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Background Intravenous antiplatelet drugs provide rapid and sustained inhibition of platelet aggregation and can mitigate the ischemic risk of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). However, there are few real-world studies comparing cangrelor to tirofiban in this patient population. Purpose The aim of this study was to evaluate the effectiveness and the safety of cangrelor compared to tirofiban in a real-world population of STEMI patients undergoing pPCI. Methods This was a prospective, multicenter, observational study including consecutive STEMI patients who received either cangrelor or tirofiban during pPCI at six Italian high-volume pPCI centers from January 2020 to January 2022. The study population was divided into two groups according the antiplatelet treatment received (cangrelor or tirofiban). The primary study outcome was impaired myocardial revascularization assessed by post-procedural Thrombolysis in Myocardial Infarction (TIMI) flow grade Results A total of 478 STEMI patients received intravenous antiplatelet therapy during pPCI. Of them, 16 patients were excluded since they received both cangrelor and tirofiban as bailout strategy. Thus, the final study population included 462 patients (mean age 63.9±11.8 years; 79.7% males): 223 patients received cangrelor (48.3%), and 239 tirofiban (51.7%). Patients treated with tirofiban had higher prevalence of prior myocardial infarction (p=0.016) and prior PCI (p=0.048) than patients receiving cangrelor (Table 1); also, they showed higher SYNTAX score (p=0.038) than patients receiving cangrelor, and a higher proportion of stent thrombosis as culprit lesion (p=0.047; Table 2). Conversely, patients treated with cangrelor had worse Killip class (p Conclusions In this real-world population of STEMI patients undergoing pPCI, periprocedural use of cangrelor was associated with improved myocardial reperfusion compared to tirofiban, but with no differences in terms of major bleeding or death during the hospitalization. Funding Acknowledgement Type of funding sources: None.

Background Left bundle branch block (LBBB) has been associated with left ventricular (LV) remodeling and dysfunction. LBBB may appear as an ominous sign in the natural course several heart diseases, or may play a causative role in the development of a “dyssynchronopathy” (LBBB-induced cardiomyopathy). LBBB represents an important therapeutic target in heart failure (HF) patients, since cardiac resynchronization therapy (CRT) aims to restore mechanical synchrony. Over the last 10 years different electrocardiographic (ECG) criteria (by the American Heart Association – AHA, and by Strauss) have been proposed to better identify and select patients suitable for CRT. The real usefulness of these criteria has been recently questioned. Purpose Aims of this single center registry were: 1) to describe the clinical and instrumental (ECG and echocardiographic) features in patients with LBBB hospitalized due to both cardiac and non-cardiac causes in a tertiary university hospital; 2) to identify the prevalence of LV remodeling/dysfunction, and its potential determinants. Methods One hundred eighty-six patients underwent clinical evaluation, 12-lead ECG, and transthoracic echocardiogram. Exclusion criteria were: 1) prior myocardial infarction with extensive anterior necrosis; 2) prior cardiac surgery or transcatheter aortic valve implantation; 3) complex congenital heart diseases; 4) permanent pacing with right ventricular stimulation. Results One hundred and three (55%) were males. Median age was 74.5 (IQR 66–82) years. Arterial hypertension was the most prevalent (65%) cardiovascular risk factor. Twenty-one patients had atrial fibrillation. Median QRS duration was 140 (IQR 140–160) msec, 70% of patients had a LBBB according to the AHA criteria, while 85% was diagnosed as having a “true” LBBB according to Strauss definition. A discordant LBBB was found in 56% of patients. Median LV ejection fraction (EF) was 42%, and LV systolic dysfunction was found in 66% of patients. There was a weak, although statistically significant, inverse correlation between QRS duration (msec) and LVEF (rho −0.23; p=0.0026). There was a significant difference in terms of QRS duration (160 vs 140 msec; p=0.008) between patients with and without LV dysfunction, while LBBB morphological criteria did not differentiate the two groups. QRS duration resulted to be the only independent determinant of LV systolic dysfunction (OR 1.022 [95% CI]=1.022 [1.002–1.042], p=0.029) on multivariable logistic regression analysis. Conclusions In a non-selected cohort of patients with LBBB, the use of strict morphological criteria does not predict the presence of LV dysfunction. QRS duration seems to be the only independent predictor of LV dysfunction. These results emphasize the complex relationship between LBBB and cardiac remodeling and dysfunction. Funding Acknowledgement Type of funding sources: None.

