ZPD Retrieval Performances of the First Operational Ship-Based Network of GNSS Receivers over the North-West Mediterranean Sea.

This work presents the design and implementation of an operational infrastructure for the monitoring of atmospheric parameters at sea through GNSS meteorology sensors installed on liners operating in the north-west Mediterranean Sea. A measurement system, capable of operationally and continuously providing the values of surface parameters, is implemented together with software procedures based on a float-PPP approach for estimating zenith path delay (ZPD) values. The values continuously registered over a three year period (2020-2022) from this infrastructure are compared with the data from a numerical meteorological reanalysis model (MERRA-2). The results clearly prove the ability of the system to estimate the ZPD from ship-based GNSS-meteo equipment, with the accuracy evaluated in terms of correlation and root mean square error reaching values between 0.94 and 0.65 and between 18.4 and 42.9 mm, these extreme values being from the best and worst performing installations, respectively. This offers a new perspective on the operational exploitation of GNSS signals over sea areas in climate and operational meteorological applications.

Single-stage versus two-stage bone flap reconstruction in chronic osteomyelitis: Multicenter outcomes comparison.

BACKGROUND: Chronic osteomyelitis is an invalidating disease, and its severity grows according to the infection's particular features. The Cierny-Maiden criteria classify it according to the anatomical aspects (I to IV) and also by physiological class (A host being in good immune condition and B hosts being locally (L) or systemically (S) compromised). The surgical approach to chronic osteomyelitis involves radical debridement and dead space reconstruction. Two-stage management with delayed reconstruction is the most common surgical management, while one-stage treatment with concomitant reconstruction is a more aggressive approach with less available literature. Which method gives the best results is unclear. The purpose of this study is to compare single and two-stage techniques. METHODS: The authors carried out a retrospective multicentric cohort study to compare two primary outcomes (bone union and infection healing) in one versus two-stage reconstructions with vascularized bone flaps in 23 cases of limb osteomyelitis (22 patients, 23 extremities). Thirteen subjects (56.5%) sustained a single-stage treatment consisting of a single surgery of radical debridement, concomitant soft tissue coverage, and bone reconstruction. Ten cases (43.5%) sustained a two-stage approach: radical debridement, simultaneous primary soft tissue closure, and antibiotic PMMA spacers implanted in 7 patients. RESULTS: No statistical differences were observed between one- and two-stage approaches in bone union rate and infection recurrence risk. Even though bone union seems to be higher and faster in the two-stage than in the one-stage group, and all infection relapses occurred in the one-stage group, data did not statistically confirm these differences. Two of the six cases (33.3%) of bone nonunion occurred in compromised hosts (representing only 17.4% of our sample). The B-hosts bone union rate was 50.0%, while it reached 78.9% in A-hosts, but the difference was not statistically significant (p = .5392). Infection recurrence was higher in B-hosts than in A-hosts (p = .0086) and in Pseudomonas aeruginosa sustained infections (p = .0208), but in the latter case, the treatment strategy did not influence the outcome (p = .4000). CONCLUSIONS: Bone union and infection healing rates are comparable between one and two-stage approaches. Pseudomonas aeruginosa infections have a higher risk of infection relapse, with similar effectiveness of one- and two-stage strategies. B-hosts have a higher infection recurrence rate without comparable data between the two approaches. Further studies with a larger sample size are required to confirm our results and define B-hosts' best strategy. LEVEL OF EVIDENCE: Level III of evidence, retrospective cohort study investigating the results of treatments.

Frontal site surgery for chronic migraine therapy.

BACKGROUND: According to the most current theories, chronic inflammation of some cranial nerves give rise to an inflammatory chain that would result in migraines. As for frontally located attacks, the nerves involved are two (on each side): the supraorbital and the supratrochlear. Surgical treatment includes complete neurolysis of both of these nerves. METHODS: In this work, we describe our experience with this type of surgery. From 2011 to 2022, we treated 98 cases suffering from chronic migraine not responsive to drugs with frontal localization. The results were evaluated through a specific questionnaire three months and one year after surgery. RESULTS: After three months post-surgery, we observed a success rate (reduction of monthly attacks equivalent to or greater than 50%) in 87% of patients (32% complete recovery). These results were essentially confirmed one year after surgery. The rare complications (mainly paresthesias and dysesthesias of the frontal area) have always resolved spontaneously within a few months. CONCLUSION: The surgical approach allowed to obtain good therapeutic results with a low rate of complications.

