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Background: Telemonitoring systems in cardiology have shown potential in improving chronic cardiovascular disease (CVD) management. This study aims to evaluate the impact of telemonitoring, mainly through mobile applications, on patient outcomes such as self-care, blood pressure control, quality of life, and hospitalization. Methods: We systematically reviewed studies assessing telemonitoring methods for patients with chronic CVD. The analysis included studies from various geographic regions and healthcare settings, focusing on qualitative outcomes without performing a meta-analysis. Results: Telemonitoring was found to aid in maintaining blood pressure and significantly enhance self-care abilities. Improvements in quality of life were observed in some studies, though results varied. Most studies indicated telemonitoring could effectively manage blood pressure and reduce hypertension-related complications. However, the heterogeneity of interventions and outcomes measured across trials posed challenges for a comprehensive meta-analysis. Conclusions: Integrating telemonitoring systems into routine care can significantly improve disease management and patient outcomes for chronic CVD patients. Future research should standardize telemonitoring interventions and outcome measures, conduct long-term studies, and evaluate the cost-effectiveness of these systems. Greater blindness in future randomized controlled trials and more studies on atrial fibrillation are also necessary. Significant potential exists for telemonitoring to improve patient outcomes and assist in managing chronic illnesses.

Supernova remnants (SNRs) provide insights into cosmic-ray acceleration and magnetic field dynamics at shock fronts. Recent X-ray polarimetric measurements by the Imaging X-ray Polarimetry Explorer (IXPE) have revealed radial magnetic fields near particle acceleration sites in young SNRs, including Cassiopeia A, Tycho, and SN 1006. We present here the spatially resolved IXPE X-ray polarimetric observation of the northwestern rim of SNR RX J1713.7–3946. For the first time, our analysis shows that the magnetic field in the particle acceleration sites of this SNR is oriented tangentially with respect to the shock front. Because of the lack of precise Faraday rotation measurements in the radio band, this was not possible before. The average measured polarization degree (PD) of the synchrotron emission is 12.5% ± 3.3%, lower than the one measured by IXPE in SN 1006, comparable to the Tycho one, but notably higher than the one in Cassiopeia A. On subparsec scales, localized patches within RX J1713.7–3946 display a PD of up to 41.5% ± 9.5%. These results are compatible with a shock-compressed magnetic field. However, in order to explain the observed PD, either the presence of a radial net magnetic field upstream of the shock or partial reisotropization of the turbulence downstream by radial magnetohydrodynamical instabilities can be invoked. From comparison of PD and magnetic field distribution with γ -rays and ^12 CO data, our results provide new inputs in favor of a leptonic origin of the γ -ray emission.

How astrophysical systems translate the kinetic energy of bulk motion into the acceleration of particles to very high energies is a pressing question. SS 433 is a microquasar that emits TeV γ -rays indicating the presence of high-energy particles. A region of hard X-ray emission in the eastern lobe of SS 433 was recently identified as an acceleration site. We observed this region with the Imaging X-ray Polarimetry Explorer and measured a polarization degree in the range 38%–77%. The high polarization degree indicates the magnetic field has a well-ordered component if the X-rays are due to synchrotron emission. The polarization angle is in the range −12° to +10° (east of north), which indicates that the magnetic field is parallel to the jet. Magnetic fields parallel to the bulk flow have also been found in supernova remnants and the jets of powerful radio galaxies. This may be caused by interaction of the flow with the ambient medium.

This paper describes a novel architecture that aims to create a template for the implementation of an IT platform, supporting the deployment and integration of the different digital twin subsystems that compose a complex urban intelligence system. In more detail, the proposed Smart City IT architecture has the following main purposes: (i) facilitating the deployment of the subsystems in a cloud environment; (ii) effectively storing, integrating, managing, and sharing the huge amount of heterogeneous data acquired and produced by each subsystem, using a data lake; (iii) supporting data exchange and sharing; (iv) managing and executing workflows, to automatically coordinate and run processes; and (v) to provide and visualize the required information. A prototype of the proposed IT solution was implemented leveraging open-source frameworks and technologies, to test its functionalities and performance. The results of the tests performed in real-world settings confirmed that the proposed architecture could efficiently and easily support the deployment and integration of heterogeneous subsystems, allowing them to share and integrate their data and to select, extract, and visualize the information required by a user, as well as promoting the integration with other external systems, and defining and executing workflows to orchestrate the various subsystems involved in complex analyses and processes.

