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Objective In patients with a history of lymphoma, each lymphadenopathy should be carefully evaluated. The aims of this study were to evaluate (i) the usefulness of high-resolution ultrasonography (US), US-guided fine-needle aspiration cytology (FNAC) and flow cytometry phenotyping (FCP) together in the diagnosis of recurrent lymphoma, and (ii) whether these tools were independent predictors of correct results. Design Retrospective cohort study with stepwise forward logistic regression analysis of results. Setting Tertiary referral centre. Participants A total of 151 patients with history of lymphoma who developed a cervical mass during follow-up. Methods On neck US, a lymphadenopathy was shown in 129 (85.4%) patients (median age 57 years, range 18-78 years), and US-guided FNAC combined with FCP were immediately performed. All patients had surgical excision and subsequent histological examination of the enlarged node(s), to establish lymphoma subclassification. Results Final histology confirmed recurrence in 82 (63.6%) patients. According to the logistic regression analysis, FNAC and FCP were independent predictors of correct results (p=0.009 and 0.028, respectively) and did not interfere with each other. The sensitivity, specificity and accuracy of the combination of all of the tools were 98.8%, 100%, and 99.2%, respectively, and the area under the receiver operating characteristic curve was 0.902 (95% CI: 0.797-0.896). Conclusion This minimally-invasive procedure is easily performed and should be recommended for all patients with cervical lymphadenopathy and a history of lymphoma, avoiding the need of core-biopsy or surgical excision if recurrence was excluded. This article is protected by copyright. All rights reserved.

Summary Background Patients who are immunocompromised because of malignancy have an increased risk of herpes zoster and herpes zoster-related complications. We aimed to investigate the efficacy and safety of an inactivated varicella zoster virus (VZV) vaccine for herpes zoster prevention in patients with solid tumour or haematological malignancies. Methods This phase 3, two-arm, randomised, double-blind, placebo-controlled, multicentre trial with an adaptive design was done in 329 centres across 40 countries. The trial included adult patients with solid tumour malignancies receiving chemotherapy and those with haematological malignancies, either receiving or not receiving chemotherapy. Patients were randomly assigned (1:1) to receive four doses of VZV vaccine inactivated by γ irradiation or placebo approximately 30 days apart. The patients, investigators, trial site staff, clinical adjudication committee, and sponsor's clinical and laboratory personnel were masked to the group assignment. The primary efficacy endpoint was herpes zoster incidence in patients with solid tumour malignancies receiving chemotherapy, which was assessed in the modified intention-to-treat population (defined as all randomly assigned patients who received at least one dose of inactivated VZV vaccine or placebo). The primary safety endpoint was serious adverse events up to 28 days after the fourth dose in patients with solid tumour malignancies receiving chemotherapy. Safety endpoints were assessed in all patients who received at least one dose of inactivated VZV vaccine or placebo and had follow-up data. This trial is registered ( NCT01254630 and EudraCT 2010-023156-89). Findings Between June 27, 2011, and April 11, 2017, 5286 patients were randomly assigned to receive VZV vaccine inactivated by γ irradiation (n=2637) or placebo (n=2649). The haematological malignancy arm was terminated early because of evidence of futility at a planned interim analysis; therefore, all prespecified haematological malignancy endpoints were deemed exploratory. In patients with solid tumour malignancies in the modified intention-to-treat population, confirmed herpes zoster occurred in 22 of 1328 (6·7 per 1000 person-years) VZV vaccine recipients and in 61 of 1350 (18·5 per 1000 person-years) placebo recipients. Estimated vaccine efficacy against herpes zoster in patients with solid tumour malignancies was 63·6% (97·5% CI 36·4 to 79·1), meeting the prespecified success criterion. In patients with solid tumour malignancies, serious adverse events were similar in frequency across treatment groups, occurring in 298 (22·5%) of 1322 patients who received the vaccine and in 283 (21·0%) of 1346 patients who received placebo (risk difference 1·5%, 95% CI −1·7 to 4·6). Vaccine-related serious adverse events were less than 1% in each treatment group. Vaccine-related injection-site reactions were more common in the vaccine group than in the placebo group. In the haematological malignancy group, VZV vaccine was well tolerated and estimated vaccine efficacy against herpes zoster was 16·8% (95% CI −17·8 to 41·3). Interpretation The inactivated VZV vaccine was well tolerated and efficacious for herpes zoster prevention in patients with solid tumour malignancies receiving chemotherapy, but was not efficacious for herpes zoster prevention in patients with haematological malignancies. Funding Merck & Co, Inc.

