Istituto Motori

Background: Renal trauma accounts for approximately 3-5% of all trauma cases, predominantly affecting young males. The most common etiology is blunt trauma, particularly due to road traffic accidents, and it frequently occurs as part of polytrauma involving multiple organ systems. Management strategies are primarily dictated by hemodynamic stability, overall clinical condition, comorbidities, and injury severity graded according to the AAST classification. This study aimed to evaluate the effectiveness of non-operative management (NOM) in high-grade renal trauma (AAST grades III-V), beyond its established role in low-grade injuries (grades I-II). Secondary endpoints included the identification of independent prognostic factors for NOM failure and in-hospital mortality. Methods: We conducted a retrospective observational study including patients diagnosed with blunt renal trauma who presented to the Emergency Department of Policlinico Umberto I in Rome between 1 January 2013 and 30 April 2024. Collected data comprised demographics, trauma mechanism, vital signs, hemodynamic status (shock index), laboratory tests, blood gas analysis, hematuria, number of transfused RBC units in the first 24 h, AAST renal injury grade, ISS, associated injuries, treatment approach, hospital length of stay, and mortality. Statistical analyses, including multivariable logistic regression, were performed using SPSS v28.0. Results: A total of 244 patients were included. Low-grade injuries (AAST I-II) accounted for 43% (n = 105), while high-grade injuries (AAST III-V) represented 57% (n = 139). All patients with low-grade injuries were managed non-operatively. Among high-grade injuries, 124 patients (89%) were treated with NOM, including observation, angiography ± angioembolization, stenting, or nephrostomy. Only 15 patients (11%) required nephrectomy, primarily due to persistent hemodynamic instability. The overall mortality rate was 13.5% (33 patients) and was more closely associated with the overall injury burden than with renal injury severity. Multivariable analysis identified shock index and active bleeding on CT as independent predictors of NOM failure, whereas ISS and age were significant predictors of in-hospital mortality. Notably, AAST grade did not independently predict either outcome. Conclusions: In line with the current international literature, our study confirms that NOM is the treatment of choice not only for low-grade renal injuries but also for carefully selected hemodynamically stable patients with high-grade trauma. Our findings highlight the critical role of physiological parameters and overall ISS in guiding management decisions and underscore the need for individualized assessment to minimize unnecessary nephrectomies and optimize patient outcomes.

A potential CO2 and water vapour adsorbent made of a NaX zeolite/Na-activated geopolymer composite material was fabricated as 3D-printed monoliths by means of Direct Ink Writing.

Abstract Amyloidosis diseases are a heterogeneous group of pathologies that have a strong impact on current society both in global health and in the economic system of each country. The analysis of how the entry of the toxic species identified into the amyloid oligomeric elements occurs is the main objective of much research in the sector. In this work, we analyze a hypothesis of the entry of oligomers into the membrane whereby, after a massive recruitment of the sphingolipid rafts thanks to their connection with the oligomers, a cleansing of the membrane itself occurs. This pathological event creates a sort of pore which, subsequently stabilized, allows the oligomers to enter the cell. In this work, we build an entry model based on dynamic networks that investigates the fundamental mechanisms that lead to the entry of amyloid oligomers into the cell after having formed a critical concentration in the oligomer-membrane complex which, thanks to the conformational changes affecting the oligomers themselves, carries out the cleansing of the membrane and the entry of these pathogenic elements. The global dynamic network is divided into subnetworks which are expressed by algorithms that identify both time and threshold concentration as the fundamental moment in triggering the entire pathological process.

The molecular mechanisms involved in the transition of cardiac hypertrophy to heart failure (HF) are not fully characterized. Autophagy is a catabolic, self-renewal intracellular mechanism, which protects the heart during HF. In the heart of a mouse model of angiotensin-II-induced hypertrophy, Sun and colleagues demonstrated that reduced levels of miR-93 lead to synaptotagmin-7 (Syt-7) upregulation and consequent inhibition of autophagy. miR-93 overexpression or syt-7 inhibition rescues autophagy and maladaptive hypertrophy. This research identifies new players in the pathophysiology of cardiac hypertrophy, opening innovative therapeutic perspectives. miR-93 may also be considered in the future as a novel circulating biomarker for patients at high risk to develop HF.