Innovative ICT technologies, approaches and applications are becoming increasingly pervasive in several domains, including in medicine and healthcare [...]

This paper introduces an updated formulation of a five-step procedure dealing with the design of fluid viscous dampers for the seismic retrofitting of existing frame buildings. The original design procedure is known as the “direct five-step procedure,” and is articulated into 5 consecutive steps guiding the designer from the identification of the expected seismic performances, to the sizing of the added viscous dampers up to the final verification of the seismic behavior through non-linear dynamic time history analyses. The procedure leads to the full definition of the mechanical characteristics of the commercial non-linear viscous dampers and allows to estimate the maximum dissipative forces acting in the dampers and the internal forces in the frame members. The objective of the design procedure, when applied to a new building, is to size the dampers in order to keep the structural elements within the linear elastic range considering a “rare” earthquake design level. However, when dealing with an existing building, especially if originally designed considering vertical loads only, the insertion of viscous dampers could be not sufficient to keep the structural elements in the elastic range. Thus, it might be necessary to accept local plastic excursion of the structural elements, by taking into account the ductility capacity (albeit probably limited) of the structural members (hysteretic dissipation associated with damage in beams and columns). This latter aspect is explicitly considered in the updated formulation of the “direct five-step procedure” presented here through the introduction of an overall response reduction factor accounting for both the ductility capacity of the structural members and the viscous damping provided by the added dampers. The design procedure is then applied to a 11-storey frame structure case study, which is representative of reinforced concrete buildings designed for vertical loads only. Three different retrofitting design strategies are considered, based on different exploitation of viscous energy dissipation provided by the dampers and hysteretic energy dissipation due to the excursion of the structural members into the inelastic regime.

We present Crab X-ray polarization measurements using Imaging X-Ray Polarimetry Explorer (IXPE) data with a total exposure of 300 ks, three times more than the initial 2022 discovery paper. Polarization is detected in three times more pulsar phase bins, revealing an S-shaped +40° polarization angle sweep in the main pulse and >1 σ departures from the OPTIMA optical polarization in both pulses, suggesting different radiation mechanisms or sites for the polarized emission at the two wavebands. Our polarization map of the inner nebula reveals a toroidal magnetic field, as seen in prior IXPE analyses. Along the southern jet, the magnetic field orientation relative to the jet axis changes from perpendicular to parallel and the polarization degree decreases by ∼6%. These observations may be explained by kink instabilities along the jet or a collision with a dense, jet-deflecting medium at the tip. Using spectropolarimetric analysis, we find asymmetric polarization in the four quadrants of the inner nebula, as expected for a toroidal field geometry, and a spatial correlation between polarization degree and photon index.

This paper proposes an innovative method that exploits a complex deep learning network architecture, called Hierarchical Deep Neural Network (HDNN), specifically developed for the eXtreme Multilabel Text Classification (XMTC) task, when the label set is hierarchically organized, such as the case of the PubMed article labeling task. In detail, the topology of the proposed HDNN architecture follows the exact hierarchical structure of the label set to integrate this knowledge directly into the DNN. We assumed that if a label set hierarchy is available, as in the case of the PubMed Dataset, forcing this information into the network topology could enhance the classification performances and the interpretability of the results, especially related to the hierarchy. We performed an experimental assessment of the PubMed article classification task, demonstrating that the proposed HDNN provides performance improvement for a baseline based on a classic flat Convolution Neural Network (CNN) deep learning architecture, in particular in terms of hierarchical measures. These results provide useful hints for integrating previous and innate knowledge in a deep neural network. The drawback of the HDNN is the high computational time required to train the neural network, which can be addressed with a parallel implementation planned as a future work.

