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From 1977 through April 2019, USDA published monthly season‐average price (SAP) forecasts for key agricultural commodities in the form of intervals meant to indicate forecasters' uncertainty but without attaching a confidence level. In May 2019, USDA eliminated the intervals and began publishing a single point estimate—a value that has a very low probability of being realized. We demonstrate how a density forecasting format can improve the usefulness of USDA price forecasts and explain how such a methodology can be implemented. We simulate 21 years of out‐of‐sample density‐based SAP forecasts using historical data, with forward‐looking, backward‐looking, and composite methods, and we evaluate them based on commonly‐accepted criteria. Each of these approaches would offer USDA the ability to portray richer and more accurate price forecasts than its old intervals or its current single point estimates. Backward‐looking methods require little data and provide significant improvements. For commodities with active derivatives markets, option‐implied volatilities (IVs) can be used to generate forward‐looking and composite models that reflect (and adjust dynamically to) market sentiment about uncertainty—a feature that is not possible using backward‐looking data alone. At certain forecast steps, a composite method that combines forward‐ and backward‐looking information provides useful information regarding farm‐level prices beyond that contained in IVs.

Our research focused on the role of vision and proprioception in modulating a defensive reflex (hand blink reflex, HBR) whose magnitude is enhanced when the threatened hand is inside the peripersonal space of the face. We capitalized on virtual reality, which allows dissociating vision and proprioception by presenting a virtual limb in congruent/incongruent positions with respect to the participants' limb. In experiment 1, participants placed their own stimulated hand in far/near positions with respect to their face (postural manipulation task), while observing a virtual empty scenario. Vision was not informative, but the HBR was significantly enhanced in near compared with far position, suggesting that proprioception is sufficient for the HBR modulation to occur. In experiment 2, participants did not perform the postural manipulation but they (passively) observed the avatar's virtual limb performing it. Proprioceptive signals were not informative, but the HBR was significantly enhanced when the observed virtual limb was near to the face, suggesting that visual information plays a role in modulating the HBR. In experiment 3, both participants and avatar performed the postural manipulation, either congruently (both of them far/near) or incongruently (one of them far, the other near). The HBR modulation was present only in congruent conditions. In incongruent conditions, the conflict between vision and proprioception confounded the system, abolishing the difference between far and near positions. Taken together, these findings promote the view that observing a virtual limb modulates the HBR, providing also new evidence on the role of vision and proprioception in modulating this subcortical reflex.

The study investigates the role of dorsal premotor cortex (PMd) in generating predicted sensory consequences of movements, i.e. corollary discharges. In 2 different sessions, we disrupted PMd and parietal hand’s multisensory integration site (control area) with transcranial magnetic stimulation (TMS) during a finger-sequence-tapping motor task. In this TMS sham-controlled design, the task was performed with normal sensory feedback and during upper-limb ischemic nerve block (INB), in a time-window where participants moved without somatosensation. Errors and movement timing (objective measures) and ratings about movement perception (subjective measures) were collected. We found that INB overall worsens objective and subjective measures, but crucially in the PMd session, the absence of somatosensation together with TMS disruption induced more errors, less synchronized movements, and increased subjective difficulty ratings as compared with the parietal control session (despite a carryover effect between real and sham stimulation to be addressed in future studies). Contrarily, after parietal area interference session, when sensory information is already missing due to INB, motor performance was not aggravated. Altogether these findings suggest that the loss of actual (through INB) and predicted (through PMd disruption) somatosensory feedback degraded motor performance and perception, highlighting the crucial role of PMd in generating corollary discharge.

The present article aims to highlight the importance of changes of personalized surgical treatment for vulvar cancer. Current international literature regarding surgical treatment of vulvar cancer was evaluated. This included several studies and systematic reviews. Radical surgery approach, such as en bloc resection, was the first therapeutic option and the standard care for many years, even if burdened with a high complication rate and frequently disfiguring. Taussing and Way introduced radical vulvectomy approach with en bloc bilateral inguinal-femoral lymphadenectomy; modified radical vulvectomy was developed, with a wide radical excision of the primary tumor. The role of inguinofemoral lymphadenectomy (mono or bilateral) changed in the years too, particularly with the advent of SLN biopsy as minimally invasive surgical approach for lymph node staging, in patients with unifocal cancer4 cm, without suspicious groin nodes. More personalized and conservative surgical approach, consisting of wide local or wide radical excisions, is necessary to reduce complications as lymphedema or sexual disfunction. The optimal surgical management of vulvar cancer needs to consider dimensions, staging, depth of invasion, presence of carcinoma at the surgical margins of resection and grading, with the goal of making the treatment as individualized as possible.

Introduction/Background* Endometrial cancer (EC) patients have a good prognosis at early stages, but for recurrent or metastatic EC the prognosis remains poor. EC treatments are related to known prognostic factors included in ESMO-ESGO-ESTRO risk classes classification, but they are not sufficient to predict outcomes or recurrence rate of early stages. To improve patient clinical management and allow personalized therapy a better characterization of risk classes in EC is needed. To fill this gap, we investigated EC immune escape processes, customized on the knowledge of maternal-fetal interface immune mechanisms, since the two processes share common pathways. Methodology This has been addressed by the identification of potential shared immune-based signatures between maternal-fetal interface and EC, such as those linked to lectin-type oxidized LDL receptor 1 (LOX-1) and NALP3 inflammasome, in order to achieve a potential immune score implementation to better characterize EC risk classes. The immunohistochemical assessment of LOX-1 and NALP3 was performed on formalin-fixed paraffin-embedded (FFPE) endometrial tissues. Result(s)* 41 patients divided in 3 groups were enrolled: healthy endometrial tissue, endometrial hyperplasia and EC. We detected an increased expression of LOX-1, by immunohistochemistry (IHC), within the endometrial carcinoma tissues, a lower expression in cases of hyperplasia, to arrive to an absent staining in the healthy endometrial tissue (*p Conclusion* An increased LOX-1 and a decreased NALP3 expression seems be associated with EC progression. To identify patients at risk of developing EC from pre-cancerous lesions, by searching potential immune prognostic factors, such as LOX-1 and NALP3 on endometrial biopsy, could re-defy the actual EC risk classes through a potential ’immune score’ creation. Nevertheless, further studies are needed to define EC transcriptome immune-based signature. Furthermore, pathways detected by deciphering the immune changes linked to EC progression, could be potential target for immunotherapy.

