Evaluation of Ingenol mebutate efficacy for the treatment of actinic keratosis with Antera 3D camera

OBJECTIVE: Cumulative exposure of the skin to ultraviolet radiation promotes mutation in keratinocytes and their abnormal growth led to the formation of scaly lesions, called actinic keratoses (AKs). Its incidence is growing at an emerging rate, becoming a worldwide problem especially for occupational ultraviolet (UV) rays exposure. Detectable lesions are often associated with field changes, where the surrounding skin is altered and subclinical lesions may be present. Thus, a field-directed therapy, such as topical treatment, should be preferred for the prevention of invasive cancer development. A retrospective analysis was made, evaluating the efficacy of ingenol-mebutate gel, using a novel device the 3D in vivo optical skin Imaging (Antera 3D, Miravex, Ireland). PATIENTS AND METHODS: We included all patients with multiple non-hypertrophic Aks, to whom it was prescribed ingenol-mebutate gel, applied at the dosages of 0.015 for lesions in the scalp/face (for 3 consecutive days) and at the dosage of 0.05% for lesions in the trunk and/or extremities (for 2 consecutive days). RESULTS: A reduction of the lesions and of median hemoglobin levels, after a follow-up of 60 days, was observed in 100% of patients. CONCLUSIONS: Ingenol mebutate gel, the last topical molecule appeared in the Italian market showed its efficacy using Antera 3D also in terms of hemoglobin reduction. Therefore, this camera could be considered an useful tool for the identification of the area to be treated and for therapeutic follow-up

Speed data collection methods: a review

Various studies have been focusing on a wide range of techniques to detect traffic flow characteristics, like speed and travel times. Therefore, a key aspect to obtain statistically significant set of data is to observe and record driver behaviours in real world. To collect traffic data, traditional methods of traffic measurement - such as detection stations, radar guns or video cameras - have been used over the years. Other innovative methods refer to probe vehicles equipped with GPS devices and/or cameras, which allow continuous surveys along the entire road route. While point-based devices provide information of the entire flow, just in the section in which they are installed and only in the time domain, probe vehicles data are referred both to temporal and space domains but ignore traffic conditions. Obviously, it is necessary that the data collected refer to representative samples, by number and composition, of the user population. The paper proposes a review of the most used methods for speed data collection, highlighting the advantages and disadvantages of each experimental approach. Accordingly, the comparison illustrates the best relief method to be adopted depending on the research and investigation that will be performed

Blending of Floating Car Data and Point-Based Sensor Data to Deduce Operating Speeds under Different Traffic Flow Conditions

Nowadays, smart mobility can rely on innovative tools for the knowledge of road system conditions, like operating speed data extracted from the so-called Floating Car Data (FCD). Probe vehicles in the traffic flow send to operation centres a large amount of travel information, collected through GPS detection systems, especially with regard to geolocation, date and time, direction and speed. As the sample deriving from these vehicles represents a tiny portion of the entire vehicular fleet, in this paper an analysis and a comparison with data obtained by point-based traffic sensors is proposed.Therefore, the study analyses data collected by inductive loop detectors and microwave radar sensors, that provide information on the entire traffic flow in the time domain, in particular with the aim to identify free flow speed time bands. Afterwards, by means of the fusion between the results obtained from the data coming from these point-based control units and the ones coming from the probe vehicles, a comparison of the operating speeds in the two conditions of constrained and unconstrained traffic flow is performed

Effectiveness of Climbing Lanes for Slow-Moving Vehicles When Riding Uphill: A Microsimulation Study

Long uphill stretches of single-carriageway rural roads with one lane per travel direction may reduce the Level of Service (LoS), due to the decreased speed of heavy vehicles. In those circumstances, a slowdown of traffic, resulting in the formation of platoons, may be generated due to the difficulty of performing overtaking maneuvers safely. To solve this critical issue, an additional (climbing) lane for slow vehicles may be included in the road platform. This study aims to evaluate the effectiveness of such climbing lanes in a real case in Italy (National Road n. 4 “Via Salaria”— around 44+000 km). Using a microsimulation model implemented in VISSIM, the study analyzes speeds and travel times, delays, and queuing waiting times, comparing the Actual Scenario (AS) without climbing lanes, with two counterfactual scenarios: the first one (CS1) with three stretches of climbing lanes, and the second one (CS2), with just two stretches, in which the first two additional lanes of CS1 are merged together. The obtained results confirm the effectiveness of installing climbing lanes on road sections with the described characteristics, and the potential of microsimulation models also to carry out such kind of evaluations

Road Infrastructure Safety Management. Proactive Safety Tools to Evaluate Potential Conditions of Risk

The identification of highly critical sections in a road network is possible by examining the network operation, with the goal of determining the risk factors and observe the critical issues, in order to better plan possible improvements. Therefore, this study proposes a method to evaluate the coherence of existing road layouts, through the analysis of the geometric characteristics, theoretical speeds and drivers operating speeds, under different environmental and flow conditions. The analysis focuses on the road network managed by ANAS SpA in the Veneto Region, for which the reconstruction of the road axes geometry, the curvature graph and the theoretical design speed profile have been obtained, according to the indications of the Italian Ministerial Decree 05/11/2001. The theoretical design speed profile has then been compared with the information relating to the road users' mobility, in terms of the 85th percentile speeds, obtained from the extraction and analysis of the Floating Car Data (FCD). The data were processed by reconstructing the continuous profile of operating speeds with a specific regression function known as "smoothing cubic spline". The comparison with the theoretical design speeds allows to observe whether the users assume a behavior close to or distant from what is expected, based on the technical and geometrical characteristics of the road layout. The proposed methodology can contribute to the implementation of a proactive road safety check, aimed at recognizing and assessing the potential risk conditions for road traffic, with particular attention to the point of view of the road user

