Reliability of Early Fetal Echocardiography for Congenital Heart Disease Detection: A Preliminary Experience and Outcome Analysis of 102 Fetuses to Demonstrate the Value of a Clinical Flow-Chart Designed for At-Risk Pregnancy Management

Early fetal echocardiography (EFEC) is a fetal cardiac ultrasound analysis performed between the 12th and 16th week of pregnancy (compared with the usual 18-22 weeks). In the last 10 years, the introduction of “aneuploidy sonographic markers” in screening for cardiac defects has led to a shift from late second to end of the first trimester or beginning of the second trimester of pregnancy for specialist fetal echocardiography. In this prospective study, early obstetric screening was performed between January 2014 and October 2015, using “aneuploidy sonographic markers” following SIEOG Guidelines 2014. These parameters were then collected and strategically combined in an evaluation score to select the group of pregnancies for performing EFEC, in accordance with the American Society of Echocardiography guidelines for fetal Echocardiography. All second-level examinations were performed transabdominally using a 3D convex volumetric probe with frequency range of 4-8 MHz (Accuvix – Samsung). The outcome data included transabdominal fetal echocardiography from 18 weeks to term and after birth. Overall, 99 pregnant women in the first trimester underwent EFEC (95 singleton and 4 twin pregnancies). Specifically, 30 fetuses were evaluated for extra-cardiac anomalies evidenced by obstetric screening (30%), 25 for family history of congenital heart diseases (25%), 8 for family history of genetic-linked diseases (8%), 4 for heart diseases suspected by obstetric screening (4%) and 19 by normal screening (19%). Was detected 11 (10.7%) CHD, when EFEC detected CHD, were compared to those performed later in pregnancy (18 weeks GA-term), a high degree of diagnosis correspondence was evidenced. The higher sensitivity value of EFEC vs late-FE, in comparison with the post-natal value, coupled with the high EFEC specificity shown vs both the end points, enabled us to consider it as a really reliable diagnostic technology, at least in perienced hands. The introduction of a key combination of the more sensitive obstetric and cardiologic variables should facilitate the formulation of a possible flow-chart as a guide for CHD at-risk pregnancies

Perceived organizational support and work engagement: the role of psychosocial variables

PurposeThis study aims to test the role that organizational sociopsychological variables may play in influencing job stress and work engagement in an organizational identity change scenario.Design/methodology/approachOn a sample of 118 employees of an Italian company in the personnel training services sector, multivariate statistical analysis tests a pattern where organizational variables such as work support (by supervisors and coworkers, independent variables) – moderated by corporate identification (moderating variable) – and mediated by organizational trust (mediating variable) – boosts employee work engagement and lowers psychosocial risks (dependent variables).FindingsThe mediating effect of "organizational trust" is significant in the relationships of "supervisor social support" and "coworker social support" with the "absence of psychosocial risks." Moreover, an increase in supervisor social support can lead to a statistically significant increase in work engagement. This occurs only for employees with low or medium identification and not in highly identified individuals.Originality/valueThe findings from the analysis on moderation are of primary importance because they show us a new perspective that can play the role of a guiding and practical principle on how to act on an organization's human resources, specifically targeting those with lower or medium corporate identification

Microleakage Analysis of Different Bulk-Filling Techniques for Class II Restorations: µ-CT, SEM and EDS Evaluations

none8This study aimed to compare two different bulk-filling techniques, evaluating the internal and external adaptation of class II resin-composite restorations, by analysing the gap formation using microcomputed tomography (µ-CT) and scanning electronic microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Two standardized mesio/disto-occlusal (MO/DO) cavities were prepared in eight extracted human third molars that were divided, according to the filling technique used, in the following two groups (n = 4): BG (Bulk&Go group) and BT (Bulk Traditional group). After universal bonding application, followed by the light curing, all teeth were restored using a bulk-fill composite. Specimens were scanned with µ-CT to evaluate 3D interfacial gaps. Acquired µ-CT data were analysed to quantify the gap formation. Complementary information to the µ-CT analysis were obtained by SEM. Thereafter, the chemical composition of tooth-restoration interface was analysed using EDS. The µ-CT analysis revealed gaps formation at the tooth-restoration interface for both the BG and BT groups, while within the restoration, only in the BT group there was evidence of microleakage formation. The scanning electron micrographs of both groups showed that the external marginal integrity of the restoration was preserved, while EDS showed the three different structures (tooth surface, adhesive layer and resin composite) of the tooth-restoration interface, highlighting the absence of gap formation. In both BG and BT, the two filling techniques did not show significant differences regarding the internal and external marginal adaptation of the restoration. To achieve a successful restoration, the clinician could be advised to restore a class II cavity using a single increment bulk-filling technique (BG), thus treating it as a class I cavity.openTosco, Vincenzo; Vitiello, Flavia; Furlani, Michele; Gatto, Maria Laura; Monterubbianesi, Riccardo; Giuliani, Alessandra; Orsini, Giovanna; Putignano, AngeloTosco, Vincenzo; Vitiello, Flavia; Furlani, Michele; Gatto, Maria Laura; Monterubbianesi, Riccardo; Giuliani, Alessandra; Orsini, Giovanna; Putignano, Angel

Multidisciplinary evaluation of the remineralization potential of three fluoride-based toothpastes on natural white spot lesions.

