Ablefaro macrostomia - síndrome e audição: relato de dois casos familiares

Introdução: Síndrome de Ablefaro MAcrostomia (AMS) é uma condição rara que compreende pálpebras ausentes ou curto, orelhas anormais, macrostomia, genitália anômalo, pele redundante e cabelos ausente. Brancati et al (2004) relataram uma ocorrência estimada de perda auditiva em 70% desta população. Estudos específicos sobre a audição em AMS não estavam presentes nos jornais que compilados. Relato dos casos: Paciente 1 é o primeiro filho de um ano de idade, a mãe 23 anos e pai de 25 anos de idade, não consangüíneos. Suas características clínicas são pouco cabelo no couro cabeludo, orelhas em forma de taça, raiz nasal larga, narinas antevertidas, macrostomia, os dedos com membranas, pele redundante e hipoplasia mamilos e lábios. Ela não tem atraso no desenvolvimento neuropsicomotor e a fala é normal. A audição foi avaliada aos 15 anos com uma perda auditiva em 6 kHz. Paciente 2 é o terceiro filho do mesmo casal. Ela tem falta grave das pálpebras, uma ponte nasal baixa com narinas hipoplásica e anteversão, macrostomia, orelhas anormalmente modelados, a ausência de mamilos, um de 6 cm onfalocele, ânus anteriormente localizado, hipoplasia dos grandes lábios, unhas hipoplasia, atenuação distal de falanges e pele redundante. Ela está se desenvolvendo com atraso no desenvolvimento neuropsicomotor, fala normal e perda auditiva condutiva leve bilateral. A avaliação audiológica incluiu quatro procedimentos: história clínica audiológica, inspeção otológica, imitanciometria, audiometria tonal e discurso. Conclusões: Os pacientes estudados com AMS apresentaram perda auditiva leve e esta perda de audição pode ser considerado como uma parte do fenótipo AMS sendo compatível os achados com a literatura.

Higher microsatellite diversity in Plasmodium vivax than in sympatric Plasmodium falciparum populations in Pursat, Western Cambodia

Previous microsatellite analyses of sympatric populations of Plasmodium vivax and Plasmodium falciparum in Brazil revealed higher diversity in the former species. However, it remains unclear whether regional species-specific differences in prevalence and transmission levels might account for these findings. Here, we examine sympatric populations of P. vivax (n = 87) and P. falciparum (n = 164) parasites from Pursat province, Western Cambodia, where both species are similarly prevalent. Using 10 genome-wide microsatellites for P. falciparum and 13 for P. vivax, we found that the P. vivax population was more diverse than the sympatric P. falciparum population (average virtual heterozygosity [HE], 0.87 vs. 0.66, P = 0.003), with more multiple-clone infections (89.6% vs. 47.6%) and larger mean number of alleles per marker (16.2 vs. 11.1, P = 0.07). Both populations showed significant multi-locus linkage disequilibrium suggestive of a predominantly clonal mode of parasite reproduction. The higher microsatellite diversity found in P. vivax isolates, compared to sympatric P. falciparum isolates, does not necessarily result from local differences in transmission level and may reflect differences in population history between species or increased mutation rates in P. vivax.

Renal GLUT1 reduction depends on angiotensin-converting enzyme inhibition in diabetic hypertensive rats

