction pattern. The effects of the persistent current can be mitigated or even canceled by an external magnetic field perpendicular to the junction plane. The radial field associated with the persistent current can be accurately modeled with the classical phenomenological sine-Gordon model for extended one-dimensional Josephson junctions. Extensive numerical simulations were carried out to disclose the basic flux-flow mechanism responsible for the appearance of the magnetically induced steps and to elucidate the role of geometrical parameters. It was found that the imprint of the field cooling is enhanced in confocal annular junctions which are the natural generalization of the well studied circular annular junctions., Comment: 26 pages, 10 figures. Supercond. Sci. Technol (2020)

Objectives CCDC6 (coiled-coil domain containing 6) is a player of the HR response to DNA damage and has been predicted to interact with BAP1, another HR-DNA repair gene highly mutated in Malignant Pleural Mesothelioma (MPM), an aggressive cancer with poor prognosis. CCDC6 levels are modulated by the deubiquitinase USP7, and CCDC6 defects have been reported in several tumors determining PARP-inhibitors sensitivity. Our aim was to investigate the functional role of CCDC6 in MPM carcinogenesis and response to PARP-inhibitors. Materials and Methods The interaction between CCDC6 and BAP1 was confirmed in MPM cells, by co-immunoprecipitation. Upon USP7 inhibition, that induces CCDC6 degradation, the ability to repair the DSBs and the sensitivity to PARP inhibitors, was explored by HR reporter and by cells viability assays, respectively. A TMA including 34 MPM cores was immunostained for CCDC6, USP7 and BAP1 and the results correlated by statistical analysis. Results MPM cells depleted of CCDC6 showed defects in DSBs repair and sensitivity to PARP inhibitors. The silencing of CCDC6 when combined with the overexpression of BAP1-mutant (Δ221-238) enhanced the HR-DNA repair defects and the PARP inhibitors sensitivity. In the TMA of MPM primary samples, the staining of CCDC6 and of its de-ubiquitinase USP7 showed a significant correlation in the tested primary samples (p = 0.01). CCDC6 was barely detected in 30% of the tumors that also carried BAP1 defects. Conclusion The combination of CCDC6 and BAP1 staining may indicate therapeutic options for DDR targeting, acting in synergism with cisplatinum.

The physics of Josephson tunnel junctions drastically depends on their geometrical configurations and here we show that also tiny geometrical details play a determinant role. More specifically, we develop the theory of short and long confocal annular Josephson tunnel junctions in the presence of an in-plane magnetic field of arbitrary orientations. The behavior of a circular annular Josephson tunnel junction is then seen to be simply a special case of the above result. For junctions having a normalized perimeter less than one the threshold curves are derived and computed even in the case with trapped Josephson vortices. For longer junctions a numerical analysis is carried out after the derivation of the appropriate motion equation for the Josephson phase. We found that the system is modeled by a modified and perturbed sine-Gordon equation with a space dependent effective Josephson penetration length inversely proportional to the local junction width. Both the fluxon statics and dynamics are deeply affected by the non-uniform annulus width. Static zero-field multiple-fluxon solutions exist even in presence of a large bias current. The tangential velocity of a traveling fluxon is not determined by the balance between the driving and drag forces due to the dissipative losses. Furthermore, the fluxon motion is characterized by a strong radial inward acceleration which causes electromagnetic radiation concentrated at the ellipse equatorial points., 21 pages, 5 figures

