Duodenal Malignant Somatostatinoma

The authors report a case of hormonally silent duodenal somatostatinoma. The main clinical features, the natural history and the currently available therapies of these rare neoplasms are described on the basis of this case and of the scientific literature. Although the antiblastic therapies are still debated, the patient showed a surprising outcome following chemotherapy

Prevalence of erectile dysfunction in patients with abdominal aortic aneurysm: an exploratory study

Erectile dysfunction (ED) is defined as the recurrent inability to achieve and maintain a satisfactory erection for sexual intercourse. Many studies have highlighted that ED shares common cardiovascular risk factors with cardiovascular disease. No data are reported about the prevalence of ED in patients with the abdominal aortic aneurysm (AAA). The aim of our study was to investigate the preoperative information given about sexual functions of patients undergoing endovascular aneurysm repair (EVAR) and to compare it with the presence and severity of steno-occlusive atherosclerotic lesions of the pelvic arterial tree at pre-operative Computed Tomography Angiography (CTA).Methods: We prospectively enrolled all men patients who underwent elective EVAR from September to November 2021. Preoperative ED was evaluated using the International Index of Erectile Function (IIEF-5) questionnaire. Preoperative imaging was routinely performed with CTA scan of the abdominal aorta and iliac-pelvic district. An innovative score of pelvic arterial disease associated to AAA was defined, dividing the iliac district in 4 zones attributing a grading of severity for each zone bilaterally (score ranges 0–24). Linear regression analysis was used to correlate IIEF-5 score to anatomical score of pelvic arterial steno-occlusive disease.Results: A total of 25 patients were enrolled. Median age was 74 ± 5.3 years. IIEF-5 average score was 14.8 ± 7.1. Eight cases (32%) had severe ED; one case (4%) had moderate, five patients (20%) had mild to moderate ED; five patients (20%) had mild ED, and 6 (24%) patients had no ED. CTA evaluation revealed an average anatomical score of 7.9 ± 4.5. Pelvic disease was considered moderate-severe in 20 cases (80%) and not significant in 20% (five cases). Linear regression analysis confirmed the hypothesis that a more diseased pelvic arterial tree was correlated to a more severe ED (Y = -1.531* × + 26.35 [slope CI: -1.946 to-1.117, p < 0.0001]).Conclusion: Although typically unreported, the prevalence of ED associated to AAA was found to be high. A vasculogenic origin of ED in patients with AAA is plausible and may be easily confirmed by the evaluation of pelvic arterial distribution at angio-CT performed for EVAR planning. Our proposed “MAPPING AND SCORING SHEET” may help to identify the vasculogenic origin of ED in AAA patients

Error mapping controller: a closed loop neuroprosthesis controlled by artificial neural networks

BACKGROUND: The design of an optimal neuroprostheses controller and its clinical use presents several challenges. First, the physiological system is characterized by highly inter-subjects varying properties and also by non stationary behaviour with time, due to conditioning level and fatigue. Secondly, the easiness to use in routine clinical practice requires experienced operators. Therefore, feedback controllers, avoiding long setting procedures, are required. METHODS: The error mapping controller (EMC) here proposed uses artificial neural networks (ANNs) both for the design of an inverse model and of a feedback controller. A neuromuscular model is used to validate the performance of the controllers in simulations. The EMC performance is compared to a Proportional Integral Derivative (PID) included in an anti wind-up scheme (called PIDAW) and to a controller with an ANN as inverse model and a PID in the feedback loop (NEUROPID). In addition tests on the EMC robustness in response to variations of the Plant parameters and to mechanical disturbances are carried out. RESULTS: The EMC shows improvements with respect to the other controllers in tracking accuracy, capability to prolong exercise managing fatigue, robustness to parameter variations and resistance to mechanical disturbances. CONCLUSION: Different from the other controllers, the EMC is capable of balancing between tracking accuracy and mapping of fatigue during the exercise. In this way, it avoids overstressing muscles and allows a considerable prolongation of the movement. The collection of the training sets does not require any particular experimental setting and can be introduced in routine clinical practice

