Transport current and magnetization of Bi-2212 wires above liquid Helium temperature for cryogen-free applications.

Since the discovery of high temperature superconductors, a possible cryogen-free scenario has always been wished. Nowadays, liquid Helium is running out, and it is likely that the cooling by will be a large part of the costs of any superconducting system. Bi-2212 wires at temperature higher than 4.2 K still show a very high irreversibility field and thus a deep investigation of their properties in such a range of temperature is very useful in order to assess the applicability in high field cryogen-free magnets. Here electrical transport and magnetic properties characterization at variable temperature and magnetic field on our "GDG-processed" wires are reported together with a well-described original approach to calculate the irreversibility field Hirr. This study is devoted to provide reference data on the behaviour of the only isotropic wire for high field application with an eye to the performances at temperatures above 4.2 K.

Current applications of deep-learning in neuro-oncological MRI.

PURPOSE: Magnetic Resonance Imaging (MRI) provides an essential contribution in the screening, detection, diagnosis, staging, treatment and follow-up in patients with a neurological neoplasm. Deep learning (DL), a subdomain of artificial intelligence has the potential to enhance the characterization, processing and interpretation of MRI images. The aim of this review paper is to give an overview of the current state-of-art usage of DL in MRI for neuro-oncology. METHODS: We reviewed the Pubmed database by applying a specific search strategy including the combination of MRI, DL, neuro-oncology and its corresponding search terminologies, by focussing on Medical Subject Headings (Mesh) or title/abstract appearance. The original research papers were classified based on its application, into three categories: technological innovation, diagnosis and follow-up. RESULTS: Forty-one publications were eligible for review, all were published after the year 2016. The majority (N = 22) was assigned to technological innovation, twelve had a focus on diagnosis and seven were related to patient follow-up. Applications ranged from improving the acquisition, synthetic CT generation, auto-segmentation, tumor classification, outcome prediction and response assessment. The majority of publications made use of standard (T1w, cT1w, T2w and FLAIR imaging), with only a few exceptions using more advanced MRI technologies. The majority of studies used a variation on convolution neural network (CNN) architectures. CONCLUSION: Deep learning in MRI for neuro-oncology is a novel field of research; it has potential in a broad range of applications. Remaining challenges include the accessibility of large imaging datasets, the applicability across institutes/vendors and the validation and implementation of these technologies in clinical practise.

Repeatability and reproducibility study of radiomic features on a phantom and human cohort.

The repeatability and reproducibility of radiomic features extracted from CT scans need to be investigated to evaluate the temporal stability of imaging features with respect to a controlled scenario (test-retest), as well as their dependence on acquisition parameters such as slice thickness, or tube current. Only robust and stable features should be used in prognostication/prediction models to improve generalizability across multiple institutions. In this study, we investigated the repeatability and reproducibility of radiomic features with respect to three different scanners, variable slice thickness, tube current, and use of intravenous (IV) contrast medium, combining phantom studies and human subjects with non-small cell lung cancer. In all, half of the radiomic features showed good repeatability (ICC > 0.9) independent of scanner model. Within acquisition protocols, changes in slice thickness was associated with poorer reproducibility compared to the use of IV contrast. Broad feature classes exhibit different behaviors, with only few features appearing to be the most stable. 108 features presented both good repeatability and reproducibility in all the experiments, most of them being wavelet and Laplacian of Gaussian features.

Amplitude concentration in a phase-modulated spectrum due to femtosecond filamentation.

We present a method by which the spectral intensity of an ultrafast laser pulse can be accumulated at selected frequencies by a controllable amount. Using a 4-f pulse shaper we modulate the phase of the frequency components of a femtosecond laser. By inducing femtosecond filamentation with the modulated pulse, we can concentrate the spectral amplitude of the pulse at various frequencies. The phase mask applied by the pulse shaper determines the frequencies for which accumulation occurs, as well as the intensity of the spectral concentration. This technique provides a way to obtain pulses with adjustable amplitude using only phase modulation and the nonlinear response of a medium. This provides a means whereby information which is encoded into spectral phase jumps may be decoded into measurable spectral intensity spikes.

