Is the adjustable lumbo-peritoneal shunt a valid option for managing symptomatic idiopathic intracranial hypertension? A case report of a multidisciplinary management

Background: Idiopathic intracranial hypertension is a rare disorder, characterized by raised intracranial pressure with no recognizable cause. Headache, decreased visual acuity and papilledema are the main clinical manifestations. Case description: A case of a 27-year-old obese woman affected by idiopathic intracranial hypertension is reported. She was initially treated conservatively, but, due to severe headache refractory to medical therapy, an adjustable lumbo-peritoneal shunt was implanted. Conclusion: Gold standard treatment of idiopathic intracranial hypertension is not defined yet, but the lumbo-peritoneal shunt could represent a valid option for managing the disease in properly selected patients. Keywords: Lumbo-peritoneal shunt, Idiopathic intracranial hypertension, Pseudotumor cerebr

Lab-on-Chip for testing myelotoxic effect of drugs and chemicals

In the last 20 years, one of the main goals in the drug discovery field has been the development of reliable in vitro models. In particular, in 2006 the European Centre for the Validation of Alternative Methods has approved the colony-forming unit granulocytes–macrophages test, which is the first and currently unique test applied to evaluate the myelotoxicity of xenobiotics in vitro. The present work aimed at miniaturizing this in vitro assay by developing and validating a Lab-on-Chip platform consisting of a high number of bioreactor chambers with screening capabilities in a high-throughput regime

Towards Exoscope Automation in Neurosurgery: A Markerless Visual-Servoing Approach

Exoscopes are a promising tool for neurosurgeons, offering improved visualisation and ergonomics compared with traditional surgical microscopes. They consist of an external scope that projects the surgical field onto a 2D or 3D monitor, providing a wider field of view and better access to the surgical site. Despite the advantages, exoscopes present some limitations, such as the need for manual or foot joystick repositioning, which can disrupt the flow of the procedure and increase the risk of user error. In this study, a markerless visual-servoing approach for autonomous exoscope control is proposed to address these limitations and enhance the ergonomics and reduce the physical and cognitive load compared with traditional joystick control. The system uses visual information from the operating field to control the exoscope, eliminating the need for markers or additional tracking devices. The proposed approach was validated using a 7-DOF robotic manipulator with a stereo camera in an eyein-hand configuration. Results showed that the system achieved 89% accuracy in detecting the target and tracking its movement with a tracking error ranging from 0.50 +/- 0.17 cm for lowspeed movements to 1.38 +/- 0.73 cm for high-speed movements. The proposed system also demonstrated improved efficiency, with a shorter execution time of 72.07 +/- 19.36 s compared with 106.52 +/- 18.50 s for the foot-joystick control. Additionally, the time out of the FoV was significantly higher in the joystick control mode and the frequency of appearance of the instrument in the centre of the image was higher when using the proposed system. The NASA TLX results indicated lower physical and cognitive load compared with the joystick control-based modality

Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study

BACKGROUND: Pulmonary rehabilitation (PR) is recognized as an evidence-based treatment in improving dyspnea and quality of life in patients with COPD. We evaluated the number needed to treat (NNT) to achieve an increase in physical capacity, as defined by a significant improvement in the six-minute walk test (6MWT) in patients with COPD undergoing PR. METHODS: The study enrolled 284 patients aged 41 to 86 years (mean age 69.4 years) divided into two groups: a study group (222 patients) undergoing a PR program, and a control group (62 patients) treated only with drugs. The study group included patients with COPD divided in four subgroups according to GOLD stages. RESULTS: In the study group, 142 out of 222 patients (64%) had an increase of at least 54 m in the 6MWT following PR versus 8 out of 62 patients (13%) in the control group after the same time interval. The NNT in the overall study group was 2; the same NNT was obtained in GOLD stages 2, 3, and 4, but was 8 in stage 1. CONCLUSIONS: PR is highly effective in improving the exercise capacity of patients with COPD, as demonstrated by a valuable NNT, with better results in patients with a more severe disease

Thyroid cartilage infiltration in advanced laryngeal cancer: prognostic implications and predictive modelling

