The management of knee osteoarthritis in elderly: results from a national survey compared to ESCEO guidelines

OBJECTIVE: Knee osteoarthritis (KOA) is a degenerative and inflammatory disease with a rising incidence and prevalence worldwide. Various therapeutic strategies have been proposed over time, depending on the degrees of severity and usually based on individual clinical practice. However, several European and international scientific societies published guidelines, to provide practical clinical stepwise guidance and to facilitate individualized therapeutic decisions regarding the management of KOA. The aim of this prospective multicentre observational study was to describe the real outpatient territorial management of patients with knee osteoarthritis and to compare it with the ESCEO guidelines, in order to identify operational strategies for delivering patient-centric care. MATERIALS AND METHODS: The educational project was divided in three modules: the first and the last through webinar; the second held in daily practice. The participants had to register structured observations. RESULTS: The project has been joined by 155 discussants, and the 2,656 observations collected allowed the understanding of the most common therapeutic approaches for knee osteoarthritis on the Italian territory. CONCLUSIONS: The educational project proved to be useful for updating on the state of the art of therapeutic management of knee osteoarthritis, and to increase expertise in detecting prevention and treatment strategies according to ESCEO guidelines to apply in the Real-Life context

Multi-COBS: A Novel Algorithm for Byte Stuffing at High Throughput

Framing methods are used to break a data stream into packets in most digital communications. The use of a reserved symbol to denote the frame boundaries is a popular practice. This end-of-frame (EOF) marker should be removed from the packet content in a reversible manner. Many strategies, such as the bit and byte stuffing processes employed by high-level data link control (HDLC) and Point-to-Point Protocol (PPP), or the Consistent Overhead Byte Stuffing (COBS), have been devised to perform this goal. These bit and byte stuffing algorithms remove the reserved EOF marker from the packet payload and replace it with some extra information that can be used to undo the action later. The amount of data added is called overhead and is a figure-of-merit of such algorithms, together with the encoding and decoding speed. Multi-COBS, a new byte stuffing algorithm, is presented in this paper. Multi-COBS provides concurrent encoding and decoding, resulting in a performance improvement of factor four or eight in common word-based digital architectures while delivering an average and worst-case overhead equivalent to the state-of-the-art. On the reference 28-nanometer field programmable gate array (FPGA) (Artix-7), Multi-COBS achieves a throughput of 6.6 Gbps, instead of 1.7 Gbps of COBS. Thanks to its parallel elaboration capability, Multi-COBS is ideal for digital systems built in programmable logic as well as modern computers

State of art in intra-articular hip injections of different medications for osteoarthritis: a systematic review

Background: Intra-articular hip injections for osteoarthritis represent a useful instrument to reduce pain and disability in the common clinical practice. Several medications can be injected locally with different level of evidence-based efficacy. Objective: The objective of this systematic review is to investigate the effectiveness of intra-articular injections of different medications or substances for the pain treatment and the management of disability in subjects affected by hip osteoarthritis. Methods: Two reviewers selected independently randomised controlled trials published in the last 10 years, using PubMed and Scopus databases. The risk of bias was evaluated with Cochrane library assessment tool. Results: 12 randomised controlled trials have been selected. We found 8 papers comparing hyaluronic acid with platelet rich plasma, with corticosteroids and with saline solution; 1 paper compares two types of hyaluronic acid with different molecular weights; 3 papers study the effects of corticosteroids alone or compared to ketorolac or saline solution. Conclusions: The studies reviewed were heterogeneous regarding sample size, level of osteoarthritis, evaluated with Kellegren-Lawrence score, medications used and follow up timings. However, we have observed that intra-articular injections of platelet-rich plasma seem to decrease pain at short term and disability at long term, in patients affected by hip osteoarthritis better than hyaluronic acid. The association of hyaluronic acid and corticosteroids could give better results compared to hyaluronic acid alone, while the use of intra-articular ketorolac and saline solution requires more studies

Relax-and-fix heuristics applied to a real-world lot-sizing and scheduling problem in the personal care consumer goods industry

This paper addresses an integrated lot-sizing and scheduling problem in the industry of consumer goods for personal care, a very competitive market in which the good customer service level and the cost management show up in the competition for the clients. In this research, a complex operational environment composed of unrelated parallel machines with limited production capacity and sequence-dependent setup times and costs is studied. There is also a limited finished-goods storage capacity, a characteristic not found in the literature. Backordering is allowed but it is extremely undesirable. The problem is described through a mixed integer linear programming formulation. Since the problem is NP-hard, relax-and-fix heuristics with hybrid partitioning strategies are investigated. Computational experiments with randomly generated and also with real-world instances are presented. The results show the efficacy and efficiency of the proposed approaches. Compared to current solutions used by the company, the best proposed strategies yield results with substantially lower costs, primarily from the reduction in inventory levels and better allocation of production batches on the machines

