Evaluation of Ingenol mebutate efficacy for the treatment of actinic keratosis with Antera 3D camera

OBJECTIVE: Cumulative exposure of the skin to ultraviolet radiation promotes mutation in keratinocytes and their abnormal growth led to the formation of scaly lesions, called actinic keratoses (AKs). Its incidence is growing at an emerging rate, becoming a worldwide problem especially for occupational ultraviolet (UV) rays exposure. Detectable lesions are often associated with field changes, where the surrounding skin is altered and subclinical lesions may be present. Thus, a field-directed therapy, such as topical treatment, should be preferred for the prevention of invasive cancer development. A retrospective analysis was made, evaluating the efficacy of ingenol-mebutate gel, using a novel device the 3D in vivo optical skin Imaging (Antera 3D, Miravex, Ireland). PATIENTS AND METHODS: We included all patients with multiple non-hypertrophic Aks, to whom it was prescribed ingenol-mebutate gel, applied at the dosages of 0.015 for lesions in the scalp/face (for 3 consecutive days) and at the dosage of 0.05% for lesions in the trunk and/or extremities (for 2 consecutive days). RESULTS: A reduction of the lesions and of median hemoglobin levels, after a follow-up of 60 days, was observed in 100% of patients. CONCLUSIONS: Ingenol mebutate gel, the last topical molecule appeared in the Italian market showed its efficacy using Antera 3D also in terms of hemoglobin reduction. Therefore, this camera could be considered an useful tool for the identification of the area to be treated and for therapeutic follow-up

Speed data collection methods: a review

Various studies have been focusing on a wide range of techniques to detect traffic flow characteristics, like speed and travel times. Therefore, a key aspect to obtain statistically significant set of data is to observe and record driver behaviours in real world. To collect traffic data, traditional methods of traffic measurement - such as detection stations, radar guns or video cameras - have been used over the years. Other innovative methods refer to probe vehicles equipped with GPS devices and/or cameras, which allow continuous surveys along the entire road route. While point-based devices provide information of the entire flow, just in the section in which they are installed and only in the time domain, probe vehicles data are referred both to temporal and space domains but ignore traffic conditions. Obviously, it is necessary that the data collected refer to representative samples, by number and composition, of the user population. The paper proposes a review of the most used methods for speed data collection, highlighting the advantages and disadvantages of each experimental approach. Accordingly, the comparison illustrates the best relief method to be adopted depending on the research and investigation that will be performed

Blending of Floating Car Data and Point-Based Sensor Data to Deduce Operating Speeds under Different Traffic Flow Conditions

Nowadays, smart mobility can rely on innovative tools for the knowledge of road system conditions, like operating speed data extracted from the so-called Floating Car Data (FCD). Probe vehicles in the traffic flow send to operation centres a large amount of travel information, collected through GPS detection systems, especially with regard to geolocation, date and time, direction and speed. As the sample deriving from these vehicles represents a tiny portion of the entire vehicular fleet, in this paper an analysis and a comparison with data obtained by point-based traffic sensors is proposed.Therefore, the study analyses data collected by inductive loop detectors and microwave radar sensors, that provide information on the entire traffic flow in the time domain, in particular with the aim to identify free flow speed time bands. Afterwards, by means of the fusion between the results obtained from the data coming from these point-based control units and the ones coming from the probe vehicles, a comparison of the operating speeds in the two conditions of constrained and unconstrained traffic flow is performed

Effectiveness of Climbing Lanes for Slow-Moving Vehicles When Riding Uphill: A Microsimulation Study

