•A new passive strategy for vibration control of wind turbine is proposed.•A design procedure has been purposely generated.•Numerical analyses have been performed with reference to a benchmark ...turbine.•It is the first use of a friction-based device for structural control of turbines.•The technique is suitable for new plants, but also for repowering of existing ones.
Wind turbines are growing in size in order to reach stronger winds and to produce more energy, even thanks to longer blades. This leads to bigger and bigger cross dimensions for the towers, with high construction costs. On the other hand, in the countries that have long been engaged in the production of wind energy, the need for repowering of existing plants is increasingly strong. In the latter case, a solution is that of replacing old towers and blades with new even longer elements for greater energy production, however taking into account the limited capacity of the existing foundation, so expensive to be replaced. Reducing the demand for stress on wind towers and, therefore, on the foundation can be definitely useful both for new installations and for upgrading existing plants. Herein a passive control technique is proposed to do that, based on the use of a rotational friction damper (RFD) installed at the base of the tower in parallel with a rotational spring. While the RFD dissipates energy thanks to the base, the spring has the task of favoring the re-centering of the tower. The design parameters for such a system have been identified and a procedure for their optimal calibration is also proposed and tested with reference to a case-study structure. The NREL 5 MW wind turbine has been subjected to three different wind loads and the results show that the proposed technique can be a suitable solution, cheap and practical to be used on wind turbines, especially for extreme winds. Actually it may lead to a reduction of base moment demand to the tower up to 40%, at the same time limiting top displacement demand and related undesired second order effects.
Background
Heat‐and‐pepsin‐sensitive plant food allergens (PR‐10 and profilin) sometimes cause systemic reaction.
Objective
To detect the risk factors for systemic reactions induced by labile food ...allergens.
Methods
A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age‐matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti‐inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered.
Results
We studied 89 patients and 81 controls. Sensitization to PR‐10 or profilin, IgE to Bet v 1 and/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced >1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; P < .025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; P < .025). Soy milk‐induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases.
Conclusion
PR‐10‐ and profilin‐induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR‐10 hypersensitive patients and should be avoided.
Hypersensitivity to labile plant‐food allergens (PR‐10 and profilin) secondary to pollen allergy frequently causes oral allergy syndrome. Labile allergens may become dangerous when the raw foods are ingested in excessive amounts or in liquid form. Other cofactors include therapy with proton pump inhibitors and fasting. The most frequently involved foods are as follows: tree nuts, Rosaceae, Apiaceae, and soy milk.
Abbreviations: NSAID, non‐steroidal anti‐inflammatory drugs; PPI, proton pump inhibitors; PR‐10, pathogenesis‐related proteins group 10
The analyses here reported aim to compare the screening performance of digital tomosynthesis (DBT) versus mammography (DM).
MAITA is a consortium of four Italian trials, REtomo, Proteus, Impeto, and ...MAITA trial. The trials adopted a two-arm randomised design comparing DBT plus DM (REtomo and Proteus) or synthetic-2D (Impeto and MAITA trial) versus DM; multiple vendors were included. Women aged 45 to 69 years were individually randomised to one round of DBT or DM.
From March 2014 to February 2022, 50,856 and 63,295 women were randomised to the DBT and DM arm, respectively. In the DBT arm, 6656 women were screened with DBT plus synthetic-2D. Recall was higher in the DBT arm (5·84% versus 4·96%), with differences between centres. With DBT, 0·8/1000 (95% CI 0·3 to 1·3) more women received surgical treatment for a benign lesion. The detection rate was 51% higher with DBT, ie. 2·6/1000 (95% CI 1·7 to 3·6) more cancers detected, with a similar relative increase for invasive cancers and ductal carcinoma in situ. The results were similar below and over the age of 50, at first and subsequent rounds, and with DBT plus DM and DBT plus synthetic-2D. No learning curve was appreciable. Detection of cancers >= 20 mm, with 2 or more positive lymph nodes, grade III, HER2-positive, or triple-negative was similar in the two arms.
Results from MAITA confirm that DBT is superior to DM for the detection of cancers, with a possible increase in recall rate. DBT performance in screening should be assessed locally while waiting for long-term follow-up results on the impact of advanced cancer incidence.
