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Background Cerebrospinal fluid (CSF) leak through petrosal air cells is a known complication after drilling the posterior wall of the internal acoustic canal (IAC) for resection of vestibular schwannoma (VS). Whereas mild pneumocephalus is common after retrosigmoid craniotomy, tension pneumocephalus has been rarely documented. Objective To testify a case of fatal tension pneumocephalus after VS resection in a patient with ventriculo-peritoneal (VP) shunt and to propose possible recommendations to limit the risk of this dramatic complication. Methods A case of fatal tension pneumocephalus after VS resection in presence of hidden CSF fistula is illustrated with pre- and post-operative images. Results In the uneventful situation of concomitant post-operative CSF fistula in presence of VP shunt, tension pneumocephalus may occur. The negative pressure created by the shunt system and the presence of osteo-dural defect allow the air to enter and, at the same time, prevent the outflow. Conclusion After VS resection, tension pneumocephalus can occur as a consequence of CSF fistula from petrosal air cells in the presence of functioning VP shunt. Precautions as pre-operative increase to 'virtual-off' the pressure of the valve, subsequences CT scans after surgery and sealing of the petrous air cells are recommended to avoid such as fatal complication.

Background Postoperative spinal epidural hematoma is a rare complication of anterior cervical discectomy and fusion. This condition may rapidly produce severe neurologic deficits, often requiring a prompt surgical decompression. A multilevel extension of the epidural bleeding has been rarely described after anterior cervical procedures. In such cases, the choice of the most suitable surgical approach may be challenging. Herein, we describe an effective surgical decompression of a C2-T1 ventral epidural hematoma following anterior cervical discectomy and fusion at the C5-C6 level. Methods By reopening the previous approach, the C5-C6 intersomatic cage was removed and the surgical field inspected for bleeding. After removal of the spinal epidural hematoma at this level, a lumbar external drainage catheter was inserted into the epidural space to perform multiple irrigations with saline solution until the washing fluid was clear. Results Immediate postoperative cervical computed tomography and magnetic resonance imaging revealed gross total removal of the epidural hematoma and complete decompression of the spinal cord all along the affected tract. Early postoperative neurologic examination revealed mild lower extremity weakness that fully recovered within hours. Conclusions Although rare, multilevel epidural hematoma following anterior cervical decompression represents a serious complication. The revision of the previous anterior cervical approach may be considered the first treatment option, allowing to control the primary bleeding site. Catheter irrigation of the epidural space with saline solution may be a useful technique for removal of unexposed residual blood collection, avoiding the need for posterior laminectomy or other unnecessary bone demolition.

The Internet of Things (IoT) is expected to bring new opportunities for improving several services for the Society, from transportation to agriculture, from smart cities to fleet management. In this framework, massive connectivity represents one of the key issues. This is especially relevant when IoT systems are expected to cover a large geographical area or a region not reached by terrestrial network connections. In such scenarios, the usage of satellites might represent a viable solution for providing wide area coverage and connectivity in a flexible and affordable manner. Our paper presents a survey on current solutions for the deployment of IoT services in remote/rural areas by exploiting satellites. Several architectures and technical solutions are analyzed, underlining their features and limitations, and real test cases are presented. It has been highlighted that low-orbit satellites offer an efficient solution to support long-range IoT services, with a good trade-off in terms of coverage and latency. Moreover, open issues, new challenges, and innovative technologies have been focused, carefully considering the perimeter that current IoT standardization framework will impose to the practical implementation of future satellite based IoT systems.

Background and Aims There is a lack of knowledge on the association of dietary factors and Lumbar Spinal Stenosis (LSS). We evaluated the association of a Mediterranean diet (MD), its major food components and ultra-processed food (UPF) with the risk of LSS. Methods and Results Participants were recruited from the Neurosurgery Department of the IRCCS Neuromed, Italy. The study sample consisted of 156 cases of LSS, and 312 controls matched 1:2 for sex, age (±6 months) and physical activity, without a history or clinical evidence of LSS who were identified from the general population. Adherence to MD was assessed by the Mediterranean Diet Score based on 9 food groups. UPF was defined according to NOVA classification and calculated as the ratio (%) of UPF (g/d) on total food consumed (g/d). In multivariable-adjusted analysis, a 2-point increase in the MD score was not associated with LSS risk (OR: 1.02, 95% CI: 0.72-1.46). An increment of 10 g/d of fruits and nuts, cereals or fish led to lower odds of LSS (OR: 0.97, 95% CI: 0.95-0.99; OR: 0.88, 95% CI: 0.82-0.94; OR: 0.87, 95% CI: 0.76-0.99, respectively). Additionally, 1% increment in the consumption of UPF in the diet was independently associated with higher LSS risk (OR: 1.09, 95% CI: 1.04 -1.14). Conclusion A diet rich in fruits, cereals, fish is associated with lower risk of LSS while a large dietary share of UPF increases the risk of this disease. Further studies with a prospective design and larger sample sizes are warranted.

