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The incidence of thyroid cancer has been increasing in many countries, mainly due to overdiagnosis. Given these rapid changes, we aim to assess the specific features of the thyroid cancer diagnosis epidemic and provide estimates of overdiagnosis across countries spanning five continents and identify areas in which coping strategies are needed.

To design a comfortable hand support, the population-specific morphological characteristics of human hands must be known. Surface and bone anthropometric data from 177 radiograms of the left hands of an unselected sample of 87 subjects (training set) belonging to the Italian, female population (age 58 ± 12) were collected. Hand Length (HL) and Hand Width (HW) were respectively 172 ± 8 mm and 81 ± 4 mm; Hand Bone Length (HBL) was 179 ± 8 mm. A separate validation set consisting of 25 radiograms from 25 patients belonging to the same population was also collected. Bone and surface measurements were compared to validate the relationships proposed by Kong et al. Their approach applied to the validation set resulted in errors between 3.1% and 8.7%, which is almost as accurate (low bias) but somewhat less precise (higher mean errors) than what found by Kong et al. on their own sample belonging to the Korean population. Two methods were developed to predict the positions of the Metacarpo-phalangeal joints of the Index, Middle, and Ring fingers with reference to the Index-Middle interdigital crotch: method PM, based on the population mean, and method PR, which also considers the Hand Width. The overall average estimation error for method PMis 1.87 mm, while for method PRit is 1.69 mm. Method PRcompared to method PMimproves the precision by up to 32% in the xdirection and 3% in the y direction. Based on these results, a 3D CAD hand model representing the target population was developed, which can be used for the design of population-specific ergonomic medical devices.

Background: In Italy, the incidence of cutaneous malignant melanoma is two-fold higher in the north than in the south. This gradient might be associated with differences in incidence trends and disease surveillance. We compared the time trends in incidence rates, mortality rates, dermatologic office visit rates and skin biopsy rates between the Emilia-Romagna Region (northern Italy) and the Sicily Region (southern Italy).Methods: The cancer registries of Parma, Modena, Ferrara and Romagna (current population, 2,606,465) and Catania-Messina-Enna, Siracusa and Ragusa (2,775,019) provided incidence and mortality records for the years 2008-2017. The records of outpatient services delivered in public health facilities were obtained from the two Regional Administrations. Trends in rates were assessed with the estimated average annual percent change. North-south differences were expressed as age-standardised rate ratios.Results: In the context of a generalised increasing incidence trend, which was more moderate in the female population of the Sicily Region, the standardised rate ratios were: 5.31 (males) and 5.20 (females) for in situ cutaneous malignant melanoma; 2.10 and 2.07 for invasive cutaneous malignant melanoma, with an excess incidence concentrated in lesions ⩽1.00 mm thick (3.58 and 3.05); 3.00 and 2.44 for dermatologic office visits; and 5.25 and 5.02 for skin biopsies. Mortality was stable in both Regions.Conclusions: In the Emilia-Romagna Region, as compared with the Sicily Region, a higher incidence of cutaneous malignant melanoma –especially of in situ and early invasive cutaneous malignant melanoma– coexisted with a higher level of clinical surveillance. The question of the direction of the cause-effect relationship between increased incidence and increased diagnostic scrutiny remains open.

The Isotope and Muon Production using Advanced-Cyclotron and Target Technology Project (IMPACT) foresees the introduction of two new target stations and three new beamlines: one for radionuclide production and two for surface muon production. The latter forms the project, High-Intensity Muon Beams (HIMB), which plans to increase the muon rate from the current world record of 108 µ+/s up to 1010 µ+/s. This work presents an overview of the future HIMB beamlines focusing on the magnet designs that have been developed to ensure increased muon rate production and transmission. Specific radiation-hard resistive coils, based on mineral insulation, are required in this case due to the proximity to the target station. A high muon capture and transmission efficiency requires solenoid-like magnets, as well as dipole magnets and crossed-field separators to select the desired particles, while suppressing unwanted background particles. The radiation-hard capture solenoid plays the most important role in the whole beamline since it must provide a high capture efficiency. Beam optics studies provided the on-axis field profile necessary for optimizing the size and shape of the capture solenoid. Therefore, the article will also elucidate on these solenoid design strategies for achieving the desired capture efficiency.