We present an application of the Industry 4.0 enabling technologies to Bottega Veneta, an Italian luxury goods house renowned in the world for its leather goods. In particular, we address the production process throughout the supply chain. The proposed framework introduces a uniform data model, used by all the actors involved in the production process to collect and represent the large amount of data involved in the production process. A DSS (Decision Support System) allows the production planner to focus on different scenarios to take better decisions.

The temporal retention in storage zones (SZs) has a strong influence on mass transport processes in natural streams. It has been shown that solute retention affects solute breakthrough curves (BTCs) by producing longer tails and thereby increasing their skewness. In terms of ecological effects, this retention increases the contact time of solute with aquatic interfaces and living species, which can lead to degradation of eco-systems when the transported substances are pollutants. An important question that arises is whether the currently available metrics can adequately represent complex retention processes. In this study, we examine the performance of two existing metrics: the hydrological retention factor (R H ) and the fraction of median travel time due to transient storage (F med ). The results presented are based on two conservative tracer tests. The tracer tests were performed in streams with distinct morphological, sediment composition, vegetation and hydraulic characteristics. The recorded concentration-time series were used to derive storage zone parameters such as storage zone area, exchange coefficient and mean residence time. The storage zone parameters were computed using a multiple storage zone model STIR with two separate exponential residence time models for transient storage, representing short timescale (STS) and long timescale storage (LTS) processes. The retention metrics were estimated separately for short and long timescale retention, and for the combined retention. The cross-correlation between the retention metrics and the storage parameters was analyzed using Pearson’s R- and significance p-values. In general, the results reveal a poor correlation between retention metrics and storage zone parameters, except for the exchange rate associated with long timescale storage, α 2. A strong cross-correlation is instead found between the retention metrics.

The invention describes augmented reality glasses (1) for medical applications configured to be worn by a user, comprising a frame (15) that supports a glasses lens (2a, 2b), wherein the frame (15) comprises an RGB lighting system comprising RGB- emitting devices (16a, 16b, 16c) configured to emit light beams (Bl, B2, B3); first optical systems (17a, 17b, 17c) configured to collimate at least par tially said beams (Bl, B2, B3) into collimated beams (Blc; B2c; B3c); wherein the frame (15) further comprises a dis play (3) configured to be illuminated by the RGB lighting system (16) by means of the collimated beams (Blc; B2c; B3c); to receive first images (I) from a first processing unit (10); to emit the first images (I) as second images (IE1) to wards the glasses lens (2a,2b), wherein the lens (2a, 2b) is configured to reflect the second images (IE1) coming from the display (3) as images projected (IP) towards an internal zone (51 ) of the glasses corresponding to an eye position zone of the user who is wearing the glasses in a configura tion for use of the glasses. The invention moreover describes an augmented reality system for medical applications on a user comprising the augmented reality glasses (1) of the in vention, biomedical instrumentation (100) configured t o d e tect biomedical and/or therapeutic and/or diagnostic data of a user and to generate first data (Dl) representative of opera tional parameters (OP_S) associated with the user, transmit ting means (101) configured to transmit the first data (Dl) to the glasses (1); wherein the glasses (1) comprise a first pro cessing unit (10) equipped with a receiving module (102) configured to receive the first data (Dl) comprising the oper ational parameters (OP_S) associated with the user.