Low-power wide-area networks are continuously gaining momentum as enablers of massive machine-type communication, thanks to long-range wireless technologies operating either on unlicensed spectrum like, e.g., Long-Range (LoRa) and Sigfox, or on licensed spectrum, as Narrowband-IoT. For the former category of technologies, stringent requirements in terms of channel utilization and radiated power must be fulfilled, thus algorithms and protocols for enhanced radio-resource management need to be investigated. In this paper, we propose a disruptive approach for LoRa systems, exploiting a novel operational mode at the gateways side called time-power multiplexing, which fully exploits the degrees of freedom of the unlicensed bands regulations. The simulation results show that the proposed solution boosts the number of users that a LoRa network can support with respect to the default operational mode.

The microbiota can play important roles in the development of human immunity and the establishment of immune homeostasis. Lifestyle factors including diet, hygiene, and exposure to viruses or bacteria, and medical interventions with antibiotics or anti‐ulcer medications, regulate phylogenetic variability and the quality of cross talk between innate and adaptive immune cells via mucosal and skin epithelia. More recently, microbiota and their composition have been linked to protective effects for health. Imbalance, however, has been linked to immune‐related diseases such as allergy and cancer, characterized by impaired, or exaggerated immune tolerance, respectively. In this AllergoOncology position paper, we focus on the increasing evidence defining the microbiota composition as a key determinant of immunity and immune tolerance, linked to the risk for the development of allergic and malignant diseases. We discuss novel insights into the role of microbiota in disease and patient responses to treatments in cancer and in allergy. These may highlight opportunities to improve patient outcomes with medical interventions supported through a restored microbiome.

In this paper, we present a new modulation, called DLoRa, similar in principle to the conventional LoRa modulation and compatible with it in terms of bandwidth and numerology. DLoRa departs from the conventional LoRa modulation as it is using a decreasing instantaneous frequency in the chirps instead of an increasing one as for the conventional LoRa modulation. Furthermore, we describe a software environment to accurately evaluate the "isolation" of the different virtual channels created by LoRa and DLoRa when using different Spreading Factors. Our results are in agreement with the ones present in the literature for the conventional LoRa modulation. They show that it is possible to double the number of channels by simultaneously using LoRa and DLora. The higher (double) number of subchannels available is the key to improve the network level performance of LoRa based networks.

Safety-critical advanced driver-assistance systems (ADAS) are expected to benefit from cellular vehicle-to-everything communication, providing both short-range and long-range wireless connectivity between vehicles and road/network infrastructure equipment. However, upon switching between adjacent coverage areas belonging to different network operators, the wireless connectivity may be discontinued. This issue prevents network service continuity and causes interruption of ADAS service availability. In this paper, we aim at assessing the average duration of service interruption due to such network reselection procedures. We provide performance evaluation results highlighting that there is a wide gap between the best case scenario and the worst case scenario. Moreover, we propose a simple heuristic to limit the downside of the lack of cooperation between network operators; our heuristic algorithm, which does not require a tight integration between the operators, performs much better than the worst case and it is fairly comparable with the best case scenario. Nevertheless the present work highlights the importance of a tighter integration between network operators to reduce the delay to the minimum.

