A Case of Syphilis With Ocular Involvement: Persistent Negative Serology in a Patient With Multiple Sclerosis

: Diagnostic algorithms for syphilis are based on serology. However, with the advent of immunosuppressive therapies, these algorithms may fail. We report a case of an individual with multiple sclerosis on treatment with ofatumumab and secondary syphilis with visual and auditory systems involvement and persistent negative treponemal and nontreponemal tests

A wireless sensor network-based approach to large-scale dimensional metrology

In many branches of industry, dimensional measurements have become an important part of the production cycle, in order to check product compliance with specifications. This task is not trivial especially when dealing with largescale dimensional measurements: the bigger the measurement dimensions are, the harder is to achieve high accuracies. Nowadays, the problem can be handled using many metrological systems, based on different technologies (e.g. optical, mechanical, electromagnetic). Each of these systems is more or less adequate, depending upon measuring conditions, user's experience and skill, or other factors such as time, cost, accuracy and portability. This article focuses on a new possible approach to large-scale dimensional metrology based on wireless sensor networks. Advantages and drawbacks of such approach are analysed and deeply discussed. Then, the article briefly presents a recent prototype system - the Mobile Spatial Coordinate-Measuring System (MScMS-II) - which has been developed at the Industrial Metrology and Quality Laboratory of DISPEA - Politecnico di Torino. The system seems to be suitable for performing dimensional measurements of large-size objects (sizes on the order of several meters). Owing to its distributed nature, the system - based on a wireless network of optical devices - is portable, fully scalable with respect to dimensions and shapes and easily adaptable to different working environments. Preliminary results of experimental tests, aimed at evaluating system performance as well as research perspectives for further improvements, are discusse

Next-generation sequencing and drug resistance mutations of HIV-1 subtypes in people living with HIV in Sicily, Italy, 2021–2023

Objectives: HIV-1 infection continues to be a significant public health concern, notwithstanding the expanded utilization of antiretroviral treatment (ART), due to the emergence of drug resistance. The prevalence of transmitted drug resistance remains uncertain, particularly concerning integrase inhibitors. This study aimed to assess the extent of HIV resistance in both ART-naïve and experienced individuals living with HIV (PLHIV) at the University Hospital in Palermo, Italy. Methods: Genotyping and mutation analysis were performed on ART naïve and experienced PLHIV admitted from June 2021 to October 2023 by the NGS method. Mutations were detected by testing different NGS frequency cut-offs: ≥5 %, ≥10 %, and ≥20 %. Demographic, clinical, virological, and immunological data were retrospectively collected. Results: Of the PLHIV, 85 (70 %) were ART-naïve, while 36 (30 %) were ART-experienced with virological failure. The main HIV-1 subtype was B (54 %), which was significantly associated with Italy-born (P < 0.001) and experienced PLHIV (P = 0.024). In the remaining cases, A1 (6 %), C (3 %), F1 (7 %), G (2 %), and Circulating Recombinant Forms (28 %) were reported. At least one mutation for a drug class was detected in 39.7 %, 45.4 %, and 53.7 % of cases at HIV-1 NGS thresholds of 20 %, 10 %, and 5 %, respectively. Drug resistance was found in 18.2 %, 25.6 %, and 33.0 %, by NGS cut-off of 20 %, 10 %, and 5 % respectively. The lowering of NGS cut-offs mainly increased the rates of integrase strand transfer inhibitor resistance. For overall resistance, no difference was observed between B and non-B subtypes for any NGS cut-offs

The Role of Bypass Surgery for the Management of Complex Intracranial Aneurysms in the Anterior Circulation in the Flow-Diverter Era: A Single-Center Series

Despite the increasing popularity of flow diverters (FDs) as an endovascular option for intracranial aneurysms, the treatment of complex aneurysms still represents a challenge. Combined strategies using a flow-preservation bypass could be considered in selected cases. In this study, we retrospectively reviewed our series of patients with complex intracranial aneurysms submitted to bypass. From January 2015 to May 2022, 23 patients were selected. We identified 11 cases (47.8%) of MCA, 6 cases (26.1%) of ACA and 6 cases (26.1%) of ICA aneurysms. The mean maximal diameter was 22.73 ± 12.16 mm, 8 were considered as giant, 9 were fusiform, 8 presented intraluminal thrombosis, 10 presented wall calcification, and 18 involved major branches or perforating arteries. Twenty-five bypass procedures were performed in 23 patients (two EC–IC bypasses with radial artery graft, seventeen single- or double-barrel STA–MCA bypasses and six IC–IC bypasses in anterior cerebral arteries). The long-term bypass patency rate was 94.5%, and the total aneurysm exclusion was 95.6%, with a mean follow-up of 28 months. Median KPS values at last follow-up was 90, and a favorable outcome (KPS ≥ 70 and mRS ≤ 2) was obtained in 87% of the cases. The use of bypass techniques represents, in selected cases, a valid therapeutic option in the management of complex anterior circulation aneurysms when a simpler direct approach, including the use of FD, is considered not feasible

