Understanding expertise in surgical gesture by means of Hidden Markov Models

Minimally invasive surgery (MIS) has became very widespread in the last ten years. Due to the difficulties encountered by the surgeons to learn and manage this technique, a huge importance has the improvement of training procedures, the improvement of surgical instrumentation and the robotic automation of surgical gesture. All these purposes require the analysis of surgical performance with the aim to understand it and to define what is expertise in surgical gesture. In this paper for the first time the Hidden Markov Models (HMMs) are used as a tool for the understanding of surgical performance and of the human factors that characterize it. In our experiments we used position data concerning the tools movements during exercises performed on a surgical simulator. Using Hidden Markov theory, we create a model of the expert surgeon performance able to evaluate surgical capability and to distinguish between expert and non-expert surgeons. By analyzing the trained model of the expert surgeon performance we show that it is possible to deduce information about features characterizing the surgical expertise

The Cosmic Web from Perturbation Theory

Context: Analyzing the large-scale structure (LSS) with galaxy surveys demands accurate structure formation models. Such models should ideally be fast and have a clear theoretical framework to rapidly scan a variety of cosmological parameter spaces without requiring large training data sets. Aims: This study aims to extend Lagrangian perturbation theory (LPT), including viscosity and vorticity, to reproduce the cosmic evolution from dark matter N-body calculations at the field level. Methods: We extend LPT to an Eulerian framework, dubbed eALPT. An ultraviolet regularisation through the spherical collapse model provided by Augmented LPT, turns out to be crucial at low redshifts. This enables modelling the stress tensor, with this introducing vorticity. The model has two free parameters apart from the choice of cosmology, redshift snapshots, cosmic volume, and the number of particles-cells. Results: We find that the cross-correlation of the dark matter distribution as compared to N-body solvers increases at $k = 1\,h$ Mpc$^{-1}$ and $z = 0$ from $\sim$55\% with the Zel'dovich approximation ($\sim$70\% with ALPT), to $\sim$95\% with three timesteps eALPT, and power spectra within percentage accuracy up to $k \simeq 0.3\,h$ Mpc$^{-1}$.Comment: 6 pages, 3 figure

Activation of diacylglycerol kinase alpha is required for VEGF-induced angiogenic signaling in vitro.

Vascular endothelial growth factor-A (VEGF-A) promotes angiogenesis by stimulating migration, proliferation and organization of endothelium, through the activation of signaling pathways involving Src tyrosine kinase. As we had previously shown that Src-mediated activation of diacylglycerol kinase-alpha (Dgk-alpha) is required for hepatocytes growth factor-stimulated cell migration, we asked whether Dgk-alpha is involved in the transduction of angiogenic signaling. In PAE-KDR cells, an endothelial-derived cell line expressing VEGFR-2, VEGF-A165, stimulates the enzymatic activity of Dgk-alpha: activation is inhibited by R59949, an isoform-specific Dgk inhibitor, and is dependent on Src tyrosine kinase, with which Dgk-alpha forms a complex. Conversely in HUVEC, VEGF-A165-induced activation of Dgk is only partially sensitive to R59949, suggesting that also other isoforms may be activated, albeit still dependent on Src tyrosine kinase. Specific inhibition of Dgk-alpha, obtained in both cells by R59949 and in PAE-KDR by expression of Dgk-alpha dominant-negative mutant, impairs VEGF-A165-dependent chemotaxis, proliferation and in vitro angiogenesis. In addition, in HUVEC, specific downregulation of Dgk-alpha by siRNA impairs in vitro angiogenesis on matrigel, further suggesting the requirement for Dgk-alpha in angiogenic signaling in HUVEC. Thus, we propose that activation of Dgk-alpha generates a signal essential for both proliferative and migratory response to VEGF-A165, suggesting that it may constitute a novel pharmacological target for angiogenesis control.

Human west nile virus lineage 2 infection: Epidemiological, clinical, and virological findings

West Nile virus (WNV) lineage 2 is expanding and causing large outbreaks in Europe. In this study, we analyzed the epidemiological, clinical, and virological features of WNV lineage 2 infection during the large outbreak that occurred in northern Italy in 2018. The study population included 86 patients with neuroinvasive disease (WNND), 307 with fever (WNF), and 34 blood donors. Phylogenetic analysis of WNV full genome sequences from patients' samples showed that the virus belonged to the widespread central/southern European clade of WNV lineage 2 and was circulating in the area at least since 2014. The incidence of WNND and WNF progressively increased with age and was higher in males than in females. Among WNND patients, the case fatality rate was 22%. About 70% of blood donors reported symptoms during follow-up. Within the first week after symptom onset, WNV RNA was detectable in the blood or urine of 80% of patients, while 20% and 40% of WNND and WNF patients, respectively, were WNV IgM-seronegative. In CSF samples of WNND patients, WNV RNA was typically detectable when WNV IgM antibodies were absent. Blunted or no WNV IgM response and high WNV IgG levels were observed in seven patients with previous flavivirus immunity

Efeito de inseticidas sobre Eurhizococcus brasiliensis (Hemiptera: Margarodidae) na cultura da videira.