Aims: Angiotensin-converting enzyme (ACE) inhibitors are used in diabetic kidney disease to reduce systemic/intra-glomerular pressure. The objective of this study was to investigate whether reducing blood pressure (BP) could modulate renal glucose transporter expression, and urinary markers of diabetic nephropathy in diabetic hypertensive rats treated with ramipril or amlodipine. Main methods: Diabetes was induced in spontaneously-hypertensive rats (~210 g) by streptozotocin (50 mg/kg). Thirty days later, animals received ramipril 15 μg/kg/day (R, n =10), or amlodipine 10 mg/kg/day (A, n= 8,) or water (C, n = 10) by gavage. After 30-day treatment, body weight, glycaemia, urinary albumin and TGF-β1 (enzyme-linked immunosorbent assay) and BP (tail-cuff pressure method) were evaluated. Kidneys were removed for evaluation of renal cortex glucose transporters (Western blotting) and renal tissue ACE activity (fluorometric assay). Key findings: After treatments, body weight (p = 0.77) and glycaemia (p = 0.22) were similar among the groups. Systolic BP was similarly reduced (p < 0.001) in A and R vs. C (172.4 ± 3.2; 186.7 ± 3.7 and 202.2 ± 4.3 mm Hg; respectively). ACE activity (C: 0.903 ± 0.086; A: 0.654 ± 0.025, and R: 0.389 ± 0.057 mU/mg), albuminuria (C: 264.8 ± 15.4; A: 140.8 ± 13.5 and R: 102.8 ± 6.7 mg/24 h), and renal cortex GLUT1 content (C: 46.81 ± 4.54; A: 40.30 ± 5.39 and R: 26.89 ± 0.79 AU) decreased only in R (p < 0.001, p < 0.05 and p < 0.001; respectively). Significance:We concluded that the blockade of the renin–angiotensin systemwith ramipril reduced earlymarkers of diabetic nephropathy, a phenomenon that cannot be specifically related to decreased BP levels.

Aerobic exercise training induces metabolic benefits in rats with metabolic syndrome independent of dietary changes

OBJECTIVES: We evaluated the effects of aerobic exercise training without dietary changes on cardiovascular and metabolic variables and on the expression of glucose transporter Type 4 in rats with metabolic syndrome. METHODS: Twenty male spontaneously hypertensive rats received monosodium glutamate during the neonatal period. The animals were allocated to the following groups: MS (sedentary metabolic syndrome), MS-T (trained on a treadmill for 1 hour/day, 5 days/week for 10 weeks), H (sedentary spontaneously hypertensive rats) and H-T (trained spontaneously hypertensive rats). The Lee index, blood pressure (tail-cuff system), insulin sensitivity (insulin tolerance test) and functional capacity were evaluated before and after 10 weeks of training. Glucose transporter Type 4 expression was analyzed using Western blotting. The data were compared using analysis of variance (ANOVA) (p<0.05). RESULTS: At baseline, the MS rats exhibited lower insulin sensitivity and increased Lee index compared with the H rats. Training decreased the body weight and Lee index of the MS rats (MS-T vs. MS), but not of the H rats (H-T vs. H). There were no differences in food intake between the groups. At the end of the experiments, the systolic blood pressure was lower in the two trained groups than in their sedentary controls. Whole-body insulin sensitivity increased in the trained groups. Glucose transporter Type 4 content increased in the heart, white adipose tissue and gastrocnemius muscle of the trained groups relative to their respective untrained groups. CONCLUSION: In conclusion, the present study shows that an isolated aerobic exercise training intervention is an efficient means of improving several components of metabolic syndrome, that is, training reduces obesity and hypertension and increases insulin sensitivity

Reaction intermediates of ethanol electro-oxidation on platinum investigated by SFG spectroscopy

Although electrochemical oxidation of simple organic molecules on metal catalysts is the basic ingredient of fuel cells, which have great technological potential as a renewable source of electrical energy, the detailed reaction mechanisms are in most cases not completely understood. Here, we investigate the ethanol-platinum interface in acidic aqueous solution using infrared-visible sum frequency generation (SFG) spectroscopy and theoretical calculations of vibrational spectra in order to identify the intermediates present during the electro-oxidation of ethanol. The complex vibrational spectrum in the fingerprint region imply on the coexistence of several adsorbates. Based on spectra in ultra-high-vacuum (UHV) and electrochemical environment from the literature and our density functional theory (DFT) calculations of vibrational spectra, new adsorbed intermediates, never before observed with conventional infrared (IR) spectroscopy, are proposed here: g2-acetaldehyde, g2-acetyl, ethylidyne, monodentate acetate, methoxy, tertiary methanol derivative, COH residue, g2-formaldehyde, mono and bidentate formate, CH3 and CH2 residues. In addition, we present new evidences for an ethoxy intermediate, a secondary ethanol derivative and an acetyl species, and we confirm the presence of previously observed adsorbates: a tertiary ethanol derivative, bidentate acetate, and COad. These results indicate that the platinum surface is much more reactive, and the reaction mechanism for ethanol electro-oxidation is considerably more complex than previously considered. This might be also true for many other molecule-catalyst systems.

