Primary intra and extradural solitary fibrous tumor/hemangiopericytoma of thoracic spine with paravertebral intrathoracic spread: Case report and review of the literature

Solitary fibrous tumors/hemangiopericytomas (SFTs/HPCs), constitute 1% of all CNS tumors. Spinal SFTs/HPCs are extremely rare. To date, few retrospective studies and case reports of primary spinal SFTs/HPCs have been published in the literature. We report clinical and radiological presentation, surgical treatment, and post-operative outcome at three years follow-up of a rare case of primary spinal intra and extradural SFT/HPC of thoracic spine with dumbbell shaped paravertebral intrathoracic spread and multidirectional erosion of the bone. A 73-year-old female presented with progressive lower limbs weakness and hypoesthesia below the rib cage. MRI showed an irregular isointense T5-T7 dumbbell shaped tumor. Tumor resection was successfully carried out through posterior and antero-lateral approach. Histological examination showed a grade II SFT/HPC. No local recurrence nor systemic metastases were observed at three years follow-up. A literature review has been performed to describe epidemiology, radiographic features, treatment, recurrence rate and mean disease-free survival of primary spinal SFTs/HPCs. No radiographic pathognomonic findings have been reported for these tumors. Differential diagnosis must be made with meningioma, schwannoma, chordoma, aggressive hemangioma, metastases, angiosarcoma. Surgical resection is the first choice of treatment, and total resection should be attempted whenever possible in all cases. Postsurgical radiotherapy does not change significantly recurrence rate after GTR, nonetheless it increases mean disease-free survival, especially in patients with extradural SFTs/HPCs. After subtotal resection, adjuvant radiotherapy is necessary to reduce progression of disease. The efficacy of chemotherapy has yet to be determined. Pathological degree and total surgical resection are the most important predictive factors of recurrence

Long-acting combination of cabotegravir plus rilpivirine: A picture of potential eligible and ineligible HIV-positive individuals from the Italian ARCA cohort

Objectives: We aimed to evaluate the prevalence and characteristics of people living with HIV (PLWH) eligible for the long-acting injectable (LAI) regimen with cabotegravir (CAB) and rilpivirine (RPV), in comparison with ineligible individuals. Methods: This was an observational, cross-sectional study from the ARCA cohort, including virologically suppressed PLWH with at least one genotypic resistance testing (GRT) for reverse transcriptase and integrase from plasma and/or PBMCs. Eligibility criteria for LAI CAB+RPV were: negative HBsAg, absence of previous virological failures and/or resistance-associated mutations for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and/or integrase strand transfer inhibitors. Potential differences between eligible and ineligible individuals were investigated by univariable and multivariable analyses. Results: A total of 514 individuals were included: 377 (73.3%) were male, median age was 51 (IQR: 43–58), on ART for 9 years (IQR: 4–17), virologically suppressed for 63 months (IQR: 35–105). Eligible individuals for CAB+RPV were 229 (44.5%, 95%CI: 40.8–48.8); compared with ineligible individuals, they received a lower number of previous regimens (aOR 0.76, 95% CI 0.71–0.83, P < 0.001) and were on current NNRTIs (aOR 2.16, 95% CI 1.38–3.37, P = 0.001). Conclusions: Less than half of virologically suppressed PLWH in the ARCA cohort were potentially eligible for CAB+RPV. They seem to be “less complicated” with shorter exposure to ART and preferably already on NNRTIs

Extended ATM for Seamless Travel (X-TEAM D2D)

In the future (up to 2050), physical infrastructure, transport systems, traffic management, operational processes and information systems will be seamlessly integrated. The combination of new emerging transport modes such as extended urban and regional air transport forms (SAT, PATS, UAM), electric and autonomous mobility (road, rail, water) with a passenger-centric view will revolutionize future mobility. A key enabler for this is integrating ATM into overall multimodal transport systems that will provide airports, authorities, transport companies and passengers with common and comprehensive information of the door-to-door (D2D) travel flows. The X-TEAM D2D project explores and analyzes the integration of ATM into the overall multimodal transport system, considering currently available transportation modalities and the emerging transport and mobility forms envisaged for the next decades. Moreover, the X-TEAM D2D focuses on the detailed consideration of Concept of Operations (ConOps) for seamless D2D mobility in urban and extended urban areas (up to regional), understanding the risks and opportunities impacting strategic policy directions. Three time horizons are considered: baseline (2025), intermediate (2035) and final (2050). The developed ConOps will be validated and evaluated against applicable Key Performance Areas (KPA) and Key Performance Indicators (KPI), using a simulation-based platform that considers the most relevant transport elements in the future, such as interfaces mode-mode, high-level network model, passenger-centric paradigm. Furthermore, specific use cases of the D2D journey under different scenarios will be identified. These use cases will be analyzed in depth to validate the ConOps and enable decision support tools

Integrating ATM and air transport into multimodal transport system for Door-to-Door travel: the X-TEAM D2D project proposed approach

The project designed ConOps has been finally validated by the construction of a simulation model of a high-level D2D case study, with the aim of assessing the performances, feasibility and limitations of the ConOps and identifying the areas of improvement between ATM and the different modes of transport. The simulation model included two parts: the regional airport and related addressed surrounding area (namely Brunswick, served by Hannover airport) and the hub airport and relatedaddressed surrounding area (namely Haarlem, served by Schiphol airport). The simulation model maintained the same structure but included different transport options in 2025, 2035 and 2050. The model implemented both the different existing transport options and perspective transfer possibilities compliant with the X-TEAM D2D designed ConOps, using real-life distances (GIS-Based) and reallife travel times (GIS-based) for the existing possibilities. It included moving objects (carrying info), such as passenger groups and transport entities, and static elements (Capacitated nodes), such as transport network and transfer stations

