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Survival rates of prostate cancer (PCa) patients have improved considerably as a result of earlier diagnosis and therapies, including radiotherapy (RT) and androgen deprivation therapy (ADT). Patients on ADT develop cancer treatment-induced bone loss (CTIBL) and a high risk of fragility fractures. Bone health (BH) assessment is strongly recommended, together with timely initiation of treatments, to counteract CTIBL and preserve bone strength. Therefore, we decided to develop an interdisciplinary pathway of care (IPC) dedicated to non-metastatic PCa patients on long-term ADT and RT.An interdisciplinary team allocated resources to support an IPC to manage patients' CTIBL and prevent fragility fractures. The team provided a diagnostic and therapeutic workflow according to patients' and professional perspectives, consistent with recommendations and healthcare policies. The hospital's quality department certified the IPC, the Ethical Committee approved procedures over the workflow. The Fracture Liaison Service (FLS) standards inspired services and professionals' activities and interactions.Preliminary data support the feasibility of the IPC from professionals' and patients' perspectives. Median age of the enrolled patients was 75 years, more than a half (58.9%) had low grade osteopenia or normal BMD (T-score ≥-1.5 standard deviation, SD), while 23.5% and 17.6% had osteoporosis and osteopenia, respectively. The IPC meets the requirements of a FLS concerning crucial indicators.Our IPC was a suitable approach to assure timely identification, assessment, initiation, and monitoring of adherence to anti-fracture treatments among non-metastatic PCa patients on long-term ADT and RT. Further data are required to show its effectiveness on fragility fracture prevention.

En este artículo se presentan los resultados de una Revisión Sistemática de la Literatura de los estudios de actitudes lingüísticas en el ámbito hispanohablante chileno, realizados entre 2010 y 2020, con el afán de determinar los temas tratados, las metodologías, los resultados de los estudios, y si existe algún vacío en la literatura. La revisión se ha hecho en las bases de datos WoS, Scopus y SciELO a través del descriptor Linguistic attitudes y ha generado un total de 12 artículos. Se concluye que la mayoría de los estudios se ha llevado a cabo en Santiago y con técnica directa; además, se plantean algunos temas que no han sido abordados y que podría ser interesante averiguar, como las actitudes hacia el lenguaje no sexista.

The North Slope of Alaska is a prolific hydrocarbon producing area, currently estimated to be the largest oil field in the United States and contains one of the greatest reserve accumulations. The North Slope is a tundra covered region including the majority of the northern portion of the state of Alaska that is underlain by an extensive and continuous permafrost layer (Jorgenson, et al., 2008). To support the vast oil and gas development on the North Slope, significant infrastructure, including well pads, facilities, air strips and pipelines/flowlines, has been constructed over the past few decades. All this infrastructure is in some way in contact with the underlying permafrost. The Alaska Department of Transportation and Public facilities has identified two primary ways through which permafrost changes can damage infrastructure. The first is through differential settlement, caused by thawing; the second is seasonal freeze-thaw cycles (Alaska Department of Transportation and Public Facilities, 2022). Both phenomena are present on the North Slope to varying degrees at varying locations. It is widely accepted that, globally, permafrost is warming and, in many cases, thawing (Runge, Nitze, & Grosse, 2022). Some studies estimate natural hazards and the risk of transportation infrastructure loss due to permafrost changes could reach 20% by the year 2030 (Tromifenko, Evgenev, & Shashina, 2017). Tromifenko et al. (2017) underline the necessity to develop climate change indicators to assess the risk to infrastructure in permafrost areas. They highlight the importance of utilizing this data during the design, construction, and operation of northern arctic infrastructure. Interferometric Synthetic Aperture Radar (InSAR) represents a powerful tool through which to assess long and short-term changes to the permafrost over extensive and remote areas. Here we will show a case study from the North Slope of Alaska. InSAR data collected and processed over the site highlights the magnitude, seasonality, and location of permafrost changes. This analysis includes developed and undeveloped areas, in different stages of the development cycle. The high temporal and spatial coverage of the InSAR point cloud allows for comparison of settlement behavior between individual pieces of infrastructure compared to their immediate surroundings. In undeveloped areas, the displacement data allows to identify the areas with the largest subsidence rates, as well as the greatest degree of seasonal freeze-thaw displacement. InSAR is a satellite based remote sensing technique for assessing ground deformation. By obtaining millimetric precision and high spatial and temporal density, it provides valuable insights to augment and enhance traditional survey techniques such as GPS. In addition to the InSAR analysis, this study also leverages the amplitude component of SAR data to analyze water body ice dynamics using a novel quantitative approach. The results of this analysis provide insights into spring break up on the rivers which transect many of the oil and gas fields in the region.