OBJECTIVES This in vitro study aimed assessing the remineralization potential of three commercial fluoride-based toothpastes in permanent teeth with natural white spot lesions (WSLs). A multidisciplinary approach based on Raman microspectroscopy (RMS), Scanning electron microscopy (SEM), Energy-dispersive x-ray spectroscopy (EDS), and Vickers microhardness (VMH) was exploited. METHODS N = 12 human molars with natural WSLs in the proximal-vestibular zone were selected and divided into 4 groups (n = 3) according to the different treatments: HAF (hydroxyapatite with fluoride ions); SMF (sodium monofluorophosphate with arginine); SF (sodium fluoride with enzymes), and CTRL (untreated group). All toothpastes tested contained 1450 ppm of fluoride. Teeth samples were submitted to the following protocol: a 7-day pH cycling treatment, with two daily exposures (2 min each time) to the commercial toothpastes described above. The surface micromorphology (SEM), the chemical/elemental composition (RMS and EDS), and the Vickers microhardness (VMH) were evaluated. Statistical analysis was performed. RESULTS A remarkable remineralization of WSLs in SEM images was observed in all treated groups compared to CTRL. In particular, HAF and SF displayed higher values of VMH, phosphates amount (I960), crystallinity (FWHM960), and lower ones of C/P (I1070/I960) with respect to CTRL. Intermediate values were found in SMF, higher than CTRL but lower with respect to HAF and SF. As regards the Ca/P ratio, statistically significant differences (p < 0.05) were found between SF and the other groups. CONCLUSIONS All the tested dentifrices have shown to remineralize the WSLs. SF and HAF have comparable capability in hardness recovery and crystallinity; however, SF shows the best remineralizing potential according to both micromorphological and chemical analyses. Clinical relevance The daily use of toothpastes containing hydroxyapatite partially replaced with fluoride, sodium monofluorophosphate with arginine and sodium fluoride toothpaste associated with enzymes represents a preventive, therapeutic, effective, and non-invasive tool for remineralize WSLs

Experimental analysis of Radar/Optical track-to-track fusion for non-cooperative Sense and Avoid

In the framework of non-cooperative Sense and Avoid solutions, major attention is reserved to the design of sensing strategies which can enable fast and reliable identification of possible near collision threats, by exploiting passive or active exteroceptive sensors. To overcome the limits of standalone technological architectures and provide more accurate tracking solutions, which can be used to improve conflict detection and thus better support avoidance strategies, data fusion approaches can be considered. Hence, this work proposes a radar/visual fusion method based on the track-to-track fusion approach. The strategy is tested on data gathered during ground-to-air experimental flight tests involving a small UAV commanded to fly near collision approach geometries with respect to a multi-sensor setup placed on the ground. Results collected analyzing three different encounters show that the fusion solution allows retrieving meter and sub-degree level accuracies in the intruder range and bearing estimation, respectively, while ensuring declaration ranges of about 500 meters

Ground-to-air experimental assessment of low SWaP radar-optical fusion strategies for low altitude Sense and Avoid

The future of UAS operations requires adequate and efficient Sense and Avoid strategies to ensure their safe and secure integration in both controlled and uncontrolled airspace. To make onboard implementation of these strategies feasible, research must focus on the development of sensing and tracking solutions, taking size, weight and power (SWaP) constraints as well as the challenging scenarios characterizing low altitude operations, into account. In this framework, visual cameras and low SWaP radars are among the most popular sensing choices. Hence, exploiting such sensing solutions, this paper proposes both single and multi-sensor detection and tracking approaches and compares their performance. Specifically, the developed techniques are tested on data retrieved during ground-to-air tests which involve a small UAV flying near collision geometries, starting from a range of about 550 m. Different tracking strategies are considered including standalone visual, standalone radar, and fused radar-visual. Concerning intruder detection, several visual-based techniques are investigated based on machine learning, morphological filtering and template matching. Radar detections are filtered and centroided with ad hoc algorithms. While in clear air conditions comparable declaration ranges, larger than 500 m, are provided by all the tested approaches, results show the advantages of using a fused strategy to attain sub-degree angular and angular rate tracking accuracy coupled with the highly accurate range and range rate, around 2 m and 1 m/s, respectively, typical of radars. Conflict detection performance is proven to also benefit from the use of a fused strategy in terms of smaller errors in the estimation of the distance at closest point of approach

