CMOS-Compatible Room-Temperature Rectifier Toward Terahertz Radiation Detection

In this paper, we present a new rectifying device, compatible with the technology of CMOS image sensors, suitable for implementing a direct-conversion detector operating at room temperature for operation at up to terahertz frequencies. The rectifying device can be obtained by introducing some simple modifications of the charge-storage well in conventional CMOS integrated circuits, making the proposed solution easy to integrate with the existing imaging systems. The rectifying device is combined with the different elements of the detector, composed of a 3D high-performance antenna and a charge-storage well. In particular, its position just below the edge of the 3D antenna takes maximum advantage of the high electric field concentrated by the antenna itself. In addition, the proposed structure ensures the integrity of the charge-storage well of the detector. In the structure, it is not necessary to use very scaled and costly technological nodes, since the CMOS transistor only provides the necessary integrated readout electronics. On-wafer measurements of RF characteristics of the designed junction are reported and discussed. The overall performances of the entire detector in terms of noise equivalent power (NEP) are evaluated by combining low-frequency measurements of the rectifier with numerical simulations of the 3D antenna and the semiconductor structure at 1 THz, allowing prediction of the achievable NEP

Terahertz rectifyier for integrated image detector

We present a new CMOS compatible direct conversion terahertz detector operating at room temperature. The rectenna consists in a truncated conical helix extruded from a planar spiral and connected to a nanometric metallic whisker at one of its edges. The whisker reaches the semiconductor substrate that constitutes the antenna ground plane. The rectifying device can be obtained introducing some simple modifications of the charge storage well in conventional CMOS APS devices, making the proposed solution easy to integrate with existing imaging systems. No need of scaling toward very scaled and costly technological node is required, since the CMOS only provides the necessary integrated readout electronics. On-wafer measurements of RF characteristics of the designed rectifying junction are reported and discussed

Regular and Irregular Multiple Serially- Concatenated Multiple-Parity-Check Codes for Wireless Applications

Multiple Serially-Concatenated Multiple-Parity-Check (M-SC-MPC) codes are a class of structured Low-Density Parity-Check (LDPC) codes, characterized by very simple encoding, that we have recently introduced. This paper evidences how the design of M-SC-MPC codes can be optimized for their usage in wireless applications. For such purpose, we consider some Quasi-Cyclic LDPC codes included in the mobile WiMax standard, and compare their performance with that of M-SCMPC codes having the same parameters. We also present a simple modification of the inner structure of M-SC-MPC codes that can help to improve their error correction performance by introducing irregularity in the parity-check matrix and increasing the length of local cycles in the associated Tanner graph. Our results show that regular and irregular M-SC-MPC codes, so obtained, can achieve very good performance and compare favorably with standard codes

3D stereophotogrammetric facial analysis of SMAII patients

Spinal muscular atrophy (SMA) is a rare neurodegenerative disease, due to autosomal recessive mutations on SMN1 gene. It is clinically classified into 4 phenotypes (SMAI-SMAIV) and it is characterized by muscular weakness and atrophy of the voluntary muscles of the legs, arms and trunk [1]. No information is available about soft tissue facial characteristics in these patients. To better define their facial phenotype and to evidence possible modifications, the 3D facial reconstructions of 12 male SMAII patients (3-8 years) were evaluated. All of them were able to sit, but not to walk independently and had respiratory problems, chewing and swallowing difficulties. The facial reconstructions were obtained through a stereophotogrammetric system, after the non-invasive identification of 50 facial reference landmarks, whose 3D coordinates were used to calculate a series of linear measurements. Data were compared with those of healthy controls, matched for age and sex, through the calculation of z-score values [2]. Results show that patients have larger skull base, mandibular and facial widths (z-score = 1.5, 2 and 1.8 respectively), together with an increased height of the nose (z-score = 3) and mandibular body length (z-score = 2.1). The mandibular ramus length is reduced (z-score = -2.6). Results are of interest to define the facial anatomy of these patients, since a detailed knowledge of their facial features can be useful to create ergonomic devices, as respiratory masks, that these patients must daily use

Growth pattern trajectories in boys with Duchenne muscular dystrophy.