Use of Sentinel-3 OLCI Images and Machine Learning to Assess the Ecological Quality of Italian Coastal Waters.

Understanding and monitoring the ecological quality of coastal waters is crucial for preserving marine ecosystems. Eutrophication is one of the major problems affecting the ecological state of coastal marine waters. For this reason, the control of the trophic conditions of aquatic ecosystems is needed for the evaluation of their ecological quality. This study leverages space-based Sentinel-3 Ocean and Land Color Instrument imagery (OLCI) to assess the ecological quality of Mediterranean coastal waters using the Trophic Index (TRIX) key indicator. In particular, we explore the feasibility of coupling remote sensing and machine learning techniques to estimate the TRIX levels in the Ligurian, Tyrrhenian, and Ionian coastal regions of Italy. Our research reveals distinct geographical patterns in TRIX values across the study area, with some regions exhibiting eutrophic conditions near estuaries and others showing oligotrophic characteristics. We employ the Random Forest Regression algorithm, optimizing calibration parameters to predict TRIX levels. Feature importance analysis highlights the significance of latitude, longitude, and specific spectral bands in TRIX prediction. A final statistical assessment validates our model's performance, demonstrating a moderate level of error (MAE of 0.51) and explanatory power (R2 of 0.37). These results highlight the potential of Sentinel-3 OLCI imagery in assessing ecological quality, contributing to our understanding of coastal water ecology. They also underscore the importance of merging remote sensing and machine learning in environmental monitoring and management. Future research should refine methodologies and expand datasets to enhance TRIX monitoring capabilities from space.

Para-oesophageal hernia in 4-month-old girl: possible role of ultrasound-case report and literature review.

Hiatal hernia is the passage of digestive tract portions into the posterior mediastinum through a defect in the esophageal diaphragmatic hiatus. By guidelines, the diagnosis uses first-level radiographic investigations such as chest X-ray and contrastographic methods. As of today, use of ultrasonography in the suspicion/diagnosis of hiatal hernia is not standardized although it shows advantages such as not using ionizing radiation, which is essential in the small pediatric patient. We report the case of a little 4-month-old patient who came to our attention for dysphagia, vomiting and borborygmus to whom Type II hiatal hernia was suspected by ultrasound investigation, later confirmed by guidelines approved methods.

Development and Calibration of a Low-Cost, Piezoelectric Rainfall Sensor through Machine Learning.

In situ measurements of precipitation are typically obtained by tipping bucket or weighing rain gauges or by disdrometers using different measurement principles. One of the most critical aspects of their operational use is the calibration, which requires the characterization of instrument responses both in laboratory and in real conditions. Another important issue with in situ measurements is the coverage. Dense networks are desirable, but the installation and maintenance costs can be unaffordable with most of the commercial conventional devices. This work presents the development of a prototype of an impact rain gauge based on a very low-cost piezoelectric sensor. The sensor was developed by assembling off-the-shelf and reused components following an easy prototyping approach; the calibration of the relationship between the different properties of the voltage signal, as sampled by the rain drop impact, and rainfall intensity was established using machine-learning methods. The comparison with 1-minute rainfall obtained by a co-located commercial disdrometer highlights the fairly good performance of the low-cost sensor in monitoring and characterizing rainfall events.

Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team's Experience.

Background: For head and neck reconstructive procedures, free flap survival depends on microsurgical and anatomical choices besides multimodal clinical management. The aim of the present study is to identify relevant variables for flap survival in our initial consecutive series. Methods: A single-center, novel reconstructive team consecutive surgical series was revised. The outcome was analyzed in terms of flap survival observing variables considered more relevant: flap type, recipient artery, vein(s), and graft interposition were discussed for facial thirds to be reconstructed. Statistical analysis was performed with Chi-square, Mann-Whitney, and Odds ratio. Results: A total of 118 free flaps were performed in 115 microsurgical procedures (93.9% for malignancies) on 109 patients, with a flap survival rate of 91.5%. For reconstruction of the middle and lower third of the face, the facial artery was privileged, because it was already transected during lymph node dissection in order to save the superior thyroid artery for further microsurgical needs. Flap failure was 50% venous. Double vein anastomosis was not related to flap survival. Deep venous drainage (as the internal jugular vein system) required fewer revisions. Half of the re-explorations saved the flap. Grafts were a risk for flap survival. Bony flaps were more critical. Conclusion: At comparable reconstructive quality, flap choice should avoid a vascular graft. The facial artery is a preferable recipient vessel, since it saves other arteries both in the case of an arterial revision and in the case of recurrence, for further free flap reconstruction. For venous anastomosis, a deep venous recipient is safer, since it offers the possibility to choose the level of anastomosis optimizing the vascular pedicle geometry. A close postsurgical flap monitoring is advisable up to 7 days postoperatively to allow for timely flap salvage.

