Microendoscopic Surgery of Middle Ear and Petrous Bone: Benefits Analysis

Objectives: Endoscopy has become routinely used in middle ear surgery. The aim of this study is to analyze where this tool may complement the traditional microscopic approach. This is a retrospective study done in single tertiary hospital. Methods: We reviewed 342 middle ear/petrous bone surgical procedures performed between 2005 and 2015. Only cases in which both microscopic and endoscope-assisted techniques were used have been included. Sixty-six patients received this double-technique surgery: 51 (77.2%) had middle ear/mastoid and petrous bone cholesteatomas (46 middle ear and mastoid and 5 acquired/congenital petrous bone cholesteatomas), 5 (7.5%) had glomus tympanicum tumors (GTT), 4 (6%) had an ossicular chain dislocation, 3 (4.5%) had purulent chronic otitis media, 2 (3%) had tympanosclerosis, and 1 (1.5%) had an ossicular chain malformation. Results: The endoscope was helpful to remove disease remnants not accessible by microscope in 41 (62%) of the cases; 37 (90%) were cholesteatomas, 3 (7%) were GTT, and only 1 (3%) was an open tympanosclerosis. In the remaining 25 (37.8%) cases, the endoscope was useful only to visualize the cavity since the microscope had already been successful in removing the entire lesion. Conclusions: The endoscopy can add valuable information and support to the usual microscope approach alone. The consensus of a single best technique does not yet exist, but the physician should choose the best modality or combination of modalities in order to cure the patient and prevent any possible complications or recurrence of the pathology

Unbalanced IDO1/IDO2 endothelial expression and skewed keynurenine pathway in the pathogenesis of COVID-19 and post-COVID-19 pneumonia

Despite intense investigation, the pathogenesis of COVID-19 and the newly defined long COVID-19 syndrome are not fully understood. Increasing evidence has been provided of metabolic alterations characterizing this group of disorders, with particular relevance of an activated tryptophan/kynurenine pathway as described in this review. Recent histological studies have documented that, in COVID-19 patients, indoleamine 2,3-dioxygenase (IDO) enzymes are differentially expressed in the pulmonary blood vessels, i.e., IDO1 prevails in early/mild pneumonia and in lung tissues from patients suffering from long COVID-19, whereas IDO2 is predominant in severe/fatal cases. We hypothesize that IDO1 is necessary for a correct control of the vascular tone of pulmonary vessels, and its deficiency in COVID-19 might be related to the syndrome's evolution toward vascular dysfunction. The complexity of this scenario is discussed in light of possible therapeutic manipulations of the tryptophan/kynurenine pathway in COVID-19 and post-acute COVID-19 syndromes

Malformazione Artero-Venosa renale trattata mediante embolizzazione arteriosa con Squid Peri.

Embolizzazione dell’apporto arterioso mediante approccio endovascolare per il trattamento della MAV renal

Genetic components of human pain sensitivity: a protocol for a genome-wide association study of experimental pain in healthy volunteers

Introduction Pain constitutes a major component of the global burden of diseases. Recent studies suggest a strong genetic contribution to pain susceptibility and severity. Whereas most of the available evidence relies on candidate gene association or linkage studies, research on the genetic basis of pain sensitivity using genome-wide association studies (GWAS) is still in its infancy. This protocol describes a proposed GWAS on genetic contributions to baseline pain sensitivity and nociceptive sensitisation in a sample of unrelated healthy individuals of mixed Latin American ancestry. Methods and analysis A GWAS on genetic contributions to pain sensitivity in the naïve state and following nociceptive sensitisation will be conducted in unrelated healthy individuals of mixed ancestry. Mechanical and thermal pain sensitivity will be evaluated with a battery of quantitative sensory tests evaluating pain thresholds. In addition, variation in mechanical and thermal sensitisation following topical application of mustard oil to the skin will be evaluated. Ethics and dissemination This study received ethical approval from the University College London research ethics committee (3352/001) and from the bioethics committee of the Odontology Faculty at the University of Antioquia (CONCEPTO 01–2013). Findings will be disseminated to commissioners, clinicians and service users via papers and presentations at international conferences