Integration of Static and Dynamic Analysis Techniques for Checking Noninterference

In this article, we present an overview of recent combinations of deductive program verification and automatic test generation on the one hand and static analysis on the other hand, with the goal of checking noninterference. Noninterference is the non-functional property that certain confidential information cannot leak to certain public output, i.e., the confidentiality of that information is always preserved. We define the noninterference properties that are checked along with the individual approaches that we use in different combinations. In one use case, our framework for checking noninterference employs deductive verification to automatically generate tests for noninterference violations with an improved test coverage. In another use case, the framework provides two combinations of deductive verification with static analysis based on system dependence graphs to prove noninterference, thereby reducing the effort for deductive verification

Using theorem provers to increase the precision of dependence analysis for information flow control

Information flow control (IFC) is a category of techniques for enforcing information flow properties. In this paper we present the Combined Approach, a novel IFC technique that combines a scalable system-dependence-graph-based (SDG-based) approach with a precise logic-based approach based on a theorem prover. The Combined Approach has an increased precision compared with the SDG-based approach on its own, without sacrificing its scalability. For every potential illegal information flow reported by the SDG-based approach, the Combined Approach automatically generates proof obligations that, if valid, prove that there is no program path for which the reported information flow can happen. These proof obligations are then relayed to the logic-based approach. We also show how the SDG-based approach can provide additional information to the theorem prover that helps decrease the verification effort. Moreover, we present a prototypical implementation of the Combined Approach that uses the tools JOANA and KeY as the SDG-based and logic-based approach respectively

Analysis of CGF biomolecules, structure and cell population: Characterization of the stemness features of CGF cells and osteogenic potential

Concentrated Growth Factors (CGF) represent new autologous (blood-derived biomaterial), attracting growing interest in the field of regenerative medicine. In this study, the chemical, structural, and biological characterization of CGF was carried out. CGF molecular characterization was performed by GC/MS to quantify small metabolites and by ELISA to measure growth factors and matrix metalloproteinases (MMPs) release; structural CGF characterization was carried out by SEM analysis and immunohistochemistry; CGF has been cultured, and its primary cells were isolated for the identification of their surface markers by flow cytometry, Western blot, and real-time PCR; finally, the osteogenic differentiation of CGF primary cells was evaluated through matrix mineralization by alizarin red staining and through mRNA quantification of osteogenic differentiation markers by real-time PCR. We found that CGF has a complex inner structure capable of influencing the release of growth factors, metabolites, and cells. These cells, which could regulate the production and release of the CGF growth factors, show stem features and are able to differentiate into osteoblasts producing a mineralized matrix. These data, taken together, highlight interesting new perspectives for the use of CGF in regenerative medicine

A Survey of Satisfiability Modulo Theory

Satisfiability modulo theory (SMT) consists in testing the satisfiability of first-order formulas over linear integer or real arithmetic, or other theories. In this survey, we explain the combination of propositional satisfiability and decision procedures for conjunctions known as DPLL(T), and the alternative "natural domain" approaches. We also cover quantifiers, Craig interpolants, polynomial arithmetic, and how SMT solvers are used in automated software analysis.Comment: Computer Algebra in Scientific Computing, Sep 2016, Bucharest, Romania. 201

Using Relational Verification for Program Slicing

Program slicing is the process of removing statements from a program such that defined aspects of its behavior are retained. For producing precise slices, i.e., slices that are minimal in size, the program\u27s semantics must be considered. Existing approaches that go beyond a syntactical analysis and do take the semantics into account are not fully automatic and require auxiliary specifications from the user. In this paper, we adapt relational verification to check whether a slice candidate obtained by removing some instructions from a program is indeed a valid slice. Based on this, we propose a framework for precise and automatic program slicing. As part of this framework, we present three strategies for the generation of slice candidates, and we show how dynamic slicing approaches - that interweave generating and checking slice candidates - can be used for this purpose. The framework can easily be extended with other strategies for generating slice candidates. We discuss the strengths and weaknesses of slicing approaches that use our framework