OBJECTIVES: The objective of this study is to analyse retrospective, observational, longitudinal growth (weight, height and BMI) data in ambulatory boys aged 5-12 years with Duchenne muscular dystrophy (DMD). BACKGROUND: We considered glucocorticoids (GC) use, dystrophin isoforms and amenability to exon 8, 44, 45, 51 and 53 skipping drug subgroups, and the impact of growth on loss of ambulation. We analysed 598 boys, with 2604 observations. This analysis considered patients from the UK NorthStar database (2003-2020) on one of five regimes: "GC naïve", "deflazacort daily" (DD), "deflazacort intermittent" (DI), "prednisolone daily" (PD) and "prednisolone intermittent" (PI). A random slope model was used to model the weight, height and BMI SD scores (using the UK90). RESULTS: The daily regime subgroups had significant yearly height stunting compared to the GC naïve subgroup. Notably, the average height change for the DD subgroup was 0.25 SD (95% CI - 0.30, - 0.21) less than reference values. Those with affected expression of Dp427, Dp140 and Dp71 isoforms were 0.77 (95% CI 0.3, 1.24) and 0.82 (95% CI 1.28, 0.36) SD shorter than those with Dp427 and/or Dp140 expression affected respectively. Increased weight was not associated with earlier loss of ambulation, but taller boys still ambulant between the age of 10 and 11 years were more at risk of losing ambulation. CONCLUSION: These findings may provide further guidance to clinicians when counselling and discussing GCs commencement with patients and their carers and may represent a benchmark set of data to evaluate the effects of new generations of GC

Italian patients with hemoglobinopathies exhibit a 5-fold increase in age-standardized lethality due to SARS-CoV-2 infection.

Since the beginning of the COVID-19 pandemic, concerns have been expressed worldwide for patients with hemoglobinopathies and their vulnerability to SARS-CoV-2 infection. Data from Lebanon confirmed a role of underlying comorbidities on COVID-19 severity, but no deaths among a cohort of thalassemia patients.1 Patients with sickle cell disease (SCD) displayed a broad range of severity after SARS-CoV-2 infection, spanning from a favorable outcome unless pre-existing comorbidities (UK cohort)2 to high case mortality in US.3 History of pain, heart, lung, and renal comorbidities was identified as risk factors of worse COVID-19 outcomes by the US SECURE-SCD Registry.4 While Italy experienced a death rate in the general population among the highest in the world, preliminary data from the first wave of the pandemic showed a lower than expected number of infected thalassemia patients (updated up to April 10, 2020), likely due to earlier and more vigilant self-isolation compared to the general population.

Abnormal fatty acid metabolism is a core component of spinal muscular atrophy

Objective: Spinal muscular atrophy (SMA) is an inherited neuromuscular disorder leading to paralysis and subsequent death in young children. Initially considered a motor neuron disease, extra-neuronal involvement is increasingly recognized. The primary goal of this study was to investigate alterations in lipid metabolism in SMA patients and mouse models of the disease. Methods: We analyzed clinical data collected from a large cohort of pediatric SMA type I-III patients as well as SMA type I liver necropsy data. In parallel, we performed histology, lipid analysis, and transcript profiling in mouse models of SMA. Results: We identify an increased susceptibility to developing dyslipidemia in a cohort of 72 SMA patients and liver steatosis in pathological samples. Similarly, fatty acid metabolic abnormalities were present in all SMA mouse models studied. Specifically, Smn2B/- mice displayed elevated hepatic triglycerides and dyslipidemia, resembling non-alcoholic fatty liver disease (NAFLD). Interestingly, this phenotype appeared prior to denervation. Interpretation: This work highlights metabolic abnormalities as an important feature of SMA, suggesting implementation of nutritional and screening guidelines in patients, as such defects are likely to increase metabolic distress and cardiovascular risk. This study emphasizes the need for a systemic therapeutic approach to ensure maximal benefits for all SMA patients throughout their life

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes