Search

et al., Among atomically thin two-dimensional (2D) materials, molybdenum disulfide (MoS) is attracting considerable attention because of its direct bandgap in the 2H-semiconducting phase. On the other hand, a 1T-metallic phase has been revealed, bringing complementary application. Recently, thanks to top-down fabrication using electron beam (EB) irradiation techniques, in-plane 1T-metal/2H-semiconductor lateral (Schottky) MoS junctions were demonstrated, opening a path toward the co-integration of active and passive two-dimensional devices. Here, we report the first transport measurements evidencing the formation of a MoS Schottky barrier (SB) junction with barrier height of 0.13-0.18 eV created at the interface between EB-irradiated (1T)/nonirradiated (2H) regions. Our experimental findings, supported by state-of-the-art simulation, reveal unique device fingerprint of SB-based field-effect transistors made from atom-thin 1T layers., This work at Aoyama Gakuin was partly supported by a Grant-in-aid for Scientific Research (Basic Research A: 24241046 and Challenging Exploratory Research: 15K13277) and grant for private University in MEXT and AOARD grant (135049) in U.S. Air Force Office of Scientific Research. The Tokyo University’s work was also supported by the Special Coordination Funds for Promoting Science and Technology. Computational resources at nanohub.org are gratefully acknowledged. S. Roche acknowledges support from the Severo Ochoa Program (MINECO, Grant No. SEV-2013-0295). G.Iannacconne, Gianluca Fiori and Stephan Roche acknowledge the funding from the European Union Seventh Framework Programme under Grant agreement No. 604391 Graphene Flagship.

ObjectiveTo evaluate the safety and effectiveness of tocilizumab and abatacept in systemic sclerosis (SSc)-polyarthritis or SSc-myopathy.Methods20 patients with SSc with refractory polyarthritis and seven with refractory myopathy from the EUSTAR (EULAR Scleroderma Trials and Research) network were included: 15 patients received tocilizumab and 12 patients abatacept. All patients with SSc-myopathy received abatacept. Clinical and biological assessments were made at the start of treatment and at the last infusion.ResultsAfter 5 months, tocilizumab induced a significant improvement in the 28-joint count Disease Activity Score and its components, with 10/15 patients achieving a EULAR good response. Treatment was stopped in two patients because of inefficacy. After 11 months’ treatment of patients with abatacept, joint parameters improved significantly, with 6/11 patients fulfilling EULAR good-response criteria. Abatacept did not improve muscle outcome measures in SSc-myopathy. No significant change was seen for skin or lung fibrosis in the different groups. Both treatments were well tolerated.ConclusionsIn this observational study, tocilizumab and abatacept appeared to be safe and effective on joints, in patients with refractory SSc. No trend for any change of fibrotic lesions was seen but this may relate to the exposure time and inclusion criteria. Larger studies with longer follow-up are warranted to further determine the safety and effectiveness of these drugs in SSc.

BACKGROUND AND STUDY AIM: The aim of this study was to assess the prevalence of nonpolypoid lesions (NPLs) in Italy and their risk of containing neoplasia or advanced histology. PATIENTS AND METHODS: This was a multicenter cross-sectional observational study on consecutive patients undergoing total colonoscopy over a 3-month period in 80 Italian centers. RESULTS: In all, 27,400 total colonoscopies were analyzed. Cancer was diagnosed in 801 patients (2.9 %). A total of 6553 precancerous lesions were detected in 5609 patients. Of these, 4154 patients (74.1 %) had polypoid lesions and 1455 patients (25.9 %) had NPLs. Therefore, the prevalence of NPLs was 5.3 % (95 %CI 5.0 - 5.6). NPLs larger than 10 mm were detected in 254 patients (17.5 %). NPLs were more predominant in the proximal colon (OR 2.92, 95 %CI 2.56 - 3.43; P < 0.0001 vs. polypoid lesions). Neoplastic tissue was diagnosed in 79.0 % and advanced histology (high-grade intraepithelial neoplasia or more) in 20.9 % of resected lesions. The risk of advanced histology was similar for polypoid and nonpolypoid lesions when adjusted for size. Depressed lesions had the highest risk of advanced histology (OR 10.56, 95 %CI 6.02 - 18.55; P < 0.0000 vs. flat-elevated). Age was an independent predictor of both neoplasia and advanced histology ( P = 0.0001). CONCLUSIONS: NPLs are relatively common in the Italian population, with a prevalence similar to that in other Western series. NPLs are not more aggressive than polypoid lesions, except for those with depressed morphology. Georg Thieme Verlag KG Stuttgart. New York.

