Forcing scale invariance in multipolarization SAR change detection

This paper considers the problem of coherent (in the sense that both amplitudes and relative phases of the polarimetric returns are used to construct the decision statistic) multi-polarization SAR change detec- tion starting from the availability of image pairs exhibiting possible power mismatches/miscalibrations. The principle of invariance is used to characterize the class of scale-invariant decision rules which are insensitive to power mismatches and ensure the Constant False Alarm Rate (CFAR) property. A maximal invariant statistic is derived together with the induced maximal invariant in the parameter space which significantly compress the data/parameters domain. A Generalized Likelihood Ratio Test (GLRT) is synthesized both for the cases of two- and three-polarimetric channels. Interestingly, for the two-channel case, it is based on the comparison of the condition number of a data-dependent matrix with a suitable threshold. Some additional invariant decision rules are also proposed. The performance of the considered scale-invariant structures is compared to those from two non- invariant counterparts using both simulated and real radar data. The results highlight the robustness of the proposed method and the performance tradeoff involve

Tecnica “a scaletta” nel trattamento delle perdite di sostanza del labbro inferiore

La patologia che con maggior frequenza colpisce il labbro inferiore è la patologia neoplastica, in particolar modo il carcinoma spinocellulare. L’approccio terapeutico di elezione è l’exeresi chirurgica ampia dalla quale possono derivare importanti alterazioni morfo-funzionali ed estetiche. Presso il Dipartimento di Chirurgia Plastica e Ricostruttiva del Policlinico Umberto I, “Sapienza” Università di Roma, dal 2005 al 2008 sono stati trattati 36 pazienti: 19 mediante escissione semplice (gruppo I) e 17 mediante la tecnica di Johanson (gruppo II), tutti sottoposti a follow-up a 6 e 12 mesi per valutate le alterazioni della funzionalità, la presenza/assenza di asimmetrie e la cicatrizzazione. Inoltre, ai pazienti è stata proposta una scheda di valutazione a punteggio costituita da 9 domande che indagano sia aspetti funzionali che estetici. Dai dati ottenuti è risultato che l’utilizzo del lembo di Johanson consente una radicalità oncologica non inferiore all’escissione semplice ma con migliori risultati funzionali ed estetici, una maggior soddisfazione da parte del paziente e tempi di degenza sovrapponibili

Giant Metatypical Carcinoma: An Unusual Tumor

Meta-typical carcinoma (MTC) or basosquamous carcinoma is a remarkable malignancy with features of both basal and squamous cell carcinoma. It is typically located on the back and face, often with clinical features of basal cell carcinoma but tending to be more aggressive with enhanced prospects of lymph node or distant metastases. Our report describes a huge neglected MTC of the back of ten-year duration, a giant ulcero-vegetative tumor measuring 20 x 25 cm. Histologic examination of specimens from the margins and periphery revealed aspects of both basal and squamous cell carcinoma, while the ulcerated center showed sclerotic tissue without tumor. Radical excision and reconstruction by grafts were performed. No metastases were observed after two years. There are many controversies surrounding the histologic definition and biologic behavior of MTC, including its metastasizing potential. The MTC we describe exhibited benign biologic behavior. This may have been related to an intense inflammatory host response with elimination of neoplastic tissue and consequent local sclerosis evident in the central tumor-free portion. This central tumor regression is to our knowledge a unique finding in MTC

Can AI Answer My Questions? Utilizing Artificial Intelligence in the Perioperative Assessment for Abdominoplasty Patients

Background Abdominoplasty is a common operation, used for a range of cosmetic and functional issues, often in the context of divarication of recti, significant weight loss, and after pregnancy. Despite this, patient-surgeon communication gaps can hinder informed decision-making. The integration of large language models (LLMs) in healthcare offers potential for enhancing patient information. This study evaluated the feasibility of using LLMs for answering perioperative queries.Methods This study assessed the efficacy of four leading LLMs-OpenAI's ChatGPT-3.5, Anthropic's Claude, Google's Gemini, and Bing's CoPilot-using fifteen unique prompts. All outputs were evaluated using the Flesch-Kincaid, Flesch Reading Ease score, and Coleman-Liau index for readability assessment. The DISCERN score and a Likert scale were utilized to evaluate quality. Scores were assigned by two plastic surgical residents and then reviewed and discussed until a consensus was reached by five plastic surgeon specialists.Results ChatGPT-3.5 required the highest level for comprehension, followed by Gemini, Claude, then CoPilot. Claude provided the most appropriate and actionable advice. In terms of patient-friendliness, CoPilot outperformed the rest, enhancing engagement and information comprehensiveness. ChatGPT-3.5 and Gemini offered adequate, though unremarkable, advice, employing more professional language. CoPilot uniquely included visual aids and was the only model to use hyperlinks, although they were not very helpful and acceptable, and it faced limitations in responding to certain queries.Conclusion ChatGPT-3.5, Gemini, Claude, and Bing's CoPilot showcased differences in readability and reliability. LLMs offer unique advantages for patient care but require careful selection. Future research should integrate LLM strengths and address weaknesses for optimal patient education.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Effectiveness of cardiac resynchronization therapy in heart failure patients with valvular heart disease: comparison with patients affected by ischaemic heart disease or dilated cardiomyopathy. The InSync/InSync ICD Italian Registry

