•Importance of reliability requirements for the civil systems.•We wanted to extend the reliability parameters to plants of civilian buildings.•We have examined the traditional parameters of ...reliability.•Allow a precise control from customers and for the product delivered.•Economical savings obtained from high-efficiency plants considering the reliability.
The present study wants to highlight the importance of the reliability parameters because of some changes that occurred in modern technology; as for example the necessity of more sophisticated equipments or plants transformed from an auxiliary service to being an actual part of the systems they were originally intended for.
Reliability, maintainability and availability are essential features if we want to define the quality that is the ability, of the plant to fulfill a specific requirement. Obviously analyzing the reliability is useful for those plants that must guarantee an uninterrupted service, thus making an estimation of the probability that a malfunctioning, either of component or a security system, can generate an accidental sequence generating a downtime. Even in plants which do not risk the occurrence of a considerable incident, the analysis of reliability can affect positively costs regarding both security and management.
The importance of reliability parameters increases when those requirements the system must fulfill change. Anyway these systems have a safe impact on the costs of exertion and management. Such costs will be added to the ones produced by the energy consumption of the plant. By using the word costs we mean: installation and management costs; a high efficient and reliable plant usually has high installation costs and low exertion costs. The opposite situation occurs in highly maintainable plants only under specific circumstances.
The significance of on-site measurements for the thermal characterization of building components is widely recognized. Walls thermal performance can be identified through the widely used Heat-Flow ...Meter (HFM) method, which has been frequently applied in literature. However, only a few scientific works have examined the convergence criteria suggested by the ISO 9869–1. Starting from this, the aim of this work is evaluating the convergence criteria in a case study using the progressive average method. Thermal conductance (C-value) measurements were carried out in a small-scale building, placed in the external area of a building school site near Rome (Italy). The building is internally equipped with an electric heating system. Heat-flux sensor and surface temperature probes were applied to assess the C-value of the envelope. The different switching-on of the heater characterized by different power levels and the reaching of regular thermal conditions after initial transients were considered to evaluate the acquired data and their influence on the results. The known walls stratigraphy allowed to compute and compare theoretical and experimental C-values. Based on the examined data, it is possible to assert that the convergence conditions are very strict, mainly due to the third criterion.
The recent successful development of monoclonal antibodies that target key components of biological pathways has expanded the armamentarium of treatment options for patients with colorectal cancer ...(CRC). In particular, the epidermal growth factor receptor (EGFR), a tyrosine kinase growth factor receptor involved in CRC development and progression, is exploited by the newest monoclonal antibody that is available for use in CRC patients. Cetuximab, the first chimeric monoclonal antibody, which has been generated against the EGFR, is currently registered in USA, Europe and worldwide, in combination with irinotecan in the treatment of metastatic CRC patients who have progressed on irinotecan containing chemotherapy. Cetuximab is well tolerated and does not exacerbate the toxicity of concomitant chemotherapy. Furthermore, a series of phase III clinical trials are currently evaluating the combination of cetuximab with standard chemotherapy regimens in the first-line treatment chemotherapy-naïve patients with metastatic CRC.
The aim of the study was to assess the toxicity and the clinical activity of biweekly oxaliplatin in combination with infusional 5-fluorouracil (5-FU) and folinic acid (FA) administered every 2 weeks ...(FOLFOX-4 regimen) in patients with advanced gastric cancer (AGC). A total of 61 previously untreated AGC patients were treated with oxaliplatin 85 mg m(-2) on day 1, FA 200 mg m(-2) as a 2 h infusion followed by bolus 5-FU 400 mg m(-2) and a 22 h infusion of 5-FU 600 mg m(-2), repeated for 2 consecutive days every 2 weeks. All patients were assessable for toxicity and response to treatment. Four (7%) complete responses and 19 partial responses were observed (overall response rate, 38%). Stable disease was observed in 22 (36%) patients, with progressive disease in the other six (10%) patients. Median time to progression (TTP) and median overall survival (OS) were 7.1 and 11.2 months, respectively. National Cancer Institute Common Toxicity Criteria grade 3 and 4 haematologic toxicities were neutropenia, anaemia and thrombocytopenia in 36, 10 and 5% of the patients, respectively. Grade 3 peripheral neuropathy was recorded in three (5%) patients. FOLFOX-4 is an active and well-tolerated chemotherapy. Response rate (RR), TTP and OS were comparable with those of other oxaliplatin-based regimens, suggesting a role for this combination in gastric cancer.
