What Germany's grand coalition means for European defence and security

Following months of coalition negotiations, a new German government has finally taken office. But what does the new government mean for the EU? Alessandra Pozzi Rocco writes that with her next term in power now secured, Merkel has the chance to craft EU history further, notably by forging ahead on common defence and security

Negative dispersion without absorption in atomic ensembles

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Tratamento conservador das lesões cervicais não cariosas.

As lesões cervicais não cariosas (LCNC) são lesões com etiologia multifatorial que surgem principalmente na população adulta. Este trabalho tem como objetivo investigar os atuais conhecimentos e métodos de tratamento para essas lesões. Antes de realizar qualquer tratamento, será importante investigar os fatores de risco que levaram ao desenvolvimento da lesão. Reconhecendo que as mudanças progressivas na área cervical do dente fazem parte de um processo fisiologicamente dinâmico que ocorre com o envelhecimento, pode evitar-se intervenção precoce e inútil. Nos casos de dentes assintomáticos, onde a vitalidade e a funcionalidade não estão comprometidas, as lesões podem ser monitorizadas. A intervenção conservadora é indispensável quando a estrutura do dente está comprometida com possível envolvimento da polpa e/ou dos tecidos periodontais, para aliviar a hipersensibilidade ou por razões estéticas. Graças ao desenvolvimento de técnicas adesivas, os materiais de primeira escolha para a execução dessas restaurações são resinas compostas que mostram que possuem propriedades físicas mecânicas e estéticas adequadas. Por fim, para problemas topográficos-anatómicos , o tratamento dessas lesões não pode ignorar a avaliação dos tecidos periodontais. A presença de recessões gengivais e a invasão da amplitude biológica requerem uma abordagem diagnóstica e operativa interdisciplinar conservadora-periodontal para a realização dos objetivos terapêuticos biológicos e estéticos

High-Definition Videobronchoscopy for the Diagnosis of Airway Involvement in Sarcoidosis

BACKGROUND: The ability of high-definition (HD) videobronchoscopy to detect airway involvement in sarcoidosis has not been evaluated previously.RESEARCH QUESTION: What is the role of HD videobronchoscopy in the identification of sarcoidosis-associated airway abnormalities (AAs)? What are the patterns of AAs more commonly observed and more frequently associated with the detection of granulomas in endobronchial biopsy (EBB)?STUDY DESIGN AND METHODS: In this prospective international multicenter cohort study, consecutive patients with suspected sarcoidosis underwent airway inspection with an HD videobronchoscope and EBB using a standardized workflow. AAs were classified according to six patterns defined a priori: nodularity, cobblestoning, thickening, plaque, increased vascularity, and miscellaneous. We assessed diagnostic yield of EBB, prevalence of AAs, and interobserver agreement for different patterns of AAs. RESULTS: AAs were identified in 64 of 134 patients with sarcoidosis (47.8%), with nodularity (n = 23 [17.2%]), plaque (n = 19 [14.2%]), and increased vascularity (n = 19 [14.2%]) being the most prevalent. The diagnostic yield of EBB was 36.6%. AAs were significantly more prevalent in patients with than in those without nonnecrotizing granulomas on EBB (67.4% vs 36.5%; P = .001). Likewise, parenchymal disease on CT scan imaging was signifi- cantly more common in patients with than in those without nonnecrotizing granulomas on EBB (79.6% vs 54.1%; P = .003). On a per-lesion analysis, nonnecrotizing granulomas were seen especially in EBB samples obtained from areas of cobblestoning (9/10 [90%]) and nod-ularity (17/29 [58.6%]). The overall diagnostic yield of random EBB was low (31/134 [23.1%]). The interobserver agreement for the different patterns of AA was fair (Fleiss k = 0.34).INTERPRETATION: In a population with a large prevalence of White Europeans, HD video-bronchoscopy detected AAs in approximately one-half of patients with sarcoidosis. The diagnostic yield of EBB was higher in patients with parenchymal involvement on CT scan imaging and in those with AAs, especially if manifesting as cobblestoning and nodularity.TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT4743596; URL: www.clinicaltrials.go