This research introduces a closed-loop method to improve the zero-rate output (ZRO) stability of amplitude-modulated (AM) capacitive MEMS gyroscopes, even in absence of quadrature compensation electrodes. The method relies on the direct measurement and closed-loop compensation of the variation of the relative phase between the quadrature output, modulated by the drive carrier frequency, and the demodulation reference. The closed loop includes a phase meter, whose output regulates the phase of the lock-in amplifier inside the sense-mode, open-loop, demodulation chain. The proposed technique, tested on the pitch axis of a consumer-grade commercial monolithic 3-axis gyroscope, brings up to 300-fold stability improvements over temperature transients, without affecting noise and scale-factor performance. Stability limits depend on the phase meter resolution and on the lock-in granularity in regulating the phase. Overall, a mdps/K stability is obtained with a one-time calibration at ambient temperature and no post-acquisition processing. [2021-0049]

Objective While vitamin D regulates immune cells, little is known about it in autoimmune Addison’s disease (AAD). We investigated the vitamin D status in AAD patients from five European populations to assess its deficiency. In addition, we studied two case-control cohorts for vitamin D metabolism and pathway genes. Design Cross-sectional study. Methods A total of 1028 patients with AAD from Germany (n = 239), Italy (n = 328), Norway (n = 378), UK (n = 44) and Poland (n = 39) and 679 controls from Germany (n = 301) and Norway (n = 378) were studied for 25(OH)D3 (primary objective). Secondary objectives (1,25(OH)2D3 and pathway genes) were examined in case-controls from Germany and Norway correlating 25(OH)D3 and single nucleotide polymorphisms within genes encoding the vitamin D receptor (VDR), 1-α-hydroxylase (CYP27B1), 25-hydroxylase (CYP2R1), 24-hydroxylase (CYP24A1) and vitamin D binding protein (GC/DBP). Results Vitamin D deficiency (25(OH)D3 10–20 ng/mL) was highly prevalent in AAD patients (34–57%), 5–22% were severely deficient (30 ng/mL). Lower 25(OH)D3 and 1,25(OH)2D3 levels were observed both in Norwegian and German AAD (P = 0.03/0.003 and P = 1 × 10-5/< 1 × 10-7, respectively) the former was associated with CYP2R1 (rs1553006) genotype G. Whereas controls achieved sufficient median 25(OH)D3 in summers (21.4 to 21.9 ng/mL), AAD patients remained largely deficient (18.0 to 21.2 ng/mL) and synthesize less 1,25(OH)2D3. Conclusion Vitamin D deficiency and insufficiency are highly prevalent in AAD patients. The vitamin D status of AAD may be influenced by genetic factors and suggests individual vitamin D requirements throughout the year.