The Trieste Habitat Micro-area Programme (HMP), an innovative social-health service policy, has offered a natural experiment to empirically evaluate the social mechanisms through which social capital may have an impact on health inequalities. To date, literature clarifying this causal chain is scanty. This empirical study tested the following hypotheses: H1) innovative social-health practices can activate social mechanisms intentionally and systematically so as to generate social capital; H2) such social mechanisms increase specific properties of social capital, in particular those influencing more vulnerable individuals’ relationships; H3) investing in these properties can enhance capabilities and, consequently, control over the health of more vulnerable individuals. The study was carried out during 2016–2018 and used both qualitative and quantitative methods. The qualitative part investigated the field experience of the HMP through interviews, focus groups and workshops with HMP professionals. The quantitative part assessed the effect HMP might have on these properties and the capacity to face health risks of more vulnerable individuals. Three samples, each of 200 individuals, residing in the target and in control areas were interviewed using a semi-structured questionnaire. One control sample was matched to the 200 treated subjects using a Propensity Score Matching. The results of the study suggest that the HMP intervention stimulated the development of empowerment, collaboration and interdependence among vulnerable people. This produced an increase in their social capital under several aspects, including enhanced trust, network extension and participation, cooperation and reciprocal help with neighbours, as well as improving their judgement on quality, timing and efficacy of the help received from institutions, relatives or friends. These findings show that socially shared relationships can create innovative local models of a universalistic generative welfare system, which would be both inclusive and able to enhance individual capabilities. These models could be disseminated and carried over to other contexts., Highlights • A qualitative and quantitative study on a local experience of generative welfare. • The role social mechanisms play in generating specific properties of social capital. • These properties enhance vulnerable individuals' capabilities and may contribute to reduce health inequalities. • These social mechanisms can be activated by public health services, to strengthen the generative welfare model.

It is well known that long Josephson tunnel junctions (JTJs) act as active transmission lines for the slow-mode propagation of magnetic flux-quanta (in the form of solitary waves) that is at the base of many superconducting circuits. At the same time, they support the propagation of quasi-TEM dispersive waves with which the magnetic flux non-linearly interact. In this work, we study the properties of the electromagnetic resonances, under different conditions of practical interest, in annular JTJs (AJTJs), in which the wavelengths are limited to the length of the circumference divided by an integer. Our analysis is based on perturbed sine–Gordon equations the (1+1)-dimensional space with periodic boundary conditions. We discuss the discrete modes of the traveling EM waves in circular AJTJs in the presence of an in-plane magnetic field, as well as in the recently introduced confocal AJTJs (in the absence of magnetic field). In both cases, a variable-separation method leads to quantitatively different Mathieu equations characterized by even and odd spatially periodic solutions with different eigenfrequencies. It implicates that a single mode circulating wave is given by the superposition of two standing waves with the same wavelengths but different frequencies, and so has a periodically inverting direction of propagation. The control parameters of this frequency splitting are the in-plane magnetic field amplitude for the circular AJTJ and the aspect ratio for the confocal AJTJs. In the appropriate limits, the previously known solutions are recovered.

Cities are complex systems and their changing are continuous. The evolution strictly depends on the relationships among the different aspects which compose the same structure, such as social, economic, political, environmental, historical aspects. The consideration of the complexity, the heterogeneity and reciprocal influences of these different elements becomes fundamental in urban regeneration projects that are characterized by many interconnected elements. Starting from a real project in the city of Pinerolo (Italy), the paper aims to investigate the potentiality of Fuzzy Cognitive Maps (FCMs) to represent the complexity of urban transformation processes, paying particular attention to the possibility of analyzing different scenarios simulation.

Steady deflagration waves are investigated for a mixture of four gases undergoing a bimolecular irreversible reaction. The influence of Mach number, of concentrations in the unperturbed state and of the chemical energy is shown via numerical simulations.

The paper deals with an integrated evaluation methodology finalized to evaluate the landscape value of the UNESCO site “Vineyard landscape of Langhe, Roero and Monferrato” (Piedmont, IT). The methodology consists in the employment of a system of landscape indicators with the aim, on one hand, to measure the landscape value in economic terms and on the other hand, to examine the pressures exercised on the landscape and its components. The present evaluation model could be considered a feasible tool in the decision support system for the definition of territorial scenarios of change.

