Extending possibilistic logic over Gödel logic

In this paper we present several fuzzy logics trying to capture different notions of necessity (in the sense of possibility theory) for Gödel logic formulas. Based on different characterizations of necessity measures on fuzzy sets, a group of logics with Kripke style semantics is built over a restricted language, namely, a two-level language composed of non-modal and modal formulas, the latter, moreover, not allowing for nested applications of the modal operator N. Completeness and some computational complexity results are shown

To hear or not to hear: Sound Availability Modulates Sensory-Motor Integration

When we walk in place with our eyes closed after a few minutes of walking on a treadmill, we experience an unintentional forward body displacement (drift), called the sensory-motor aftereffect. Initially, this effect was thought to be due to the mismatch experienced during treadmill walking between the visual (absence of optic flow signaling body steadiness) and proprioceptive (muscle spindles firing signaling body displacement) information. Recently, the persistence of this effect has been shown even in the absence of vision, suggesting that other information, such as the sound of steps, could play a role. To test this hypothesis, six cochlear-implanted individuals were recruited and their forward drift was measured before (Control phase) and after (Post Exercise phase) walking on a treadmill while having their cochlear system turned on and turned off. The relevance in testing cochlear-implanted individuals was that when their system is turned off, they perceive total silence, even eliminating the sounds normally obtained from bone conduction. Results showed the absence of the aftereffect when the system was turned off, underlining the fundamental role played by sounds in the control of action and breaking new ground in the use of interactive sound feedback in motor learning and motor development

The encaged lung: rapidly progressive idiopathic pleurisy.

Here we present a case of an idiopathic fibrinous pleurisy affecting a 56-year old non-smoker male that has shown a rapidly progressive course. With a brief review of the literature we discuss the absence of any identified cause of pleurisy as a relatively common condition, requiring attention and clinical awareness

SARS-CoV-2 tracheitis in laryngectomised patients: A consecutive case-series study

Key points SARS-CoV-2 is a possible cause of acute severe tracheitis in laryngectomees. In our series, the clinical picture was characterized by a haemorrhagic tracheitis with a slow resolution pattern. We observed a histological pattern of erosive inflammation of the respiratory epithelium. Planned tracheo-bronchoscopy and tracheal toilettes are recommended to prevent critical obstruction of the airway, which can be fatal in patients with associated impairment of lung function caused by SARS-CoV-2 infection. The present cases highlight the need for close interdisciplinary working and communication in the management of airway complications of COVID-19 infection

Vanishing lung emphysema during chemotherapy for malignant pleural mesothelioma.

We report the case of a 79-year-old man with a tobacco smoke-related left dystrophic bullous emphysema that showed a considerable recovery of the cystic abnormalities during chemotherapy for pleural malignant mesothelioma. We suggest that the disappearance of the dystrophic emphysema could be explained by the combined effect of chemotherapy and pleural disease. We briefly review the literature and we discuss the possible mechanism of this unforeseen manifestation

Inspiratory effort and lung mechanics in spontaneously breathing patients with acute respiratory failure due to COVID-19. A matched control study.

Several physical and biological mechanisms can drive progression between the different phases of lung injury due to SARS-CoV-2 infection, thus modifying the mechanical properties and behavior of COVID-19 over time. In this research letter we have presented the findings of a registered clinical trial aimed at describing and comparing the inspiratory effort (primary outcome) and the breathing pattern of spontaneously breathing patients with ARF in COVID-19 and historically matched non-COVID-19 patients, either candidate to NIV. Moreover, we reported the response to a 2 hours NIV trial in the two groups. Spontaneously breathing COVID-19 at their early onset of acute respiratory failure with indication for NIV showed different mechanical characteristics and breathing pattern when compared with non-COVID-19

Value of a Multidisciplinary Approach in Sinonasal Inverted Papilloma with Extensive Ossification

Objective: Background: Casa Report: Conclusions: Rare disease Inverted papilloma is a benign epithelial lesion of the nasal cavities. Although commonly encountered in clinical practice, it rarely presents with extensive ossification and few cases have been described in the literature. Herein, we describe the case of a 51-year-old man who presented to clinical attention for persistent right nasal obstruction. Magnetic resonance imaging (MRI) and computed tomography (CT) scans of the facial bones showed a lobated lesion with ossification occupying most of the right nasal cavity. The lesion was removed by endoscopic sinus surgery, leaving the surrounding bone structures intact. On pathological examination, mature bone tissue was found within an inverted papilloma. The pathologist contacted the surgeon, who confirmed that no healthy bone tissue was removed during the procedure. Therefore, a diagnosis of inverted papilloma with ossification could be made without the use of ancillary techniques. Inverted papilloma with ossification is a common lesion with a rare feature. Our report investigates the diagnostic difficulties of a paradigmatic case, highlighting the importance of multidisciplinary teamwork in reach-ing the final diagnosis