Models for the study of neuronal activity during cognitive tasks

Assessment of brain connectivity among different brain areas during cognitive or motor tasks is a crucial problem in neuroscience today. Aim of this research study is to use neural mass models to assess the effect of various connectivity patterns in cortical EEG power spectral density (PSD), and investigate the possibility to derive connectivity circuits from EEG data. To this end, two different models have been built. In the first model an individual region of interest (ROI) has been built as the parallel arrangement of three populations, each one exhibiting a unimodal spectrum, at low, medium or high frequency. Connectivity among ROIs includes three parameters, which specify the strength of connection in the different frequency bands. Subsequent studies demonstrated that a single population can exhibit many different simultaneous rhythms, provided that some of these come from external sources (for instance, from remote regions). For this reason in the second model an individual ROI is simulated only with a single population. Both models have been validated by comparing the simulated power spectral density with that computed in some cortical regions during cognitive and motor tasks. Another research study is focused on multisensory integration of tactile and visual stimuli in the representation of the near space around the body (peripersonal space). This work describes an original neural network to simulate representation of the peripersonal space around the hands, in basal conditions and after training with a tool used to reach the far space. The model is composed of three areas for each hand, two unimodal areas (visual and tactile) connected to a third bimodal area (visual-tactile), which is activated only when a stimulus falls within the peripersonal space. Results show that the peripersonal space, which includes just a small visual space around the hand in normal conditions, becomes elongated in the direction of the tool after training, thanks to a reinforcement of synapses.

Numerical simulations of magma chamber dynamics at Campi Flegrei, and associated seismicity, deformation and gravity changes

