Spintronic memristors for neuromorphic circuits based on the angular variation of tunnel magnetoresistance.

In this study, a new type of compact magnetic memristor is demonstrated. It is based on the variation of the conductivity of a nano-sized magnetic tunnel junction as a function of the angle between the in-plane reference layer magnetization and a free layer exhibiting an isotropic in-plane coercivity. The free layer magnetization is rotated by two spin transfer torque contributions: one originating from the in-plane magnetized reference layer and the other one from an additional perpendicular polarizer integrated in the stack. Thanks to a proper tuning of the relative influence of these two torques, the magnetization of the free layer can be rotated step by step clockwise or anticlockwise in a range of angle between 0° (parallel configuration) and 180° (anti-parallel configuration) by sending pulses of current through the stack, of one or opposite polarity. The amplitude of the rotation steps and therefore of the conductance variations depends on the pulse amplitude and duration. In this way, we achieve monotonous variations of the resistance with the voltage polarity through the application of pulses in the ns range. We also retrieve the analytical expression of critical current density which is found to be in good agreement with the experimental results. The thermal stability of the intermediate resistance levels and the role of Joule heating are also discussed.

Phosphorescent columnar hybrid materials containing polyionic inorganic nanoclusters.

The ternary polyionic inorganic compound Cs2Mo6Br14 and 18-crown-6 ethers bearing two o-terphenyl units have been combined to design phosphorescent columnar liquid crystalline hybrid materials. The obtained host-guest complexes are very stable even at high temperatures. Depending on their surrounding atmosphere, these hybrids switch reversibly from a high-to-low luminescence state and show a very stable emission intensity up to 140 °C.

PET/CT and contrast enhanced CT in single vs. two separate sessions: a cost analysis study.

AIM: Aim of the study was to quantify the economic impact of PET/CT and contrast enhanced (c.e.) CT performed in a single session examination vs. stand-alone modalities in oncological patients. METHODS: One-hundred-forty-five cancer patients referred to both PET/CT and c.e. CT, to either stage (N.=46) or re-stage (N.=99) the disease, were included. Seventy-two/145 performed both studies in a single session (innovative method) and 73/145 in two different sessions (traditional method). The cost-minimization analysis was performed by evaluating: 1) institutional costs, data obtained by hospital accountability (staff, medical materials, equipment maintenance and depreciation, departments utilities); 2) patients costs, data obtained by a specific survey provided to patients (travel, food, accommodation costs, productivity loss). RESULTS: Economic data analysis showed that the costs for innovative method was lower than those of traditional method, both for Institution (106 € less per test) and for patient (21 € less per patient). The loss of productivity for patient and caregivers resulted lower for the innovative method than the traditional method (3 work-hour less per person). CONCLUSION: PET/CT and c.e. CT performed in a single session is more cost-effective than stand-alone modalities, by reducing both Institutional and patients costs. These advantages are mainly due to lower Institutional cost (single procedure) and to lower cost related to travel and housing.

Confronting the psychological burden of haemophilia.

Providing comprehensive care, counselling and support to haemophilic patients, and their parents have always been quite complex for haemophilia treatment centres. Nowadays, starting with recent developments in genetic counselling, prenatal diagnosis and carrier testing, the psychological burden on patients and parents might possibly have increased, compared with even the recent past. The emotional strains and worries associated with a possibly affected newborn and his care through childhood and adolescence may also have a grievous impact on couple dynamics and marital relationship. The impact may be even higher in families in which haemophilia is newly diagnosed. The main psychological problems faced by parents and then by affected individuals are herein chronologically reviewed, starting from genetic counselling before conception through childhood, adolescence and adulthood. Aware of the psychosocial burden on patients and their families associated with haemophilia, from prenatal diagnosis and carrier testing until later stages of life of the affected individual, a board of Italian haemophilia specialists and psychologists is designing and organizing an innovative network of psychological support services in some Italian haemophilia centres and promoting specific educational programmes in this setting.

Positron emission tomography/computed tomography introduction in the clinical management of patients with suspected recurrence of ovarian cancer: a cost-effectiveness analysis.

