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Posterior glottic lesions resembling granulomas unresponsive to conservative treatment should raise suspicion of a neoplastic condition. Although surgery is rarely recommended for arytenoid granulomas due to their high recurrence rate, histological evaluation is mandatory in cases of uncertain diagnosis. Clinicians should be aware that, although very rare, a laryngeal neuroendocrine tumor occurring in the posterior glottis can mimic the appearance of an idiopathic granuloma, presenting a diagnostic challenge., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)

Recent developments have led to the possibility of embedding machine learning tools into experimental platforms to address key problems, including the characterization of the properties of quantum states. Leveraging on this, we implement a quantum extreme learning machine in a photonic platform to achieve resource-efficient and accurate characterization of the polarization state of a photon. The underlying reservoir dynamics through which such input state evolves is implemented using the coined quantum walk of high-dimensional photonic orbital angular momentum and performing projective measurements over a fixed basis. We demonstrate how the reconstruction of an unknown polarization state does not need a careful characterization of the measurement apparatus and is robust to experimental imperfections, thus representing a promising route for resource-economic state characterization.

The distribution of entangled states is a key task of utmost importance for many quantum information processing protocols. A commonly adopted setup for distributing quantum states envisages the creation of the state in one location, which is then sent to (possibly different) distant receivers through some quantum channels. While it is undoubted and, perhaps, intuitively expected that the distribution of entangled quantum states is less efficient than that of product states, a thorough quantification of this inefficiency (namely, of the difference between the quantum-state transfer fidelity for entangled and factorized states) has not been performed. To this end, in this work, we consider n -independent amplitude-damping channels, acting in parallel, i.e., each, locally, on one part of an n -qubit state. We derive exact analytical results for the fidelity decrease, with respect to the case of product states, in the presence of entanglement in the initial state, for up to four qubits. Interestingly, we find that genuine multipartite entanglement has a more detrimental effect on the fidelity than two-qubit entanglement. Our results hint at the fact that, for larger n -qubit states, the difference in the average fidelity between product and entangled states increases with increasing single-qubit fidelity, thus making the latter a less trustworthy figure of merit.

(1) Background: In our previous study, acute ischemic stroke (AIS) patients showed increased levels of circulating miRNAs (-195-5p and -451a) involved in vascular endothelial growth factor A (VEGF-A) regulation. Here, we evaluated, for the first time, both circulating miRNAs in acute intracerebral hemorrhagic (ICH) patients. (2) Methods: Circulating miRNAs and serum VEGF-A were assessed by real-time PCR and ELISA in 20 acute ICH, 21 AIS patients, and 21 controls. These were evaluated at hospital admission (T0) and after 96 h (T96) from admission. (3) Results: At T0, circulating miRNAs were five-times up-regulated in AIS patients, tending to decrease at T96. By contrast, in the acute ICH group, circulating miRNAs were significantly increased at both T0 and T96. Moreover, a significant decrease was observed in serum VEGF-A levels at T0 in AIS patients, tending to increase at T96. Conversely, in acute ICH patients, the levels of VEGF-A were significantly decreased at both T0 and T96. (4) Conclusions: The absence of a reduction in circulating miRNAs (195-5p and -451a), reported in acute ICH subjects after 96 h from hospital admission, together with the absence of increment of serum VEGF-A, may represent useful biomarkers indicating the severe brain damage status that characterizes acute ICH patients.

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.

It has long been recognized that emission of radiation from atoms is not an intrinsic property of individual atoms themselves, but it is largely affected by the characteristics of the photonic environment and by the collective interaction among the atoms. A general belief is that preventing full decay and/or decoherence requires the existence of dark states, i.e., dressed light-atom states that do not decay despite the dissipative environment. Here, we show that, contrary to such a common wisdom, decoherence suppression can be intermittently achieved on a limited time scale, without the need for any dark state, when the atom is coupled to a chiral ring environment, leading to a highly non-exponential staircase decay. This effect, that we refer to as intermittent decoherence blockade, arises from periodic destructive interference between light emitted in the present and light emitted in the past, i.e., from delayed coherent quantum feedback.