We present the IXPE observation of GRB 221009A, which includes upper limits on the linear polarization degree of both prompt and afterglow emission in the soft X-ray energy band. GRB 221009A is an exceptionally bright gamma-ray burst (GRB) that reached Earth on 2022 October 9 after traveling through the dust of the Milky Way. The Imaging X-ray Polarimetry Explorer (IXPE) pointed at GRB 221009A on October 11 to observe, for the first time, the 2–8 keV X-ray polarization of a GRB afterglow. We set an upper limit to the polarization degree of the afterglow emission of 13.8% at a 99% confidence level. This result provides constraints on the jet opening angle and the viewing angle of the GRB, or alternatively, other properties of the emission region. Additionally, IXPE captured halo-rings of dust-scattered photons that are echoes of the GRB prompt emission. The 99% confidence level upper limit to the prompt polarization degree depends on the background model assumption, and it ranges between ∼55% and ∼82%. This single IXPE pointing provides both the first assessment of X-ray polarization of a GRB afterglow and the first GRB study with polarization observations of both the prompt and afterglow phases.

ixpeobssim is a simulation and analysis framework specifically developed for the Imaging X-ray Polarimetry Explorer (IXPE). Given a source model and the response functions of the telescopes, it is designed to produce realistic simulated observations, in the form of event lists in FITS format, containing a strict superset of the information included in the publicly released IXPE data products. The core simulation capabilities are complemented by a full suite of post-processing applications which support the spatial, spectral, and temporal models needed for analysis of typical polarized X-ray sources, allowing for the implementation of complex, polarization-aware analysis pipelines, and facilitating the interoperation with the standard visualization and analysis tools traditionally in use by the X-ray community. Although much of the framework is specific to IXPE, the modular nature of the underlying implementation makes it potentially straightforward to adapt it to different missions with polarization capabilities.

The present study compares the dynamic properties and seismic performances offered by reinforced concrete frame structures characterized by different beams distribution. The understanding of the influence of beams distribution on spatial frames is not only useful when dealing with the seismic vulnerability assessment of existing buildings that may show unusual layouts of beams, such as alternating beams at each storey, but also when facing the design of new buildings with fluid viscous dampers for which some structural flexibility is required. A systematic study is described in this paper. Four (2-, 3-, 6-, and 10-storey) regular frame buildings with rectangular plan are considered as reference structures. Different models are developed according to various layouts of the primary beams, exploring alternatives to the full three-dimensional organisation of beams and frames. For instance: beams placed along the longitudinal direction at the odd storeys and placed along the transversal direction at the even storeys, and vice versa; alternating beams every one and two storeys; beams just placed along one direction. Modal analysis has been conducted to evaluate the influence of beams distribution on the dynamic properties (periods of vibration and modal participating mass ratios). Response spectrum analysis and linear time-history dynamic analysis have been carried out to assess the effects of beams distribution on the fundamental seismic response parameters (shear forces, bending moments, top-storey displacements, interstorey drifts, and floor accelerations). On the contrary of what could be expected, the results indicate that structures with beams alternating every storey may show interesting advantages in terms of reduced total base shear, almost comparable bending moments and accelerations, within a still balanced overall behaviour along the two directions, with respect to the complete three-dimensional frame. Two effects are recognized: the period effect and the static scheme effect. The former acting basically on the storey shear forces; the latter acting mainly on the bending moments.

The seismic design of industrial flat-bottom ground-supported silos filled with granular material still presents several challenges to be addressed. They are related to the main aspects which differentiate silo structures containing granular material from other civil structural typologies: 1) the relatively low silo structure mass as compared to the ensiled content mass; 2) the granular nature of the ensiled material. Indeed, the internal actions in the structural members are governed by the complex dynamic interactions along the interfaces between granular content and silo wall or base, or even the internal interaction between particles. More in detail, even though the scientific interest in such complex interactions dates back to the middle of the 19th century, several issues are still unclear such as the dependency of the fundamental dynamic properties (period of vibration and damping ratio) on the characteristics of the dynamic excitation (intensity, frequency content, duration) or the amount of ensiled material mass activated during a seismic excitation and provoking extra pressures on the wall (effective mass). Therefore, most of current seismic code provisions for silos are grounded on rather approximate and simplified assumptions leading to often over-conservative evaluations. The present paper intends to provide a comprehensive summary of the mainly acknowledged experimental and theoretical advances in the dynamic and seismic behavior of silos, supporting the potential researcher in the field to understand the real differences between the code assumptions and recommendations and the actual conditions, as well as illustrating the open issues to be still further investigated.