Complications of mechanical thrombectomy for acute ischemic stroke: Incidence, risk factors, and clinical relevance in the Italian Registry of Endovascular Treatment in acute stroke

BACKGROUND: There are limited data concerning procedure-related complications of endovascular thrombectomy for large vessel occlusion strokes. AIMS: We evaluated the cumulative incidence, the clinical relevance in terms of increased disability and mortality, and risk factors for complications. METHODS: From January 2011 to December 2017, 4799 patients were enrolled by 36 centers in the Italian Registry of Endovascular Stroke Treatment. Data on demographic and procedural characteristics, complications, and clinical outcome at three months were prospectively collected. RESULTS: The complications cumulative incidence was 201 per 1000 patients undergoing endovascular thrombectomy. Ongoing antiplatelet therapy (p < 0.01; OR 1.82, 95% CI: 1.21-2.73) and large vessel occlusion site (carotid-T, p < 0.03; OR 3.05, 95% CI: 1.13-8.19; M2-segment-MCA, p < 0.01; OR 4.54, 95% CI: 1.66-12.44) were associated with a higher risk of subarachnoid hemorrhage/arterial perforation. Thrombectomy alone (p < 0.01; OR 0.50, 95% CI: 0.31-0.83) and younger age (p < 0.04; OR 0.98, 95% CI: 0.97-0.99) revealed a lower risk of developing dissection. M2-segment-MCA occlusion (p < 0.01; OR 0.35, 95% CI: 0.19-0.64) and hypertension (p < 0.04; OR 0.77, 95% CI: 0.6-0.98) were less related to clot embolization. Higher NIHSS at onset (p < 0.01; OR 1.04, 95% CI: 1.02-1.06), longer groin-to-reperfusion time (p < 0.01; OR 1.05, 95% CI: 1.02-1.07), diabetes (p < 0.01; OR 1.67, 95% CI: 1.25-2.23), and LVO site (carotid-T, p < 0.01; OR 1.96, 95% CI: 1.26-3.05; M2-segment-MCA, p < 0.02; OR 1.62, 95% CI: 1.08-2.42) were associated with a higher risk of developing symptomatic intracerebral hemorrhage compared to no/asymptomatic intracerebral hemorrhage. The subgroup of patients treated with thrombectomy alone presented a lower risk of symptomatic intracerebral hemorrhage (p < 0.01; OR 0.70; 95% CI: 0.55-0.90). Subarachnoid hemorrhage/arterial perforation and symptomatic intracerebral hemorrhage after endovascular thrombectomy worsen both functional independence and mortality at three-month follow-up (p < 0.01). Distal embolization is associated with neurological deterioration (p < 0.01), while arterial dissection did not affect clinical outcome at follow-up. CONCLUSIONS: Complications globally considered are not uncommon and may result in poor clinical outcome. Early recognition of risk factors might help to prevent complications and manage them appropriately in order to maximize endovascular thrombectomy benefits

The infrastructure powering IBM's Gen AI model development

AI Infrastructure plays a key role in the speed and cost-competitiveness of developing and deploying advanced AI models. The current demand for powerful AI infrastructure for model training is driven by the emergence of generative AI and foundational models, where on occasion thousands of GPUs must cooperate on a single training job for the model to be trained in a reasonable time. Delivering efficient and high-performing AI training requires an end-to-end solution that combines hardware, software and holistic telemetry to cater for multiple types of AI workloads. In this report, we describe IBM's hybrid cloud infrastructure that powers our generative AI model development. This infrastructure includes (1) Vela: an AI-optimized supercomputing capability directly integrated into the IBM Cloud, delivering scalable, dynamic, multi-tenant and geographically distributed infrastructure for large-scale model training and other AI workflow steps and (2) Blue Vela: a large-scale, purpose-built, on-premises hosting environment that is optimized to support our largest and most ambitious AI model training tasks. Vela provides IBM with the dual benefit of high performance for internal use along with the flexibility to adapt to an evolving commercial landscape. Blue Vela provides us with the benefits of rapid development of our largest and most ambitious models, as well as future-proofing against the evolving model landscape in the industry. Taken together, they provide IBM with the ability to rapidly innovate in the development of both AI models and commercial offerings.Comment: Corresponding Authors: Talia Gershon, Seetharami Seelam,Brian Belgodere, Milton Bonill

