Non-perturbative effects in spin glasses

We present a numerical study of an Ising spin glass with hierarchical interactions - the hierarchical Edwards-Anderson model with an external magnetic field (HEA). We study the model with Monte Carlo (MC) simulations in the mean-field (MF) and non-mean-field (NMF) regions corresponding to $d\geq4$ and $d<4$ for the $d$-dimensional ferromagnetic Ising model respectively. We compare the MC results with those of a renormalization-group (RG) study where the critical fixed point is treated as a perturbation of the MF one, along the same lines as in the $\epsilon$-expansion for the Ising model. The MC and the RG method agree in the MF region, predicting the existence of a transition and compatible values of the critical exponents. Conversely, the two approaches markedly disagree in the NMF case, where the MC data indicates a transition, while the RG analysis predicts that no perturbative critical fixed point exists. Also, the MC estimate of the critical exponent $\nu$ in the NMF region is about twice as large as its classical value, even if the analog of the system dimension is within only $\sim 2\%$ from its upper-critical-dimension value. Taken together, these results indicate that the transition in the NMF region is governed by strong non-perturbative effects

A renormalization group computation of the critical exponents of hierarchical spin glasses

The infrared behaviour of a non-mean field spin-glass system is analysed, and the critical exponent related to the divergence of the correlation length is computed at two loops within the epsilon-expansion technique with two independent methods. Both methods yield the same result confirming that the infrared behaviour of the theory if well-defined and the underlying ideas of the Renormalization Group hold also in such non-mean field disordered model. By pushing such calculation to high orders in epsilon, a consistent and predictive non-mean field theory for such disordered system could be established

The Hierarchical Random Energy Model

We introduce a Random Energy Model on a hierarchical lattice where the interaction strength between variables is a decreasing function of their mutual hierarchical distance, making it a non-mean field model. Through small coupling series expansion and a direct numerical solution of the model, we provide evidence for a spin glass condensation transition similar to the one occuring in the usual mean field Random Energy Model. At variance with mean field, the high temperature branch of the free-energy is non-analytic at the transition point

The ultrasound risk stratification systems for thyroid nodule have been evaluated against papillary carcinoma: a meta-analysis

Thyroid imaging reporting and data systems (TIRADS) are used to stratify the malignancy risk of thyroid nodule by ultrasound (US) examination. We conducted a meta-analysis to evaluate the pooled cancer prevalence and the relative prevalence of papillary, medullary, follicular thyroid cancer (PTC, MTC, and FTC) and other malignancies among nodules included in studies evaluating their performance. Four databases were searched until February 2020. Original articles with at least 1000 nodules, evaluating the performance of at least one TIRADS among AACE/ACE/AME, ACR-TIRADS, ATA, EU-TIRADS, or K-TIRADS, and reporting data on the histological diagnosis of malignant lesions were included. The number of malignant nodules, PTC, FTC, MTC and other malignancies in each study was extracted. For statistical pooling of data, a random-effects model was used. Nine studies were included, evaluating 19,494 thyroid nodules. The overall prevalence of malignancy was 34% (95%CI 21 to 49). Among 6162 histologically proven malignancies, the prevalence of PTC, FTC, MTC and other malignancies was 95%, 2%, 1%, and 1%, respectively. A high heterogeneity was found for all the outcomes. A limited number of studies generally conducted using a retrospective design was found, with possible selection bias. Acknowledging this limitation, TIRADSs should be regarded as accurate tools to diagnose PTC only. Proposed patterns and/or cut-offs should be revised and other strategies considered to improve their performance in the assessment of FTC, MTC and other malignancies