A smartphone-based petrographic microscope.

Photomicrographs of thin sections provide a swift and efficient means of sharing information for consultation, education, documentation and publication within the Geosciences and related areas. In general terms, the main way to capture digital microscopic images involves the use of a mounted camera unit on a high-end costly benchtop microscope. However, freehand methods to capture microscope-scale images using a smartphone, as well as smartphone adapters that can be attached to a microscope have emerged during recent years. This paper presents the design features of a costless system able to obtain photomicrographs without requiring a conventional microscope. The imaging device is comprised of a mini-objective lens attached to a smartphone and a structure that allows it to focus as well as to rotate the stage and to insert/remove a polarized sheet. The quality and magnification of the images attainable from the new design is comparable to the images normally obtained by a conventional petrographic microscope using a ×4 objective and a ×10 ocular (total magnification ×40).

Extended field-of-view ultrathin microendoscopes for high-resolution two-photon imaging with minimal invasiveness.

Imaging neuronal activity with high and homogeneous spatial resolution across the field-of-view (FOV) and limited invasiveness in deep brain regions is fundamental for the progress of neuroscience, yet is a major technical challenge. We achieved this goal by correcting optical aberrations in gradient index lens-based ultrathin (≤500 µm) microendoscopes using aspheric microlenses generated through 3D-microprinting. Corrected microendoscopes had extended FOV (eFOV) with homogeneous spatial resolution for two-photon fluorescence imaging and required no modification of the optical set-up. Synthetic calcium imaging data showed that, compared to uncorrected endoscopes, eFOV-microendoscopes led to improved signal-to-noise ratio and more precise evaluation of correlated neuronal activity. We experimentally validated these predictions in awake head-fixed mice. Moreover, using eFOV-microendoscopes we demonstrated cell-specific encoding of behavioral state-dependent information in distributed functional subnetworks in a primary somatosensory thalamic nucleus. eFOV-microendoscopes are, therefore, small-cross-section ready-to-use tools for deep two-photon functional imaging with unprecedentedly high and homogeneous spatial resolution.

Development and characterization of portable smartphone-based imaging device.

Many diseases in rural areas and developing countries are detected late at an advanced stage when treatment might involve complications and higher cost, resulting in a greater number of fatalities. This study aims to make early disease detection simpler and affordable for people living in remote areas and developing countries. A new age optical microscope with high sensitivity diagnosis can revolutionize this gap in disease detection. Here, a smartphone-based imaging device (SID) using optics and a smartphone interface was developed to speedup the process of diagnosis in areas that do not have easy access to health centers and diagnostic clinics. The device was built using acrylic sheets to make it less bulky and customizable and three-dimensional (3D) printed mechanical parts were used to increase stability. The study includes calibration, and testing the device with various samples to determine its capabilities. Images were acquired using the various types of BLIPS lens integrated onto the smartphone camera lens and compared with optical microscope images. The device can visualize single human blood cell which is 8 µm in size using ultra-BLIPS lens and magnification is comparable to an objective lens used in an optical microscope.

Accurate assessment of nonalcoholic fatty liver disease lesions in liver allograft biopsies by a smartphone platform: A proof of concept.

Macrovesicular steatosis (MS) is a major risk factor for liver graft failure after transplantation and pathological microscopic examination of a frozen tissue section remains the gold standard for its assessment. However, the latter requires an experienced in-house pathologist for correct and rapid diagnosis as well as specific equipment that is not always available. Smartphones, which are must-have tools for everyone, are very suitable for incorporation into promising technology to generate moveable diagnostic tools as for telepathology. The study aims to compare the microscopic assessment of nonalcoholic fatty liver disease (NAFLD) spectrum in liver allograft biopsies by a smartphone microscopy platform (DIPLE device) to standard light microscopy. Forty-two liver graft biopsies were evaluated in transmitted light, using an iPhone X and the microscopy platform. A significant correlation was reported between the two different approaches for graft MS assessment (Spearman's correlation coefficient: r = .93; p < .001) and for steatohepatitis feature (r = .56; p < .001; r = .45; p < .001). Based on these findings, a smartphone integrated with a cheap microscopy platform can achieve adequate accuracy in the assessment of NAFLD in liver graft and could be used as an alternative to standard light microscopy when the latter is unavailable.