The University of Bari (Italy), in cooperation with the National Institute of Geophysics and Volcanology (INGV) (Italy), has installed the OTRIONS micro-earthquake network to better understand the active tectonics of the Gargano promontory (Southern Italy). The OTRIONS network operates since 2013 and consists of 12 short period, 3 components, seismic stations located in the Apulian territory (Southern Italy). This data article releases the waveform database collected from 2013 to 2018 and describes the characteristics of the local network in the current configuration. At the end of 2018, we implemented a cloud infrastructure to make more robust the acquisition and storage system of the network through a collaboration with the RECAS-Bari computing centre of the University of Bari (Italy) and of the National Institute of Nuclear Physics (Italy). Thanks to this implementation, waveforms recorded after the beginning of 2019 and the station metadata are accessible through the European Integrated Data Archive (EIDA, https://www.orfeus-eu.org/data/eida/nodes/INGV/)., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships which have or could be perceived to have influenced the work reported in this article., (© 2021 The Authors. Published by Elsevier Inc.)

(1) Background: Circulating micro-RNAs (miRNAs) modulate the expression of molecules in diabetes. We evaluated the expression of serum miRNA-195-5p and -451a in diabetic patients with ischemic stroke and correlated them with two markers of brain tissue integrity. (2) Methods: Seventy-eight subjects with acute ischemic stroke (AIS) or transient ischemic attack (TIA) (40 with diabetes) were enrolled. Serum miRNA levels, brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor A (VEGF-A) were assessed at admission and 24 and 72 h after a post-ischemic stroke, and were compared to 20 controls. (3) Results: Both circulating miRNAs were two-fold up-regulated in diabetic AIS and TIA patients compared to non-diabetics. Their levels progressively decreased at 24 and 72 h in both AIS and TIA patients. Interestingly, in the non-diabetic TIA group, both circulating miRNAs, although higher than the controls, tended to achieve a complete decay after 72 h. Furthermore, miRNA-195-5p and miRNA-451a levels inversely correlated with both BDNF and VEGF-A serum levels. (4) Conclusions: These data show a different profile of both micro-RNAs in diabetic versus non-diabetic patients after acute ischemic stroke, suggesting their pivotal role in cerebrovascular ischemic attack.

Universality is key to the theory of phase transitions, stating that the equilibrium properties of observables near a phase transition can be classified according to few critical exponents. These exponents rule an universal scaling behaviour that witnesses the irrelevance of the model's microscopic details at criticality. Here we discuss the persistence of such a scaling in a one-dimensional quantum Ising model under sinusoidal modulation in time of its transverse magnetic field. We show that scaling of various quantities (concurrence, entanglement entropy, magnetic and fidelity susceptibility) endures up to a stroboscopic time τ bd , proportional to the size of the system. This behaviour is explained by noticing that the low-energy modes, responsible for the scaling properties, are resilient to the absorption of energy. Our results suggest that relevant features of the universality do hold also when the system is brought out-of-equilibrium by a periodic driving.

As discovered by P. W. Anderson, excitations do not propagate freely in a disordered lattice, but, due to destructive interference, they localise. As a consequence, when an atom interacts with a disordered lattice, one indeed observes a non-trivial excitation exchange between atom and lattice. Such non-trivial atomic dynamics will in general be characterised also by a non-trivial quantum information backflow, a clear signature of non-Markovian dynamics. To investigate the above scenario, we consider a quantum emitter, or atom, weakly coupled to a uniform coupled-cavity array (CCA). If initially excited, in the absence of disorder, the emitter undergoes a Markovian spontaneous emission by releasing all its excitation into the CCA (initially in its vacuum state). By introducing static disorder in the CCA the field normal modes become Anderson-localized, giving rise to a non-Markovian atomic dynamics. We show the existence of a functional relationship between a rigorous measure of quantum non-Markovianity and the CCA localization. We furthermore show that the average non-Markovianity of the atomic dynamics is well-described by a phenomenological model in which the atom is coupled, at the same time, to a single mode and to a standard - Markovian - dissipative bath.

Objectives and Methods: Low free plasma triiodothyronine (fT3) is associated with inflammation and cardiovascular damage in patients with end-stage renal disease (ESRD). We investigated the relationship between fT3, left ventricular systolic function and left ventricular mass in a group of 234 dialysis patients, and modelled the association between fT3 and cardiomyopathy in statistical analyses including both direct (interleukin-6 and C-reactive protein) and inverse (serum albumin) acute phase inflammation markers., Results: Plasma fT3 concentration in dialysis patients was significantly (P < 0.001) reduced in comparison with healthy participants and clinically euthyroid patients with normal renal function. Left ventricular systolic function was depressed (P