En el campo natural (CN) de Uruguay la introducción de leguminosas con fertilización fosfatada (CN+LP) evita restricciones nutricionales, pero son poco conocidos sus efectos sobre el suelo y la pastura. Para evaluar estos efectos en el largo plazo se utilizó un experimento previo de introducción de Lotus corniculatus y fertilización fosfatada con un tratamiento testigo de CN (1995-2002). Entre 2013 y 2015 se determinó la producción primaria neta aérea (PPNA), contenido de nutrientes de la planta, composición y diversidad florística. En el suelo se analizó pH, contenido de C orgánico, P disponible y orgánico. En dos gramíneas nativas se evaluó la colonización micorrícica. El suelo CN+LP presentó mayor contenido de P disponible, pero no hubo diferencias en C orgánico. Aunque la PPNA fue similar, el contenido de P del forraje fue mayor en CN+LP respecto a CN, mientras que la micorrización fue mayor en CN. La composición florística y la diversidad no difirieron. Se concluye que, aunque no se mantuvieron las ventajas productivas de CN+LP en PPNA, hubo una mejora en la calidad del forraje debido a su mayor contenido de P. Sin embargo, no hubo efectos en servicios ecosistémicos claves como la diversidad de especies.

The Beam Expander Testing X-ray facility (BEaTriX) is a unique X-ray apparatus now operated at the Istituto Nazionale di Astrofisica (INAF), Osservatorio Astronomico di Brera (OAB), in Merate, Italy. It has been specifically designed to measure the point spread function (PSF) and the effective area (EA) of the X-ray mirror modules (MMs) of the Advanced Telescope for High-ENergy Astrophysics (ATHENA), based on silicon pore optics (SPO) technology, for verification before integration into the mirror assembly. To this end, BEaTriX generates a broad, uniform, monochromatic, and collimated X-ray beam at 4.51 keV. [...] In BEaTriX, a micro-focus X-ray source with a titanium anode is placed in the focus of a paraboloidal mirror, which generates a parallel beam. A crystal monochromator selects the 4.51 keV line, which is expanded to the final size by a crystal asymmetrically cut with respect to the crystalline planes. [...] After characterization, the BEaTriX beam has the nominal dimensions of 170 mm x 60 mm, with a vertical divergence of 1.65 arcsec and a horizontal divergence varying between 2.7 and 3.45 arcsec, depending on the monochromator setting: either high collimation or high intensity. The flux per area unit varies from 10 to 50 photons/s/cm2 from one configuration to the other. The BEaTriX beam performance was tested using an SPO MM, whose entrance pupil was fully illuminated by the expanded beam, and its focus was directly imaged onto the camera. The first light test returned a PSF and an EA in full agreement with expectations. As of today, the 4.51 keV beamline of BEaTriX is operational and can characterize modular X-ray optics, measuring their PSF and EA with a typical exposure of 30 minutes. [...] We expect BEaTriX to be a crucial facility for the functional test of modular X-ray optics, such as the SPO MMs for ATHENA., Accepted on 29 June 2022 for publication in Astronomy & Astrophysics, Sect. 13, Astronomical instrumentation of Astronomy and Astrophysics. Version after language correction

Background High on-treatment platelet reactivity (HTPR) has been associated with high risk of ischemic events in STEMI patients. Body mass index (BMI) and specifically overweight and obesity are risk factors for increased platelet reactivity in different series of patients, however data regarding their relationship with pharmacodynamic response to oral 3rd generation P2Y12 inhibitors is still lacking. Purpose This study aims to assess the association between BMI and HTPR in STEMI patients treated with oral 3rd generation P2Y12 inhibitors. Methods Overall, 429 STEMI were enrolled in this study. Patients were divided into two groups according to BMI (BMI Results The mean age of the enrolled population was 62±12 and male rate was 75%. Patients with a BMI ≥25 were younger (61±12 Vs 64±11, p=0.006), with a higher prevalence of male gender (78% vs 68%, p=0.035), and hypertension (56% vs 46%, p=0.072), and they were less frequently treated with pre-PCI mophine use (30% Vs 42%; p=0.018). After propensity score matching (Table), patients with BMI ≥25 had similar values of baseline platelet reactivity [T0: 308 (285–342) vs 300 (281–330), p=0.396), while they had higher level of platelet reactivity at 1 and 2 hours after the LD [T1: 285 (200–308) vs 265 (196–320), p=0.047); T2: 241 (87–305) vs 200 (56–256), p=0.004)] and higher rate of HRPT [T1: (66% vs 47%, p=0.004); T2: (40% vs 24%, p=0.006)]. Furthermore, multivariable analysis demonstrated that BMI ≥25 was an independent predictor of HTPR at 2h (OR 2.01, 95% CI 1.18–3.42; p=0.009). Conversely, starting from 4 hour after the LD, platelet reactivity values [T3: 68 (7–173) vs 15 (6–71), p=0.76); T4: 38 (4–104) vs 44 (4–82), p=0.958)] and HRPT rates (T3: 13% vs 10%, p=0.595; T4: 1% vs 1%, p=0.320) were comparable among the study groups. Conclusions A BMI ≥25 is associated with decelerated pharmacodynamic response to oral 3rd generation P2Y12 inhibitors LD and resulted a strong predictor of HRPT in STEMI patients treated by dual antiplatelet therapy with ticagrelor or prasugrel. Funding Acknowledgement Type of funding sources: None. Table, panel ATable, panel B