Peptides may revolutionize the treatment of disease by combining the pharmacological benefits found in both large and small molecules into once-daily oral formulations. For decades, batch-mode solid-phase peptide synthesis (SPPS) has been employed throughout peptide drug discovery and development; however, numerous drawbacks have persisted despite advancements in the technology. Herein, we describe a continuous-flow (CF) SPPS workflow to optimize and deliver multigram quantities of peptide fragments, which are easily transformed to macrocyclic or linear peptide APIs. To develop this workflow, we leveraged a 10-amino acid peptide based on a recently disclosed macrocyclic peptide inhibitor of PCSK9. Compared with batch-mode SPPS, CF-SPPS enables rapid, data-rich optimization of peptide sequences with drastic reductions in development efforts, process execution timelines, and waste generation. To meet project demands and deliver multigram quantities, a hydraulically controlled CF-SPPS prototype was developed, which leverages small-scale optimization data to facilitate a seamless transition to larger deliveries of peptides.

Since the 2000s, Brazil has witnessed a surge in socio-environmental conflicts fueled by the expanding control of transnational companies over the mineral extraction frontier. To mitigate the potential damage to their corporate image and shareholder value caused by socio-environmental conflicts, mining companies have resorted to using “corporate social technologies” in the affected territories. These practices aim to “pacify” the surrounding communities through “social risk and cost” management policies, which involve co-opting leaders of popular movements, through practices of assistentialism, and employing mitigation policies to establish and maintain the so-called “social license to operate”. This approach aims to prevent affected communities from organizing effective resistance to mining projects. This paper analyzes some specific cases of transnational mining in Brazil, focusing on how corporate social responsibility policies and technological projects operate as tools of conflict management within the framework of neoliberal governance. The research method consists of a case study and a literature review. Our findings have revealed the emergence of corporate social technologies designed to manage conflicts by controlling the surrounding communities. These practices aim to deflect social and environmental criticism while ensuring the continuation of the processes of mineral spoliation, effectively disrupting the organization of resistance by prioritizing the logic of preventing and/or pacifying the conflict.

Music experience is considered a highly pleasant activity, with musical stimuli evoking emotions and activating reward brain circuits. The Barcelona Music Reward Questionnaire (BMRQ) evaluates the main facets of music experience that could describe individual differences in music-associated reward. In this work, we validated an Italian version of the BMRQ since only Spanish, English, and French versions are currently available. The original version was translated into Italian, adapted and validated following the methodology proposed in the original BMRQ. The questionnaire was administered to adult participants through an online survey. A total of 1,218 participants were considered for the analysis. Our primary factor analysis showed an overall good structural validity (goodness of fit index > .999). The reliability estimates of each facet varied from .839 and .930, with some items showing higher factor loadings for a different facet than the expected one. Similar findings resulted from an additional analysis performed on a restricted sample (age <= 30 years and upper secondary education level), more comparable with those of the other studies. The Italian BMRQ appears overall valid and reliable despite some differences with the previous studies, suggesting its applicability might be worth testing with different populations and contexts (e.g., clinical context).

ABSTRACTPhytoplanktonic communities have been moulded from a higher level in the food web by zooplankton predation. Diatoms, which are the major primary producers in present day oceans, have evolved many strategies to thrive in the presence of copepods, their predators. Chemical signals are released in the aquatic environment by microarthropods and elicit morphological, behavioural and/or physiological modifications in diatom cells which allow them to cope with predators. Other than the most studied effects of copepod signals on the release of toxins by diatoms, the role of chemical cues on growth and biology of non-toxic diatoms has been little investigated, although it may broaden our knowledge of co-evolutive physiological mechanisms. To examine the response of diatoms to copepod-derived signals, Phaeodactylum tricornutum, Chaetoceros muelleriand Cylindrotheca fusiformis(Bacillariophyceae) were grown in the presence of copepod cues. Physiological modifications occurred and differed in sign and magnitude between species: i) in P. tricornutumcell density was higher, and dry weight lower, suggesting energy allocation into cell division at the expense of lipid and protein quotas; ii) C. muellerishowed a very homeostatic behaviour; and iii) in C. fusiformiscell density was lower and lipid content higher, showing energy allocation into lipids, which likely act as deterrent to feeders. Copepod cues are here suggested to have ruled diatom species composition in the ocean by affecting species-specific growth performance and the energy allocation into macromolecules.

