Impact of reduced mass of light commercial vehicles on fuel consumption, CO2 emissions, air quality, and socio-economic costs.

This study presents a modelling system to evaluate the impact of weight reduction in light commercial vehicles with diesel engines on air quality and greenhouse gas emissions. The PROPS model assesses the emissions of one vehicle in the aforementioned category and its corresponding reduced-weight version. The results serve as an input to the RIAT+ tool, an air quality integrated assessment modelling system. This paper applies the tools in a case study in the Lombardy region (Italy) and discusses the input data pre-processing, the PROPS-RIAT+ modelling system runs, and the results.

Electromagnetic disturbances rejection with single skin contact in the context of ECG measurements with cooperative sensors.

Classical approaches to make high-quality measurements of biopotential signals require the use of shielded or multi-wire cables connecting the electrodes to a central unit in a star arrangement. Consequently, increasing the number of leads increases cabling and connector complexity which is not only limiting patient comfort but also anticipated as the main limiting factor for future miniaturization and cost reduction of tomorrow's wearables. We have recently introduced a novel sensing architecture that significantly reduces cabling complexity by eliminating shielded or multi-wire cables as well as by allowing simple connectors thanks to a bus arrangement. In this architecture, electrodes are replaced by so-called cooperative sensors. However, in this design, one of the cooperative sensors needs to be equipped with two contacts with the skin for proper common mode rejection, thus making its miniaturization problematic. This paper presents a novel common mode rejection principle which overcomes this limitation. When compared to others, the suggested approach is advantageous as it keeps the cabling complexity to its minimum. First measurements demonstrated in a real-life scenario the feasibility of this common mode rejection principle for a wearable 12-lead electrocardiogram monitoring system.

Cooperative dry-electrode sensors for multi-lead biopotential and bioimpedance monitoring.

Cooperative sensors is a novel measurement architecture that allows the acquiring of biopotential signals on patients in a comfortable and easy-to-integrate manner. The novel sensors are defined as cooperative in the sense that at least two of them work in concert to measure a target physiological signal, such as a multi-lead electrocardiogram or a thoracic bioimpedance.This paper starts by analysing the state-of-the-art methods to simultaneously measure biopotential and bioimpedance signals, and justifies why currently (1) passive electrodes require the use of shielded or double-shielded cables, and (2) active electrodes require the use of multi-wired cabled technologies, when aiming at high quality physiological measurements.In order to overcome the limitations of the state-of-the-art, a new method for biopotential and bioimpedance measurement using the cooperative sensor is then presented. The novel architecture allows the acquisition of the aforementioned biosignals without the need of shielded or multi-wire cables by splitting the electronics into separate electronic sensors comprising each of two electrodes, one for voltage measurement and one for current injection. The sensors are directly in contact with the skin and connected together by only one unshielded wire. This new configuration requires one power supply per sensor and all sensors need to be synchronized together to allow them to work in concert.After presenting the working principle of the cooperative sensor architecture, this paper reports first experimental results on the use of the technology when applied to measuring multi-lead ECG signals on patients. Measurements performed on a healthy patient demonstrate the feasibility of using this novel cooperative sensor architecture to measure biopotential signals and compliance with common mode rejection specification accordingly to international standard (IEC 60601-2-47) has also been assessed.By reducing the need of using complex wiring setups, and by eliminating the presence of central recording devices (cooperative sensors directly sense and store the measured biosignals on the site), the depicted novel technology is a candidate to a novel generation of highly-integrated, comfortable and reliable technologies that measure physiological signals in real-life scenarios.

Quantitative 3D evaluation of step ascent and descent in individuals with Down syndrome--analysis of a daily challenging task.

BACKGROUND: Step ascent and descent can perturb stability increasing the incidence of falls, especially in older individuals with functional limitations and intellectual disabilities, such as those with Down syndrome (DS). The aim of this study was to investigate the biomechanics and motor coordination of step ascent and descent in adults with DS and compare them with a group of healthy individuals, considering movement kinematics and kinetics. METHOD: Fourteen adults with DS and 12 similarly aged adults without DS who were free of known motor problems were quantitatively assessed during ascending and descending a step using an optoelectronic system (BTS SMART-D), force platforms and video recording. Kinematic and kinetic parameters were identified and calculated for each study participant and comparisons were made between the DS and a control group (CG). RESULTS: Despite similar age ranges, subjects in the DS group performed the step ascent and descent movements slower, with longer duration and with a more accentuated range of motion of the trunk and of the ankle joint than those in the CG. Additionally, the double stance phase on the step was substantially longer in the DS group when represented as a percentage of the entire stepping sequence (ascent, double stance on the step and descent). In terms of kinetics, ground force platform data revealed that the DS subjects showed higher instability in the medio-lateral direction during double support phase than similarly aged CG subjects and cannot be attributed to age-associated changes in stability. CONCLUSIONS: These findings help to elucidate the complex biomechanical strategy of people with DS during a step ascent and descent movement task and may have a major role in the multidimensional evaluation and tailored management for them.