Chronic rhinosinusitis (CRS) is thought to be a multifactorial disease that includes a direct involvement of bacteria that trigger inflammation and contribute to CRS pathogenesis. Staphylococcus aureus infection and persistence is associated with chronic rhinosinusitis (CRS), and it may be particularly relevant in the form with nasal polyps (CRSwNP). The large array of exotoxins deployed by S. aureus is instrumental for the bacterium to warrant its infection and dissemination in different human body districts. Here, we analyze the common Th2 environment in CRSwNP and prospect a possible dynamic role played by S. aureus leukocidins in promoting this chronic inflammation, considering leukocidin ED (LukED) as a strong prototype candidate worth of therapeutic investigation. CCR5 is an essential target for LukED to exert its cytotoxicity towards T cells, macrophages and dendritic cells. Therefore, CCR5 blockade might be an interesting therapeutic option for CRS and, more specifically, persistent and relapsing CRSwNP. In this perspective, the arsenal of CCR5 antagonists being developed to inhibit HIV-1 entry (CCR5 being the major HIV-1 co-receptor) could be easily repurposed for CRS therapeutic investigation. Finally, direct targeting of LukED by neutralizing antibodies could represent an important additional solution to S. aureus infection.

Background Colloid cysts of the third ventricle are rare benign lesions, which amount to approximately 1% of all intracranial tumors. Because these lesions grow predominantly in the anterior aspect of the third ventricle, they may cause the occlusion of the foramina of Monro, generating obstructive hydrocephalus. Surgery is mandatory in cases of large cysts and/or in symptomatic patients. Among the different surgical strategies described in colloid cysts surgery, the microsurgical transcallosal approach still constitutes the procedure of choice in many centers. In this study, we describe a modified microsurgical transcallosal approach, the interhemispheric transgenual approach, in a series of 13 consecutive patients operated on for colloid cysts of the third ventricle. Methods All the procedures were performed by the senior author (V.E.) at Neuromed Institute of Pozzilli (Is, Italy). The operative procedure is described in its various steps, illustrating the differences and potential advantages compared with the traditional microsurgical transcallosal approach. Results No surgical complications or new-onset neurologic deficits were observed in the postoperative period. The postoperative magnetic resonance imaging confirmed in all cases complete lesion removal without any sign of parenchymal damage. No lesion recurrence or need for permanent cerebrospinal fluid diversion was detected in the patients of this series during the follow-up period. Conclusions In our experience, the interhemispheric transgenual approach has been effective in providing complete colloid cyst removal with minimal risk of vascular and parenchymal damage. Further studies are required to confirm its efficacy in improving the overall outcome of the microsurgical transcallosal approach.

A ball resonator, positioned on the tip of an optical fiber, has been developed as a biosensor for the prototypic detection of thrombin. The device was fabricated with a fast and repeatable CO2 laser splicing method, followed by gold-sputtering and functionalization for the measurement of various protein concentrations. The ball resonator acts as a weak interferometer with a return loss below − 50 dB, and it is interrogated with an optical backscatter reflectometer measuring the reflection spectrum. We report here a sample presenting high sensitivity (1273.74 nm/RIU, RIU = refractive index units), which allows protein detection in the range 0.4–100 pM, with a limit of detection of 1.56 pM in logarithmic response.

Low power wide area networks (LPWAN) are emerging as a new paradigm, especially in the field of Internet of Things (IoT) connectivity. LoRa is one of the LPWAN and it is gaining quite a lot of commercial traction. The modulation underlying LoRa is patented and has never been described theoretically. The aim of this letter is to give the first rigorous mathematical signal processing description of the modulation and demodulation processes. We provide as well a theoretical derivation of the optimum receiver entailing a low-complexity demodulation process, resorting to the Fast Fourier Transform. We compare then the performance of the LoRa modulation and the frequency-shift keying modulation both in an additive white gaussian noise channel and a frequency selective channel, showing the superiority of the LoRa modulation in the frequency selective channel. The results of this letter will enable a further assessment of the LoRa based networks, much more rigorous than what has been done until now.

The fifth-generation (5G) cellular networks will face the challenge of integrating the traditional broadband services with the Internet of Things (IoT), which is characterized by sporadic uplink transmissions of small data packets. Indeed, the access procedure of the previous generation cellular network (4G) is not able to support IoT traffic efficiently, because it requires a large amount of signaling for the connection setup before the actual data transmission. In this context, we introduce two innovative radio access protocols for sporadic transmissions of small data packets, which are suitable for 5G networks, because they provide a resource-efficient packet delivery exploiting a connectionless approach. The core of this paper resides in the derivation of an analytical framework to evaluate the performance of all the aforementioned protocols. The final goal is the comparison between 4G and 5G radio access solutions employing both our analytical framework and computer simulations. The performance evaluation results show the benefits of the protocols envisioned for 5G in terms of signaling overhead and access latency.