Understanding the complex relationships between quantities measured by volcanic monitoring network and shallow magma processes is a crucial headway for the comprehension of volcanic processes and a more realistic evaluation of the associated hazard. This question is very relevant at Campi Flegrei, a volcanic quiescent caldera immediately north-west of Napoli (Italy). The system activity shows a high fumarole release and periodic ground slow movement (bradyseism) with high seismicity. This activity, with the high people density and the presence of military and industrial buildings, makes Campi Flegrei one of the areas with higher volcanic hazard in the world. In such a context my thesis has been focused on magma dynamics due to the refilling of shallow magma chambers, and on the geophysical signals detectable by seismic, deformative and gravimetric monitoring networks that are associated with this phenomenologies. Indeed, the refilling of magma chambers is a process frequently occurring just before a volcanic eruption; therefore, the faculty of identifying this dynamics by means of recorded signal analysis is important to evaluate the short term volcanic hazard. The space-time evolution of dynamics due to injection of new magma in the magma chamber has been studied performing numerical simulations with, and implementing additional features in, the code GALES (Longo et al., 2006), recently developed and still on the upgrade at the Istituto Nazionale di Geofisica e Vulcanologia in Pisa (Italy). GALES is a finite element code based on a physico-mathematical two dimensional, transient model able to treat fluids as multiphase homogeneous mixtures, compressible to incompressible. The fundamental equations of mass, momentum and energy balance are discretised both in time and space using the Galerkin Least-Squares and discontinuity-capturing stabilisation technique. The physical properties of the mixture are computed as a function of local conditions of magma composition, pressure and temperature.The model features enable to study a broad range of phenomenologies characterizing pre and sin-eruptive magma dynamics in a wide domain from the volcanic crater to deep magma feeding zones. The study of displacement field associated with the simulated fluid dynamics has been carried out with a numerical code developed by the Geophysical group at the University College Dublin (O’Brien and Bean, 2004b), with whom we started a very profitable collaboration. In this code, the seismic wave propagation in heterogeneous media with free surface (e.g. the Earth’s surface) is simulated using a discrete elastic lattice where particle interactions are controlled by the Hooke’s law. This method allows to consider medium heterogeneities and complex topography. The initial and boundary conditions for the simulations have been defined within a coordinate project (INGV-DPC 2004-06 V3_2 “Research on active volcanoes, precursors, scenarios, hazard and risk - Campi Flegrei”), to which this thesis contributes, and many researchers experienced on Campi Flegrei in volcanological, seismic, petrological, geochemical fields, etc. collaborate. Numerical simulations of magma and rock dynamis have been coupled as described in the thesis. The first part of the thesis consists of a parametric study aimed at understanding the eect of the presence in magma of carbon dioxide in magma in the convection dynamics. Indeed, the presence of this volatile was relevant in many Campi Flegrei eruptions, including some eruptions commonly considered as reference for a future activity of this volcano. A set of simulations considering an elliptical magma chamber, compositionally uniform, refilled from below by a magma with volatile content equal or dierent from that of the resident magma has been performed. To do this, a multicomponent non-ideal magma saturation model (Papale et al., 2006) that considers the simultaneous presence of CO2 and H2O, has been implemented in GALES. Results show that the presence of CO2 in the incoming magma increases its buoyancy force promoting convection ad mixing. The simulated dynamics produce pressure transients with frequency and amplitude in the sensitivity range of modern geophysical monitoring networks such as the one installed at Campi Flegrei . In the second part, simulations more related with the Campi Flegrei volcanic system have been performed. The simulated system has been defined on the basis of conditions consistent with the bulk of knowledge of Campi Flegrei and in particular of the Agnano-Monte Spina eruption (4100 B.P.), commonly considered as reference for a future high intensity eruption in this area. The magmatic system has been modelled as a long dyke refilling a small shallow magma chamber; magmas with trachytic and phonolitic composition and variable volatile content of H2O and CO2 have been considered. The simulations have been carried out changing the condition of magma injection, the system configuration (magma chamber geometry, dyke size) and the resident and refilling magma composition and volatile content, in order to study the influence of these factors on the simulated dynamics. Simulation results allow to follow each step of the gas-rich magma ascent in the denser magma, highlighting the details of magma convection and mixing. In particular, the presence of more CO2 in the deep magma results in more ecient and faster dynamics. Through this simulations the variation of the gravimetric field has been determined. Afterward, the space-time distribution of stress resulting from numerical simulations have been used as boundary conditions for the simulations of the displacement field imposed by the magmatic dynamics on rocks. The properties of the simulated domain (rock density, P and S wave velocities) have been based on data from literature on active and passive tomographic experiments, obtained through a collaboration with A. Zollo at the Dept. of Physics of the Federici II Univeristy in Napoli. The elasto-dynamics simulations allow to determine the variations of the space-time distribution of deformation and the seismic signal associated with the studied magmatic dynamics. In particular, results show that these dynamics induce deformations similar to those measured at Campi Flegrei and seismic signals with energies concentrated on the typical frequency bands observed in volcanic areas. The present work shows that an approach based on the solution of equations describing the physics of processes within a magmatic fluid and the surrounding rock system is able to recognise and describe the relationships between geophysical signals detectable on the surface and deep magma dynamics. Therefore, the results suggest that the combined study of geophysical data and informations from numerical simulations can allow in a near future a more ecient evaluation of the short term volcanic hazard.

