Sulle tracce dei pastori-allevatori pre-protostorici nel Carso (e altrove): esempi di uso integrato di indicatori diversi

The Classical Karst is a plateau of low rounded hills and low mountains ranging from 100-200 m to 800-900 m above sea level, that covers the eastern most part of northern Italy and the southwestern part of Slovenia. The outcropping rocks are chiefly limestones, crossed by two flysch (marl and sandstone) belts, a dozen kilometres wide. The area is not suitable for agriculture, and since historical times pastoralism / herding of sheep and goats has been one of the main economic activities. Its importance also in prehistoric times – hinted at already at the end of the 19th century by Marchesetti – was confirmed in the late 1990s, when sedimentological and soil micro-morphological analyses of some cave deposits indicated that these sites, at least in the investigated areas, had been used by prehistoric shepherds for stabling their flocks. The re-examination of the archaeological materials found in the same caves suggested that the pastoral use presumably started in the Neolithic and continued till the Bronze or Iron Age. In the course of millennia the agents and the ways of using the caves would have clearly changed: on the grounds of the available data, and still referring to the models proposed by Brochier c. 20 years ago, at present the hypothesis that most of the Karst caves were basically used as “grottes-bergeries” – i.e. as stables almost without a contemporaneous human presence –, rather than “habitats-bergeries”, is likely, though not beyond doubt. Our interpretation combines direct and indirect indicators from different scientific fields: besides sedimentology, soil micromorphology and archaeology, at the basis of the renewed interest in pastoralism, archaeometry, geomorphology, archaeozoology, ethnohistory and ethnography. To test the potentiality of the use of data derived in particular from the last two fields, we have recently extended our research to other geographical areas, close to the Karst, immediately to the north, in the northeastern part of the region Friuli Venezia Giulia, and far away, in Sardinia

The Patients with Incidentally Discovered Adrenal Adenoma (Incidentaloma) Are Not at Increased Risk of Osteoporosis

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Blood management in fast-track orthopedic surgery: An evidence-based narrative review

Background and purpose: Innovations able to maintain patient safety while reducing the amount of transfusion add value to orthopedic procedures. Opportunities for improvement arise especially in elective procedures, as long as room for planning is available. Although many strategies have been proposed, there is no consensus about the most successful combination. The purpose of this investigation is to identify information to support blood management strategies in fast-track total joint arthroplasty (TJA) pathway, to (i) support clinical decision making according to current evidence and best practices, and (ii) identify critical issues which need further research. Methods and materials: We identified conventional blood management strategies in elective orthopedic procedures. We performed an electronic search about blood management strategies in fast-track TJA. We designed tables to match every step of the former with the latter. We submitted the findings to clinicians who operate using fast-track surgery protocols in TJA at our research hospital. Results: Preoperative anemia detection and treatment, blood anticoagulants/aggregants consumption, transfusion trigger, anesthetic technique, local infiltration analgesia, drainage clamping and removals, and postoperative multimodal thromboprophylaxis are the factors which can add best value to a fast-track pathway, since they provide significant room for planning and prediction. Conclusion: The difference between conventional and fast-track pathways does not lie in the contents of blood management, which are related to surgeons/surgeries, materials used and patients, but in the way these contents are integrated into each other, since elective orthopedic procedures offer significant room for planning. Further studies are needed to identify optimal regimens

A parallel pattern for iterative stencil + reduce

We advocate the Loop-of-stencil-reduce pattern as a means of simplifying the implementation of data-parallel programs on heterogeneous multi-core platforms. Loop-of-stencil-reduce is general enough to subsume map, reduce, map-reduce, stencil, stencil-reduce, and, crucially, their usage in a loop in both data-parallel and streaming applications, or a combination of both. The pattern makes it possible to deploy a single stencil computation kernel on different GPUs. We discuss the implementation of Loop-of-stencil-reduce in FastFlow, a framework for the implementation of applications based on the parallel patterns. Experiments are presented to illustrate the use of Loop-of-stencil-reduce in developing data-parallel kernels running on heterogeneous systems

Modular implant design affects metal ion release following metal-on-metal hip arthroplasty: a retrospective study on 75 cases

Metal-on-Metal (MoM) total hip arthroplasty (THA) has been associated to wear and metal-ions release, controversially related to a variety of clinical complications. Little is known about the relevant design-dependent parameters involved in this process. The present study investigated the correlation between metal ion release in blood and revision rate as a function of: (i) specific MoM implant modular design parameters, (i.e. acetabular cup and femoral head diameters, taper adapter material and size, femoral neck material and modularity and stem size); (ii) MoM bilaterality. Co and Cr ions concentration levels in blood of 75 patients were retrospectively-evaluated with a mean follow-up of 4.8 years (range: 1.8-6.3). Patients were divided in a unilateral and a bilateral group. Statistical analysis was performed to find any significant difference related to acetabular cup diameter, femoral head diameter, taper adapter material/size, neck material/size and stem size. The bilateral MoM group had 4-times higher metal ion levels in blood than the unilateral one (p=0.017 only Cr), related to a higher revision rate (30% vs 20%): differences were 10-times higher particularly with a 48 mm femoral head diameter (p=0.012) and a Ti-alloy neck (p=0.041). Within the monolateral group using a shorter taper adapter and a shorter neutrally-oriented neck demonstrated higher ion levels (p=0.038 only Cr and p=0.008 only Co, respectively). The aforementioned design-features and MoM bilaterality are important risk-factors for metal-ion release in modular MoM THA