Uplink ultra-reliable low-latency communication (URLLC) entails dependable and almost instantaneous packet transmissions from industrial Internet of Things terminals to the serving base station. While most of the literature addresses terminals which are always connected to the network, here we focus on terminals which would benefit from a connection-less radio access , because they are employed for low-duty-cycle applications related to industrial safety, while still requiring a URLLC quality of service . Our aim is to investigate the performance of two standard-compliant radio access protocols, i.e., the one-stage approach and the two-stage approach, in supporting uplink URLLC in connection-less mode. We derive a mathematical model of these protocols under the assumption that the base station has multi-user detection capabilities. The model is used to cross-validate our simulator and calibrate the protocols together with the validated simulator, providing well-grounded guidelines for the selection of the parameter values. The simulator is finally exploited to assess the URLLC performance of the proposed protocols. The key outcome of this study is that, when combined with multi-user detection at the base station and after an appropriate system parameters selection, the one-stage approach satisfies the desired URLLC service requirements, thus representing a viable solution to support safety-related industrial applications.

An aptasensor based on etched tilted fiber Bragg grating (eTFBG) is developed on a single-mode optical fiber targeting biomolecule detection. TFBGs were chemically etched using hydrofluoric acid (HF) to partially remove the fiber cladding. The sensor response was coarsely interrogated, resulting on a sensitivity increase from 1.25 nm/RIU (refractive index unit) at the beginning of the process, up to 23.38 nm/RIU at the end of the etching, for a RI range from 1.3418 to 1.4419 RIU. The proposed aptasensor showed improved RI sensitivity as compared to the unetched TFBG, without requiring metal depositions on the fiber surface or polarization control during the measurements. The proposed sensor was tested for the detection of thrombin-aptamer interactions based on silane-coupling surface chemistry, with thrombin concentrations ranging from 2.5 to 40 nM. Functionalized eTFBGs provided a competitive platform for biochemical interaction measurements, showing sensitivity values ranging from 2.3 to 3.3 p.m./nM for the particular case of thrombin detection.&nbsp

Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both antitumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveillance, immunomodulation and the functions of IgE-mediated immune responses against cancer, to derive novel insights into more effective treatments. Coincident with rapid expansion in clinical application of cancer immunotherapies, here we review the current state-of-the-art and future translational opportunities, as well as challenges in this relatively new field. Recent developments include improved understanding of Th2 antibodies, intratumoral innate allergy effector cells and mediators, IgE-mediated tumour antigen cross-presentation by dendritic cells, as well as immunotherapeutic strategies such as vaccines and recombinant antibodies, and finally, the management of allergy in daily clinical oncology. Shedding light on the crosstalk between allergic response and cancer is paving the way for new avenues of treatment.

In this paper we consider the application of the LoRaWAN™ technology for metering purposes. We compare this technology with a well established technology for metering applications such as the WM-Bus. We take as key performance indicator the battery lifetime, keeping the same Quality of Service. The distinctive features of this paper is to collect real data from measurement campaigns in full fledged carrier grade networks and to consider two generations of meters from the same manufacturer. The results of the measurements show that the LoRaWAN meters outperforms the WMBus meters significantly as far as the battery lifetime is concerned.

The paper deals with the Low Power Wide Area Networks working in unlicensed spectrum. In particular, Lo-RaWAN™ networks are considered the most prominent technology in this field. Specifically, the paper addresses the coexistence in the same bands of LoRaWAN™ networks and the incumbent application featuring the so-called Short Range Devices, a category encompassing different type of devices ranging from gate openers to the traditional home automation technology. To assess this coexistence the paper is proposing a simulation approach using the standard tool used by the regulators in Europe and deriving the input data as well from the official regulators documentation. The results of the simulation campaign is that, by using the parameters of the current regulation in Europe, LoRaWAN™ can inter-operate flawlessly with the incumbent legacy Short Range Devices. These results are in contrast with some proposals one can find in literature which suggest to impose stricter limitations on LoRaWAN™ networks.