Long uphill stretches of single-carriageway rural roads with one lane per travel direction may reduce the Level of Service (LoS), due to the decreased speed of heavy vehicles. In those circumstances, a slowdown of traffic, resulting in the formation of platoons, may be generated due to the difficulty of performing overtaking maneuvers safely. To solve this critical issue, an additional (climbing) lane for slow vehicles may be included in the road platform. This study aims to evaluate the effectiveness of such climbing lanes in a real case in Italy (National Road n. 4 “Via Salaria”— around 44+000 km). Using a microsimulation model implemented in VISSIM, the study analyzes speeds and travel times, delays, and queuing waiting times, comparing the Actual Scenario (AS) without climbing lanes, with two counterfactual scenarios: the first one (CS1) with three stretches of climbing lanes, and the second one (CS2), with just two stretches, in which the first two additional lanes of CS1 are merged together. The obtained results confirm the effectiveness of installing climbing lanes on road sections with the described characteristics, and the potential of microsimulation models also to carry out such kind of evaluations

Road Infrastructure Safety Management. Proactive Safety Tools to Evaluate Potential Conditions of Risk

The identification of highly critical sections in a road network is possible by examining the network operation, with the goal of determining the risk factors and observe the critical issues, in order to better plan possible improvements. Therefore, this study proposes a method to evaluate the coherence of existing road layouts, through the analysis of the geometric characteristics, theoretical speeds and drivers operating speeds, under different environmental and flow conditions. The analysis focuses on the road network managed by ANAS SpA in the Veneto Region, for which the reconstruction of the road axes geometry, the curvature graph and the theoretical design speed profile have been obtained, according to the indications of the Italian Ministerial Decree 05/11/2001. The theoretical design speed profile has then been compared with the information relating to the road users' mobility, in terms of the 85th percentile speeds, obtained from the extraction and analysis of the Floating Car Data (FCD). The data were processed by reconstructing the continuous profile of operating speeds with a specific regression function known as "smoothing cubic spline". The comparison with the theoretical design speeds allows to observe whether the users assume a behavior close to or distant from what is expected, based on the technical and geometrical characteristics of the road layout. The proposed methodology can contribute to the implementation of a proactive road safety check, aimed at recognizing and assessing the potential risk conditions for road traffic, with particular attention to the point of view of the road user

Thyroid ultrasonography reporting: consensus of Italian Thyroid Association (AIT), Italian Society of Endocrinology (SIE), Italian Society of Ultrasonography in Medicine and Biology (SIUMB) and Ultrasound Chapter of Italian Society of Medical Radiology (SIRM)

Thyroid ultrasonography (US) is the gold standard for thyroid imaging and its widespread use is due to an optimal spatial resolution for superficial anatomic structures, a low cost and the lack of health risks. Thyroid US is a pivotal tool for the diagnosis and follow-up of autoimmune thyroid diseases, for assessing nodule size and echostructure and defining the risk of malignancy in thyroid nodules. The main limitation of US is the poor reproducibility, due to the variable experience of the operators and the different performance and settings of the equipments. Aim of this consensus statement is to standardize the report of thyroid US through the definition of common minimum requirements and a correct terminology. US patterns of autoimmune thyroid diseases are defined. US signs of malignancy in thyroid nodules are classified and scored in each nodule. We also propose a simplified nodule risk stratification, based on the predictive value of each US sign, classified and scored according to the strength of association with malignancy, but also to the estimated reproducibility among different operators

Primary cutaneous alk positive anaplastic large cell lymphoma in a melanoma patient

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a raresubset of CD30+ lymphoproliferative disorder, characterized by the presenceof large anaplastic cells, which express CD30, CD2, CD3, CD4, and CD5. A 62 year-old male patient presented to our Institute with a history of a fastgrowing and pinkish-brown asymptomatic cutaneous nodule. His medical past history was positive for a malignant melanoma (MM) of the abdomen (0.7 mm Breslow thickness; pT1a). Histologically the lesion showed a diffuse infiltrate consisting in cohesive sheets of large cells with anaplastic morphology with a kidney-shaped nucleus, also known as hallmark cells. Immunohistochemical studies revealed a CD30 expression, and a positivity to perforin and anaplastic lymphoma kinase (ALK). The laboratory and instrumental investigations were all normal and a final diagnosis of PCALCL was made. The patient showed a good response to radiotherapy. Usually PCALCL shares with systemic anaplastic large cell lymphoma (ALCL) the presence of neoplastic CD30+ large T cells, but lack ALK translocations and protein expression. However, the detection of ALK expression in PCALCL should be considered highly suspicious of a cutaneous manifestation of an underlying systemic disease (not detected in our patient). We recommend to exclude a systemic involvement in this kind of disease, with a strict follow-up, especially in patients with double malignancies