Insulin autoimmune syndrome (IAS), also named Hirata's disease, is a rare condition characterized by hypoglycemic episodes due to the presence of high titers of insulin autoantibodies (IAA). IAS is a form of immune-mediated hypoglycemia, which develops when a triggering factor (ie, a medication or a viral infection) acts on an underlying predisposing genetic background. IAS pathogenesis involves the formation of insulin-IAA complexes that induce glycemic alterations with a double-phase mechanism: IAA prevent insulin to bind its receptor in the postprandial phase, possibly resulting in mild hyperglycemia; thereafter, insulin is released from the complexes irrespective of blood glucose concentrations, thus inducing hypoglycemia. The diagnosis of IAS is challenging, requiring a careful workup aimed at excluding other causes of hyperinsulinemic hypoglycemia. The gold standard for the definitive diagnosis is the finding of IAA in a blood sample. Because IAS is frequently a self-remitting disease, its management mostly consists of supportive measures, such as dietary modifications, aimed at preventing the development of hypoglycemia. Pharmacological therapies may occasionally be necessary for patients presenting with severe manifestations of IAS. Available therapies may include drugs that reduce pancreatic insulin secretion (somatostatin analogues and diazoxide, for instance) and immunosuppressive agents (glucocorticoids, azathioprine and rituximab). The purpose of this review is to provide a comprehensive analysis of the disease, by describing the burden of knowledge that has been obtained in the 50 years following its first description, took in 1970, and by highlighting the points that are still unclear in its pathogenesis and management.

This article presents a new UWB impulse radar system consisting of a central radiating antenna (1.9-GHz center frequency, 2-GHz bandwidth) and four receiving antennas designed for the detection and location of dielectrically large objects with dimensions comparable to the spatial dimensions of the probe pulse. Together with the radar system, a solution method for determining the coordinates for detected targets is developed based on the time of flight (TOF) of the probing pulse along raypaths from the radiating antenna to the object, and then reflected to each of the receiving antennas. An algorithm based on the Pearson’s correlation coefficient is used to accurately determine the TOF of the signals scattered by the object. The antenna geometry makes it possible to use simple trigonometry and Heron’s formula, to calculate the coordinates of the reflecting bright spot on a target. The algorithm has been tested by numerical simulations and experiments with a cylindrical metallic object (diameter 10 cm) and a plastic-cased PMN-2 landmine buried in natural clay soil. For the experiment, GPR signals were acquired on a $4 \times 4$ square grid at 10-cm step from a height of about 30 cm above the ground. The system detected the test object in all positions and the positioning error in majority is equivalent to the object size.

Reservoir surveillance is a key component of SAGD operations. There are several widely used surveillance techniques which vary in spatial and temporal coverage, resolution, and cost. The most common of which include pressure and temperature observation wells and 4D seismic. This study aims to demonstrate the value of InSAR as a decision-making tool over operating SAGD pads when used in a coordinated surveillance program alongside existing techniques. Results acquired from conventional surveillance techniques such as 4D seismic are often compared to those from InSAR at the scale of one of the data sets. A frequent challenge when making these comparisons is different acquisition frequency and coverage. This study compares the relative results from each data set to determine if the same conclusions could be drawn from InSAR as from seismic at varying scales. To do this, SAGD wells are divided into segments at various scales (half, third and quarter well). Results from InSAR and 4D seismic are extracted for each segment and statistics analyzed to determine if InSAR and 4D seismic lead to the same relative outcome and thus might lead to the same operational decisions. Results will focus on the ability of InSAR to provide decision making information to SAGD operators like that of other surveillance techniques, but at higher temporal frequency. In particular, the scale at which InSAR provides comparable results to 4D seismic will be investigated and how using InSAR in coordination with seismic may result in more frequent well production optimization. Previous attempts to correlate InSAR to existing SAGD surveillance techniques have shown mixed, though often promising results. Difficulties have arisen from attempts to directly compare discrete InSAR values to those of other techniques, often resulting in poor regression coefficients and a lack of confidence. Qualitative comparisons of gridded surfaces provide little insight on how to utilize the InSAR data. This study will demonstrate the scale at which InSAR can provide information to make operational SAGD decisions.