Two inhibitors of phosphatidylinositol 3-kinase (PI3K) pathway taselisib, targeting the mutant PI3K-subunit-alpha (PI3KA) and ipatasertib, AKT-inhibitor, are currently under clinical investigation in ...breast cancer (BC) patients. We have previously demonstrated the anti-tumor efficacy of these anti-PI3K/AKT-inibitors in combination with anti-microtubule drugs in human BC cell lines, through a complete cytoskeleton disorganization. In this work, we generated ex-vivo three-dimensional (3D) cultures from human BC as a model to test drug efficacy and to identify new molecular biomarkers for selection of BC patients suitable for anti-PI3K/AKT-inibitors treatment. We have established 3D cultures from 25/27 human BC samples, in which the ability of growth in vitro replicates the clinical and biological aggressiveness of the original tumors. According to the results of next generation sequencing analysis, a direct correlation was found between PI3KA mutations and the sensitivity in 3D models in vitro to taselisib and ipatasertib alone and combined with anti-microtubule agents. Moreover, mutations in HER and MAPK families related genes, including EGFR, KRAS and BRAF, were found in resistant samples, suggesting their potential role as negative predictive factors of response to these agents. Thus, we demonstrated that ex vivo 3D cultures from human BC patients allow a rapid and efficient drug screening for chemotherapies and targeted agents in genetically selected patients and represent an innovative model to identify new biomarkers of drug resistance.
•PI3K/AKT inhibitors exert synergistic antitumor activity with anti-microtubule drugs in breast cancer ex vivo 3D-cultures.•The presence of PI3K-alpha subunit mutation correlates with sensitivity in 3D models in vitro to taselisib and ipatasertib alone and combined with anti-microtubule agents.•Breast cancer ex vivo 3D-cultures represent an innovative model for an efficient drug and biomarkers screening.
•Proper design of efficient lighting systems.•The reliability and durability of the light sources.•Maintenance of lighting systems.•Quality standards of LED lamps.•Optimum economic choice of light ...sources.
The performance of lighting system must be calculated in order to determine the energy requirements of the building. In the normative EN 12464-1 are established lighting requirements which have effects on energy needs. The European standard EN 15193 provides guidance on that evaluation. The easiest way to comply with reduction of energy requirements leads to the replacement of traditional lamps with LED ones, but if we calculate also the reliability parameters, the economic return is not guaranteed.
Using bibliographic data, we have compared lighting’s results for a museum (LED lamps versus CFL and halogen lamps). The objective function of the study is to optimize the energy consumption of lighting systems, but at the same time to assess the reliability (MTTF of the lamps) of these systems. Without accurate information about this last parameters, the right choice of the lamps cannot be done successfully.
Carbon dioxide (CO2) pneumoperitoneum effects are still controversial. The aim of this study was to investigate cardiopulmonary changes in patients subjected to different surgical procedures for ...cholecystectomy.
In this study, 15 patients were assigned randomly to three groups according to the surgical procedure to be used: open cholecystectomy (OC), CO2 pneumoperitoneum cholecystectomy (PP), and laparoscopic gasless cholecystectomy (abdominal wall lifting AWL), respectively. A pulmonary artery catheter was used for hemodynamic monitoring in all patients. A subcutaneous multiplanar device (Laparo Tenser) was used for abdominal wall lifting. To avoid misinterpretation of results, conventional anesthesia was performed with all parameters, and the position of the patients held fixed throughout surgery. The following parameters were analyzed: mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI), stroke volume index (SVI), central venous pressure (CVP), systemic vascular resistances index (SVRI), mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP), pulmonary vascular resistances index (PVRI), peak inspiratory pressure (PIP), end-tidal CO2 pressure (ETCO)2, CO2 arterial pressure (PaCO2), and arterial pH.
