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Purpose In the last edition of the American Joint Committee on Cancer (AJCC) staging system, differentiated thyroid cancers (DTC) showing microscopic extrathyroidal extension (mETE) are considered comparable to intrathyroidal cancers for their clinical behavior and prognosis. The aim of the study is to evaluate the impact of this updated assessment of T, when applied to the postoperative recurrence risk stratification, according to the American Thyroid Association Guidelines (ATA-RR). Methods One-hundred DTC patients who underwent total thyroidectomy were retrospectively evaluated. The downstaging of mETE was introduced in the definition of T, and the updated classification defined as modified ATA-RR (ATAm-RR). For each patient, post-surgical basal and stimulated thyroglobulin (Tg) levels, neck ultrasound (US) and post-ablative 131-I whole body scan (WBS) reports were considered. The predictive performance (PP) of disease recurrence was calculated both for each single parameter, as well as for all of them. Results According to ATAm-RR classification, 19/100 patients (19%) were downstaged. ATA-RR proved a significant PP for disease recurrence (DR) (sensitivity 75.0%, specificity 63.0%, p = 0.023). However, ATAm-RR performed slightly better due to an increased specificity (sensitivity 75.0%, specificity 83.7%, p Conclusion Our results suggest that the new assessment of T considering mETE resulted in a downgrading of ATA-RR class in a significant number of patients. This provides a better PP for disease recurrence, and the best PP was obtained when considering the whole predictive variables together.

Sodium is essential to life. However, its dietary excess is detrimental to the cardiovascular system, and sodium restriction is a crucial step in cardiovascular prevention. Iodine deficiency has been fought worldwide for decades, and substantial success has been achieved introducing the use of iodine-enriched salt. Nevertheless, areas of iodine deficiency persist around the world, both in developing and industrialized countries, and a major concern affecting dietary sodium reduction programs is represented by a possible iodine intake deficiency. There are substantial differences in the source of alimentary iodine among countries, such as iodized salt added, household tap water, seafood, or salt employed in packaged food. It is clear that a sodium-restricted diet can induce differences in terms of iodine intake, depending on the country considered. Moreover, iodine status has undergone relevant changes in many countries in the last years.Systematic review of literature evidence about the possible effects of sodium restriction on population iodine status.To date, the available results are conflicting, depending on country, salt iodization policy, as well as time frame of data collection. However, to ensure an optimal iodine supply by salt fortification, without exceeding the current recommendation by World Health Organization for salt intake, seems to be an achievable goal.A balanced approach may be obtained by an adequate iodine concentration in fortified salt and by promoting the availability of iodized salt for household consumption and food industry use. In this scenario, updated prospective studies are strongly needed.

Guidelines recommend adults with pituitary disease in whom GH therapy is contemplated, to be tested for GH deficiency (AGHD); however, clinical practice is not uniform. Aims (1) To record current practice of AGHD management throughout Europe and benchmark it against guidelines; (2) To evaluate educational status of healthcare professionals about AGHD. Design Online survey in endocrine centres throughout Europe. Patients and methods Endocrinologists voluntarily completed an electronic questionnaire regarding AGHD patients diagnosed or treated in 2017–2018. Results Twenty-eight centres from 17 European countries participated, including 2139 AGHD patients, 28% of childhood-onset GHD. Aetiology was most frequently non-functioning pituitary adenoma (26%), craniopharyngioma (13%) and genetic/congenital midline malformations (13%). Diagnosis of GHD was confirmed by a stimulation test in 52% (GHRH+arginine: 45%; insulin-tolerance: 42%, glucagon: 6%; GHRH alone and clonidine tests: 7%); in the remaining, ≥3 pituitary deficiencies and low serum IGF-I were diagnostic. Initial GH dose was lower in older patients, but only women Conclusion Despite guideline recommendations, GH replacement in AGHD is still not available or reimbursed in all European countries. Knowledge among professionals and health administrators needs improvement to optimise the care of adults with GHD.

GeoGrabber features functionalities and potential societal benefits in a desktop tool enabling the development of downstream services for non-experts periodically downloading and processing data from Sentinel sources.

