SAPIENT-Simulator Modelling and Architecture

Future aeronautical communications will be based on the TCP/IP protocol stack, and will occur through a number of different data-link channels (e.g., satellite, terrestrial), with multipath capabilities – the so-called multilink. Seamless vertical handover between different data-links is a requirement and it will improve the safety and reliability of AEROCOM systems, possibly enabling remote-piloted aircrafts (RPAs) for civil operations. This paper describes the modelling, design and implementation of an AEROCOM system simulator based on OMNeT++, developed in the framework of the SAPIENT EU project. The simulator includes models of the aircrafts, including their mobility, terrestrial and satellite data links and core network. Moreover, it includes a solution to simulate the effect of multilink capabilities, which enables one to test multilink decision policies

A Cross-Sectional Survey on Burnout Prevalence and Profile in the Sicilian Population of Ambulance Driver-Rescuers

Introduction: Burnout is present at a high rate in emergency medicine. The ambulance driver-rescuers, who furnish first aid to the victims, are the non-medical part of the Italian 118-service staff. There is a lack of research on burnout risk in Italian Emergency Medical Services and, particularly, for this category of workers. The two Italian studies, including a little group of ambulance driver-rescuers, reported inconsistent findings. Hypothesis: This survey investigated for the first time the prevalence and exact profile of burnout in a large sample of Italian driver-rescuers. As a secondary aim, the study described how the items of the Italian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) cluster in components in this sample. Methods: This cross-sectional census survey was conducted from June 2015 through May 2016 and involved all the driver-rescuers operating in Sicily, the biggest and most southern region of Italy. The subjects received a classification according to different profiles of burnout by using the Italian version of the MBI-HSS (burnout, engagement, disengagement, over-extension, and work-inefficacy). In order to explore the existence of independent factors, a Principal Component Analysis (PCA) was conducted on the survey to obtain eigenvalues >one for each component in the data. Results: The final sample comprised 2,361 responders (96.6% of the initial sample). Of them, 29.8% were in burnout (95% confidence interval [CI], 27.8% to 31.8%) and 1.7% presented a severe form (95% CI, 1.1% to 2.3%); 30.0% were engaged in their work (95% CI, 21.0% to 34.8%), 24.7% of responders were disengaged (95% CI, 22.9% to 26.5%), 1.2% presented an over-extension profile (95% CI, 0.8% to 1.7%), and 12.6% felt work-inefficacy (95% CI, 11.3% to 14.1%). The factors loaded into a five-factor solution at PCA, explaining 48.1% of the variance and partially replicating the three-factor structure. The Emotional Exhaustion (EE) component was confirmed. New dimensions from Personal Accomplishment (PA) and Depersonalization (DP) sub-scales described empathy and disengagement with patients, respectively, and were responsible for the increased risk of burnout. Conclusions: These results endorse the importance of screening and psychological interventions for this population of emergency workers, where burnout could manifest itself more insidiously. It is also possible to speculate that sub-optimal empathy skills could be related to the disengagement and work-inefficacy feelings registered

Detection of HER2 from Haematoxylin-Eosin Slides Through a Cascade of Deep Learning Classifiers via Multi-Instance Learning

Breast cancer is the most frequently diagnosed cancer in woman. The correct identification of the HER2 receptor is a matter of major importance when dealing with breast cancer: an over-expression of HER2 is associated with aggressive clinical behaviour; moreover, HER2 targeted therapy results in a significant improvement in the overall survival rate. In this work, we employ a pipeline based on a cascade of deep neural network classifiers and multi-instance learning to detect the presence of HER2 from Haematoxylin–Eosin slides, which partly mimics the pathologist’s behaviour by first recognizing cancer and then evaluating HER2. Our results show that the proposed system presents a good overall effectiveness. Furthermore, the system design is prone to further improvements that can be easily deployed in order to increase the effectiveness score.Eduardo Conde-Sousa was supported by the project PPBI-POCI-01-0145-FEDER-022122, in the scope of Fundação para a Ciência e Tecnologia, Portugal (FCT) National Roadmap of Research Infrastructures

Quality of life, alexithymia, and defence mechanisms in patients affected by breast cancer across different stages of illness

Objectives: The aim of this study was to evaluate the effect of alexithymia and defence mechanisms on the quality of life of patients affected by breast cancer at different stages of the disease. Methods A convenience sample of 110 patients with breast cancer was involved in the study: 41 were receiving adjuvant chemotherapyafter surgery, 29 had disease-free survival in follow-up and 40 were receiving chemotherapy for metastatic disease. Quality of life, alexithymia and defence mechanisms were assessed using the following instruments: EORTC QLQ-C30-BR23, Toronto Alexithymia Scale (TAS-20) and Defense Mechanism Inventory (DMI). Results Compared to the other groups, patients receiving chemotherapy for metastatic disease reported poorer quality of life in several domains, more severe cancer-related and treatment-related symptoms and higher levels of alexithymia. When the effect of other potential predictors was taken into account, TAS-20 difficulty in identifying feelings was significantly related to all the EORTC functional subscale. Conclusion: This study underlined the relevance of difficulty in emotional processing and defence mechanisms in modulating psychological adjustment in women affected by breast cancer, suggesting that these might be potential targets of psychological intervention for this population