AbstractBloodstream infections caused by vancomycin-resistant enterococci are increasingly reported and a consensus therapy does not exist. Oritavancin has shown good antimicrobial activity against VRE, but its use is mainly limited to skin, soft tissue, and/or bone infections. Fosfomycin is increasingly used for enterococcal infections (including bloodstream infections and endocarditis) as a partner drug given its anti-biofilm and synergistic properties. Recently in vitroand in vivosynergism between oritavancin and fosfomycin against VRE isolates has been demonstrated. Herein we report the case of a hematologic patient with a VRE bloodstream infection successfully treated with oritavancin and fosfomycin as sequential treatment.

L’actinomicosi è una patologia rara causata da batteri anaerobi e filamentosi, gli Actinomyces, che si presenta sotto forma di tumefazione sottocutanea, infiammatoria e cronica il più delle volte. L’actinomicosi può avere varie localizzazioni, ma quella più spesso interessata è la regione cervicofacciale. Alcuni fattori favoriscono la comparsa di questa patologia (immunodepressione, trauma orale). La presentazione clinica è poco specifica e la diagnosi è spesso ritardata. Il quadro clinico può suggerire una patologia tumorale o anche una tubercolosi. L’evoluzione clinica può portare alla fistolizzazione cutanea della tumefazione. Il bilancio di diagnostica per immagini ed ematico è poco specifico. I prelievi batteriologici e anatomopatologici (agoaspirato, biopsia, tampone di pus) confermano la diagnosi. Per trattare l’actinomicosi si propone una terapia antibiotica, a volte associata a un trattamento chirurgico.

La actinomicosis es una patología rara causada por Actinomyces,unas bacterias anaerobias y filamentosas. Su presentación muy a menudo consiste en una tumefacción subcutánea, inflamatoria y crónica. La actinomicosis puede aparecer en diversas localizaciones, pero la región cervicofacial es la más frecuente. Algunos factores favorecen la aparición de esta patología (inmunodepresión, traumatismo oral). La presentación clínica es poco específica y el diagnóstico suele ser tardío. El cuadro clínico puede hacer sospechar una patología tumoral e incluso una tuberculosis. La evolución clínica puede culminar en la fistulización cutánea de la tumefacción. Las pruebas de imagen y los análisis de sangre son poco específicos. Las muestras bacteriológicas y patológicas (punción-aspiración con aguja fina, biopsia, frotis del pus) confirman el diagnóstico. El tratamiento de la actinomicosis consiste en una antibioticoterapia, asociada en ocasiones a un tratamiento quirúrgico.

Objective: To describe the practice of prostate-specific antigen (PSA) testing over more than 20 years in Friuli Venezia Giulia (FVG), North-Eastern Italy.Methods: A population-based, ecological study was conducted using information derived from regional administrative health-related databases. Data on PSA and prostate biopsies performed on resident men aged ⩾45 years from 1998 to 2019 were retrieved. PSA and biopsy rates were calculated as the number of men who had at least one such procedure in each calendar year over the mean resident male population of the same year. Temporal trends were analyzed using joinpoint regression (annual percentage change –APC).Results: A total of 2,502,670 PSA were made between 1998 to 2019 in men aged ⩾45 years. The number of PSA steadily increased from 51,055 in 1998-1999 to 134,504 in 2010-2011, then dropped to 122,080 in 2018-2019. Significant changes in the slopes of PSA rates emerged in 2002 and 2009: the largest increase occurred during 1998-2002 (APC 18.4), followed by a smaller increase in 2002-2009 (APC 3.4) and a subsequent reduction (APC -2.5). Similar patterns emerged for all ages, but the decrease since 2009 was smaller for men aged ⩾65 years. An upward trend emerged in biopsy rate from 1998 to 2001 (APC 13.0), followed by a smaller increase until 2007 (APC 5.7) and a subsequent decrease. Biopsies as percentage of PSA decreased from 3.2% to 2.2%, particularly in those aged ⩾75 years.Conclusions: Although overall declining PSA rates have been observed in FVG since 2009, rates remained higher in the ⩾65-year-old group than in the 45-64–year-old group.