Femtosecond-laser-induced shockwaves in water generated at an air-water interface.

We report generation of femtosecond-laser-induced shockwaves at an air-water interface by millijoule femtosecond laser pulses. We document and discuss the main processes accompanying this phenomenon, including light emission, development of the ablation plume in the air, formation of an ablation cavity, and, subsequently, a bubble developing in water. We also discuss the possibility of remotely controlling the characteristics of laser-induced sound waves in water through linear acoustic superposition of sound waves that results from millijoule femtosecond laser-pulse interaction with an air-water interface, thus opening up the possibility of remote acoustic applications in oceanic and riverine environments.

A large outbreak of Opisthorchis felineus in Italy suggests that opisthorchiasis develops as a febrile eosinophilic syndrome with cholestasis rather than a hepatitis-like syndrome.

We describe the greatest Italian human acute opisthorchiasis outbreak acquired from eating raw tenches. Out of 52 people with suspected opisthorchiasis, 45 resulted in being infected. The most frequent symptoms and laboratory findings were fever, abdominal pain and eosinophilia. Seven tri-phasic computed tomography (CT) scans were done, showing multiple hypodense nodules with hyper-enhancement in the arterial phase. All patients took one day of praziquantel 25 mg/kg TID without failures. Reported symptoms suggested a febrile eosinophilic syndrome with cholestasis rather than a hepatitis-like syndrome. It seems common to find hepatic imaging alterations during acute opisthorchiasis: CT scan could be the most suitable imaging examination. Even if stool test remains the diagnostic gold standard, we found earlier positivity with the serum antibody test. Without previous freezing, the consumption of raw freshwater fish should be avoided.

PET in the clinical work-up of patients with spondylodiscitis: a new tool for the clinician?

AIM: The role of 18F-fluorodeoxyglucose-positron-emission tomography (FDG-PET) in the clinical management of patients with inflammatory diseases (e.g., chronic inflammatory diseases, fever of unknown origin, ostemyelitis, prosthesis infections) is still under investigation. The aim of the present study was to evaluate the usefulness of PET in the diagnostic work-up of patients with spondylodiscitis and to compare it with magnetic resonance imaging (MRI). METHODS: This retrospective study included 33 patients with suspected/confirmed spondylodiscitis. Two groups were created: 1) disease definition (n=24); and 2) treatment assessment (N.=16, 21 exams). Disease status was defined on the basis of data collected for symptoms, hematological parameters, imaging studies and histological findings, when available. Qualitative and semiquantitative analysis of the PET images was performed. The minimum duration of follow-up was 6 months. RESULTS: For the Disease Definition group, FDG-PET showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 92.9%, 50%, 72.2%, 83.3%, and 75%, respectively, and MRI showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 50%, 76.9%, 100%, and 81.3%, respectively. For the Treatment Assessment group, FDG-PET showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 90%, 81.8%, 81.8%, 90%, and 85.7%, respectively, and MRI showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 16.7%, 58.3%, 100% and 61.5%, respectively. No significant differences were observed between qualitative and semiquantitative evaluation of PET scans. CONCLUSION: PET and MRI showed similar accuracy in the diagnosis of spondylodiscitis, indicating that PET can be used when MRI is doubtful or unavailable. PET was more accurate and more specific than MRI in treatment assessment, suggesting that PET should be preferred over MRI for determining when treatment can be safely discontinued.

IGF-1 abuse in sport: clinical and medico-legal aspects.