Improved Sensing Strategies for Low Altitude Non Cooperative Sense and Avoid

Very low altitude non-cooperative sense and avoid is considered as an essential component of multi-layered mitigation strategies for collision hazard within the UTM/U-Space framework. However, it currently represents a challenging problem with open issues concerning performance trade-offs and technological options. In fact, low altitude operations emphasize sensing challenges such as ground clutter removal for radar, and below-the-horizon detection for optical sensors. These issues have a significant impact in scenarios involving small UAS, which may be characterized by low detectability though potentially generating relatively fast encounter geometries. As a contribution to this framework, this paper proposes some improved sensing strategies for these scenarios. The first idea is to optimize architectural and algorithmic trade-offs by accounting for the possible closure rates corresponding to near collision scenarios. This approach can be used to develop adaptive sensing strategies, as well as to select different sensors to cover different areas of the aircraft field of regard. The concept is demonstrated in numerical analyses focused on the computation of probability of missed and false conflict detection. Then, with regards to purely visual architectures, the possibility to extract and use shape-based ranging information to improve conflict detection performance is investigated through flight tests with small UAS. Finally, the paper describes first experimental activities conducted with a compact collision avoidance radar

Onboard and External Magnetic Bias Estimation for UAS through CDGNSS/Visual Cooperative Navigation

This paper describes a calibration technique aimed at combined estimation of onboard and external magnetic disturbances for small Unmanned Aerial Systems (UAS). In particular, the objective is to estimate the onboard horizontal bias components and the external magnetic declination, thus improving heading estimation accuracy. This result is important to support flight autonomy, even in environments characterized by significant magnetic disturbances. Moreover, in general, more accurate attitude estimates provide benefits for georeferencing and mapping applications. The approach exploits cooperation with one or more “deputy” UAVs and combines drone-to-drone carrier phase differential GNSS and visual measurements to attain magnetic-independent attitude information. Specifically, visual and GNSS information is acquired at different heading angles, and bias estimation is modelled as a non-linear least squares problem solved by means of the Levenberg–Marquardt method. An analytical error budget is derived to predict the achievable accuracy. The method is then demonstrated in flight using two customized quadrotors. A pointing analysis based on ground and airborne control points demonstrates that the calibrated heading estimate allows obtaining an angular error below 1°, thus resulting in a substantial improvement against the use of either the non-calibrated magnetic heading or the multi-sensor-based solution of the DJI onboard navigation filter, which determine angular errors of the order of several degrees

Detection and tracking of non-cooperative flying obstacles using low SWaP radar and optical sensors: an experimental analysis

Improvements in low altitude, non-cooperative sense and avoid are of major interest for collision hazard mitigation within the UTM/UAM/U-Space framework. In this regard, the sensing architecture must be carefully designed so that its detection and tracking performance is suitable for timely and reliable conflict assessment, while respecting size, weight, power and costs constraints, which are particularly strict for small aerial vehicles. Within this framework, an experimental assessment of non-cooperative sensing solutions based on a lightweight radar and a visual camera, respectively, is presented in this paper. Visual detections are obtained by using a Deep Learning-based neural network, while raw detections produced by the radar are first filtered based on Doppler information to remove ground clutter, and then clustered by means of a centroiding approach. The resulting detection sets are used to generate tentative and firm tracks using customized Kalman filtering techniques. Following a research plan that foresees data gathering with incremental complexity, ground-to-air tests have been carried out using a small UAV as flying intruder, and Carrier-Phase Differential GNSS to get a reference solution and assess visual-based and radar-based detection and tracking performance. Results achieved by standalone radar and visual sensing solutions clearly highlight the potential of sensor fusion strategies to take advantage of their complementary characteristics

Non-Cariogenic Effect of Milk and Dairy Products on Oral Health in Children and Adolescents: A Scoping Review

Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this scoping review was to analyze the scientific literature on the non-cariogenic effect of milk and DPs, with a focus on their potential to prevent dental caries in children and adolescents. PubMed, EMBASE, and Web of Science were searched for publications relevant to our topic from January 2013 to 30 September 2023. Thirty-eight studies were included in the qualitative analysis. The included studies highlight the properties of milk and DPs that contribute to enamel remineralization, exhibit antibacterial action, inhibit the growth of cariogenic bacteria, and promote a balanced oral microbiome. With regard to the addition of probiotics (PBs) and fluoride (F) to DPs, the mixed results of the studies analyzed did not allow a clear statement to be made about their non-cariogenic effects. However, several studies show that the addition of PBs can reduce cariogenic bacteria, create a protective barrier against pathogens and support the host’s natural defense mechanisms. Further long-term and high-quality studies are needed to understand the impact of milk and its constituents on oral health in order to promote effective caries prevention strategies in children and adolescents