Endovascular management of giant visceral artery aneurysms

Endovascular management of small visceral artery aneurysms is an established treatment with satisfactory outcomes. However, when size exceeds 5 cm visceral aneurysms are considered as “giant” (giant visceral artery aneurysms or GVAAs) and management is significantly more complex. Between August 2007 and June 2019 eleven cases of GVAAs that were endovascularly treated were retrospectively reviewed and included in this single center study. Mean size was 80 mm (± 26.3 mm) x 46 mm (+ -11.8 mm). Nine of the lesions were true aneurysms, and two were pseudoaneurysms. In 8 patients, the lesion was causing compression symptoms in the surrounding organs, one patient developed a contained rupture while 2 patients were completely asymptomatic. However, all patients were hemodynamically stable at the time of treatment. Technical success was defined as immediate complete exclusion of the aneurysmal sac, and clinical success as complete relief from clinical symptoms. Follow-up was performed with CT angiography, ultrasound and clinical examination. Mean follow-up was 45 months (range 6–84). Technical and clinical success were both 91%. Complications were one lack of control of contained rupture that was subsequently operated, one case of self-limiting non-target spleen embolization and one case of splenic abscess. Three patients died, one due to the contained rupture 15 days after procedure, the other two for other causes and occurred during the long-term follow-up. This series suggests that endovascular treatment of giant visceral artery aneurysms and pseudoaneuryms is a valid minimally invasive solution with very satisfactory immediate and long-term outcomes unless the aneurysm is already ruptured. A variety of endovascular tools may be required for successful treatment

TTRV30M oligomeric aggregates inhibit proliferation of renal progenitor cells but maintain their capacity to differentiate into podocytes in vitro

Publicado em: The Proceedings of the XIIIth International Symposium on Amyloidosis, May 6-10, 2012, Groningen, The NetherlandsIn Familial Amyloidotic Polyneuropathy, the amyloid deposition of mutant transthyretin TTR V30M can lead to renal complications. An unexplored mechanism is the toxicity of oligomeric TTR aggregates. A subset of renal progenitor cells (RPC) in the adult human kidney can induce regeneration of podocytes and tubular structures of the nephron, which can be critical for preventing irreversible renal failure. We assessed whether RPC are vulnerable, in vitro, to TTRV30M oligomers. RPC proliferation was reduced by 16.3±9.7% and 32.6±6.3% after 48 and 72 hours, respectively, in the presence of the oligomers. However, oligomers did not induce apoptosis or alterations in cell cycle to any significant extent, and did not influence RPC differentiation into podocytes. From this first attempt, we can say that TTRV30M oligomers inhibit RPC proliferation but do not influence their capacity to differentiate into mature podocytes, and thus should not compromise tissue regeneration.FC

A New Constructive Heuristic for the Fm|block|ST

This paper deals with the blocking flow shop problem and proposes new constructive procedures for the total tardiness minimization of jobs. The heuristic has three-phases to build the sequence; the first phase selects the first job to be scheduled, the second phase arranges the remaining jobs and the third phase uses the insertion procedure of NEH to improve the sequence. The proposed procedures evaluate the tardiness associated to the sequence obtained before and after the third phase in order to keep the best of both because the insertion phase can worsen the result. The computational evaluation of these procedures against the benchmark constructive procedures from the literature reveals their good performance.Postprint (published version

Semantic technologies for the production and publication of open data in ACI - Automobile club d’Italia

Semantic technologies combine knowledge representation techniques with artificial intelligence in order to achieve a more effective management of enterprise knowledge bases, thanks to the separation of the conceptual level of the applications from the logical and physical ones, and to the automatic reasoning services they deploy for data access and control. In this context, Ontology-based Data Management (OBDM) [3] has consolidated itself as a paradigm for data integration and governance, based on a three-tier architecture: the ontology, the data sources, and the mappings, which declaratively link the ontology predicates to the data in the sources. In this talk1 we present a joint project by Sapienza University of Rome, the Automobile Club d’Italia (ACI), and OKKAM S.r.l.2, a spinoff of the University of Trento. The objectives of the project were the definition of an ontology of ACI’s Public Vehicle Register (PRA) and car tax domains, the development of an OBDM system to access the data through such ontology, and the creation of a web portal for the publication of ACI’s car parc data in Linked Open format

Effect of the systemic administration of methylprednisolone on the lungs of brain-dead donor rats undergoing pulmonary transplantation

OBJECTIVE: Most lung transplants are obtained from brain-dead donors. The physiopathology of brain death involves hemodynamics, the sympathetic nervous system, and inflammatory mechanisms. Administering methylprednisolone 60 min after inducing brain death in rats has been shown to modulate pulmonary inflammatory activity. Our objective was to evaluate the effects of methylprednisolone on transplanted rat lungs from donors treated 60 min after brain death. METHODS: Twelve Wistar rats were anesthetized, and brain death was induced. They were randomly divided into two groups (n = 6), namely a control group, which was administered saline solution, and a methylprednisolone group, which received the drug 60 min after the induction of brain death. All of the animals were observed and ventilated for 2 h prior to being submitted to lung transplantation. We evaluated the hemodynamic and blood gas parameters, histological score, lung tissue levels of thiobarbituric acid-reactive substances, level of superoxide dismutase, level of tumor necrosis factor-alpha, and level of interleukin-1 beta. RESULTS: After transplantation, a significant reduction in the levels of tumor necrosis factor-alpha and IL-1β was observed in the group that received methylprednisolone (p = 0.0084 and p = 0.0155, respectively). There were no significant differences in tumor necrosis factor-alpha and superoxide dismutase levels between the control and methylprednisolone groups (p = 0.2644 and p = 0.7461, respectively). There were no significant differences in the blood gas parameters, hemodynamics, and histological alterations between the groups. CONCLUSION: The administration of methylprednisolone after brain death in donor rats reduces inflammatory activity in transplanted lungs but has no influence on parameters related to oxidative stress