SESAR EXPLORATORY RESEARCH SAPIENT PROJECT OVERVIEW

The SESAR (Single European Sky ATM Research) Exploratory Research project called SAPIENT (Satellite and terrestrial architectures improving performance, security and safety in ATM) is a program of the SESAR Joint Undertaking under the European Union’s Horizon 2020 research and innovation programme under grant agreement 699328 [1][2]. It aims at defining Satellite and Terrestrial Architectures improving performance security and Safety in ATM (Air Traffic Management) through new and innovative functionalities for future CNS (Communication, Navigation and Surveillance) and ATM systems and future European RPAS (Remotely Piloted Air System) C2/C3 satellite Data Link (DL) for governmental initiatives (C2 states for Command and Control, while C3 states Command, Control and Communications). In this context it has been defined SAPIENT which is a novel cost-effective and performance-efficient system solution for aeronautical communications, aimed at adapting and optimizing the capacity and safety performance of aeronautical communication applications, e.g. CPDLC (Controller-Pilot Data Link Communications) and ADS-C (Automatic Dependent Surveillance – Contract), in view of the estimated ‘status’ of air ground ATM SoL (Safety of Life) terrestrial and satellite datalinks over actual flown trajectories. To meet these targets, SAPIENT exploits the information on actual 4D aircraft trajectories – in terms of dynamic position in space and time – and performance data of ATM Air Ground Datalinks, produced by aircraft and other elements of the ATM Communication Infrastructure [3]. The innovative aspects addressed in the SAPIENT Project are related to the TAS-I patent “System for Aeronautical Safety of Life Applications Providing Adaptation of Services and Communication Resources for Maximized Safety and Capacity Performance” [4] . Significant references for the ATM Datalink aspects are the activities undergong in SESAR on VDL2 (VHF Digital Link Mode 2) [5] and other new generation digital datalinks and in ESA on Iris [7]. The SAPIENT solution is a multilink/data link monitor and control system. It is aimed at providing information on the aircraft perception of the operational layout goodness in order to correct or operate more effectively with respect to the ATM communication goals. The main objectives are: - Support the multilink function during the selection of the optimal data link; - Foresee retroaction on the in-use data link, and change the resources during the flight, according to information obtained through it and according to the information collected from the other SAPIENT system actors; - Retroact on multilink function in order to change the priority between data links (i.e. need of load balancing in a common coverage area with traffic hot spots). The use of the SAPIENT system is expected to positively impact: - The efficiency of the data-links management in a multilink environment, resulting in less resources needed by ATM communication system elements, with main focus on effective and efficient use of RF spectrum The Communication issues in the ATM air/ground links minimizing the need of tactical interventions from ATC (Air Traffic Control) and pilots to de-conflict situations - Communication issues in the RPAS C3 satellite DL minimizing the use of RPAS safety procedure that will limit the execution of the RPAS missions - The Air Navigation Service providing a cost saving obtained by improving the Air navigation Service productivity and the frequency band usage The aim of this paper is to present the SAPIENT reference architecture and system boundaries, the SAPIENT protocol and the main SAPIENT simulation result

Non-Invasive Detection of a De Novo Frameshift Variant of STAG2 in a Female Fetus: Escape Genes Influence the Manifestation of X-Linked Diseases in Females

Background: We report on a 20-week-old female fetus with a diaphragmatic hernia and other malformations, all of which appeared after the first-trimester ultrasound. Methods and Results: Whole trio exome sequencing (WES) on cell-free fetal DNA (cff-DNA) revealed a de novo frameshift variant of the X-linked STAG2 gene. Loss-of-function (LoF) STAG2 variants cause either holoprosencephaly (HPE) or Mullegama–Klein–Martinez syndrome (MKMS), are de novo, and only affect females, indicating male lethality. In contrast, missense mutations associate with milder forms of MKMS and follow the classic X-linked recessive inheritance transmitted from healthy mothers to male offspring. STAG2 has been reported to escape X-inactivation, suggesting that disease onset in LoF females is dependent on inadequate dosing for at least some of the transcripts, as is the case with a part of the autosomal dominant diseases. Missense STAG2 variants produce a quantity of transcripts, which, while resulting in a different protein, leads to disease only in hemizygous males. Similar inheritance patterns are described for other escapee genes. Conclusions: This study confirms the advantage of WES on cff-DNA and emphasizes the role of the type of the variant in X-linked disorders

Performances Analysis of Titanium Prostheses Manufactured by Superplastic Forming and Incremental Forming

Abstract Titanium and its alloys are widely used in cranioplasty because they are biocompatible with excellent mechanical properties and favor the osseointegration with the bone. However, when Titanium alloys have to be worked several problems occurred from a manufacturing point of view: the standard procedure for obtaining Titanium prostheses is represented by the machining processes, which result time and cost consuming. The aim of this research consist to introduce alternative flexible sheet forming processes, i.e. Super Plastic Forming (SPF) and Single Point Incremental Forming (SPIF), for the manufacturing of patient-oriented titanium prostheses. The research activities have already highlighted the potentiality of the investigated forming processes that can be alternatively used taking into account both the damage morphology and the need of urgency operation. In the present work, the way of manufacturing the Ti prostheses by SPF and SPIF is described. A comparative analysis has been performed, thus highlighting the peculiarities of the investigated processes and the prostheses feasibility