[Mohs micrographic surgery for the treatment of basal cell carcinoma]. / Cirugía micrográfica de Mohs en el tratamiento de carcinoma basocelular.

INTRODUCTION: Basal cell carcinoma accounts for 75% of all nonmelanoma skin cancer. Although various treatment modalities are available, the most frequently used option is surgical excision. Here, we evaluate the efficacy of Mohs micrographic surgery for the treatment of basal cell carcinoma. MATERIAL AND METHODS: A retrospective review of cases of basal cell carcinoma treated with Mohs micrographic surgery between October 2003 and June 2009 was performed using patient records from Hospital Italiano in Buenos Aires, Argentina. RESULTS: A total of 2412 basal cell carcinomas treated with Mohs micrographic surgery were identified; 50.5% were in women and 49.5% in men. The mean age of the patients was 70.7 years (range, 8-100 years). The histologic type of the tumor was solid in 65.3% of cases and in 89% of cases the tumor was located on the head or neck. Ten percent of the tumors were recurrent following previous treatment. A mean of 1.74 Mohs stages were used, with a mean of 3.81 sections. The mean size of the initial defect was 0.86 cm² and the mean final defect was 1.88 cm². The ratio of initial tumor size to final defect was estimated at 1.02. Over a mean follow-up of 32 months, there were 9 cases of tumor recurrence (0.37%). CONCLUSIONS: In our experience, Mohs micrographic surgery is effective for the treatment of high-risk basal cell carcinoma.

Maintenance and characterization of lymphocytes in human long term bone marrow cultures to study immunotoxicity.

Immunotoxicity of xenobiotics is of growing concern for various levels in society, including industry and regulatory authorities. Despite that EU legislation aims at reducing the number of laboratory animals by promoting the development of alternative validated methods, at present, immunotoxicity is generally evaluated through standard in vivo toxicity studies. The lack of alternative methods is due, in particular, to the complexity of the immune system and its responses, but possibly alternative methods for immunosuppressive chemicals are most achievable. The present study describes a long term culture (LTC) method capable of inducing the formation of lymphocyte subsets from human mononuclear bone marrow cells that may allow evaluation of lymphotoxicity. The LTC consisted of a two stages: a myeloid stage to allow the formation of a stromal layer and a lymphoid stage to allow expansion of lymphocytes. Results show that the use of IL-7 in LTC inhibits precursor and mature B cells, while it supports the proliferation of CD3(+)CD8(+) and CD3(+)CD4(+) T-cells. The bone marrow LTC model may in future be used to test the effect of xenobiotics on stromal dependent lymphocyte formation.

In vitro toxicity of naphthalene, 1-naphthol, 2-naphthol and 1,4-naphthoquinone on human CFU-GM from female and male cord blood donors.

In animal models, naphthalene toxicity has been studied in different target organs and has been shown to be gender-dependent and metabolism related. In humans, it is readily absorbed and is metabolised by several cytochrome P450's. Naphthalene and its metabolites can cross the placental barrier and consequently may affect foetal tissues. The aim of this study was to compare the in vitro toxicity of naphthalene and its metabolites, 1-naphthol, 2-naphthol and 1,4-naphthoquinone, on human haematopoietic foetal progenitors (CFU-GM) derived from newborn male and female donors. The mRNA expression of Cyp1A2 and Cyp3A4 was also evaluated. Naphthalene did not affect CFU-GM proliferation, while 1-naphthol, 2-naphthol and particularly 1,4-naphthoquinone strongly inhibited the clonogenicity of progenitors, from both male and female donors. mRNA of Cyp1A2 and Cyp3A4 was not expressed neither at the basal level, nor after naphthalene treatment, while treatment with 1,4-naphthoquinone induced expression of both enzymes in both genders, with Cyp1A2 being expressed four times more than Cyp3A4. Female CFU-GM was significantly more sensitive to 1,4-naphthoquinone than male and after treatment both enzymes were expressed twice as much as in the male precursors. These results suggest that a gender-specific 1,4-naphthoquinone metabolic pathway may exist, which gives rise to unknown toxic metabolites.

TBTC induces adipocyte differentiation in human bone marrow long term culture.

