Optical coherence tomography and optical coherence tomography angiography in uveitis : a review

Optical coherence tomography (OCT) has dramatically changed the understanding and management of uveitis and other ocular conditions. Currently, OCT angiography (OCTA) combines structural information with the visualization of blood flow within the imaged area. The aim of this review is to present the basic principles of OCT and OCTA interpretation and to investigate the role of these imaging techniques in the diagnosis and management of uveitis. Common complications of intraocular inflammation such as macular oedema and inflammatory choroidal neovascularization are often diagnosed and followed with OCT/OCTA scans. However, uveitis specialists can obtain much more information from tomographic scans. This review provides a comprehensive description of typical OCT/OCTA findings characterizing different ocular structures in uveitis, proceeding from the cornea to the choroid. A careful interpretation of OCT/OCTA images can help in the differential diagnosis, the prediction of clinical outcomes, and the follow-up of patients with uveitis

Zero Emission Geothermal Flash Power Plant

The successful exploitation of geothermal energy for power production relies on the availability of nearly zero emission and efficient technologies. Two zero emission flash plant layouts, with full reinjection of the geothermal fluid (non-condensable gas included), are considered. This paper focusses on the CO2issue, and therefore only the carbon dioxide is considered as non-condensable gas present in the geothermal fluid; the CO2 flow is separated, compressed, and reinjected with the geothermal fluid. Both the reservoir and the power plant are simulated. A first scheme of plant presents a conventional layout in which the CO2is separated and compressed after the condenser. The second scheme presents a plant layout that allows the separation of the CO2at higher pressure with respect to the conventional layout, thus reducing the requested power consumption. The conventional plant scheme performs always better at higher temperature and at lower concentration of CO2. The new layout results better for low temperature and higher gas content

IMU-based human activity recognition and payload classification for low-back exoskeletons

Nowadays, work-related musculoskeletal disorders have a drastic impact on a large part of the world population. In particular, low-back pain counts as the leading cause of absence from work in the industrial sector. Robotic exoskeletons have great potential to improve industrial workers’ health and life quality. Nonetheless, current solutions are often limited by sub-optimal control systems. Due to the dynamic environment in which they are used, failure to adapt to the wearer and the task may be limiting exoskeleton adoption in occupational scenarios. In this scope, we present a deep-learning-based approach exploiting inertial sensors to provide industrial exoskeletons with human activity recognition and adaptive payload compensation. Inertial measurement units are easily wearable or embeddable in any industrial exoskeleton. We exploited Long-Short Term Memory networks both to perform human activity recognition and to classify the weight of lifted objects up to 15 kg. We found a median F1 score of 90.80 % (activity recognition) and 87.14 % (payload estimation) with subject-specific models trained and tested on 12 (6M-6F) young healthy volunteers. We also succeeded in evaluating the applicability of this approach with an in-lab real-time test in a simulated target scenario. These high-level algorithms may be useful to fully exploit the potential of powered exoskeletons to achieve symbiotic human–robot interaction

Open challenges in the management of autoimmune hepatitis

Autoimmune Hepatitis (AIH) is a rare autoimmune disease of the liver with many open questions as regards its aetiopathogenesis, natural history and clinical management. The classical picture of AIH is chronic hepatitis with fluctuating elevation of serum transaminases and Immunoglobulin G levels, the presence of circulating autoantibodies and typical histological features. However, atypical presentations do occur and are not well captured by current diagnostic scores, with important consequences in terms of missed diagnoses and delayed treatments. AIH is treated with corticosteroids and immunosuppressive drugs but up to 40% of patients do not achieve full biochemical response and are at risk of progressing to cirrhosis and liver failure. Moreover, standard therapies are associated by significant side-effects which may impair the quality of life of patients living with AIH. However, advances in the understanding of the underlying immunology of AIH is raising the prospect of novel therapies and optimisation of existing therapeutic approaches to reduce side-effect burdens and potentially restore immunological tolerance. In this review we outline the clinical characteristics, aetiopathogenesis and management of AIH and current challenges in the diagnosis and management of AIH and provide evidence underlying the evolution of diagnostic and clinical management protocols