Young supernova remnants strongly modify the surrounding magnetic fields, which in turn play an essential role in accelerating cosmic rays (CRs). The X-ray polarization measurements probe magnetic field morphology and turbulence at the immediate acceleration site. We report the X-ray polarization distribution in the northeastern shell of SN 1006 from a 1 Ms observation with the Imaging X-ray Polarimetry Explorer. We found an average polarization degree of 22.4% ± 3.5% and an average polarization angle of −45.°4 ± 4.°5 (measured on the plane of the sky from north to east). The X-ray polarization angle distribution reveals that the magnetic fields immediately behind the shock in the northeastern shell of SN 1006 are nearly parallel to the shock normal or radially distributed, similar to that in the radio observations, and consistent with the quasi-parallel CR acceleration scenario. The X-ray emission is marginally more polarized than that in the radio band. The X-ray polarization degree of SN 1006 is much larger than that in Cas A and Tycho, together with the relatively tenuous and smooth ambient medium of the remnant, favoring that CR-induced instabilities set the magnetic turbulence in SN 1006, and CR acceleration is environment-dependent.

Supernova remnants are commonly considered to produce most of the Galactic cosmic rays via diffusive shock acceleration. However, many questions regarding the physical conditions at shock fronts, such as the magnetic-field morphology close to the particle acceleration sites, remain open. Here we report the detection of a localized polarization signal from some synchrotron X-ray emitting regions of Tycho’s supernova remnant made by the Imaging X-ray Polarimetry Explorer. The derived degree of polarization of the X-ray synchrotron emission is 9% ± 2% averaged over the whole remnant, and 12% ± 2% at the rim, higher than the value of polarization of 7%–8% observed in the radio band. In the west region, the degree of polarization is 23% ± 4%. The degree of X-ray polarization in Tycho is higher than for Cassiopeia A, suggesting a more ordered magnetic field or a larger maximum turbulence scale. The measured tangential direction of polarization corresponds to the radial magnetic field, and is consistent with that observed in the radio band. These results are compatible with the expectation of turbulence produced by an anisotropic cascade of a radial magnetic field near the shock, where we derive a magnetic-field amplification factor of 3.4 ± 0.3. The fact that this value is significantly smaller than those expected from acceleration models is indicative of highly anisotropic magnetic-field turbulence, or that the emitting electrons either favor regions of lower turbulence, or accumulate close to where the orientation of the magnetic field is preferentially radially oriented due to hydrodynamical instabilities.

Imaging X-ray Polarimetry Explorer (IXPE) is a Small Explorer mission by NASA and Agenzia Spaziale Italiana, launched on 2021 December 9, dedicated to investigating X-ray polarimetry allowing angular-, time-, and energy-resolved observations in the 2–8 keV energy band. IXPE is in the science observation phase since 2022 January; it is comprised of three identical telescopes with grazing-incidence mirrors, each one having in the focal plane a gas pixel detector. In this paper, we present a possible guideline to obtain an optimal background selection in polarimetric analysis, and a rejection strategy to remove instrumental background. This work is based on the analysis of IXPE observations, aiming to improve as much as possible the polarimetric sensitivity. In particular, the developed strategies have been applied as a case study to the IXPE observation of the 4U 0142+61 magnetar.

Digitization in healthcare systems, with the wid adoption of Electronic Health Records, connected medical devices, software and systems providing efficient healthcare service delivery and management. On the other hand, the use of these systems has significantly increased cyber threats in the healthcare sector. Vulnerabilities in the existing and legacy systems are one of the key causes for the threats and related risks. Understanding and addressing the threats from the connected medical devices and other parts of the ICT health infrastructure are of paramount importance for ensuring security within the overall healthcare ecosystem. Threat and vulnerability analysis provides an effective way to lower the impact of risks relating to the existing vulnerabilities. However, this is a challenging task due to the availability of massive data which makes it difficult to identify potential patterns of security issues. This paper contributes towards an effective threats and vulnerabilities analysis by adopting Machine Learning models, such as the BERT neural language model and XGBoost, to extract updated information from the Natural Language documents largely available on the web, evaluating at the same time the level of the identified threats and vulnerabilities that can impact on the healthcare system, providing the required information for the most appropriate management of the risk. Experiments were performed based on CS news extracted from the Hacker News website and on Common Vulnerabilities and Exposures (CVE) vulnerability reports. The results demonstrate the effectiveness of the proposed approach, which provides a realistic manner to assess the threats and vulnerabilities from Natural Language texts, allowing adopting it in real-world Healthcare ecosystems.

