Italian family paediatricians' approach and management of celiac disease: a cross-sectional study in Puglia Region, 2012.

BACKGROUND: Celiac disease (CD) is a chronic autoimmune illness of the small intestine triggered by gluten consumption in genetically predisposed individuals. CD presentation is not limited to the gastrointestinal tract and it is still under-diagnosed. Complete resolution of clinical manifestations follows if a gluten-free diet is adopted. In western countries, CD prevalence is approximately 1%. Age of onset is often between 6 months and 7 years.We assessed the approach to diagnosis and management of celiac patients by the paediatricians in Puglia Region, Italy. METHODS: We conducted a cross-sectional survey among the 589 Apulian Family Paediatricians (FPs) during January 2011-January 2012 using a self-administered web-based standardized questionnaire including self-assessment of their knowledge, diagnostic path and type of management they would follow for CD, clinical information on their celiac patients. We assessed associations among the explored variables by defining double-entry contingency tables and calculating Odds Ratio (OR) with 95% Confidence Intervals (CIs). RESULTS: The 218 (37%) FPs participating in the study reported 1,020 CD patients (representing approximately 1% of the child population covered by the enrolled FPs). Of them, 55% were female; 45% were aged 5-10 years. Weight loss and stunting were the main reported symptoms at diagnosis (41%). The majority (98%) of FPs requested anti-transglutaminase antibody (tTG-Ab) titres for CD diagnosis. Approximately 78% of FPs recommended gluten introduction in the diet of infants at the age of 6 months; 12% and 8% recommended introduction of gluten before and after 6 months of age respectively.The degree of knowledge for either CD diagnosis making process or CD related diseases was medium/high in 97% and 82% of the participating FPs respectively. FPs (83%) who had a medium or high degree of knowledge of CD patients' diet were more likely to experience low or no difficulty in providing their patients with dietary advices (OR:5.5; 95%CI:1.7-17.5). CONCLUSIONS: Apulian FPs report a good degree of knowledge of CD, its diagnosis and its management. We will diffuse results and recommendations to all paediatricians in the Region. Actions aiming to continued education on CD in medical under and postgraduate trainings are crucial to prevent under-diagnosis.

Long-short term memory networks for modeling track geometry in laser metal deposition.

Modeling metal additive manufacturing processes is of great importance because it allows for the production of objects that are closer to the desired geometry and mechanical properties. Over-deposition often takes place during laser metal deposition, especially when the deposition head changes its direction and results in more material being melted onto the substrate. Modeling over-deposition is one of the necessary steps toward online process control, as a good model can be used in a closed-loop system to adjust the deposition parameters in real-time to reduce this phenomenon. In this study, we present a long-short memory neural network to model over-deposition. The model has been trained on simple geometries such as straight tracks, spiral and V-tracks made of Inconel 718. The model shows good generalization capabilities and can predict the height of more complex and previously unseen random tracks with limited performance loss. After the addition to the training dataset of a small amount of data coming from the random tracks, the performance of the model for such additional shapes improves significantly, making this approach feasible for more general applications as well.

Generalized Behavior Framework for Mobile Robots Teaming With Humans in Harsh Environments.

Industrial contexts, typically characterized by highly unstructured environments, where task sequences are difficult to hard-code and unforeseen events occur daily (e.g., oil and gas, energy generation, aeronautics) cannot completely rely upon automation to substitute the human dexterity and judgment skills. Robots operating in these conditions have the common requirement of being able to deploy appropriate behaviours in highly dynamic and unpredictable environments, while aiming to achieve a more natural human-robot interaction and a broad range of acceptability in providing useful and efficient services. The goal of this paper is to introduce a deliberative framework able to acquire, reuse and instantiate a collection of behaviours that promote an extension of the autonomy periods of mobile robotic platforms, with a focus on maintenance, repairing and overhaul applications. Behavior trees are employed to design the robotic system's high-level deliberative intelligence, which integrates: social behaviors, aiming to capture the human's emotional state and intention; the ability to either perform or support various process tasks; seamless planning and execution of human-robot shared work plans. In particular, the modularity, reactiveness and deliberation capacity that characterize the behaviour tree formalism are leveraged to interpret the human's health and cognitive load for supporting her/him, and to complete a shared mission by collaboration or complete take-over. By enabling mobile robotic platforms to take-over risky jobs which the human cannot, should not or do not want to perform the proposed framework bears high potential to significantly improve the safety, productivity and efficiency in harsh working environments.