•MAITA is a population-based, multicentre, and multivendor consortium of trials.•DBT plus DM or plus s2D is superior to DM alone in detecting invasive cancers.•We did not observe any overall decrease in recall rate•Differences between centres in recall ranged from no effect to +50% in DBT vs. DM.•Our results impose to assess locally the impact of DBT in screening.
Despite a successful antiretroviral therapy (ART), adolescents living with perinatally acquired HIV (PHIV) experience signs of B-cell hyperactivation with expansion of 'namely' atypical B-cell ...phenotypes, including double negative (CD27-IgD-) and termed age associated (ABCs) B-cells (T-bet+CD11c+), which may result in reduced cell functionality, including loss of vaccine-induced immunological memory and higher risk of developing B-cells associated tumors. In this context, perinatally HIV infected children (PHIV) deserve particular attention, given their life-long exposure to chronic immune activation.
We studied 40 PHIV who started treatment by the 2
year of life and maintained virological suppression for 13.5 years, with 5/40 patients experiencing transient elevation of the HIV-1 load in the plasma (Spike). We applied a multi-disciplinary approach including immunological B and T cell phenotype, plasma proteomics analysis, and serum level of anti-measles antibodies as functional correlates of vaccine-induced immunity.
Phenotypic signs of B cell hyperactivation were elevated in subjects starting ART later (%DN T-bet+CD11c+ p=0.03; %AM T-bet+CD11c+ p=0.02) and were associated with detectable cell-associated HIV-1 RNA (%AM T-bet+CD11c+ p=0.0003) and transient elevation of the plasma viral load (spike). Furthermore, B-cell hyperactivation appeared to be present in individuals with higher frequency of exhausted T-cells, in particular: %CD4 TIGIT+ were associated with %DN (p=0.008), %DN T-bet+CD11c+ (p=0.0002) and %AM T-bet+CD11c+ (p=0.002) and %CD4 PD-1 were associated with %DN (p=0.048), %DN T-bet+CD11c+ (p=0.039) and %AM T-bet+CD11c+ (p=0.006). The proteomic analysis revealed that subjects with expansion of these atypical B-cells and exhausted T-cells had enrichment of proteins involved in immune inflammation and complement activation pathways. Furthermore, we observed that higher levels of ABCs were associated a reduced capacity to maintain vaccine-induced antibody immunity against measles (%B-cells CD19+CD10- T-bet+, p=0.035).
We identified that the levels of hyperactivated B cell subsets were strongly affected by time of ART start and associated with clinical, viral, cellular and plasma soluble markers. Furthermore, the expansion of ABCs also had a direct impact on the capacity to develop antibodies response following routine vaccination.
International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at ...risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR.
This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" 1.
10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients.
The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.
Background
Since its approval, the use of alteplase had been limited to patients aged ≤80 years.
Aims
TESPI trial had been designed to evaluate whether alteplase treatment within 3 h in patients with ...acute ischemic stroke aged >80 years resulted in favorable benefit/risk ratio compared with standard care. The meta-analysis of randomized controlled trials was updated to put findings in the context of all available evidence.
Methods
TESPI was a multicenter, open-label with blinded outcome evaluation, randomized, controlled trial. Main clinical endpoints were 90-day favorable functional outcome (mRS score 0–2) and mortality and symptomatic intracerebral hemorrhage. The trial was prematurely terminated for ethical reasons after publication of IST-3 trial which provided evidence of treatment benefit in elderly.
Results
Of the planned 600 patients, 191 (88 assigned to alteplase) were enrolled. Overall, 24/83 (28.9%) alteplase patients had a favorable outcome compared to 22/95 (23.2%) controls (non-significant absolute difference of 5.7% for alteplase; OR 1.35, 95% CI 0.69–2.64, P = 0.381). Rates of death were non-significantly lower in the alteplase patients (18.1% vs. 26.5%); rates of symptomatic intracerebral hemorrhage were similar between the two groups (5.9% vs. 5.1%). The updated meta-analysis showed consistent results with prior estimates and add weights.
Conclusions
The effects of alteplase observed in this interrupted trial did not reach statistical significance, probably for the small numbers, but are consistent with and add weight to the sum total of the randomized evidence demonstrating that alteplase is beneficial in patients with acute ischemic stroke aged over 80 years, particularly if given within 3 h.