SOAP vs. REST in un contesto di Informatica Gestionale

Il web è cambiato! In questi ultimi anni internet ha subito grandi cambiamenti, è passato da un web formato da sole pagine ad un web fornitore di servizi. Questi servizi chiamati ‘Web Service’ vengono utilizzati ampiamente per sviluppare la maggior parte delle applicazioni web. A questo proposito, viene presentata brevemente la tecnologia dei Web Service, per passare successivamente ad analizzare due tipi di standard: quelli basati su SOAP con disegni strettamente accoppiati simili a chiamate di procedura e quelli basati su REST con disegni debolmente accoppiati, simili alla navigazione di link. Questa tesi si pone l’obiettivo di fornire informazioni sulle caratteristiche, l’interoperabilità, le differenze e l’implementazione dei due standard, descrivendo l’utilizzo di queste architetture in un contesto di informatica gestionale, nello specifico, lo scenario di Infor ERP LN.

Entwicklung eines immunologischen Testsystems zur Detektion des marinen Biotoxins Domoinsäure

Domoinsäure ist ein von mehreren Arten mariner Kieselalgen der Gattung Pseudonitzschia produziertes Toxin, welches während einer Algenblüte in Molluscen wie z.B. der Miesmuschel Mytilus sp. akkumuliert werden kann. Beim Verzehr solch kontaminierter Muscheln können sowohl beim Menschen als auch bei Tieren erhebliche Vergiftungserscheinungen auftreten, die von Übelkeit, Kopfschmerzen und Orientierungsstörungen bis hin zum Verlust des Kurzzeitgedächtnisses (daher auch als amnesic shellfish poisoning bekannt) reichen und in einigen Fällen tödlich enden. rnDie heute gängigen Methoden zur Detektion von Domoinsäure in Muschelgewebe wie Flüssigkeitschromatographie und Maus-Bioassay sind zeit- und kostenintensiv bzw. in Anbetracht einer Verbesserung des Tierschutzes aus ethischer Sicht nicht zu vertreten. Immunologische Testsysteme stellen eine erstrebenswerte Alternative dar, da sie sich durch eine vergleichsweise einfache Handhabung, hohe Selektivität und Reproduzierbarkeit auszeichnen.rnDas Ziel der vorliegenden Arbeit war es, ein solches immunologisches Testsystem zur Detektion von Domoinsäure zu entwickeln. Hierfür wurden zunächst Antikörper gegen Domoinsäure gewonnen, wofür das Toxin wiederum als erstes über die Carbodiimid-Methode an das Trägerprotein keyhole limpet hemocyanin (KLH) gekoppelt wurde, um eine Immunantwort auslösen zu können. Kaninchen und Mäuse wurden mit KLH-DO-Konjugaten nach vorgegebenen Immunisierungsschemata immunisiert. Nach vier Blutabnahmen zeigte das polyklonale Kaninchenantiserum eine ausreichend hohe Sensitivität zum Antigen; das nachfolgende Detektionssystem wurde mit Hilfe dieses polyklonalen Antikörpers aufgebaut. Zwar ist es gegen Ende der Arbeit auch gelungen, einen spezifischen monoklonalen Antikörper aus der Maus zu gewinnen, jedoch konnte dieser aus zeitlichen Gründen nicht mehr im Detektionssystem etabliert werden, was durchaus wünschenswert gewesen wäre. rnWeiterhin wurde Domoinsäure im Zuge der Entwicklung eines neuartigen Testsystems an die Trägerproteine Ovalbumin, Trypsininhibitor und Casein sowie an Biotin konjugiert. Die Kopplungserfolge wurden im ELISA, Western Blot bzw. Dot Blot nachgewiesen. Die Ovalbumin-gekoppelte sowie die biotinylierte Domoinsäure dienten im Folgenden als die zu messenden Größen in den Detektionsassays- die in einer zu untersuchenden Probe vorhandende, kompetitierende Domoinsäure wurde somit indirekt nachgewiesen. rnDer zulässige Höchstwert für Domoinsäure liegt bei 20 µg/g Muschelgewebe. Sowohl mit Biotin-DO als auch mit OVA-DO als den zu messenden Größen waren Domoinsäurekonzentrationen unterhalb dieses Grenzwertes nachweisbar; allerdings erwies sich der Aufbau mit Biotin-DO um das ca. 20-fache empfindlicher als jener mit OVA-DO. rnDie in dieser Arbeit präsentierten Ergebnisse könnten als Grundlage zur Etablierung eines kommerzialisierbaren immunologischen Testsystems zur Detektion von Domoinsäure und anderen Biotoxinen dienen. Nach erfolgreicher Validierung wäre ein solches Testsystem in seiner Handhabung einfacher als die gängige Flüssigkeitschromatographie und besser reproduzierbar als der Maus-Bioassay.rn