The frequent revisions of prohibited substances list established by WADA are aimed at keeping up with those drugs that, being increasingly used in medicine and in sports, play on one side a therapeutic role and, on the other, a doping role. Among the various hormone substances widely used in sports, the authors draw particular attention on IGF-1, a growth factor that is rapidly widespreading among athletes. Moreover, IGF-1 diffusion is not exclusively correlated with the doping phenomenon, being various the pathological conditions that may require the therapeutic use of this substance. As a consequence, during pathologies or medical treatments of various nature, the athletes should be informed of the IGF-1 administration because, if they are not duly apprised, they risk undergoing unjust sanctions from the competent authority. In fact, the athlete is given the possibility of communicating, before using, he is taking a medication of the WADA list for therapeutic reasons by applying for a TUE (Therapeutic Use Exemption). If this application is accepted on certified clinical grounds, the athlete will be allowed to use that substance even during sports competitions. However, the IGF-1 detection in the athlete's body shows, at the present state-of-art, two different problems: the first one has a technical character and concerns the differential diagnosis between the quantity of the physiologically produced substance and the quantity of the exogenously administrated substance; the second problem has an economic character and regards to the high cost of the analysis and, consecutively, the necessity of finding a well-equipped laboratory centre.

Assessment of aflatoxin exposure of laboratory worker during food contamination analyses. Assessment of the procedures adopted by an A.R.P.A.L. laboratory (Liguria Region Environmental Protection Agency).

BACKGROUND: Aflatoxins are mycotoxins derived from foodstuffs colonized by fungal species of the genus Aspergillus; they are common food contaminants with immunosuppressive, mutagenic and carcinogenic activity. Aflatoxins are heat-resistant and are thus easily transmitted along the food chain. They are hepatotoxic and have the potential to induce hepatocellular carcinoma. Agri-food industry workers are thus at risk of ingestion as well as transmucosal absorption or inhalation of toxins released during product preparation or processing. OBJECTIVES: To measure the levels of airborne mycotoxins, particularly aflatoxins, in a laboratory analysing imported foodstuffs for mycotoxin contamination. METHODS: The protocol used to analyse a batch of shelled peanuts from Vietnam, especially the grinding phase, which is held to be at the highest risk ofgenerating airborne toxins, was assessed at the A.R.PA.L. laboratory (Liguria Region Environmental Protection Agency) of Genoa, Italy, which participates in a European aflatoxin monitoring project. RESULTS: Wet grinding was performed to avoid production of large amounts of dust. Comparison of airborne concentrations before and after grinding with legal thresholds disclosed that the analytical procedures involved negligible aflatoxin levels for operators (environmental burden 0.11 pg/ m3). CONCLUSIONS: Given the toxicity of aflatoxins, worker protection measures should be consistently adopted and enforced. Threshold limit values for working environments should be introduced besides the existing ones for public health.

Bilateral loss of cortical somatosensory evoked potential at birth predicts cerebral palsy in term and near-term newborns.

Bilateral loss of cortical somatosensory evoked potential (SEP) is considered the single best indicator of adverse outcome in acute encephalopathy of adult patients and older children. This study determines whether the presence or absence of the neonatal cortical SEP can predict cerebral palsy at two years in survivors of neonatal encephalopathy scored according to Sarnat criteria. We also compare SEPs with visual evoked potentials (VEPs), the EEG and neonatal neurological status. Fifty-nine neonates admitted to the neonatal intensive care unit had SEP, VEP and EEG recordings analysed according to the presence (n=37, 63%) or absence (n=22, 37%) of neonatal encephalopathy (score >or=1). Cortical SEP was always present in the perinatal period in those surviving without major neurological disability, while it was bilaterally absent in all but one patient with a subsequent diagnosis of cerebral palsy. Multivariate analysis using the logistic regression model showed that bilateral loss of cortical SEP and Sarnat Score correctly classified the neurological outcome in all patients. Bilateral absence of cortical SEP indicates early identification of neonates at risk of cerebral palsy indicating that EPs have a clinical role in the workup of neonatal encephalopathy.

Tethered cord in patients with anorectal malformation: preliminary results.