An effective biodiversity conservation in Protected Areas (PAs) requires that they are seen as part of larger ecosystems and that the ecological connectivity is maintained beyond PA administrative boundaries. The study of ecological processes that link PAs to their surrounding landscapes is thus of great importance to understand which actions should be implemented to promote inside-outside ecological connectivity. In this paper, we used a system of indicators and a mathematical model (PANDORA model) to describe in a quantitative way the present and the foreseen ecological state of a Regional Nature Park (Parc Naturel Regional de la Montagne de Reims) and its surrounding area. The landscape ecological quality was assessed in terms of the capability of the system to transmit its biological energy all around its territory, thus highlighting the degree of ecological connectivity in landscapes situated both inside and outside the Park. The outcomes showed how the areas situated outside the Park are characterized by a less positive evolutionary trajectory with respect to those situated inside the Park. This is mainly due to urbanization processes that are taking place precisely outside the Parks' boundary. To avoid the risk of Park's “insularization”, the need and ways of developing integrated inside-outside planning and management policies, both by the Park Authority and external authorities, is highlighted. The mathematical approach presented here could be replicated also in other PAs, to sustain and address an integrated spatial planning of PAs and their context.

The peptides orexin-A and orexin-B and their G protein-coupled OX1 and OX2 receptors are involved in multiple physiological processes in the central nervous system and peripheral organs. Altered expression or signaling dysregulation of orexins and their receptors have been associated with a wide range of human diseases including narcolepsy, obesity, drug addiction, and cancer. Although orexin-A, its precursor molecule prepro-orexin and OX1 receptor have been detected in the human normal and hyperplastic prostate tissues, their expression and function in the prostate cancer (PCa) remains to be addressed. Here, we demonstrate for the first time the immunohistochemical localization of orexin-A in human PCa specimens, and the expression of prepro-orexin and OX1 receptor at both protein and mRNA levels in these tissues. Orexin-A administration to the human androgen-dependent prostate carcinoma cells LNCaP up-regulates OX1 receptor expression resulting in a decrease of cell survival. Noteworthy, nanomolar concentrations of the peptide counteract the testosterone-induced nuclear translocation of the androgen receptor in the cells: the orexin-A action is prevented by the addition of the OX1 receptor antagonist SB-408124 to the test system. These findings indicate that orexin-A/OX1 receptor interaction interferes with the activity of the androgen receptor which regulates PCa onset and progression, thus suggesting that orexin-A and its receptor might represent novel therapeutic targets to challenge this aggressive cancer.

Versão dos autores para esta publicação., In this paper we derive a BGK relaxation model for a mixture of polyatomic gases with a continuous structure of internal energies. The emphasis of the paper is on the case of a quaternary mixture undergoing a reversible chemically reaction of bimolecular type. For such a mixture we prove an H-theorem and characterize the equilibrium solutions with related mass action law of chemical kinetics. Further, a Chapman-Enskog asymptotic analysis is performed in view of computing the first-order non-equilibrium corrections to the distribution functions and investigating the transport properties of the reactive mixture. The chemical reaction rate is explicitly derived at the first-order and the balance equations for the constituent number densities are derived at the Euler level., The paper is partially supported by the Italian National Group GNFM of INdAM and by the Portuguese Funds FCT Project UID/MAT/00013/2013. One of the Authors (AJS) thanks the Italian institution for the financial support given in her visiting professor program in Italy., info:eu-repo/semantics/publishedVersion

This chapter focuses on the analysis of quality conventions in five different food chains, both alternative and conventional ones. In line with quality conventions theory, we consider quality as an emergent social construct of a specific social field where strategic maneuvering takes place. After a descriptive analysis of how quality conventions are connected to consumers’ conventions and chains’ attributes, Barbera, Dagnes, and Di Monaco illustrate the interplay and overlapping of quality conventions in alternative, conventional, and high-end food chains. Specifically, they argue that high-end food retailers mimic AFNs in order to satisfy consumers’ desire for “alternative” quality conventions.