PLATO [1] has been selected and adopted by ESA as the third medium-class Mission (M3) of the Cosmic Vision Program, to be launched in 2026 with a Soyuz-Fregat rocket from the French Guiana. Its Payload (P/L) is based on a suite of 26 telescopes and cameras in order to discover and characterise, thanks to ultra-high accurate photometry and the transits method, new exoplanets down to the range of Earth analogues. Each camera is composed of 4 CCDs working in full-frame or frame-transfer mode. 24 cameras out of 26 host 4510 by 4510 pixels CCDs, operated in full-frame mode with a pixel depth of 16 bits and a cadence of 25 s. Given the huge data volume to be managed, the PLATO P/L relies on an efficient Data Processing System (DPS) whose Units perform images windowing, cropping and compression. Each camera and DPS Unit is connected to a fast SpaceWire (SpW) network running at 100 MHz and interfaced to the satellite On-Board Computer (OBC) by means of an Instrument Control Unit (ICU), performing data collection and compression.

Hybrid Automatic Repeat reQuest (HARQ) techniques are widely employed in the most important wireless systems, e.g., the Long Term Evolution (LTE) cellular standard, to increase the reliability of the communication. Despite these schemes have been widely studied in literature in the past several years, the recent results obtained by Polyanskiy, Poor, and Verd&uacute, on the finite-blocklength regime disclosed new possibilities for the research on HARQ schemes. Indeed, new communications trends, which are usually part of the Internet of Things (IoT) paradigm, are characterized by very short packet sizes and a high reliability requirement and, therefore, they call for efficient HARQ techniques. In many scenarios, the energy efficiency of the communication plays a key role as well. In this paper, we aim at providing a comprehensive performance comparison of various kinds of HARQ schemes in the context of short-packet transmissions with energy constraints. We derive optimal power allocation strategies and we show that a minimum 50% energy saving can be achieved after very few transmission attempts if we enable packet combining at the receiver side.

CCR5 and its interaction with chemokine ligands have been crucial for understanding and tackling HIV-1 entry into target cells. However, over time, CCR5 has witnessed an impressive transition from being considered rather unimportant in physiology and pathology to becoming central in a growing number of pathophysiological conditions. It now turns out that the massive efforts devoted to combat HIV-1 entry by interfering with CCR5, and the subsequent production of chemokine ligand variants, small chemical compounds, and other molecular entities and strategies, may set the therapeutic standards for a wealth of different pathologies. Expressed on various cell types, CCR5 plays a vital role in the inflammatory response by directing cells to sites of inflammation. Aside HIV-1, CCR5 has been implicated in other infectious diseases and non-infectious diseases such as cancer, atherosclerosis, and inflammatory bowel disease. Individuals carrying the CCR5Δ32 mutation live a normal life and are warranted a natural barrier to HIV-1 infection. Therefore, CCR5 antagonism and gene-edited knockout of the receptor gained growing interest for the therapeutic role that CCR5 blockade may play in the attenuation of the severity or progression of numerous diseases.

Recently, the role of Low-Power Wide Area Networks (LPWANs) as enablers of the Internet of Things (IoT) is emerging. Contrary to what is commonly believed, despite they operate in unlicensed frequency bands, these technologies are subject to stringent spectrum usage regulations, in terms of both channel occupancy and transmission power. In this work, we focus on the LPWAN technology based on the Long-Range™ (LoRa) modulation, proposing a radically new approach with respect to the default Medium Access Control (MAC) procedure in LoRaWAN™, i.e., the protocol stack most widely used on top of LoRa. In particular, we describe and evaluate a new MAC protocol that exploits a novel operation mode called time-power multiplexing, to boost the capacity of LoRa networks. The simulation results show that, with respect to the default LoRaWAN MAC protocol, the proposed solution effectively increases the number of users that the network can sustain.

Recently, the role of Low-Power Wide Area Networks (LPWANs) as enablers of the Internet of Things (IoT) is emerging. However, many concerns arise on the performance of LPWANs if higher Quality of Service (QoS) requirements are needed by certain classes of IoT services. In this work, we will focus on one of the most prominent of these technologies, i.e., Long-RangeTM (LoRa). Our aim is to study to what extent a LoRa network is able to support uplink (UL) traffic that requires to be confirmed by the Network Server (NS). The simulation results show that the network performance is severely impacted by the downlink (DL) traffic generated by feedback packets.