A complete understanding of the role of grain-scale particle-flow interaction in sediment entrainment and transport has still not\ud been achieved in spite of recent technological advancement in measurement capabilities. In this study, the initial motion of natural sediment\ud particles in a gravel deposit was detected and combined with simultaneous local measurements of the velocities on a horizontal plane located\ud above the bed surface using a three-component stereoscopic PIV. A series of experimental tests with increasing low values of boundary shear\ud stress were conducted. The acquisition system allowed coupling between streamwise and vertical near-bed velocity and the entrainment of\ud more than 900 individual grains. Initial analysis agreed with previous observations on the predominance of sweeps (Quadrant IV), and to a\ud lesser extent, of outward interactions (Quadrant I) in entraining gravel particles. However, the latter were found to move sediments just as\ud efficiently as sweeps impacting on particles that had long periods of rest and so were exhibiting higher levels of stability. This behavior\ud suggests that sweep-induced lift based on Bernoulli’s principle does not entirely explain the generation of vertical forces on highly stable bed\ud particles. Closer inspection of the data revealed that many entrainments were correlated to occasions when stable bed grains interacted with\ud grains travelling in their close vicinity. Approximately 30% of the entrained population was observed to initiate motion in this type of\ud situation. For this subsample of entrainment events, outward interactions were found to be comparatively more effective than for the noninterference\ud case, whereas the relative contribution of sweeps exhibited an opposite trend.

Objective To compare clinical evaluation, transvaginal sonography (TVS), saline contrast sonovaginography (SCSV) and magnetic resonance imaging (MRI) in the diagnosis of posterior deep pelvic endometriosis (DPE). Methods Women suspected of having posterior DPE on the basis of subjective symptoms and clinical evaluation underwent digital vaginal and rectal examination, TVS, SCSV and MRI. Laparoscopy was performed and specimens were sent for histological examination. Sensitivity, specificity, positive and negative predictive value, as well as positive and negative likelihood ratios were analyzed for each diagnostic method. Results Fifty-four out of 102 women suspected of having posterior DPE underwent laparoscopic surgery. Among these, in 46 (85.2%) cases DPE was confirmed at laparoscopic and histological examination. SCSV correctly identified 43 (93.5%) cases, presenting higher accuracy than did the other procedures. SCSV and MRI were more accurate in diagnosing and discriminating between the different locations of endometriotic lesions, with respective sensitivities of 94.7 and 73.1% for vaginal fornix, 88.9 and 66.7% for the uterosacral ligaments and 80.6 and 83.3% for involvement of the rectovaginal septum. The specificity of SCSV and MRI, respectively, was 97.1 and 94.3% for vaginal fornix, 95.6 and 95.6% for uterosacral ligaments and 100 and 77.8% for involvement of the rectovaginal septum. In the diagnosis of rectal endometriosis, we found a sensitivity of 66.7% for both techniques and specificity of 93.8% for SCSV and 95.8% for MRI. Conclusion TVS should be used as the first-line diagnostic technique and SCSV and/or MRI as second-line methods in the diagnosis of posterior DPE. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

SUMMARY Idiopathic carotidynia or Fay syndrome is a little known pathology, which in the past was the subject of much controversy. Even though carotydinia was removed as a pathological entity from the second International Headache Society classification in 2004, recent reports seem to confirm that the disease demonstrates unusual radiological findings. The presence of a typical amorphous enhancing soft tissue surrounding the carotid artery by MRI, CT and ultrasonography in patients with carotidynia has reopened discussion on the hypothesis that carotidynia may represent a distinctive inflammatory process. The aetiology of carotidynia is unknown. We report a case of carotidynia that developed after an upper airway infection, wherein MR studies demonstrated typical enhanced tissue surrounding the common carotid artery in contiguity with pathological enhancement in laryngeal tissue.

