Acute hemorrhagic edema of young children: a concise narrative review

Acute hemorrhagic edema of young children is an uncommon but likely underestimated cutaneous leukocytoclastic vasculitis. The condition typically affects infants 6-24months of age with a history of recent respiratory illness with or without course of antibiotics. The diagnosis is made in children, mostly nontoxic in appearance, presenting with nonpruritic, large, round, red to purpuric plaques predominantly over the cheeks, ears, and extremities, with relative sparing of the trunk, often with a target-like appearance, and edema of the distal extremities, ears, and face that is mostly non-pitting, indurative, and tender. In boys, the lesions sometimes involve the scrotum and, more rarely, the penis. Fever, typically of low grade, is often present. Involvement of body systems other than skin is uncommon, and spontaneous recovery usually occurs within 6-21days without sequelae. In this condition, laboratory tests are non-contributory: total blood cell count is often normal, although leukocytosis and thrombocytosis are sometimes found, clotting studies are normal, erythrocyte sedimentation rate and C-reactive protein test are normal or slightly elevated, complement level is normal, autoantibodies are absent, and urinalysis is usually normal. Experienced physicians rapidly consider the possible diagnosis of acute hemorrhagic edema when presented with a nontoxic young child having large targetoid purpuric lesions and indurative swelling, which is non-pitting in character, and make the diagnosis either on the basis of clinical findings alone or supported by a skin biopsy stud

Body fluids and salt metabolism - Part II

There is a high frequency of diarrhea and vomiting in childhood. As a consequence the focus of the present review is to recognize the different body fluid compartments, to clinically assess the degree of dehydration, to know how the equilibrium between extracellular fluid and intracellular fluid is maintained, to calculate the effective blood osmolality and discuss both parenteral fluid maintenance and replacement

Emergent Ascomycetes in viticulture: an interdisciplinary overview

The reduction of pesticide usage is a current imperative and the implementation of sustainable viticulture is an urgent necessity. A potential solution, which is being increasingly adopted, is offered by the use of grapevine cultivars resistant to its main pathogenic threats. This, however, has contributed to changes in defense strategies resulting in the occurrence of secondary diseases, which were previously controlled. Concomitantly, the ongoing climate crisis is contributing to destabilizing the increasingly dynamic viticultural context. In this review, we explore the available knowledge on three Ascomycetes which are considered emergent and causal agents of powdery mildew, black rot and anthracnose. We also aim to provide a survey on methods for phenotyping disease symptoms in fields, greenhouse and lab conditions, and for disease control underlying the insurgence of pathogen resistance to fungicide. Thus, we discuss fungal genetic variability, highlighting the usage and development of molecular markers and barcoding, coupled with genome sequencing. Moreover, we extensively report on the current knowledge available on grapevine-ascomycete interactions, as well as the mechanisms developed by the host to counteract the attack. Indeed, to better understand these resistance mechanisms, it is relevant to identify pathogen effectors which are involved in the infection process and how grapevine resistance genes function and impact the downstream cascade. Dealing with such a wealth of information on both pathogens and the host, the horizon is now represented by multidisciplinary approaches, combining traditional and innovative methods of cultivation. This will support the translation from theory to practice, in an attempt to understand biology very deeply and manage the spread of these Ascomycetes

Erector spinae plane versus fascia iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block

Background Ultrasound-guided supra-inguinal fascia iliaca block (FIB) provides effective analgesia after total hip arthroplasty (THA) but is complicated by high rates of motor block. The erector spinae plane block (ESPB) is a promising motor-sparing technique. In this study, we tested the analgesic superiority of the FIB over ESPB and associated motor impairment. Methods In this randomized, observer-blinded clinical trial, patients scheduled for THA under spinal anesthesia were randomly assigned to preoperatively receive either the ultrasound-guided FIB or ESPB. The primary outcome was morphine consumption 24 h after surgery. The secondary outcomes were pain scores, assessment of sensory and motor block, incidence of postoperative nausea and vomiting and other complications, and development of chronic post-surgical pain. Results A total of 60 patients completed the study. No statistically significant differences in morphine consumption at 24 h (P = 0.676) or pain scores were seen at any time point. The FIB produced more reliable sensory block in the femoral nerve (P = 0.001) and lateral femoral cutaneous nerve (P = 0.018) distributions. However, quadriceps motor strength was better preserved in the ESPB group than in the FIB group (P = 0.002). No differences in hip adduction motor strength (P = 0.253), side effects, or incidence of chronic pain were seen between the groups. Conclusions ESPBs may be a promising alternative to FIBs for postoperative analgesia after THA. The ESPB and FIB offer similar opioid-sparing benefits in the first 24 h after surgery; however, ESPBs result in less quadriceps motor impairment

Marker-assisted breeding for Downy mildew, Powderey mildew and Phylloxera resistance at FEM

Il programma di miglioramento genetico per le resistenze a stress biotici ha avuto inizio presso la Fondazione Edmund Mach (FEM) nel 2010. Inizialmente è stata condotta una caratterizzazione sia genotipica che fenotipica di materiali acquisiti da altri programmi di breeding e di materiale selvatico raccolto in New Jersey. Sia i genotipi conosciuti nei database internazionali che i genotipi sconosciuti, imparentati e non, sono stati impiegati come linee parentali nel processo di introgressione e di piramidazione di loci di interesse. Una volta pianificati e ottenuti gli incroci, la valutazione delle progenie è avvenuta seguendo un processo di Marker-Assisted Selection: dapprima è avvenuta la selezione fenotipica in serra in base al tipo di malattia e al numero di loci attesi per la medesima malattia; successivamente si è proceduto con lo screening molecolare in base ai loci specifici attesi nei parentali. Cinque sono i loci Run/Ren associati alla resistenza all'oidio presenti nel programma FEM; riguardo ai loci associati alla resistenza alla peronospora, quattro Rpv sono ben rappresentati nel piano di incroci. Ad oggi il 26% delle F1 è piramidizzato per quattro loci di resistenza