Integrating ATM and air transport into multimodal transport system for Door-to-Door travel: the X-TEAM D2D project proposed approach

The X-TEAM D2D project activities have been successfully concluded in 2022 and delivered several relevant results. First, the project provided the definition of future scenarios and use cases for the integration of the vertical transport with the surface transport towards integrated intermodal transport system and the identification of the resulting barriers. Based on that, the project carried out the design of the ConOps for integration of ATM and aviation, as well as UTM and UAM, in intermodal transport infrastructure and the parallel and cooperative design of the ConOps for the integration of ATM and UTM into overall intermodal service to passengers. The resulting overall ConOps for the seamless integration of ATM and air transport into an overall intermodal network, including other available transportation means (surface, water), to support the door-to-door connectivity has been finally successfully validated by means of dedicated simulation environment setup by the project as well as external experts assessment. The validation results indicated the feasibility and effectiveness of the proposed ConOps in achieving its target as well as allowed providing suggestions for its future development and improvement, beyond the project scope

An Outline of A Concept of Operations fFor Integration of ATM and Air Transport into Multimodal Transport System for Door-fo-Door Travel

In the framework of the research activities supported by SESAR JU, dedicated research stream is devoted to investigation of integration of Air Traffic Management (ATM) and aviation into a wider transport system able to support the implementation of Door-to-Door (D2D) travel concept. In this framework, the project X-TEAM D2D (Extended ATM for Door-to-Door Travel) has been funded by SESAR JU under the call SESAR-ER4-10-2019: ATM Role in Intermodal Transport, with Grant Agreement n. 891061. The project aims defining, developing and initially validating a Concept of Operations (ConOps) for the seamless integration of ATM and air transport into an overall intermodal network, including other available transportation means (surface, water), to support the door-to-door connectivity, in up to 4 hours, between any location in Europe, in compliance with the target assigned by the ACARE SRIA FlightPath 2050 goals. The project is focused on the consideration of ConOps for ATM and air transport integration in intermodal transport network serving urban and extended urban (up to regional level) mobility, taking into account the transportation and passengers service scenarios envisaged for the next decades, according to baseline (2025), intermediate (2035) and final (2050) time horizons. In this paper, the outcomes of the first phase of the project activities, aimed to provide the initial definition (concept outline) of the proposed overall ConOps are illustrated, emphasizing the specific activities that have been carried out up to date and the related achievements. In addition, an outlook is provided in the paper on the next project activities, expected to be carried out towards the conclusion of the studies and the validation, by means of dedicated numerical simulation campaigns, of the proposed ConOps

Exploring the Efficiency of Future Multimodal Networks: A Door-to-Door Case in Europe

It is expected that future transportation technologies will positively impact how passengers travel to their destinations. Europe aims to integrate air transport into the overall multimodal transport network to provide better service to passengers, while reducing travel time and making the network more resilient to disruptions. This study presents an approach that investigates these aspects by developing a simulation platform consisting of different models, allowing us to simulate the complete door-to-door trajectory of passengers. To address the future potential, we devised scenarios considering three time horizons: 2025, 2035, and 2050. The experimental design allowed us to identify potential obstacles for future travel, the impact on the system’s resilience, and how the integration of novel technology affects proxy indicators of the level of service, such as travel time or speed. In this paper, we present for the first time an innovative methodology that enables the modelling and simulation of door-to-door travel to investigate the future performance of the transport network. We apply this methodology to the case of a travel trajectory from Germany to Amsterdam considering a regional and a hub airport; it was built considering current information and informed assumptions for future horizons. Results indicate that, with the new technology, the system becomes more resilient and generally performs better, as the mean speed and travel time are improved. Furthermore, they also indicate that the performance could be further improved considering other elements such as algorithmic governance

Effect of Non-Lethal Selection on Spontaneous Revertants of Frameshift Mutations: The Escherichia coli&nbsp;hisF Case

Microorganisms possess the potential to adapt to fluctuations in environmental parameters, and their evolution is driven by the continuous generation of mutations. The reversion of auxotrophic mutations has been widely studied; however, little is known about the reversion of frameshift mutations resulting in amino acid auxotrophy and on the structure and functioning of the protein encoded by the revertant mutated gene. The aims of this work were to analyze the appearance of reverse mutations over time and under different selective pressures and to investigate revertant enzymes&rsquo; three-dimensional structures and their correlation with a different growth ability. Escherichia coli FB182 strain, carrying the hisF892 single nucleotide deletion resulting in histidine auxotrophy, was subjected to different selective pressures, and revertant mutants were isolated and characterized. The obtained results allowed us to identify different indels of different lengths located in different positions in the hisF gene, and relations with the incubation time and the selective pressure applied were observed. Moreover, the structure of the different mutant proteins was consistent with the respective revertant ability to grow in absence of histidine, highlighting a correlation between the mutations and the catalytic activity of the mutated HisF enzyme

Humeral shaft non-union after intramedullary nailing

The humerus shaft is one of the sites with the largest probability of developing pseudoarthrosis after fracture. We present the results of nine patients with atrophic pseudoarthrosis of humeral shaft treated with angular stability plate associated with allograft and platelet-rich plasma (PRP), after a first treatment with intramedullary nail to correct the fracture