<div class="section abstract"><div class="htmlview paragraph">Within the context of environmental impact reduction for small size spark ignition (SI) engines, especially green-house gas emissions, this study looked at laminar flame speed as an optimization parameter for hydrogen-methane fueled micro-generators. To this aim, SI engine operation was modeled in a 0D/1D simulation framework, so as to identify the best choice of methane-hydrogen ratios in different conditions. Starting from experimental data recorded on a small size engine, an optimization method was implemented for achieving the proposed goal. One of the main conclusions is that high concentrations of hydrogen and resulting fast burn rates are beneficial at high engine speed settings, while the opposite is true at low engine speed. Hydrogen addition was also considered as an additional control margin during lean operation, given that stable combustion can be achieved even with very low equivalence ratios. This aspect was closely correlated to limits imposed by non-road emission standards.</div></div>

Syngas production from biomass gasification and its use in combined heat and power (CHP) generation systems is a feasible alternative to traditional fuels in Internal Combustion Engines (ICEs), although its quality is poorer in terms of calorific value and energy density. Therefore, a viable option for its exploitation can be assured if ICEs operate in dual-fuel (DF) mode, where employing non-edible oils (as Waste Vegetable Oils, WVO) as a further residual material may solve issues related both to the utilization of diesel fuels and to the high costs for biodiesel production. The practice promotes a virtuous circle to enhance material recovery without disposal. A combined experimental-numerical activity for the analysis of the performances of a Compression Ignition (CI) engine in the DF mode with syngas and WVO is here presented. An appropriate pre-heating system is mounted on the engine injection line to reduce the WVO viscosity. Experimental data collected in terms of in-cylinder pressure cycle, heat release rates and main pollutants at different loads are used to validate a properly developed three-dimensional (3D) Computational Fluid Dynamics (CFD) model, that helps investigating the detail of the syngas fuelling on power output and emissions.

Soot engine-out emissions are no longer a prerogative of Diesel engines. Emission regulations related to Gasoline units aim to curb the soot emissions along with other pollutants. In this scenario, Computational Fluid Dynamics (CFD) is a very promising research and development tool to explore the influence of engine design and operational parameters, as well as of the fuel chemical nature, on the particulate matter formation. Among the soot models, the Sectional Method is an advanced resource to provide information on Particle Number, Particulate Mass and Particle Size Distribution. In this study, the Sectional Method is applied in conjunction with a customized soot library, where the source terms governing the soot sections transport equations are stored. The library is computed via chemical kinetics simulation of a 0D constant pressure reactor, which provides fuel-related coefficients for each individual source term over the entire range of conditions experienced by the 3D-CFD model. 3D-CFD simulations are then carried out for three different injection timings without case-by-case tuning. Numerical results are then compared to the experimental dataset by using a consistent methodology. A satisfactory agreement between 3D-CFD results and experimental measurements is reached for soot mass and particle numbers, while the particle size distribution function is only partially reproduced. Soot-related quantities are thoroughly analyzed for each of the examined injection strategies to understand the mechanisms leading to soot formation and emissions.

Compression ignition (CI) engines are widely used in modern society, but they are also recognized as a significative source of harmful and human hazard emissions such as particulate matter (PM) and nitrogen oxides (NOx). Moreover, the combustion of fossil fuels is related to the growing amount of greenhouse gas (GHG) emissions, such as carbon dioxide (CO2). Stringent emission regulatory programs, the transition to cleaner and more advanced powertrains and the use of lower carbon fuels are driving forces for the improvement of diesel engines in terms of overall efficiency and engine-out emissions. Ethanol, a light alcohol and lower carbon fuel, is a promising alternative fuel applicable in the dual-fuel (DF) combustion mode to mitigate CO2 and also engine-out PM emissions. In this context, this work aims to assess the maximum fuel substitution ratio (FSR) and the impact on CO2 and PM emissions of different nozzle holes number injectors, 7 and 9, in the DF operating mode. The analysis was conducted within engine working constraints and considered the influence on maximum FSR of calibration parameters, such as combustion phasing, rail pressure, injection pattern and exhaust gas recirculation (EGR). The experimental tests were carried out on a single-cylinder light-duty CI engine with ethanol introduced via port fuel injection (PFI) and direct injection of diesel in two operating points, 1500 and 2000 rpm and at 5 and 8 bar of brake mean effective pressure (BMEP), respectively. Noise and the coefficient of variation in indicated mean effective pressure (COVIMEP) limits have been chosen as practical constraints. In particular, the experimental analysis assesses for each parameter or their combination the highest ethanol fraction that can be injected. To discriminate the effect on ethanol fraction and the combustion process of each parameter, a one-at-a-time-factor approach was used. The results show that, in both operating points, the EGR reduces the maximum ethanol fraction injectable; nevertheless, the ethanol addition leads to outstanding improvement in terms of engine-out PM. The adoption of a 9 hole diesel injector, for lower load, allows reaching a higher fraction of ethanol in all test conditions with an improvement in combustion noise, on average 3 dBA, while near-zero PM emissions and a reduction can be noticed, on the average of 1 g/kWh, and CO2 compared with the fewer nozzle holes case. Increasing the load insensitivity to different holes number was observed.