Thymic epithelial tumors (TETs) are a heterogenous group of rare tumors, with a complex histopatological classification. Furthermore, the recent introduction of the first TNM staging system, that is scheduled to replace the Masaoka-Koga system, may create further difficulties in TET management, that remains challenging. Several guidelines for treatment of TETs are available and provide recommendations based mainly on non randomized trials and retrospective or limited series. Often the lack of evidence leads to formulation of indications based on expert opinions. As for other rare cancers it is crucial to create networks to coordinate the work among centres involved in treatment of these diseases in order to offer the best diagnostic and therapeutic tools. For this purpose, in 2014 a network named TYME (ThYmic MalignanciEs), was founded in Italy with the aim of improving care and research in TETs. In September 2017 a panel of multidisciplinary experts from TYME network and from other Italian centres strongly involved in TET diagnosis and treatment convened a first Italian Expert meeting together with representatives of association for patients affected by rare thoracic cancers Tu.To.R, to explore how these tumors are managed in the different centres of Italy compared to ESMO guidelines. In this paper we summarize the issues discussed during that meeting and we propose recommandations based on Masaoka Koga and the new TNM staging system.

Background: The natural history and the best modality of follow-up of atypical lung carcinoids (AC) remain ill defined. The aim of this study was to analyze recurrence-free survival (RFS) after complete resection (R0) of stage I-III pulmonary AC. Secondary objectives were prognostic parameters, the location of recurrences, and the modality of follow-up. Methods: A retrospective review of 540 charts of AC patients treated between 1998 and 2008 at 10 French and Italian centers with experience in lung neuroendocrine tumor management was undertaken. The exclusion criteria were MEN1-related tumor, history of another cancer, referral after tumor relapse, and being lost to follow-up. A central pathological review was performed in each country. Results: Sixty-two patients were included. After a median follow-up time of 91 months (mean 85, range 6-165), 35% of the patients experienced recurrence: 16% were regional recurrences and 19% were distant metastases. Median RFS was not reached. The 1-, 3-, and 5-year RFS rate was 90, 79, and 68%, respectively. In univariate analysis, lymph node involvement (p = 0.0001), stage (p = 0.0001), mitotic count (p = 0.004), and type of surgery (p = 0.043) were significantly associated with RFS. In multivariate analysis, lymph node involvement was significantly associated with RFS (HR 95% CI: 0.000-0.151; p = 0.004). During follow-up, somatostatin receptor scintigraphy, fibroscopy, and abdominal examination results were available for 22, 12, and 25 patients, respectively. The median time interval for imaging follow-up was 10 months. Conclusions: After complete resection of AC, recurrences were observed mostly within the first 5 years of follow-up, within bronchi, mediastinal nodes, the liver, and bones. In R0 patients, lymph node involvement could help to stratify follow-up intervals. Suboptimal imaging is evidenced.

The systematic integration of landscape dimension into general and sector-focused planning policies is one of the European Landscape Convention crucial points. This aspect is still poorly implemented in Italy, where landscape is often conceived as a field of action separate from the territorial context. The article presents the outcomes of a multidisciplinary research aimed at integrating landscape dimension into sector-focused policies, namely retail policies, in the Autonomous Province of Trento (Trentino-Alto Adige Region, Italy). The local government recently reformed its territorial retail development policies so as to comply with European reform regulations and with national decrees regulating the programming of services. It implemented the sector’s liberalization, but it did not give up the territorial planning and the conservation of the landscape values. In this context, a research was developed to evaluate retail development scenarios, and, more specifically, the opportunity to plan a Gross Leasable Area of territorial relevance. Two methods were used: an indicator matrix to assess landscape quality and a mathematical model to assess population mobility preferences among retail structures. This integrated evaluation approach allowed to highlight both the “rights of the landscape” and those of potential buyers. The outcomes of the research have been recently adopted by the APT regulatory framework on retail planning. The evaluation process actually acted as a process of collective learning, supporting political decision-making.