Low-Power Wide Area Networks (LPWANs) are continuously gaining momentum as fundamental enablers of the Internet of Things (IoT) paradigm. These networks provide longrange coverage to end nodes, exploiting license-free frequency bands. The focus of this work is on one of the most prominent LPWAN technologies: LoRa™. We implemented a new ns-3 module to study the performance of a LoRa-based IoT network in a typical urban scenario. Simulation results show that a LoRa network can scale well, achieving packet success rates above 95% in presence of a number of end devices in the order of 104.

One of the most important features of the next generation cellular network, commonly referred to as 5G, is the native support of Internet of Things (IoT) traffic, in order to overcome the issues of the actual cellular standard, the Long Term Evolution (LTE), in managing this kind of traffic. However, the IoT market growth is so fast that a seamless integration of IoT traffic from 4G to 5G should be provided. In this context, first of all we tailor the LTE physical channels to the case of small packet traffic. Then, we design a mathematical framework to analyze the performance of two possible variants of the LTE radio access protocol to efficiently support the IoT.

The low-power wide-area network (LPWAN) paradigm is gradually gaining market acceptance. In particular, three prominent LPWAN technologies are emerging at the moment: LoRaWAN™ and SigFox™, which operate on unlicensed frequency bands, and NB-IoT, operating on licensed frequency bands. This paper deals with LoRaWAN™, and has the aim of describing a particularly interesting feature provided by the latest LoRaWAN™ specification—often neglected in the literature—i.e., the roaming capability between different operators of LoRaWAN™ networks, across the same country or even different countries. Recalling that LoRaWAN™ devices do not have a subscriber identification module (SIM) like cellular network terminals, at a first glance the implementation of roaming in LoRaWAN™ networks could seem intricate. The contribution of this paper consists in explaining the principles behind the implementation of a global LoRaWAN network, with particular focus on how to cope with the lack of the SIM in the architecture and how to realize roaming.

IgE is a highly elusive antibody class, yet a tremendously powerful elicitor of immune reactions. Despite huge efforts spent on the characterization and understanding of the IgE system many questions remain either unanswered or only marginally addressed. One above all relates to the role of IgE. A common doubt is based on whether IgE mode of action should only be relegated to anti-parasite immunity and allergic manifestations. In search for a hidden role of IgE, reports from several laboratories are described herein in which a natural IgE link to cancer or the experimental redirection of IgE against cancer have been investigated. Epidemiological and investigational studies are trying to elucidate a possible direct intervention of endogenous IgE against cancer, raising thus far no definitive evidence. Conversely, experimental approaches implementing several strategies and engineered IgE formats built up a series of convincing results indicating that cancer might be tackled by the effector functions of this immunoglobulin class. Because of its peculiar immune features, IgE may present a superior anti-tumor performance as compared to IgG. However, extreme care should be taken on how IgE-based anti-tumor approaches should be devised. Overall, IgE appears as a promising resource, likely destined to enrich the anti-cancer arsenal.

Extrusion of disc material within the spinal canal complicates up to 28.6% of lumbar disc herniations. Due to the anatomical “corridors” created by the anterior midline septum and lateral membranes, relocation occurs with an anterior and anterolateral axial topography. Posterior migration is an extremely rare condition and anterior-to-posterior circumferential migration is an even rarer condition. Its radiological feature can be enigmatic and since, in more than 50% of cases, clinical onset is a hyperacute cauda equina syndrome, it may imply a difficult surgical decision in emergency settings. Surgery is the gold standard but when dealing with such huge sequestrations, standard microdiscectomy must be properly modified in order to minimize the risk of surgical trauma or traction on the nerve roots.

The aim of this study was to compare the combined sonographic and clinical effects of botulinum toxin type A (BoNT-A) and extracorporeal shock wave therapy (ESWT) versus BoNT-A alone in children with cerebral palsy.Ten children with spastic cerebral palsy were randomly assigned to one of two groups. Group 1 received BoNT-A injection into the spastic muscles of the affected limbs plus three ESWT sessions. Group 2 received BoNT-A alone. Assessment was performed before and 1 month after injection. Sonographic outcomes were injected muscles echo intensity and their hardness percentage, and clinical outcomes the modified Ashworth scale and the Tardieu scale.At 1-month evaluation, significant differences in the injected muscles percentage of hardness (P = 0.021) and the modified Ashworth scale (P = 0.001) were found between groups.Our results support the hypothesis that the combined effects of BoNT-A and ESWT derive from their respective action on neurological and non-neural rheological components in spastic muscles.