Determination of the absolute configuration of (-)-(3R)-O-beta-D-glucopyranosyloxy-5-phenylpentanoic acid from Polygonum salicifolium

The absolute configuration of the title compound has been determined after its enzymatic hydrolysis to 3-hydroxy-5-phenylpentanoic acid, esterification, and identification of the enantiomerically pure methyl (3R)-hydroxy-5-phenylpentanoate by HPLC on Chiralcel(R)OD-H. For reasons of inconsistent literature data, enantioselective reductions of methyl 3-oxo-5-phenylpentanoate have been reinspected and the stereochemical outcome unequivocally confirmed by both chiroptical and HPLC retention data. Chirality 12:139-142, 2000. (C) 2000 Wiley-Liss, Inc

Phenylvaleric acid and flavonoid glycosides from Polygonum salicifolium

(3R)-O-β-D-Glucopyranosyloxy-5-phenylvaleric acid (1), (3R)-O-β-D- glucopyranosyloxy-5-phenylvaleric acid n-butyl ester (2), and a new dihydrochalcone diglycoside 4'-O-[β-D-glucopyranosyl-(1→-6)- glucopyranosyl]-oxy-2'-hydroxy-3',6'-dimethoxydihydrochalcone (3), together with six known flavonoid glycosides [kaempferol-3-O-β-D-glucopyranoside (= astragalin) (4), kaempferol-3-O-β-D-galactopyranoside (5), quercetin-3-O-β- D-glucopyranoside (= isoquercitrin) (6), quercetin-3-O-β-D-galactopyranoside (= hyperoside) (7), quercetin-3-O-(2'-O-galloyl)-β-D-glucopyranoside (8), and quercetin-3-O-β-D-glucuronopyranoside (9)] were isolated from the aerial parts of Polygonum salicifolium. The structure elucidation of the isolated compounds was performed by spectroscopic (UV, IR, ESI-MS, 1D- and 2D-NMR), chemical (methylation, enzymatic hydrolysis, partial synthesis), and chromatographic methods (HPLC, Chiralcel OD). The flavonoid glycosides (4-9) demonstrated scavenging properties toward the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical in TLC autographic assays

Inhibition of thromboxane biosynthesis and platelet function by indobufen in type II diabetes mellitus.

Indobufen is a reversible inhibitor of platelet prostaglandin G/H-synthase. To verify the dose dependence of the antiplatelet effect of indobufen on ex vivo and in vivo indexes of thromboxane (TX) biosynthesis and TXA2-dependent platelet function, we studied nine patients with non-insulin-dependent diabetes mellitus (NIDDM). This was a randomized, double-blind, crossover study in which each patient was treated with three different daily regimens (50 mg BID, 100 mg BID, and 200 mg BID) of indobufen for 1 week, with a 7-day washout period between treatments. Urinary 11-dehydro-TXB2 excretion averaged 58.2 +/- 21.8 ng/h at baseline. TX metabolite excretion was reduced dose dependently by indobufen: by 67% at 50 mg BID, 72% at 100 mg BID, and 81% at 200 mg BID. Platelet cyclooxygenase activity, ATP release, collagen-induced platelet aggregation, and bleeding time also were modified dose dependently by indobufen. Biochemical demonstration of suppressed platelet TXA2 in vivo was accompanied by evidence of inhibited platelet function as assessed ex vivo. Under pathophysiological conditions, such as NIDDM, which are associated with enhanced TXA2 synthesis, more than 95% suppression of platelet cyclooxygenase activity may be necessary to produce virtually maximal inhibition of platelet TXA2 biosynthesis in vivo

MicroRNA expression as predictor of local recurrence risk in oral squamous cell carcinoma

Background Oral squamous cell carcinoma (OSCC) is the sixth most common cancer worldwide with a high rate of recurrence. MicroRNAs (miRNAs) are gene regulators playing an important role in oral carcinogenesis. The purpose of this study was for us to identify and functionally characterize miRNAs that predict recurrence in OSCC. Methods We collected 92 OSCC with their normal tissue counterparts and we performed miRNAs expression profiling on 74 OSCC and 38 normal tissues. The association between the expression of miRNAs and clinical outcome was evaluated in the follow-up of 69 patients. Results Four of the miRNAs deregulated between OSCC and normal tissues are prognostic for recurrence either when considered individually or as a group. Depletion of the expression of prognostic miRNAs inhibit the proliferation of OSCC cells Conclusion MiRNAs are differentially expressed in OSCC versus normal samples. The expression of 4 prognostic miRNA signatures is able to predict recurrence risk independently from other clinical factors in OSCC