Deep Learning algorithms for automatic COVID-19 detection on chest X-ray images

Coronavirus disease (COVID-19) was confirmed as a pandemic disease on February 11, 2020. The pandemic has already caused thousands of victims and infected several million people around the world. The aim of this work is to provide a Covid-19 infection screening tool. Currently, the most widely used clinical tool for detecting the presence of infection is the reverse transcription polymerase chain reaction (RT-PCR), which is expensive, less sensitive and requires the resource of specialized medical personnel. The use of X-ray images represents one of the latest challenges for the rapid diagnosis of the Covid-19 infection. This work involves the use of advanced artificial intelligence techniques for diagnosis using algorithms for classification purposes. The goal is to provide an automatic infection detection method while maximizing detection accuracy. A public database was used which includes images of COVID-19 patients, patients with viral pneumonia, patients with pulmonary opacity, and healthy patients. The methodology used in this study is based on transfer learning of pre-trained networks to alleviate the complexity of calculation. In particular, three different types of convolutional neural networks, namely, InceptionV3, ResNet50 and Xception, and the Vision Transformer are implemented. Experimental results show that the Vision Transformer outperforms convolutional architectures with a test accuracy of 99.3% vs 85.58% for ResNet50 (best among CNNs). Moreover, it is able to correctly distinguish among four different classes of chest X-ray images, whereas similar works only stop at three categories at most. The high accuracy of this computer-assisted diagnostic tool can significantly improve the speed and accuracy of COVID-19 diagnosis

Internal fixation of femur fractures: a new wireless electromechanical dynamization system

Dynamization of fracture fixation is an important strategy to reduce the time of recovery for a patient. The principal aim of this treatment is to stimulate the proliferation of callus in the early phase of recovery and to accelerate the new bone formation. External stabilization is a gold standard technique for this type of treatment, but internal fixation has recently gained increasing attention. In this framework, the here introduced dynamization system has been developed for the treatment of polytraumatized patients, who would benefit from the fast recovery guaranteed by a minimally invasive technique and by the elimination of the need for re-intervention. Indeed, thanks to an innovative concept, an electromechanical wireless system has been developed in order to accomplish in a simple outpatient intervention the unlocking of the axial load from static to dynamic mode

Genesis and mechanisms controlling tornillo seismo-volcanic events in volcanic areas

Volcanic activity is often preceded or accompanied by different types of seismo-volcanic signals. Among these signals, the so-called tornillo (Spanish for "screw") events are considered to belong to a unique class of volcano-seismicity characterised by a long-duration coda, amplitude modulation and high-quality factor. These data constitute important evidence for the gas fraction inside magmatic fluids. However, the mechanism behind this unique signal remains not fully understood. Here we report new laboratory evidence showing that two different processes have either scale-invariant or scale-dependent effects in generating tornillo-like events. These processes are respectively the gas pressure gradient, which triggers the event and regulates the slow decaying coda, and the fluid resonance into small scale structures which, in turn, control the frequency content of the signal. Considering that the gas pressure gradient is proportional to the fluid flow, these new findings, as applied to volcanoes, provide new information to better quantify both gas rate and volume, and the dimension of the resonator.Publishedid 73385V. Processi eruttivi e post-eruttiviJCR Journa

Percutaneous Edge-to-Edge Mitral Valve Repair with the Mitraclip System in Barlow's Disease

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In-hospital and thirty-day outcomes of the SAPIEN 3 Ultra balloon-expandable transcatheter aortic valve : the S3U registry

Aims: The aim of this study was to evaluate 30-day safety and efficacy outcomes of transcatheter aortic valve implantation (TAVI) performed with the SAPIEN 3 Ultra system. Methods and results: The S3U registry is a physician-led, post-approval, multicentre, observational registry of transfemoral TAVI with the SAPIEN 3 Ultra. New features include an improved sealing skirt, a 14 Fr expandable sheath and a new delivery catheter. Overall, 139 consecutive patients at nine participating centres were enrolled. Mean age was 81.4 +/- 8.3 years, average STS score 3.8 +/- 2.4%. The vast majority (97.2%) underwent TAVI with local anaesthesia (28.8%) or conscious sedation (68.3%). Balloon predilatation was performed in 30 patients (21.6%), post-dilatation in three (2.2%). In-hospital, there were no cases of death, stroke, or conversion to open heart surgery. Major vascular complications occurred in three patients (2.2%), as well as major or life-threatening bleedings in three patients (2.2%). There were two moderate (1.4%) and no moderate/severe paravalvular leaks. Median length of stay after TAVI was three days (IQR 3-5 days). At 30 days, there were no deaths, MI, or strokes, and the incidence of new permanent pacemaker implantation was 4.4%. Conclusions: This first multicentre international experience of transfemoral TAVI with the SAPIEN 3 Ultra transcatheter heart valve shows good in-hospital and 30-day clinical outcomes.Peer reviewe