All the operations were completed successfully. The Laparo Tenser allowed good exposition of the surgical field. A slight impairment of the cardiopulmonary functions, with reduction of SVRI, MAP, and CI and elevation of pulmonary pressures and vascular resistance, followed induction of anesthesia. However, these effects tended to normalize in the OC and AWL groups over time. In contrast, CO2 insufflation produced a complex hemodynamic and pulmonary syndrome resulting in increased right- and left side filling pressures, significant cardiac index reduction, derangement of the respiratory mechanics, and respiratory acidosis. All of these effects normalized after desufflation.
Cardiopulmonary adverse effects of general anesthesia were significant but transitory and normalized during surgery. Carbon dioxide pneumoperitoneum caused a significant impairment in cardiopulmonary functions. In high-risk patients, gasless laparoscopy may be preferred for reliability and absence of cardiopulmonary alterations.
•A thermo fluid-dynamic analysis of an urban street canyon is proposed.•This study has been carried out by a CFD method using the Solar Ray Tracing.•Flow and temperature fields have been evaluated ...within the urban street canyon.
A microclimatic analysis in a typical urban configuration, has been carried out. Using a CFD method, a N-S oriented urban street canyon, with a given H/W ratio, has been examined. The standard k–ε turbulence model has been used to simulate a three-dimensional flow field and to calculate the thermo-fluid dynamics parameters that characterize the street canyon. The aim of this study is to investigate the effect of solar radiation on the flow field and thermal parameters within the canyon. A comparison between transient and stationary simulations has been performed to evaluate the importance of considering the thermal inertia effects in an urban street canyon study. The dynamic characteristics of the 3D flow in the canyon have been compared with other numerical simulations and experimental results. Furthermore a thermo-fluid dynamic analysis of natural convection effects on the heat transfer coefficient and turbulent kinetic energy, has been carried out.
Increased insulin-like growth factor (igf) signalling has been observed in breast cancer, including endocrine-responsive cancers, and has been linked to disease progression and recurrence. In ...particular, igf-1 has the ability to induce and promote lymphangiogenesis through the induction of vascular endothelial growth factor C (vegfc). In the present study, we analyzed serum and tumour samples from 60 patients with endocrine-positive breast cancer to determine the expression and the possible relationship of circulating igf-1, igf binding protein 3 (igfbp3), and vegfc with the presence of lymphatic metastasis and other immunohistochemical parameters. The analysis revealed a clear and significant correlation between high basal levels of igf-1, igfbp3, and vegfc and lymph node metastasis in endocrine-responsive breast cancer. In addition, expression of those molecules was significantly higher in breast cancer patients than in healthy control subjects. Those findings may enable more accurate prediction of prognosis in patients with breast cancer.
To date, few studies of preoperative chemotherapy or chemoradiotherapy (crt) in gastroesophageal junction (gej) cancer have been statistically powered; indeed, gej tumours have thus far been grouped ...with esophageal or gastric cancer in phase iii trials, thereby generating conflicting results.
We studied 41 patients affected by locally advanced Siewert type i and ii gej adenocarcinoma who were treated with a neoadjuvant crt regimen folfox4 (leucovorin-5-fluorouracil-oxaliplatin) for 4 cycles, and concurrent computed tomography-based three-dimensional conformal radiotherapy delivered using 5 daily fractions of 1.8 Gy per week for a total dose of 45 Gy, followed by surgery. Completeness of tumour resection (performed approximately 6 weeks after completion of crt), clinical and pathologic response rates, and safety and outcome of the treatment were the main endpoints of the study.
All 41 patients completed preoperative treatment. Combined therapy was well tolerated, with no treatment-related deaths. Dose reduction was necessary in 8 patients (19.5%). After crt, 78% of the patients showed a partial clinical response, 17% were stable, and 5% experienced disease progression. Pathology examination of surgical specimens demonstrated a 10% complete response rate. The median and mean survival times were 26 and 36 months respectively (95% confidence interval: 14 to 37 months and 30 to 41 months respectively). On multivariate analysis, TNM staging and clinical response were demonstrated to be the only independent variables related to long-term survival.
In our experience, preoperative chemoradiotherapy with folfox4 is feasible in locally advanced gej adenocarcinoma, but shows mild efficacy, as suggested by the low rate of pathologic complete response.
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