The paper investigates the dynamic behavior of structural systems obtained by connecting a moment-resisting frame structure with a vertical rigid truss pinned at the base, known in literature as “strongback,” and equipped with added fluid-viscous dampers. The strongback, designed in order to remain in the elastic field under strong seismic ground motion, acts as a mast by imposing to the structure a linear lateral deformed shape. By regularizing the lateral drift profile of the structure, the strongback limits undesired effects such as weak-storey mechanisms, damage concentration and residual drifts. In addition, when supplemental dampers are inserted in the structure, a considerable amount of energy can be dissipated, thus reducing the peak seismic response. The aim of the work is twofold: i) to provide analytical formulations for the preliminary design of added dampers based on the Generalized Single Degree Of Freedom (GSDOF) concept, and ii) to evaluate the increase in energy dissipation capabilities for selected dampers configurations thanks to the presence of the strongback. The formulas are developed for different configurations of added viscous dampers: dampers inserted within the frame between all or selected consecutive storeys (inter-storey placement) and dampers located at the base of the strongback to realize a rigid “dissipative tower.” The effectiveness of the dampers configurations is evaluated through dynamic time-history analyses.

Abstract Background Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos. Methods The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution. Results Mortality was significantly increased for ‘All Causes’ and ‘All Malignant Neoplasm (MN)’, in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%. Conclusions Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studies.

In the last few years, the rapid growth in available digitised medical data has opened new challenges for the scientific research community in the healthcare informatics field [...]

The large availability of clinical natural language documents, such as clinical narratives or diagnoses, requires the definition of smart automatic systems for their processing and analysis, but the lack of annotated corpora in the biomedical domain, especially in languages different from English, makes it difficult to exploit the state-of-art machine-learning systems to extract information from such kinds of documents. For these reasons, healthcare professionals lose big opportunities that can arise from the analysis of this data. In this paper, we propose a methodology to reduce the manual efforts needed to annotate a biomedical named entity recognition (B-NER) corpus, exploiting both active learning and distant supervision, respectively based on deep learning models (e.g., Bi-LSTM, word2vec FastText, ELMo and BERT) and biomedical knowledge bases, in order to speed up the annotation task and limit class imbalance issues. We assessed this approach by creating an Italian-language electronic health record corpus annotated with biomedical domain entities in a small fraction of the time required for a fully manual annotation. The obtained corpus was used to train a B-NER deep neural network whose performances are comparable with the state of the art, with an F1-Score equal to 0.9661 and 0.8875 on two test sets.

Full base shear seismic demand analyses with calculated examples for heavy stone masonry buildings are not present in the literature. To address this shortcoming, analyses and calculations are performed on nominally reinforced rubble stone masonry house and school designs, as typically built in Nepal. The seismic codes are literally applied for countries where the technique is still allowed (Nepal, India, China, Tajikistan, Iran, Croatia), or should be reintroduced based on current practices (Pakistan, Afghanistan, Turkey). First, this paper compares the base shear formulas and the inertia forces distributions of these codes, as well as material densities, seismic weights, seismic zoning, natural periods of vibration, response spectra, importance factors and seismic load combinations. Large differences between approaches and coefficients are observed. Then, by following Equivalent Lateral Force-principles for Ultimate Limit State verifications (10%PE50y), the base shear and story shears are calculated for a design peak ground acceleration of 0.20 g, as well as the effects of critical load combinations on the forces and moments acting on the lateral-resisting elements. It is concluded that Pakistan has the most tolerant code, Nepal represents an average value, whereas India and China are most conservative toward the case study buildings. Overall, it is observed that heavy-masonry-light-floor systems with negligible diaphragm action behave different under seismic motion than most other building typologies. Given the observations in this paper, the applicability of conventional ELF, S-ELF and S-Modal methods for heavy masonry buildings is questionable. The codes however do not introduce modified approaches that address these differences. Possible implications of the exclusion of plinth masonry and large portions of seismic weight need further assessment and validation, for which different (possibly more sophisticated) concepts must be considered, such as the equivalent frame method or distributed mass system. Since Nepal allows stone masonry in areas with higher seismic hazard levels >0.40 g (opposed to India