Eco-efficient asphalt recycling for urban slow mobility

Cycling infrastructures contribute to advancing zero-impact transport systems, aligning with the European Commission’s proactive climate change mitigation policies. This paper explores the potential of innovative and sustainable pavements for cycling paths with mixtures composed of road-milling materials. This investigation involves low-environmental-impact bituminous-based mixtures differing from recipe, mixing method, and laying. Up to 100% secondary aggregates are used as alternative materials to design the Grande Raccordo Anulare delle Biciclette (GRAB), a 44-km cycling ring in Rome. According to the European standard EN 15804, their “from cradle to gate” life cycle analysis allows a comprehensive assess- ment and comparison of the environmental impact. Core and additional environmental impact categories and resource use indicators were quantified using primary data from asphalt producers and secondary data from the Ecoinvent database in the SimaPro software. Within the H2020 InfraROB project (grant agreement no. 955337), which aims at enhancing road infrastructure integrity, performance, and safety through autonomous robotic solutions and modularization, experimental sections have been constructed using a cold-mixed asphalt composed entirely of recycled asphalt and a rejuvenating addi- tive. The results underscore the potential of the examined low-impact approach in conserving Earth’s resources, ensuring long-lasting infrastructure for vulnerable urban populations and fostering sustainable environmental management

Paraneoplastic pemphigus. A trait d’union between dermatology and oncology

Paraneoplastic pemphigus is a rare autoimmune disease of the skin associated with neoplasm. Nowadays, the pathogenesis of paraneoplastic pemphigus is not fully understood. Due to its rarity, various criteria have been proposed for the diagnosis. For this reason, several diagnostic methods have been considered useful for the diagnosis of paraneoplastic pemphigus including indirect immunofluorescence, direct immune of fluorescence, immunoprecipitation,immunoblotting, and enzyme-linked immunosorbent assay (ELISA). However, the polymorphic clinical features and the various results of laboratory tests and pathological evaluation present a challenge for the clinician

Diagnostic Imaging of Agminated Blue Lesions and Blue Lesions with Satellitosis: Case Series with a Concise Review of the Current Literature

Background: Agmination and or satellitosis in pigmented blue lesions is a phenomenon rarely mentioned in the literature and not well known. This phenomenon can be expressed by several benign and malignant pigmented blue lesions, such as blue nevi, Spitz nevi, melanocytoma and melanoma. On this spectrum, dermoscopy, reflectance confocal microscopy (RCM) and dynamic Optical coherence tomography (D-OCT) represent non-invasive imaging technologies, which may help clinicians in the diagnosis of melanoma and non-melanoma skin cancers in daily clinical practice. Methods: Currently, in the literature there is a lack of new data about agminated blue lesions and blues lesions with satellitosis, as well as the lack of a recent and updated review of the literature about this topic. Therefore, considering that clinicians must be confident with the diagnosis of these rare skin lesions, we decided to carry out this work. Results: In this paper, four new cases of agminated pigmented cutaneous lesions were described. Moreover, a review of the current literature on this topic was performed. Conclusions: A clinical pathological correlation is often needed to reach a correct diagnosis; currently, dermoscopy and non-invasive diagnostic techniques, such as reflectance confocal microscopy and optical coherence tomography, due to the depth of these skin lesions in the dermis, can only make a partial and limited contribution