Temporal lobe epilepsy (TLE) surgery is associated with the best seizure outcome in adults, although its long-term results remain suboptimal. Retrospective pediatric studies suggest better figures whose determinants are poorly understood.To conduct a systematic review and meta-analysis of studies on the efficacy of TLE surgery in children (age younger than 18 years) and adults.We searched MEDLINE, Embase, and Cochrane Library for TLE surgery original research from January 1, 1990, until May 12, 2020. The outcome measures were seizure freedom since surgery and seizure freedom either at last or longest follow-up. We meta-analyzed the proportion of children and adults achieving either Engel I/International League Against Epilepsy (ILAE) 1 or Engel IA/ILAE 1A outcome by follow-up duration, type of surgery, histopathology, neuroimaging, quality of the studies, and publication period. We used a random effects model with Freeman-Tukey double arcsine transformation of proportions.From 40 409 records identified, we included 277 studies (30 848 patients). The proportions of patients achieving Engel I/ILAE 1 and Engel IA/ILAE 1A outcomes were 0.74 (95% CI, 0.69-0.78) and 0.61 (0.48-0.74) for children and 0.69 (0.67-0.71) and 0.56 (0.52-0.60) for adults. Histopathology significantly influenced Engel I/ILAE 1 outcome in adults but not in children ( P.0001), while the type of surgery significantly influenced Engel I/ILAE 1 outcome in children but not in adults.The proportion of seizure freedom after TLE surgery was higher in children, although not significantly. Histopathology and the surgical approach can influence seizure outcome, with age-related variability.

Context: Glucocorticoid (GC) replacement therapy in patients with adrenal insufficiency (AI) is life saving. After over 50years of conventional GC treatment, novel formulations are now entering routine clinical practice. Methods: Given the spectrum of medications currently available and new insights into the understanding of AI, the authors reviewed relevant medical literature with emphasis on original studies, prospective observational data and randomized controlled trials performed in the past 35years. The Expert Opinion of a panel of selected endocrinologists was sought to answer specific clinical questions. The objective was to provide an evidence-supported guide, for the use of GC in various settings from university hospitals to outpatient clinics, that offers specific advice tailored to the individual patient. Results: The Panel reviewed available GC replacement therapies, comprising short-acting, intermediate and long-acting oral formulations, subcutaneous formulations and the novel modified-release hydrocortisone. Advantages and disadvantages of these formulations were reviewed. Conclusions: In the Panel’s opinion, achieving the optimal GC timing and dosing is needed to improve the outcome of AI. No-single formulation offers the best option for every patients. Recent data suggest that more emphasis should be given to the timing of intake. Tailoring of GS should be attempted in all patients—by experts—on a case-by-case basis. The Panel identified specific subgroups of AI patients that could be help by this process. Long-term studies areneeded to confirm the short-term benefits associated with the modified-release GCs. The impact of GC tailoring has yet to be proven in terms of hospitalization rate, morbidity and mortality.

