Abstract:Wastewater treatment is an important link in the water cycle that allows for water sanitation and reuse, facilitates energy generation, and allows for the recovery of products from waste. The scientific community has paid significant attention to wastewater treatment, especially from a technical point of view. Extensive literature is available on new technologies, processes, and materials to improve wastewater treatment. However, scant studies have been conducted in the management field focusing on the development of a performance measurement tool that supports plant managers. The current article addresses this literature gap, developing a reporting tool that integrates technical and cost measures and implements it in a large wastewater utility. The tool successfully identifies cause and effect linkages among key plant performance drivers and supports management in finding activities with poor performance and allows them to delay non-relevant measures of control.
BackgroundMetastatic penile carcinoma derived from cholangiocarcinoma (CCA) has not been previously reported in the literature. Common metastatic sites for CCA include the regional lymph nodes and adjacent organs. CCAs are not highly vascularised tumours, making hematogenous metastases uncommon. Hematogenous CCA metastases commonly occur at distant organs such as the lungs, adrenal glands, and bones. Median survival for patients with metastatic disease is generally less than 1 year.Case presentationA 74-year-old Caucasian man consulted us after having undergone penile ultrasonography for pain and increased thickness at the base of the penis after self-examination. The patient presented with a history of hepatitis C-related cirrhosis and intrahepatic CCA, diagnosed 3 years previously. A biopsy of the corpora cavernosa on both sides revealed a carcinoma harbouring the same histological and immunophenotypical features as the primary hepatic lesion.ConclusionsTo date, there is no case of penile or urogenital system metastasis from CCA described in the literature. Therefore, this article represents the first case report of penile metastasis from CCA.
3D survey and advanced modeling in the study of the Forts of Rome: the Forte Monte AntenneIn the studies the authors are conducting on the entrenched camp of Rome, 3D surveys and digital models are used as means to understand constructions with the aim of developing restoration and re-utilization projects. For Forte Monte Antenne (1882-1891), the authors have carried out systematic studies of the formal and structural aspects. The data acquired from a direct survey and with laser scanner, drone and photogrammetry, integrated with data obtained from iconographic and bibliographic sources, were integrated in the creation of a digital model, which made the classification of the various elements in a structured database possible, including the verification of the relationship among the parts at varying levels, and the system of aeration ducts. Convective motions and the thermo-hygrometric and visual comfort within some of the environments, as well as thermographic surveys of the walls were conducted. The BIM model was integrated, therefore, with a MEP model. The hypothesis of restoration and possible adaptation to new functions cannot disregard the analysis of those parameters which complete the picture of environmental quality and thus of the effective potentials in repurposing of the structure.
Urinary incontinence is a common and debilitating problem in patients undergoing radical prostatectomy. Current methods developed to treat urinary incontinence include conservative treatments, such as lifestyle education, pelvic muscle floor training, pharmacotherapy, and surgical treatments, such as bulking agents use, artificial urinary sphincter implants, retrourethral transobturator slings, and adjustable male sling system. Pelvic floor muscle exercise is the most common management to improve the strength of striated muscles of the pelvic floor to try to recover the sphincter weakness. Antimuscarinic drugs, phosphodiesterase inhibitors, duloxetine, and a-adrenergic drugs have been proposed as medical treatments for urinary incontinence after radical prostatectomy. Development of new surgical techniques, new surgical tools and materials, such as male slings, has provided an improvement of outcomes after UI surgery. Such improvement is still ongoing, and the uptake of new devices might lead to even better outcomes after UI surgery.
The therapeutic landscape of metastatic hormone sensitive and metastatic castration-resistant prostate cancer (mCRPC) is rapidly changing. We reviewed the current treatment options for mCRPC, with insights on new available therapeutic strategies. Chemotherapy with docetaxel or cabazitaxel (for patients progressing on docetaxel), as well as treatment with androgen receptor axis targeted therapies, and Radium-223 are well-established treatment options for patients with mCRPC. The advent of theragnostic in prostate cancer established Lutetium-177 (177Lu)-PSMA-617 as a new standard of care for PSMA-positive mCRPC previously treated with ARAT and taxane-based chemotherapy. Olaparib, a poly-ADP-ribose polymerase (PARP) inhibitor, is approved for selected patients with mCRPC progressed on ARATs and in combination with abiraterone acetate as first-line treatment for mCRPC. Immunotherapy showed limited efficacy in unselected patients with mCRPC and novel immunotherapy strategies need to be explored. The search for biomarkers is a growing field of interest in mCRPC, and predictive biomarkers are needed to support the choice of treatment and the development of tailored strategies.
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