Thyroid ultrasonography reporting: consensus of Italian Thyroid Association (AIT), Italian Society of Endocrinology (SIE), Italian Society of Ultrasonography in Medicine and Biology (SIUMB) and Ultrasound Chapter of Italian Society of Medical Radiology (SIRM)

Thyroid ultrasonography (US) is the gold standard for thyroid imaging and its widespread use is due to an optimal spatial resolution for superficial anatomic structures, a low cost and the lack of health risks. Thyroid US is a pivotal tool for the diagnosis and follow-up of autoimmune thyroid diseases, for assessing nodule size and echostructure and defining the risk of malignancy in thyroid nodules. The main limitation of US is the poor reproducibility, due to the variable experience of the operators and the different performance and settings of the equipments. Aim of this consensus statement is to standardize the report of thyroid US through the definition of common minimum requirements and a correct terminology. US patterns of autoimmune thyroid diseases are defined. US signs of malignancy in thyroid nodules are classified and scored in each nodule. We also propose a simplified nodule risk stratification, based on the predictive value of each US sign, classified and scored according to the strength of association with malignancy, but also to the estimated reproducibility among different operators

Primary cutaneous alk positive anaplastic large cell lymphoma in a melanoma patient

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a raresubset of CD30+ lymphoproliferative disorder, characterized by the presenceof large anaplastic cells, which express CD30, CD2, CD3, CD4, and CD5. A 62 year-old male patient presented to our Institute with a history of a fastgrowing and pinkish-brown asymptomatic cutaneous nodule. His medical past history was positive for a malignant melanoma (MM) of the abdomen (0.7 mm Breslow thickness; pT1a). Histologically the lesion showed a diffuse infiltrate consisting in cohesive sheets of large cells with anaplastic morphology with a kidney-shaped nucleus, also known as hallmark cells. Immunohistochemical studies revealed a CD30 expression, and a positivity to perforin and anaplastic lymphoma kinase (ALK). The laboratory and instrumental investigations were all normal and a final diagnosis of PCALCL was made. The patient showed a good response to radiotherapy. Usually PCALCL shares with systemic anaplastic large cell lymphoma (ALCL) the presence of neoplastic CD30+ large T cells, but lack ALK translocations and protein expression. However, the detection of ALK expression in PCALCL should be considered highly suspicious of a cutaneous manifestation of an underlying systemic disease (not detected in our patient). We recommend to exclude a systemic involvement in this kind of disease, with a strict follow-up, especially in patients with double malignancies

Paraneoplastic pemphigus. A trait d’union between dermatology and oncology

Paraneoplastic pemphigus is a rare autoimmune disease of the skin associated with neoplasm. Nowadays, the pathogenesis of paraneoplastic pemphigus is not fully understood. Due to its rarity, various criteria have been proposed for the diagnosis. For this reason, several diagnostic methods have been considered useful for the diagnosis of paraneoplastic pemphigus including indirect immunofluorescence, direct immune of fluorescence, immunoprecipitation,immunoblotting, and enzyme-linked immunosorbent assay (ELISA). However, the polymorphic clinical features and the various results of laboratory tests and pathological evaluation present a challenge for the clinician

Syphilis, the great Imitator—clinical and dermoscopic features of a rare presentation of secondary syphilis

Syphilis is characterized by a wide range of variable clinical symptoms; therefore, it is often referred to as "The Great Imitator". Here, we report the case of a 69-year-old hepatitis-C-positive MSM patient, who was admitted to our clinic due to a solitary firm painless erythematous maculopapular lesion with a central crater-like crust on the upper right thigh that occurred two months prior. The dermoscopy showed an erythematous, copper-colored, oval lesion with diffuse monomorphic dotted and glomerular vessels, central crust, and circular scaling (Biett's sign). The histological findings ruled out neoplasia and described a plasma cell infiltrate and endothelial swelling. Finally, the combination of the dermoscopic image, histological findings and the additionally acquired knowledge about the sexual history of the patient at the second visit led to the diagnosis, which was then confirmed with serological tests. Dermoscopy may become a supportive tool to facilitate the recognition of secondary syphilis; however, the reporting of these atypical cases is crucial to highlight the many faces of the disease so that clinicians consider syphilis as part of the differential diagnosis of non-specific lesions

Materials study to implement a 3D printer system to repair road pavement potholes

InfraRob is a research project funded by the European Commission's research programme Horizon 2020 that aims to maintain integrity, performance, and safety of the road infrastructure through autonomous robotized solutions and modularization. A specific task of the project is focused on the development of a system 3D printer able to extrude a specific mixture for filling in small cracks and potholes, to be integrated with an existing small autonomous carrier. The first step of the research deals with the definition of the optimal parameters of the system 3D printer/mixture, by studying in parallel the material design and the printer design. This paper presents the study performed on a mixture chosen among those commonly used for road potholes repair. The mixture is studied to achieve and balance the different conflicting performances: consistence, flowability homogeneity, and internal structure. In addition to the basic components, the use of special additives has also been explored to improve the plasticity and adhesivity of the mixture. The first phase of tests is conducted to define the main printing controls: i) Extrudability control: materials for 3D printing need to have an acceptable degree of extrudability, which is related to the capacity of a material to pass continuously through the printing head; ii) Flowability control, to ensure the mixture can be easy-pumpable in the delivery system and easy-usable on the crack or the pothole to be filed-in; iii) Setting time control: printing material requires a certain setting time to maintain a consistent flow rate for good extrudability, thus appropriate additives are needed to control the setting time. The second phase includes in situ tests to verify the compaction of the mixture under the traffic loads. The paper presents the results of the lab and in situ tests, and the features of the chosen mix, suitable to be managed by the 3D printer