Background Smoking habit is a well known risk factor for cardiovascular disease. High on-treatment platelet reactivity has been associated with high risk of ischemic events in STEMI patients. The relationship between platelet reactivity and smoking habit was investigated only in few studies, and the impact of smoke on platelet reactivity in STEMI patients treated with 3rd generation P2Y12 inhibitor is still lacking. Purpose This study aim to assess the impact of smoking habits on baseline and on-treatment platelet reactivity in STEMI patients treated with 3rd generation P2Y12 inhibitor. Methods Overall, 429 STEMI patients were enrolled in this study. Patients were divided into two groups according to smoking habit. Platelet reactivity was assessed by VerifyNow at baseline and after 3rd generation P2Y12 inhibitor (ticagrelor or prasugrel) loading dose (LD). Blood samples were obtained at baseline (T0), and after 1 hour (T1), 2 hours (T2), 4–6 hours (T3) and 8–12 hours (T4) after LD. Results The mean age of the enrolled population was 62±12 and male rate was 75%. Patients with smoking habit were younger (75.8% vs 38.9%, p Conclusions Smoker status is associated with lower platelet reactivity either at baseline or after LD and with a better short-term prognosis in STEMI patients treated by dual antiplatelet therapy with ticagrelor or prasugrel. Funding Acknowledgement Type of funding sources: None.

To test the hypothesis that virtual functional assessment index (vFAI) is related with regional flow parameters derived by quantitative positron emission tomography (PET) and can be used to assess abnormal vasodilating capability in coronary vessels with stenotic lesions at coronary computed tomography angiography (CCTA). Methods and results: vFAI, stress myocardial blood flow (MBF), and myocardial flow reserve (MFR) were assessed in 78 patients (mean age 62.2 ± 7.7 years) with intermediate pre-test likelihood of coronary artery disease (CAD). Coronary stenoses ≥50% were considered angiographically significant. PET was considered positive for significant CAD, when more than one contiguous segments showed stress MBF ≤2.3 mL/g/min for O-water or

The construction of the BEaTriX facility is ongoing at INAF/OAB. The facility will generate a broad (170 x 60 mm2), uniform and lowdivergent (1.5 arcsec HEW) X-ray beam within a small lab (~ 9 x 18m2, see Fig. 7), using an X-ray microfocus source, a paraboloidal mirror, a crystal monochromation system with simmetrically cut crystals, and an asymmetrically-cut crystal for beam expansion. The facility is designed to operate at 1.49 keV and 4.51 keV. These properties, in addition to the copious flux of the source (1011-1012 ph/sec/sterad), a moderate vacum level of 10-3 mbar, and a modular vacuum approach, will enable the testing of the Silicon Pore Optics modules of the ATHENA telescope at the rate of 3 MM/day, following production.

The Wide Field X-ray Telescope (WFXT) is a medium class mission proposed to address key questions about cosmic origins and physics of the cosmos through an unprecedented survey of the sky in the soft X-ray band (0.2-6 keV) [1], [2]. In order to get the desired angular resolution of 10 arcsec (5 arcsec goal) on the entire 1 degrees Field Of View (FOV), the design of the optical system is based on nested grazing-incidence polynomial profiles mirrors, and assumes a focal plane curvature and plate scale corrections among the shells. This design guarantees an increased angular resolution also at large off-axis positions with respect to the usually adopted Wolter I configuration. In order to meet the requirements in terms of mass and effective area (less than 1200 kg, 6000 cm 2 c 1 keV), the nested shells are thin and made of quartz glass. The telescope assembly is composed by three identical modules of 78 nested shells each, with diameter up to 1.1 m, length in the range of 200-440 mm and thickness of less than 2.2 mm. At this regard, a deterministic direct polishing method is under investigation to manufacture the WFXT thin grazing-incidence mirrors made of quartz. The direct polishing method has already been used for past missions (as Einstein, Rosat, Chandra) but based on much thicker shells (10 mm ore more). The technological challenge for WFXT is to apply the same approach but for 510 times thinner shells. The proposed approach is based on two main steps: first, quartz glass tubes available on the market are ground to conical profiles; second the pre-shaped shells are polished to the required polynomial profiles using a CNC polishing machine. In this paper, preliminary results on the direct grinding and polishing of prototypes shells made by quartz glass with low thickness, representative of the WFXT optical design, are presented.