BACKGROUND: A tethered cord (TC) has been reported in as much as 50% of the patients affected by anorectal malformation (ARM). No guidelines for timing and modality of diagnosis and treatment have been established. We present the preliminary results of a multidisciplinary protocol carried out at our center. METHODS: Seventy-four ARM patients underwent spinal magnetic resonance imaging (MRI). All TC patients underwent videourodynamic (UD), somatosensory-evoked potentials (SEPs), and neurological examination at baseline and, if normal, at 5 and 10 years of age. Conversely, when UD or SEP abnormalities were detected the follow-up was individually tailored at shorter time. RESULTS: 25/74 patients had a neuroradiological TC (33.7%). Based on the results of UD, SEP, and neurological status, four patients were untethered, eight are possible candidates, nine are stable, and four were excluded because of incomplete data. DISCUSSION: Tethered cord is frequent in ARM patients. Because neurological deficits secondary to TC can contribute to neurological disability, we recommend routine MRI examination and a multidisciplinary program of follow-up in cases of TC. Preliminary results suggest the combined use of SEPs and UD could represent a useful adjunct to clinical examination in patients in whom a "wait and see" approach is preferred to the prophylactic surgery.

A short course of pegylated interferon-alpha in acute HCV hepatitis.

Acute hepatitis C virus (HCV) infection evolves to chronicity in 50-84% cases. Treatment with interferon-alpha (IFN-alpha) was repeatedly found to provide sustained cure rates higher than that in chronic HCV infection, but the optimal treatment strategy has not yet been defined. In a multicentre open-label study, we investigated the therapeutic performance of a short course of pegylated (peg) IFN-alpha in patients with acute HCV hepatitis. Peg IFN-alpha2b, 1.0-1.5 micro g/kg weekly, was administered for 12 weeks. Forty-six patients were enrolled; 26 of them were intravenous drug users. Eleven patients had jaundice. Treatment was started within 1-90 days from the peak alanine aminotransferase. Treatment was well tolerated with a single dropout (2%). Thirty-three of 46 patients (72%) had a sustained virological response (SVR) after a 6 months post-treatment follow-up, 8 (17%) relapsed after treatment and 4 were nonresponders (9%). A lower peak viraemia, receiving at least 1.2 micro g/kg of peg IFN-alpha, and a negative HCV-RNA at week 4 and week 12 were predictors of SVR. Thus, in patients with early (week 4) viral response, a short course of peg IFN-alpha at a weekly dose >1.2 micro g/kg, may be a valuable option for the treatment of acute HCV hepatitis.

[Compromise of work capacity and quality of life of epileptic subjects]. / Compromissione della capacità lavorativa e qualità della vita nei soggetti epilettici.

The authors test epileptic subjects as far as their professional ability is concerned. An enquiry into patients admitted to the Epilepsy Centre of San martino Hospital in Genova has been performed through a questionnaire about professional performance and quality of life. As far as work related problems are concerned 44.6 per cent of the subjects show the presence of difficulties, while the quality of life is primarily repressed in men relatively to work and in women relatively to social relationship.

Treatment with interferon-alpha2b of naive non-cirrhotic patients with chronic hepatitis C according to viraemia and genotype. Results of a randomized multicentre study. The North West Italian Hepatological Group.