The brain mechanisms underlying the emergence of a normal sense of body ownership can be investigated starting from pathological conditions in which body awareness is selectively impaired. Here, we focused on pathological embodiment, a body ownership disturbance observed in brain-damaged patients who misidentify other people’s limbs as their own. We investigated whether such body ownership disturbance can be classified as a disconnection syndrome, using three different approaches based on diffusion tensor imaging: (i) reconstruction of disconnectome maps in a large sample (N = 70) of stroke patients with and without pathological embodiment; (ii) probabilistic tractography, performed on the age-matched healthy controls (N = 16), to trace cortical connections potentially interrupted in patients with pathological embodiment and spared in patients without this pathological condition; (iii) probabilistic ‘in vivo’ tractography on two patients without and one patient with pathological embodiment. The converging results revealed the arcuate fasciculus and the third branch of the superior longitudinal fasciculus as mainly involved fibre tracts in patients showing pathological embodiment, suggesting that this condition could be related to the disconnection between frontal, parietal and temporal areas. This evidence raises the possibility of a ventral self-body recognition route including regions where visual (computed in occipito-temporal areas) and sensorimotor (stored in premotor and parietal areas) body representations are integrated, giving rise to a normal sense of body ownership.

Exchange rate fluctuations could influence economic activity not only via the standard trade channel, but also through a financial channel, which operates through the impact of exchange rate fluctuations on borrowers’ balance sheets and lenders’ risk-taking capacity. This paper explores the “triangular” relationship between (1) the strength of the US dollar, (2) cross-border bank flows and (3) real investment. We conduct two sets of empirical exercises—a macro (country-level) study and a micro (firm-level) study. We find that a stronger dollar is associated with lower growth in dollar-denominated cross-border bank flows and lower real investment in emerging market economies. An important policy implication of our findings is that a stronger US dollar has real macroeconomic effects that go in the opposite direction to the standard trade channel.

Giant cell tumors (GTC) of bone are benign, locally aggressive tumors generally occurring in young people with a female predominance during reproductive age. Considering their worsening during pregnancy it has been suggested that pregnancy can accelerate GCT progression or favor recurrence but correlation between tumor growth and pregnancy has not yet been clarified. Aim of this study was to clarify clinical characteristics, timing and type of treatment through a literature review on GTCs occurring during pregnancy.An electronic search was performed in December 2020 in PubMed, Scopus, Embase, Medline, Cochrane Register using the keywords "giant cell tumor" AND "pregnancy" looking for papers reporting cases of giant cell tumors of the bone onset or recurred during pregnancy. The electronic search identified 212 papers; sixteen studies were selected, for a total of 32 cases.The diagnosis was made during pregnancy in 24 cases and after the partum in 8 cases. 27 cases were new diagnoses while 5 cases were recurrences. Pulmonary metastases were reported in 3 patients. The treatment was performed during the pregnancy in 7 out of 32 cases; in the remaining 27 cases treatment was performed after delivery. The hormone receptor status was reported in 14 patients. Data regarding follow-up was reported for 26 out of 32 patients; three patients had local recurrences that were treated with wide resection and amputation in 2 and 1 case, respectively; at the last follow-up all patients were apparently without any evidence of disease except for three patients who had stable lung metastases.In case of GCT during pregnancy, a multidisciplinary approach is necessary to offer the patients the best treatment in terms of mother and child's health. A correct diagnosis is necessary and not confusing tumor symptoms with ones of pregnancy is mandatory in order not to delay the diagnosis and let the tumor progress. Actually, even though pregnancy would seem to promote GCT growth and aggressiveness, the relationship is not clear. More studies are necessary to clarify this interesting aspect.IV, systematic review.

Breast reconstruction plays a fundamental role in the therapeutic process of breast cancer treatment and breast implants represents the leading breast reconstruction strategy. Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), locoregional recurrence in the skin flap, and skin flap necrosis are well-known complications following mastectomy and immediate breast reconstruction (IBR). We report a case of locoregional cancer recurrence in the mastectomy flap mimicking BIA-ALCL, in a patient who underwent 6 breast procedures in four facilities across 15 years including immediate breast reconstruction with macrotextured breast implants. Despite the rate and onset of the disease, clinicians should be aware of BIA-ALCL. Due to the risk of false negative results of fine needle aspiration, clinical suspicion of BIA-ALCL should drive clinicians' choices, aside from cytological results. In the present case, surgical capsulectomy of the abnormal periprosthesic tissue revealed locoregional recurrence.

The ability to identify our own body and its boundaries is crucial for survival. Ideally, the sooner we learn to discriminate external stimuli occurring close to our body from those occurring far from it, the better (and safer) we may interact with the sensory environment. However, when this mechanism emerges within ontogeny is unknown. Is it something acquired throughout infancy, or is it already present soon after birth? The presence of a spatial modulation of multisensory integration (MSI) is considered a hallmark of a functioning representation of the body position in space. Here, we investigated whether MSI is present and spatially organized in 18- to 92-h-old newborns. We compared electrophysiological responses to tactile stimulation when concurrent auditory events were delivered close to, as opposed to far from, the body in healthy newborns and in a control group of adult participants. In accordance with previous studies, adult controls showed a clear spatial modulation of MSI, with greater superadditive responses for multisensory stimuli close to the body. In newborns, we demonstrated the presence of a genuine electrophysiological pattern of MSI, with older newborns showing a larger MSI effect. Importantly, as for adults, multisensory superadditive responses were modulated by the proximity to the body. This finding may represent the electrophysiological mechanism responsible for a primitive coding of bodily self boundaries, thus suggesting that even just a few hours after birth, human newborns identify their own body as a distinct entity from the environment.

Purpose The lateral elbow musculature conveys a dynamic valgus moment to the elbow, increasing joint stability. Muscular or tendinous lesions to the anterior half of the common extensor origin (CEO) may provoke a deficiency in the elbow dynamic stabilizers, regardless of their traumatic, degenerative, or iatrogenic aetiology. Furthermore, a role for the radial band of the lateral collateral ligament (R-LCL) has been postulated in the aetiology of lateral elbow pain. This study aimed to evaluate the effects of sequential lateral releases with dynamic ultrasound, evaluating its capability to detect lesions of the CEO and of the R-LCL. Methods Ultrasound investigation of the lateral compartment of the elbow was performed on nine cadaveric specimens with a 10 MHz linear probe in basal conditions, after the release of the anterior half of the CEO and after complete R-LCL release. The lateral joint line widening (λ) was the primary outcome parameter, measured as the linear distance between the humeral and radial articular surfaces. Results The release of the anterior half of the CEO significantly increased λ by 200% compared to the starting position (p = 0.0008) and the previously loaded position (p = 0.0015). Conversely, further release of the R-LCL caused only a marginal, non-significant increase in λ. Conclusions Ultrasound evaluation can detect changes related to tendon tears or muscular avulsions of the CEO and can depict lateral elbow compartmental patholaxity by assessing articular space widening while scanning under dynamic stress. However, it cannot reliably define if the R-LCL is injured. Iatrogenic damage to the CEO should be carefully avoided, since it causes a massive increase in compartmental laxity.

The 2018 December 26th earthquake (MW = 4.9) at the south-eastern slope of Mt. Etna provides new insights for improving the knowledge of the kinematics of the eastern flank of the volcano. The earthquake was preceded by a seismic swarm on the upper southern-western sector of the volcano and by a short eruptive event in the summit area. The associated crustal deformation triggered seismic reactivation of tectonic structures in the eastern flank of the volcano. The seismogenic source has been localized along one of the segments cutting the south-eastern slope the volcanic edifice, the NW-SE trending Fiandaca Fault, one of the most active shear zone belonging to the upslope extension of the Timpe fault system. In the last centuries, all these faults have been the source of very shallow, low magnitude, but destructive earthquakes. In order to determine the response of the unstable eastern flank of Mt. Etna to the volcano-tectonic events, we applied a multidisciplinary approach based on: i) analysis of historical and instrumental seismicity; ii) mapping of coseismic fracturing, iii) analysis of GPS and InSAR data. This study allows to better define the seismotectonic framework of the shear zone occurring in the eastern flank of Mt. Etna, framing it in the seismogenic belt extending as far as the Ionian offshore.

The financial channel of exchange rates operates through changes in risk-taking by investors and is reflected in the response of financial conditions to exchange rate movements. We show that stock returns also reflect the financial channel of exchange rates, with higher local currency stock returns associated with a weaker dollar. The broad dollar index emerges as a global factor, consistent with the financial channel operating through swings in risk-taking by global investors. We introduce the ‘dollar beta’ as the sensitivity of stock returns to swings in the broad dollar index and show that emerging market stock indices that have a higher dollar beta tend to have higher average returns, implying that the dollar beta is a cross-section risk factor that is priced.

Simple Summary In assessing the risk factors for the recurrence of EC, the length of the vaginal cuff removed during surgery has shown discrepant results. The aim of this study was to investigate the role of the excised vaginal cuff length as a prognostic factor and its correlation with the expression of L1CAM. To our knowledge, this is the first study evaluating this prognostic factor in such a secluded and tidy cohort. According to our results, vaginal cuff length does not seem to be an independent variable in an EC low-risk group in terms of DFS. Moreover, L1CAM seems to be associated with a higher risk of distant recurrence. A prospective randomized trial in an EC low-risk group is needed to confirm its negative prognostic role, and to determine its potential value in clinical practice to detect that subgroup of low-risk patients which is at a higher risk of recurrence, especially at distant. Abstract Objective: The aim of our study was to investigate the role of the excised vaginal cuff length as a prognostic factor in terms of DFS and recurrence rate/site, in low-risk endometrial cancer (EC) patients. Moreover, we correlated the recurrence with the expression of L1CAM. Material and Methods: From March 2001 to November 2016, a retrospective data collection was conducted of women undergoing surgical treatment for low-risk EC according to ESMO-ESGO-ESTRO consensus guidelines. Patients were divided into three groups according to their vaginal cuff length: V0 without vaginal cuff, V1 with a vaginal cuff shorter than 1.5 cm and V2 with a vaginal cuff longer than or equal to 1.5 cm. Results: 344 patients were included in the study: 100 in the V0 group, 179 in the V1 group and 65 in the V2 group. The total recurrence rate was 6.1%: the number of patients with recurrence was 8 (8%), 10 (5.6%) and 3 (4.6%), in the V0, V1 and V2 group, respectively. No statistically significant difference was found in the recurrence rate among the three groups. Although the DFS was higher in the V2 group, the result was not significant. L1CAM was positive in 71.4% of recurrences and in 82% of the distant recurrences. Conclusions: The rate of recurrence in patients with EC at low risk of recurrence does not decrease as the length of the vaginal cuff removed increases. Furthermore, the size of the removed vaginal cuff does not affect either the site of recurrence or the likelihood of survival.

We explore the relationship between portfolio flows and financial conditions by using a unique and comprehensive database of US investor flows into emerging market government bonds. We find that mutual funds display a more procyclical pattern of flows relative to other investor types. Delving into the dynamics of portfolio flows at monthly frequency reveals that dollar appreciation amplifies the sell-off in EM local currency bonds, but not dollar-denominated bonds, possibly reflecting clientele effects of stickier investors toward dollar-denominated bonds. Our findings underscore how borrowing in domestic currency has not insulated emerging markets from fluctuations in global financial conditions.

During the rubber hand illusion (RHI), the synchronous stroking of the participants’ concealed hand and a visible rubber hand induces a conflict among visuo-tactile inputs, leading healthy subjects to perceive the illusion of being touched on the rubber hand, as if it were part of their body. The predictive coding theory suggests that the RHI emerges to settle the conflict, attenuating somatosensory inputs in favour of visual ones, which “capture” tactile sensations. Here, we employed the psychophysical measure of perceptual threshold to measure a behavioural correlate of the somatosensory and visual modulations, to better understand the mechanisms underpinning the illusion. Before and after the RHI, participants underwent a tactile (Experiment 1) and a visual (Experiment 2) task, wherein they had to detect stimuli slightly above the perceptual threshold. According to the predictive coding framework, we found a significant decrease of tactile detection (i.e. increased tactile perceptual threshold) and a significant increase of visual detection (i.e. decreased visual perceptual threshold), suggesting a diametrical modulation of somatosensory and visual perceptual processes. These findings provide evidence of how our system plastically adapts to uncertainty, attributing different weights to sensory inputs to restore a coherent representation of the own body.

Highlights • Superficial myofibroblastoma of the Labia Majora. • Differential diagnosis between vulvar superficial myofibroblastoma and cyst/hydrocele of Nuck duct. • Differential diagnosis between vulvar superficial myofibroblastoma and inguinal/crural hernia.

Introduction The aim of this study is to revise the experience of two reference centers for vulvar cancer treatment during the last 2 years, evaluating the ECT procedure in terms of clinical outcome and side effects profile. Methods Data were retrospectively collected from November 2017 to November 2019 in two Italian oncologic Institutes: Regina Elena Institute and Fondazione Policlinico Universitario Agostino Gemelli. ECT was offered in a palliative setting to patients with a primary or recurrent vulvar cancer diagnosis unsuitable for surgery or any other treatment, because of poor performance status or previous delivered treatments. All patients underwent general anaesthesia. Intravenous Bleomycin was administered. Follow-up examinations were performed at 1, 3 and 6 months. Results 15 patients were included in the study. No intra-procedure complications occurred. 1 patient had pneumonia during post-operative stay. 1-month overall response rate (2 CR and 10 PR) was 80%. At 3-month follow-up, 3 patients (20%) showed PD, 3 patients (20%) died from the ongoing disease, 1 patients (6.7%) died for other reasons, whereas the other patients maintained their 1-month clinical response. 8 out of 13 patients (61.5%) were alive at 6-month follow-up, whereas 6 out of 12 patients (50%) were alive at 1-year follow-up. Conclusion ECT has proven to be a feasible, easy to perform, reproducible and repeatable procedure. For these reasons, it may have a role in the management of VC, especially as palliative treatment when other therapies are no longer applicable.

Problem While there are several known causes for recurrent pregnancy loss (RPL), about 50% are unexplained (uRPL), and in these cases, an aberrant immune regulation seems to be involved. Although fetally derived trophoblast cells have a key role in immune regulation, it is difficult to study their immune function during pregnancy, and it is not known whether trophoblast function may be an inherent aberration in uRPL or whether it is associated with the outcome of the current pregnancy. Method of study Chorionic villus sampling (CVS) was performed for clinical indications at 12 weeks of gestation. Superfluous materials, divided in small explants, were cultured for 20-24 hours, and supernatants (conditioned medium) were collected from 36 women with singleton normal pregnancies, of whom 9 women had a history of RPL. The secreted immune protein profile was measured by proximity extension assay, and the conditioned medium was further used in functional ex vivo models to assess ability to polarize blood monocytes and CD4(+)T cells into immune regulatory phenotypes, as detected by flow cytometry. Results Conditioned medium from chorionic villi, human fetally derived placental tissue, was able to induce a decidual-type of M2-like macrophages, as well as an expansion of Treg cells ex vivo, both in women with uRPL and in control women. The preserved immunological properties were confirmed by a maintained immune protein profile in RPL compared with controls. Conclusion Trophoblasts in an ex vivo model maintain tolerogenic and proteomic profile features in successful pregnancies, despite a previous history of RPL. Funding Agencies|Swedish Research CouncilSwedish Research Council [2018-02776]; Linkoping University; Tor Vergata University; ALF Grants

Background/aim Coronavirus disease is spreading worldwide. Due to fast transmission and high fatality rate drastic emergency restrictions were issued. During the lockdown, only urgent medical services are guaranteed. All non-urgent services, as breast cancer (BC) screening, are temporarily suspended. The potential of breast cancer screening programs in increasing the survival rate and decreasing the mortality rate has been widely confirmed. Suspension could lead to worse outcomes for breast cancer patients. Our study aimed to analyse the data and provide estimates regarding the temporary BC screening suspension. Patients and methods Data regarding breast cancer and respective screening programs were achieved through literature research and analysis. Results Considering three different scenarios with respect to the lockdown's impact on breast cancer screening, we estimate that approximately 10,000 patients could have a missed diagnosis during these 3 months. Considering a 6-month period, as suggested by the Imperial college model, the number of patients who will not receive a diagnosis will rise to 16,000. Conclusion Breast cancer screening should be resumed as soon as possible in order to avoid further breast cancer missed diagnosis and reduce the impact of delayed diagnosis.

The ability to identify our own body is considered a pivotal marker of self-awareness. Previous research demonstrated that subjects are more efficient in the recognition of images representing self rather than others' body effectors (self-advantage). Here, we verified whether, at an electrophysiological level, bodily-self recognition modulates change detection responses. In a first EEG experiment (discovery sample), event-related potentials (ERPs) were elicited by a pair of sequentially presented visual stimuli (vS1; vS2), representing either the self-hand or other people's hands. In a second EEG experiment (replicating sample), together with the previously described visual stimuli, also a familiar hand was presented. Participants were asked to decide whether vS2 was identical or different from vS1. Accuracy and response times were collected. In both experiments, results confirmed the presence of the self-advantage: participants responded faster and more accurately when the self-hand was presented. ERP results paralleled behavioral findings. Anytime the self-hand was presented, we observed significant change detection responses, with a larger N270 component for vS2 different rather than identical to vS1. Conversely, when the self-hand was not included, and even in response to the familiar hand in Experiment 2, we did not find any significant modulation of the change detection responses. Overall our findings, showing behavioral self-advantage and the selective modulation of N270 for the self-hand, support the existence of a specific mechanism devoted to bodily-self recognition, likely relying on the multimodal (visual and sensorimotor) dimension of the bodily-self representation. We propose that such a multimodal self-representation may activate the salience network, boosting change detection effects specifically for the self-hand.

Surgery in suspected/confirmed COVID-19 patients is a high-risk venture. In infected patients, COVID-19 is present in the body cavity. During surgery it could be nebulized in the spray generated by surgical instruments and could theoretically infect members of the surgical team. Nevertheless, some surgical gynecologic pathologies cannot be postponed. We present a list of the most frequent gynecologic diseases and recommendations on their surgical management during the COVID-19 pandemic, based on expert opinion, current available information, and international scientific society recommendations to support the work of gynecologists worldwide. In brief, any kind of surgical treatment should be scrutinized and postponed if possible. Nonoperative conservative treatment including pharmacological therapies for hormone-sensitive pathologies should be implemented. Health risk assessment by patient history and COVID-19 test before elective surgery are pivotal to protect both patients and healthcare providers. In confirmed COVID-19 patients or highly suspected cases, elective surgery should be postponed until full recovery.

Volcano ground deformations needs hardware and software tools of high complexity related to the processing of raw GNSS data, filtering of outliers and spikes and clear visualization of displacements occurring in real time. In this project we developed a web application for high rate real time signals visualization from permanent GNSS remote stations managed by INGV OE (Istituto Nazionale di Geofisica e Vulcanologia, Osservatorio Etneo). Currently the new software tool is able to import GNSS data processed by some of the most important high rate real time software like GeoRTD® (owned by Geodetics), GNSS Spider® (Owned by Leica Geosystems) and RTKlib. The tool is based on the Grafana open source platform and InfluxDB open source database. Various dashboards have been configured to display time series of the North-East-Up coordinates to monitor single stations, to compare signals coming from different data sources and to display the displacement vectors on the map. We also applied a simple alghoritm for the detection of abnormal variations due to impending volcanic activity.This web interface is applied to different active Italian volcanoes as Etna (Sicily), Stromboli (Aeolian Islands) and Phlegrean Fields (Naples). We tested the performance of this software using as a case study the 24th December 2018 dike intrusion on the Etna volcano.

Since 2000 an intense development of remote stations, transmission device, data processing software and tools for time series analysis aimed to high rate GNSS surveillance and monitoring of active Italian volcanoes has been realized or implemented at INGV. Since the very first case study (the 2001 Mt.Etna’s eruption) to the 2019 paroxysms of Stromboli, many observations and a lot of specific experience has been achieved on Italian active volcanoes (Etna, Stromboli) to track rapidly developing deformation patterns associated to different volcanic processes, as dike intrusions or explosive activity. Moreover, we here describe the hardware and software improvements for High Rate GNSS monitoring network with a specific attention to the recently realized network in the densely populated area of the Campi Flegrei caldera.

Objective: The objective of this study is to assess whether the subpubic arch angle (SPA) changes throughout pregnancy. Materials and Methods: We recruited a group of nulliparous women in the first trimester of pregnancy. Each woman was assessed 3 times throughout pregnancy, once per each trimester, by measuring SPA using a recently described highly reproducible three-dimensional transperineal ultrasound (linear reconstruction with contrast enhancement technique; OmniView-volume contrast imaging). Repeated measures analysis of variance was used to study SPA changes during pregnancy. Results: Overall, 97 women were included in the final analysis. SPA increased progressively and significantly (F = 27.824, p < 0.001) from the first to the second trimester (121.8 ± 8.7 vs. 123.5 ± 8.4°, p = 0.01) and from the second to the third trimester (123.5 ± 8.4 vs. 125.3 ± 8.1°, p = 0.01). Conclusion: SPA width increases progressively but slightly during pregnancy. Although this finding is interesting, the extremely small difference detected is unlikely to be clinically significant.

In the last few decades, the use of GNSS Continuously Operating Reference Station (CORS) networks allowed improving the accuracy of real-time positioning and post-processing positioning. In this way, several applications have been performed including remote sensing, agriculture, cultural heritage and geodynamics studies. The latter have been developed analysing CORS time-series and consistent data over long periods were needed to validate the results. In Italy, specifically in Sicily, two CORS networks were be used to monitor the geodynamics motions: the Istituto Nazionale di Geofisica e Vulcanologia (INGV) GNSS CORS network in the eastern part and the University of Palermo (UNIPA) GNSS CORS network in the western part. In this research, preliminary results of time series about geodynamics motions of the western part of Sicily have been presented. In particular, the time series of the UNIPA GNSS CORS network have been analyzed over time by using the static positioning, over a period of approximately 5 years. Results showed a linear trend for all CORS time series, according to literature. An innovative methodology, the static Precise Point Positioning (PPP) has been also tested, to determine the time series of one CORS and compare the results with the static solution. The comparison between the two methodologies (static and PPP) demonstrated the capabilities of PPP technique with benefits in terms of costs and time.

The strength of the US dollar has attributes of a barometer of dollar credit conditions, whereby a stronger dollar is associated with tighter dollar credit conditions. Using finely disaggregated data on export shipments, we examine how dollar strength impacts exports through the availability of dollar financing for working capital - an issue of importance due to the greater working capital needs for exports arising from longer supply chains and greater delay in receiving payments. We find that exporters who are reliant on dollar-funded bank credit suffer a decline in exports, and that this decline is larger than any decline in domestic sales. Our findings shed light on the broad dollar index as a global financial factor with real effects on the economy.

ObjectiveSince vulvar cancer is such a rare disease, the international experience with electrochemotherapy has been derived from only a few centers. The aim of this study was to evaluate clinical outcome and side effects profile with the use of electrochemotherapy in patients with primary or recurrent vulvar cancer.MethodsData were retrospectively collected from November 2017 to November 2019 in two major Italian oncologic institutes: Regina Elena Institute and Fondazione Policlinico Universitario Agostino Gemelli IRCCS. Electrochemotherapy was offered in a palliative setting to patients with a primary or recurrent vulvar cancer who were not candidates for surgery or any other treatment, because of poor performance status or previous delivered treatments. All patients underwent general anesthesia. Electrical pulses were delivered using a pulse generator. Intravenous bleomycin was administered in conjunction with electrochemotherapy. Follow-up examinations were performed at 1, 3, and 6 months. Primary endpoint was to assess the response rate of electrochemotherapy as palliative treatment in patients with vulvar cancer.ResultsA total of 15 patients were included in the study. Fourteen patients (93.3%) had a squamous cell carcinoma and one patient had vulvar carcinosarcoma. Ten patients (66.7 %) had a single lesion and 5 patients (33.3%) had multiple lesions. Median number of electrical pulses was 22 (range 3–42) and median operative time was 13 (range 7–20) min. No intra-procedure complications occurred. One patient had pneumonia during their post-operative stay. Overall response rate after 1 month was 80%. At the 3-month follow-up, 3 patients (20%) had disease progression, 3 patients (20%) had died from ongoing disease, 1 patient (6.7%) died for other reasons, whereas the other patients maintained their 1-month clinical response. A total of 8/13 patients (61.5%) were alive at 6-month follow-up, whereas 6/12 patients (50%) were alive at 1-year follow-up.ConclusionsElectrochemotherapy is a feasible, easy to perform, and reproducible procedure in patients with primary or recurrent vulvar cancer who are unable to undergo surgery. Survival after 1 year in this population was 50%. Electrochemotherapy may have a role in the management of vulvar cancer, especially as palliative treatment when other therapies are no longer applicable.