The implementation of an X-ray mission with high imaging capabilities, similar to those achieved with Chandra (< 1 arc second Half Energy Width, HEW), but with a much larger throughput (2.5 m2 effective area @1 keV), represents a compelling request by the scientific community. To this end the Lynx/XRS mission is being studied in USA, with the participation of international partners. In order to figure out the challenging technological task of the mirror fabrication, different approaches are considered, based on monolithic and segmented shells. Starting from the experience done on the glass prototypal shell realized in the past years, the direct polishing of thin (2 mm thick) fused silica monolithic shells is being investigated as a possible solution. A temporary stiffening structure is designed to support the shell during the figuring and polishing operations and to manage the handling up to its integration in the telescope structure. After the grinding and the polishing phases, in order to achieve the required surface accuracy, a final ion beam figuring correction is foreseen. In this paper, we present the technological process and the results achieved so far on a prototypal shell under development.

A novel position sensorless permanent-magnet synchronous motor (PMSM) drive that uses only a direct current (dc)-link sensor is presented in this paper. This concept is already known, but several new implementation details are shown in this paper. The proposed drive system is simple and can be implemented using low-cost control hardware. The dynamic performance of the proposed drive is evaluated and compared with the performance of position sensorless and full sensored drives.

Background: In advanced not selected NSCLC chemotherapy achieved an advantage of approximately 1–2 months on median survival versus best supportive care. Chemotherapy seems to improve symptoms control, even if randomised studies with quality of life as first endpoint are lacking and often chemotherapy toxicity compromises the frail cost/benefit ratio. The aim of the present study is to evaluate the impact on QoL, substituting cisplatin, a pivot drug in NSCLC therapy, with carboplatin, an analogue with an improved toxicity profile. The combination of cisplatin with Mitomycin and Vinblastine was one of the most frequently used in the palliative setting at the time of design of our study. Methods: Patients were randomized to receive MVP regimen (Mitomycin-C 8 mg/m 2 d1, Vinblastine 4 mg/m 2 d 1–8, Cisplatin 100 mg/m 2 d1) or MVC regimen (Mitomycin-C 8 mg/m 2 d1, Vinblastine 4 mg/m 2 d 1–8, Carboplatin 300 mg/m 2 d1) every 3 weeks. The QoL was evaluated by the Spitzer QL-Index and by the EORTC QLQ-C30+LC 13 questionnaires before chemotherapy, after one cycle, after three cycles, and then every 6 weeks in the first 6 months and every 3 months thenafter. Results: From September 1994 to July 1997, 153 consecutive patients were randomized to MVP (75 patients) or MVC arm (78 patients). Despite difficulties in carrying out and analysing QoL items in such patients, the global QoL evaluated by the Spitzer's questionnaire suggested an advantage for MVC regimen ( P =0.05) and a significant difference was observed in global health subdomain ( P =0.04). The disease-related symptoms improved with time, and the benefits lasted for the entire treatment period. When evaluated with the EORTC questionnaire there was significantly less nausea and vomiting ( P =0.0001), appetite loss ( P =0.01), insomnia ( P =0.03), constipation ( P =0.01) and peripheral neuropathy ( P =0.01) in favour of MVC, and a trend for less hair loss ( P =0.05). The advantage lasted for all the duration of chemotherapy. No differences were observed in global quality of life subdomain ( P =0.40) between the two regimen. QoL was the first endpoint and the statistical power was inadequate to assess other parameters. However, we reported a response rate of 43.1 and 38.6%, respectively, in MVP and MVC arm ( P =0.59) and a median survival of 10.2 and 7.2 months, respectively, for cisplatin and carboplatin arm ( P =0.39). Conclusions: The carboplatin containing regimen (MVC) has a significant better toxicity profile than the cisplatin containing (MVP) regimen as proven both by the EORTC questionnaires and by the WHO toxicity data reported by physicians. No significant differences in terms of response rate, time to progression and overall survival were observed between the two regimen. The two chemotherapy regimen showed a similar effectiveness in symptom palliation when evaluated with C30 addendum of EORTC QOL questionnaire. With the Spitzer's questionnaires a trend towards an improved quality of life index was observed during treatment with the carboplatin combination in comparison to the cisplatin combination. This difference, however, was not observed when the global quality of life was evaluated with the EORTC patients compiled questionnaires. A carboplatin containing regimen with better toxicity profile and a similar potentiality for symptoms control offers an option in comparison to similar cisplatin containing combinations in the palliative treatment of advanced NSCLC.