Background The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii) to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46%) showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%), than in aggression toward other people (20%). A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%), followed by depression (16%) and personality disorders (14%), and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge), while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge) and depression (41 vs 32% during stay and 44 vs 25% at discharge). Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%). Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self-reported compliance increased during hospital stay. Conclusion Results confirm the widespread use of antipsychotics and the increasing trend in atypical drugs prescription, in both psychiatric in- and outpatients.

Background The SARS-CoV-2 pandemic has had a huge impact on healthcare systems, resulting in many routine diagnostic procedures either being halted or postponed. Aims To evaluate whether the diagnoses of colorectal, gastric and pancreatic cancers have been impacted by the SARS-CoV-2 pandemic in Italy. Methods A survey designed to collect the number of histologically-proven diagnoses of the three cancers in gastroenterology services across Italy from January 1 to October 31 in 2017–2020. Non-parametric ANOVA for repeated measurements was applied to compare distributions by years and macro-areas. Results Compared to 2019, in 2020 gastric cancer diagnoses decreased by 15.9%, CRC by 11.9% and pancreatic by 9.9%. CRC distributions showed significant differences between all years, stomach cancer between 2018 and 2020 and 2019–2020, and pancreatic cancer only between 2017 and 2019. The 2019–2020 comparison showed fewer CRC diagnoses in the North (-13.7%), Center (-16.5%) and South (-4.1%), fewer stomach cancers in the North (-19.0%) and South (-9.4%), and fewer pancreatic cancers in the North (-14.1%) and Center (-4.7%), with an increase in the South (+12.3%). Distributions of CRC and gastric cancer were significantly different between all years in the North. Conclusions This survey highlights the concerning effects of the COVID-19 pandemic on the diagnostic yield of gastroenterology services for stomach, colorectal and pancreatic cancers in Italy.

Nowadays, Doppler system performance evaluation is a widespread issue because a shared worldwide standard is still awaited. Among the recommended Doppler test parameters, the lowest detectable signal could be considered mandatory in Quality Control (QC) protocols for Pulsed Wave (PW) Doppler. Such parameter is defined as the minimum signal level that can be clearly distinguished from noise and therefore, it is considered as related to PW Doppler sensitivity. The present study focuses on proposing and validating a novel image analysis based method for the estimation of the Lowest Detectable Signal in the spectrogram image (LDSIMG), namely Automatic Doppler Sensitivity Measurement Method (ADSMM), as well as to compare its results with the outcomes retrieved from the Naked Eye Doppler Sensitivity Method (NEDSM), based on the mean judgment of three independent observers. Data have been collected from a Doppler flow phantom, through three ultrasound systems for general purpose imaging, equipped with two linear array probes each and with two configuration settings. Results are globally compatible among the proposed methods, US systems and settings. Further studies could be carried out on a higher number of US diagnostic systems, Doppler frequencies and observers, as well as with different probe and phantom models.

This preliminary study concerns the dynamic characterization of a MEMS microgripper for biomedical applications. In particular, a prototype of microgripper, embedded with electrostatic comb-drive actuators, has been powered with a 10V sinusoidal input at different frequencies, 0.5 Hz, 1.0 Hz and 4.0 Hz. The response of the device has been recorded with a trinocular optical microscope, equipped with a digital camera and the recorded videos have been analysed with an in-house software implemented by the authors for the measurement of the comb-drive angular displacement, velocity and acceleration. The uncertainty analysis has been carried out to identify the uncertainty sources that characterize the measurements. Experimental data showed that the maximum angular displacement is (13.2 ± 0.2)•10-3 rad, (13.6 ± 0.2)•10-3 rad and (13.1 ± 0.3)•10-3 rad, the maximum angular velocity is (2.8 ± 0.2)•10-2 rad/s, (5.7 ± 0.4)•10-2 rad/s and (19.9 ± 1.5)•10-2 rad/s, and the angular acceleration is 0.178 ± 0.015 rad/s2, 0.72 ± 0.04 rad/s2 and 6.3 ± 0.7 rad/s2 for 0.5 Hz, 1.0 Hz and 4.0 Hz, respectively. The measurement results have been compared with the expected values from the theoretical model that describes the behaviour of the microgripper: the overall percentage error (PE) between the measured and the expected values at different frequencies is lower than 1%, 1% and 3% for the angular displacement, velocity and acceleration respectively.

Maximum depth of penetration (DOP) is among the most relevant parameters in quality assurance programs for Ultrasound (US) scanners. Nowadays, a generally-accepted protocol for DOP estimation is still awaited and, in common practice, DOP is visually assessed despite the low accuracy. To overcome the eye-based assessment subjectivity, automatic image analysis methods have been proposed in literature. The present work focuses on a novel automatic method, namely the adaptive Signal to Noise Ratio (SNR) threshold method (AdSTM), developed in the MATLAB environment, by comparing it with an existing automatic approach, namely the tangent threshold method (TTM), and the mean judgment of eight observers (naked eye method). The three investigated methods were applied on data acquired from four US scanners for general purpose imaging, equipped with linear, convex, and vector array probes. Tests were carried out in two different configuration settings (raw scanner and default preset working conditions). AdSTM outcomes were tested by means of Monte Carlo Simulations. Most of measurement results were compatible despite the fact that the AdSTM seemed to be more sensitive and faster than the TTM. The results analysis confirms the higher dispersion of the naked eye method in DOP assessment with respect to the proposed automatic methods.

Background: Understanding the level of patients’ satisfaction with treatment and its determinants have the potential to impact therapeutic management and clinical outcome in chronic conditions such as chronic obstructive pulmonary disease (COPD). Methods: A national, multicenter, longitudinal, observational study of COPD from 20 Italian pulmonary centers to explore patients’ satisfaction to treatment [assessed by the Treatment Satisfaction Questionnaire, 9 items (TSQM-9)] and association with clinical parameters [including dyspnea score, COPD Assessment Test (CAT) score, exacerbation rate], adherence to treatment [Morisky Medication-Taking Adherence Scale (MMAS-4)], illness perception [evaluated by Brief Illness Perception Questionnaire (B-IPQ)] in a 1-year follow up. Results: A total of 401 COPD patients were enrolled [69.4% group B Global Initiative for COPD (GOLD), considering 366 patients with available GOLD 2017 classification at enrollment]. At enrollment, satisfaction with treatment was moderate, being TSQM-9 mean scores for effectiveness 64.2 [95% confidence interval (CI) 62.5–65.9], for convenience 75.8 (95% CI 74.2–77.3), and for global satisfaction 65.7 (95% CI 64.0–67.4). Global satisfaction was negatively associated with disease perception (β = −0.4709, p Conclusions: The results of this real-life study showed that the patients’ satisfaction with treatments is only moderate in COPD. A high grade of patients’ satisfaction is associated mainly with a low perception of the disease, high adherence to treatment and lower level of dyspnea. Trial Registration: Clinicaltrials.gov identifier: NCT02689492 The reviews of this paper are available via the supplemental material section.