Autonomous robotic polishing of free-form poly-surfaces: planning from scanning in realistic industrial setting

We propose a novel solution for generating robot tool paths to achieve uniform surface polishing of free-form poly-surfaces, addressing the limitations of imperfect surface reconstruction in real industrial settings and of abruptly varying curvatures. Existing approaches assume perfect 3D surface knowledge and overlook pieces with abrupt changes in principal curvatures, leading to unsatisfactory outcomes like non-smooth paths and incomplete coverage. Our research aims to develop an algorithm that adapts the polishing path for uniform coverage despite imperfect reconstruction or aggressive varying curvatures of the objects to be polished. Users can control the path points density, overlapping, edge proximity, and scanning direction. By segmenting the surface based on curvature similarity and connecting the separately computed trajectories, we minimize polishing time and achieve optimal polishing quality of free -form poly -surfaces in real industrial settings

Parents with binge eating disorders: Which are the influences on adult-child feeding interactions and on the child’s behavioral/emotional functioning?

Feeding during the first years of life represents one of the main domains of adult-child interactions and plays a crucial role in children’s later development. It has been suggested that some kinds of adult psychopathology are more likely to compromise early feeding exchanges. This is the case of parental Binge Eating Disorder (BED) which has resulted to be associated with poor parent–infant interactions during feeding and with children’s emotional and behavioral problems during infancy. The present study aimed to investigate, through a longitudinal research design, the influence of maternal and paternal BED diagnosis on parent–infant feeding interactions and on later children’s behavioral/emotional functioning. The study involved 408 families divided into four groups, according to the presence or absence of BED diagnosis in the parents: Group 1 included families with both parents diagnosed with BED, Group 2 and 3 included families with one parent diagnosed with BED, Group 0 was a healthy control. The assessment took place at two different points, when the children were respectively 18 (T1) and 36 months (T2). Feeding interactions were assessed through the Scale for the Assessment of Feeding Interactions (SVIA) while the children’s behavioral/emotional functioning was evaluated through the Child Behavior Check-List (CBCL). When compared to healthy controls, the groups with one or both parents diagnosed with BED showed higher scores on the SVIA and on the CBCL internalizing and externalizing scales, suggesting more difficulties in adult–child feeding interactions and in the children’s behavioral/emotional functioning. Maternal and paternal BED diagnosis resulted to have a direct effect on feeding interactions and an indirect effect on behavioral/emotional difficulties at 36 months, mediated by the quality of feeding exchanges, both at 18 and 36 months. Moreover the influence of maternal and paternal BED diagnosis resulted to assume a different weight over time. The presence of BED diagnosis in one or both parents appears to affect negatively the quality of adult–infant feeding exchanges and children’s behavioral/emotional functioning over time, thus affecting later child development. These results appear particularly important since they can help to understand more in depth the influence of parental BED diagnosis on child development and on family functioning

Integrating Bayesian Optimization and Machine Learning for the Optimal Configuration of Cloud Systems

Bayesian Optimization (BO) is an efficient method for finding optimal cloud configurations for several types of applications. On the other hand, Machine Learning (ML) can provide helpful knowledge about the application at hand thanks to its predicting capabilities. This work proposes a general approach based on BO, which integrates elements from ML techniques in multiple ways, to find an optimal configuration of recurring jobs running in public and private cloud environments, possibly subject to blackbox constraints, e.g., application execution time or accuracy. We test our approach by considering several use cases, including edge computing, scientific computing, and Big Data applications. Results show that our solution outperforms other state-of-the-art black-box techniques, including classical autotuning and BO- and ML-based algorithms, reducing the number of unfeasible executions and corresponding costs up to 2–4 times

Prevalence of methicillin-resistant staphylococci isolated from different biological samples at Policlinico Umberto I of Rome: correlation with vancomycin susceptibility

