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Objective The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East–West gradient in the incidence of IBD in Europe exists. Design A prospective, uniformly diagnosed, population based inception cohort of IBD patients in 31 centres from 14 Western and eight Eastern European countries covering a total background population of approximately 10.1 million people was created. One-third of the centres had previous experience with inception cohorts. Patients were entered into a low cost, web based epidemiological database, making participation possible regardless of socioeconomic status and prior experience. Results 1515 patients aged 15 years or older were included, of whom 535 (35%) were diagnosed with Crohn's disease (CD), 813 (54%) with ulcerative colitis (UC) and 167 (11%) with IBD unclassified (IBDU). The overall incidence rate ratios in all Western European centres were 1.9 (95% CI 1.5 to 2.4) for CD and 2.1 (95% CI 1.8 to 2.6) for UC compared with Eastern European centres. The median crude annual incidence rates per 100 000 in 2010 for CD were 6.5 (range 0–10.7) in Western European centres and 3.1 (range 0.4–11.5) in Eastern European centres, for UC 10.8 (range 2.9–31.5) and 4.1 (range 2.4–10.3), respectively, and for IBDU 1.9 (range 0–39.4) and 0 (range 0–1.2), respectively. In Western Europe, 92% of CD, 78% of UC and 74% of IBDU patients had a colonoscopy performed as the diagnostic procedure compared with 90%, 100% and 96%, respectively, in Eastern Europe. 8% of CD and 1% of UC patients in both regions underwent surgery within the first 3 months of the onset of disease. 7% of CD patients and 3% of UC patients from Western Europe received biological treatment as rescue therapy. Of all European CD patients, 20% received only 5-aminosalicylates as induction therapy. Conclusions An East–West gradient in IBD incidence exists in Europe. Among this inception cohort—including indolent and aggressive cases—international guidelines for diagnosis and initial treatment are not being followed uniformly by physicians.

The objective of this study was to demonstrate a dose-response effect with 1- and 2-tablet doses of combination hydrocodone 7.5 mg with ibuprofen 200 mg and placebo in patients with moderate to severe postoperative abdominal or gynecologic pain. Hydrocodone 7.5 mg with ibuprofen 200 mg is the only approved fixed-dose combination analgesic containing an opioid and ibuprofen. Previous studies with this combination have demonstrated that the components have an additive analgesic effect as well as efficacy compared with other fixed-dose combination analgesics. This randomized, parallel-group, double-blind, single-dose, placebo-controlled study compared 1 tablet of hydrocodone 7.5 mg with ibuprofen 200 mg (n = 60), 2 tablets of hydrocodone 7.5 mg with ibuprofen 200 mg (n = 60), and placebo (n = 60) in patients with moderate or severe pain after abdominal or gynecologic surgery. Analgesia was evaluated over 8 hours. Mean pain relief (PR) scores were significantly greater for the 2-tablet dose than for the 1-tablet dose at 80 (P = 0.027) and 100 (P = 0.017) minutes and at 2 (P = 0.013), 2.5 (P = 0.012), 3 (P = 0.006), 4 (P = 0.029), 5 (P = 0.002), 6 (P = 0.032), 7 (P = 0.036), and 8 (P = 0.01) hours. Mean pain intensity difference scores were significantly greater for the 2-tablet dose than for the 1-tablet dose at 80 (P = 0.013) and 100 (P = 0.007) minutes and at 2 (P = 0.003), 2.5 (P = 0.002), 3 (P = 0.002), 4 (P = 0.009), 5 Accepted for publication June 7, 2000. Printed in the USA. Reproduction in whole or part is not permitted. 990 0149-2918/00/$19.00 (P < 0.001), 6 (P = 0.004), 7 (P = 0.009), and 8 (P = 0.001) hours. Mean total PR scores were significantly greater for the 2-tablet dose than for the 1-tablet dose for all measured time intervals (0 to 3 hours, P = 0.01; 0 to 4 hours, P = 0.006; 0 to 6 hours, P = 0.003; 0 to 8 hours, P = 0.003). Mean sum of pain intensity differences was significantly greater for the 2-tablet dose than for the 1-tablet dose for all measured time intervals (0 to 3 hours, P = 0.004; 0 to 4 hours, P < 0.001; 0 to 6 hours, P < 0.001; 0 to 8 hours, P < 0.001). Mean peak PR score and median time-to-remedication were significantly greater for the 2-tablet dose than for the 1-tablet dose (P < 0.029 and P = 0.017, respectively). Both doses were superior to placebo. There were no significant differences in the number of patients experiencing adverse events between the 2-tablet dose (n = 6 [10.0%]), the 1-tablet dose (n = 4 [6.7%]), and placebo (n = 1 [1.7%]). Adverse events were not serious, and none of the patients discontinued therapy because of side effects. This study demonstrated that a 2-tablet dose of hydrocodone with ibuprofen provided significantly more analgesia than a 1-tablet dose (a positive dose-response effect) and that both doses were superior to placebo.