A Fast HW/SW FPGABased Thermal Emulation Framework for MultiProcessor SystemonChip

With the growing complexity in consumer embedded products and the improvements in process technology, Multi-Processor System-On-Chip (MPSoC) architectures have become widespread. These new systems are complex to design as they must execute multiple complex applications (e.g. video processing, 3D games), while meeting additional design constraints (e.g. energy consumption or time-to-market). Moreover, the rise of temperature in the die for MPSoC components can seriously affect their final performance and reliability. Therefore, mechanisms to efficiently evaluate complete HW/SW MPSoC designs in terms of energy consumption, temperature, performance and other key metrics are needed. In this paper, we present a new HW/SW FPGA-based emulation framework that allows designers to rapidly extract a number of critical statistics from processing cores, memories and interconnection systems being emulated on a FPGA. This information is then used to interact in real-time with a SW thermal model running on a host computer via an Ethernet port. The results show speed-ups of three orders of magnitude compared to cycle-accurate MPSoC simulators, which enable a very fast exploration of a large range of MPSoC design alternatives at the cycle-accurate level. Finally, our HW/SW framework allows designers to test run-time thermal management strategies with real-life inputs without any loss in the performance of the emulated system

Co-circulation of SARS-CoV-2 Alpha and Gamma variants in Italy, February and March 2021

: BackgroundSeveral SARS-CoV-2 variants of concern (VOC) have emerged through 2020 and 2021. There is need for tools to estimate the relative transmissibility of emerging variants of SARS-CoV-2 with respect to circulating strains.AimWe aimed to assess the prevalence of co-circulating VOC in Italy and estimate their relative transmissibility.MethodsWe conducted two genomic surveillance surveys on 18 February and 18 March 2021 across the whole Italian territory covering 3,243 clinical samples and developed a mathematical model that describes the dynamics of co-circulating strains.ResultsThe Alpha variant was already dominant on 18 February in a majority of regions/autonomous provinces (national prevalence: 54%) and almost completely replaced historical lineages by 18 March (dominant across Italy, national prevalence: 86%). We found a substantial proportion of the Gamma variant on 18 February, almost exclusively in central Italy (prevalence: 19%), which remained similar on 18 March. Nationally, the mean relative transmissibility of Alpha ranged at 1.55-1.57 times the level of historical lineages (95% CrI: 1.45-1.66). The relative transmissibility of Gamma varied according to the assumed degree of cross-protection from infection with other lineages and ranged from 1.12 (95% CrI: 1.03-1.23) with complete immune evasion to 1.39 (95% CrI: 1.26-1.56) for complete cross-protection.ConclusionWe assessed the relative advantage of competing viral strains, using a mathematical model assuming different degrees of cross-protection. We found substantial co-circulation of Alpha and Gamma in Italy. Gamma was not able to outcompete Alpha, probably because of its lower transmissibility

HW-SW Emulation Framework for Temperature-Aware Design in MPSoCs

New tendencies envisage Multi-Processor Systems-On-Chip (MPSoCs) as a promising solution for the consumer electronics market. MPSoCs are complex to design, as they must execute multiple applications (games, video), while meeting additional design constraints (energy consumption, time-to-market). Moreover, the rise of temperature in the die for MPSoCs can seriously affect their final performance and reliability. In this paper, we present a new hardware-software emulation framework that allows designers a complete exploration of the thermal behavior of final MPSoC designs early in the design flow. The proposed framework uses FPGA emulation as the key element to model the hardware components of the considered MPSoC platform at multi-megahertz speeds. It automatically extracts detailed system statistics that are used as input to our software thermal library running in a host computer. This library calculates at run-time the temperature of on-chip components, based on the collected statistics from the emulated system and the final floorplan of the MPSoC. This enables fast testing of various thermal management techniques. Our results show speed-ups of three orders of magnitude compared to cycle-accurate MPSoC simulator