Molecular Mechanisms and Physiological Changes behind Benign Tracheal and Subglottic Stenosis in Adults

Laryngotracheal stenosis (LTS) is a complex and heterogeneous disease whose pathogenesis remains unclear. LTS is considered to be the result of aberrant wound-healing process that leads to fibrotic scarring, originating from different aetiology. Although iatrogenic aetiology is the main cause of subglottic or tracheal stenosis, also autoimmune and infectious diseases may be involved in causing LTS. Furthermore, fibrotic obstruction in the anatomic region under the glottis can also be diagnosed without apparent aetiology after a comprehensive workup; in this case, the pathological process is called idiopathic subglottic stenosis (iSGS). So far, the laryngotracheal scar resulting from airway injury due to different diseases was considered as inert tissue requiring surgical removal to restore airway patency. However, this assumption has recently been revised by regarding the tracheal scarring process as a fibroinflammatory event due to immunological alteration, similar to other fibrotic diseases. Recent acquisitions suggest that different factors, such as growth factors, cytokines, altered fibroblast function and genetic susceptibility, can all interact in a complex way leading to aberrant and fibrotic wound healing after an insult that acts as a trigger. However, also physiological derangement due to LTS could play a role in promoting dysregulated response to laryngo-tracheal mucosal injury, through biomechanical stress and mechanotransduction activation. The aim of this narrative review is to present the state-of-the-art knowledge regarding molecular mechanisms, as well as mechanical and physio-pathological features behind LTS

Fibrotic idiopathic interstitial lung disease: the molecular and cellular key players.

Interstitial lung disease (ILDs) that are known as diffuse parenchymal lung diseases (DPLDs) lead to the damage of alveolar epithelium and lung parenchyma culminating into inflammation and widespread fibrosis. ILDs that account for more than 200 different pathologies, can be di-vided into two groups: ILDs that have a known cause and those where the cause is unknown clas-sified as Idiopathic Interstitial Pneumonia (IIPs). IIPs include idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP), cryptogenic organizing pneumonia (COP) known also as bronchiolitis obliterans organizing pneumonia (BOOP), Acute interstitial pneumonia (AIP), Desquamative Interstitial Pneumonia (DIP), Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), and lymphocytic interstitial pneumonia (LIP). In this review our aim is to de-scribe the pathogenic mechanisms that lead to the onset and progression of the different IIPs, starting from IPF as the most studied, in order to find both common and standalone molecular and cellular key players among them. Finally, a deeper molecular and cellular characterization of different interstitial lung disease without known cause, would contribute to give a more accurate diagnosis to the patients, that would translate in a more effective treatment decision

Subclinical liver fibrosis in patients with idiopathic 1 pulmonary fibrosis.

Background - Data on the presence of subclinical fibrosis across multiple organs in patients with idiopathic lung fibrosis (IPF) are lacking. Our study aimed at investigating through hepatic transient elastography (HTE) the prevalence and clinical impact of subclinical liver fibrosis in a cohort of patients with IPF. Methods - Patients referred to the Centre for Rare Lung Disease of the University Hospital of Modena (Italy) from March 2012 to February 2013with established diagnosis of IPF and without a documented history of liver diseases were consecutively enrolled and underwent HTE. Based on hepatic stiffness status as assessed through METAVIR score patients were categorized as \u201c with liver fibrosis \u201d (corresponding to a METAVIR score of F1-F4) and \u201c without liver fibrosis\u201d (METAVIR F0). Potential predictors of liver fibrosis were investigated through logistic regression model among clinical and serological variables. The overall survival (OS) was assessed according to liver fibrosis and multivariate Cox regression analysis was used to identify independent predictors. Results - In 13 out of 37 patients (35%) with IPF a certain degree of liver fibrosis was documented.No correlation was found between liver stiffness and clinical-functional parameters. OS was lower in patients \u2018 with liver fibrosis\u2019 than in patients \u2018 without liver fibrosis\u2019 (median months 33[23-55] vs. 63[26-94], p=0.038). Patients \u2018 with liver fibrosis\u2019 presented a higher risk of death at seven years as compared to patients \u2018without liver fibrosis\u2019 (HR=2.6, 95%CI[1.003\u20136.7],p= 0.049). Higher level of AST to platelet ratio Index (APRI)was an independent predictor of survival (HR=4.52 95%CI[1.3\u201315.6], p=0.02). Conclusions - In our cohort, more than one third of IPF patients had concomitant subclinical liver fibrosis that negatively affected OS. These preliminary claims further investigation aimed at clarifying the mechanisms beyond multiorgan fibrosis and its clinical implication in patients with IPF