Aim. Predict the rate of perceived exertion (RPE) of pianists using inertial measurement units (IMUs)-based kinematic descriptors. Method. Fifty expert pianists played Digital (right-hand 16-tone sequence) and Chord (right-hand chord sequence) excerpts in a continuous loop for 12 min or until exhaustion. Partial least square regression was used to predict RPE with IMUs-based kinematic descriptors. The mean error of prediction over 50 iterations with five-folds cross-validation was used to assess the quality of the model. Variable importance in projection was calculated to determine the most relevant features for predicting the RPE and reduce the number of input predictors. Results. Thirty and twenty-six participants showed signs of fatigue before 12 min of the Digital and Chord tasks, respectively, and were included in the analysis. The reduced model of 275 and 227 input variables including four-latent variables explained 86.95 ± 0.46 and 83.91 ± 0.54 of the variance of the RPE on the training set with an absolute error of 0.976 ± 0.033 and 1.189 ± 0.068 on the testing set for both Digital and Chord tasks, respectively. The best features, variables, and sensor positions to predict RPE were different between both Digital and Chord tasks suggesting a task-dependency in the prediction of effort exertion during piano performance. Conclusion. These results highlight the feasibility of continuously monitoring RPE in pianists using kinematic descriptors. These results are promising for developing methods to prevent high levels of fatigue and injuries in musicians.

The BES TEST™ (Bone Elastic Structure Test), is a recently developed software medical device that detects pathological changes of bone trabecular architecture by measuring its elastic characteristics, known to be directly related to its resistance. The results are expressed by the Bone Structure Index (BSI) or by its T-score, that is the number of standard deviations from the healthy population average. Purpose: Evaluate the precision of BES TEST™ under reproducibility conditions, defined as repeated measurements on the same or similar objects which include different locations, operators, and measuring systems. Methods: A total of 51 replicate measurements were performed by four different operators on five different phantoms. Each phantom was 3D printed using Stereolithography (SLA) and Fused Deposition Modeling (FDM) and has a unique internal structure that mimics trabecular bone. ISO 5725 guidelines were followed for the interpretation of results. Results: The 3D-printed phantoms performed like real bones when analyzed with BES TEST™. The reproducibility 95% Confidence Interval expressed in BSI is CIR=±11.1, which corresponds in T-score to CIR,Tscore=±0.49. The Least Significant Change in BSI is LSCR=±7.9, which corresponds to LSCR,Tscore=±0.35. Conclusion: The reproducibility of BES TEST™ within the admissible range is not inferior to that of gold standard tests for osteoporosis. 3D printing proved a valuable tool to perform reliable replicate measurements without having patients undergo unnecessary tests.

Introduction: This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 status.Methods: Study patients underwent SARS-CoV-2 molecular-testing between 22 February 2020 and 31 July 2020, and were found infected (CoV2+ve) or uninfected. History of malignancy was obtained from regional population-based cancer registries. Cancer-patients were distinguished by time between cancer diagnosis and SARS-CoV-2 testing (<12/⩾12 months). Comorbidities, hospitalization, and death at 15 September 2020 were retrieved from regional population-based databases. The impact of cancer history on SARS-CoV-2 infection and clinical outcomes was calculated by fitting a multivariable logistic regression model, adjusting for sex, age, and comorbidities.Results: Among 552,362 individuals tested for SARS-CoV-2, 55,206 (10.0%) were cancer-patients and 22,564 (4.1%) tested CoV2+ve. Irrespective of time since cancer diagnosis, SARS-CoV-2 infection was significantly lower among cancer patients (1,787; 3.2%) than non-cancer individuals (20,777; 4.2% - Odds Ratio (OR)=0.60; 0.57-0.63). CoV2+vecancer-patients were older than non-cancer individuals (median age: 77 versus 57 years; p<0.0001), were more frequently men and with comorbidities. Hospitalizations (39.9% versus 22.5%; OR=1.61; 1.44-1.80) and deaths (24.3% versus 9.7%; OR=1.51; 1.32-1.72) were more frequent in cancer-patients. CoV2+vecancer-patients were at higher risk of death (lung OR=2.90; 1.58-5.24, blood OR=2.73; 1.88-3.93, breast OR=1.77; 1.32-2.35).Conclusions: The risks of hospitalization and death are significantly higher in CoV2+veindividuals with past or present cancer (particularly malignancies of the lung, hematologic or breast) than in those with no history of cancer.