AimsTo analyse the effectiveness of cardiac resynchronization therapy (CRT) in patients with valvular heart disease (a subset not specifically investigated in randomized controlled trials) in comparison with ischaemic heart disease or dilated cardiomyopathy patients.Methods and resultsPatients enrolled in a national registry were evaluated during a median follow-up of 16 months after CRT implant. Patients with valvular heart disease treated with CRT (n = 108) in comparison with ischaemic heart disease (n = 737) and dilated cardiomyopathy (n = 635) patients presented: (i) a higher prevalence of chronic atrial fibrillation, with atrioventricular node ablation performed in around half of the cases; (ii) a similar clinical and echocardiographic profile at baseline; (iii) a similar improvement of LVEF and a similar reduction in ventricular volumes at 6-12 months; (iv) a favourable clinical response at 12 months with an improvement of the clinical composite score similar to that occurring in patients with dilated cardiomyopathy and more pronounced than that observed in patients with ischaemic heart disease; (v) a long-term outcome, in term of freedom from death or heart transplantation, similar to patients affected by ischaemic heart disease and basically more severe than that of patients affected by dilated cardiomyopathy.ConclusionIn 'real world' clinical practice, CRT appears to be effective also in patients with valvular heart disease. However, in this group of patients the outcome after CRT does not precisely overlap any of the two other groups of patients, for which much more data are currently available

Ulcere cutanee in paziente con policitemia vera in trattamento con idrossicarbamide. Case report

Le ulcere dell’arto inferiore sono una complicanza grave e frequente della policitemia vera. Esse derivano da una azione sinergica di meccanismi fisiopatologici di natura vascolare, neurologica e infettiva. Inoltre, le terapie citostatiche impiegate per controllare la patologia mieloproliferativa interferiscono negativamente sullo sviluppo del tessuto di granulazione delle ulcere, ritardandone la guarigione. Viene descritto il caso di una donna di 70 anni, affetta da policitemia vera, con ulcere calcaneari e perimalleolari molto dolorose, tali da impedire il sonno e la normale deambulazione e particolarmente resistenti alle terapie. Esami approfonditi hanno evidenziato che le ulcere erano complicanza della terapia in atto con idrossicarbamide e non della patologia ematologica. La comparsa di ulcere alle gambe in corso di terapia con idrossicarbamide è una condizione relativamente frequente ma sottostimata. La patogenesi è legata a numerosi fattori tra cui il danno cellulare e l'ipossia tissutale conseguenziali alla macroeritrocitosi indotta dal farmaco. La sostituzione del farmaco e la prosecuzione delle terapie topiche hanno permesso nella nostra paziente la risoluzione nelle ulcere cutanee gravi per estensione e sintomatologia

Innovative microsurgical device in perforator free flaps surgery

Dissection of the small perforating vessels through the muscle/septum can be difficult, and microsurgical success is closely linked on a clear and well-magnified field vision. Since 2004, Varioscope®M5 has been employed in our Plastic Surgery Departments. It is the first and only head-mounted microscope. In this study was examined 10 patients underwent to reconstructive procedures by harvest of perforator free flaps, working with Varioscope®M5. At long-term follow-up, all patient present an exceptional outcome. Considering cost-effectiveness, portability, operator freedom, and effectiveness in the perforator flaps dissection and in the anastomosis making,we think that Varioscope®M5 offers essential advantage

Effects of Prophylactic Lipofilling After Radiotherapy Compared to Non–Fat Injected Breasts: A Randomized, Objective Study

Background: Patients who are suffering from invasive breast cancer may require post-mastectomy radiation therapy (PMRT). PMRT improves outcomes in breast cancer patients in terms of locoregional recurrence. Preliminary studies indi- cate that fat injections reduce post-radiation damage of soft tissue and implants. Objectives: The aim of this study was to demonstrate the safety and effectiveness of prophylactic fat injections on radi- ated implanted breasts. Methods: The authors randomly assigned 60 female patients to either Group A or B. Group A patients received 3 breast fat injections, according to Coleman’s technique, after radiotherapy and before expander removal with definitive implant insertion. Group B patients underwent surgery without lipofilling. At each surgical operation, skin biopsies were performed in a specific breast area to evaluate adipose tissue thickness, and a statistical analysis of the thickness variations was per- formed with the Wilcoxon’s sum test. Disability was assessed according to the Late Effects of Normal Tissues-Subjective Objective Management Analytic scale. Results: The study demonstrates a qualitative and quantitative improvement about tissues after fat injection. This is high- lighted by the significant increase in thickness after lipofilling. Conclusions: The study, which is based on both clinical and histological findings and is supported by the comparison of a control group with a 1-year follow-up, demonstrates that fat injections reduce tissue radio damage, improving recon- structive surgery outcomes and quality of life

Mammary compliance: an objective measurement of capsular contracture.

Capsular contracture is the most unpredictable complication after mammary augmentation. It presents an uncertain evolution, and is one of the most difficulty complications to treat. Evaluation of this condition usually was relegated to the surgeon's judgment, but currently there are three methods for measuring capsular contracture: palpation, applanation tonometry, and measure of mammary compliance. A prospective study was conducted to evaluate the different methods for managing capsular contracture. Particular attention was paid to the measure mammary compliance with a new device: the Anton Paar Mammacompliance system. This study found a good match between clinical and objective measurements, and also between the measure of applanation tonometry and the measure of mammary compliance. The Anton Paar Mammacompliance system seems to be effective in eliminating the descriptive part and keeping to the measurements and objective data. It is easily reproducible in the various check ups. It permits objective assessment for the measure of capsular contracture