Ageusia, hyposmia, dizziness and tinnitus as presenting symptoms of multiple sclerosis

Multiple Sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system characterized by the destruction of myelin sheaths and axonal loss. Presenting symptoms of multiple sclerosis may vary and if not promptly identified may lead to a delayed diagnosis of Multiple sclerosis. In this paper, we present a rare case of a patient with ageusia as presenting symptom of Multiple sclerosis; the symptom spontaneously resolved after two weeks and was followed by hyposmia, dizziness, tinnitus and facial paraesthesia that eventually led to a clinical diagnosis of Multiple sclerosis. The presence of gustatory, olfactory and audio-vestibular symptoms has been associated with disease activity and progression of several inflammatory and neurodegenerative diseases of the central nervous system including Multiple sclerosis. Gustatory alterations may be due to the presence of demyelinating lesion in the brain area of taste; the progression of the disease may explain the additional olfactory and audio-vestibular symptoms described in this patient. Even if taste alteration is an extremely rare presenting symptom of Multiple sclerosis, its presence in young women should always be carefully investigated as it could be an early sign of Multiple sclerosis

Audio-vestibular symptoms in systemic autoimmune diseases

Immune-mediated inner ear disease can be primary, when the autoimmune response is against the inner ear, or secondary. The latter is characterized by the involvement of the ear in the presence of systemic autoimmune conditions. Sensorineural hearing loss is the most common audiovestibular symptom associated with systemic autoimmune diseases, although conductive hearing impairment may also be present. Hearing loss may present in a sudden, slowly, rapidly progressive or fluctuating form, and is mostly bilateral and asymmetric. Hearing loss shows a good response to corticosteroid therapy that may lead to near-complete hearing restoration. Vestibular symptoms, tinnitus, and aural fullness can be found in patients with systemic autoimmune diseases; they often mimic primary inner ear disorders such as Menière’s disease and mainly affect both ears simultaneously. Awareness of inner ear involvement in systemic autoimmune diseases is essential for the good response shown to appropriate treatment. However, it is often misdiagnosed due to variable clinical presentation, limited knowledge, sparse evidence, and lack of specific diagnostic tests. The aim of this review is to analyse available evidence, often only reported in the form of case reports due to the rarity of some of these conditions, of the different clinical presentations of audiological and vestibular symptoms in systemic autoimmune diseases

Cerebral gray matter volume in patients with chronic migraine: correlations with clinical features

Abstract Background To date, few MRI studies have been performed in patients affected by chronic migraine (CM), especially in those without medication overuse. Here, we performed magnetic resonance imaging (MRI) voxel-based morphometry (VBM) analyses to investigate the gray matter (GM) volume of the whole brain in patients affected by CM. Our aim was to investigate whether fluctuations in the GM volumes were related to the clinical features of CM. Methods Twenty untreated patients with CM without a past medical history of medication overuse underwent 3-Tesla MRI scans and were compared to a group of 20 healthy controls (HCs). We used SPM12 and the CAT12 toolbox to process the MRI data and to perform VBM analyses of the structural T1-weighted MRI scans. The GM volume of patients was compared to that of HCs with various corrected and uncorrected thresholds. To check for possible correlations, patients’ clinical features and GM maps were regressed. Results Initially, we did not find significant differences in the GM volume between patients with CM and HCs (p < 0.05 corrected for multiple comparisons). However, using more-liberal uncorrected statistical thresholds, we noted that compared to HCs, patients with CM exhibited clusters of regions with lower GM volumes including the cerebellum, left middle temporal gyrus, left temporal pole/amygdala/hippocampus/pallidum/orbitofrontal cortex, and left occipital areas (Brodmann areas 17/18). The GM volume of the cerebellar hemispheres was negatively correlated with the disease duration and positively correlated with the number of tablets taken per month. Conclusion No gross morphometric changes were observed in patients with CM when compared with HCs. However, using more-liberal uncorrected statistical thresholds, we observed that CM is associated with subtle GM volume changes in several brain areas known to be involved in nociception/antinociception, multisensory integration, and analgesic dependence. We speculate that these slight morphometric impairments could lead, at least in a subgroup of patients, to the development and continuation of maladaptive acute medication usage

L.A.U.D.E: Learning Automata for Urban Development Exploration. The Case Study of Rome Urban System

