The aim of this paper is the design of a Solar-Electric Boat for tourists’ transport along the coast, in the rivers, in the lakes. Our idea is to define the project guidelines for the realization of a zero impact boat. This paper illustrates the practical new technologies (naval architecture small craft design, mechanical and electrical design), rational design and engineering approach, safety and reliability methods used in solar boats. In our project, the boat is powered by lith- ium-ion batteries that can be charged at any time by the photovoltaic generator placed on a flat top structure. The pro- ject is designed for brief trip around coast, where the public transport becomes very polluting during summer. Starting from the consideration that this boat is used during sunny weather, it is possible to know the boat’s energy demand and proceed with the design of a suitable electric boat and of the energy storage/management system. It is also proposed an innovative management of charge/discharge of the batteries. With this management, we have optimized the use and prolonged the time of life of the batteries during the navigation and the control of the real autonomy of it

Background & Aims The ultrasound‐based controlled attenuation parameter (CAP) is a non‐invasive tool widely validated for assessing liver steatosis across different etiologies. However, few studies, with liver biopsy available, have investigated its performance in individuals with morbid obesity. Herein, we aimed to evaluate the diagnostic accuracy of CAP in participants with morbid obesity from the MAFALDA study before bariatric surgery. Methods A total of 120 individuals with valid examinations within three months from bariatric surgery were included. Clinical, laboratory, FibroScan® (XL probe), and liver biopsy data were collected using standardized procedures. The overall accuracy of CAP for detecting liver steatosis was estimated by the area under the receiver‐operating characteristics curve (AUROC). Optimal cut‐offs were chosen at points with the highest Youden index. Results The AUROCs of CAP for detecting S ≥ S1, S ≥ S2, and S = S3 were 0.91 (95% CI 0.86–0.97), 0.83 (95% CI 0.76–0.90), and 0.86 (95% CI 0.79–0.94), respectively. The best CAP cut‐offs for S ≥ S1, S ≥ S2, and S = S3 were 300 dB/m (95% CI 275–316), 328 dB/m (95% CI 296–345), and 344 dB/m (95% CI 343–352), respectively. CAP values were independently influenced by steatosis grade (estimate 20.60, 95% CI 12.70–28.40, P = 1.05 × 10−6). The AUROC of FibroScan‐AST (FAST) score for detecting progressive non‐alcoholic steatohepatitis was 0.76 (95% CI 0.66–0.86). Conclusions In individuals with morbid obesity, CAP measured by XL probe is an accurate non‐invasive tool for grading liver steatosis. Measurement of liver fat content by CAP may help identify those eligible for bariatric procedures and estimate the effect of bariatric surgery on hepatic steatosis. Lay Summary The ultrasound‐based controlled attenuation parameter (CAP) by using the XL probe has an excellent performance for grading liver steatosis among individuals with morbid obesity. CAP may represent an accurate tool for the non‐invasive assessment of liver steatosis among individuals with morbid obesity before and after bariatric surgery.

INTRODUCTION Cigarette smoking is the most important risk factor for Crohn's disease (CD). The effectiveness of smoking cessation programs (SCPs) in patients with CD is still poorly understood. METHODS This was a retrospective, observational, single-centre, cohort study of 136 active smokers with mean age 55 years (SD=11), 58% males, including 27 (19.8%) patients with CD who entered the multidisciplinary SCP of the Luigi Sacco University Hospital of Milan from January 2017 through January 2019. A pulmonologist was responsible for the clinical and pharmacological management, while a psychiatrist and a psychologist conducted the counselling and assessed the motivation to quit, anxiety and depression using the Brief Psychiatric Rating Scale (BPRS) and the nicotine dependence with the Fagerström test. Patients were defined as quitters after 12 months. RESULTS Demographic and clinical characteristics, and Fagerström score, did not differ in patients with and without CD. At baseline, patients with CD had a higher BPRS (median: 27, IQR: 22-32; vs 25 and 22-28.5; p=0.03), and a lower motivation to quit score (median: 10, IQR: 9-13; vs 14 and 12-15; p<0.001). After 12 months, the quitting rate of smokers with CD was significantly lower (14.8% vs 36.7%; p<0.022) and the chance of quitting was negatively associated with the baseline BPRS (r=-0.256; p<0.003). Varenicline and nicotine replacement therapy tended to be less effective in patients with CD. CONCLUSIONS The lower efficacy of SCPs in patients with CD might be secondary to a higher prevalence of anxiety and depression. Psychological issue recognition and support should be enhanced to increase SCP effectiveness in CD.

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