Jesolo - area "central park" centro per la conoscenza del territorio

Il progetto si propone di individuare le potenzialità del paesaggio naturale di Jesolo, in particolare dell'ambiente lagunare e costiero, e dei suoi caratteri architettonici riproponendo tali caratteristiche all'interno dell'area a scopo conoscitivo, con l'obiettivo di sostenere l'educazione e la sensibilizzazione alla tutela del patrimonio naturale e storico attraverso luoghi per la didattica e proposte educative che consentano un'osservazione e una esperienza diretta sul luogo.

Besafe: un'applicazione Android per la rilevazione di aggressioni attraverso il riconoscimento del tipo di mobilità

Tematiche di violenza e aggressione sono oggi di estrema attualità e sempre più spesso se ne sente parlare al telegiornale o in programmi specializzati. Aggressione per molestie, furto o per scopi razziali; le motivazioni e i casi d'interesse sono vari e spesso hanno inizio senza alcun apparente motivo e la sensazione di sentirsi sempre meno al sicuro, anche appena usciti di casa, può degenerare ad una vera e propria paranoia. L'unica cosa che è sempre al nostro fianco, oggi giorno, sono i nostri smartphone, che risultano sempre più sofisticati e intelligenti; perché, allora, non provare ad usarli come protezione? L'obiettivo su cui si è incentrata questa tesi è, appunto, il riconoscimento di un'aggressione basata sull'analisi della situazione in cui si trova l'utente, attraverso l'uso dei sensori messi a disposizione dagli odierni smartphone in circolazione. Esistono già numerose applicazioni per la sicurezza personale, ma il metodo utilizzato per la segnalazione di un'aggressione è sempre basato sulla pressione di un pulsante o un'azione particolare che l'utente deve svolgere. L'applicazione creata in questo studio, invece, cerca di riconoscere le situazioni di pericolo osservando i movimenti dell'utente e basa il riconoscimento sulla presenza di situazioni fuori dalla normale quotidianità che, attraverso dei "controlli di conferma", permettono di riconoscere il pericolo in maniera completamente autonoma. Si è deciso di approcciarsi ad un riconoscimento autonomo, in quanto, non sempre si ha la possibilità, o il tempo, di prendere in mano il proprio smartphone per avvisare del pericolo e molte volte il panico potrebbe far perdere la lucidità alla vittima, il cui primo pensiero è quello di difendersi e scappare e non utilizzare il dispositivo. Altre volte, distrarsi anche per un secondo, potrebbe essere fatale per la propria sicurezza. Per questo motivo si è ricercato un'approccio di riconoscimento basato "sull'osservazione" di ciò che sta accadendo, piuttosto che sull'attesa di un segnale. L'obiettivo di riconoscimento prefissato è stato quello delle aggressioni in strada e i sensori utilizzati a questo scopo sono stati: accelerometro, giroscopio, GPS e microfono. Attraverso la combinazione di questi sensori, infatti, è stato possibile riconoscere cadute (di forte entità), urla e probabili spinte/strattoni. Si sono studiate, per tanto, le caratteristiche che collegassero queste tipologie di situazioni per ogni sensore preso in esame, costruendo un'approccio di riconoscimento risultato valido per gli obiettivi minimi prefissati.