SOI-based micro-mechanical terahertz detector operating at room-temperature

We present a micro-mechanical terahertz (THz) detector fabricated on a silicon on insulator (SOI) substrate and operating at room-temperature. The device is based on a U-shaped cantilever of micrometric size, on top of which two aluminum half-wave dipole antennas are deposited. This produces an absorption extending over the $\sim 2-3.5$THz frequency range. Due to the different thermal expansion coefficients of silicon and aluminum, the absorbed radiation induces a deformation of the cantilever, which is read out optically using a $1.5\mu$m laser diode. By illuminating the detector with an amplitude modulated, 2.5 THz quantum cascade laser, we obtain, at room-temperature and atmospheric pressure, a responsivity of $\sim 1.5 \times 10^{8}$pm/W for the fundamental mechanical bending mode of the cantilever. This yields an noise-equivalent-power of 20 nW/Hz$^{1/2}$ at 2.5THz. Finally, the low mechanical quality factor of the mode grants a broad frequency response of approximately 150kHz bandwidth, with a response time of $\sim 2.5\mu$s

Transoral glossoepiglottopexy in the treatment of adult obstructive sleep apnoea: A surgical approach [Glossoepiglottoplastica con approccio trans-orale nel trattamento delle apnee ostruttive notturne nell\u2019adulto]

The treatment of obstructive sleep apnoea syndrome (OSAS) is still a matter of debate; among the different therapeutic alternatives, both surgical and conservative, treatment with continuous positive airway pressure (CPAP) is considered the \u201cgold standard\u201d. The recent scientific literature reports that even if CPAP represents an effective solution for sleep apnoeas, 12% of patients do not benefit from its use. In most cases, primary collapse of the epiglottis is responsible for failure. We developed a surgical technique that provides a stable support to the epiglottis without influencing its function during swallowing while preserving laryngeal anatomy and physiology. The procedure we propose is based on that conceived by Monnier for children affected by laryngomalacia. We analysed a group of 20 patients who underwent glossoepiglottopexy between January 2015 and September 2016 and compared data (AHI, ODI, t90, ESS, EAT10, etc.) collected before and 6 months after surgery to demonstrate the safety and effectiveness of our glossoepiglottopexy (GEP). The results allow us to consider GEP as a valid choice to treat adults who suffer from sleep apnoeas

Magnetic Resonance vs. Intraoral Ultrasonography in the Preoperative Assessment of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Background: Preoperative assessment is critical to decide the most adequate surgical strategy for oral squamous cell carcinoma (SCC). Magnetic resonance (MR) and intraoral ultrasonography (US) have been reported to be of great value for preoperative estimation of depth of invasion (DOI) and/or tumor thickness (TT). This review aims to analyze the accuracy of MR and intraoral US in determining DOI/TT in oral SCC, by assuming histological evaluation as the reference method. Methods: The procedure was conducted following the modified 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We performed a systematic search of papers on PubMed, Scopus, Web of Science, and Cochrane Library databases until July 31st, 2019. For quantitative synthesis, we included nine studies (487 patients) focused on MR, and 12 (520 patients) focused on intraoral US. The Pearson correlation coefficient (r) between DOI/TT evaluated with MR or intraoral US was assumed as effect size. A meta-analysis (MA) for each study group (MR and US) was performed by using the random-effects models with the DerSimonian\u2013Laird estimator and r-to-z transformation. Results: In the MA for MR studies, a high heterogeneity was found (I2 = 94.84%; Q = 154.915, P < 0.001). No significant risk of bias occurred by evaluating funnel plot asymmetry (P = 0.563). The pooled (overall) r of the MR studies was 0.87 (95% CI from 0.82 to 0.92), whereas the pooled r-to-z transformed was 1.44 (95% CI from 1.02 to 1.85). In the MA for US studies a high heterogeneity was found (I2 = 93.56%; Q = 170.884, P < 0.001). However, no significant risk of bias occurred (P = 0.779). The pooled r of the US studies was 0.96 (95% CI from 0.94 to 0.97), whereas the pooled r-to-z transformed was 1.76 (95% CI from 1.39 to 2.13). These outputs were confirmed in additional MA performed by enrolling only MR (n = 8) and US (n = 11) studies that evaluated TT. Conclusions: MR and intraoral US seem to be promising approaches for preoperative assessment of DOI/TT in oral SCC. Remarkably, a higher pooled r and r-to-z transformed were observed in the intraoral US studies, suggesting that this approach could be more closely related to histopathological findings

Confident texture-based laryngeal tissue classification for early stage diagnosis support

Early stage diagnosis of laryngeal squamous cell carcinoma (SCC) is of primary importance for lowering patient mortality or after treatment morbidity. Despite the challenges in diagnosis reported in the clinical literature, few efforts have been invested in computer-assisted diagnosis. The objective of this paper is to investigate the use of texture-based machine-learning algorithms for early stage cancerous laryngeal tissue classification. To estimate the classification reliability, a measure of confidence is also exploited. From the endoscopic videos of 33 patients affected by SCC, a well-balanced dataset of 1320 patches, relative to four laryngeal tissue classes, was extracted. With the best performing feature, the achieved median classification recall was 93% [interquartile range ðIQRÞ ¼ 6%]. When excluding low-confidence patches, the achieved median recall was increased to 98% (IQR ¼ 5%), proving the high reliability of the proposed approach. This research represents an important advancement in the state-of-the-art computer-assisted laryngeal diagnosis, and the results are a promising step toward a helpful endoscope-integrated processing system to support early stage diagnosis