Organotins are widely used in agriculture and the chemical industry, causing persistent and widespread pollution. Organotins may affect the brain, liver and immune system and eventually human health. Recently, it has been shown that tri-butyltin (TBT) interacts with nuclear receptors PPAR gamma (peroxisome proliferator-activated receptor gamma) and RXR (retinoid x receptor) leading to adipocyte differentiation in the 3T3 cell line. Since adipocytes are known to influence haematopoiesis, for instance through the expression of cytokines and adhesion molecules, it was considered of interest to further study the adipocyte-stimulating effect of TBTC in human bone marrow cultures. Nile Red spectrofluorimetric analysis showed a significant increase of adipocytes in TBTC-treated cultures after 14 days of long term culture. Real-time PCR and Western blot analysis confirmed the high expression of the specific adipocyte differentiation marker aP2 (adipocyte-specific fatty acid binding protein). PPAR gamma, but not RXR, mRNA was increased after 24 h and 48 h exposure. TBTC also induced a decrease in a number of chemokines, interleukins, and growth factors. Also the expression of leptin, a hormone involved in haematopoiesis, was down regulated by TBTC treatment. It therefore appears that TBTC induced adipocyte differentiation, whilst reducing a number of haematopoietic factors. This study indicates that TBTC may interfere in the haematopoietic process through an alteration of the stromal layer and cytokine homeostasis.

[Helmet delivered CPAP for in-patients]. / CPAP con scafandro nei reparti di degenza.

The scanty availability of intensive care beds in our hospital, compared with the needings of the area, led us to employ surgical department beds as post-intensive beds. The possibility of delivering non invasive ventilation by head helmet allowed, also in such settings, the ventilation of patients. This paper analyses the main capacities and problems that are faced by the nurse in the management of head helmet delivered CPAP. Main systems for gas delivery that can be used in the departments, PEEP application modalities and psychologic management of the patient are detailed.

Genetic diversity of GBV-C/HGV strains among HIV infected-IVDU and blood donors from Buenos Aires, Argentina.

GBV-C/HGV RNA was investigated in serum samples from 70 HIV(+) intravenous drug users (IVDU), as well as from 200 blood donors from Buenos Aires, Argentina. Viral RNA was demonstrated in 21 IVDU by reverse transcription-nested PCR of the 5' UTR. c-DNA amplified products were analyzed and their sequences compared with those downloaded from GenBank. A phylogenetic tree based on 171 sequences demonstrated the presence of three major genogroups, including two subgroups, within local samples, i.e. group 1 (n=1), 2a (n=11), 2b (n=4) and 3 (n=5). These results agreed entirely with those obtained by a novel RFLP (J. Clin. Microbiol. 37, 1340-1347, 1999) of the same 5' UTR amplicons. As expected, GBV-C/HGV RNA prevalence was significantly higher among IVDU than among blood donors (P<0.0001), although within the latter group an unexpectedly high rate was also detected, since 11 of 200 sera (5.5%) proved positive. These viral isolates were ascribed either to subgroup 2a (n=5), subgroup 2b (n=5) or genogroup 3 (n=1). Briefly, this partial view of GBV-C/HGV molecular epidemiology in Argentina shows: (i) different rates of GBV-C/HGV infection within both IVDU and blood donors; (ii) a high prevalence of viral RNA among blood donors; and (iii) a predominant circulation of genogroup 2, with minor contribution of groups 3 and 1.

GB virus C/hepatitis G virus groups and subgroups: classification by a restriction fragment length polymorphism method based on phylogenetic analysis of the 5' untranslated region.

A phylogenetic tree based on 150 5' untranslated region sequences deposited in GenBank database allowed segregation of the sequences into three major groups, including two subgroups, i.e., 1, 2a, 2b, and 3, supported by bootstrap analysis. Restriction site analysis of these sequences predicted that HinfI and either AatII or AciI could be used for genomic typing with 99.4% accuracy. cDNA sequencing and subsequent alignment of 21 Argentine GB virus C/hepatitis G virus strains confirmed restriction fragment length polymorphism patterns theoretically predicted. This method may be useful for a rapid screening of samples when either epidemiological or transmission studies of this agent are carried out.

[Study of human papillomavirus via chemiluminescence technic and polymerase chain reaction in transitional cell carcinoma of the bladder]. / Ricerca del papillomavirus umano mediante tecniche di chemiluminescenza e di polymerase chain reaction nel carcinoma a cellule transizionali della vescica.

