Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study

Objective: To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods: Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann–Whitney U test, respectively (α = 0.05). Results: The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter-and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions: Integrating remote monitoring systems, such as Dental Monitoring®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted

Functional Tricuspid Regurgitation Repair at the time of Left-Sided Valve Surgery. the Impact on the Cardiac Rehabilitation Program

Objective: to compare the early post-operative functional status and the efficacy of the cardiac rehabilitation program (CRP) after isolated left-sided valvular surgery or with concomitant tricuspid valve repair (TVR). Methods: we retrospectively enrolled patients admitted to the Cardiac Rehabilitation Unit of our institution from January 2014 to January 2019, following mitral or aortic valve surgery. In agreement with current guidelines, concomitant tricuspid annuloplasty was added to patients with severe functional tricuspid regurgitation (TR) and in those with mild to moderate TR when annulus dilatation was present. A 6-minute walk test (6mWT) was performed within the second day of admission and repeated predischarge. The distances walked on the 6mWT were reported as absolute value and as a percentage of the predicted value, taking into account anthropometric variables. Changes in the 6mWT performance and Barthel index (BI) were assessed to evaluate the impact of CRP on exercise tolerance and functional independence, respectively. Results: of 117 patients, 62 (53%) had isolated left-sided valvular surgery and 55 (47%) had concomitant TVR. There were no significant differences between the two groups in the baseline 6mWT performance and its improvement at the end of CRP. TVR was associated with a worse BI on admission, but with a greater improvement after the CRP and a pre-discharge BI comparable to isolated left-sided surgery. Upon linear regression analysis, diabetes and chronic renal disease were predictors of the baseline 6mWT performance. Conclusion: TVR does not affect the early post-operative functional status and the efficacy of the CRP after valvular surgery

Emergency Department as an epidemiological observatory of Human Mobility: the experience of the Moroccan population

We conducted a retrospective study of the accesses to the Emergency Department registered from January 2000 to December 2014 in 5 major hospitals in the Metropolitan Area of Rome. We extrapolated data relating to patients of Moroccan origin from about 5 million total accesses, so we compared with Italians data which, in the same period, came to ED. The Moroccan population is distinguished by a larger number of diagnoses belonging to the ICD-9 code of Infectious Diseases and, more precisely, to Respiratory Infectious Diseases. There are also no differences in the assignment of such diagnoses to Moroccans with Italian citizenship, and this led to think that this could play an important role in the use of the ED and moreover that enrollment to the National Health Service may reduce its inappropriate use. Regarding to Degenerative Disorders, the result of our analysis is quite emblematic, showing that the accesses to the ED is due to Cardiovascular Diseases: 6.33% of Italians' accesses against 1.81% of Moroccans and 2.36% of Moroccans with Italian citizenship. The main explanation for this difference is, obviously, due to the age of the population: about 60% of Moroccans who accessed to ED was less than 40 years old. It is interesting how, in the field of ​​Cardiovascular Diseases, Moroccans have a lower percentage of diagnosis compared to Italians for acute diseases and a greater percentage of diagnoses for chronic diseases, suggesting once again that accesses to ED for migrants often is due to the inability to use the general services of the National Health Service. In conclusion, from the point of view of the Emergency Department, Migration Medicine still has Infectious Diseases as the main reason for access. Degenerative Disorders remain a prerogative of the Italians, but we could certainly assume that the Moroccan population would develop at some point with the aging

ROSES, the only RObotic System for any Endovascular Surgery, Including the Control of an Animated Catheter Characterized by the Presence of two Controlled Curvatures

The paper presents ROSES, its robotic components, the different devices, not necessarily sterile, and its disposables, suitable for any endovascular procedure, both actually performed and presently not assisted by any robotic system, and open in the future for new application yet to come, such as what will be allowed by the new animated catheter. In fact, this is due to the mechanical configuration of the robotic actuators based on a peculiar gear train which presents a big passage hole which allows both the passage of big catheters and even hemostasis valves, as well as full control of very small catheters and guide wires. The system measures forces opposed by the body showing their value both numerically and analogically without the need of any. special tool, measures length of penetration of each catheter and guide wires recording their value. Thus, it may become in future, connected to a work station that will register in real time also the fluoroscopic images, a kind of black box of endovascular surgeries, separating completely doctor and nurses from the patient, using also cameras and microphones to replace the physical contact with the patient