When body ownership is impaired after brain-damage, the capacity to discriminate between one's own and others' body-parts is lost. Delusional body-ownership has been recently described in patients who misidentify someone else's limb as their own (pathological embodiment) whenever it is positioned in a body congruent position. This delusion can be frequently associated with somatosensory and attentional deficits. Here, we leveraged the phenomenon of tactile extinction, as this clinical sign can be substantially ameliorated when contralesional touches are combined with proximal visual stimulation. Is body ownership a necessary prerequisite to modulate cross-modal processing and thus reducing tactile extinction? Fourteen patients with tactile extinction (TE+) took part in the study: eight of them with pathological embodiment (E+, experimental group) and six of them without pathological embodiment (E-, control group). In two different paradigms, differing for the nature of visuo-tactile stimuli, bilateral tactile stimulation of the patients' hands was combined with visual stimuli occurring on A) their own contralesional (affected) hand, B) the examiner's hand (embodied in E+), or C) a neutral object. In both groups, visual stimuli proximal to the own hand significantly improved contralesional tactile detection, while visual stimuli occurring on the neutral object did not. Crucially, only in E+TE+ patients did visual stimuli on the examiner's (embodied) hand improve contralesional tactile detection. This finding shows that cross-modal visuo-tactile integration is conditional to body-ownership, so that it ameliorates tactile extinction when visual stimuli occur on what is believed to be one's own body. From a clinical point of view, this study suggests that the effectiveness of cross-modal rehabilitative intervention can benefit from a careful evaluation of the patients' sense of body-ownership, so often impaired after brain-damage.

We present the results of the analysis of GNSS (Global Navigation Satellite System) and InSAR (Interferometric synthetic-aperture radar) data collected in the frame of a project financed by the “Struttura Terremoti” of INGV (Istituto Nazionale di Geofisica e Vulcanologia). Combined investigations pointed out for potential seismogenic sources for destructive earthquakes recorded in southwestern Sicily, including the 1968 Belice earthquake sequence and that supposed to have destroyed the Greek city of Selinunte which, according to geoarcheological data experienced two earthquakes in historical times. Our approach is aimed to evaluate the current deformation rate in SW Sicily and to improve the knowledge about the seismic potential of this area. The geodetic data proposed in this paper show that the Campobello di Mazara–Castelvetrano alignment (CCA) is currently deforming with a vertical and horizontal displacements of 2 mm/yr and 0.5 mm/yr respectively, according to the tectonic setting of the area.

Introduction/Background Endometrial cancer (EC) is mostly diagnosed at an early stage with a favorable overall survival. 5-year survival decreases from 95% for localized disease to less than 20% for metastatic disease. Survival is related to known prognostic factors. Nevertheless, they are not sufficient to predict either outcome or recurrence rate/site: to decipher the underlying aberrant biomolecular pathways seems to be promising, although it is not yet applicable in a clinical setting. In that purpose, to investigate EC recurrence patterns according to ESMO-ESGO-ESTRO risk classes, could be beneficial for an early recurrences detection and treatment with a survival rate improvement. Methodology 758 women diagnosed with EC, and a 5-years follow-up, were enrolled: they were divided into the ESMO-ESGO-ESTRO risk classes (low LR, intermediate IR, intermediate-high I-HR, and high risk HR) and surgically treated as recommended, followed by adjuvant therapy, when appropriated. Results Recurrences were detected in 19,5%. Higher recurrence rate (RR) was significantly detected (p Conclusion These results strengthen the need to identify biological factors to stratify patients at higher risk of relapse, independently or in addition to their risk class prognosis and current surgical and clinical managements. Disclosure Nothing to disclose.

Anatomo-clinical evidence from motor-awareness disorders after brain-damages suggests that the premotor cortex (PMC) is involved in motor-monitoring of voluntary actions. Indeed, PMC lesions prevent patients from detecting the mismatch between intended, but not executed, movements with the paralyzed limb. This functional magnetic resonance imaging study compared, in healthy subjects, free movements against blocked movements, precluded by a cast. Cast-related corticospinal excitability changes were investigated by using transcranial magnetic stimulation. Immediately after the immobilization, when the cast prevented the execution of left-hand movements, the contralateral right (ventral) vPMC showed both increased hemodynamic activity and increased functional connectivity with the hand area in the right somatosensory cortex, suggesting a vPMC involvement in detecting the mismatch between planned and executed movements. Crucially, after 1 week of immobilization, when the motor system had likely learned that no movement could be executed and, therefore, predictions about motor consequences were changed, vPMC did not show the enhanced activity as if no incongruence has to be detected. This can be interpreted as a consequence of the plastic changes induced by long-lasting immobilization, as also proved by the cast-related corticospinal excitability modulation in our subjects. The present findings highlight the crucial role of vPMC in the anatomo-functional network generating the human motor-awareness.

We study the governance choices of firms in a voluntary regulatory regime. We find that firms with a dominant shareholder are more likely to deviate from standards of best practice in corporate governance. However, lesser governance standards in firms where a dominant shareholder is present are not associated with lower performance. Our results suggest that standard governance practices that mostly empower the board of directors with a monitoring role are less relevant when the large shareholder is the monitor in place. Overall, we argue that the corporate governance of firms is the result of complex interdependences that go beyond a one-size-fits-all model.

Exchange rates affect the economy not only through the competitiveness of exports but also through a financial channel. The financial channel goes in the opposite direction to the competitiveness channel in that a stronger currency goes hand-in-hand with more buoyant real economic activity on the back of faster credit growth and cross-border banking flows. The effect is particularly marked for emerging market economies for the broad dollar index: a stronger dollar may actually lead to a decline in trade volumes of an emerging market economy. Our paper develops a stylized model that generates such an effect and finds supporting evidence in a firm-level investigation of manufacturing firms from Asia.

