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Mid-Term Results of the Multicenter CAMPARI Registry Using the E-Liac Iliac Branch Device for Aorto-Iliac Aneurysms
No full textAbstract
Background: Intentional occlusion of the internal iliac artery (IIA) during endovascular repair of aorto-iliac aneurysms may predispose patients to pelvic ischemic complications such as gluteal claudication, erectile dysfunction, and bowel ischemia. Iliac branch devices (IBDs) have been developed to preserve hypogastric perfusion. E-Liac (Artivion/Jotec) is one of the latest modular IBDs yet reports on mid-term performance are limited to small single-center cohorts with short follow-up. The CAMpania PugliA bRanch IliaC (CAMPARI) study is a multicenter investigation of E-Liac outcomes. Methods: A retrospective observational cohort study was conducted across five Italian vascular centers. All consecutive patients undergoing E-Liac implantation for aorto-iliac or isolated iliac aneurysms between January 2015 and December 2024 were identified from prospectively maintained registries. Inclusion criteria comprised elective or urgent endovascular repair of aorto-iliac aneurysms in which an adequate distal sealing zone was not available without covering the IIA and suitability for the E-Liac device according to its instructions for use (IFU). Patients with a life expectancy 5 mm. Results: A total of 69 consecutive patients (68 male, 1 female, median age 72.0 years) received 74 E-Liac devices, including 5 bilateral implantations. The mean infrarenal aortic diameter was 45 mm and the mean CIA diameter 34 mm; 14 patients (20.0%) had a concomitant IIA aneurysm (>20 mm). Concomitant fenestrated or branched aortic repair was performed in 23% of procedures. Two patients received a standalone IBD without implantation of a proximal aortic endograft. Technical success was achieved in 71/74 cases (96.0%); three failures occurred due to inability to catheterize the IIA. Distal landing was in the main IIA trunk in 58 cases and in the posterior branch in 13 cases. Over a median follow-up of 18 (6; 36) months, there were four branch instability events (5.4%): three occlusions and one bridging stent detachment. Seven patients (9.5%) developed endoleaks (one type Ib, two type II, two type IIIa, and two type IIIc). Five patients (6.8%) required reintervention, and five (6.8%) reported gluteal claudication. There were seven all-cause deaths (10%), none within 30 days or related to aneurysm rupture; causes included COVID-19 pneumonia, acute coronary syndrome, melanoma, gastric cancer, and stroke. No acute renal or respiratory failure occurred. Kaplan–Meier analysis showed 92% (95% CI 77–100) freedom from branch instability in the main-trunk group and 89% (60–100) in the posterior-branch group (log-rank p = 0.69). Freedom from any endoleak at 48 months was 87% (95% CI 75–95), and freedom from reintervention was 93% (95% CI 83–98). Conclusions: In this multicenter cohort, the E-Liac branched endograft demonstrated high technical success and favorable early–mid-term outcomes. Preservation of hypogastric perfusion using E-Liac was associated with low rates of branch instability, endoleak, and reintervention, with no 30-day mortality or aneurysm-related deaths. These findings support the safety and efficacy of E-Liac for aorto-iliac aneurysm management, although larger prospective studies with longer follow-up are needed
Napoli milionaria! Ovvero: è meglio morire di fame che essere disonesti
No full textIl testo è un'analisi sociale e politica del dramma di Eduardo con particolare riferimento al ruolo che i personaggi principali hanno nel contesto storico e drammaturgico del tempo
Expanding frontiers: harnessing plant biology for space exploration and planetary sustainability
No full text: Plants are critical for sustaining human life and planetary health. However, their potential to enable humans to survive and thrive beyond Earth remains unrealized. This Viewpoint presents a collective vision outlining priorities associated with plant science to support a new frontier of human existence. These priorities are drawn from the International Space Life Sciences Working Group (ISLSWG) Plants for Space Exploration and Earth Applications workshop, held at the European Low Gravity Research Association (ELGRA) conference in September 2024. First, we highlight transformative advances gained from using the 'laboratory of space' in understanding how plants respond to gravity and other stressors. Second, we introduce a new crop Bioregenerative Life Support System (BLSS) readiness level (BRL) framework - extending the existing Crop Readiness Level (CRL) - to assist in overcoming challenges to establish resilient, sustainable crop production. Materializing the vision of plants as enablers of space exploration will require innovative approaches, including predictive modeling, synthetic biology, robust Earth-based analogue systems, and reliable space-based instruments to monitor biological processes. Success relies upon a unified international community to promote sharing of resources, facilities, expertise, and data to accelerate progress. Ultimately, this work will both advance human space exploration and provide solutions to enhance sustainable plant production on Earth
Eredità in Architettura. Atelier(s) Alfonso Femia – Park
No full textEredità in Architettura – Atelier(s) Alfonso Femia e Park è la quarta di un ciclo di mostre a cadenza biennale organizzate a Napoli dal Dipartimento di Architettura dell’Università degli Studi di Napoli “Federico II” e dedicate all’architettura contemporanea italiana. Una riflessione su alcune tra le più significative ricerche progettuali che interpretano il patrimonio costruito come eredità attiva, risorsa da rinnovare e trasmettere attraverso il progetto contemporaneo
RISOLUZIONE DEI CONTRATTI PUBBLICI DI APPALTO E CONCESSIONE
No full textL’art. 122 c.c.p., nel recepire le ipotesi di scioglimento dal contratto di appalto previste dall’art. 73 della direttiva UE n. 24/2014, regola, analogamente al previgente art. 108 del d.lgs. 18 aprile 2016, n. 50, di cui recepisce in larga parte l’impostazione, fattispecie eterogenee di risoluzione. Analoga disciplina è contenuta nell'art. 190 del d.lgs. 36/2023, in tema d concessione di lavori e servizi pubblici.