Optimal detection of losses by thermal probes

We consider the discrimination of lossy bosonic channels and focus to the case when one of the values for the loss parameter is zero, i.e., we address the detection of a possible loss against the alternative hypothesis of an ideal lossless channel. This discrimination is performed by inputting one-mode or two-mode squeezed thermal states with fixed total energy. By optimizing over this class of states, we find that the optimal inputs are pure, thus corresponding to single- and two-mode squeezed vacuum states. In particular, we show that for any value of the damping rate smaller than a critical value there is a threshold on the energy that makes the two-mode squeezed vacuum state more convenient than the corresponding single-mode state, whereas for damping larger than this critical value two-mode squeezed vacua are always better. We then consider the discrimination in realistic conditions, where it is unlikely to have pure squeezing. Thus by fixing both input energy and squeezing, we show that two-mode squeezed thermal states are always better than their single- mode counterpart when all the thermal photons are directed into the dissipative channel. Besides, this result also holds approximately for unbalanced distribution of the thermal photons. Finally, we also investigate the role of correlations in the improvement of detection. For fixed input squeezing (single-mode or two-mode), we find that the reduction of the quantum Chernoff bound is a monotone function of the two-mode entanglement as well as the quantum mutual information and the quantum discord. We thus verify that employing squeezing in the form of correlations (quantum or classical) is always a resource for loss detection whenever squeezed thermal states are taken as input.Comment: 13 pages, 8 figures. Revised versio

Circuit training during physical education classes to prepare cadets for military academies tests: Analysis of an educational project

Background: The aim of this study was to test the efficacy of an eight-week physical education program based on circuit training to better improve the overall physical and military-specific performance compared to a conventional physical education program in military high school students. Methods: Sixty-four students were enrolled in this study and randomly assigned to an experimental (EG, circuit training) or a control group (CG, traditional physical education program). Immediately before and after the eight-week training period, participants were tested on strength and endurance performance, circuit training tests, and military tests. Moreover, the acquisition of the educational objectives and the pleasantness of the experimental intervention were tested using a qualitative approach. Results: Despite the higher workload in EG than CG during the training period, the effect of the experimental intervention compared to the control was only possibly to likely positive for a few strength and endurance performances and circuit training tests, respectively. A trivial effect was shown in the military tests. On the contrary, the high percentage of motivation (76%), understanding (78%) and collaboration (86%) showed by the students suggests the achievement of acquisition of the educational objectives and a fair pleasantness of the lessons. Conclusions: A lack of clear and marked effect of the experimental intervention could be ascribed to an insufficient exposure time to the training and a high subjective overall workload encountered in military high school students

Safety of vedolizumab in liver transplant recipients : a systematic review

Background: The management of inflammatory bowel disease in patients who have previously undergone liver transplantation can be a clinical challenge. There are serious concerns among physicians regarding the use of biologics for treating such immuno-compromised patients. Objective: We performed a systematic review on vedolizumab therapy in transplant recipients to assess its safety. Methods: PubMed/Embase/Scopus were searched up to November 2018 to identify papers regarding liver transplant recipients and therapy with vedolizumab. Primary outcomes were adverse events. Secondary outcomes were liver transplant and inflammatory bowel disease outcomes. Results: Eight studies (31 patients) were included. Nine out of 31 patients experienced an infection within a mean follow-up time ranging from 5\u201320 months. No malignancies were reported. Inflammatory bowel disease clinical response was experienced by 20/26 patients. Abnormalities in liver tests were recorded in 2/22 patients. Conclusion: Vedolizumab may be considered safe for treating inflammatory bowel disease in liver transplant recipients. Caution is recommended for patients with an unstable liver graft function

The Search for a Practical Approach to Emerging Diseases: The Case of Severe Acute Respiratory Syndrome (SARS)

The plague, which the Board of Health had feared might enter with the German troops into the Milanese, had entered it indeed, as is well known; and it is likewise well known, that it paused not here, but invaded and ravaged a great part of Italy. (A. Manzoni, The Bethrothed, 1826

Optical coherence tomography features of the repair tissue following RPE tear and their correlation with visual outcomes

To assess the optical coherence tomography (OCT) features of the repair tissue after retinal pigment epithelial (RPE) tear in neovascular age-related macular degeneration. Retrospective, observational study. Medical and imaging records of patients that developed tears after starting anti-VEGF treatment and with at least 12 months of follow-up were reviewed. OCT reflectivity of the RPE-subretinal hyperreflective tissue (SHT) complex was measured at 6, 12 and 18 months (when available). Reflectivity of the adjacent unaffected RPE-Bruch’s membrane was taken as internal reference. Other variables: grade and rip occurrence (early/late); number of intravitreal injections; type of macular neovascularization; sub-macular hemorrhage (SMH) at onset. Forty-nine eyes (age: 76.1 ± 7.0 years; VA: 0.54 ± 0.27 LogMAR) were included. Thirty-eight eyes had OCT signs of healing during the follow-up, with 21 showing SMH at baseline. Final VA positively correlated with the number of injections and negatively correlated with the RPE-SHT reflectivity and the presence of SMH (p < 0.001). Reflectivity of the RPE-SHT complex was positively associated with time and SMH at baseline (p < 0.05). In our study, most eyes showed signs of tissue repair after RPE tear. The reflectivity of repair tissue, the SMH presence and the number of anti-VEGF injections appeared to be major predictors of visual outcomes