Amylin receptors (AMYRs), heterodimers of the calcitonin receptor (CTR) and one of three receptor activity-modifying proteins, are promising obesity targets. A hallmark of AMYR activation by Amy is the formation of a ‘bypass’ secondary structural motif (residues S19–P25). This study explored potential tuning of peptide selectivity through modification to residues 19–22, resulting in a selective AMYR agonist, San385, as well as nonselective dual amylin and calcitonin receptor agonists (DACRAs), with San45 being an exemplar. We determined the structure and dynamics of San385-bound AMY3R, and San45 bound to AMY3R or CTR. San45, via its conjugated lipid at position 21, was anchored at the edge of the receptor bundle, enabling a stable, alternative binding mode when bound to the CTR, in addition to the bypass mode of binding to AMY3R. Targeted lipid modification may provide a single intervention strategy for design of long-acting, nonselective, Amy-based DACRAs with potential anti-obesity effects.

This paper presents the methods deployed by the Horizon 2O2O SCIPPER project to characterize emission performance of vessels, mainly under the perspective of checking compliance to new emissions regulations. Various on-board and remote measurement techniques have been demonstrated within five experimental campaigns conducted at Europe's main sea areas and ports. Almost a thousand of ship plumes has been measured and crossed checked with various instrumentation, revealing the emission profile of ships during actual operation Accuracy of each measurement technique was also tested. Emission measurements are further exploited to assess the impact of shipping on air quality of coastal areas, by identifying the transformations of pollutants performed in the atmosphere as plume evolves and quantifying onshore pollutants concentrations attributed to shipping activity.

Agriculture provides people with food, but poses environmental challenges. Viacomprehensive observations on an agricultural land at Qvidja in Southern Finland, we were able to show that soil-emitted compounds (mainly ammonia and amines), together with available sulfuric acid, form new aerosol particles which then grow to climate-relevant sizes by the condensation of extremely low volatile organic compounds originating from a side production of photosynthesis (compounds emitted by ground and surrounding vegetation). We found that intensive local clustering events, with particle formation rates at 3 nm about 5–10 times higher than typical rates in boreal forest environments, occur on around 30% of all days. The requirements for these clustering events to occur were found to be clear sky, a low wind speed to accumulate the emissions from local agricultural land, particularly ammonia, the presence of low volatile organic compounds, and sufficient gaseous sulfuric acid. The local clustering will then contribute to regional new particle formation. Since the agricultural land is much more effective per surface area than the boreal forest in producing aerosol particles, these findings provide insight into the participation of agricultural lands in climatic cooling, counteracting the climatic warming effects of farming.

This article aims at presenting a lexicographical proposal focused on Spanish expressions that are made up of a verb and an adverbial idiom (e.g. dormir a pierna suelta, estar hasta los pelos, luchar/defender a brazo partido, reír a mandíbula batienteand ver/mirar con buenos ojos). These polilexical units have been defined by several linguists as complex collocations(e.g. Barrios Rodríguez 2015; García-Page Sánchez 2004, 2013; Koike 2001, 2005; Penadés Martínez 2017). Monolingual and bilingual dictionaries, as well as dictionaries of idioms, have managed these units in different ways. In fact, they are sometimes labelled as verbal idioms, and other times as adverbial ones.