Objective Isolated hypogonadotropic hypogonadism (IHH) is a rare disorder with pubertal delay, normal (normoosmic-IHH, nIHH) or defective sense of smell (Kallmann syndrome, KS). Other reproductive and non-reproductive anomalies might be present although information on their frequency are scanty, particularly according to the age of presentation. Design Observational cohort study carried out between January 2008 and June 2016 within a national network of academic or general hospitals. Methods We performed a detailed phenotyping of 503 IHH patients with: (1) manifestations of hypogonadism with low sex steroid hormone and low/normal gonadotropins; (2) absence of expansive hypothalamic/pituitary lesions or multiple pituitary hormone defects. Cohort was divided on IHH onset (PPO, pre-pubertal onset or AO, adult onset) and olfactory function: PPO-nIHH (n = 275), KS (n = 184), AO-nIHH (n = 36) and AO-doIHH (AO-IHH with defective olfaction, n = 8). Results 90% of patients were classified as PPO and 10% as AO. Typical midline and olfactory defects, bimanual synkinesis and familiarity for pubertal delay were also found among the AO-IHH. Mean age at diagnosis was significantly earlier and more frequently associated with congenital hypogonadism stigmata in patients with Kallmann’s syndrome (KS). Synkinesis, renal and male genital tract anomalies were enriched in KS. Overweight/obesity are significantly associated with AO-IHH rather than PPO-IHH. Conclusions Patients with KS are more prone to develop a severe and complex phenotype than nIHH. The presence of typical extra-gonadal defects and familiarity for PPO-IHH among the AO-IHH patients indicates a common predisposition with variable clinical expression. Overall, these findings improve the understanding of IHH and may have a positive impact on the management of patients and their families.

The contribution briefly describes some of the outcomes of the ERMES FP7 project for what concerns the devleopment of regional-scale agro monitoring systems targeted to rice production

The present short paper describes the functionalities of a desktop tool enabling non-expert users to develop downstream services for the periodic download and processing of data from Sentinel sources.

The contribution briefly describes some of the outcomes of the ERMES FP7 project for what concerns exploitation of HR satellite imageru to support variable rate fertilisation

Summary Objective Lanreotide Autogel® 120 mg (ATG120; Ipsen S.p.A, Milan, Italy) is a high-dose, sustained-release aqueous gel formulation, supplied in a prefilled syringe and given by deep subcutaneous injection. The aim of this study was to compare efficacy and tolerability of ATG120 given every 4–8 weeks with those of octreotide LAR (o-LAR) given every 4 weeks. Design patients and intervention A phase III multicentre Italian open clinical study of 23 acromegalic patients (15 female, 8 male). All patients had received o-LAR for 6–18 months and, after 3 months wash out, ATG120 was given every 6 weeks for a total of four injections (Period 1). Then the interval between ATG120 injections was adjusted according to three different schemes: every 4, 6 or 8 weeks depending on GH levels (GH > 2·5 µg/l; 1

Cloud technologies are still characterized by critical issues, which pose specific challenges for application developers and operators. In particular cloud application-level and infrastructure-level are completely decoupled both in the development and runtime phases leading in poor QoS cloud services. Main issues related to the optimize the use of the hardware resources are partially solve with virtualization technologies but innovative methodology in the automatic management of resources, applications provisioning and deployment are urgently needed. This paper presents ALM Automation Platform over CHEF framework in context of services virtualization for Public Administration where typically a large number of technologies heterogeneous resources, applications are deployed and managed.

Hyperspectral remote sensing can support exploration activities helping in the recognition of lithologycal outcrops over extended areas. This is mainly due to the nature of the mineral reflectance spectra which feature very narrow absorption peaks, therefore requiring hyperspectral sensors to be assessed. In this work, the capabilities for geolithology recognition of aerial hyperspectral data have been tested to map outcrops in an Alpine carbonates test basin, located in the North-Eastern part of Italy. Two hyperspectral datasets, from MIVIS and SASI sensors, have been classified to retrieve the geolithological map of the test basin. The classification procedure was based on a decision tree approach, in order to combine different spectral and morphological features, in a flexible, robust and scalable solution. Despite the geological complexity of the study area (Alpine environment, spread vegetation cover, strong presence of shadow areas and presence of transitional geologic formations) the results, as compared to reference geological maps, prove satisfactory mapping capabilities, particularly for carbonatic rocks. In fact, the use of aerial hyperspectral data not only allows their accurate detection, but also the distinction between dolostones and limestones. The main classification issues are related to the outcrops' extent which, in a such lithology-fragmented area, avoids the detection of many small outcrops.

This contribution discusses the role of VGI created by means of mobile devices connected to the internet to tag observations on the territory and the use of SDI for sharing such information on the Web. Some guidelines are drawn to adopt an open and integrated SDI framework to manage and share VGI and heterogeneous multisource geospatial information, thus achieving interoperability among different information sources and thus making possible a wider fruition of the information available on the Web by the public. Applications supporting agriculture are case study examples of the approach.

