Digital dermoscopy monitoring of melanocytic lesions: Two novel calculators combining static and dynamic features to identify melanoma.

BACKGROUND: Early diagnosis is the most effective intervention to improve the prognosis of cutaneous melanoma. Even though the introduction of dermoscopy has improved the diagnostic accuracy, it can still be difficult to distinguish some melanomas from benign melanocytic lesions. Digital dermoscopy monitoring can identify dynamic changes of melanocytic lesions: To date, some algorithms were proposed, but a universally accepted one is still lacking. OBJECTIVES: To identify independent predictive variables associated with the diagnosis of cutaneous melanoma and develop a multivariable dermoscopic prediction model able to discriminate benign from malignant melanocytic lesions undergoing digital dermoscopy monitoring. METHODS: We collected dermoscopic images of melanocytic lesions excised after dermoscopy monitoring and carried out static and dynamic evaluations of dermoscopic features. We built two multivariable predictive models based on logistic regression and random forest. RESULTS: We evaluated 173 lesions (65 cutaneous melanomas and 108 nevi). Forty-two melanomas were in situ, and the median thickness of invasive melanomas was 0.35 mm. The median follow-up time was 9.8 months for melanomas and 9.1 for nevi. The logistic regression and random forest models performed with AUC values of 0.87 and 0.89, respectively, were substantially higher than those of the static evaluation models (ABCD TDS score, 0.57; 7-point checklist, 0.59). Finally, we built two risk calculators, which translate the proposed models into user-friendly applications, to assist clinicians in the decision-making process. CONCLUSIONS: The present study demonstrates that the integration of dynamic and static evaluations of melanocytic lesions is a safe approach that can significantly boost the diagnostic accuracy for cutaneous melanoma. We propose two diagnostic tools that significantly increase the accuracy in discriminating melanoma from nevi during digital dermoscopy monitoring.

Raltegravir-based therapy in a cohort of HIV/HCV co-infected individuals.

The relationship between hepatic tolerance and hepatitis C virus (HCV) co-infection has not been extensively studied in clinical practice. We assessed the efficacy and safety of raltegravir-based therapy in an Italian cohort of HIV/HCV co-infected patients. One hundred and forty patients with HIV/HCV co-infection initiating raltegravir from SCOLTA project (Surveillance Cohort Long-Term Toxicity Antiretrovirals) were examined. Of them, 43 were women, with mean age of 45.4±6.4years; 65 (46%) had undetectable HIV-RNA<50copies/mL and 75 (54%) HIV-RNA≥50copies/mL. According to CDC classification, 49 (35%) were in stage C. Based on Fib4 score at the time of starting raltegravir, patients were classified in class I in 41 cases, class II in 68 and in class III in 31 cases. Globally, the Fib4 score slightly decreased during 24months follow-up, from 2.2 to a value of 1.8. Hepatic adverse events of any grade were observed in 67 patients, of which only 2 cases (3%) had severe liver toxicity (grade 3-4). Only one patient had to discontinue the therapy because of adverse events. According to univariate analysis, being in CDC stage C represented a risk for the development of liver toxicity, with a hazard ratio (HR) of 2.27 (95% CI 1.06-4.84, P=0.033). None of the other variables considered (age, sex, years since detection of HIV and HCV-RNA detectable, years of previous HIV therapy, concomitant therapy with PI or NRTI, CD4+ cell count, Fib4, and transaminases level at baseline) resulted statistically correlated to the outcome. In conclusion, raltegravir-based regimens can be safely used in HCV infected patients; in this study, the hepatic toxicity has been found to be more frequent in patients with an advanced HIV disease (CDC stage C), independently of HIV-RNA suppression at raltegravir initiation.

An advanced lithium-air battery exploiting an ionic liquid-based electrolyte.

A novel lithium-oxygen battery exploiting PYR14TFSI-LiTFSI as ionic liquid-based electrolyte medium is reported. The Li/PYR14TFSI-LiTFSI/O2 battery was fully characterized by electrochemical impedance spectroscopy, capacity-limited cycling, field emission scanning electron microscopy, high-resolution transmission electron microscopy, and X-ray photoelectron spectroscopy. The results of this extensive study demonstrate that this new Li/O2 cell is characterized by a stable electrode-electrolyte interface and a highly reversible charge-discharge cycling behavior. Most remarkably, the charge process (oxygen oxidation reaction) is characterized by a very low overvoltage, enhancing the energy efficiency to 82%, thus, addressing one of the most critical issues preventing the practical application of lithium-oxygen batteries.

Raman investigation of the ionic liquid N-methyl-N-propylpyrrolidinium bis(trifluoromethanesulfonyl)imide and its mixture with LiN(SO2CF3)2.

A preliminary Raman investigation of the ionic liquid N-methyl-N-propylpyrrolidinium bis(trifluoromethanesulfonyl)imide (PYR(13)TFSI) and its 2/1 complex with the lithium salt LiN(SO(2)CF(3))(2) is reported. The study was performed over a temperature range extending from -100 to +60 degrees C, i.e., with PYR(13)TFSI in the crystalline and melt states. For comparison purposes, the study was extended to PYR(13)I, which is the precursor used in the synthesis of PYR(13)TFSI.

Airbag and hearing loss: our experience.

The international literature reports sporadic cases of sudden sensorineural hearing loss associated with Airbag inflation in subjects involved in car accidents, who had never suffered from hearing loss and had no history of pathologies that could otherwise explain the hearing loss. The authors have studied the actual incidence of this possibility, analysing 25 subjects submitted to an airbag inflation. Only subjects who had never suffered from previous otological pathology were considered for the study. The examination was carried out 3 to 10 days after the accident. Otoscopical examination, tympanometry and audiometry were normal in all the examined subjects. The Author's opinion is that traumatic hearing loss following airbag inflation is a rare or exceptional incident that probably occurs in subjects with a particular susceptibility and sensitivity.

Determination of LiCF(3)SO(3) and gamma-LiAlO(2) in composite PEO-based polymer electrolytes by flame atomic absorption spectrometry.

A simple and rapid method for the determination of LiCF(3)SO(3) and gamma-LiAlO(2) in composite PEO (poly(ethylene)oxide)-based polymer electrolytes, both in mixtures and thin films, is described. The method is based on the dissolution of LiCF(3)SO(3) in anhydrous ethanol at room temperature and subsequently dissolution of PEO in water for the separation of gamma-LiAlO(2). Determination of the lithium content in LiCF(3)SO(3) and gamma-LiAlO(2) was performed by flame atomic absorption spectrometry (FAAS). A fast and total recovery of the components is achieved, being within 99-100%. The analysis of variance (ANOVA) is used to estimate the contribution of variance of chemical analysis and sampling procedure to the total variance. The results from ANOVA show a high level of homogeneity of the samples.

Evidence of bilayer structure in V2O5 xerogel.

Polarized X-ray absorption spectroscopy has been used to study the short-range structure of deposited films of V2O5 xerogel. The material is characterized by a layer of VO5 units with the V-O apical bond perpendicular to the basal (xy) plane. We have focused our attention along the z axis. Experiments were carried out by extended X-ray absorption fine structure (EXAFS) spectroscopy in a grazing incidence geometry and showed evidence for close interactions between neighboring layers of V2O5. The structure is described by two sheets of V2O5 facing each other. Fitting of the EXAFS data has confirmed the existence of a vanadium-vanadium interaction between two different V2O5 layers and an oxygen bridge between them.