The image biomarker standardization initiative: Standardized convolutional filters for reproducible radiomics and enhanced clinical insights

Standardizing convolutional filters that enhance specific structures and patterns in medical imaging enables reproducible radiomics analyses, improving consistency and reliability for enhanced clinical insights. Filters are commonly used to enhance specific structures and patterns in images, such as vessels or peritumoral regions, to enable clinical insights beyond the visible image using radiomics. However, their lack of standardization restricts reproducibility and clinical translation of radiomics decision support tools. In this special report, teams of researchers who developed radiomics software participated in a three-phase study (September 2020 to December 2022) to establish a standardized set of filters. The first two phases focused on finding reference filtered images and reference feature values for commonly used convolutional filters: mean, Laplacian of Gaussian, Laws and Gabor kernels, separable and nonseparable wavelets (including decomposed forms), and Riesz transformations. In the first phase, 15 teams used digital phantoms to establish 33 reference filtered images of 36 filter configurations. In phase 2, 11 teams used a chest CT image to derive reference values for 323 of 396 features computed from filtered images using 22 filter and image processing configurations. Reference filtered images and feature values for Riesz transformations were not established. Reproducibility of standardized convolutional filters was validated on a public data set of multimodal imaging (CT, fluorodeoxyglucose PET, and T1-weighted MRI) in 51 patients with soft-tissue sarcoma. At validation, reproducibility of 486 features computed from filtered images using nine configurations × three imaging modalities was assessed using the lower bounds of 95% CIs of intraclass correlation coefficients. Out of 486 features, 458 were found to be reproducible across nine teams with lower bounds of 95% CIs of intraclass correlation coefficients greater than 0.75. In conclusion, eight filter types were standardized with reference filtered images and reference feature values for verifying and calibrating radiomics software packages. A web-based tool is available for compliance checking

Referendum, ordine pubblico, Costituzione

Ordine pubblico e referendum nella dinamica del sistema politico (Stefano Rodotà) - Realtà politica e realtà costituzionale nelle attuali tendenze legislative in materia di referendum e ordine pubblico (Paolo Barile) - Ordine e democrazia nella crisi (Franco Bricola) - Il referendum in una società capace di autogoverno (Valerio Onida) - Concorso dei cittadini alla determinazione della politica nazionale, partiti politici e referendum (Ernesto Bettinelli) - Sulle iniziative dirette alla modifica della legge 25 maggio 1970 n. 352 e degli artt. 75 e 138 della Costituzione (Paolo Caretti) - Il referendum nel disegno e nella effettività costituzionale (achille Chiappetti) - Proposte di aumento del quorum di firme per la richiesta di referendum e coerenza della classe politica (Sergio Bartole) - Il referendum come strumento di educazione politica (Gianfranco Pasquino) - Il ruolo della Corte costituzionale nell’attuale fase di sviluppo del sistema politico-costituzionale (Gustavo Zagrebelsky) - Il ruolo della Corte dei conti nel sistema costituzionale dei pesi e contrappesi (Silvio Pergameno) - A proposito di “protezionismo” e di “centralità” del Parlamento (Stefano Rodotà) - I poteri dell’Ufficio centrale per il referendum in relazione a “modifiche sostanziali della legge oggetto del referendum” (Michele Taruffo) - Il referendum come “contropotere” e garanzia nel sistema costituzionale italiano (Sergio Fois) - Presupposti per una ricostruzione storica del referendum: i referendum “di stimolo” e i “referendum di rottura” (Alessandro Pizzorusso) - Referendum e conflitto politico (Angelo Panebianco e Massimo Teodori) - Referendum e centralità del Parlamento (Andrea Manzella) - Il referendum per l’attuazione della Costituzione (Marco Pannella) - Arco costituzionale, Movimento e democrazia borghese (Alex Langer) - In tema di garantismo e di diritti civili (Vincenzo Ferrari) - Astrattismo illuministico e questioni in tema di disciplina dell’ordine pubblico (Guido Neppi Modona) - Libertà per i compagni arrestati a Bologna (Collettivo di Giurisprudenza dell’Università di Bologna) - Libertà sindacale, riforma della polizia, Costituzione e sinistre (Federico Mancini) - Il dilemma penale: garantismo o realpolitik? (Gaetano Pecorella) - Legislazione eccezionale e lotta alla criminalità (Salvatore Senese) - Sui limiti della discrezionalità del legislatore in materia di attuazione delle modalità del referendum abrogativo e di disciplina dell’ordine pubblico (Paolo Barile) - Politica istituzionale e strategia della sinistra (Stefano Rodotà) - Alcune precisazioni in merito all’art. 21 del disegno di legge n. 1798 (Franco Bricola) - Il referendum nel rapporto tra sistema politico e società (Valerio Onida) - TAVOLA ROTONDA SUL TEMA “PERCHE’ SI PARLA DI COSTITUZIONE ALLA DERIVA?” “Interventi” degli Onn. Renato Ballardini (PSI), Aldo Bozzi (PLI), Franco Mazzola (DC), Marco Pannella (PR) e dei Senn. Ugo Spagnoli (PCI), Agostino Viviani (PSI)

Introducing series elastic links

This paper introduces the concept of Series Elastic Link which exploits the inherent elasticity of flexible links to implement compliant actuation and control using lightweigt and low cost components