The methicillin-resistance is increasing all over the world in the last decade. It is more frequent among coagulase-negative staphylococci (MRCoNS); infact the 52% of S. epidermidis strains results to be resistant to methicillin.The methicillin-resistant strains also show a reduced sensitivity towards the first-line agents such as glycopeptides and other antibiotics commonly used in therapy such as trimethoprim-sulphamethoxazole, imipenem, gentamycin, fosfomycin and chlarytromicin. Unlike MRSA (Methicillin-resistant S. aureus), MRCoNS resistance to glycopeptides generally concerns teicoplanin. Although vancomycin resistance is rare in Staphylococcus isolates, the detected shift towards higher values of MICs might affect patient's clinical outcome

Age and diabetes related changes of the retinal capillaries: an ultrastructural and immunohistochemical study

Normal human aging and diabetes are associated with a gradual decrease of cerebral flow in the brain with changes in vascular architecture. Thickening of the capillary basement membrane and microvascular fibrosis are evident in the central nervous system of elderly and diabetic patients. Current findings assign a primary role to endothelial dysfunction as a cause of basement membrane (BM) thickening, while retinal alterations are considered to be a secondary cause of either ischemia or exudation. The aim of this study was to reveal any initial retinal alterations and variations in the BM of retinal capillaries during diabetes and aging as compared to healthy controls. Moreover, we investigated the potential role of vascular endothelial growth factor (VEGF) and pro-inflammatory cytokines in diabetic retina.Transmission electron microscopy (TEM) was performed on 46 enucleated human eyes with particular attention to alterations of the retinal capillary wall and Müller glial cells. Inflammatory cytokines expression in the retina was investigated by immunohistochemistry.Our electron microscopy findings demonstrated that thickening of the BM begins primarily at the level of the glial side of the retina during aging and diabetes. The Müller cells showed numerous cytoplasmic endosomes and highly electron-dense lysosomes which surrounded the retinal capillaries. Our study is the first to present morphological evidence that Müller cells start to deposit excessive BM material in retinal capillaries during aging and diabetes. Our results confirm the induction of pro-inflammatory cytokines TNF-α and IL-1β within the retina as a result of diabetes.These observations strongly suggest that inflammatory cytokines and changes in the metabolism of Müller glial cells rather than changes in of endothelial cells may play a primary role in the alteration of retinal capillaries BM during aging and diabetes

A Novel null homozygous mutation confirms <i>CACNA2D2</i> as a gene mutated in epileptic encephalopathy

Contribution to epileptic encephalopathy (EE) of mutations in CACNA2D2, encoding α2δ-2 subunit of Voltage Dependent Calcium Channels, is unclear. To date only one CACNA2D2 mutation altering channel functionality has been identified in a single family. In the same family, a rare CELSR3 polymorphism also segregated with disease. Involvement of CACNA2D2 in EE is therefore not confirmed, while that of CELSR3 is questionable. In a patient with epilepsy, dyskinesia, cerebellar atrophy, psychomotor delay and dysmorphic features, offspring to consanguineous parents, we performed whole exome sequencing (WES) for homozygosity mapping and mutation detection. WES identified extended autozygosity on chromosome 3, containing two novel homozygous candidate mutations: c.1295delA (p.Asn432fs) in CACNA2D2 and c.G6407A (p.Gly2136Asp) in CELSR3. Gene prioritization pointed to CACNA2D2 as the most prominent candidate gene. The WES finding in CACNA2D2 resulted to be statistically significant (p = 0.032), unlike that in CELSR3. CACNA2D2 homozygous c.1295delA essentially abolished α2δ-2 expression. In summary, we identified a novel null CACNA2D2 mutation associated to a clinical phenotype strikingly similar to the Cacna2d2 null mouse model. Molecular and statistical analyses together argued in favor of a causal contribution of CACNA2D2 mutations to EE, while suggested that finding in CELSR3, although potentially damaging, is likely incidental