Il capitolo "RISOLUZIONE DEI CONTRATTI PUBBLICI DI APPALTO E CONCESSIONE", affronta, tra i primi lavori in argomento (non si rilevano contributi precedenti, aventi una simile impostazione), in modo organico e con metodo critico, le diverse ipotesi di scioglimento del rapporto contrattuale, tra esercizio - in taluni casi - di poteri autoritativi e - in altri - di poteri di autotutela di natura privatistica. Il lavoro, inoltre, si concentra non solo sulle diverse ipotesi disciplinate dagli artt. 122 e 190 c.c.p. ma anche sulle complicate questioni sollevate a proposito di risoluzione dei rapporti contrattuali di fatto, di risoluzione per inadempimento della P.A., di annullamento in autotutela dell'aggiudicazione, con la conseguente caducazione del rapporto (ed eventuali obblighi restitutori), di eccessiva onerosità e di rinegoziazione dei rapporti. Sono oggetto di indagine, poi, le conseguenze patrimoniali che derivano dai differenti casi di scioglimento dei rapporti contrattuali. Il lavoro, infine, propone una ricostruzione del tema del riparto di giurisdizione, che invero appare assai più complesso rispetto al passato, in ragione dell'evoluzione dell'Ordinamento, con soluzioni che mirano a superare taluni equivoci, generati da tralatizie affermazioni di principio ancora presenti soprattutto nella giurisprudenza di merito e di legittimità
Short-Term Effectiveness and Safety of Deucravacitinib in Psoriasis: A Multicenter Real-World Study with Scalp-Specific Outcomes—IL PSO (Italian Landscape Psoriasis)
No full textIntroduction: Real-world evidence on deucravacitinib in moderate-to-severe psoriasis remains limited, especially regarding difficult-to-treat areas such as scalp involvement. We conducted a multicenter retrospective study to assess the short-term effectiveness and safety of deucravacitinib in routine clinical practice, with a specific focus on scalp outcomes. Methods: We enrolled 111 adult patients with moderate-to-severe psoriasis treated with deucravacitinib for at least 16 weeks across 19 different Italian dermatology units. Effectiveness was assessed in terms of PASI (Psoriasis Area and Severity Index) responses and scalp-specific Physician's Global Assessment (ss-PGA). Results: At week 16, PASI 75, PASI 90, and PASI 100 were achieved by 49.6%, 29.7%, and 18.9% of patients, respectively, with response rates further improving to 84.9%, 60.6%, and 45.5% at week 32. Among patients with baseline scalp involvement (n = 49), 89.8% reached ss-PGA 0/1 at week 16 and 100% at week 32, showing rapid and sustained scalp clearance. Notably, baseline scalp involvement did not negatively affect overall skin response. Deucravacitinib demonstrated a favorable safety profile. Adverse events (AEs) were reported by 8.1% of patients and were all mild in severity. Treatment was discontinued in 2.7% of patients, and no severe AEs were observed. Conclusion: Deucravacitinib demonstrated clinical effectiveness and a favorable safety profile in real-world practice, including excellent scalp clearance rates, confirming its therapeutic value even in patients with difficult-to-treat areas
Special Issue on “Seismic Performance of Non-Structural Elements and Systems”
No full textIn earthquake engineering, the non-structural elements (NSEs) are all parts of a building and its
contents, except the structural elements specifically designed to be part of the load-resisting system.
NSEs are often categorized into three main groups: 1) architectural elements, 2) systems and equipment,
and 3) contents. Since the development of performance-based earthquake engineering, the role of NSEs in the
design and assessment of buildings, reducing seismic risk, facilitating return to functionality, and
enhancing overall infrastructure resilience has become increasingly apparent. Recent and high profile
earthquakes striking highly developed countries, like Loma Prieta (US) 1989, Northridge (US) 1994,
Hanshin (Japan) 1995, Wenchuan (China) 2008, Christchurch (NZ) 2011, Emilia-Romagna (Italy)
2012, Central Italy 2016, Turkiye-Syria (Turkey) 2023 among others, showed that major economic
losses were due to damage of NSEs. NSE damage (as a percentage of total damage) has varied
according to the use of the building and its structural system, reaching peaks of 60% for residential
buildings to more than 90% for hospital buildings. These high losses are often a result of building downtime
Load disaggregation based on supervised learning algorithms for energy consumption pattern recognition in residential buildings
No full textClimate change and global warming are causing growing environmental concerns, prompting many countries to increase investments in renewable energies and green strategies. The high growth rate of intermittent energy sources in the energy supply systems is causing balancing challenges that need to be addressed. Thus, demand-side flexibility is attracting interest as a viable solution to guarantee grid reliability. In this framework, the present study aims to identify consumption behaviors for both thermal and electrical loads in residential building sector to assess the flexibility potential that end-users can offer to the Distribution System Operator (DSO). Moreover, based on performance and flexibility capacity, the main energy appliances have been disaggregated by means of a Supervised Learning algorithms assessing consumption forecasting. The proposed model has been applied on a large dataset of residential customers provided by the Spanish DSO of a 30.000 habitants municipality. The results obtained show that the neural network is able to explain 91.7% of the variability of synthetic dataset (R2 = 0.917), with an average absolute error of 1,797 kW in the process of disaggregating the consumption of 14 household appliances belonging to 558 homes. Finally, this research study provides valuable guidelines to carry out short-term energy resource planning and alleviate the existing operational problems of the energy systems