Il rischio di un secondo tumore, valutato in 38.535 pazienti con tumori tiroidei (TT) diagnosticati tra il 1998 e il 2012 in Italia, era 1,16 (+16%, rispetto alla popolazione generale) per tutti i tumori, per secondi tumori delle ossa/connettivo 2,0, mammella 1,2, prostata 1,4, reni 2,2 e emolinfopoietici 1,4 mentre non si è evidenziato alcun aumento dopo un TT follicolare (1,06) o midollare (0,95). Il rischio di TT dopo un altro tumore è 1,49 (+49%), rispetto alla popolazione generale, simile per tutti i sottotipi di TT.

Ketoconazole HRA is approved for endogenous Cushing's syndrome (CS). A post-authorization safety study (PASS) in 200 CS patients>12 years is ongoing to confirm Ketoconazole safety and effectiveness. Interim data are presented below.

Objective: To describe smoking behaviours of patients with incident cancer attending an Italian cancer centre and to examine changes in their smoking habits within 12 months from cancer diagnosis, evaluating determinants of smoking cessation.Methods: A hospital-based prospective cohort included patients hospitalized in an Italian cancer centre (2016–2018). Patients were mostly female (74%) and included a limited proportion of aerodigestive cancers (7%). Face-to-face interviews were performed during hospital stay to gather information on patient characteristics and smoking history. Changes in smoking habits were assessed through telephone interviews at 3, at 6, and at 12 months after cancer diagnosis.Results: Among 1011 enrolled patients, 222 (22%) were current smokers at cancer diagnosis. Smoking prevalence was high in male patients (30%), in patients <50 years old (28%), in those with aerodigestive cancers (50%), and in those diagnosed at advanced stages (26%). Among current smokers at cancer diagnosis, 38% quit smoking after 12 months, 26% reduced intensity, and 36% did not modify smoking habits. Smoking cessation was associated with chemotherapy and, although not statistically significant, with female sex, older age, and advanced cancer stage. Patients with gastrointestinal, breast, or genitourinary cancer and those treated with surgery were less likely to quit smoking.Conclusions: Our results highlighted that 62% of smoking patients with cancer did not quit the habit. Smoking cessation programs targeted to patients with cancer need intensification, particularly for those who may underestimate smoking effects after diagnosis.

Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years).

The increasing need of society to develop more sustainable and renewable materials has made vegetal fibers an interesting potential substitute for synthetic fibers in strengthening systems, due to their considerable strength and deformation capacity. This paper aims to increase the knowledge on how the materials interact between them in vegetal FRCM composites to strengthen concrete structures. To do it, two fibers were selected: cotton (CO), due to its good deformation capacity, and hemp (HE), due to its high strength. A low-viscosity and high adherence epoxy resin was used to coat the yarns to protect them from the alkali environment of the cementitious matrix. To study the FRCM-substrate interaction, an adaptation of the test methodology described in ISO 10080:2005 was developed and performed. Three different lengths (30, 40, and 50 cm) were used to obtain the optimal bonding length for hemp case. A single case (50 cm) for cotton was tested to compare its behaviour against hemp. In the FRCM-substrate interaction, it is noticed that hemp-FRCM shows complete bonding as all except one specimen failed by mesh failure. In the case of cotton-FRCM, its deformation capacity (at least 4 times hemp-FRCM) made all specimens deform until the geometric end of the testing set up without the mesh breakage, bearing a lower load but keeping it constant through fiber-matrix friction. In terms of load, hemp-FRCM reached the highest load, 10% higher than cotton-FRCM’s peak load. To conclude, the testing method for assessing steel reinforcement bonding in reinforced concrete was proved to be satisfactory at assessing FRCM-concrete interaction, being able to transmit the load from the substrate to the composite without the slippage of the vegetal-FRCM.