Environmental enrichment may slow cognitive decay possibly acting through an improvement in vascular function. Aim of the study was to assess the effects of a 7-month cognitive, social, and physical training program on cognitive and vascular function in patients with mild cognitive impairment. In a single-center, randomized, parallel-group study, 113 patients (age, 65–89 years) were randomized to multidomain training (n=55) or usual care (n=58). All participants underwent neuropsychological tests and vascular evaluation, including brachial artery flow-mediated dilation, carotid–femoral pulse wave velocity, carotid distensibility, and assessment of circulating hematopoietic CD34+ and endothelial progenitor cells. At study entry, an age-matched control group (n=45) was also studied. Compared with controls, patients had at study entry a reduced flow-mediated dilation (2.97±2.14% versus 3.73±2.06%; P =0.03) and hyperemic stimulus (shear rate area under the curve, 19.1±15.7 versus 25.7±15.1×10 −3 ; P =0.009); only the latter remained significant after adjustment for confounders ( P =0.03). Training improved Alzheimer disease assessment scale cognitive (training, 14.0±4.8 to 13.1±5.5; nontraining, 12.1±3.9 to 13.2±4.8; P for interaction visit×training=0.02), flow-mediated dilation (2.82±2.19% to 3.40±1.81%, 3.05±2.08% to 2.24±1.59%; P =0.006; P =0.023 after adjustment for diameter and shear rate area under the curve), and circulating hematopoietic CD34 + cells and prevented the decline in carotid distensibility (18.4±5.3 to 20.0±6.6, 23.9±11.0 to 19.5±7.1 Pa −1 ; P =0.005). The only clinical predictor of improvement of cognitive function after training was established hypertension. There was no correlation between changes in measures of cognitive and vascular function. In conclusion, a multidomain training program slows cognitive decline, especially in hypertensive individuals. This effect is accompanied by improved systemic endothelial function, mobilization of progenitor CD34 + cells, and preserved carotid distensibility. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01725178.

Purpose Fasting blood homocysteine is increased in PCOS women and is involved in several of its co-morbidities including cardiovascular disease and infertility. Corrective interventions based on the administration of supra-physiologic doses of folic acid work to a low extent. We aimed to test an alternative approach. Methods This was a prospective, randomized, parallel group, open label, controlled versus no treatment clinical study. PCOS women aged > 18, free from systemic diseases and from pharmacological treatments were randomized with a 2:1 ratio for treatment with activated micronutrients in support to the carbon cycle (Impryl, Parthenogen, Switzerland—n = 22) or no treatment (n = 10) and followed-up for 3 months. Fasting blood homocysteine, AMH, testosterone, SHBGs, and the resulting FTI were tested before and at the end of the follow-up. Results The mean baseline fasting blood homocysteine was above the normal limit of 12 μMol/L and inversely correlated with SHBG. AMH was also increased, whereas testosterone, SHBG, and FTI were within the normal limit. The treatment achieved a significant reduction of homocysteine, that did not change in the control group, independently of the starting value. The treatment also caused an increase of AMH and a decrease of SHBGs only in the subgroup with a normal homocysteine at baseline. Conclusions In PCOS ladies, blood homocysteine is increased and inversely correlated with the SHBGs. Physiologic amounts of activated micronutrients in support to the carbon cycle achieve a reduction virtually in all exposed patients. Whether this is of clinical benefit remains to be established.

In many cryogenic systems, during useful life, defects or degradation of performance are found. Frequently these malfunctions are due to the presence of alterations in the characteristics o...

This paper investigates different topologies of springs used to couple the orthogonal translational motion of proof masses in Micro-Electro-Mechanical Systems (MEMS). This type of coupling is a key issue, since the dynamic response, and hence, the performance of various devices (e.g., MEMS gyroscopes) critically depends on the mechanical behavior of such deformable components. We first analytically investigate the problem through a model based on a modified second-order Timoshenko beam theory developed for both compact and built-up section beams. Its predictions inspire the design of three test structures, whose purpose is to highlight, through different spring topologies, the transition from a hardening behavior to a softening behavior, with possible intermediate optimum conditions for linear response at large displacements. The structures are characterized in detail, with variable forced displacements at resonance (25 kHz) up to about $10~\mu \text{m}$ . Experiments validate the model predictions in all the considered situations. [2018-0181]

Extreme weather events are a major concern for Transmission System Operators (TSOs) because of their increasing frequency and disruptive effects on system infrastructure and load supply. The assessment of component vulnerability to natural threats is essential for an accurate evaluation of power system resilience. However this task is very challenging also due to the interactions among different threats: models should be sufficiently complete to take this complexity into account, but also practical enough to be applied to large power systems. A notable example concerns snow and wind, which determine combined actions both directly on the infrastructure of an overhead line (OHL) and indirectly on the environment (such as trees) around the line path. The paper presents an analytical model of the vulnerability of OHL to the combined actions of snow and wind, assuring a good tradeoff between accuracy and tractability. Simulations performed on a line from an area of the Italian transmission grid show the ability of the model to account for the combinations of snow and wind induced actions both on the OHL infrastructure and on the environment interfering with the OHL.