Nearly 325 seismic and masonry codes from all over the world have been analyzed, of countries where stone masonry was, or still is, abundantly practiced. This paper compares and summarizes design specifications and construction requirements, with a specific focus on “nominally reinforced rubble stone masonry (NRM) with cement mortar and wooden diaphragms in seismic areas.” Currently, the technique is only allowed and described in some detail in the codes of Nepal, India, China, Tajikistan, Georgia, Iran and Croatia. It is concluded that the design specifications vary greatly without any consensus on the main sizes, dimensions or details. This raises questions about the completeness and correctness, as well as the reliability and actual value of the knowledge in this field. It is further observed that types of stone masonry and stone properties are seldom clearly described in the codes. It is also noted that several countries where stone masonry is still broadly practiced, are currently not allowing the technique (or have no codes in place), such as Afghanistan, Pakistan, Bhutan, Azerbaijan, Kyrgyzstan, Morocco, Tunisia, Turkey, Yemen and Albania. This, however, does not serve the current engineering practices and construction needs in these countries. To address all shortcomings, the paper recommends clear descriptions and terminology; the international adaption of NRM as a fourth masonry category; and the development of a stand-alone code specifically for this technique. Therefore, the authors propose a full assessment, validation, optimization and complementation of the existing knowledge, by means of the current state-of-the-art for calculating, testing and modeling. This envisions a structured research approach with focus on vernacular and traditional construction techniques, called “Non-Engineered 2.0,” for which a research initiative is started under the name “SMARTnet,” meaning “Seismic Methodologies for Applied Research and Testing of non-engineered techniques.” The findings of this paper will serve as the starting point for the upcoming follow-up paper, which will complement the seismic demand with hand-made base shear calculations for countries that still allow the technique. The paper ends with an appeal to experts, academics and final-year students worldwide, to exchange their knowledge and to support the project with their time and expertise.

The heterogeneity of the formats and standards of clinical data, which includes both structured, semi-structured, and unstructured data, in addition to the sensitive information contained in them, require the definition of specific approaches that are able to implement methodologies that can permit the extraction of valuable information buried under such data. Although many challenges and issues that have not been fully addressed still exist when this information must be processed and used for further purposes, the most recent techniques based on machine learning and big data analytics can support the information extraction process for the secondary use of clinical data. In particular, these techniques can facilitate the transformation of heterogeneous data into a common standard format. Moreover, they can also be exploited to define anonymization or pseudonymization approaches, respecting the privacy requirements stated in the General Data Protection Regulation, Health Insurance Portability and Accountability Act and other national and regional laws. In fact, compliance with these laws requires that only de-identified clinical and personal data can be processed for secondary analyses, in particular when data is shared or exchanged across different institutions. This work proposes a modular architecture capable of collecting clinical data from heterogeneous sources and transforming them into useful data for secondary uses, such as research, governance, and medical education purposes. The proposed architecture is able to exploit appropriate modules and algorithms, carry out transformations (pseudonymization and standardization) required to use data for the second purposes, as well as provide efficient tools to facilitate the retrieval and analysis processes. Preliminary experimental tests show good accuracy in terms of quantitative evaluations.