Aim The aim of this study was to investigate the possible association between recurrent miscarriage (RM) and ectopic pregnancy (EP). Methods In this case-control retrospective study, the clinical cards of women followed as outpatients in the RM and low-risk pregnancy offices of the Obstetrics and Gynecology Unit at the Policlinico Tor Vergata University Hospital were carefully reviewed for the occurrence of EP. Results Overall, 598 women with RM and 2043 normal women without RM (controls) were included in the study. Among these women, 4974 pregnancies were analyzed, in which 2028 miscarriages occurred. The EP rate (3.51%) was significantly higher in RM than in control women (1.51%) [odds ratio = 2.31 (95% confidence interval: 2.3-2.4)]; it was particularly high in women with primary RM (5.11%). However, when EP rates were calculated not by women but by overall pregnancies, no differences could be found between RM and control women. In control women, the absence of a miscarriage in the reproductive history was associated with a lower rate of EP. Conclusions Women with RM, particularly primary RM, are at increased risk of EP. This increased risk seems to be dependent on the high number of pregnancies occurring in women with RM rather than to specific characteristics of these women.

There is no consensus on whether, and to what extent, actions contribute to constructing awareness of one's own body. Here we investigated at both physiological and behavioral level whether a prolonged limb immobilization affects body ownership. We tested a group of healthy participants, whose left-hand movements were prevented by a cast for one week, and a control group without any movement restriction. In both groups, we measured the strength of the rubber hand illusion (i.e., proprioceptive shift and questionnaire on ownership) and the physiological parameters known to be modulated by short-term arm immobilization (i.e., resting motor threshold, motor evoked potentials and force parameters) before and after the week of immobilization. Our results showed stronger illusory effects on the immobilized hand on both behavioral indexes and weaker illusory effects on the non-immobilized hand on the questionnaire. Additionally, the increased proprioceptive shift was positively correlated to the motor threshold of the contralateral hemisphere. Our findings show at both behavioral and physiological level that altering those movement-related signals which constantly stem from our own body parts, modulates the experience of those body parts as mine. This, in turn, supports the view of a direct role of actions in the developing and maintaining a coherent body ownership.

In July and August 2019, Stromboli volcano underwent two dangerous paroxysms previously considered “unexpected” because of the absence of significant changes in usually monitored parameters. We applied a multidisciplinary approach to search for signals able to indicate the possibility of larger explosive activity and to devise a model to explain the observed variations. We analysed geodetic data, satellite thermal data, images from remote cameras and seismic data in a timespan crossing the eruptive period of 2019 to identify precursors of the two paroxysms on a medium-term time span (months) and to perform an in-depth analysis of the signals recorded on a short time scale (hours, minutes) before the paroxysm. We developed a model that explains the observations. We call the model “push and go” where the uppermost feeding system of Stromboli is made up of a lower section occupied by a low viscosity, low density magma that is largely composed of gases and a shallower section occupied by the accumulated melt. We hypothesize that the paroxysms are triggered when an overpressure in the lower section is built up; the explosion will occur at the very moment such overpressure overcomes the confining pressure of the highly viscous magma above it.

Detection and characterization of volcanic eruptions is important both for public health and aircraft safety. A variety of ground sensors are used to monitor volcanic eruptions. Data from these ground sensors are subsequently incorporated into models that predict the movement of ash. Here a method to detect volcanic plumes using GPS signals is described. Rather than carrier phase data used by geodesists, the method takes advantage of attenuations in signal to noise ratio (SNR) data. Two datasets are evaluated: the 2009 Redoubt Volcano eruptions and the 2013/2015 eruptions at Mt. Etna. SNR-based eruption durations are compared with previously published seismic, infrasonic, and radar studies at Redoubt Volcano. SNR-based plume detections from Mt. Etna are compared with L-band radar and tremor observations. To place these SNR observations from Redoubt and Etna in context, a model of the propagation of GPS signals through both water/water vapor and tephra is developed. Neither water nor fine ash particles will produce the observed attenuation of GPS signals, while scattering caused by particles > 1 cm in diameter potentially could.

Background The direct role of antiphospholipid antibodies (aPL) at maternal-fetal interface has not been fully investigated, especially whether they are involved in physiological and pathological implantation conditions, in an antiphospholipid syndrome (APS)-independent manner. In fact, trophoblast cells and placental endothelial cells at the implantation site express potential aPL targeted-phospholipid antigens (PL Ags); thus, the local production and presence of their specific antibodies, not related to APS (characterized by aPL presence in the peripheral blood), could be a potential marker of aberrant invasion, implantation and fetal-maternal immune tolerance processes. Methods Anti-Beta2glycoprotein I (anti-β2GPI) and anticardiolipin (aCL Ab) antibodies (the most clinically relevant aPL) were detected by immunoenzymatic assay (ELISA), in the amniotic fluid (AF) of 167 women with physiological and complicated common pregnancy conditions, sharing an aberrant implantation process, such as recurrent pregnancy loss (RPL), autoimmune hypothyroidism (ahT) and smoking. All women included in the study were negative to peripheral blood aPL. Results aCL and anti-β2GPI antibodies were detectable in all the AF samples. RPL, ahT and smoking patients had higher level of anti-β2GPI Abs (IgM) compared to women with physiological pregnancies (p stimuli, could be hypothesized. Conclusions The presence of aPL in the AF (not related to APS) could reveal a potential clinical significance at maternal-fetal interface in selected pregnancy complications, in which an aberrant implantation process, and in turn an impaired fetal-maternal immune tolerance cross-talk, could occur.

Endometrial cancer (EC) known prognostic factors are not sufficient to predict either outcome or recurrence rate/site: to investigate EC recurrence patterns according to ESMO-ESGO-ESTRO risk classes, could be beneficial for a more tailored adjuvant treatment and follow-up schedule.758 women diagnosed with EC, and a 5-years follow-up, were enrolled: they were divided into the ESMO-ESGO-ESTRO risk classes (low LR, intermediate IR, intermediate-high I-HR, and highrisk HR) and surgically treated as recommended, followed by adjuvants therapies when appropriate.Higher recurrence rate (RR) was significantly detected (p 0,001) in the HR group (40,3%) compared to LR (9,6%), IR (16,7%) and I-HR (17,1%). Recurrences were detected more frequently at distant sites (64%) compared to pelvic (25,3%) and lymph nodes (10,7%) recurrences (p 0,0001): only in LR group, no differences were detected between local and distant recurrences. 5-Year distant-free (LR 99%, IR 94%,I-HR 86%, HR 88%) and local-free survivals (LR 99%, IR 100%,I-HR 98%, HR 95%) significantly differ between groups (p 0,0001 and p = 0,003, respectively). Adjuvant therapy modifies RRs only in LR group (p = 0,01).To identify biological factors to stratify patients at higher risk of relapse is needed. Distant site relapse could be the main reason of endometrial cancer failure follow-up, independently or in addition to their risk class prognosis.