Aim To investigate the prevalence and burden (combination of number and severity) of vertebral fractures in men and women with hip fracture. Methods We investigated 458 of 490 hip-fracture patients admitted consecutively to a rehabilitation hospital. Lateral radiographs of the spine were taken 19.2 ± 5.5 days (mean ± SD) after hip-fracture occurrence. To obtain a summary measure of vertebral fracture burden, we calculated the spinal deformity index (SDI) by summing the fracture grades assessed using Genant's method of all vertebrae (T4 to L4). Results The median SDI score was 2 in both the 411 women and the 47 men (interquartile range 0–4 in both groups), and no significant between-sex differences were found (P = 0.52). A total of 69% of the women (95% CI 65–74%), and 60% of the men (95% CI 45–74%) had at least one mild vertebral fracture (SDI score ≥1), 41% of the women (95% CI 36–46%) and 38% of the men (95% CI 24–53%) had a SDI score ≥3, whereas 16% of the women (95% CI 12% 19%) and 17% of the men (95%CI 6−28%) had at least one severe vertebral fracture. Sex was not significantly associated with a SDI score ≥1, or ≥3 or with the presence of at least one severe vertebral fracture after adjustment for age, hip-fracture type, cognitive impairment, pressure ulcers, neurological impairment, comorbidities, number of medications in use and Barthel index scores. Conclusions The prevalence of vertebral fractures was high after hip fracture in both men and women. We found no significant between-sex differences in the prevalence and burden of vertebral fractures. Geriatr Gerontol Int 2015; ●●: ●●–●●.

The magnetic field dependence of the Eck step voltage in long Josephson tunnel junctions (LJTJs) can be exploited for ultralow-noise magnetic sensing. The magnetic flux to be measured is captured by a non-interrupted superconducting pickup loop in which a narrow constriction, forming the LJTJ wiring layer, produces a local high density circulating currents which, in turn, induces a magnetic field large enough to set a biased LJTJ at a finite voltage proportional to the field strength (flux-flow state). On this basis, an innovative and ultralow-noise superconducting device has been realized having a highly linear voltage responsivity and an intrinsic voltage spectral density down to few pV/ $\surd $ Hz. Being that the intrinsic voltage fluctuations of these all-Niobium sensors are very low (at $T = 4.2$ K), a double transformer superconducting quantum interference device (SQUID) amplifier has been used to determine the amplitude of its voltage spectral density obtaining a value as low as 10 pV/ $\surd $ Hz. In addition, the 1/ ${f}$ noise does not affect the sensor performance down to a few hertz. The corresponding magnetic field noise, equal to 10 fT/ $\surd $ Hz, together with highly linear and broadband voltage responsivity over a wide magnetic flux range, features performances that are comparable with those of a SQUID magnetometers having a comparable flux capture area.

Versão dos autores para este artigo., A Network Landscape Model (NLM) for the evaluation of the ecological trend of an environmental system is here presented and investigated. The model consists in a network of dynamical systems, here each node represents a single Landscape Unit (LU), endowed by a system of ODEs for two variables relevant to the production of bio-energy and to the percentage of green areas, respectively. The main goal of the paper consists in testing the relevance of connectivity between the LUs. For this purpose we consider rst the Single LU Model (SLM) and investigate its equilibria and their stability, in terms of two bifurcation parameters. Then the network dynamics is theoretically investigated by means of a bifurcation analysis of a proper simpli ed di erential system, that allows to understand how the coupling between di erent LUs modi es the asymptotic scenarios for the single LU model. Numerical simulations of NLM are performed, with reference to an environmental system in Northern Italy, and results are discussed in connection with SLM., GNFM - INdAM; FCT