Among the three main cereals harvested in the world, rice it is the most important staple crop in terms of human consumption, especially in low- and lower-middle-income countries of Africa and Asia. The availability of up-to-date information on the crop season results a very important task for supporting food security initiative. In this contest the contribution of Remote Sensing images and technics could provide a strong contribution for near-real time agro-ecosystem monitoring system to retrieve spatial distribution information on large scale. The present paper aims to (i) evaluate the reliability of an automatic image processing methodology developed for rice detection and rice seasonal monitoring, and (ii) quantify remote sensed phenological metrics contribution to describe rice yields variability. The algorithm "PhenoRice", was applied and tested on Senegal (West Africa), producing rice cropped areas maps and estimations of four phenological metrics: crop seeding/transplanting (MIN), start of season (SoS), peak/flowering (MAX) and maturity (EoS). These indices, together with the maximum value of NDVI in the season (NDVI-max), were estimated for each year of the period 2001 ÷ 2010 using temporal series of vegetation indices from MOD09A1 data. Remote sensing estimations were aggregated at regional and national level and used as independent variables in a multivariate model to explain yearly variability of rice production. Results demonstrate that: i) despite errors due to the well know low-resolution bias, the mapping method was able to detect the crop in the main rice districts of the study area, ii) the remote sensed seasonal indices were able to explain up to 75% of annual yield variability at regional level. The proposed approach can be of fundamental support for early warning monitoring system and for crop modelling simulation in areas where information on crop calendar are absent or not reliable.

Ill-known environmental phenomena are often modeled by means of multisource spatial data fusion. Generally, these fusion strategies have to cope with distinct kinds of uncertainty, related to the ill-defined knowledge of the phenomenon, the lack of classified data, the distinct trust of the information sources, the imprecision of the observed variables. In this chapter we discuss the advantage of modeling multisource spatial data fusion in the environmental field based on the OWA operator, and overview two applications. The first application is aimed at defining an environmental indicator of anomaly at continental scale based on a fusion of partial hints of evidence of anomaly. The second application computes seismic hazard maps based on a consensual fusion strategy defined by an extended OWA operator that accounts for data imprecision, and reliability of the data sources. In particular, the proposed fusion function models a consensual dynamics and is parameterized so as to consider a varying spatial neighborhood of the data to fuse.

Vegetation cover plays a key role in various biophysical processes related to terrestrial ecosystems and global climate. In this chapter we review the main concepts and techniques for monitoring vegetation conditions at continental scale using time series of satellite optical observations. A new approach based on a synthetic indicator of anomalies in vegetated land cover is also presented. This indicator is obtained by aggregating through the use of fuzzy sets theory the contributions from several factors derived from the analysis of time series of satellite products. The application of the method in the detection of anomalous conditions over the African continent is presented.

It is known that hypopituitarism reduces life expectancy and increases the risk of death for cardio- and cerebrovascular disease. Many studies report this phenomenon due to vascular diseases, and GH deficiency (GHD) seems to significantly contribute to the higher mortality. Aim of this article is to review the relationship between GH and cardiovascular risk factors to evaluate the beneficial effects of therapy in the adult GHD. GH replacement therapy (GHRT) improves insulin sensitivity, and reduces LDL cholesterol and triglyceride levels. Several studies also documented a decrease in the intima-media thickness at major arteries and improvement in microvascular and endothelial function. Other studies showed a decrease of inflammatory markers and the normalization of coagulation parameters. Finally, some authors have reported improvements in cardiac performance as well. These data evidence the positive effects of GHRT in the prevention of premature atherosclerosis in adults with GHD, and encourage the early administration of replacement therapy.

CARTELGIS (Diffusione e sperimentazione della Cartografia, del Telerilevamento e dei Sistemi Informativi Geografici), come tecnologie didattiche applicate allo studio del territorio e dell'ambiente, è un progetto proposto dall'Università di Bologna e IREA del CNR di Milano, finanziato dal MIUR e svolto negli anni 2004-2006. Suo obiettivo è diffondere la conoscenza delel discipline che a vario titolo si occupano dell'osservazione della Terra e di sperimentare la loro efficacia come strumenti conoscitivi del territorio e dell'ambiente a supporto delle attività didattiche interdiscipolinari a livello scolastico ed universitario. Vengono descritte le caratteristiche del progetto e si traccia un bilancio dell'esperienza e delle sue possibili prospettive.

The conversion of power lines from rigid insulators into string insulators is very important for the quality of electrical supply. The conversion needs the replacement of existing head pole brackets with innovative brackets. The necessity to design a one piece, open, light, elastic structure, requiring simple manoeuvres to safely assemble in existing lines, with live working techniques, became a goal. The reply: FALCON/spl trade/, tubular "C" shaped bracket (patent TO2000A000822) and GATOR/spl trade/ (patent TO2002A000361), a new functional open crib suspension clamp.