This paper deals with urban cellular automata. It is organized in two parts. The first one is concerning theory, methodology and operational aspects of the application of cellular automata to the simulation of dynamics of urban systems. Starting with a review of the literature on this research field (Batty, Cecchini, Couclelis, White et al.) we present: ? as to theoretical foundation of the approach, a clarification on the distinction between global and local description (the traditional modelling and cellular automata, respectively); ? as to methodology, an analysis of different ways of association of cellular automata to urban phenomena (cells as individuals, cells as "spatial zones" of the city, etc.); ? as to operational problems, a discussion - among other things - of the treatment of distances, size and shape of cells, random effects, dynamics ... . Second part of the paper is more specifically concerning with identification of the transition rules controlling the temporal evolution of cellular automata. We present: ? the general theory of identification (and calibration) of cellular automata; ? a short recall to "cellular automata with endogenous identification" (i.e. learning automata) developed by two of the authors (Papini and Rabino, 1996); ? an extended report on the application of these learning automata to the explanation of the development of a territorial system (i.e. an experimental case-study)

Technical Feasibility of Laser Dissimilar Welding of Superalloys on Casted Nozzle Guide Vanes

Abstract An increasing degree of automation is required both in the automotive and aircraft industry in order to allow scrap reduction and flexibility. In this frame, the shift from arc welding to laser beam welding is being investigated for a number of applications on metals in aerospace engineering, where strict standards apply. In comparison with conventional welding methods, a number of advantages are benefited; nevertheless, when moving to a new technology, some issues must be addressed. Hence this study is aimed to investigate laser dissimilar welding of real metal components, in order to assess the technical feasibility as well as to discuss set-up and operating issues in view of the implementation of the process for actual industrial application. A second-stage stator of low-pressure turbine is considered: lightening of the airfoils of the nozzle guide vane is achieved thanks to inner hollows which are drained from wax upon casting; afterward, the core exits on the outer side of the nozzle must be conveniently closed off by means of metal plates. Joining of the plates to the nozzle is performed by fusion welding along the edge of each plate and a condition of dissimilar welding is in place, being the nozzle and the plates made of C1023 and Nimonic 75, respectively. A mixed factorial plan has been arranged, laser power, welding speed and focus position being the leading processing parameters; a convenient welding set-up is proposed. Reasons are given for the implementation of laser beam welding as an alternative to conventional arc welding

Le trasformazioni dello spazio urbano: la quarta dimensione nella georeferenziazione dell’iconografia storica di Rome

Se si considera la componente fisica del sistema città come espressione materiale dell’insieme dei fenomeni evolutivi dei luoghi, appare evidente come la sua rappresentazione possa essere considerata come sistema di conoscenza generale in grado di manifestare una convergenza di informazioni di natura altamente eterogenea. Le vaste trasformazioni che hanno interessato le città nella storia hanno determinato una evoluzione non solo nelle modifiche morfologiche degli assetti territoriali e nella stratificazione architettonica delle strutture urbane, ma anche nella percezione e fruizione degli spazi urbani. Se si considera l’organizzazione dello spazio urbano come ambito di relazione tra gli uomini, i contributi che provengono dalle fonti bibliografiche, iconografiche e cartografiche in particolare possono consentire la ricostruzione diacronica dei tessuti urbani. Questa ricostruzione è resa possibile dalla lettura delle diverse rappresentazioni che della città sono state date nel tempo, come rappresentazioni iconografiche o pittoriche, talvolta simboliche se non addirittura metaforiche, che consentono di acquisire conoscenze dei luoghi, anche quando presentano uno scarso grado di attendibilità. L’introduzione dell’informatica nel rilevamento e nella rappresentazione cartografica e la realizzazione dei sistemi informativi territoriali hanno aperto nuove possibilità non solo nella realizzazione di database collegati e georeferenziati, che possono contenere una notevole quantità di informazioni di diversa natura progressivamente incrementabili, ma soprattutto rendendo agevoli sia le molteplici interrogazioni sia le successive elaborazioni. Lo sviluppo della cartografia digitale dalla quale si possono derivare direttamente modelli tridimensionali, si pone quindi come punto di partenza per una corretta rappresentazione della complessità del fenomeno urbano e per un ripensamento dello spazio non più sulla base di esplorazioni planimetriche, ma tramite la creazione di modelli virtuali generati in maniera più o meno automatica a partire dalla cartografia stessa. In questo senso, il modello di derivazione cartografica costituisce l’aspetto metrico-quantitativo della rappresentazione della città, aspetto che risulta tanto più esatto, obiettivo e verificabile in quanto ottenuto con strumenti che rendono le misurazioni sufficientemente attendibili. Si tratta dunque di esplorare la cartografia tridimensionale cogliendone le peculiarità e la ricchezza nella restituzione dello spazio urbano, caratteristiche, queste, che suggeriscono immediatamente di tentare di ricostruire con la stessa vivacità rappresentativa anche tutti i trascorsi storici della città o, quanto meno, di alcuni dei suoi momenti topici, con particolare attenzione alle trasformazioni di natura orografica ed edilizia. In questo quadro emergono due distinti aspetti di natura metodologica, l’uno concernente la generazione del modello urbano e le implicazioni tecniche che questo comporta (implementazione di dati, automatismi, studi tipo-morfologici, scala del modello, …), l’altro relativo all’evoluzione della città attraverso il confronto tra modelli cartografici diversi (bi e tridimensionali). La realizzazione di un modello virtuale basato sulla cartografia digitale 3D, che fotografa lo stato attuale della struttura urbana, può rappresentare la griglia tridimensionale di riferimento per una visualizzazione delle trasformazioni spaziali attuata con una procedura che ripercorre a ritroso il cammino della storia. Si tratta di riferire a questa griglia orientata sulla base di capisaldi topografici certi i dati cartografici e iconografici provenienti dalla ricerca storico-documentaria, sulla base della individuazione di elementi invarianti della struttura urbana, come assetti orografici, vuoti urbani o edifici esistenti, etc., che non hanno mutato la loro localizzazione e le loro caratteristiche morfologiche. Così concepito, il modello tridimensionale di derivazione cartografica si caratterizza per la capacità di recepire e valorizzare documenti molto diversi e non necessariamente “scientifici” ai fini di una visualizzazione interattiva della storia del singolo brano di città o del singolo edificio per valutarne le trasformazioni sul piano morfologico e dimensionale, ma anche percettivo.Peer Reviewe

