La conducibilit\ue0 elettrica come strumento per stimare lo sviluppo del reticolo ipogeo

Una delle principali sfide nella ricerca speleologica \ue8 quella di stimare in modo il pi\uf9 possibile accurato l\u2019entit\ue0 (dimensione, estensione e sviluppo) e la localizzazione del reticolo ipogeo presente in un\u2019area carsica. Quando l\u2019attivit\ue0 esplorativa classica non risolve tutte le problematiche si utilizzano tecniche indirette quali per esempio la geofisica o le analisi idrogeologiche. In quest\u2019ottica nel 2015 \ue8 partita una proficua collaborazione tra gli speleologi del Gruppo Speleologico Monfalconese \u201cAmici del Fante\u201d, speleologi del Gruppo Speleologico \u201cTalpe del Carso\u201d - Jamarski Klub \u201cKraski Krti\u201d, studiosi indipendenti e ricercatori del dipartimento di Matematica e Geoscienze volta alla comprensione dei deflussi sotterranei e delle modalit\ue0 di ricarica/esaurimento del settore occidentale del Carso Classico. In questi ultimi 3 anni \ue8 stata sviluppata una metodologia che attraverso l\u2019analisi della conducibilit\ue0 elettrica delle acque superficiali e sotterranee presenti nell\u2019area di studio permette di individuare l\u2019origine e la provenienza delle diverse tipologie di acque presenti. La scelta del parametro conducibilit\ue0 elettrica non deriva solo dalla sua significativit\ue0, ma anche dal fatto che essa rappresenta un parametro di facile acquisizione e che non necessita di complesse e costose metodologie di analisi. Dato che la ricarica dell\u2019acquifero \ue8 dovuta principalmente a tre componenti quali le perdite dell\u2019Isonzo, l\u2019infiltrazione efficace e il contributo del sistema Reka-Timavo, da giugno 2015 ai primi mesi del 2018 sono state effettuate quasi 100 uscite sul terreno che hanno permesso di acquisire dati di conducibilit\ue0 elettrica e temperatura presso l\u2019Isonzo, il Reka, i laghi di Doberd\uf2 e Pietrarossa, le sorgenti di Sablici di Moschenizze, di Sardos e del Timavo. Nel contempo sono state installate due sonde multiparametriche sul fondo dell\u2019Abisso Samar di Riky (cat. FVG n.4709) e della Grotta del Proteo (cat. FVG n.1191) presso Sagrado (GO), che ogni 30 minuti acquisiscono informazioni sulla conducibilit\ue0 elettrica, la temperatura e il livello delle acque. L\u2019analisi dei dati ha permesso di individuare i valori caratteristici delle tre componenti principali di ricarica dell\u2019acquifero: l\u2019Isonzo con un valore di 240 uS/cm, le acque carsiche dovute al contributo delle precipitazioni con 470 uS/cm e il Reka con 310 uS/cm. Utilizzando questi valori \ue8 stato possibile quantificare il contributo delle diverse componenti sia in corrispondenza delle sorgenti che dei laghi carsici nei diversi regimi idrogeologici. Nel contempo l\u2019analisi dei dati in continuo ha permesso di stimare le modalit\ue0 di ricarica ed esaurimento del sistema ipogeo. Il lavoro che si presenta \ue8 stato realizzato grazie anche al contributo della Federazione Speleologica Isontina, dell\u2019Universit\ue0 degli Studi di Trieste e della Fondazione Carigo di Gorizia

AME position statement on adrenal incidentaloma.

Objective: To assess currently available evidence on adrenal incidentaloma and provide recommendations for clinical practice. Design: A panel of experts (appointed by the Italian Association of Clinical Endocrinologists (AME)) appraised the methodological quality of the relevant studies, summarized their results, and discussed the evidence reports to find consensus. Radiological assessment: Unenhanced computed tomography (CT) is recommended as the initial test with the use of an attenuation value of <= 10 Hounsfield units (HU) to differentiate between adenomas and non-adenomas. For tumors with a higher baseline attenuation value, we suggest considering delayed contrast-enhanced CT studies. Positron emission tomography (PET) or PET/CT should be considered when CT is inconclusive, whereas fine needle aspiration biopsy may be used only in selected cases suspicious of metastases (after biochemical exclusion of pheochromocytoma). Hormonal assessment: Pheochromocytoma and excessive overt cortisol should be ruled out in all patients, whereas primary aldosteronism has to be considered in hypertensive and/or hypokalemic patients. The 1 mg overnight dexamethasone suppression test is the test recommended for screening of subclinical Cushing's syndrome (SCS) with a threshold at 138 nmol/l for considering this condition. A value of 50 nmol/l virtually excludes SCS with an area of uncertainty between 50 and 138 nmol/l. Management: Surgery is recommended for masses with suspicious radiological aspects and masses causing overt catecholamine or steroid excess. Data are insufficient to make firm recommendations for or against surgery in patients with SCS. However, adrenalectomy may be considered when an adequate medical therapy does not reach the treatment goals of associated diseases potentially linked to hypercortisolism

FITFES: A Wearable Myoelectrically Controlled Functional Electrical Stimulator Designed Using a User-Centered Approach