Valutazione preliminare dell'effetto domino negli stabilimenti a rischio di incidente rilevante dell'Emilia Romagna

Nell'ambito dell'industria di processo, si definisce "effetto domino" la propagazione di un evento incidentale primario dovuta all’accadimento di uno o più incidenti secondari innescati dall’evento primario, con amplificazione dell’area di danno. Un incidente con effetto domino vede infatti la presenza iniziale di uno scenario incidentale primario, solitamente causato dal rilascio di sostanze pericolose e/o dal rilascio di energia tali da determinare effetti dannosi in grado di innescare successivamente degli eventi incidentali secondari, che determinino un'intensificazione delle conseguenze dell'evento iniziale. Gli incidenti con effetto domino possono avere conseguenze all'interno dello stabilimento in cui ha origine lo scenario incidentale primario o all'esterno, eventualmente coinvolgendo, stabilimenti limitrofi: nel primo caso si parla di effetto domino intra-stabilimento, nel secondo di effetto domino inter-stabilimento. Gli ultimi decenni hanno visto un forte aumento della domanda di prodotti dell'industria chimica e dunque del numero di impianti di processo, talvolta raggruppati nei cosiddetti "chemical clusters", ossia aree ad elevata concentrazione di stabilimenti chimici. In queste zone il rischio di effetto domino inter-stabilimento è particolarmente alto, a causa della stretta vicinanza di installazioni che contengono elevati quantitativi di sostanze pericolose in condizioni operative pericolose. È proprio questa consapevolezza, purtroppo confermata dal verificarsi di diversi incidenti con effetto domino, che ha determinato negli ultimi anni un significativo aumento delle ricerche relative all'effetto domino e anche una sua maggiore considerazione nell'ambito della normativa. A riguardo di quest'ultimo aspetto occorre citare la Direttiva Europea 2012/18/UE (comunemente denominata Direttiva Seveso III) e il suo recepimento nella normativa italiana, il Decreto Legislativo del 26 giugno 2015, "Attuazione della direttiva 2012/18/UE relativa al controllo del pericolo di incidenti rilevanti connessi con sostanze pericolose, entrato in vigore il 29 luglio 2015: questo decreto infatti dedica ampio spazio all'effetto domino e introduce nuovi adempimenti per gli stabilimenti a Rischio di Incidente Rilevante presenti sul territorio nazionale. In particolare, l'Allegato E del D. Lgs. 105/2015 propone una metodologia per individuare i Gruppi domino definitivi, ovvero i gruppi di stabilimenti a Rischio di Incidente Rilevante tra i quali è possibile il verificarsi di incidenti con effetto domino inter-stabilimento. Nel presente lavoro di tesi, svolto presso ARPAE (Agenzia Regionale per la Prevenzione, l'Ambiente e l'Energia) dell'Emilia Romagna, è stata effettuata, secondo la metodologia proposta dall'Allegato E del D. Lgs. 105/2015, la valutazione dell'effetto domino inter-stabilimento per gli stabilimenti a Rischio di Incidente Rilevante presenti in Emilia Romagna, al fine di individuare i Gruppi domino definitivi e di valutare l'aggravio delle conseguenze fisiche degli eventi incidentali primari origine di effetto domino.

Reversible microbial colonization of germ-free mice reveals the dynamics of IgA immune responses

The lower intestine of adult mammals is densely colonized with nonpathogenic (commensal) microbes. Gut bacteria induce protective immune responses, which ensure host-microbial mutualism. The continuous presence of commensal intestinal bacteria has made it difficult to study mucosal immune dynamics. Here, we report a reversible germ-free colonization system in mice that is independent of diet or antibiotic manipulation. A slow (more than 14 days) onset of a long-lived (half-life over 16 weeks), highly specific anticommensal immunoglobulin A (IgA) response in germ-free mice was observed. Ongoing commensal exposure in colonized mice rapidly abrogated this response. Sequential doses lacked a classical prime-boost effect seen in systemic vaccination, but specific IgA induction occurred as a stepwise response to current bacterial exposure, such that the antibody repertoire matched the existing commensal content.