Some false paths are caused by redundant stuck-at faults. Removal of those stuck-at faults automatically eliminates such false paths from the circuit. However, there are other false paths that are not associated with any redundant stuck-at fault. All links of such a false path are shared with other testable paths. We focus on the elimination of this type of false paths. We use a nonenumerative path delay fault simulator, which duplicates selected gates to separate the detected and undetected path delay faults. The expanded circuit may contain new redundant stuck-at faults, corresponding to those undetected paths that are false. This happens because in the expanded circuit some new links have only false paths passing through them. Such links become the sites for redundant stuck-at faults. Removal of these redundant faults eliminates false paths. The quality of the result may depend on the coverage of testable paths by the vectors that are simulated. Since a non-enumerative path delay simulation and an implication-based redundancy removal technique are used, the present procedure of false-path elimination can be applied to very large circuits.

Background and Study Aims: Lactase non-persistence (LNP), or primary hypolactasia, is a genetic condition that mediates lactose malabsorption and can cause lactose intolerance. Here we report the prevalence of lactose intolerance in a double-blind placebo study. Methods: The LCT C>T-13910 variant was genotyped by RT-PCR in 121 volunteers and lactose malabsorption was assessed using the hydrogen breath test (HBT) after consuming 25 g of lactose. Lactose intolerance was assessed by scoring symptoms (SS) using a standardized questionnaire following challenge with a lactose solution or saccharose placebo. Results: The LNP genotype was observed in 57% of the volunteers, among whom 87% were HBT(+). In the HBT(+) group the median SS was 9 and in the HBT(-) group the median SS was 3 (p < 0.001). No difference was observed in the SS when both groups were challenged with the placebo. The most common symptoms included audible bowel sounds, abdominal pain and meteorism. In the ROC curve analysis, an SS ≥6 demonstrated 72% sensitivity and 81% specificity for predicting a positive HBT. To estimate prevalence, lactose intolerance was defined as the presence of an SS ≥6 points after subtracting the placebo effect and 34% of the study population met this definition. Conclusions: The LNP genotype was present in more than half of subjects evaluated and the observed prevalence of lactose intolerance was 34%.

One of the most difficult requests to be accomplished from the technological point of view for next generation x-ray telescopes is to combine high angular resolution and effective area. A significant increase of effective area can be reached with high precision but at the same time thin (2-3 mm thickness for mirror diameters of 30-110 cm) glass mirror shells. In the last few years the Brera Observatory has lead a development program for realizing this kind of monolithic thin glass shell. The fused silica has been chosen as shell substrate due to its thermal and mechanical properties. To bring the mirror shells to the needed accuracy, we have adopted a deterministic direct polishing method (already used for past missions as Einstein, Rosat, Chandra) to ten time thinner shells. The technological challenge has been solved using a temporary stiffening structure that allows the handling and the machining of so thin glass shells. The results obtained with a prototype shell at an intermediate stage of its development (17’’ HEW measured in full illumination mode with x-ray) indicate that the working concept is feasible and can be further exploited using the very large Ion Beam Facility available in our labs for the final high accuracy figuring of the thin shells. In this paper we present the required tolerances for the shell realization, the shells production chain flow and the ion beam facility up grading. Forecast on figuring time and expected performances of the figuring will also be given on the basis on the metrological data collected during past shell development.

A detailed analysis of the behaviour of a Modular Multilevel Converter (MMC) in a HVDC system, in case of both DC and AC faults, is provided. Results related to a two-terminal HVDC system are presented.

A theoretical analysis of the Modular Multilevel Converter is presented. The interaction between arm currents and modulating signals causes capacitors voltage oscillation at both fundamental frequency and twice the fundamental frequency. Capacitors voltage oscillation is the cause of undesired DC and second order harmonic voltage in the converter arms, besides an additional voltage at the fundamental frequency. All these components are compensated modifying the ideal modulating signals by means of additional DC, first and second order harmonic signals.

This paper presents a novel approach for monitoring the current produced by arrays (strings) of photovoltaic modules. The approach is based on Wireless Sensor Networks (WSN) devices for data transmission. The solution lets the creation of a self-configuring wireless network of low-power and low-cost devices, in order to dramatically reduce the installation cost and time. No wires are required for data transmission, as well for supplying power to the devices. The wireless acquisition device is the foundation of a complete architectural solution for monitoring photovoltaic power plants, and has been the business idea for the creation of a start-up company.

A new generalized fault tolerant space vector modulator for cascaded multilevel converters is presented. Exploiting the redundancy properties inherent in multilevel modulation schemes, a generalized space vector modulation algorithm is devised, also aimed to the extension of the normal, full rated operation, to a limited rate, fault tolerant mode. Based on the exploitation of switching vectors redundancy properties and discontinuous modulation technique, solutions have been devised for the equalization of semiconductor components switching frequency, in either no-fault and fault operating conditions, in order to reach an equal distribution of converter dissipated power. The new fault tolerant space vector modulation technique is validated through a case study.