INTRODUCTION: The exact ethiology of bladder carcinoma isn't yet known; an implication of human papillomavirus (HPV) has been recently hypothesized. MATERIALS AND METHODS: In this study HPV-DNA was investigated in urethral secretion and in bladder carcinoma of 37 patients. The analysis was performed by in vitro hybridization (chemiluminescent assay) and Polymerase Chain Reaction in order to detect HPV 6, 11, 16, 18, 31, 33 through specific primers. RESULTS: On 3 out of 37 patients (8.1%) we found the presence of HPV-DNA, only in bladder T.U.R. and not in the corresponding urethral swab. CONCLUSIONS: Our data suggest that human papillomavirus is unlikely to be involved in the pathogenesis of transitional cell carcinoma, in agreement with most European and American research groups.

Fine needle aspiration biopsy of hepatocellular carcinoma resembling neuroendocrine tumor. A case report.

BACKGROUND: The incidence of hepatocellular carcinoma (HCC) is steadily increasing in western countries. Its present incidence in Italy is about 6.9/100,000. The diagnosis is usually made by a combination of ultrasound (US), computed tomography (CT) and fine needle aspiration biopsy (FNAB). HCC resembling a neuroendocrine tumor has been described, but no previous FNAB diagnosis was reported. CASE: An asymptomatic 45-year-old man underwent a CT scan after incidental US detection of multiple focal lesions in both lobes of the liver. FNAB showed clusters of small neoplastic cells with hyperchromatic nuclei and scanty cytoplasm. A thin tissue core showed a microacinar pattern very similar to that of a neuroendocrine tumor. A large panel of specific antibodies displayed an immunophenotype consistent with HCC. CONCLUSION: In this rare variant of HCC, the final diagnosis could be assessed only by correlating the cytologic, microhistologic and immunohistochemical features.

[Cystic papillary tumors of the pancreas: 3 new cases]. / Tumore papillare cistico del pancreas: tre nuovi casi.

Three cases of papillary cystic tumor of the pancreas (PCTP) are described. They were observed in two female patients aged 42 and 39, and in a male patient aged 55. A fine-needle ultrasound-guided aspiration biopsy was performed in the man. The cytologic and histologic features turned out to be diagnostic and in compliance with literature data. In the three cases immunohistochemical analyses showed positive reaction to vimentin and alpha-1-antitrypsin. Two cases expressed neuron-specific enolase. Ultrastructural examination revealed similarities between neoplastic cells and normal centroacinar cells of the pancreas. Flow cytometric study revealed a diploid G0/1 peak in two cases. The patients underwent wide surgical excision of the neoplasia. No recurrences or metastases are found with follow-up of 10 years, 8 years and 10 month respectively.

[Prognostic value of cellular ploidy in adenocarcinoma of the middle rectum]. / Valore prognostico della ploidia cellulare nell'adenocarcinoma del retto medio.

A retrospective study of DNA content in 38 medium-rectal adenocarcinomas (a rectal part between 8 and 12 cm. from anus) was performed using flow cytometry in order to find probable correlations among ploidy, grading, staging and survival in patients who had undergone a surgical operation from January 1975 to December 1989. At the beginning of the work, 21 patients were alive and 17 were dead. Histologically 15 carcinomas (39.4%) were G1, 22 (57.8%) were G2 and only 1 (2.6%) was G3. Moreover 1 case (2.6%) was pT1, 7 (18.4%) were pT2 and 30 (78.9%) were pT3. 11 adenocarcinomas (29%) were euploid and 27 (71%) were aneuploid. These percentages agree with literature data. 11 of dead patients (64.7%) had aneuploid neoplasias and 6 (35.3%) diploid; 16 of alive patients (72.2%) had aneuploid carcinomas and 5 (23.8%) diploid. The difference of survival between aneuploid and diploid carcinomas isn't statistically significative (X2 = 0.168 ns). No correlation was found among aneuploidy, grading and staging, probably on account of small number of analyzed cases, owing to particular and little rectal part included in the study. Likely, having a larger case number we'll be able to obtain more incisive informations from this type of analysis in the next future.

[Planning of a prospective study with a biological bank]. / Progettazione di uno studio prospettico con banca biologica.

This present work aims to give a critical description of the organization and operative aspects of project ORDET (prospective study on diet and hormones in the aetiology of breast cancer). A number of problems which could arise when carrying-out a prospective study are described: they concern participant recruitment, laboratory organization, planning of a biological bank plus relative security checks in order to ensure full workability and personnel standardization in questionnaire administration and anthropometrical measurements. The methods adopted by ORDET, or at least some of them, could be useful for those engaged in the planning phase of a similarly designed project using a biological bank.