Laser Metal Deposition of Inconel 718 Alloy and As-built Mechanical Properties Compared to Casting.

In the last years, powder-based Laser Metal Deposition (LMD) has been attracting attention as a disruptive Additive Manufacturing (AM) technique for both the fabrication and restoration of Inconel 718 components, enabling to overcome current limitations faced by conventional manufacturing processes in terms of manufacturing costs, tool wear, and lead time. Nevertheless, the uncertainty related to the final mechanical performance of the as-built LMD parts limits a wider adoption of such technology at industrial level. This research work focuses on the mechanical characterization of as-built Inconel 718 specimens through split Hopkinson tensile bar tests performed at different strain rate conditions. The influence of laser power on the final mechanical behavior of the as-built tensile samples is discussed and compared with the mechanical response of as-cast ones. The as-built specimens exhibit a high internal density (i.e., 99.92% and 99.90% for 300 W and 400 W, respectively) and a more ductile behavior compared to the as-cast ones for every evaluated strain rate condition. The strain hardening capacity of the as-built samples increases with the laser power involved in the LMD process, reaching an average Yield Strength of 703 MPa for specimens realized at 400 W and tested at 800/s.

[Leptomeningeal carcinomatosis as the first clinical manifestation of lung adenocarcinoma: case report]. / Carcinomatose leptomeníngea como primeira manifestação de adenocarcinoma pulmonar: relato de caso.

Leptomeningeal carcinomatosis is a neurological complication of several systemic tumors and is characterized by multifocal invasion of the meninges by neoplastic cells. It is estimated that 5% of all patients with cancer will present leptomeningeal carcinomatosis at some time during the course of the illness. Clinical manifestations are heterogeneous and present with signs and symptoms related to involvement of multiple areas of the nervous system, particularly cranial nerves and spinal roots. The diagnosis is based on suggestive clinical findings, cerebrospinal fluid (CSF) testing and imaging studies. The most informative findings come from CSF where the presence of neoplastic cells is definitive for the diagnosis. The purpose of this report is to describe, along with a review of the literature, a clinical case of a 42 years old man in whom the first clinical signs of a lung cancer manifested with symptoms suggestive of meningeal involvement.

Paternò-Büchi reaction between aromatic carbonyl compounds and 1-(3-furyl)alkanols.

The photochemical reaction between aromatic carbonyl compounds and 3-furylmethanol derivatives occurs with high regioselectivity. In most of the experiments formation of oxetanes occurs at the hydroxyalkylated double bond. With chiral 1-(3-furyl)alkanols the reaction occurs with good-high stereoselectivity. In the case of 1-(3-furyl)-benzyl alcohol the stereoselectivity can be explained on the basis of the conformers of the reagent, assuming the formation of a complex between the carbonyl compound and the hydroxyl group.

Carcinomatose leptomeníngea como primeira manifestaçäo de adenocarcinoma pulmonar. Relato de caso / Leptomeningeal carcinomatosis as the first clinical manifestation of lung adenocarcinoma: case report

A carcinomatose leptomeníngea é uma complicaçäo neurológica de alguns tumores sistêmicos caracterizada por invasäo multifocal das leptomeninges por células neoplásicas. Estima-se que 5 por cento de todos os pacientes com câncer apresentem carcinomatose leptomeníngea. As manifestações clínicas säo heterogêneas e caracterizam-se por sinais e sintomas relacionados a comprometimento de múltiplas áreas do sistema nervoso, particularmente nervos cranianos e raízes nervosas. O diagnóstico é baseado nos achados clínicos, exame do líquido cefalorraqueano (LCR) e exames de neuroimagem. O estudo mais informativo para o diagnóstico de metástase meníngea é o exame do LCR através do qual o achado de células neoplásicas é definitivo para o diagnóstico. O intuito deste trabalho é realizar revisäo da literatura a partir de descriçäo de um caso clínico, de um homem de 42 anos de idade, em que a primeira manifestaçäo de neoplasia pulmonar consistiu de sintomas e sinais sugestivos de comprometimento neoplásico das leptomeninges