Chronic renal insufficiency is a situation characterized by high plasma concentration of neuropeptide Y (NPY). Because this neuropeptide interferes with cardiovascular (CV) function, it is possible that it is involved in the high CV-related morbidity and mortality of these patients. To test this hypothesis, a follow-up study was performed (average duration, 34 mo; range 0.2 to 52.0 mo) in a cohort of 277 patients with end-stage renal disease receiving chronic dialysis. Univariate analysis revealed that plasma NPY was directly related to plasma norepinephrine (r = 0.37, P < 0.001) and epinephrine (r = 0.17, P = 0.005), exceeding the upper limit of the normal range in the majority of patients with end-stage renal disease (170 of 277, 61%). One hundred thirteen patients had one or more fatal and nonfatal CV events; 112 patients died, 66 of them (59%) of CV causes. Plasma NPY failed to predict all-cause mortality but was an independent predictor of adverse CV outcomes (hazard ratio [10 pmol/L increase in plasma NPY], 1.32; 95% confidence interval, 1.09 to 1.60; P = 0.004) in a Cox proportional-hazard model that included a series of traditional and nontraditional CV risk factors. Plasma NPY maintained its predictive power for CV events in statistical model including plasma norepinephrine. Plasma NPY predicts incident CV complications in end-stage renal disease. Controlled trials are needed to establish whether interference with the sympathetic system, NPY, or both may reduce the high CV morbidity and mortality of dialysis patients.

Background: Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD)., Methods: We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 +/- 20 months)., Results: On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer > or = 1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77)., Conclusion: C. pneumoniae seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. It is highly unlikely that C. pneumoniae infection is a major risk factor in patients with ESRD.

Endothelin-1 (ET-1) is an endothelial-derived 21-amino-acid peptide with potent vasoconstrictor and mitogenic properties implicated in several cardiovascular disorders. To evaluate the plasma ET-1 response to mental stress in patients with intermittent claudication, plasma endothelin concentrations were measured by radioimmunoassay in 15 claudicant outpatients (13 men and 2 women; mean age 62 +/- 4 years) and in 15 sex- and age-matched healthy control subjects (12 men and 3 women; mean age 60 +/- 8 years) before and after mental arithmetic performed for 10 minutes. Venous blood samples were drawn from an antecubital vein at baseline, at the end of the mental arithmetic, and at 10 minutes of recovery. Baseline ET-1 values were higher in patients with intermittent claudication as compared with control subjects (4.5 +/- 0.5 pmol/L and 2.2 +/- 0.3 pmol/L, respectively, p < 0.0001). At the end of mental stress, ET-1 levels rose significantly in both groups from baseline (p < 0.001) reaching a higher value in patients with intermittent claudication than in control subjects (5.6 +/- 0.7 pmol/L and 2.4 +/- 0.4 pmol/L, respectively, p < 0.0001). The percent increases (delta%) in ET-1 plasma concentrations from baseline in response to mental stress were significantly greater in claudicant patients than in control subjects (+23 +/- 9% and +9 +/- 7%, respectively, p < 0.0001). ET-1 plasma concentrations returned to baseline values similarly in both groups at minute 10 of the recovery period. These findings show that acute mental stress causes an exaggerated release of ET-1 in patients with intermittent claudication and suggest that this could be a potential pathophysiological mechanism through which mental stress may trigger adverse acute cardiac events and accelerate progression of atherosclerosis in these patients.

We have recently observed that in patients with end-stage renal disease (ESRD) raised plasma norepinephrine (NE) is an independent predictor of incident cardiovascular events but that its prognostic power is reduced when this sympathetic marker is tested in statistical models including also left ventricular mass. Because left ventricular hypertrophy (LVH) may be a mechanism whereby NE contributes to the high rate of cardiovascular events in ESRD, we examined the relationship between plasma NE and echocardiographic parameters of left ventricle mass in a large group of ESRD patients. Mean wall thickness (MWT) was higher in patients in the third NE tertile than in the other 2 tertiles (P=0.001), and such an increase was paralleled by a rise in relative wall thickness (RWT) (P=0.006). Concentric LVH was more prevalent in patients in the third NE tertile (46%) than in the second (38%) and first (25%) NE tertiles. Multivariate regression analysis confirmed that the association of plasma NE with the muscular component of left ventricle (MWT) and with RWT was independent (P< or =0.001) of other cardiovascular risk factors, and in these models, plasma NE ranked as the second correlate of MWT and RWT. Similarly, multiple logistic regression analysis showed that the association of plasma NE with concentric LVH was strong and again independent of other risk factors (P=0.003). Plasma NE is associated to concentric LVH in ESRD patients. These observations constitute a sound basis for testing the effect of anti-adrenergic drugs on left ventricle mass and on cardiovascular outcomes in patients with ESRD.