Treatment of chronic Osteomyelitis with vascularized bone flaps in one-stage-procedure.

BACKGROUND: Chronic osteomyelitis is a long-standing infection of the bone. Treatment is often combined, using antibiotics and surgery (with radical debridement and secondary or concomitant reconstruction). One-stage management is an alternative approach, with few reported cases in literature. PATIENTS/MATERIAL AND METHODS: We carried out an observational retrospective multicenter study to evaluate the results of one-stage reconstructions with vascularized bone flaps. We assessed bone and infection healing in 14 cases, with a mean follow-up of 63.6 months. RESULTS: Bone union was obtained in 10 cases (71.4 %) in a mean period of 7.9 months. Nonunion occurred in 4 cases (28.6 %), 2 of them with infection persistence. Bone nonunion risk increases in polymicrobial infections (p = 0.0269) and in compromised hosts (p = 0.0110). Infection healing was achieved in 11 cases (78.6 %). Fistula recurred in 3 cases of forearm osteomyelitis (21.4 %) in 10 months on average. Infection recurrence is associated with polymicrobial infections (p = 0.0378) and is higher in internal fixation and compromised hosts with no statistically significant relation. CONCLUSIONS: One-stage surgical treatment seems to be an effective approach in selected patients, in particular when an important impairment of local soft tissue and bone exposure are present, and immediate bone coverage with vascularized soft tissue is needed. Most complications occurred in compromised hosts and in patients with polymicrobial cultures. Further research, with comparison between one and two-stage procedures, is needed in order to strengthen the level of evidence.

Bone Defect Management with Vascularized Fibular Grafts in the Treatment of Grade III-IV Osteomyelitis.

PURPOSE: This study is a retrospective analysis of our experience in microsurgical bone transfers for complex limb reconstructions. The aim of this study is to evaluate reliability of the vascularized fibula technique: infection recurrence, hypertrophy, time to bone union, complications, and time to healing in severe osteomyelitis (Cierny-Mader III and IV) cases over a 38 to 93 month follow-up. PATIENTS AND METHODS: From March 2010 until December 2015, 18 patients' limbs (6 females and 1 2 males; mean age 48.7 years) were reconstructed with 10 free fibula flaps, 5 pedicled fibula flaps, 3 peroneus brevis osteomuscular flaps. We reconstructed 2 radiuses, 2 ulnae, 4 femurs, 4 tibiae, 1 acetabulum and 3 fibular malleoli. RESULTS: We considered as successful results all cases where patients had successful functional bone reconstruction with no recurrence of infection during the follow up (mean time 63.6 months). We obtained 14 complete functional reconstructions, 2 limb salvages with impaired function, and 2 failures which underwent major amputations. In only one case there was an infection recurrence. CONCLUSIONS: The bone defect reconstruction with vascularized fibula grafts in severe bone infections is an effective option, but requires a well trained multidisciplinary team to manage the high rate of complications. Complications, in our series, were demonstrated to be significantly associated to patients defined as B-hosts according to Cierny-Mader's classification (P < 0.05), and caliber discrepancy between fibula and reconstructed bones such as Tibia and Femur (P < 0.005). Furthermore, stress fractures in the grafted fibulae were prognostic indicators for overall treatment failure (P < 0.05).

Reconstructive surgery for thumb osteomyelitis: a new way of remodelling the vascularized medial femoral condyle flap. A case report.

BACKGROUND: Authors propose a technical innovation for the remodelling of the medial femoral condyle flap (MFCF) for reconstruction of small to medium bone defects performed after the surgical treatment of a thumb osteomyelitis. MATERIALS AND METHODS: A 45 year old male had thumb proximal phalanx osteomyelitis after a crush trauma of the dominant right hand and multiple previous unsuccessful surgical attempts in other hospitals. In our centre he underwent to a two stage surgical treatment of the infection through bone and soft tissue reconstruction with a MFCF shaped in a new three dimensional (3D) approach with multiple osteotomies. RESULTS: Bone union was achieved after 30 days with a stable thumb reconstruction and good soft tissue healing. No vascular complication occurred after surgery. There was no sign of infection recurrence. CONCLUSIONS: MFCF offers a variety of options for its 3 D shaping which make it a good solution in hand surgery reconstructions after surgical excision of small and medium size bony segments.