Aim of this study was to evaluate the economic impact of the introduction of positron emission tomography/computed tomography (PET/CT) in the early detection of recurrent ovarian cancer through a cost-effectiveness analysis of different diagnostic strategies. Thirty-two consecutive patients with suspected ovarian cancer recurrence, studied by both contrast enhanced abdominal CT and PET/CT, were retrospectively included in the study. Three different diagnostic strategies were evaluated and compared: (1) CT only or baseline strategy; (2) PET/CT for negative CT or strategy A; (3) PET/CT for All or strategy B. For each one, expected costs, avoided surgery and incremental cost-effectiveness ratio (ICER) were calculated to identify the most cost-effective strategy. The number of positive patients increased from baseline strategy (20/32) to strategy A and B (30/32 and 29/32 respectively). Positron emission tomography/computed tomography reoriented physician choice in 31% and 62% of patients (strategies A and B respectively). Strategy A is dominated by strategy B, which is more expensive (2909 euro vs. 2958 euro), but also more effective (3 cases of surgery avoided) and presents an ICER of 226.77 euro per surgery avoided (range: 49.50-433.00 euro). Positron emission tomography/computed tomography introduction in this population is cost-effective and allowed to redirect the clinical management of patients towards more appropriate therapeutic choices.

Cost-effectiveness analysis in the clinical management of patients with known or suspected lung cancer: [18F]fluorodeoxyglucose PET and CT comparison.

AIM: The aim of this study was to evaluate the economic impact of the introduction of positron emission tomography (PET) in the clinical management of patients with known or suspected lung cancer through a cost-effectiveness analysis of different diagnostic strategies. METHODS: In Italy, 75 patients with known or suspected lung cancer were included in the study. Three different diagnostic strategies were compared: 1) baseline or traditional strategy, i.e. computed tomography (CT) alone; 2) strategy A, i.e. PET for indefinite CT; 3) strategy B, i.e. PET for all. For each strategy expected costs and life expectancy, as measured by life year saved (LYS), were evaluated. Incremental cost-effectiveness ratio (ICER) was calculated to identify the most effective strategy. RESULTS: Compared to the baseline strategy, the introduction of PET changed the clinical management in 40% of cases in strategy A and in 51% of cases in strategy B, with an optimization of the clinical management. Costs of strategy A (2735.42 Euro) and strategy B (2984.52 Euro) were, respectively, 8% and 18% higher than the baseline strategy (2534.81 Euro). LYS was 2.04 and 2.64 for strategy A and B, which were, respectively, 4% and 35% higher than the baseline strategy (1.96 LYS). The ICERs were 2507.63 Euro/LYS and 415.17 Euro/LYS for strategy A and B, respectively. Strategy A is dominated by strategy B, which is more expensive, but also more effective. CONCLUSION: In Italy, the introduction of PET in the clinical management of all patients with known or suspected lung cancer previously evaluated with CT is cost-effective and allows to gain 2.64 life years at an annual cost of about 415 Euro.

A nontraditional technique for obtaining optimal esthetics for an immediate denture: a clinical report.

Bimaxillary protrusion and severe labioversion of anterior teeth complicate impression procedures and increase the difficulty in making esthetic predictions for the immediate complete denture patient. The presented technique, performed in reverse order of traditional methods, is accomplished in stages in which the anterior and nonessential posterior teeth are extracted and interim removable partial dentures placed. An opportunity is thus created to evaluate esthetics, phonetics, and anterior tooth function before extraction of the remaining dentition and delivery of immediate complete dentures. This technique facilitated the determination of the need for alveoplasty of the anterior maxilla.

The Twin-Flex removable partial denture: design, fabrication, and clinical usage.

A rationale for the use of Twin-Flex clasps is presented. Twin-Flex clasps may provide improved esthetics, an increased number of clasping sites, and enhanced patient comfort when compared with conventional clasping systems. Two fabrication methods are described, and departures from conventional clasping techniques are explained.

A comprehensive approach to die trimming.

Proper trimming of stone dies is an essential step in fixed prosthodontics. Die trimming requires meticulous technique and a thorough understanding of required elements in die design. By dividing the die into three zones, die contour requirements can be better understood, discussed, and demonstrated. A two-step technique provides optimal results, incorporating a logical plan with the use of proper magnification and illumination.

Evaluation of incisal guide calibrations.

The incisal guide calibrations of three adjustable articulators were investigated and compared to determine the significance of the different incremental markings of each. A method to use vertical changes in the anterior incisal guide of these three articulators accurately to measure jaw and tooth separation was proposed. The relationship between pin opening and incisor opening was evaluated by direct measurement and calculation. Twenty sets of diagnostically mounted casts were examined to evaluate the accuracy of the radius that generates each curved pin in relation to incisor position. Considering the as-manufactured incisal guide markings, casts mounted in a Denar D5A or TMJ articulator will bear a closer relationship between pin opening and incisor separation than casts mounted in a Stuart gnathological computer. To approximate linear incisor separation per calibration mark for each instrument, a table of values was presented for casts mounted at various positions.