Myoelectrically Controlled Functional Electrical Stimulation (MeCFES) has proven to be a useful tool in the rehabilitation of the hemiplegic arm. This paper reports the steps involved in the development of a wearable MeCFES device (FITFES) through a user-centered design. We defined the minimal viable features and functionalities requirements for the device design from a questionnaire-based survey among physiotherapists with experience in functional electrical stimulation. The result was a necklace layout that poses minimal hindrance to task-oriented movement therapy, the context in which it is aimed to be used. FITFES is battery-powered and embeds a standard low power Bluetooth module, enabling wireless control by using PC/Mobile devices vendor specific built-in libraries. It is designed to deliver a biphasic, charge-balanced stimulation current pulses of up to 113 mA with a maximum differential voltage of 300 V. The power consumption for typical clinical usage is 320 mW at 20mA stimulation current and of less than $10~\mu \text{W}$ in sleep mode, thus ensuring an estimated full day of FITFES therapy on a battery charge. We conclude that a multidisciplinary user-centered approach can be successfully applied to the design of a clinically and ergonomically viable prototype of a wearable myoelectrically controlled functional electrical stimulator to be used in rehabilitation

Vertebral Augmentation: Is It Time to Get Past the Pain? A Consensus Statement from the Sardinia Spine and Stroke Congress

Vertebral augmentation has been used to treat painful vertebral compression fractures and metastatic lesions in millions of patients around the world. An international group of subject matter experts have considered the evidence, including but not limited to mortality. These considerations led them to ask whether it is appropriate to allow the subjective measure of pain to so dominate the clinical decision of whether to proceed with augmentation. The discussions that ensued are related below

Impaired activation of plasmacytoid dendritic cells via toll-like receptor 7/9 and STING is mediated by melanoma-derived immunosuppressive cytokines and metabolic drift

IntroductionPlasmacytoid dendritic cells (pDCs) infiltrate a large set of human cancers. Interferon alpha (IFN-α) produced by pDCs induces growth arrest and apoptosis in tumor cells and modulates innate and adaptive immune cells involved in anti-cancer immunity. Moreover, effector molecules exert tumor cell killing. However, the activation state and clinical relevance of pDCs infiltration in cancer is still largely controversial. In Primary Cutaneous Melanoma (PCM), pDCs density decreases over disease progression and collapses in metastatic melanoma (MM). Moreover, the residual circulating pDC compartment is defective in IFN-α production.MethodsThe activation of tumor-associated pDCs was evaluated by in silico and microscopic analysis. The expression of human myxovirus resistant protein 1 (MxA), as surrogate of IFN-α production, and proximity ligation assay (PLA) to test dsDNA-cGAS activation were performed on human melanoma biopsies. Moreover, IFN-α and CXCL10 production by in vitro stimulated (i.e. with R848, CpG-A, ADU-S100) pDCs exposed to melanoma cell lines supernatants (SN-mel) was tested by intracellular flow cytometry and ELISA. We also performed a bulk RNA-sequencing on SN-mel-exposed pDCs, resting or stimulated with R848. Glycolytic rate assay was performed on SN-mel-exposed pDCs using the Seahorse XFe24 Extracellular Flux Analyzer.ResultsBased on a set of microscopic, functional and in silico analyses, we demonstrated that the melanoma milieu directly impairs IFN-α and CXCL10 production by pDCs via TLR-7/9 and cGAS-STING signaling pathways. Melanoma-derived immunosuppressive cytokines and a metabolic drift represent relevant mechanisms enforcing pDC-mediated melanoma escape.DiscussionThese findings propose a new window of intervention for novel immunotherapy approaches to amplify the antitumor innate immune response in cutaneous melanoma (CM)

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Background: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

Hardware-assisted memory isolation in hypervisors for multicore real-time systems

La tesi affronta il problema dell'isolamento della memoria in sistemi real-time multicore con vincoli temporali complessi. Dopo aver analizzato le problematiche più rilevanti, sarà implementato un modulo per hypervisor per supportare l'estensione ARM MPAM, al fine di verificare come questa tecnologia possa affrontarle. Nella seconda parte, si valuterà la funzionalità dei QoS regulator presenti nella piattaforma Xilinx Ultrascale+, allo scopo di verificare la loro efficacia nel limitare la banda di memoria utilizzata dalle periferiche di I/O. The thesis deals about memory isolation in multicore real-time systems with complex temporal constraints. After analysing the most relevant issues, an hypervisor module to support the MPAM ARM extension will be implemented, in order to verify how this technology can address them. In the second part, the functionalities of the QoS regulators the Xilinx Ultrascale+ platform is provided with will be evaluated, in order to test their efficacy in the limitation of the memory bandwidth utilized by the I/O devices

Codex[ml]

Codex[ml] integrated system has been developed by CILEA with the aim of meeting management, storage and fruition requirements of digital objects. Using Codex[ml] every agency and every library that deals with organ¬ized information can offer the fruition of its own works, text or archives, through an on-line navigation based on different xml metadata standards. Codex[ml] performs import, creation, long-term storage, delivery and fruition of xml documents that follow administrative standards for data management. It is an open system, which is able to manage METS, MAG and other standards, even not yet developed (adding new metadata interface modules). This is a modular and scalar software: every component is developed over a common framework to guarantee full interoperability.Il sistema integrato Codex[ml] è stato sviluppato dal CILEA per la gestione, conservazione e fruizione via web di risorse digitali. La piattaforma consente a ogni istituzione culturale, biblioteca o archivio che possieda informa¬zioni cartacee digitalizzate, la relativa fruizione attraverso la navigazione via web, sfruttando l’analisi dei diversi standard di metadati, in linguaggio XML. Il sistema si presenta modulare e scalabile: ogni modulo è un elemento indipendente che interagisce con gli altri per garantire la possibilità di creare, conservare, distribuire immagini corredate da metadati. L’utente può navigare all’interno della risorsa digitale visualizzandola con un’interfaccia web, sfruttando la struttura descritta nei metadati, codificati in linguaggio XML, secondo le specifiche previste dagli standard METS, MAG, etc., ma predisposta anche per nuovi standard non ancora scritti