Thermal Care of Functional Dyspepsia Based on Bicarbonate-Sulphate-Calcium Water: A Sequential Clinical Trial

Drug treatment of functional dyspepsia is often unsatisfactory. We assessed the efficacy of a bicarbonate-sulphate-calcium thermal water cycle of 12 days, in patients with functional dyspepsia. Patients with functional dyspepsia were sent by their general practitioners to 12 days of treatment with thermal water, 200–400 ml in the morning, at temperature of 33°C (91.4 F) and were evaluated on a strict intention to treat basis. Four efficacy endpoints were analyzed as follows: (i) reduction of the global symptoms score, (ii) reduction of intensity to a level not interfering with everyday activities, (iii) specific efficacy on ulcer-like or dysmotility-like dyspepsia and (iv) esophageal or abdominal-associated symptoms. Statistical significance was reached for all three primary outcomes after the first 29 consecutive patients. Thermal water reduced the global symptom score, reduced intensity of symptoms to a level not interfering with everyday activity, but was unable to completely suppress all symptoms. A parallel effect emerged for ulcer-like and dyspepsia-like subgroups. The effect on heartburn and abdominal symptoms was not significant, suggesting a specific effect of the water on the gastric and duodenal wall. The Roma II criteria identify a natural kind of dyspepsia that improves with thermal water. Ulcer-like and dysmotility-like are not therapeutically distinguishable subgroups. Patients with dominant esophageal or abdominal symptoms should receive a different therapy. Sequential methods are very effective for the evaluation of traditional care practices and should be considered preliminary and integrative to randomized controlled trials in this context

A SVM-Based Three-Dimensional Multi-Resolution Approach for Biomedical Inverse Scattering Problems

In the last few years, microwave imaging techniques have been successfully used to provide the spatial distribution of tissues. In particular, because of the significant contrast of the dielectric properties between the normal tissue and the malignant tissue at microwave frequencies, microwave methods seem to be very promising diagnosis methods for the early cancer detection [1]

Robot-assisted rehabilitation of people with breast cancer developing upper limb lymphedema: protocol of a randomized controlled trial with a 6-month follow‐up

Upper limb lymphedema (ULLy) is an external (and/or internal) manifestation of lymphatic system insufficiency and deranged lymph transport for more than 3 months and frequently affects people as a consequence of breast cancer (BC). ULLy is often underestimated despite diminished motor skills, mood, and cognitive-behavioral complaints negatively condition the health-related quality of life (HRQoL) of persons. BC can also metastasize to the jawbone, further impacting on the HRQoL. In time, the implementation of robot-assisted rehabilitation (RR) for neurological diseases has grown to improve HRQoL and pain. This study aims to evaluate the effectiveness of a RR program in the treatment of individuals who develop an ULLy; as a further analysis, the study will assess the effectiveness of the same program in people with jawbone metastases from BC who will also develop ULLy. A randomized, parallel-group superiority-controlled trial will be conducted. 44 participants will be randomly allocated to either the experimental (receiving a RR program) or the control group (regular rehabilitation). Both groups will follow individual-based programs three times a week for 10 weeks. The main outcome measure will be the Lymphedema Quality of Life Questionnaire. Secondary outcomes will be a pain intensity numerical rating scale and the Cranio-Facial Pain Disability Inventory. Evaluations are before and after training and 6 months later. Findings may provide evidence on the effectiveness of a RR program on inducing improvements in the HRQoL and pain of individuals with ULLy due to BC. People with ULLy and jawbone metastases from BC are expected for similar or higher improvements as per the same comparisons above. This trial might contribute towards defining guidelines for good clinical rehabilitation routines and might be used as a basis for health authorities' endorsements.Trial registration OSF REGISTRIES, osf-registrations-jz7ax-v1 . Registered on 26 June 2023

Unlocking Onboard SAR Processing: Focusing and Ship Detection on Sentinel-1 IW Data

This work demonstrates the possibility of enabling onboard processing of SAR data in real-time through the adoption of an innovative focusing technology coupled with object detection, using limited computational resources. Our approach aims to provide a coarse focused product onboard to unlock real-time monitoring capabilities, complementing the ground-based detailed focusing algorithms. The focusing algorithm transforms the Level-0 raw signal into Level-1 Single-Look-Complex (SLC) data. It consists of a two-layers hybrid architecture: a traditional Fast-Fourier Transform (FFT) algorithm for range processing and a Deep Neural Network (DNN), trained to solved the azimuth processing task, which provides scalability and modularity benefits. After focusing, an object detection network is trained to detect the presence of ships in the SLC data. The whole processing chain has been optimized and deployed on different embedded devices, including NVIDIA Jetson Nano, and NVIDIA Jetson Xavier, to demonstrate the feasibility of running the overall pipeline onboard the future generations of SAR missions