While desired for the cure of allergy, regulatory immune cell subsets and non-classical Th2-biased inflammatory mediators in the tumour microenvironment can contribute to immune suppression and escape of tumours from immunological detection and clearance. A key aim in the cancer field is therefore to design interventions that can break immunological tolerance and halt cancer progression, whereas on the contrary allergen immunotherapy exactly aims to induce tolerance. In this position paper, we review insights on immune tolerance derived from allergy and from cancer inflammation, focusing on what is known about the roles of key immune cells and mediators. We propose that research in the field of AllergoOncology that aims to delineate these immunological mechanisms with juxtaposed clinical consequences in allergy and cancer may point to novel avenues for therapeutic interventions that stand to benefit both disciplines. This article is protected by copyright. All rights reserved.

Currently one of the most established protocols for machine to machine (M2M) communications is LoRaWAN, designed to provide low power wide area network with features specifically needed to support low-cost, mobile, secure bidirectional communication for the Internet of Things (IoT). In this context security is of pivotal importance, as IoT constitutes a pervasive network of devices highly integrated with our daily life. In this paper we examine key security issues of the procedure used in LoRaWAN to allow an end device to establish a connection with the network server. We have identified vulnerabilities in this protocol, in particular with reference to the use of a random number in the join procedure packet, meant to prevent replay attacks. We first discuss the options that a network server has when detecting a replay attack and then we examine a) the possibility that a legitimate receiver is considered an attacker because of the random number generation issues and b) the possibility for an attacker to exploit this protocol to generate a denial of service (DoS). A wide set of experiments has been conducted using a widely used LoRaWAN chip showing the vulnerabilities of the protocol.

We consider a cellular Internet of things (CIoT) network where many source nodes aim at exchanging messages with a single concentrator node. To this end, they are assisted by anchor nodes that are trusted and securely connected with the concentrator node. In this context, we aim at providing a message authentication scheme based on the characteristics of the channel between the source nodes and the anchor nodes. According to this approach, the anchor nodes estimate the channel to source nodes in an initially externally authenticated fashion, while forthcoming messages are authenticated by comparing the current channel estimate with the initial estimate. Moreover, assuming that the anchor nodes have a limited energy availability, we derive suitable scheduling policies for the activation of the anchor nodes for authentication purposes. In particular, we aim at maximizing the anchors lifespan while guaranteeing given false alarm and missed detection probabilities of the authentication process. The performance of the proposed authentication protocols is evaluated in a typical CIoT scenario.

The new terrestrial digital video broadcasting standard DVB-T2 provides a specific symbol - called P1-symbol - for the initial time and frequency synchronization. In this paper the maximum likelihood (ML) time and carrier frequency offset (CFO) synchronization scheme, which exploits the structure of the P1 symbol in both time and frequency domains is derived. Two lower-complexity solutions are then proposed: (1) a ML estimator that only exploits the time structure of the P1 symbol and (2) a pseudo ML (PML) scheme that resorts to a suboptimal CFO estimator while still performing ML time synchronization. The proposed schemes are compared in terms of both synchronization capabilities and implementation complexity. The Cramer-Rao bounds for the CFO estimators are also evaluated. Simulation results in a typical DVB-T2 scenario show that both ML and PML schemes have a very close performance while significantly outperforming existing schemes.

Given a synchronous wireless network with N nodes uniformly located at random on a finite plane, we consider the problem of distributed peer discovery: all nodes want to discover as many other nodes as possible. We assume that there are a total of K physical resources dedicated for the discovery purpose. Each node can pick one resource to transmit its node identifier on, and can receive on the remaining K-1 resources. We assume that node identifiers are broadcast via coded transmission on one single physical resource. This paper addresses link level strategies to increase the average number of discovered devices when N ≅ aK, where a is the degree of density of the network. A classical strategy of discovering one node per resource would lead to a maximum of K-1 nodes being discovered. We focus on a multiple-access channel (MAC) scernario where multiple interferer users are jointly decoded. We propose a scheme to improve the performance. The method, based on iterative belief propagation on factor graph, is called joint iterative decoding (JID). It is shown, through system simulations, that JID may gain by significantly more than 100% over the classical single-user decoding, and by 20-25% over the successive interference cancellation (SIC).

