On Christoffel and standard words and their derivatives

We introduce and study natural derivatives for Christoffel and finite standard words, as well as for characteristic Sturmian words. These derivatives, which are realized as inverse images under suitable morphisms, preserve the aforementioned classes of words. In the case of Christoffel words, the morphisms involved map $a$ to $a^{k+1}b$ (resp.,~$ab^{k}$) and $b$ to $a^{k}b$ (resp.,~$ab^{k+1}$) for a suitable $k>0$. As long as derivatives are longer than one letter, higher-order derivatives are naturally obtained. We define the depth of a Christoffel or standard word as the smallest order for which the derivative is a single letter. We give several combinatorial and arithmetic descriptions of the depth, and (tight) lower and upper bounds for it.Comment: 28 pages. Final version, to appear in TC

Chapter Thematic atlas of Italian oncological research: the analysis of public IRCCS

This paper has been developed in the frame of the research project “V:ALERE 2019” focused on Italian public-owned Academic Medical Centers. The main aim of the project is to provide evidence, advice, and remarks to help the agents of the public health system to address the many challenges that they face. In recent years, there is an increasing recognition of the potential value of research evidence as one of the many factors considered by policymakers and practitioners. Even more, in the case of medical science, the analysis of research and its impact is indispensable, in light of its implications for public health. The starting point for mapping a research area is to review the related scientific literature because by synthesizing past research findings, it is possible to effectively use the existing knowledge base and advance lines of future researches. In this sense, bibliometrics becomes useful, by providing a structured analysis to a large body of information, to infer trends over time, themes researched, and to show the “big picture” of extant research. In particular, in this work, we focus our attention on the scientific production of the last 20 years of the Scientific Institutes for Research, Hospitalization, and Healthcare (IRCCS “Istituto di Ricovero e Cura a Carattere Scientifico”) specialized in the oncology research. IRCCS are biomedical institutions of relevant national interest that drive clinical assistance in strong relation to research activities. They are committed to being a benchmark for the whole public health system for both the quality of patient care and the innovation skills in the field of the organization. All the analyses were carried out by using the Bibliometrix, an open-source tool for quantitative research in scientometrics and bibliometrics that includes all the main bibliometric methods of analysis

Skin graft donor site: a procedure for a faster healing

Background: The authors want to evaluate the efficacy of fibrillary tabotamp dressing in skin graftdonor site. A comparison was made with Vaseline gauzes. Tabotamp is an absorbable haemostatic product of Ethicon (Johnson and Johnson) obtained by sterile and oxidized regenerated cellulose (Rayon). It is used for mild to moderate bleeding. Materials and methods: 276 patients were subject to skin graft and divided into two group: Group A and Group B. The donor site of patients in Group A was medicated with fibrillary tabotamp, while the patients of Group B were medicated only with Vaseline gauze. We recorded infection, timing of healing, number of dressing change, the pain felt during and after the dressing change with visual analog scale (VAS) and a questionnaire. Results: Patients allocated in Group A healed faster than the Group B. Questionnaires and VAS analysis showed lower pain felt, lower intake of pain drugs and lower infection rate in the Group A than the Group B. Analysis of coast showed lower dressing change in Group A than the Group B. Conclusion: We believe that the use of tabotamp is a very viable alternative to improve healing. (www.actabiomedica.it)

A case of extramammary inguinal Paget disease in a male patient: surgical treatment with an abdominal advancement cutaneous flap

Extramammary Paget disease (EMPD) is a rare neoplasm. The clinical case of a 55-year-old man with a two-year history of a pruritic, painless erythematous skin rash on the inguinal region and scrotum is described. After a delay due to improper diagnosis and improper treatments, the patient came to the attention of the Division of plastic surgery. He underwent a punch biopsy and the pathology report came back as EMPD. Surgical excision was carried out, and an abdominal advancement cutaneous flap was performed for the defect repair. This is the first description of a reconstruction after surgical removal of inguinal EMPD with a flap of this type and we think that this type of treatment can be useful and reliable for disease localization in the groin area, especially for patients that present an excess of abdominal skin

Ischemic Damage of the Flaps: New Treatments.

n/

Integrating tools for an effective testing of connected and automated vehicles technologies

The development of connected and automated driving functions involves that the interaction of autonomous/ automated vehicles with the surrounding environment will increase. Accordingly, there is a necessity for an improvement in the usage of traditional tools of the automotive development process. This is a critical problem since the classic development process used in the automotive field uses a very simplified driver model and the traffic environment, while nowadays it should contemplate a realistic representation of these elements. To overcome this issue, the authors proposed an integrated simulation environment, based on the co-simulation of Matlab/Simulink environment with simulation of urban mobility, which allows for a realistic model of vehicle dynamic, control logics, driver behaviour and traffic conditions. Simulation tests have been performed to prove the reasoning for such a tool, and to show the capabilities of the instrument. By using the proposed platform, vehicles may be modelled with a higher level of details (with respect to microscopic simulators), while the autonomous/automated driving functions can be tested in realistic traffic scenarios where the features of the road traffic environment can be varied to verify in a realistic way the level of robustness of the on-board implemented functions