Use of Telemedicine Healthcare Systems in Pediatric Assistance at Territorial Level: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

Technological innovation can contribute to a reorganization of healthcare, particularly by supporting the shift in the focus of care from the hospital to the territory, through innovative citizen-centered models, and facilitating access to services in the territory. Health and social care delivery modalities, enabled by telemedicine, are crucial in this regard. The objective of this Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, is to define a standard for its use at the territorial level in various declinations in the pediatric field; this paper also identifies priority areas for its application and the types of services that most require intervention and investment. The changes that are underway in digital transformation in all sectors are unstoppable, and for the digital transformation to take place in a productive sense, the contribution of not only all health professionals, but also of patients, is necessary. From this perspective, authors from different backgrounds were involved in the drafting of this Consensus and, in the future, other figures, primarily patients, are expected to be involved. In fact, this belongs to the vision of connected care, in which the citizen/patient actively participates in the treatment path so that they are assisted in a personalized, predictive and preventive way. The future scenario must be able to provide for the involvement of patients from the initial stages of planning any treatment path, even in the pediatric age, and increasing, where possible, the proximity of the health service to the families

Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

: Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens

Information and Training on the Use of Telemedicine in Pediatric Population: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP), and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

Telemedicine has entered the daily lives of doctors, although the digital skills of healthcare professionals still remain a goal to be achieved. For the purpose of a large-scale development of telemedicine, it is necessary to create trust in the services it can offer and to favor their acceptance by healthcare professionals and patients. In this context, information for the patient regarding the use of telemedicine, the benefits that can be derived from it, and the training of healthcare professionals and patients for the use of new technologies are fundamental aspects. This consensus document is a commentary that has the aim of defining the information on and training aspects of telemedicine for pediatric patients and their caregivers, as well as pediatricians and other health professionals who deal with minors. For the present and the future of digital healthcare, there is a need for a growth in the skills of professionals and a lifelong learning approach throughout the professional life. Therefore, information and training actions are important to guarantee the necessary professionalism and knowledge of the tools, as well as a good understanding of the interactive context in which they are used. Furthermore, medical skills can also be integrated with the skills of various professionals (engineers, physicists, statisticians, and mathematicians) to birth a new category of health professionals responsible for building new semiotics, identifying criteria for predictive models to be integrated into clinical practice, standardizing clinical and research databases, and defining the boundaries of social networks and new communication technologies within health services

Use of Telemedicine Healthcare Systems in Pediatric Assistance at Territorial Level: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

Technological innovation can contribute to a reorganization of healthcare, particularly by supporting the shift in the focus of care from the hospital to the territory, through innovative citizen-centered models, and facilitating access to services in the territory. Health and social care delivery modalities, enabled by telemedicine, are crucial in this regard. The objective of this Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, is to define a standard for its use at the territorial level in various declinations in the pediatric field; this paper also identifies priority areas for its application and the types of services that most require intervention and investment. The changes that are underway in digital transformation in all sectors are unstoppable, and for the digital transformation to take place in a productive sense, the contribution of not only all health professionals, but also of patients, is necessary. From this perspective, authors from different backgrounds were involved in the drafting of this Consensus and, in the future, other figures, primarily patients, are expected to be involved. In fact, this belongs to the vision of connected care, in which the citizen/patient actively participates in the treatment path so that they are assisted in a personalized, predictive and preventive way. The future scenario must be able to provide for the involvement of patients from the initial stages of planning any treatment path, even in the pediatric age, and increasing, where possible, the proximity of the health service to the families