Background and aim: The safety of endoscopic resection of large colorectal lesions (LCLs) (≥20 mm) is clinically relevant. The aim of the present study was to assess the rate of post-resection adverse events (AEs) in a real-life setting. Patients and methods: In a prospective, multicentre, observational study, data from consecutive resections of LCLs over a 6-month period were collected in 24 centres. Patients were followed up at 15 days from resection for AEs. The primary endpoint was intra-procedural bleeding according to lesion morphology. Secondary endpoints were delayed bleeding and perforation. Patient and polyp characteristics, and polypectomy techniques were analysed with respect to the bleeding events. Results: In total, 1504 patients (female/male: 633/871, mean age, 66.1) with 1648 LCLs (29.1% pedunculated and 70.9% non-pedunculated lesions) were included. Overall, 168 (11.2%) patients had post-resection bleeding (8.5 and 2.0% immediate and delayed, respectively), while 15 (1.0%) cases of perforation occurred. Independent predictors of immediate bleeding for pedunculated lesions were bleeding prophylaxis (odds ratio (OR) 0.28, 95% confidence interval (CI) 0.13–0.62), simple polypectomy (versus endoscopic mucosal resection, OR 0.38, 95% CI 0.17–0.88) and inpatient setting (OR 2.21, 95% CI 1.07–5.08), while bleeding prophylaxis (OR 0.37, 95% CI 0.30–0.98), academic setting (OR 0.27, 95% CI 0.12–0.54) and size (OR 1.03, 95% CI 1.00–1.05) were predictors for those non-pedunculated. Indication for colonoscopy (screening versus diagnostic (OR 0.33, 95% CI 0.12–0.86)), antithrombotic therapy (OR 3.12, 95% CI 1.54–6.39) and size (OR 2.34, 95% CI 1.12–4.87) independently predicted delayed bleeding. Conclusions: A low rate of post-resection AEs was observed in a real-life setting, reassuring as to the safety of endoscopic resection of ≥2 cm colorectal lesions. Bleeding prophylaxis reduced the intra-procedural bleeding risk, while antithrombotic therapy increased delayed bleeding. CLINICALTRIAL: (NCT02694120).

Background and Aims: Most of the evidence supporting endoscopic submucosal dissection (ESD) comes from Asia. European data are primarily reported by specialized referral centers and thus may not be representative of common European ESD practice. The aim of this study is to understand the current state of ESD practice across Italian endoscopy centers. Methods: All Italian endoscopists who were known to perform ESD were invited to complete a structured questionnaire including: operator features and competencies, ESD training details and clinical outcomes over a 2-year period. Results: Twenty-nine operators from 23 centers (69% response rate) completed the questionnaire: 18 (62%) were 150 in 8 (27.5%). Colorectal ESD was predominant for operators with an experience >80 cases. En-bloc resection rates ranged from 77.2 to 97.2% depending on the anatomic location with an R0 resection rate range of 75.3–93.6%. ESD perforation rates in the colon and rectum were significantly lower when experience was >150 compared to 80–150 cases (p < 0.0001 and p = 0.006 for colon and rectum, respectively). Conclusion: ESD in Italy is performed by a significant number of operators. Overall, Italian endoscopists performing ESD have achieved a good competence level. However, there is much variability in training protocols, initial supervision of procedures, practice settings, case mix and procedural volume/year that are likely responsible for some of the suboptimal resectional outcomes and increased perforation risk, mainly in the colon. Standardized training programs, practice parameters and auditing of outcomes are required.

Data on puberty development are available for several countries but not for Central Asia.Using data collected during the Kazakhstan Health and Nutrition Survey (KHA-ES), we evaluated the relationship between the living environment (rural vs. urban), ethnicity (Russians vs. Kazakhs) and pubertal status in children living in Kazakhstan.Genital (G1-G5), breast (B1-B5) and pubic hair (PH1-PH5) development were evaluated in a sample of 2389 boys and 2416 girls using Tanner's criteria. Age at menarche was evaluated using the 'status quo' and 'recall' methods.Rural children were older than urban children at stagesor =G2 for males andor =B2 for females, and this difference was more evident for Russian males. Differences levelled out at later stages of development in Kazakh males and in the pooled girls. The living environment was slightly but significantly associated with median age at menarche (12.89 years for urban Kazakhs to 13.43 years for rural Kazakhs). Male and female Kazakhs were older than Russians at stages 4 and 5, especially in the urban area.A relationship between pubertal status and the living environment was present in a rapidly modernizing country such as Kazakhstan.

