From advanced hydraulic modelling to performance indicator for the efficiency of investments in leakage management of pressurized water systems.

INTRODUCTION: The digital transition is meant as the review of processes using digital technologies and strategies to increase efficiency based on a simpler collection of representative data. The process of interest here is the leakage management in systems distributing water. OBJECTIVE: To develop a novel key performance indicator (KPI) for leakage management considering the needs of ongoing digital transition in the water sector, which is opening a new era in the management of drinking water infrastructures. METHODOLOGY: The novel KPI, named Asset Management Support Indicator, is developed starting from advanced hydraulic modelling and the physical laws governing leakage outflows, in order to be physically based and rational for increasing the efficiency of leakage management activities using representative process data. RESULTS: The Asset Management Support Indicator supports effective leakage management strategies by driving towards efficiency, as discussed and demonstrated using several real case studies. CONCLUSION: The novel indicator is consistent with the digital transition perspective and current need of increasing the efficiency of water utilities, and it is also suitable to be adopted by water authorities to benchmark their performances, because it overcomes the weaknesses of traditional KPIs.

Serum neopterin levels in spontaneous urticaria and atopic dermatitis.

Serum neopterin may be considered a diagnostic marker of the degree of activation of the immune system. This preliminary study was performed to measure serum neopterin levels in patients with acute spontaneous urticaria (ASU), chronic spontaneous urticaria (CSU) and atopic dermatitis (AD). In total, 180 patients [96 men, 84 women; mean age 23.1 years; 41 with spontaneous urticaria (13 ASU and 28 CSU), 48 with AD] and 96 healthy controls were enrolled in the study. Patients with ASU had the highest neopterin levels, and all three groups of patients (ASU, CSU and AD) had higher values than normal subjects. This preliminary study demonstrates that serum neopterin could be a biomarker of immune activation in patients with SU or AD.

An effective multi-objective approach to prioritization of sewer pipe inspection.

The first step in the decision making process for proactive sewer rehabilitation is to assess the condition of conduits. In a risk-based decision context the set of sewers to be inspected first should be identified based on the trade-off between the risk of failures and the cost of inspections. In this paper the most effective inspection works are obtained by solving a multi-objective optimization problem where the total cost of the survey programme and the expected cost of emergency repairs subsequent to blockages and collapses are considered simultaneously. A multi-objective genetic algorithm (MOGA) is used to identify a set of Pareto-optimal inspection programmes. Regardless of the proven effectiveness of the genetic-algorithm approach, the scrutiny of MOGA-based inspection strategies shows that they can differ significantly from each other, even when having comparable costs. A post-processing of MOGA solutions is proposed herein, which allows priority to be assigned to each survey intervention. Results are of practical relevance for decision makers, as they represent the most effective sequence of inspection works to be carried out based on the available funds. The proposed approach is demonstrated on a real large sewer system in the UK.

Proteome Analysis of Urticating Setae From Thaumetopoea pityocampa (Lepidoptera: Notodontidae).

Thaumetopoea pityocampa (Denis & Schiffermüller) (Lepidoptera: Notodontidae) is harmful to conifer trees because of defoliation and to public health because of the release of urticating setae from the caterpillars. Contact with setae by humans and domestic animals induces dermatitis, usually localized to the exposed areas. Recent studies demonstrated the presence of a complex urticating mechanism where proteins present in the setae may play a role as activators of immune responses. Yet, limited information is available at present about the proteins occurring in the setae of T. pityocampa. Using a refined method for protein extraction from the setae, and a combination of liquid chromatography tandem-mass spectrometry (LC-MS/MS), de novo assembly of transcriptomic data, and sequence similarity searches, an extensive data set of 353 proteins was obtained. These were further categorized by molecular function, biological process, and cellular location. All the 353 proteins identified were found to match through BLAST search with at least one Lepidoptera sequence available in databases. We found the previously known allergens Tha p 1 and Tha p 2 described from T. pityocampa, as well as enzymes involved in chitin biosynthesis, one of the principal components of the setae, and serine proteases that were responsible for inflammatory and allergic reactions in other urticating Lepidoptera. This new proteomic database may allow for a better understanding of the complexity of allergenic reactions due to T. pityocampa and to other Lepidoptera sharing similar defense systems.

Ambulatory blood pressure monitoring: a critical review of the current methods to handle outliers.

OBJECTIVES: To examine the methods to handle marginal readings in the analysis of ambulatory blood pressure. DESIGN: Data obtained from automatic ambulatory blood pressure monitoring include several 'outliers', i.e. readings at the frontier of physiologically acceptable ranges. Several methods have been used to handle these readings. We need to know whether using different methods to reject outliers leads to different results in the analysis of the data. If so, then it is important that a common method be used by different authors. METHODS: Ten reported methods to handle outliers were selected and applied to a large set of unpublished blood pressure profiles (Novacor Diasys system). We compared the effects of data rejection by these methods on the mean values and standard deviations (calculated over 24 h, daytime and night-time) of the remaining data. RESULTS: The different methods had quite different effects on the same data set. Depending on the method used, the discarded data varied from 1 to 17% of the total number of readings. Among the rejected data, readings that occurred in the daytime varied from 14 to 56%. Also, 'high-value' outliers varied from 1 to 60% of the rejected data. On average over the total sample, the rejection of outliers had only a small effect on the mean values of blood pressure. In contrast, it may strongly reduce the standard deviation of the readings. CONCLUSION: The study emphasized the need to use a common method to handle outliers in the analysis of ambulatory blood pressure data.

Surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBLE) in Northern France: a five-year multicentre incidence study.