Introduction: A group of adult septic shock patients treated with hemoperfusion (HA) with the Cytosorb®associated with CVVHD were studied to determine (a) the effects of this technique on different clinical variables; and (b) the impact of the pre CytoSorb®interval and its intensity on the outcome.Methods: The catecholamine index (CI) and the pressure-catecholamine Index (PCAI) were used to assess the amount of catecholamine administered at baseline and during the procedure, respectively. The pre-treatment time was calculated since the onset of the septic-shock related hypotension and the initiation of the first session and the intensity was assessed considering either the total volume of blood processed and the duration of the HA.Results: Overall, 51 patients with septic shock (30 m, 21 f), age 68 years (IQR 59–76) were retrospectively enrolled in the study; 26 were discharged alive form the ICU (S) and 25 died in ICU (NS); in the S group either CI and PCAI decreased significantly but in NS the CI increased and the PCAI remained stable in NS. In S, the time elapsing from the onset of symptoms and the start of Cytosorb®was shorter than in NS; the duration of the treatment and the volume of blood processed were significantly higher in S than in NS.Conclusions: In this group of septic shock patients, the earlier initiation of Cytosorb®, its longer duration and the higher volume of blood processed were associated with a better survival.

Le taux de complications de la thermoablation par radiofréquence des nodules thyroïdiens bénins est faible, lorsqu’elle est réalisée par des opérateurs expérimentés pour des indications ciblées. La nécrose trachéale est une complication grave.

Additive manufacturing played a keyrole in investigating the precision of a recently-developed device that measures the elastic characteristics of the trabecular bone by simulating the application of loads on a virtual biopsy obtained from radiographic images of the proximal epiphyses in the patient’s hand fingers. The simulation results are combined in a Bone Structure Index (BSI), which has shown to be able to detect trabecular bone alterations due to osteoporosis or other pathological situations. In order to obtain a large number of measurements without having voluntary patients undergo unnecessary radiations, the precision assessment tests were carried out on a 3D-printed phantom hand, in which different mimicked trabecular structures (chips) were inserted. Each mimicked bone had a unique internal structure and density and was 3D-printed using radiopaque composite materials. Fifteen different chips were additively manufactured; 20 measurements were performed on each chip. BSI and BSI_T-score precision values were computed according to ISO 5725 and ISCD standards. For all the chips, no relationship was found between the mean mjand standard deviation sjof the measurements in each chip. The range of the 95% confidence interval (CI) was computed assuming the repeatability standard deviation sras the known standard deviation of the measurement method (average of sjvalues): CIBSI=±8.14, corresponding to CITscore=±0.36. Least Significant Change was evaluated as well: LSCBSI=13.1, corresponding to LSCTscore=0.58. The 95% confidence intervals are small when compared to the commonly-accepted diagnostic values, where a patient is classified as osteoporotic if T-score < −2.5, non-osteoporotic if T-score > -1 and osteopoenic if -2.5 < T-score < -1. The LSC results are in line with the requirements for the gold-standard osteoporosis diagnostic systems. Additive manufacturing made it possible to avoid irradiation of humans in this precision assessment.

Current discrete manufacturing systems are characterized by an ever-increasing complexity, demanding for innovative solutions, capable to optimize performances while increasing the resilience and the capability to adapt to production modifications. With such a background, changing perspective to deal with distributed modular architectures of Cyber Physical Systems is mandatory, and the IEC 61499 standard, its object oriented, and event-based approaches promote this paradigm shift. The multi-disciplinary nature of the CPS entities and the possibility to exploit their digital counterparts, paves the way for the development of enhanced decision-support systems like the ones dedicated to Virtual Commissioning (VC). VC supports the automation developer in evaluating the impact of different management strategies, increasing the reliability of the final control applications, while reducing the amount of time to carry on physical tests on the real mechatronic system. However, creating a virtual commissioning model is still a complex and potentially expensive process that needs to be carried out by different professionals who must tightly cooperate to generate an effective playground for the automation testing. We propose a new approach to the design and develop virtual commissioning models, that, leveraging the synergies between modular simulation and IEC 61499 automation technologies, aims at improving the efficiency of the overall process of implementing 3D simulation digital twins for complex automated discrete manufacturing systems. The paper describes an open architecture, composed of reference data models and software API, and presents a proof-of-concept implementation of an integrated engineering platform of VC models.