A pérola-da-terra Eurhizococcus brasiliensis é uma cochonilha subterrânea considerada uma das principais pragas da cultura da videira. O controle químico é realizado através da aplicação no solo de inseticidas neonicotinóides (imidacloprido e thiametoxam) no período de reprodução (novembro a janeiro)

Formation of callus on rootstock cuttings with different substrates during the forcing.

Nowadays the global viticulture scenario has being verifying high levels of an event known as ?young grapevine decline? related to various diseases, such as Esca, Petri and Black Foot. On the grapevine plant propagation, the process of callus formation is crucial to ensure protection against the infection of these fungus during the rooting process on the field. In the heated rooms, the formation of callus on the rootstock cuttings act like a preventive barrier against a possible infection by these fungus. The callusing process (called ?forcing?) is based on the usage of substrates for the maintenance of humidity of the cuttings and for providing optimum conditions of temperature and relative humidity in the dark chamber

Avaliação da solarização do solo para o controle de Ralstonia solanacearum.

O presente trabalho avaliou o emprego da solarização como uma alternativa para o controle da murcha bacteriana, causada por Ralstonia solanacearum, em amostras de solo infestado com o patógeno, dispostas em bolsas de náilon e enterradas em parcelas solarizadas ou não. Dois experimentos foram instalados, um em Campinas (SP), de fevereiro a abril de 2001, e o outro em Piracicaba (SP), de dezembro de 2001 a janeiro de 2002. Os ensaios foram efetuados em delineamento inteiramente casualizado, esquema fatorial, com quatro repetições, tendo cada parcela 4 x 4 m. Os fatores avaliados foram a solarização (com ou sem), efetuada com filme plástico transparente de 100 µm de espessura, o período de tratamento (30 e 60 dias e 37 e 60 dias para o primeiro e o segundo experimentos, respectivamente) e a profundidade de colocação das amostras (10 e 20 cm), fator verificado apenas no segundo ensaio. Após os períodos estipulados de solarização, o solo de cada bolsa foi colocado em vasos, para os quais foram transplantadas mudas de tomateiro (Lycopersicon esculentum). No solo não solarizado, em ambos os experimentos, 43 a 100% dos tomateiros murcharam. No segundo experimento, 6 a 22% dos tomateiros murcharam no solo solarizado por 37 dias. Entretanto não foram detectadas plantas murchas nas parcelas solarizadas do primeiro experimento e no segundo ensaio nenhum tomateiro murchou solo solarizado por 60 dias, nas duas profundidades estudadas. Os resultados indicam que a solarização é uma técnica promissora para o controle de R. solanacearum

Guidelines for the diagnosis, prevention and management of osteoporosis

Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management

Cutting edge: Selective up-regulation of chemokine receptors CCR4 and CCR8 upon activation of polarized human type 2 Th cells

Polarized Th1 and Th2 cells differentially express adhesion molecules and chemokine receptors, endowing these cells with distinct tissue homing capabilities. Here we report that, in contrast to other chemokine receptors, the expression of CCR4 and CCR8 on Th2 cells is transiently increased following TCR and CD28 engagement. IL-4 is not required for this activation-induced up-regulation of CCR4 and CCR8. In accordance with receptor expression, the response of Th2 cells to I-309 (CCR8 ligand) and thymus- and activation-regulated chemokine (CCR4 and CCR8 ligand) is enhanced upon activation. Moreover, activated Th1 cells up-regulate CCR4 expression and functional responsiveness to thymus- and activation-regulated chemokine. Analysis of polarized subsets of CD8+ T cells reveals a similar pattern of chemokine receptor expression and modulation of responsiveness. Taken together, these findings suggest that an up-regulation of CCR4 and CCR8 following Ag encounter may contribute to the proper positioning of activated T cells within sites of antigenic challenge and/or specialized areas of lymphoid tissues