A new sensorless PMSM (Permanent Magnet Synchronous Motor) drive with reduced current sensors and field weakening algorithm is presented in this paper. After an overview among the different kinds of sensorless drives that appear in the literature, phase current and position/speed estimators used in this application are explained. Simulation and experimental results are reported.

The surgically aided rapid maxillary expansion (SARME) is indicated to treat the hypoplasia of the upper jaw, with a reduction of the palatal transverse diameters, even in absence of mono- or bilateral crossbite, in the adult patient. In such cases, maxillary osteotomies are made in order to reduce the sutural resistance and facilitate the expansion of the maxillary complex. A case of surgically-aided expansion of the maxilla by the use of laser Er:Yag is reported. This device is able to guarantee targeted osteotomies of the bone, without inducing iatrogenic damages of the soft tissues. The orthodontic treatment has been performed using a bonded palatal expander (type Hyrax) in association with a class III orthopedic traction (face mask). After this a fixed appliance at both the arches was bonded. The preliminary radiographic examination and the cefalometric evaluation have been repeated at the end of the maxillary protraction (60 days after surgery) and at the end of the orthodontic treatment. The entire duration of the treatment was 18 months. The use of the laser Er:Yag has showed several advantages if compared to the traditional tools (bur), as more safety, more cutting precision and less probability to determine side effects on the soft tissue. The orthodontic treatment has been performed according to the standard protocol and the results were similar to the referred in literature.

87 patients with high risk of recurrence FIGO stage I and II ovarian carcinoma were treated with adjuvant chemotherapy consisting of cisplatin 50 mg/m2 plus cyclophosphamide 600 mg/m2 on day 1 every 28 days for 6 courses. Toxicity and efficacy of the regimen was evaluated after a median follow-up of 45 months. Treatment-related toxicity was mild and reversible, consisting chiefly of acute WHO grade 2 myelosuppression (10% of patients) and controllable grade 3 emesis (55%). No late toxicity was observed. Actuarial 7-year survival and relapse-free survival (RFS) were 76% and 61%, respectively; a statistically significant difference in outcome was observed for undifferentiated grade tumour (G1 vs. G2 vs. G3: P less than 0.01) but not for FIGO stage disease (stage I vs. stage II). In our opinion, short-term chemotherapy including the most active single agent, i.e. cisplatin, appears a tolerable and effective treatment which deserves further evaluation in large randomised trials.

Natural history of patients with acute myocardial infarction has significantly improved in the last 20 years. The main reason for this progress was the introduction of effective reperfusion strategies. It has been clearly documented that the speed, extension, and duration of reperfusion are key prognostic factors. Mechanical reperfusion during primary percutaneous coronary interventions has been shown to be superior to fibrinolysis in order to achieve theseAll the techniques able to positively interact with the ischemia-reperfusion process and that have been evaluated so far (stent, adjunctive pharmacological therapy, anti-embolic devices, etc.) will be discussed.

An active surveillance for nosocomial infections has been lead in a Thoracic Surgery with the intention, first to point out their frequency and characteristics, and then to outline all the measures to remove the main risk factors checking the results obtained. A prospective incidence study has been promoted in a Thoracic Surgery in the years 2000, 2001, 2002. The analysis has been lead weekly gathering all necessary data from the health records and making laboratory tests to look for microbes growth in the air of Thoracic Surgery Operating Rooms. A nosocomial infections incidence of 13.3% among surgically treated patients has been registered in 2000. Deep surgical site infections were the most frequent localizations, and microbes isolated were Staphylococcus aureus and coagulase negative Staphylococcus with an high oxacillin resistance (70.6%-76.5%). From the observation of the risk factors the sterilization system has been modified and the assistance and environmental protocols have been improved. In the further evaluation period, a global reduction of nosocomial infections incidence (7.1%), of surgical site infections (from 10.1% to 4.5%) (p = 0.007), of Staphylococcus aureus and coagulase negative Staphylococcus isolations have been obtained even if short results in antibiotic resistances have been registered. Thoracic Surgery has to be considered an area at medium-high risk of nosocomial infections. The quite high incidence of nosocomial infections recorded at the beginning of the study in presence of prevalent deep surgical site infections from staphylococci with an high oxacillin resistance compelled to promote corrections. These lead to a remarkable decrease in incidence of nosocomial infections even if the same results can not be reached in antibiotic resistances.

The SCALAR Project consortium is a balanced mix of university research groups, large multinational European companies (Ericsson Telecom AB (S), Bang & Olufsen (DK)) and SME (EID (P), INESC (P)). Three university research groups which participate in the consortium have been long involved in research on image coding problems in complementary areas (University of Linkoping (S), University of Surrey (UK)) and research on image processing, multimedia systems and architectures, real-time systems in particular (University of Genoa (I)). Umea University (S) is the main educational institute in North of Sweden. The SCALAR project started at the end of 1995 and the field test will end in the first half of 1999.