Background: Sympathetic tone is consistently raised in patients with end-stage renal disease (ESRD). We therefore tested the hypothesis that sympathetic activation is associated with mortality and cardiovascular events in a cohort of 228 patients undergoing chronic hemodialysis who did not have congestive heart failure at baseline and who had left ventricular ejection fraction >35%., Methods and Results: The plasma concentration of norepinephrine (NE) was used as a measure of sympathetic activity. Plasma NE exceeded the upper limit of the normal range (cutoff 3.54 nmol/L) in 102 dialysis patients (45%). In a multivariate Cox regression model that included all univariate predictors of death as well as the use of sympathicoplegic agents and beta-blockers, plasma NE proved to be an independent predictor of this outcome (hazard ratio [1-nmol/L increase in plasma NE]: 1.07, 95% CI 1.01 to 1.14, P=0.03). Similarly, plasma NE emerged as an independent predictor of fatal and nonfatal cardiovascular events (hazard ratio [1-nmol/L increase in plasma NE] 1.08, 95% CI 1.02 to 1.15, P=0.01) in a model that included previous cardiovascular events, pulse pressure, age, diabetes, smoking, and use of sympathicoplegic agents and beta-blockers. The adjusted relative risk for cardiovascular complications in patients with plasma NE >75th percentile was 1.92 (95% CI 1.20 to 3.07) times higher than in those below this threshold (P=0.006)., Conclusions: Sympathetic nerve overactivity is associated with mortality and cardiovascular outcomes in ESRD. Controlled trials with antiadrenergic drugs are needed to determine whether interference with the sympathetic system could reduce the high cardiovascular morbidity and mortality in dialysis patients.

Background: We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 +/- 12 months., Methods: Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95% confidence interval (CI)., Results: During the follow-up period 51 patients died, 31 of them (61%) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P=0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95% CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P=0.005)., Conclusions: There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.

Left ventricular hypertrophy (LVH) is exceedingly frequent in patients undergoing dialysis. Cardiac mass is proportional to body size, but the influence of various indexing methods has not been studied in patients with end-stage renal disease. The issue is important because malnutrition and volume expansion would both tend to distort the estimate of LV mass (LVM) in these patients. In a cohort of 254 patients, the prognostic impact on all-cause mortality and cardiovascular outcomes of LVH values, calculated according to two established methods of indexing, either body surface area (BSA) or height(2.7), was assessed prospectively. When LVM was analyzed as a categorical variable, the height(2.7)-based method identified a larger number of patients with LVH than the corresponding BSA-based method. One hundred and thirty-seven fatal and nonfatal cardiovascular events occurred during the follow-up period. Overall, 90 patients died, 51 of cardiovascular causes. In separate Cox models, both the LVM/height(2.7) and the LVM/BSA index independently predicted total and cardiovascular mortality (P < 0.001). However, the height(2.7)-based method coherently produced a closer-fitting model (P < or = 0.02) than did the BSA-based method. The height(2.7) index was also important for the subcategorization of patients according to the presence of concentric or eccentric LVH because the prognostic value of such subcategorization was apparent only when the height(2.7)-based criterion was applied. In conclusion, LVM is a strong and independent predictor of survival and cardiovascular events in patients undergoing dialysis. The indexing of LVM by height(2.7) provides more powerful prediction of mortality and cardiovascular outcomes than the BSA-based method, and the use of this index appears to be appropriate in patients undergoing dialysis.

This study was designed to investigate the relationship among brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) and left ventricular mass (LVM), ejection fraction, and LV geometry in a large cohort of dialysis patients without heart failure (n = 246) and to test the prediction power of these peptides for total and cardiovascular mortality. In separate multivariate models of LVM, BNP and ANP were the strongest independent correlates of the LVM index. In these models, the predictive power of BNP was slightly stronger than that of ANP. Both natriuretic peptides also were the strongest independent predictors of ejection fraction, and again BNP was a slightly better predictor of ejection fraction than ANP. In separate multivariate Cox models, the relative risk of death was significantly higher in patients of the third tertile of the distribution of BNP and ANP than in those of the first tertile (BNP, 7.14 [95% confidence interval (CI), 2.83 to 18.01, P = 0.00001]; ANP, 4.22 [95% CI, 1.79 to 9.92, P = 0.001]), and a similar difference was found for cardiovascular death (BNP, 6.72 [95% CI, 2.44 to 18.54, P = 0.0002]; ANP, 3.80 [95% CI, 1.44 to 10.03, P = 0.007]). BNP but not ANP remained as an independent predictor of death in a Cox's model including LVM and ejection fraction. Cardiac natriuretic peptides are linked independently to LVM and function in dialysis patients and predict overall and cardiovascular mortality. The measurement of the plasma concentration of BNP and ANP may be useful for risk stratification in these patients.