The work presents a consistent follow-up on a study to identify the critical impact energy of suspended polysilicon masses onto stoppers [1], to prevent creation of debris and particles which affect the lifetime stability of MEMS inertial sensors. The proposed test device is capable of detecting debris generation by monitoring the leakage current between buried electrodes underneath the mass-stopper contact region. Results indicate that leakage begins to appear at 15 nJ impact energy, and manifests on 100% of tested structures at energies of 25 nJ. Optical analyses after device uncapping confirm the prediction, validating the test method.

Mount Meager, a glacier-clad volcanic complex in British Columbia, Canada, is known for its large landslides, as well as a major eruption about 2360 years ago. In 2010, after decades of glacier retreat, the south flank of Mount Meager collapsed, generating a huge (53 Mm3) landslide. In 2016, fumaroles formed ice caves in one of the glaciers on the complex. This glacier is bordered by a large unstable slope presently moving about 3.5 cm per month. If this slope were to fail, a long-runout debris avalanche would reach the floor of the Lillooet River valley, with possible destructive effects on downstream infrastructure. The unloading of the volcanic edifice from an abrupt failure would also have unknown effects on the magmatic plumbing system. From geochemical, geophysical, and petrological data, we infer the presence of a magmatic chamber at 3–16 km depth. Based on numerical model simulations carried out to constrain the stress change, the failure would affect the stress field to depths of up to ~6 km, with changes in effective stress of up to ~4 MPa. The change in effective stress following such a landslide might destabilize the magmatic chamber and trigger an eruption. This result also suggests that a previously documented major flank collapse may have had a role in the 2360 cal yr BP eruption.

Extreme weather events are a major concern for Transmission System Operators (TSOs) because of their increasing frequency and disruptive effects on system infrastructure and load supply. Modelling the component vulnerabilities to natural threats is a fundamental pillar to face such events in a resilience perspective. In particular, advanced analytical models of component vulnerability to threats have an important advantage over statistical models: being less sensitive to classification errors, they may favour the development of approaches and tools to support operators’ choices in power system management. Among all natural threats, strong wind represents a very important cause of damages to HV and EHV lines, together with wet snow, in the Italian EHV grid. This paper proposes analytical models to simulate the vulnerability of overhead lines to the direct and indirect effects of strong wind, considering three major subcomponents of the line namely phase conductors, shield wires, and tower supports. Simulations performed on a set of HV and EHV lines from a portion of the Italian grid demonstrate the ability of the model to quantify the benefit of specific mitigation measures on the line vulnerability to strong wind.

This paper contains a review of various radar systems that are designed for the detection of landmines. The main principles of their operation, their methods of application, and their achievements are considered. We review both functioning systems and prospective future systems.

This paper discusses a technique for automatic detection of subsurface objects using the impulse UWB radar of the "UGO-1st" robotic platform. The method is programmed as a Web application with capabilities for flexible adjustment of data processing parameters by the user. It provides reliable detection without false alarms and with correct calculation of coordinates for shallow buried subsurface objects.

This paper covers advances made in the tripwire detection aspect of the Landmine Detection 4.0 project. This includes algorithmic improvements - most importantly a comparison between a gradient-sigmoid filter and a derivative subtraction filter - and testing of these algorithms on tripwire scenes. We used a Canon DSLR camera for testing, which provides higher resolution and a different spectral range than the FLIR thermal camera we had used in previous testing. We have also begun investigating the use of near-infrared cameras as a possible alternative. Additionally, we have investigated methods to reduce false-positive detections within images with the intention to implement and test some of these methods in the near future.