Non-small cell lung cancer (NSCLC) is the main cause of cancer-related death worldwide and new therapeutic strategies are urgently needed. In this study, we have characterized a panel of NSC lung cancer cell lines for the expression of coiled-coil-domain containing 6 (CCDC6), a tumor suppressor gene involved in apoptosis and DNA damage response. We show that low CCDC6 protein levels are associated with a weak response to DNA damage and a low number of Rad51 positive foci. Moreover, CCDC6 deficient lung cancer cells show defects in DNA repair via homologous recombination. In accordance with its role in the DNA damage response, CCDC6 attenuation confers resistance to cisplatinum, the current treatment of choice for NSCLC, but sensitizes the cells to olaparib, a small molecule inhibitor of the repair enzymes PARP1/2. Remarkably, the combination of the two drugs is more effective than each agent individually, as demonstrated by a combination index

To investigate the contribution of muscle mass and handgrip strength in predicting the functional outcome after hip fracture in women.Observational study.Rehabilitation hospital.White women (N=123 of 149) who were consecutively admitted to a rehabilitation hospital because of their first fracture of the hip.Not applicable.We measured appendicular lean mass (aLM) by dual-energy x-ray absorptiometry (DXA) 21.1 ± 8.7 (mean ± SD) days after hip fracture occurrence in the 123 women. On the same day, we assessed grip strength at the nondominant arm with a dynamometer. At the end of acute inpatient rehabilitation we measured the ability to function in activities of daily living by using the Barthel Index, and lower limb performance by using the Timed Up and Go (TUG) test.We found significant correlations between handgrip strength measured before rehabilitation and Barthel Index scores after rehabilitation (ρ=.50; P.001), Barthel Index effectiveness (ρ=.45; P.001), and the TUG test (ρ=-.41; P.001). Conversely, we found no significant correlations between aLM/height(2) and Barthel Index scores after rehabilitation (ρ=.075; P=.41), Barthel Index effectiveness (ρ=.06; P=.53), or the TUG test (ρ=.005; P=.96). Significant associations between grip strength and all the outcome measures persisted after adjustment for 8 potential confounders, including Barthel Index scores before rehabilitation, age, number of medications, number of comorbidities, pressure ulcers, concomitant infections, time between fracture occurrence and assessment, and aLM/height(2).Grip strength, but not DXA-assessed aLM, significantly predicted short-term functional outcome in women after a hip fracture.

The present paper focuses on the role covered by dynamic models as support for the decision-making process in the evaluation of policies and actions for increasing the resilience of cities and territories. In recent decades, urban resilience has been recognized as a dynamic and multidimensional phenomenon that characterizes urban and metropolitan area dynamics. Therefore, it may be considered a fundamental aspect of urban and territorial planning. The employment of quantitative methods, such as dynamic models, is useful for the prediction of the dynamic behavior of territories and of their resilience. The present work discusses the system dynamics model and the Lotka&ndash, Volterra cooperative systems and shows how these models can aid technicians in resilience assessment and also decision makers in the definition of policies and actions, especially if integrated in wide evaluation frameworks for urban resilience achievements. This paper aims to provide an epistemological perspective of the application of dynamic models in resilience assessment, underlying the possible contribution to this issue through the analysis of a real case study and methodological framework. The main objective of this work is to lay the basis for future compared applications of these two models to the same case study.

Parathyroid hormone (PTH) exerts several actions beyond mineral metabolism and may affect body composition. The aim of our study was to assess the association between serum PTH and body fat compartment in hip fracture patients. We studied 575 of 630 inpatients with hip fracture consecutively admitted to our Rehabilitation ward. Dual-energy X-ray absorptiometry (DXA) was used to measure body composition. DXA scan was performed 18.5 ± 8.6 (mean ± SD) days after hip fracture occurrence. A blood sample was collected within 4 days after DXA scan. In each subject, we evaluated PTH, 25-hydroxyvitamin D, calcium, phosphate, albumin, magnesium, and creatinine. Glomerular filtration rate was estimated by a conventional formula. In the 57 men, we found a significant correlation between PTH and both body mass index (BMI) (ρ = 0.37; p = 0.020) and trunk fat percentage (ρ = 0.62; p