In a cooperative multi-cell network the uplink signal coming from each mobile terminal (MT) is simultaneously demodulated by multiple base stations (BSs). Both backhaul capacity and BS processing capabilities limit the number of demodulating BSs. In order to fit the information exchange among BSs to backhaul resources we minimize the average number of demodulating BSs, under a constraint on the average outage probability. The BS selection problem becomes more complicated when error control configurations as automatic repeat request (ARQ) and hybrid ARQ (HARQ) with chase combining or incremental redundancy are considered. Multi-cell processing is implemented both by decoding the packet at each BS and by a joint decoding among BSs. We first derive the outage probability as a function of the number of cooperating BSs and the error control strategy. A heuristic approach for BS selection is then developed, to find at each frame which BSs perform demodulation and share the information in the backhaul. Lastly, we show that backhaul usage can be reduced up to 64% with respect to an unoptimized solution.

Second generation terrestrial digital video broadcasting (DVB-T2) standard aims at providing high definition television and high rate services for the same spectrum allocation of current DVB-T standard. This goal is achieved by adopting new physical layer features that increase the spectrum efficiency. In this respect, the insertion of pilot tones in the orthogonal frequency division multiplexed (OFDM) signal, though allowing an efficient channel estimation, decreases the spectral efficiency. In this paper we evaluate performance of the coded decision directed demodulation (CD3) technique for channel estimation in DVB-T2. In fact, by iterating between decoding and channel estimation, with the latter obtained by using previously decoded symbols, CD3 is able to provide an accurate channel estimation with very few pilots, even in the presence of highly frequency dispersive and time-variant channels. Numerical results are provided for a comparison in terms of achievable throughput between DVB-T2 with CD3 and current DVB-T. Moreover, multiple antennas at the base station are also considered to provide spatial diversity and hence further improve system performance.

Connectivity is probably the most basic building block of the Internet of Things (IoT) paradigm. Up to know, the two main approaches to provide data access to the \emph{things} have been based either on multi-hop mesh networks using short-range communication technologies in the unlicensed spectrum, or on long-range, legacy cellular technologies, mainly 2G/GSM, operating in the corresponding licensed frequency bands. Recently, these reference models have been challenged by a new type of wireless connectivity, characterized by low-rate, long-range transmission technologies in the unlicensed sub-GHz frequency bands, used to realize access networks with star topology which are referred to a \emph{Low-Power Wide Area Networks} (LPWANs). In this paper, we introduce this new approach to provide connectivity in the IoT scenario, discussing its advantages over the established paradigms in terms of efficiency, effectiveness, and architectural design, in particular for the typical Smart Cities applications.

The idea that we are moving towards a future networked society is widely accepted. The increase of network access, in particular to the Internet, and the wide heterogeneity of devices and components that access the network, and occasionally communicate with each other, pose great design challenges, but at the same time open unprecedent opportunities. In order to be able to fully exploit the new opportunities, a uniform and standardized software architecture must be adopted. The aim is to regulate and organize the multidisciplinary nature of the Internet-of-Things (IoT) applications. In this article we first introduce the REpresentational State Transfer (REST) architecture style as one of the de-facto standards in a totally-IP-connected world. Then the main focus will move to a new M2M RESTful framework for the IoT, developed following the REST paradigm, but enhancing its interface to introduce new web functionalities that are still accessed via the usual interface of the Internet Web sites.

The effect of plasmapheresis on cellular immunity was studied in 8 patients with active systemic lupus erythematosus (SLE), by evaluating before and after treatment the percentage of E-rosette forming cells (E-RFC), the inhibitory effect of patients’ sera on rosette formation by normal lymphocytes, the Con A-induced suppressor activity, and T-cell subsets studied by means of monoclonal antibodies. After plasmapheresis a significant improvement was observed in E-rosette formation, and in Con A-induced suppressor activity, along with a marked reduction in the inhibitory effect of patients’ sera on rosette formation. No change was observed in the number and percentage of T-cells subsets after plasmapheresis.