American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer

Purpose To update American Society of Clinical Oncology/American Society of Hematology recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. Methods An Update Committee reviewed data published between January 2007 and January 2010. MEDLINE and the Cochrane Library were searched. Results The literature search yielded one new individual patient data analysis and four literature-based meta-analyses, two systematic reviews, and 13 publications reporting new results from randomized controlled trials not included in prior or new reviews. Recommendations For patients undergoing myelosuppressive chemotherapy who have a hemoglobin (Hb) level less than 10 g/dL, the Update Committee recommends that clinicians discuss potential harms (eg, thromboembolism, shorter survival) and benefits (eg, decreased transfusions) of ESAs and compare these with potential harms (eg, serious infections, immune-mediated adverse reactions) and benefits (eg, rapid Hb improvement) of RBC transfusions. Individual preferences for assumed risk should contribute to shared decisions on managing chemotherapy-induced anemia. The Committee cautions against ESA use under other circumstances. If used, ESAs should be administered at the lowest dose possible and should increase Hb to the lowest concentration possible to avoid transfusions. Available evidence does not identify Hb levels � 10 g/dL either as thresholds for initiating treatment or as targets for ESA therapy. Starting doses and dose modifications after response or nonresponse should follow US Food and Drug Administration–approved labeling. ESAs should be discontinued after 6 to 8 weeks in nonresponders. ESAs should be avoided in patients with cancer not receiving concurrent chemotherapy, except for those with lower risk myelodysplastic syndromes. Caution should be exercised when using ESAs with chemotherapeutic agents in diseases associated with increased risk of thromboembolic complications. Table 1 lists detailed recommendations. This guideline was developed through a collaboration between the American Society of Clinical Oncology and the American Society of Hematology and has been published jointly by invitation and consent in both Journal of Clinical Oncology and Blood.

American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer

Purpose: To update American Society of Hematology/American Society of Clinical Oncology recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. Methods: An Update Committee reviewed data published between January 2007 and January 2010. MEDLINE and the Cochrane Library were searched. Results: The literature search yielded one new individual patient data analysis and four literature-based meta-analyses, two systematic reviews, and 13 publications reporting new results from randomized controlled trials not included in prior or new reviews. Recommendations: For patients undergoing myelosuppressive chemotherapy who have a hemoglobin (Hb) level less than 10 g/dL, the Update Committee recommends that clinicians discuss potential harms (eg, thromboembolism, shorter survival) and benefits (eg, decreased transfusions) of ESAs and compare these with potential harms (eg, serious infections, immune-mediated adverse reactions) and benefits (eg, rapid Hb improvement) of RBC transfusions. Individual preferences for assumed risk should contribute to shared decisions on managing chemotherapy-induced anemia. The Committee cautions against ESA use under other circumstances. If used, ESAs should be administered at the lowest dose possible and should increase Hb to the lowest concentration possible to avoid transfusions. Available evidence does not identify Hb levels 10 g/dL either as thresholds for initiating treatment or as targets for ESA therapy. Starting doses and dose modifications after response or nonresponse should follow US Food and Drug Administration-approved labeling. ESAs should be discontinued after 6 to 8 weeks in nonresponders. ESAs should be avoided in patients with cancer not receiving concurrent chemotherapy, except for those with lower risk myelodysplastic syndromes. Caution should be exercised when using ESAs with chemotherapeutic agents in diseases associated with increased risk of thromboembolic complications. Table 1 lists detailed recommendations.