Burning Fog: Cognitive Impairment in Burning Mouth Syndrome

Background: Due to its common association with chronic pain experience, cognitive impairment (CI) has never been evaluated in patients with burning mouth syndrome (BMS). The purpose of this study is to assess the prevalence of CI in patients with BMS and to evaluate its relationship with potential predictors such as pain, mood disorders, blood biomarkers, and white matter changes (WMCs). Methods: A case-control study was conducted by enrolling 40 patients with BMS and an equal number of healthy controls matched for age, gender, and education. Neurocognitive assessment [Mini Mental State Examination (MMSE), Digit Cancellation Test (DCT), the Forward and Backward Digit Span task (FDS and BDS), Corsi Block-Tapping Test (CB-TT), Rey Auditory Verbal Learning Test (RAVLT), Copying Geometric Drawings (CGD), Frontal Assessment Battery (FAB), and Trail Making A and B (TMT-A and TMT-B)], psychological assessment [Hamilton Rating Scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and 36-Item Short Form Health Survey (SF-36)], and pain assessment [Visual Analogic Scale (VAS), Total Pain Rating index (T-PRI), Brief Pain Inventory (BPI), and Pain DETECT Questionnaire (PD-Q)] were performed. In addition, blood biomarkers and MRI of the brain were recorded for the detection of Age-Related WMCs (ARWMCs). Descriptive statistics, the Mann-Whitney U-test, the Pearson Chi-Squared test and Spearman's correlation analysis were used. Results: Patients with BMS had impairments in most cognitive domains compared with controls (p < 0.001**) except in RAVLT and CGD. The HAM-D, HAM-A, PSQI, ESS, SF-36, VAS, T-PRI, BPI and PD-Q scores were statistically different between BMS patients and controls (p < 0.001**) the WMCs frequency and ARWMC scores in the right temporal (RT) and left temporal (LT) lobe were higher in patients with BMS (p = 0.023*). Conclusions: Meanwhile, BMS is associated with a higher decline in cognitive functions, particularly attention, working memory, and executive functions, but other functions such as praxis-constructive skills and verbal memory are preserved. The early identification of CI and associated factors may help clinicians to identify patients at risk of developing time-based neurodegenerative disorders, such as Alzheimer's disease (AD) and vascular dementia (VD), for planning the early, comprehensive, and multidisciplinary assessment and treatment

factors underlying the development of chronic temporal lobe epilepsy in autoimmune encephalitis

Abstract Purpose Limbic encephalitis (LE) is an autoimmune condition characterized by amnestic syndrome, psychiatric features and seizures. Early diagnosis and prompt treatment are crucial to avoid long-term sequelae, including psycho-cognitive deficits and persisting seizures. The aim of our study was to analyze the characteristics of 33 LE patients in order to identify possible prognostic factors associated with the development of chronic epilepsy. Methods This is a retrospective cohort study including adult patients diagnosed with LE in the period 2010–2017 and followed up for ≥12 months. Demographics, seizure semiology, EEG pattern, MRI features, CSF/serum findings were reviewed. Results All 33 LE patients (19 M/14F, mean age 61.2 years) presented seizures. Thirty subjects had memory deficits; 22 presented behavioural/mood disorders. Serum and/or CSF auto-antibodies were detected in 12 patients. In 31 subjects brain MRI at onset showed typical alterations involving temporal lobes. All patients received immunotherapy. At follow-up, 13/33 had developed chronic epilepsy; predisposing factors included delay in diagnosis (p = .009), low seizure frequency at onset (p = .02), absence of amnestic syndrome (p = .02) and absence/rarity of inter-ictal epileptic discharges on EEG (p = .06). Conclusions LE with paucisymptomatic electro-clinical presentation seemed to be associated to chronic epilepsy more than LE presenting with definite and severe "limbic syndrome"

Prevalence of hypertension and correlation with mental health in women with burning mouth syndrome: A case-control study

BackgroundThe relationship between hypertension (HTN) and chronic pain is still a matter of debate, and its prevalence in patients with burning mouth syndrome (BMS) has never been evaluated. This study aimed to assess the prevalence of HTN in women with BMS and to evaluate its relationship with potential predictors such as risk factors for cardiovascular diseases, pain, and mental health status analyzing differences with healthy women.MethodsIn total, 250 women with BMS (WBMS) were prospectively recruited and compared with an equal number of healthy women (HW) matched for age. Education, body mass index, smoke and alcohol consumption, intensity and quality of pain, and psychological profile were further investigated to identify the potential predictors of HTN. Specifically, pain assessment [the Numeric Rating Scale (NRS) and Short-Form McGill Pain Questionnaire (SF-MPQ)] and psychological assessment [Hamilton Rating Scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS)] was carried out for the participants.ResultsHTN was found in 128 (51.2%) WBMS and 76 (30.4%) HW (p &lt; 0.001**). The scores of the NRS, SF-MPQ, HAM-D, HAM-A, and PSQI were statistically significantly higher in the WBMS than in the HW (p &lt; 0.001**). A strongly linear correlation between HTN and employment status, systemic diseases, and education level (p &lt; 0.001**) was found in WBMS, while a strong correlation between HTN and employment status, hypercholesterolemia, systemic diseases, and drug consumption was found in HW (p &lt; 0.001**). No statistically significant correlation was found between HTN and pain, anxiety, depression, and sleep disturbances.ConclusionThese results suggest that WBMS showed a higher prevalence of HTN compared with controls. Unemployed WBMS with lower education and other systemic comorbidities are at an increased risk of developing HTN. HTN is associated with alteration in the vascular structure and function of the brain, and these processes accelerate brain aging, which contributes to a reduction in intracortical connectivity, thus affecting the modulatory system of control of pain in patients with BMS, independently of their mental health assessment. Predictors that may underlie this association remain unclear, taking into account the differences found in HW, and should be further elucidated