Testing feasibility of an accurate microscopic assessment of macrovesicular steatosis in liver allograft biopsies by smartphone add-on lenses.

Light microscopy is an essential tool in histological examination of tissue samples. However, the required equipment for a correct and rapid diagnosis is sometimes unavailable. Smartphones and mobile phone networks are widespread, and could be used for diagnostic imaging and telemedicine. Macrovesicular steatosis (MS) is a major risk factor for liver graft failure, and is only assessable by microscopic examination of a frozen tissue section. The aim of this study was to compare the microscopic assessment of MS in liver allograft biopsies by a smartphone with eyepiece adaptor (BLIPS device) to standard light microscopy. Forty liver graft biopsies were evaluated in transmitted light, using an Iphone 5s and 4 different mini-objective, add-on lenses. A significant correlation was reported between the two different approaches for graft MS assessment (Spearman's correlation coefficient: rs = 0.946; p < .001). Smartphone with eyepiece adaptor had similar discriminatory power to identify MS in liver grafts than standard light microscopy. Based on these findings, a smartphone integrated with a low-cost eyepiece adaptor can achieve adequate accuracy in the assessment of MS in liver graft, and could be used as an alternative to standard light microscope when unavailable.

The peroneus brevis flap in the treatment of bone infections of the lower limb.

The Peroneus Brevis Flap is a described option for the soft tissue coverage and for small bone gap reconstruction in the lower third of the lower leg, where few other local flaps are available and reliable. We analysed retrospectively a case series of 11 consecutive patients whose age ranged from 31 to 87 years (mean 56), who underwent a reconstruction with a PB flap in the treatment of post-traumatic bone infections from October 2010 to February 2012. In our series, only one patient at a 3 year minimum follow-up showed recurrence of the bone infection and required further surgical treatment. Main complications were partial flap necrosis or overlying skin graft necrosis, but without the need of secondary surgery. In our experience, the PB flap is a reliable option for soft tissue coverage in the treatment of distal leg and ankle osteomyelitis.

Real-Time Rain Rate Evaluation via Satellite Downlink Signal Attenuation Measurement.

We present the NEFOCAST project (named by the contraction of "Nefele", which is the Italian spelling for the mythological cloud nymph Nephele, and "forecast"), funded by the Tuscany Region, about the feasibility of a system for the detection and monitoring of precipitation fields over the regional territory based on the use of a widespread network of new-generation Eutelsat "SmartLNB" (smart low-noise block converter) domestic terminals. Though primarily intended for interactive satellite services, these devices can also be used as weather sensors, as they have the capability of measuring the rain-induced attenuation incurred by the downlink signal and relaying it on an auxiliary return channel. We illustrate the NEFOCAST system architecture, consisting of the network of ground sensor terminals, the space segment, and the service center, which has the task of processing the information relayed by the terminals for generating rain field maps. We discuss a few methods that allow the conversion of a rain attenuation measurement into an instantaneous rainfall rate. Specifically, we discuss an exponential model relating the specific rain attenuation to the rainfall rate, whose coefficients were obtained from extensive experimental data. The above model permits the inferring of the rainfall rate from the total signal attenuation provided by the SmartLNB and from the link geometry knowledge. Some preliminary results obtained from a SmartLNB installed in Pisa are presented and compared with the output of a conventional tipping bucket rain gauge. It is shown that the NEFOCAST sensor is able to track the fast-varying rainfall rate accurately with no delay, as opposed to a conventional gauge.

Scanless functional imaging of hippocampal networks using patterned two-photon illumination through GRIN lenses.

Patterned illumination through the phase modulation of light is increasingly recognized as a powerful tool to investigate biological tissues in combination with two-photon excitation and light-sensitive molecules. However, to date two-photon patterned illumination has only been coupled to traditional microscope objectives, thus limiting the applicability of these methods to superficial biological structures. Here, we show that phase modulation can be used to efficiently project complex two-photon light patterns, including arrays of points and large shapes, in the focal plane of graded index (GRIN) lenses. Moreover, using this approach in combination with the genetically encoded calcium indicator GCaMP6, we validate our system performing scanless functional imaging in rodent hippocampal networks in vivo ~1.2 mm below the brain surface. Our results open the way to the application of patterned illumination approaches to deep regions of highly scattering biological tissues, such as the mammalian brain.