Background Endoscopic mucosal resection (EMR) is an effective therapeutic technique well-standardized worldwide for the treatment of gastrointestinal neoplasm limited to the mucosal layer. To date, no study has compared technical and clinical differences based on the number of EMRs performed per year. This study aimed to compare EMR technical success, complications, and clinical outcome between low-volume centers (LVCs) and high-volume centers (HVCs). A total of nine endoscopic centers were included in the study. Methods This prospective study investigated consecutive patients with sessile polyps or flat colorectal lesions 1 cm or larger referred for EMR. Results A total of 427 lesions were resected in 384 patients at nine endoscopic centers. Males accounted for 60.4 % and females for 39.6 % of the patients. Most of the EMRs (84.8 %) were performed in HVCs and only 15.2 % in LVCs. All the lesions were resected in only one session. Argon plasma coagulation was performed on the margins of piecemeal resection in 15.7 % of the patients in HVCs only. Complete excision was achieved for 98.6 % of the lesions in HVCs and 98.8 % of the lesions in LVCs. The complication rate was 4.4 % in HVCs and 4.6 % in LVCs (p = 0.94). Delayed bleeding occurred in 2.5 % of the HVC cases and 3.1 % of the LVC cases. Perforation occurred in 1.9 % of the HVC cases and 1.5 % of the LVC cases (p = 1.00). Recurrences were experienced with 15 % of the lesions: 15.5 % in HVCs and 14 % in LVCs (p = 0.79). Conclusions The study showed that EMR can be performed also in LVC.

Objective. To evaluate in SSc, the frequency of digital lesions and the morphology, characteristics, natural course and time to healing of 1614 digital ulcers (DUs). Methods. One hundred SSc patients were followed up for 4 years. In the first step, the digital lesions were observed and classified at the time of presentation [digital pitting scar (DPS); DU; calcinosis; gangrene]. In the second step, DUs were divided into subsets according to their origin and main features. In the third step, the time to healing was recorded for each DU and the influence of DU main characteristics on time to healing was also evaluated. Results. In the first step, 1614 digital lesions were observed: DPS, 712 (44.1%) lesions; DU, 785 (48.6%); calcinosis, 110 (6.8%); and gangrene, 7 (0.8%). In the second step, DUs were subsetted as follows: DU developed on DPS (8.8%), pure DU; DU developed on calcinosis (60%); DU derived from gangrene. In the third step, the mean time to healing was 25.6 (15.6) days in DPS, 76.2 (64) days in pure DU, 93.6 (59.2) days in calcinosis ulcers and 281.1 (263.3) in gangrene. Conclusions. In SSc, digital lesions are represented by DPS, DU, calcinosis and gangrene, and provide an evidence-based DU subsetting according to their origin and main characteristics. Subsetting may be helpful for a precise DU evaluation and staging, and in randomized controlled trials for a precise identification of those DUs that are to be included in therapeutic studies. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

In this paper the modelling approaches for determination of the drain current in nanoscale MOSFETs pursued by various partners in the frame of the European Projects Pullnano and Nanosil are mutually compared in terms of drain current and internal quantities (average velocity and inversion charge). The comparison has been carried out by simulating template devices representative of 22 nm Double-Gate and 32 nm Single-Gate FD-SOI. A large variety of simulation models has been considered, ranging from drift-diffusion to direct solutions of the Boltzmann- Transport-Equation. The predictions of the different approaches for the 32 nm device are quite similar. Simulations of the 22 nm device instead, are much less consistent. Comparison with experimental data for a 32 nm device shows that the modeling approach used to explain the mobility reduction induced by the high-k dielectric is critical.