Severe reperfusion lung injury after double lung transplantation

AIM: To demonstrate the effects of combined inhaled nitric oxide and surfactant replacement as treatment for acute respiratory distress syndrome. This treatment has not previously been documented for reperfusion injury after double lung transplantation. METHOD: A 24-year-old female with cystic fibrosis underwent double lung transplantation. During implantation of the second lung a marked increase in pulmonary artery pressure associated with systemic hypotension, hypoxemia and low cardiac output were observed. Notwithstanding the patient received support from cardiovascular drugs and pulmonary vasodilators cardiopulmonary by-pass was necessary. In the intensive care unit the patient received the same drug support, inhaled nitric oxide and two bronchoscopic applications of bovine surfactant. RESULTS: A rapid improvement in PaO(2)/FiO(2) within 2–3 hours of administration of surfactant was seen. The patient is well at follow-up 1 year post-transplant. CONCLUSION: There is a potential role for a combined therapy with inhaled nitric oxide and surfactant replacement in reperfusion injury after lung transplantation

Interacting social processes on interconnected networks

We propose and study a model for the interplay between two different dynamical processes -one for opinion formation and the other for decision making- on two interconnected networks A and B. The opinion dynamics on network A corresponds to that of the M-model, where the state of each agent can take one of four possible values (S = -2,-1, 1, 2), describing its level of agreement on a given issue. The likelihood to become an extremist (S = ±2) or a moderate (S = ±1) is controlled by a reinforcement parameter r ≥ 0. The decision making dynamics on network B is akin to that of the Abrams-Strogatz model, where agents can be either in favor (S = +1) or against (S = -1) the issue. The probability that an agent changes its state is proportional to the fraction of neighbors that hold the opposite state raised to a power β. Starting from a polarized case scenario in which all agents of network A hold positive orientations while all agents of network B have a negative orientation, we explore the conditions under which one of the dynamics prevails over the other, imposing its initial orientation. We find that, for a given value of β, the two-network system reaches a consensus in the positive state (initial state of network A) when the reinforcement overcomes a crossover value r∗(β), while a negative consensus happens for r ∗(β). In the r - β phase space, the system displays a transition at a critical threshold βc, from a coexistence of both orientations for β c to a dominance of one orientation for β > βc. We develop an analytical mean-field approach that gives an insight into these regimes and shows that both dynamics are equivalent along the crossover line (r∗, β∗).Facultad de Ciencias ExactasInstituto de Física de Líquidos y Sistemas Biológico

Seismic risk assessment of a new RC-framed skin technology for integrated retrofitting interventions on existing buildings

A RC-framed-skin technology for the integrated seismic and thermal retrofitting interventions on existing buildings, recently proposed by some of the authors, is thoroughly investigated. By means of numerical analyses, its effectiveness and suitability within the framework of seismic risk class assessment is proved. The system is composed of a RC-framed structure with an external reinforced plaster layer that does not offer a structural contribution to the capacity of the system in ultimate conditions, but which can be effective by increasing the lateral stiffness in serviceability conditions. The system is realized from the outside of the existing building so guaranteeing limited invasiveness of the intervention and preventing the interruption of the building use by their occupants. An existing RC building, representative of a typical example of the Italian building stock, is analyzed as a case study, and its seismic risk class upgrade, obtained by the proposed strengthening intervention, is assessed by non-linear static analysis. The numerical models are developed within the OpenSees framework. The Expected Annual Loss (EAL) parameter, together with the Life Safety Index (LS-I), are chosen as synthetic measures that include both aspects related to Ultimate Limit state (ULS) and Serviceability Limit State (SLS) conditions. The risk class accounting for or disregarding the contribution of the external reinforced plaster are finally compared

Transesophageal echocardiography in orthotopic liver transplantation: a comprehensive intraoperative monitoring tool

Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction. However, intraoperative transesophageal echocardiography can be used to â\u80\u9cvisualizeâ\u80\u9d other organs too; thanks to its proximity and access to multiple acoustic windows: liver, lung, spleen, and kidney. Although only limited scientific evidence exists promoting this comprehensive use, we describe the feasibility of TEE in the setting of liver transplantation: it is a highly valuable tool, not only as a cardiovascular monitoring, but also as a tool to evaluate lungs and pleural spaces, to assess hepatic vein blood flow and inferior vena cava anastomosis and patency, i.e., in cases of modified surgical techniques. The aim of this case series is to add our own experience of TEE as a comprehensive intraoperative monitoring tool in the field of orthotopic liver transplantation (and major liver resection) to the literature

Effectiveness of endoscopic trans-tendineous repair for partial-thickness tears of medius gluteus: A systematic review of literature

Tears of the gluteus medius can result in chronic hip pain over time. Pathological onsets involving the gluteus medius cause pain and weakness of abductor strength. Endoscopic repair is a suitable, effective and safe surgical alternative to traditional open techniques and give satisfactory results over time restoring the footprint of gluteus medius. The purpose of this systematic review is to analyse the effectiveness of endoscopic trans-tendinous technique for partial-thickness tears, analysing the subjective and functional outcome over the time. A search of literature (PubMed, Scopus, WebOfKnowledge) was performed. The PRISMA method was used to screen the articles. A total of 4 articles was screened and included for qualitative analysis. For data extraction patient characteristics, pre-clinical examination, imaging, timing from symptoms to surgery, technique performed, subjective scales, functional outcomes, post-operative clinical assessment were analysed. Subjective scores at mean follow-up of 18 months show a significative improvement in all the scales reported, in relief of pain (VAS score) and in terms of strength of abductor. Trans-tendinous technique represents the gold standard to treat endoscopically these injuries. Furthermore, other studies with larger number of patients and longer follow-up are required to validate the best surgical approach for these injuries