ROSES: The most Complete System for Endovascular Surgery

ROSES, an innovative Robotic System for Endovascular Surgery, features a unique mechanism that continuously measures the resistance encountered by catheters and guide wires as they advance within the body. This feature operates seamlessly without the need for additional specialized components. The system is comprised of a series of robotic actuators (up to three) arranged linearly on slides running along a rail, inclined toward the patient. Another slide, housing a pair of step motors, facilitates the adjustment of relative positions between the actuators, with the proximal actuator affixed to the motor slide by a lateral bar. A force transducer, linked to the motor slide via a wire, is responsive to the gravitational component of any object on the rail. Importantly, this force remains constant even as the actuators move. However, the force dynamically changes if an external obstruction hinders the progress of catheters and guide wires, serving as an alert to the attending physician. The system, uniquely, is also capable of guiding the introduction of the first catheter, even if it is pre-curved. This capability facilitates the complete separation of the doctor from the patient throughout the entire surgical procedure. The system employs compact, purely mechanical disposables designed for a wide range of interventions utilizing commercially available catheters and guide wires, including angioplasty, brain and carotid surgery (for aneurysms or thrombi), TAVI, and various lower and upper limb procedures. Future developments include the incorporation of animated catheters capable of altering their shape configuration under console control. As the system also records the penetration length of each device and transmits this data to a workstation along with X-ray images, it effectively becomes the "black box" of endovascular surgeries. This functionality allows for a complete separation between physicians and patients throughout the entire surgical procedure. The system is safeguarded by multiple pending international patent applications

TEVAR for traumatic thoracic injury with the first-generation stent graft

Thoracic endovascular aortic repair (TEVAR) is a life-saving treatment for blunt thoracic aortic injury. We report long-term outcomes of two young patients who underwent TEVAR for blunt thoracic aortic injury with first-generation thoracic stent grafts. The off-label use of the endograft affected the outcomes: one case of open surgery conversion due to an aortoesophageal fistula and one case of endovascular relining for a voluminous pseudoaneurysm associated with a type III endoleak. Long-term follow-up is crucial in TEVAR, especially in case of a first-generation device used in an urgent setting

Dome C East radar: Preliminary analysis of echo statistics

Ionospheric echo occurrence rates for the Dome C East Super Dual Auroral Radar Network radar are presented with a focus on seasonal and solar cycle effects

Low energy high angular resolution neutral atom detection by means of micro-shuttering techniques: the BepiColombo SERENA/ELENA sensor

The neutral sensor ELENA (Emitted Low-Energy Neutral Atoms) for the ESA cornerstone BepiColombo mission to Mercury (in the SERENA instrument package) is a new kind of low energetic neutral atoms instrument, mostly devoted to sputtering emission from planetary surfaces, from E ~20 eV up to E~5 keV, within 1-D (2x76 deg). ELENA is a Time-of-Flight (TOF) system, based on oscillating shutter (operated at frequencies up to a 100 kHz) and mechanical gratings: the incoming neutral particles directly impinge upon the entrance with a definite timing (START) and arrive to a STOP detector after a flight path. After a brief dissertation on the achievable scientific objectives, this paper describes the instrument, with the new design techniques approached for the neutral particles identification and the nano-techniques used for designing and manufacturing the nano-structure shuttering core of the ELENA sensor. The expected count-rates, based on the Hermean environment features, are shortly presented and discussed. Such design technologies could be fruitfully exported to different applications for planetary exploration.Comment: 11 page

COVID-19-associated orphanhood and caregiver death in the United States

Background: Most COVID-19 deaths occur among adults, not children, and attention has focused on mitigating COVID-19 burden among adults. However, a tragic consequence of adult deaths is that high numbers of children might lose their parents and caregivers to COVID-19-associated deaths. Methods: We quantified COVID-19-associated caregiver loss and orphanhood in the US and for each state using fertility and excess and COVID-19 mortality data. We assessed burden and rates of COVID-19-associated orphanhood and deaths of custodial and co-residing grandparents, overall and by race/ethnicity. We further examined variations in COVID-19-associated orphanhood by race/ethnicity for each state. Results: We found that from April 1, 2020 through June 30, 2021, over 140,000 children in the US experienced the death of a parent or grandparent caregiver. The risk of such loss was 1.1 to 4.5 times higher among children of racial and ethnic minorities, compared to Non-Hispanic White children. The highest burden of COVID-19-associated death of parents and caregivers occurred in Southern border states for Hispanic children, Southeastern states for Black children, and in states with tribal areas for American Indian/Alaska Native populations. Conclusions: We found substantial disparities in distributions of COVID-19-associated death of parents and caregivers across racial and ethnic groups. Children losing caregivers to COVID-19 need care and safe, stable, and nurturing families with economic support, quality childcare and evidence-based parenting support programs. There is an urgent need to mount an evidence-based comprehensive response focused on those children at greatest risk, in the states most affected