OBJECTIVE: To establish whether tailoring the dosage of interferon (IFN)-alpha2b in non-cirrhotic naive patients with chronic hepatitis C according to hepatitis C virus (HCV) genotype and viraemic level improves the rate of sustained response (normal alanine aminotransferase values and HCV-RNA negativity 6 months after the end of therapy). PATIENTS: A total of 538 consecutively collected HCV-positive patients with non-cirrhotic chronic hepatitis who had not been previously treated. METHODS: Quantitative viraemia and genotype were determined in each patient by a core laboratory. The patients were randomized to: Group 1, 86 patients with genotype non-1 and viraemia < 1,000,000 HCV genome equivalents/ml (GenEq/ml) treated with 3 Million Units (MU) IFN three times weekly (t.i.w.) for 1 year; Group 2, 42 patients with genotype 1 and viraemia < 1,000,000 GenEq/ ml treated with 3 MU IFN t.i.w. for 1 year; Group 3, 46 patients with genotype 1 and viraemia < 1,000,000 GenEq/ ml treated with 5 MU IFN t.i.w. for 1 year; Group 4, 85 patients with genotype non-1 and viraemia > 1,000,000 GenEq/ml treated with 3 MU IFN t.i.w. for 1 year; Group 5, 88 patients with genotype non-1 and viraemia > 1,000,000 GenEq/ml treated with 5 MU IFN t.i.w. for 1 year; Group 6, 94 patients with genotype 1 and viraemia > 1,000,000 GenEq/ml treated with 3 MU IFN t.i.w. for 1 year; Group 7, 97 patients with genotype 1 and viraemia > 1,000,000 GenEq/ml treated with 5 MU IFN daily for 2 months followed by 5 MU t.i.w. for a further 10 months. RESULTS: According to an intention-to-treat analysis, a sustained virological response (negative HCV-RNA by polymerase chain reaction 6 months after the end of therapy) was observed in 42% of Group 1 patients, in 21% of Group 2 patients versus 24% of Group 3 patients [P = not significant (NS)], in 28% of Group 4 patients versus 35% of Group 5 patients (P = NS), and in 8.5% of Group 6 patients versus 12% of Group 7 patients (P = NS). CONCLUSIONS: Even though a trend towards a therapeutic improvement is observed, the adoption of more aggressive IFN protocols, such as induction therapy, does not appear to significantly improve the rate of sustained response in patients with chronic hepatitis C associated with HCV genotype 1 and highly viraemic levels compared with standard therapy. Moreover, patients with only one unfavourable predictive factor (genotype 1 or high viraemia) do not gain major therapeutic benefits when treated with high doses of IFN.

Weight loss after dieting with behavioral modification for obesity: the predicting efficiency of some psychometric data.

The aim of the study was to identify the predicting efficiency of some psychometric data on weight loss after behavior modification in moderately obese patients. A group of patients on a weight loss program with a moderately hypoenergetic diet plus behavior modification therapy for 24 weeks completed the Eating Inventory (EI), the Eating Disorder Inventory (EDI), the Body Shape Questionnaire (BSQ) and the Body Attitude Questionnaire (BAQ). Correlations between the pre-diet and post-treatment scores were evaluated by stepwise regression analysis. The weight loss percentage was positively correlated with the EDI Bulimia scale and the BAQ Feeling Fat, and negatively with the EDI Body Dissatisfaction and Interpersonal Distrust scores. These findings indicate the true effectiveness of the behavior modification technique employed to extinguish bulimic behaviors. Furthermore, it can be suggested that realistic attitudes towards own fatness with a strong motivation and a good relationship with the therapist guarantee a greater weight loss.

Hepatitis C virus genotypes in a non-cirrhotic Italian population with chronic hepatitis C: correlation with clinical, virological and histological parameters. Results of a prospective multicentre study.

To identify correlations between the distribution of hepatitis C virus (HCV) genotypes and demographic, pathological and virological parameters of HCV-infected patients, we prospectively recruited 650 patients with biopsy-proven chronic hepatitis C without histological aspects of cirrhosis; none had been treated with antiviral therapy. Data regarding gender, age, mode of HCV transmission, alanine aminotransferase (ALT) and HCV RNA levels, immunoglobulin M (IgM) anticore values, liver histology and histological activity were obtained from each patient and correlated on multivariate analysis with infecting HCV genotype. Fifty-five per cent of the patients were infected with HCV genotype 1, 20% with HCV genotype 2, 18% with HCV genotype 3 and 7% with HCV genotype 4. Non-transfusional HCV transmission, low ALT levels, IgM anticore reactivity and a low histological grading score were independent variables associated with HCV genotype 1. Older age, female gender, post-transfusional transmission and a high histological grading score were related to HCV genotype 2, whilst younger age, history of current/previous drug abuse, high ALT values, low IgM anticore reactivity and high viraemic levels were associated with HCV genotype 3. History of illicit use of intravenous drugs and low HCV RNA levels were the only independent variables correlated with HCV genotype 4. Genotype 1 remains predominant in Italy but the prevalence of HCV genotypes is changing in relation to age and mode of transmission: Italian patients with HCV genotype 3 are younger and exhibit higher levels of ALT and HCV RNA than patients with other genotypes.

