Lucchini (Italy)

Awake prone positioning research focuses primarily on improving oxygenation and reducing intubation and mortality rates. Secondary outcomes concerning patient safety have been poorly addressed. To summarize current evidence on the frequency of adverse events during awake prone positioning and the effects on patients' safety, comfort, and tolerance. This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. MEDLINE/PubMed and CINAHL databases were the primary sources for the systematic search. The review included 19 original studies involving 949 patients who underwent awake prone positioning. No major complications such as death, severe respiratory compromise, or hemodynamic disease were reported. Ten studies reported the following secondary adverse events related to awake prone positioning: skin breakdown (1%-6% of patients), pain (12%-42%), discomfort (35%-43%), vomiting (2%-7%), intolerance (3%-47%), and vascular catheter dislodgment (5%). The duration of awake prone positioning sessions varied widely (0.3-19 hours). Seven studies reported that nurses helped patients during prone positioning maneuvers, including monitoring and surveillance, and 3 studies reported patients placing themselves in the prone position. In 6 studies light or moderate sedation was employed in the procedures. Awake prone positioning was not related to cardiorespiratory consequences but was associated with pain, intolerance, discomfort, and patients' refusal. Patients should receive education regarding awake prone positioning to improve their acceptance. Health care professionals should optimize pain control, communication, patient comfort, patient adherence, and correct positioning.

Internal hernia (IH) is a serious complication that can occur after both laparoscopic and open surgery for the treatment of gastric cancer; the transverse colon and mesocolon, act as a natural partition between stomach and the small intestine and, once any type of gastrojejunal anastomosis is constructed, a potential space for internal hernia is created. We present the case of a 68-year-old patient diagnosed with intestinal ischemia due to an IH in the site of the jejunojejunostomy after an open gastrectomy for gastric cancer, treated with negative wound pressure therapy (NWPT) on open abdomen (ABTHERATM dressing).

A sedimentary sequence of fluvial deposits preserved in the Corchia Cave (Alpi Apuane) provides new chronological constraints for the evolution of the cave system and the timing and rate of uplift of this sector of the Alpi Apuane since the late Pliocene. Supported by magnetostratigraphic analysis performed on fine-grained fluvial deposits, and by radiometric dating of speleothems, we suggest that the deposition of fluvial sediments occurred between ~1.6–1.2 Ma. This implies that the host volume of rock was already located close to the local base level, adding key information about the recent tectonic evolution of the Alpi Apuane. A few before ~1 Ma, an erosive phase occurred due to the base-level lowering, followed by continuous speleothem deposition since at least 0.97 Ma. From that time, Monte Corchia uplifted at a maximum rate of ~0.5 mm/year, which is consistent with isostatic uplift mainly driven by erosional unloading. The petrographical study of the fluvial deposits highlights the presence of material derived from the erosion of rocks that today are absent in the cave’s catchment area, suggesting a different surface morphology during the Early Pleistocene. This study highlights the potential of cave sediments as archives for reconstructing the uplift history of mountain ranges.

Worn railway wheels after service in the desert were investigated by means of failure analysis, hardness measurements, tensile tests, fracture toughness tests and low-cycle fatigue (LCF) tests. The results complete both previous small-scale laboratory experiments and FEM simulations performed by the authors on widely used steels and new steel grades allowing to better understand the main damage mechanisms due to the sand. These new steel grades were developed for forged-rolled solid wheels in alternative to AAR Class B/C/D steel grades and were designed to ensure high resistance to wear and rolling contact fatigue in the presence of sand, debris or gravel on the rails. This paper covers the in-depth mechanical characterization of wheels made of the new steels. Hardness measurements, tensile tests, fracture toughness tests and LCF tests were carried out. The results are compared with AAR Class B/C/D steels showing an excellent combination of fracture toughness, cyclic yield strength and ductility.

The interaction between wear and rolling contact fatigue in wet contact was investigated by means of experiments on a two-disk test bench. Specimens of various railway wheel steels were coupled with specimens of the same rail steel, subjected to rolling and sliding wet contact with varying sliding/rolling ratio. Some tests with a dry rolling–sliding contact phase preceding wet contact were carried out as well (dry–wet tests). The pressurization of the fluid entrapped in the surface cracks was the cause of a rapid and severe damage in the dry–wet tests, due to the nucleation of surface cracks by ratcheting in the dry phase, which subsequently propagate in the wet phase. In the wet tests, the fluid pressurization effect was much mitigated due to the absence of initial surface cracks; the specimens subjected to higher sliding/rolling ratio showed the best performance against rolling contact fatigue, due to the effect of wear in reducing the length of surface cracks. A model for assessing the interaction between wear and rolling contact fatigue was proposed, based on the correction of the classical Paris law for crack propagation by taking into account the effect of wear on crack length reduction. The application of the model to the experimental tests allowed finding a correlation between the model predictions and the occurrence of fatigue failure.

In the last decades, the contribution of different scientific disciplines in the field of restoration and conservation of cultural heritage to finding alternative methods of investigation that are even more effective and fully respect artworks, operators and environment, has greatly increased. An example is the University of Milan patent that provides for the use of some specialized bacteria as cleaning agents. This method, known as biocleaning, is based on the use of Desulfovibrio vulgaris, a sulfate reducing bacterium, for the removal of sulfate alterations from stone surfaces. Recently, the university spin-off Micro4yoU purchased the patent by initiating a series of investments aimed at enhancing the commercial product from prototype. The present work describes: the desulfation mechanism operated by Desulfovibrio vulgaris and the technological shift necessary to obtain a biological formulation usable in situ, with two practical case studies.