A new kind of neural approach to image compression based on a self-adaptive size masking procedure is presented. The neural network (NN) generalization capability has been proved to be a key-element for their application to image compression. In order to improve this feature, an adaptive approach based on pattern classification by activity measure for training and validation is studied. Because of different regions being characterized by different activity, a variable block-size technique has been adopted, in order to improve quality and compression. Different neural networks with different input masks and hidden number are trained on different activity patterns and used on different activity regions. The results have proved this approach to be able to remarkably improve the compression ratio and the global generalization capability of networks. Several tests on learned and unlearned pictures and comparisons with fixed size NNs and DCT-based (JPEG) approaches are reported. >

Purpose: The usual therapeutic approach to acute breast abscesses (ABAs) not responsive to systemic antibiotics is surgical incision and drainage. Our purpose was to assess the efficacy of treating ABAs with serial US-guided percutaneous aspiration and local injection of antibiotics. Material and Methods: Twenty-six patients with 28 ABAs, in whom systemic antibiotic therapy had failed, underwent serial US-guided aspiration with local injection a of large-spectrum antibiotic. The treatment was repeated weekly until complete resolution was observed at clinical and US examination. The volume of the ABAs was calculated before each US-guided aspiration. Follow-up US examinations were performed at 1, 4, and 12 weeks after clinical and US resolution. A comparison betweeen costs of surgical and US-guided treatment of ABAs in our institution was done. Results: In 27 ABAs the treatment was successful: a progressive volume reduction and a complete resolution at clinical and US examination was observed within 1 to 7 weeks. In 1 case only, with a large ABA markedly increased in volume at the second examination, surgical drainage was performed. Conclusion: US-guided aspiration with local antibiotic injection is a safe and effective approach to ABAs, cheaper than surgical drainage of these lesions.

A total of 38 suspected primary (26) or recurrent (12) breast tumors underwent enhanced magnetic resonance imaging (MRI) of the breast after positive (19) or uncertain (19) mammography. Spin echo T1-weighted images before and after intravenous administration of 0.15 mmol/kg Gd-DTPA, the latter ones at 1, 3, and 5 min, were obtained to characterize the mammographic findings. When contrast enhancement was absent, the same images were also obtained at 10 min. Evident and early focal enhancement was considered as an MRI sign of malignancy. All the lesions were submitted to histological examination (seven by core-biopsy only). Mammography results were 23 true positives and 15 false positives. MRI results were 22 true positives, 13 true negatives, 2 false positives, and 1 false negative. Twelve uncertain-mammography cases became true negatives at MRI; 1 uncertain-mammography case was the only MRI false negative; 1 positive-mammography cases became true negative at MRI. Resting on this limited series of patients, MRI is confirmed as a useful imaging technique after uncertain mammography.

We sought to elucidate the flow-function relation in chronic postischemic dysfunction during vasodilator stress.In patients with ischemia and regional dysfunction, stress echocardiography can elicit three responses in the dysfunctioning segments: no change, improvement or worsening. The physiology underlying these responses is unclear.Seventeen patients with ischemia and left ventricular dysfunction underwent evaluation of regional function by two-dimensional echocardiography and myocardial blood flow by positron emission tomography and 13N-ammonia. Flow (ml/min per g) and function (regional wall motion score [RWMS] from 1 = normal to 4 = dyskinetic) were evaluated both at rest and after dipyridamole (0.56 mg/kg body weight over 4 min).In 45 normal segments, rest to dipyridamole flow increased from 0.83 +/- 0.22 (mean +/- 1 SD) to 1.87 +/- 0.90 (p0.01) with a hyperkinetic contraction pattern. Among dysfunctioning segments, responders (n = 11) showed an upsloping flow-function curve during stress (i.e., increased function [RWMS rest 2.5 +/- 0.5 vs. dipyridamole 1.2 +/- 0.4] and increased flow [rest 0.69 +/- 0.30 vs. dipyridamole 1.89 +/- 1.43, p0.01]); nonresponders (n = 20) had a flat flow-function curve during dipyridamole (i.e., fixed function [RWMS rest and dipyridamole 2.6 +/- 0.5] and no flow increase [rest 0.64 +/- 0.24 vs. dipyridamole 0.87 +/- 0.51, p = NS): Ischemic segments (n = 9) exhibited a downsloping flow-function curve during dipyridamole (i.e., worsened function [RWMS rest 2 +/- 0.5, dipyridamole 3.1 +/- 0.6] and no significant flow change [rest 0.67 +/- 0.29 vs. dipyridamole 0.79 +/- 0.23, p = NS]).Myocardial segments with rest dysfunction and a contractile reserve elicitable by a vasodilator stress more often exhibit residual flow reserve, whereas segments with a fixed or worsening mechanical response during stress show a flat flow response.