Effect of fenretinide on bone mineral density and metabolism in women with early breast cancer.

Prolonged administration of natural or synthetic retinoids has been associated with significant skeletal abnormalities, including osteoporosis. We studied the effects of the synthetic retinoid fenretinide (N-4-hydroxyphenylretinamide, or 4-HPR) administered for a mean of 40 months on bone mineral density and metabolism in 66 consecutive women with early breast cancer belonging to a secondary prevention trial. The mean (+/-SD) bone mineral density at the distal and ultradistal forearm were, respectively, 0.61+/-0.08 and 0.30+/-0.05 g/cm2 in 33 treated women and 0.62+/-0.07 and 0.29+/-0.07 g/cm2 in 33 control women (p = ns for both). Also, no significant difference was observed in markers of bone formation such as bone alkaline phosphatase and osteocalcin, nor in urinary bone resorption markers such as calcium, hydroxyproline, and type I bone collagen cross-linked N-telopeptide (NTx). However, a border-line higher excretion of urinary calcium and NTx was found in the 4-HPR group after adjustment for menopausal status. We conclude that prolonged administration of 4-HPR is not associated with significant alterations of bone mineral density of the forearm. However, a trend towards an increase in bone resorption markers suggests the need for further assessment at different skeletal sites.

Preperitoneal prosthetic herniorrhaphy. One surgeon's successful technique.

OBJECTIVES: To review the senior author's experience with preperitoneal mesh inguinal herniorrhaphy, evaluate the recurrence rate, and compare it with previously published data and with the developing technique of laparoscopic herniorrhaphy. DESIGN: A retrospective records review of 204 herniorrhaphies, follow-up of patients (mean follow-up, 3.5 years), and review of the literature. SETTING: One general surgeon's clinical practice in an 860-bed regional referral hospital. PATIENTS: One hundred sixty-two men and 13 women (mean age, 63 years) who underwent preperitoneal prosthetic herniorrhaphy by the senior author between 1984 and 1991 and whose medical records were available for review (175 [96%] of 183 patients). MAIN OUTCOME MEASURES: Short- and long-term postoperative complications and hernia recurrence. RESULTS: One hundred fifty-two primary and 52 recurrent inguinal hernias were repaired using a preperitoneal prosthetic approach and either general or regional anesthesia. Wound complications occurred in 12 (5.9%) of 204 operations, and one recurrence (0.5%) was detected over the mean long-term follow-up period of 42 months (range, 7.9 to 110 months). A 25-year recurrence rate of 1% was predicted. CONCLUSIONS: This repair compares favorably with similar, previously reported repairs and is suggested as a standard for comparison with the developing technique of laparoscopic herniorrhaphy.

[Nosologic evaluation of Noonan syndrome and description of nine cases]. / Inquadramento nosologico della sindrome di Noonan e descrizione di nove casi.

Noonan syndrome was first described over 20 years ago by Noonan and Ehmke. They defined a specific group of nine patients with valvular pulmonary stenosis who, in addition, had short stature, mild mental retardation, hypertelorism and unusual facies. The incidence of Noonan syndrome has been estimated to be between 1 in 1000 and 1 in 2500 live births. The primary biochemical defect in Noonan's syndrome is unknown. We analyzed 9 patients (5 males and 4 females) in an age range of 6 months to 10 years and 3 months with Noonan syndrome. Patients were diagnosed as having the syndrome if they had characteristic facies and a normal karyotype, plus one of the following signs: cardiac defects, short stature or undescended testes. All patients have ocular anomalies (epicanthal folds, ptosis of eyelids, hypertelorism, downslanting palpebral fissures and ocular proptosis). Congenital heart malformations are present in 8 patients and the more frequent cardiopath is pulmonary valve stenosis due to a dysplastic or thickened valve. Short stature is present in 6 patients and 3 of them are actually on treatment with rhGH. A moderate-mild mental retardation is present in 6 patients. Case n. 9 had a syringomyelia and tethered cord. These malformations are rarely reported in Noonan's syndrome.