The effect of long-term immobilization on the motor system has been described during motor preparation, imagination or execution, when the movement has to be performed. But, what happens when the movement has to be suppressed? Does long-term limb immobilization modulate physiological responses underlying motor inhibition? Event-related potentials (ERPs) were recorded in healthy participants performing a Go/Nogo task, either with both hands free to respond (T1/T4: before/after the immobilization) or when left-hand movements were prevented by a cast (T2: as soon as the cast was positioned; T3: after one week of immobilization). In the right (control) side, N140, N2, and P3 components showed the expected greater amplitude in Nogo than in Go trials, irrespective of the timepoint. On the contrary, in the left (manipulated) side, each component of the ERP responses to Nogo trials showed specific differences across timepoints, suggesting that the inhibition-related EEG activity is significantly reduced by the presence of the cast and the duration of the immobilization. Furthermore, inhibition-related theta band activity to Nogo stimuli decreased at post-immobilization blocked session (T3-blocked). Altogether these findings can be interpreted as a consequence of the plastic changes induced by the immobilization, as also demonstrated by the cast-related corticospinal excitability modulation (investigated by using TMS) and by the decreased beta band in response to Go and Nogo trials. Thus, only if we are free to move, then inhibitory responses are fully implemented. After one week of immobilization, the amount of inhibition necessary to block the movement is lower and, consequently, inhibitory-related responses are reduced.

Low-molecular-weight heparin (LMWH) is widely used to treat recurrent pregnancy loss (RPL) because of its anti-coagulant effects. Although in vitro studies have suggested additional immunological effects, these are debated. We therefore investigated whether LMWH could modulate immune responses in vivo during pregnancy of women with unexplained RPL. A Swedish open multi-centre randomised controlled trial included 45 women treated with tinzaparin and 42 untreated women. Longitudinally collected plasma samples were obtained at gestational weeks (gw) 6, 18, 28 and 34 and analysed by multiplex bead technology for levels of 11 cytokines and chemokines, chosen to represent inflammation and T-helper subset-associated immunity. Mixed linear models test on LMWH-treated and untreated women showed differences during pregnancy of the Th1-associated chemokines CXCL10 (p = 0.01), CXCL11 (p amp;lt; 0.001) and the Th17-associated chemokine CCL20 (p = 0.04), while CCL2, CCL17, CCL22, CXCL1, CXCL8, CXCL12, CXCL13 and IL-6 did not differ. Subsequent Students t-test showed significantly higher plasma levels of CXCL10 and CXCL11 in treated than untreated women at gw 28 and 34. The consistent increase in the two Th1-associated chemokines suggests a potential proinflammatory and unfavourable effect of LMWH treatment during later stages of pregnancy, when Th1 immunity is known to disrupt immunological tolerance. Funding Agencies|Stig and Ragna Gorthon foundation, Helsingborg; Thelma Zoegas foundation for medical research, Lund; Medical Research Council of Southeast Sweden [FORSS-159721]; ALF grants, Region Ostergotland, Linkoping University; Skane County Councils Research and Development

After a period of mild eruptive activity, Stromboli showed between 2017 and 2018 a reawakening phase, with an increase in the eruptive activity starting in May 2017. The alert level of the volcano was raised from “green” (base) to “yellow” (attention) on 7 December 2017, and a small lava overflowed the crater rim on 15 December 2017. Between July 2017 and August 2018 the monitoring networks recorded nine major explosions, which are a serious hazard for Stromboli because they affect the summit area, crowded by tourists. We studied the 2017–2018 eruptive phase through the analysis of multidisciplinary data comprising thermal video-camera images, seismic, geodetic and geochemical data. We focused on the major explosion mechanism analyzing the well-recorded 1 December 2017 major explosion as a case study. We found that the 2017–2018 eruptive phase is consistent with a greater gas-rich magma supply in the shallow system. Furthermore, through the analysis of the case study major explosion, we identified precursory phases in the strainmeter and seismic data occurring 77 and 38 s before the explosive jet reached the eruptive vent, respectively. On the basis of these short-term precursors, we propose an automatic timely alarm system for major explosions at Stromboli volcano.

Background The potential role of antinuclear antibodies (ANA) in recurrent pregnancy loss (RPL) pathogenesis is still debated, although some evidences suggest that they could affect pregnancy outcome, leading to a higher miscarriage rate in these patients. A hypothesized mechanism is through changes in uterine flow in pre-conceptional stage, by modifying endometrial receptivity in RPL. However, scant data are available, in pregnancy, about their role in RPL placental perfusion, also in relation to its potential treatments, such as low molecular weight heparin (LMWH). The aim of this study is to retrospectively further investigate the correlation between two-dimensional (2D) and three-dimensional (3D) uterine and placental flow indexes and the presence or the absence of ANA in women with unexplained RPL (uRPL), treated or not treated with LMWH. Methods 2D Doppler measurement of pulsatility index (PI) of the uterine arteries and 3D ultrasonography determination of vascularization index (VI), flow index (FI) and vascularization flow index (VFI) was carried out with the aid of the virtual organ computer-aided analysis (VOCAL) technique in LMWH treated (n 24) and not treated-uRPL patients (n 20) and in the relative control group (n 27), each group divided in ANA+ and ANA- subgroups. Serum assay for the presence of ANA was performed in all women. Results No differences were found in PI, VFI and VI values, by comparing the different groups. A difference in VI values was found for ANA- patients between RPL women not treated with LMWH and the treated ones (p = 0,01), which have lower VI values and similar to controls. By considering only ANA- treated and not treated RPL patients, the ROC curve shows an area of 0,80 and at the VI cut-off of 11,08 a sensitivity of 85% and a specificity of 67%. Conclusions LMWH could exert a potential beneficial effect in restoring the physiological blood flow supply in terms of VI in uRPL ANA- status, suggesting to include ANA and VI investigations in the RPL diagnostic algorithm in a research context, since further studies are needed to clarify this challenging hypothesis in order to try to ameliorate ANA and abnormal placental vascularization negative influence on RPL pregnancy outcome .