Objective To assess antibody persistence after vaccination with a new, fully liquid, hexavalent DTaP-IPV-Hep B-PRP-T vaccine at 18 months of age versus licensed DTaP-IPV//PRP-T and hepatitis B (Hep B) vaccines, and to assess the immunogenicity and safety of a subsequent DTaP-IPV//PRP-T booster. Methods A phase III, open-label, single-center study was conducted. Infants previously primed with 3 doses of DTaP-IPV-Hep B-PRP-T (Hexaxim: N = 232 [group 1]) or DTaP-IPV//PRP-T and hepatitis B vaccine (Pentaxim + Engerix B Pediatrico: N = 226 [group 2]) at 2, 4, and 6 months of age received a DTaP-IPV//PRP-T booster at 18 months of age. Antibodies were measured before and 1 month after booster vaccination. Safety was evaluated from parental reports. Analyses were descriptive. Results Antibody persistence was high and similar in each group for each antigen except for Hep B, for which the percentage (95% confidence interval) of participants with a titer of ≥ 10 mIU/mL was higher in group 2 (99.5% [97.5%, 100.0%]) than in group 1 (85.5% [80.3%, 89.8%]). Postbooster seroprotection (diphtheria, tetanus, inactivated poliovirus, polyribosyl-ribitol phosphate) and serconversion (pertussis toxoid, filamentous hemagglutinin) rates were high and similar in each group, and geometric mean antibody concentrations increased markedly in both groups. Safety after the booster vaccination was good and independent of the primary-series vaccine, although one serious adverse event of convulsions was considered to be vaccine related. Conclusions The DTaP-IPV/PRP-T booster vaccination at 18 months of age was similarly immunogenic and well tolerated after primary-series vaccination with either the investigational hexavalent vaccine or the reference pentavalent vaccine. This confirms the suitability of a booster vaccination of DTaP-IPV//PRP-T after a primary series of the new DTaP-IPV-Hep B-PRP-T vaccine.

In this paper a modelling approach is presented to predict local scour under time varying flow conditions. The approach is validated using experimental data of unsteady scour at bed sills. The mode ...

Solute transport in rivers is controlled by surface hydrodynamics and by mass exchanges with distinct retention zones. Surface and hyporheic retention processes can be accounted for separately in solute transport models with multiple storage compartments. In the simplest two component model, short term storage can be associated to in-channel transient retention, e.g. produced by riparian vegetation or surface dead zones, and the long-term storage can be associated to hyporheic exchange. The STIR (Solute Transport In Rivers) multiple domain transport model is applied here to tracer test data from three very different Mediterranean streams with distinctive characteristics in terms of flow discharge, vegetation and substrate material. The model is used with an exponential residence time distribution (RTD) to represent surface storage processes and two distinct modeling closures are tested to simulate hyporheic retention: a second exponential RTD and a power-law distribution approximating a known solution for bedform-induced hyporheic exchange. Each stream shows distinct retention patterns characterized by different timescales of the storage time distribution. Both modeling closures lead to very good approximations of the observed breakthrough curves in the two rivers with permeable bed exposed to the flow, where hyporheic flows are expected to occur. In the one case where the occurrence of hyporheic flows is inhibited by bottom vegetation, only the two exponential RTD model is acceptable and the time scales of the two components are of the same magnitude. The significant finding of this work is the recognition of a strong signature of the river properties on tracer data and the evidence of the ability of multiple-component models to describe individual stream responses. This evidence may open a new perspective in river contamination studies, where rivers could possibly be classified based on their ability to trap and release pollutants.

The effect of the flood recession time on the local scour depth at bed sills in gravel deposits is examined. Experiments were carried out to study the development of scour holes under time-varying hydraulic conditions with no upstream sediment feed. Triangular-shaped hydrographs, having recession times up to three times the duration of the rising limb, were used. Traditionally, the peak water discharge in any flood event is used as a design value in estimating the final depth of scour formed by a flood. This approach is overly conservative when the flow hydrograph is steep, i.e., during the occurrence of flash floods. The actual reduction of the scour depth from this estimated value is dependent on both the characteristics of the flood event and the characteristics of the stream. The results show that the maximum potential scour depth can be achieved only for hydrographs with long recession times, while the rate of this process can be estimated as a function of the ratio between a characteristic flood time and the steady-state temporal scale of scour development. A method is proposed for the prediction of the scouring process under unsteady flows in terms of two dimensionless temporal parameters. Results obtained for clear-water boundary conditions can be extended to sediment-supply tests if specific supply input conditions hold.

Erythrocytic glutathione-peroxidase (GSH-Px) activity and plasma selenium concentrations were measured in 14 patients: 7 with iron deficiency and 7 with raised serum iron levels. The decreased enzymatic activity in iron deficiency was confirmed. Plasma selenium was significantly lower in patients with lower serum iron; furthermore there is a significant correlation between serum iron and plasma selenium concentrations. Another correlation even more significant was found between plasma selenium and enzyme activity in all the cases we studied. These data suggests that the importance of iron for GSH-Px activity may be merely due to its relationship with selenium and that plasma selenium concentration may be of critical importance for enzyme activity.