Genital involvement is a rare manifestation in discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE), and there are few reports on vulvar clinical features. We describe a 41-year old Caucasian woman with bilateral vulvar DLE. Although vulvar lesions in lupus are probably more common than is realized, the present report is the first case of genital DLE documented in a female.

We report here the case of an epithelioid haemangioendothelioma (EHE) arising in the nasal cavity which is, to the best of our knowledge, the first ever described example in the world literature in that particular site. The patient is a 23-year-old male who presented with repeated episodes of epistaxis from the nasal cavity and with a 1.5 cm reddish, polypoid, smooth, spontaneously bleeding nodule in the rightmiddle meatus. This lesion was histologically diagnosed as epithelioid haemangioendothelioma. Immunohistochemically the neoplasm displayed striking positivity for CD31, CD34 and vimentin. A surgical approach was performed by ’facial degloving’, removing the right inferior turbinate, the anterior two-thirds of the middle turbinate and the medial wall of the ethmoid bone. After 12 months follow-up the patient is disease-free, without any local or distant recurrence.

This paper investigates the complex interaction between wave hydrodynamics and aquatic vegetation, emphasizing its importance for the management of coastal ecosystems. Vegetation plays a crucial role in the dynamics of river and coastal flows, influencing their structure and turbulence, as well as the transport and distribution of nutrients, sediments, ecosystems, and habitats. For example, mangroves serve as a natural defense against tsunamis and extreme waves. Nature-based coastal defense technologies are increasingly being adopted, in alignment with the principles of ecohydraulics. Riparian vegetation represents one of the most effective nature-based solutions for coastal protection. In addition, lagoons and estuarine areas often feature structures such as mussel farms and boat guides, such as the Venetian Briccole. Therefore, accurate evaluation of wave transmission through cylindrical stem arrays is essential to assess their coastal protection capabilities and designing effective protective structures, such as mangrove restoration projects. This paper presents a theoretical study of wave attenuation for regular (Airy) and solitary waves propagating through rigid, emergent, and submerged cylindrical stems on horizontal and sloping bottoms. The theoretical model results are compared with numerical simulations obtained using the SPH (Smoothed Particle Hydrodynamics) Lagrangian numerical code, which does not rely on mesh-based methods. Furthermore, the bulk drag coefficients of rigid stem arrays are evaluated on the basis of stem density, diameter, and submersion ratio. This paper aims to engage a broad audience, including scientists and practitioners in ecohydrology, coastal hydrodynamics, and environmental management, providing actionable insights to improve the ecological resilience of coastal systems.

A forest of the black coral Antipathella subpinnata was found from 52 to 80 m depth in three different sites at Tremiti Islands Marine Protected Area (MPA; Mediterranean Sea), with two of them hosting a monospecific forest on horizontal and vertical substrates. Colonies of A. subpinnata showed a mean density between 0.22 ± 0.03 and 2.40 ± 0.26 colonies m −2 (maximum local values of 2.4–7.2 colonies m −2 ). The link between the local distribution of A. subpinnata and the main oceanographic features confirmed the fundamental role of the currents in shaping the distribution of the species in presence of hard substrata. This black coral forest represents the only one known thus far in the Adriatic Sea, but it could be linked with other unseen forests all over the Mediterranean Sea. The associated megafauna highlights the importance of these forests as habitat for species of both conservation and commercial importance but, at the same time, makes such habitat a target for fishing practices, as many lost fishing gears were found within the coral forest. The enlargement of the MPA borders and the enforcement of controls in the area of the A. subpinnata forest is urgently needed for the proper conservation of this protected species.