OBJECTIVES: DAS was an artificial clay which, once molded, hardened at room temperature. It was largely used as a toy between 1963 and 1975 in Italy, Netherlands, Germany, UK and Norway. This case report describes and reports the presence of asbestos in DAS. METHODS: We investigated the presence of asbestos in DAS using light and electron microscopy on samples of the original material. We searched administrative documents at the State Archive of Turin and conducted interviews with past employees on annual production, suppliers, and purchasers. RESULTS: The analytical tests confirmed the presence of asbestos fibers in DAS: about 30% of its composition. The documents found at the State Archive confirmed the annual purchase of hundreds tons of raw asbestos from the Amiantifera di Balangero, the Italian asbestos mine. DAS was found to be used also within craftsmanship. CONCLUSIONS: Asbestos fibers in DAS may have caused exposure to production workers and a variety of users, including artists, teachers, and children. Over 13 years, about 55 million packs of DAS were produced and sold. The number of users is difficult to estimate but may have been in the order of millions. In Italy, a specific question on the use of DAS has been included in a routinely used mesothelioma questionnaire. As DAS was exported to other countries, our findings suggest that mesothelioma patients should be asked about their past use of DAS, in particular individuals not reporting a clear past asbestos exposure. Additionally, this discovery shows the incompleteness of records on asbestos uses and suggests to test items, including toys, imported from countries where asbestos is not forbidden.

After the 2005 M7.6 Kashmir earthquake (Pakistan), field observations reported that several buildings manufactured with local traditional techniques resisted well to that strong seismic event. In this paper, the attention is focused on a typical vernacular construction technique commonly named as “Bhatar,” still practiced in the Himalayan regions of India and Pakistan. It is grounded upon the “timber lacing” or “timber reinforcement masonry” concept, i.e., the combination of dry-stacked loose stones with timber beams to increase the wall confinement. Despite its good seismic performances, it has still not been deeply studied from a structural engineering point of view. This paper represents a first attempt to fill this gap. It presents a full analytical study on the structural behavior of a simple one-storey building unit characterized by a 3.6 m × 3.6 m square plan covered by a heavy wooden roof with 20-cm-thick earth coverage, in order to investigate its response under gravity and seismic inertial loadings. Materials properties, static analysis, and seismic analysis are discussed. In detail, Shorea Robusta wood and limestone rocks are identified as the most used construction materials for the Bhatar buildings. The Barton’s model is applied to characterize the shear strength of the rubble stone layers in the wall. Static analysis reveals that normal stresses at the ground level are around 92 kPa, which can be considered acceptable for common soils. With respect to earthquake, the Bhatar technique can absorb wall cracking and distortion mechanisms, and can dissipate energy through friction between stones. Under the assumption of no vertical ground motion, the acceleration which activates in-plane sliding mechanisms is found to be around 0.5 g, being dependent on the interface friction between adjacent layers. Some preliminary considerations about the out-of-plane seismic behavior are also provided concerning overturning and bending failure mechanisms. The results are based on assumptions taken by several authors and have not been verified with experimental tests. Nevertheless, some practical suggestions can be derived to improve the seismic shear strength and to ensure friction also in the case of significant vertical component of earthquake ground motions.

Gabion-boxes, made with steel wire mesh and filled with stones of appropriated size, are normally stacked up one into another to form a retaining wall. Given their reduced costs and the easy availability of their constituting materials, gabion-box walls have been extensively used in developing countries (such as Nepal) also to realize simple one-storey residential buildings. In recent years, many of these structures have been subjected to several strong earthquakes and have shown a good seismic behavior, even if they have never been the object of a proper structural design. In the scientific literature, research studies have been developed on gabion-box walls used as retaining systems, but no investigations have been conducted on the performances of gabion-box walls buildings. In this respect, the general objective of this research work is to give a first insight into the static and seismic behavior of such gabion-box walls buildings through analytical considerations and numerical models. In detail, with reference to a typical 5 m × 5 m plan model, this article investigates the in-plane and out-of-plane seismic responses of its constituting walls, by means of simple analytical interpretations and Discrete Element Method numerical simulations. Even if this study should be considered as a starting point and even if the fundamental cellular behavior of the three-dimensional structure has not been fully taken into account, some criticalities have been disclosed and the order of magnitude of the seismic activation load multipliers has been estimated. The out-of-plane collapse mechanism is characterized by multiplier around 0.15, while the in-plane mechanism multiplier depends on the position of the door in the single wall (0.10–0.20), but it can be easily increased with lintel beams placement. The results are based on the assumptions taken by several authors and have not been verified with experimental tests. Nevertheless, some practical suggestions (basically in terms of spacing and construction details, such as vertical connectors and reinforcing steel knots) can be derived to improve the construction in order to ensure a better seismic behavior.