Objective: Detection of laryngeal cartilage invasion is of great importance in staging of laryngeal squamous cell carcinoma (LSCC). The role of prognosticators in locally advanced laryngeal cancer are still widely debated. This study aimed to assess the impact of volume of thyroid cartilage infiltration, as well as other histopathologic variables, on patient survival. Materials and methods: We retrospectively analysed 74 patients affected by pT4 LSCC and treated with total laryngectomy between 2005 and 2021 at the Department of Otorhinolaryngology - Head and Neck Surgery of the University of Brescia, Italy. We considered as potential prognosticators histological grade, perineural (PNI) and lympho-vascular invasion (LVI), thyroid cartilage infiltration, and pTN staging. Pre-operative CT or MRI were analysed to quantify the volume of cartilage infiltration using 3D Slicer software. Results: The 1-, 3-, and 5-year disease free survivals (DFS) were 76%, 66%, and 64%, respectively. Using machine learning models, we found that the volume of thyroid cartilage infiltration had high correlation with DFS. Patients with a higher volume (> 670 mm3) of infiltration had a worse prognosis compared to those with a lower volume. Conclusions: Our study confirms the essential role of LVI as prognosticator in advanced LSCC and, more innovatively, highlights the volume of thyroid cartilage infiltration as another promising prognostic factor

The impact of COVID-19 pandemic on surgical neuro-oncology: A survey from the Italian society of neurosurgery (SINch)

Background: The COVID-19 pandemic and its impact on hospitals' activity and organization has imposed a vast change in standard neurosurgical oncology practice to accommodate for shifting resources. Aims: This investigation aims to analyse the nationwide capability in reorganizing the surgical neuro-oncological activity during the COVID-19 pandemic to evaluate whether COVID-19-pandemic influenced the surgical management in these patients. Method: A web-based dataset model organized by the Italian Neurosurgical Society (SINCh) was sent to all the Italian neurosurgical departments in May 2021, requesting to report the types and numbers of surgical procedures performed in the pre-pandemic period (from March 9th 2019 to March 9th 2020) compared to the pandemic period (from March 10th 2020 to March 10th 2021). Results: This multicentre investigation included the surgical activity of 35 Italian Neurosurgical Departments in a pre-pandemic year versus a pandemic year. During the COVID period, 699 fewer neuro-oncological patients were operated on than in the pre-COVID period. We noted a slight increase in urgency and a more severe decrease in elective and benign pathology. None of these differences was statistically significant. Surgically treated patients who tested positive for SARS-CoV-2 were 36, of which 11 died. Death was found to be COVID-related only in 2 cases. Conclusion: The reorganization of the Italian Neurosurgical Departments was able to guarantee a redistribution of the CNS tumors during the inter-pandemic periods, demonstrating that patients even in the pandemic era could be treated without compromising the efficacy and safety of the surgical procedure

COSINUS: Cryogenic Calorimeters for the Direct Dark Matter Search with NaI Crystals

COSINUS (Cryogenic Observatory for SIgnatures seen in Next-generation Underground Searches) is an experiment employing cryogenic calorimeters, dedicated to direct dark matter search in underground laboratories. Its goal is to cross-check the annual modulation signal the DAMA collaboration has been detecting for about 20 years (Bernabei et al. in Nucl Part Phys Proc 303-305:74-79, 2018. 10.1016/j.nuclphysbps.2019.03.015) and which has been ruled out by other experiments in certain dark matter scenarios. COSINUS can provide a model-independent test by the use of the same target material (NaI), with the additional chance of discriminating beta/gamma events from nuclear recoils on an event-by-event basis, by the application of a well-established temperature sensor technology developed within the CRESST collaboration. Each module is constituted by two detectors: the light detector, that is a silicon beaker equipped with a transition edge sensor (TES), and the phonon detector, a small cubic NaI crystal interfaced with a carrier of a harder material (e.g. CdWO4), also instrumented with a TES. This technology had so far never been applied to NaI crystals because of several well-known obstacles, and COSINUS is the first experiment which succeeded in operating NaI crystals as cryogenic calorimeters. Here, we present the COSINUS project, describe the achievements and the challenges of the COSINUS prototype development and discuss the status and the perspectives of this NaI-based cryogenic frontier

Discovery of the 151^{151}Eu α\alpha decay

We report on the first compelling observation of $\alpha$ decay of $^{151}$Eu to the ground state of $^{147}$Pm. The measurement was performed using a 6.15 g Li$_6$Eu(BO$_3$)$_3$ crystal operated as a scintillating bolometer. The Q-value and half-life measured are: Q = 1948.9$\pm 6.9(stat.) \pm 5.1(syst.)$ keV, and T$_{1/2}=\left( 4.62\pm0.95(stat.)\pm0.68(syst.)\right) \times 10^{18}$ y . The half-life prediction of nuclear theory using the Coulomb and proximity potential model are in good agreement with this experimental result