The effects of global warming have been addressed on coral reefs in tropical areas, while it is still unclear how coral forests are reacting, particularly at temperate latitudes. Here we show how mesophotic coral forests are affected by global warming in the Mediterranean Sea. We highlight how the current warming trend is causing the lowering of the thermocline and it is enhancing mucilaginous blooms. These stressors are facilitating a massive macroalgal epibiosis on living corals, here reported for the first time from different areas in the Western and Central Mediterranean Sea. We provide a focus of this phenomenon at Tremiti Islands Marine Protected Area (Adriatic Sea), were the density of the endemic red gorgonian Paramuricea clavata decreased of up to 47% in 5 years, while up to the 96% of the living corals showed signs of stress and macroalgal epibiosis. Only populations deeper than 60 m depth were not touched by this emerging phenomenon. Spot observations performed at Tuscan Archipelago and Tavolara Marine Protected Area (Tyrrhenian Sea) suggest that this this combination of stressors is likely widespread at basin scale.

Science and engineering research studies are currently concentrating on synthesizing, designing, producing, and consuming ecologically benign chemical species to replace harmful chemicals. This is due to the increasing demands of conservation knowledge and strict ecological regulations. Numerous environmentally friendly substitutes produced from natural resources, including biopolymers, plant extracts, chemical pharmaceuticals (drugs), and so on, are now frequently used as inhibitors to replace dangerous corrosion inhibitors. Many compounds have been extensively used. A range of methods, including physisorption, chemisorption, barrier protection, thin-film growth, and electrochemical procedures, will be used to provide corrosion resistance. The various kinds of corrosion inhibitors (CIs), the mechanisms underlying inhibition, and the evaluation procedures have all been covered in-depth. This review provides an overview of the relevant literature in which researchers and scientists used different types of CIs, the effect of CIs on metals, and information about designs and mechanisms used to minimize corrosion in a variety of equipment composed of alloys or metals, along with electrochemical evaluation studies. This review will provide scholars with fresh insights to advance the discipline.

The present work aims at illustrating how the joint use of monitoring data and numerical models can be beneficial in understanding coastal processes. In the first part, we show and discuss an annual dataset provided by a monitoring system installed in a vulnerable coastal basin located in Southern Italy, subjected to human and industrial pressures. The collected data have been processed and analysed to detect the temporal evolution of the most representative parameters of the inspected site and have been compared with recordings from previous years to investigate recursive trends. In the second part, to demonstrate to what extent such type of monitoring actions is necessary and useful, the same data have been used to calibrate and run a 3D hydrodynamic model. After this, a reliable circulation pattern in the basin has been reproduced. Successively, an oil pollution transport model has been added to the hydrodynamic model, with the aim to present the response of the basin to some hypothetical cases of oil spills, caused by a ship failure. It is evident that the profitable prediction of the hydrodynamic processes and the transport and dispersion of contaminants strictly depends on the quality and reliability of the input data as well as on the calibration made.

This paper presents a brief history of the hydraulic jump and a literature review on hydraulic jumps’ experimental and numerical studies. Leonardo da Vinci noticed this phenomenon early on, but it was only later studied by Bidone in 1820. Since the beginning of the 20th century, the hydraulic jump has received a lot of attention following the development of energy dissipater designs and stilling basins. The late 1920s and early 1930s saw many experimental studies researching the surface roller profile and energy dissipation. The study of internal flow features started in the late 1950s. Starting in the 70s, it was believed that the flow of a jump must be analyzed in its actual configuration of air–water mixture, an aspect that cannot be overlooked. Several experimental studies in the late 1980s and 1990s highlighted the existence of oscillating phenomena under specific flow conditions and particularly, a cyclic variation of jump types over long-lasting experiments. The early 2000s saw many experimental studies researching the complex structure of the separated region in very large channels downstream of the lateral shockwaves. Whereas most of the experiments provide measurements at a point or on a plane, the complete flow field supplied by CFD simulations enables us to have a deeper understanding of the dynamics of coherent structures that are responsible for free-surface fluctuations and aeration in hydraulic jumps. Therefore, in recent years, the computational fluid dynamics (CFD) method, through turbulence models, has become a useful tool to study this complex environmental fluid mechanic problem.