Undifferentiated embryonal sarcoma of the liver is a malignancy with poor prognosis observed more frequently in children between 6 and 10 years old and very rarely found in adults. We present a case of embryonal sarcoma of the liver in a 60-year-old woman without significant medical history who presented to our attention with constitutional symptoms. Preoperative assessments did not show alterations in blood chemistry or tumor markers. Imaging studies showed a huge mass lying in the right abdominal quadrants, strictly adherent to the liver. The tumor was partially cystic with a thickened wall, sporadic contrast enhancement, and solid component. The patient underwent excision of the mass with associated liver bisegmentectomy S5-S6. Postoperative course was uneventful. The definitive histological diagnosis revealed the presence of embryonal sarcoma of the liver. We describe the clinical, histopathological, and therapeutic options adopted in the multimodal treatment of this disease.

At 01:36 UTC (03:36 local time) on August 24th 2016, an earthquake Mw 6.0 struck an extensive sector of the central Apennines (coordinates: latitude 42.70° N, longitude 13.23° E, 8.0 km depth). The earthquake caused about 300 casualties and severe damage to the historical buildings and economic activity in an area located near the borders of the Umbria, Lazio, Abruzzo and Marche regions. The Istituto Nazionale di Geofisica e Vulcanologia (INGV) located in few minutes the hypocenter near Accumoli, a small town in the province of Rieti. In the hours after the quake, dozens of events were recorded by the National Seismic Network (Rete Sismica Nazionale, RSN) of the INGV, many of which had a ML > 3.0. The density and coverage of the RSN in the epicentral area meant the epicenter and magnitude of the main event and subsequent shocks that followed it in the early hours of the seismic sequence were well constrained. However, in order to better constrain the localizations of the aftershock hypocenters, especially the depths, a denser seismic monitoring network was needed. Just after the mainshock, SISMIKO, the coordinating body of the emergency seismic network at INGV, was activated in order to install a temporary seismic network integrated with the existing permanent network in the epicentral area. From August the 24th to the 30th, SISMIKO deployed eighteen seismic stations, generally six components (equipped with both velocimeter and accelerometer), with thirteen of the seismic station transmitting in real-time to the INGV seismic monitoring room in Rome. The design and geometry of the temporary network was decided in consolation with other groups who were deploying seismic stations in the region, namely EMERSITO (a group studying site-effects), and the emergency Italian strong motion network (RAN) managed by the National Civil Protection Department (DPC). Further 25 BB temporary seismic stations were deployed by colleagues of the British Geological Survey (BGS) and the School of Geosciences, University of Edinburgh in collaboration with INGV. All data acquired from SISMIKO stations, are quickly available at the European Integrated Data Archive (EIDA). The data acquired by the SISMIKO stations were included in the preliminary analysis that was performed by the Bollettino Sismico Italiano (BSI), the Centro Nazionale Terremoti (CNT) staff working in Ancona, and the INGV-MI, described below.

Endometrial carcinoma is the most common neoplasia of female genital tract. The prognosis of early stage disease (FIGO I and FIGO II) is excellent: recurrence after surgery is less than 15%, most of which are reported within 3 years after primary treatment. Herein we report a case of late rectal recurrence from FIGO Ib endometrial adenocarcinoma. Patient had also familiar and personal history of colonic adenocarcinoma and previous findings of microsatellite instability (MSI); molecular analysis evidenced heterozygotic somatic mutation in MLH1 gene. Twenty-eight years after hysterectomy and bilateral salpingoovariectomy, a rectal wall mass was detected during routine colonoscopy. Patients underwent CT scan, pelvic MRI, and rectal EUS with FNA: histopathological and immunohistochemical analysis revealed differentiated carcinoma cells of endometrial origin. No neoadjuvant treatment was planned and low rectal anterior resection with protective colostomy was performed; histology confirmed rectal lesion as metastasis from endometrial carcinoma. Recurrence of early stage endometrial carcinoma after a long period from primary surgery is possible. It is important to keep in mind this possibility in order to set a correct diagnostic and therapeutic algorithm, including preoperative immunohistochemical staining, and to plan a prolonged follow-up program.