Voluntary lung function screening to reveal new COPD cases in southern Italy

Background: Underdiagnosis of COPD is a relevant issue, and most frequently involves patients at early stages of the disease. Physicians do not routinely recommend smokers to undergo spirometry, unless they are symptomatic. Aims: To investigate the effectiveness of voluntary lung function screening in bringing to light patients with previously unknown COPD and to evaluate the relationships among symptoms, smoking status, and airway obstruction. Methods: A voluntary screening study for COPD was conducted during two editions of the annual Fiera del Levante (2014 and 2015), an international trade fair in Bari. Subjects were eligible for the study if they fulfilled the following inclusion criteria: age â¥35 years, smoker/ex-smoker â¥5 pack-years (PYs), or at least one chronic respiratory symptom (cough, sputum production, shortness of breath, and wheezing). A free post-β2-agonist spirometry test was performed by trained physicians for each participant using portable spirometers. Post-β2-agonist forced expiratory volume in 1 second (FEV1):forced vital capacity ratio &lt;0.7 was chosen to establish the diagnosis of COPD. Sensitivity, specificity, and negative and positive predictive values (NPVs and PPVs) of symptoms for the presence of obstruction were calculated. Results: A total of 1,920 individuals were eligible for the study; 188 subjects (9.8%) met COPD criteria. There was a 10.4% prevalence of COPD in subjects with one or more symptoms who had never smoked or smoked â¤5 PYs. Among COPD patients, prevalence of symptoms increased in the presence of FEV1&lt;80%. COPD smokers were more symptomatic than smokers without COPD. Sensitivity and specificity in all subjects with one or more symptoms were 87% and 32%, respectively, whereas in smoker subgroups, sensitivity and specificity were 71% and 41% (â¥5 PYs) and 74% and 35% (â¥10 PYs), respectively. In all subjects, the presence of at least one symptom was associated with a low PPV for COPD of 11%, but a very high NPV (96%). These data did not change if the analysis was limited to smokers. Conclusion: Voluntary public lung function screening programs in Italy are effective, and may detect a large number of undiagnosed subjects with COPD in early stages. In our population, COPD symptoms had low specificity and PPV, even considering smokers only

Long-term voice monitoring with smartphone applications and contact microphone

In recent years, the growing interest in the recognition of voice disorders as occupational diseases has required screening methods adaptable to the clinical requirements, capable to extend the collection of baseline data. In this framework, the use of smartphones has gained increasing interest, thanks to advancements in digital technology, which made them suitable for recording and analyzingacoustic signals. Two smartphone applications, based on the Voice Care® technology, have been developed for long-term monitoring of voice activity when combined with a cheap contact microphone embedded in a collar. The applications have been tested in laboratory and used for the monitoring of teachers at kindergarten, primary school, and university. Vocal Holter App allows the selection of short and long term monitoring mode, and three different clusters of vocal parameters related to intensity, intonation, and load, respectively. Most of the results are based on the distributions of occurrences of vocal parameters. A headlight informs the person under monitoring of pathologic voice. Vocal Holter Rec allows data recording and to perform a personalized analysis based on updated parameters. The equipment allows downloading and saving data on a dedicated web site for further processing, comparisons over time, or sharing with physicians or rehabilitators

Voluntary lung function screening to reveal new COPD cases in southern Italy

Background: Underdiagnosis of COPD is a relevant issue, and most frequently involves patients at early stages of the disease. Physicians do not routinely recommend smokers to undergo spirometry, unless they are symptomatic. Aims: To investigate the effectiveness of voluntary lung function screening in bringing to light patients with previously unknown COPD and to evaluate the relationships among symptoms, smoking status, and airway obstruction. Methods: A voluntary screening study for COPD was conducted during two editions of the annual Fiera del Levante (2014 and 2015), an international trade fair in Bari. Subjects were eligible for the study if they fulfilled the following inclusion criteria: age â¥35 years, smoker/ex-smoker â¥5 pack-years (PYs), or at least one chronic respiratory symptom (cough, sputum production, shortness of breath, and wheezing). A free post-Î22-agonist spirometry test was performed by trained physicians for each participant using portable spirometers. Post-Î22-agonist forced expiratory volume in 1 second (FEV1):forced vital capacity ratio &lt;0.7 was chosen to establish the diagnosis of COPD. Sensitivity, specificity, and negative and positive predictive values (NPVs and PPVs) of symptoms for the presence of obstruction were calculated. Results: A total of 1,920 individuals were eligible for the study; 188 subjects (9.8%) met COPD criteria. There was a 10.4% prevalence of COPD in subjects with one or more symptoms who had never smoked or smoked â¤5 PYs. Among COPD patients, prevalence of symptoms increased in the presence of FEV1&lt;80%. COPD smokers were more symptomatic than smokers without COPD. Sensitivity and specificity in all subjects with one or more symptoms were 87% and 32%, respectively, whereas in smoker subgroups, sensitivity and specificity were 71% and 41% (â¥5 PYs) and 74% and 35% (â¥10 PYs), respectively. In all subjects, the presence of at least one symptom was associated with a low PPV for COPD of 11%, but a very high NPV (96%). These data did not change if the analysis was limited to smokers. Conclusion: Voluntary public lung function screening programs in Italy are effective, and may detect a large number of undiagnosed subjects with COPD in early stages. In our population, COPD symptoms had low specificity and PPV, even considering smokers only