Purpose
We present a comprehensive investigation into the organizational, social, and ethical impact of implementing digital breast tomosynthesis (DBT) as a primary test for breast cancer screening ...in Italy. The analyses aimed to assess the feasibility of DBT specifically for all women aged 45–74, women aged 45–49 only, or those with dense breasts only.
Methods
Questions were framed according to the European Network of Health Technology Assessment (EuNetHTA) Screening Core Model to produce evidence for the resources, equity, acceptability, and feasibility domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) decision framework. The study integrated evidence from the literature, the MAITA DBT trials, and Italian pilot programs. Structured interviews, surveys, and systematic reviews were conducted to gather data on organizational impact, acceptability among women, reading and acquisition times, and the technical requirements of DBT in screening.
Results
Implementing DBT could significantly affect the screening program, primarily due to increased reading times and the need for additional human resources (radiologists and radiographers). Participation rates in DBT screening were similar, if not better, to those observed with standard digital mammography, indicating good acceptability among women. The study also highlighted the necessity for specific training for radiographers. The interviewed key persons unanimously considered feasible tailored screening strategies based on breast density or age, but they require effective communication with the target population.
Conclusions
An increase in radiologists’ and radiographers’ workload limits the feasibility of DBT screening. Tailored screening strategies may maximize the benefits of DBT while mitigating potential challenges.
Bridges to Scandinavia Storskog, Camilla; Meregalli, Andrea
01/2016, Letnik:
15
eBook, Book
Odprti dostop
This volume is the final output of a project started in 2013 on the occasion of the fortieth anniversary of the Scandinavian Section of the University of Milan. A group of scholars working on ...different European and non-European cultural and literary traditions come together here to discuss the relationships between their areas of study and the Nordic countries. The range of the contributions expands over time and space, from the Middle Ages to the present day, from Poland in the east to the United States in the west, across various European countries. Through various kinds of expertise and different perspectives, this intercultural discourse deals with diverse themes, including the perception of Nordic culture(s) by foreign writers as well as the image of other cultures in Scandinavian works. In particular, the literary and cultural interchange of models and ideas between the North and other areas is investigated in a number of essays devoted to numerous authors, including, among others, Klaus Böldl, Carmen de Burgos, Carlo Emilio Gadda, Gerhart Hauptmann, Henrik Ibsen, Stieg Larsson, Carl von Linné, Rainer Maria Rilke, J.D. Salinger, Henryk Sienkiewicz, Mme de Staël, August Strindberg, and Tomas Tranströmer.
Background aims The impact of chronic lymphatic leukemia (CLL) tumor burden on the autologous immune system has already been demonstrated. This study attempted to elucidate the molecular mechanisms ...underlying T-cell immunologic deficiencies in CLL. Methods Freshly isolated CD3+ T cells from patients with a diagnosis of CLL and healthy donors were analyzed by gene expression profiling. Activated T cells from 20 patients with CLL were tested in vitro for cytotoxicity against mutated and unmutated autologous B cells and DAUDI, K562 and P815 cell lines. To investigate T-cell mediated cytotoxicity in vivo , we co-transplanted OKT3-activated T lymphocytes and autologous B-cell CLL (B-CLL) cells into NOD/SCID mice. Results Gene expression profiles of peripheral blood T cells from B-CLL patients showed 25 down-regulated, and 31 up-regulated, genes that were mainly involved in cell differentiation, proliferation, survival, apoptosis, cytoskeleton formation, vesicle trafficking and T-cell activation. After culture, the T-cell count remained unchanged, CD8 cells expanded more than CD4 and a cytotoxicity index >30% was present in 5/20 patients. Cytotoxicity against B autologous leukemic cells did not correlate with B-cell mutational status. Only activated T cells exerting cytotoxicity against autologous leukemic B cells prevented CLL in a human-mouse chimera. Conclusions This study indicates that patients with CLL are affected by a partial immunologic defect that might be somewhat susceptible to repair. This study identifies the molecular pathways underlying T-cell deficiencies in CLL and shows that cytotoxic T-cell functions against autologous B-CLL can be rebuilt at least in part in vitro and in vivo.