In order to measure the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and of Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBLE), and to evaluate the impact of the national guidelines for multidrug-resistant bacteria (MDRB) prevention in hospitals of Northern France, a multicentre study was conducted for three months every year starting in 1996, in volunteer hospital laboratories. All clinical specimens positive for MRSA and ESBLE were prospectively surveyed. During the five-year surveillance period, the overall proportion of MRSA was 38.4% in the 28,534 strains of S. aureus, and that of ESBLE was 11.4% in the 6121 strains of Klebsiella pneumoniae and 47.7% in the 2353 strains of Enterobacter aerogenes. The overall incidence rates of clinical specimens positive for MRSA, ESBL-K. pneumoniae and E. aerogenes were 0.84. 0.05 and 0.12/1000 hospital-days (HD), respectively. In the 23 hospitals that participated in the survey every year, the proportion and incidence of ESBLE decreased. Hence, despite recommendations as for isolation precautions, MRSA remains poorly controlled and requires more effective measures.

Cottonseed protein derivatives as nutritional and functional supplements in food formulations.

Cottonseeds contain protein with desirable food functional and nutritional properties. Storage globulins make up most of the protein stored in cottonseed and can be separated into five fractions by gel filtration chromatography. Each fraction is distinguishable from the other by its amino acid and polyacrylamide gel electrophoretic properties. Proteins of cottonseed contribute greatly to the functional properties of emulsions, co-isolates, and texturized derivatives. For example, increasing the amount of high protein cottonseed flour in wheat suspensions from 2% to 10% improved the capacity (54-97 ml of oil) and viscosity (5,000-100,000+ cps) of emulsions. The 10% suspension formed emulsions with increasing oil capacity (84-100 ml) and viscosity (28,000-100,000+ cps) as the pH was adjusted from 4.5 to 9.5. Consistencies of the products ranged from that of salad dressing (low percent suspensions, or acid pH) to that of mayonnaise (high percent, or basic pH). These data were utilized to derive a multiple regression model to predict optimum use of cottonseed proteins in emulsions of varying consistencies. A coprecipitated isolate containing greater than 94% protein was prepared from a blend of cottonseed and peanut flours. Amino acid content of the co-isolate reflected that of the protein in the two flours of the composite. The co-isolate has lower gossypol level and improved color and functional properties than a cottonseed protein isolate. Storage protein isolate of cottonseed suspended in aqueous solution and heated with constant stirring forms a texturized product; the quality of the product depends on heat, pH, salt, and the quantity of nonstorage proteins. Protein and amino acid content of meat products were improved by the addition of the texturized protein of cottonseed.

[Choledochal calculosis due to a suture thread]. / Calcolosi coledocica da filo di sutura.

The authors recently observed a patient suffering from recurrent choledochal, postcholecystectomy calculosis caused by suture thread. Given the relative rarity of this pathology, the difficulty of preoperative diagnosis and the possible confusion with other anatomoclinical syndromes, they take this opportunity to make a number of diagnostic and therapeutic comments in the light of the latest literature on this subject.

[Intestinal infarct: a critical review of the cases observed in the decade of 1981-1991]. / L'infarto intestinale: revisione critica dei casi osservati nel decennio 1981-1991.

The authors consider the causes of bowel infarction and report the up-to-date diagnostic tools for optional treatment. They verify management and outcome of 97 cases treated during the last decade.

[Original method of the treatment of achalasic megaesophagus with EEA stapler]. / Originale metodica di trattamento del megaesofago acalasico con EEA stapler.

Esophageal sutures require the same general criteria applied for the realization of an intestinal suture. The lack of a serous membrane and the particular vascularization of the organ, though, make this portion of the gastroenteric tract very prone to serious complications. Undoubtedly, the introduction of new systems of suture renders easier, faster and more efficacious the work of the surgeon. In particular, the Authors stress the advantages that staplers can offer for the treatment of achalasic megaesophagus.

Ambulatory blood pressure in young subjects with familial history of hypertension.

Office blood pressure (BP), ambulatory blood pressure, (one determination every 15 min, over an entire 24 h span), were measured in 206 young male subjects, including 96 individuals having first degree familial history of hypertension (the F group) and 110 control subjects, matched for age, having no familial history of hypertension (the C group). In both groups, age ranged from 19 to 25 y. After a complete clinical and laboratory examination, all subjects were diagnosed as in good health. In particular, none had cardiac, renal or neurologic involvement. No subject received medication. Over the whole sample, 126 subjects had normal office BP and 80 had borderline office BP. No difference was found in office diastolic BP between the C and F groups. Office systolic BP was somewhat higher in the F group, when compared to the C group, but the difference was in the limit of statistical significance (0.05 less than p less than 0.10). In contrast, ambulatory systolic BP was significantly higher in the F group, when compared to the C group, the difference (0.05 less than p less than 0.001) occurred in daytime and at night. The above difference was more significant (p less than 0.02 to p less than 0.005) and persisted over larger time-spans when only subjects with normal office BP in the C and F groups are compared. In contrast, when restricted to the borderlines only, office and ambulatory BP was the same in subjects with and without familial history of hypertension.

Enzymatic activation of lymphoid population following inflammatory reactions in the human appendix.

We have histochemically evaluated the LAP, AP and ANE activities of the human appendix in 100 surgical specimens. The mucosa has been particularly investigated for its different aspects during inflammatory conditions. Two main facts have been ascertained: the subepithelial location of macrophages, and the AP and ANE activities of two groups of cells in the germinal centers. Subepithelial macrophages show conspicuous AP activity that correlates with the degree of inflammatory response and of exposure to luminal antigens. In the germinal centers, AP and ANE activities disclose two further groups of positive cells, probably the same cells reacting to both technics. One group is rooted to the core of the germinal center; the other to the intermediate area between the germinal center and the follicular mantle.