By combining the excellent intrinsic thermo-mechanical properties of the SiC (Silicon Carbide) with a structural design based on a sandwich structure composed of two SiC face sheets CVD (Chemical Vapor Deposition) deposited on a foam core of the same material, it is possible to manufacture very light and stiff primary mirrors for telescopes to be operated in space. The paper presents an analysis of the mechanical properties of this structure and it points out the important saving in weight wich is possible with respect to other approaches used to manufacture light weight mirrors.

PURPOSE The aim of the study was to compare high-versus low-dose cisplatin in combination with cyclophosphamide and epidoxorubicin as primary chemotherapy for suboptimal stage III and IV ovarian cancer. PATIENTS AND METHODS One hundred forty-five patients were randomized to receive six courses of cisplatin 50 or 100 mg/m2 plus epidoxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2. The two treatment arms were well balanced; all patients had greater than 2 cm and 37.2% had greater than 5 cm of residual disease; 29.6% had stage IV disease. RESULTS Patients in the high-dose arm received a double dose-intensity and double total dose of cisplatin. The high-dose regimen induced significantly more episodes of leukopenia (47.8% v 32.8%, P = .05), thrombocytopenia (21.7% v 3.2%, P = .003), anemia (37.6% v 12.5%, P = .002), nephrotoxicity (six v one patient), and neurotoxicity (30.4% v 6.3%, P = .002). There were no significant differences in efficacy in terms of clinical response rate (high-dose 57.5% v low-dose 61.1%), pathologic complete response (CR) (9.6% v 18.1%), median survival times (29 v 24 months), and median progression-free survival (18 v 13 months). CONCLUSION This study shows that doubling the dose-intensity and total dose of cisplatin in combination with epidoxorubicin and cyclophosphamide has significant toxic effects and does not improve clinical outcome in patients with suboptimal ovarian cancer.

From 1987 to 1992 at our Institute, 253 patients with non palpable breast lesions (NBPL) underwent a surgical excision. Fifty-one lesions (19.7%) were localized by an injection of a sterile 3% charcoal suspension under sonographic guide. The sonographic features of NBPL were classified as follows: positive in one case (2%), doubtful in 31 cases (60%) and negative in 19 cases (38%). According to our data the preoperative sonographic localization is a useful alternative procedure to stereotactis mammography in case of breast masses and/or areas of increased tissue density or distorted breast architecture.

Fine-needle aspiration (FNA) provides a suitable diagnostic tool in the management of patients with breast cancer lesions. The current study reports on tumor proliferative activity, by 3H-Thymidine Labelling Index (TLI), assessed on 59 FNA (TLI1) and 28 surgical specimens (TLI2) from the same breast cancer patients. Median TLI values from FNA and surgical material were 1.0% and 0.7%, respectively. In the 28 patients, evaluable for the comparison between TLI1 and TLI2, the association was found to be highly significant (p = 0.000). Moreover, no change in tumor proliferative activity was observed in the majority (79%) of cases when evaluated preoperatively and at surgery. This study confirms the feasibility of TLI analysis on FNA from breast cancer and provides results superimposable on those obtained in a tissue sample from the same patient.

WORKBENCH, as suggested by the name, is a personal computer (PC)-based electronic laboratory. Most implementations of Computer Assisted Learning in electronics and computer science limit themselves to interactive presentation of training material or to software simulations of circuits and systems. WORKBENCH leads the trainee one step further, by allowing, in addition to the above mentioned functions, practical, laboratory-style experimentation on circuits and systems assembled by the student under software guidance. workbench's hardware structure provides the physical tools for data acquisition, I/O and measuring. The hardware is controlled by low-level software primitives that relieve the user from detailed programming of the measurements. Finally, the courseware achieves the integration of hardware, software and teaching resources. The learning material is presented to the trainee in a hypertext structure and the control of the instrumentation interface is transparent to the user. The result is a powerful and flexible teaching tool that lends itself very well to school, industrial training and self-teaching environments. Given its professional characteristics, it can also be used as a test or research tool.

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Parodi E.-G. Del passaggio di v in b e di certe perturbazioni delle leggi fonetiche nel latino volgare. In: Romania, tome 27 n°106, 1898. pp. 177-240.

One challenging goal in cell biology is to monitor “on line” the exchange of electrochemical signals between various cells of a cell population. Especially in the field of cell neurobiology, the simultaneous recording of the electrical activities of various interconnected neurons and/or the simultaneous recording of the activities in all the arborizations of a single cell are results of major importance for the understanding of the computational properties of neuronal networks.