Prospective validation of the CLIP score: a new prognostic system for patient with cirrhosis and hepatocellular carcinoma

Prognosis of patients with cirrhosis and hepatocellular carcinoma (HCC) depends on both residual liver function and tumor extension. The CLIP score includes Child-Pugh stage, tumor morphology and extension, serum alfa-fetoprotein (AFP) levels, and portal vein thrombosis. We externally validated the CLIP score and compared its discriminatory ability and predictive power with that of the Okuda staging system in 196 patients with cirrhosis and HCC prospectively enrolled in a randomized trial. No significant associations were found between the CLIP score and the age, sex, and pattern of viral infection. There was a strong correlation between the CLIP score and the Okuda stage, As of June 1999, 150 patients (76.5%) had died. Median survival time was 11 months, overall, and it was 36, 22, 9, 7, and 3 months for CLIP categories 0, 1, 2, 3, and 4 to 6, respectively. In multivariate analysis, the CLIP score had additional explanatory power above that of the Okuda stage. This was true for both patients treated with locoregional therapy or not. A quantitative estimation of 2-year survival predictive power showed that the CLIP score explained 37% of survival variability, compared with 21% explained by Okuda stage. In conclusion, the CLIP score, compared with the Okuda staging system, gives more accurate prognostic information, is statistically more efficient, and has a greater survival predictive power. It could be useful in treatment planning by improving baseline prognostic evaluation of patients with RCC, and could be used in prospective therapeutic trials as a stratification variable, reducing the variability of results owing to patient selection

Pulmonary nocardiosis in Chronic Obstructive Pulmonary Disease: A new clinical challenge

AbstractPulmonary nocardiosis (PN) is a rare but severe disease caused by Nocardia spp. Despite the traditional description as opportunistic infection, case reports and case series of pulmonary nocardiosis have recently been reported in immunocompetent patients too, in particular among people with chronic pulmonary diseases such as advanced Chronic Obstructive Pulmonary Disease (COPD).PN is characterized by non-specific symptoms and radiological findings; bacteriological culture can be difficult. For the reasons above, diagnosis of PN is challenging, sometimes resulting in a misdiagnosis of tuberculosis.We report an interesting case of PN in a 75-year-old male with COPD. He complained a 3-months history of fatigue, evening rise in body temperature, night sweats, unexplained weight loss of 5 kg, worsening dyspnea, cough and mucopurulent sputum. The chest X-ray showed multiple nodules with cavitations bilaterally in the apical and subclavian regions. Nocardia cyriacigeorgica with 100% identity was identified in three sputum samples.Since the patient has never undergone a systemic and/or inhaled steroid therapy, and has no respiratory failure and comorbidities entailing immunodepression, it is conceivable that, in this immunocompetent patient, the COPD could represent an isolated risk factor for PN.Risk factors, clinical presentations, radiographic findings, differential diagnosis and review of the literature of PN cases in COPD, pointing out the similarities and differences, are also described

Pulmonary alveolar microlithiasis: Review of the 1022 cases reported worldwide

Pulmonary alveolar microlithiasis (PAM) is a rare disease characterised by the widespread intra-alveolar accumulation of minute calculi called microliths. It is caused by mutation of the SLC34A2 gene encoding the type IIb sodium phosphate cotransporter in alveolar type II cells. The present study explores the epidemiological, familial, genetic, clinical, diagnostic, radiological and therapeutic aspects with the aim of contributing to a better understanding of this uncommon disease. We searched articles on PAM published up to December 2014 and 544 papers were found, accounting for 1022 cases. PAM is present in all continents and in many nations, in particular in Turkey, China, Japan, India, Italy and the USA. Familiality is frequent. The clinical course is not uniform and the causes of this clinical variability seem to be largely nongenetic. The optimal diagnostic procedure is the association of chest high-resolution computed tomography (HRCT) with bronchoalveolar lavage, but a chest radiograph may suffice in families in which a case has already been diagnosed. Moreover, chest radiography and HRCT allow the classification of the evolutionary phase of the disease and its severity. At present lung transplantation is the only effective therapy. However, better knowledge of the gene responsible offers hope for new therapies