Bilateral Severe Corneal Ulcer in a Patient with Lung Adenocarcinoma Treated with Gefitinib

We describe the case of Gefitinib-related bilateral corneal perforation. An 86-year-old female patient had bilateral painless and progressive vision loss due to neurotrophic corneal ulcer, following a 2-month treatment with Gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor for metastatic adenocarcinoma of the lung with confirmed EGFR gene mutation. She had no signs of ocular infection, inflammation, or lid problems to account for the development of corneal damage. Neurotrophic ulcer evolved into a frank perforation in one eye and an impending perforation on the other eye. EGFR inhibitors have been associated with dry eye, epithelial erosions, ulcerative keratitis, and corneal edema. However, to the best of our knowledge, this is the first case of bilateral severe corneal ulcer due to Gefitinib. The patient went on to have bilateral corneal graft surgery. This case aims to raise awareness among ophthalmologists and oncologists of the association between EGFR inhibitors, corneal neurotrophic ulcers, and possible evolution in corneal perforation

A study of the factors affecting flange-climb derailment in railway vehicles

Avoiding flange climb derailment is one main issue with ensuring the running safety of railway vehicles. This paper discusses the different causes that can lead to the derailment of a railway wheel, particularly in the light of different derailment criteria used by the standards or proposed by various researchers. Furthermore the paper presents two case studies, one for a vehicle with solid axles and one for a bogie with independently rotating wheels, reporting a description of the derailment case and discussing the causes that led to derailment, by making combined use of measurements and numerical simulation. Based on these exemplary cases, some conclusions are drawn concerning the validity of the derailment criteria presently used by the standards in force

Italian well-being indices, purposes, limitations, and evolutions

The identification of well-being measures is a matter that has been facing for a long time. In the past, the most commonly employed index was the Gross Domestic Product (GDP), but its adequacy has been questioned for quite all the 20th century, concluding that its use can lead to misleading conclusions (Fleurbaey, 2009). To overcome GDP, have been developed alternative approaches that are still nowadays a core topic. Following the capability approach proposed by Sen (2003), the European Commission, European Parliament, Club of Rome, Organization for Economic Co-operation and Development (OECD) and WWF, in 2007 hosted the conference titled "Beyond GDP". In August 2009, the European Commission released its road map, the Communication "GDP and beyond: Measuring progress in a changing world", when the so-called Stiglitz Commission (Stiglitz et al., 2009) suggested to build a complementary statistical system, focused on social well-being and suitable for measuring sustainability. The advice is to develop indicators that are as clear and appealing as GDP, but more inclusive of environmental and social aspects of progress (OECD, 2013). The proposed measure accounts a set of indicators representing both objective and subjective assessment, and including also people's perception of quality of life. Following the Commission\u2019s prompts a huge number of well-being indices have been developed, with different structures, considering a great variety of dimensions and for many purposes. International examples are: the Human Development Index, the Better Life Index, the Happy Planet Index, the Canadian Index of Well-being and the Gross National Happiness Index. In the field of subjective well-being, new measures have been recently proposed using big data, Facebook or Twitter data, to predict life satisfaction based on lexical and topical features (Schwartz et al., 2016, Dodds et al., 2011, Abdullah et al., 2015). In Italy, Iacus et al. (2017) developed the Social Well-being Index (SWBI), a multidimensional well-being composite indicator relying on Twitter data but derived from a new human supervised technique of sentiment analysis. All these new proposals try to overcome the lack in official statistics, however, for this kind of measures, the methodological challenges are still many and open. This work proposes a review of the traditional indices used to measure well-being in Italy, introducing their purposes, limitations, and their progressive evolution. The aim is to provide a detailed image, also to policy-makers, describing the accuracy, timeliness and territorial coverage. All these characteristics are a challenge for a good planning, for a correct international comparison or to integrate well-being indices with new data, represented, as example, by big data

Regularised Model Identification Improves Accuracy of Multisensor Systems for Noninvasive Continuous Glucose Monitoring in Diabetes Management

Continuous glucose monitoring (CGM) by suitable portable sensors plays a central role in the treatment of diabetes, a disease currently affecting more than 350 million people worldwide. Noninvasive CGM (NI-CGM), in particular, is appealing for reasons related to patient comfort (no needles are used) but challenging. NI-CGM prototypes exploiting multisensor approaches have been recently proposed to deal with physiological and environmental disturbances. In these prototypes, signals measured noninvasively (e.g., skin impedance, temperature, optical skin properties, etc.) are combined through a static multivariate linear model for estimating glucose levels. In this work, by exploiting a dataset of 45 experimental sessions acquired in diabetic subjects, we show that regularisation-based techniques for the identification of the model, such as the least absolute shrinkage and selection operator (better known as LASSO), Ridge regression, and Elastic-Net regression, improve the accuracy of glucose estimates with respect to techniques, such as partial least squares regression, previously used in the literature. More specifically, the Elastic-Net model (i.e., the model identified using a combination of ${l}_{1}$ and ${l}_{2}$ norms) has the best results, according to the metrics widely accepted in the diabetes community. This model represents an important incremental step toward the development of NI-CGM devices effectively usable by patients

Multi-Provider Secure Processing of Sensors Data

We describe the implementation of an approach for supporting secure query processing over sensors data in a multi-provider scenario. Our solution relies on the definition of authorizations regulating access to data according to three different visibility levels (no visibility, encrypted visibility, and plaintext visibility). Data processing is performed by multiple providers based on the restrictions imposed by authorizations, which may require to adjust data visibility on the fly. We describe the structure of the query optimizer and show how the operations of a computation can be assigned to different cloud providers to build an efficient, secure, and economical plan for collaborative data processing