Digital reconstruction of the Ceprano calvarium (Italy), and implications for its interpretation

The Ceprano calvarium was discovered in fragments on March 1994 near the town of Ceprano in southern Latium (Italy), embedded in Middle Pleistocene layers. After reconstruction, its morphological features suggests that the specimen belongs to an archaic variant of H. heidelbergensis, representing a proxy for the last common ancestor of the diverging clades that respectively led to H. neanderthalensis and H. sapiens. Unfortunately, the calvarium was taphonomically damaged. The postero-lateral vault, in particular, appears deformed and this postmortem damage may have infuenced previous interpretations. Specifcally, there is a depression on the fragmented left parietal, while the right cranial wall is warped and angulated. This deformation afected the shape of the occipital squama, producing an inclination of the transverse occipital torus. In this paper, after X-ray microtomography (μCT) of both the calvarium and several additional fragments, we analyze consistency and pattern of the taphonomic deformation that afected the specimen, before the computer-assisted retrodeformation has been performed; this has also provided the opportunity to reappraise early attempts at restoration. As a result, we ofer a revised interpretation for the Ceprano calvarium’s original shape, now free from the previous uncertainties, along with insight for its complex depositional and taphonomic history

A comprehensive system for semantic spatiotemporal assessment of risk in urban areas

AbstractRisk assessment of urban areas aims at limiting the impact of harmful events by increasing awareness of their possible consequences. Qualitative risk assessment allows to figure out possible risk situations and to prioritize them, whereas quantitative risk assessment is devoted to measuring risks from data, in order to improve preparedness in case of crisis situations. We propose an automatic approach to comprehensive risk assessment. This leverages on a semantic and spatiotemporal representation of knowledge of the urban area and relies on a software system including: a knowledge base; two components for quantitative and qualitative risk assessments, respectively; and a WebGIS interface. The knowledge base consists of the TERMINUS domain ontology, to represent urban knowledge, and of a geo‐referenced database, including geographical, environmental and urban data as well as temporal data related to the levels of operation of city services. CIPcast DSS is the component devoted to quantitative risk assessment, and WS‐CREAM is the component supporting qualitative risk assessment based on computational creativity techniques. Two case studies concerning the city of Rome (Italy) show how this approach can be used in a real scenario for crisis preparedness. Finally, we discuss issues related to plausibility of risks and objectivity of their assessment

RoSunLand: A Sustainable Self-Construction Village for Emigrant African Workers in Italy

The paper regards a research, aimed to purpose an architectonic project to realize a self-construction village in a farming town, Rosarno, located in Calabria, that is the southernmost Italian region. The project is purposed in alternative to a temporary camp, realized by the army, after a the revolt of many African emigrants, who live in this area and work in the oranges plantations with scarce protection of their rights and forced to live inside old abandoned industrial buildings. The protest, determined by inhuman life and working conditions of these young Africans, however, did not find an appropriate solution by governative institutions, which have built a refugee camp in order to receive, but also to control them, relegating them away from the city. Our project proposal, RoSunLand, wants to be an alternative solution, capable to be expression of a culture, which accepts diversity as a humanizing wealth and to remind that work is one of most relevant social means to achieve dignity