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Introduction: MRI-targeted prostate biopsy is the best diagnostic tool for clinically significant Prostate Cancer (PCa) detection. However, compared to the cognitive approach, the superiority of the approach with US/MRI fusion software for the detection rate is still unanswered. The study aim to assess possible differences in the detection rate of transperineal Freehand US/MRI fusion target prostate biopsy using the Esaote MyLabTM9 System® in two different settings: outpatient setting with local anesthesia and patients undergoing deep sedation. Case Study: A retrospective monocentric study was carried out at “San Pio” Hospital of Castellaneta, Italy, including 81 patients undergoing transperineal prostate biopsy from January 2021 to June 2022. The fusion biopsy was performed under local anesthesia or under deep sedation. All the enrolled patients performed a multiparametric prostate MRI before undergoing a prostate biopsy. All the Freehand US/MRI fusion target prostate biopsies were performed using the Esaote MyLabTM9 System®, standard sampling, and targeted sampling. We evaluated the detection rate differences between the local anesthesia approach and that under deep sedation. Results: There are no statistically significant differences between the two approaches to PI-RADS 4 (p>0,05; p=0,63) and Prostate Imaging Reporting and Data System (PI-RADS) 5 lesions. Conclusion: These data highlight the lack of potential detection rate benefits of the deep sedation approach over the procedure under local anesthesia.

Aims: To assess the analgesic efficacy of a Palmitoylethanolamide and Magnesium based product (PEAMag) on acute and chronic pelvic pain due to different causes, such as CPPS, acute and chronic prostatitis, acute and recurrent cystitis and bladder stones. Methods: A pilot, open-label, prospective, monocentric study was carried out involving 32 patients treated with PEAMag sticks administered orally sublingual for a period of 3 months. Pelvic pain was evaluated using the Visual Analogue Scale (VAS score) and Quality of Life (QoL) associated with pelvic pain using number 9 domain (Quality of Life) of the Italian version of the NIH-CPSI scale. Results: A significant and progressive reduction in pain intensity after 1 month of treatment with PEAMag (p

To be used efficiently, transportation networks require control strategies to optimize flow distribution. However, the location and type of controllers employed in a transportation network directly impact the level of performance reachable by traffic control policies. In order to guarantee that the highest level of performance is reachable, fully exploiting the available network capacity and reducing negative externalities, we explore methods to identify relevant controller locations in transportation networks while minimizing the number of controllers used. Previous work provided an exact approach to identify controller locations on complex networks. However, said approach exhibits complications when applied to transportation networks containing bi-directional links. We therefore propose simple heuristic algorithms relying only on topological information to solve this problem, while also avoiding heavy computation, thus being able to determine a solution to the minimal controller location set problem on large networks. Based on the existing framework, we aim to provide an experimental setup, with diverse network sizes and configurations to analyze the performances of different heuristic methods, in order to develop an efficient algorithm.

Traffic control policies aim at reducing the negative externalities that ever-growing demand is causing on transportation networks, such as congestion and pollutant emissions. To achieve these goals, strategies coordinating and aligning the effects of several individual traffic controllers have received increasing attention in research and development in the past decades. However, a considerable gap still exists between the desired and experienced performance of advanced dynamic traffic management systems, resulting in failure to completely prevent the increasing peak-hour congestion in main urban areas worldwide. In this work we contribute to assessing whether this gap might be tied to inefficient network design, rather than algorithmic prowess. Based upon our earlier work, we investigate whether a trend can be found between determining locations of controllers in a network following control theoretical insights, and try to confirm our earlier intuitions when dealing with dynamic traffic assignment, featuring accurate propagation and spillback dynamics. To achieve these goals, we extend an existing synthetic network generation tool to allow us to test this hypothesis on real-life-like road networks, and extend our previously developed algorithms for the controller location problems allowing for sufficient generalization. Test results are presented on a simpler deterministic scenario and on 240 randomly generated networks, showcasing that placing controllers following controllability-based principles is advantageous from the perspective of model-based dynamic traffic management applications.

The clinical outcomes of maxillary rehabilitation with the additively manufactured sub-periosteal jaw implant (AMSJI; CADskills BV) were evaluated in edentulous patients with a Cawood-Howell atrophy classification ≥5 in all regions of the maxilla. Fifteen consecutive patients were included in the study and followed up for 1 year. They were interviewed using a survey protocol and were examined clinically and radiographically preoperatively (T0) and at 1 (T1), 6 (T2), and 12 (T3) months after permanent upper prosthesis placement. The patients reported an increased oral health-related quality of life. The overall mean Oral Health Impact Profile-14 score at T0 was 17.20 (standard deviation (SD) 6.42). When results at T0 were compared to those at T1 (mean 8.93, SD 5.30), a statistically significant difference was seen (P = 0.001). At T3, the mean value was 5.80 (SD 4.18). Compared to T0, there was also a statistically significant difference at T3 (P = 0.001). General satisfaction based on the numerical rating scale was a mean 49.93 at T1, which was less than patient expectation prior to treatment at T0 (52.13). A higher overall value was seen at T3 (53.20) when compared to T0. Within the constraints of the short follow-up, the AMSJI appears to be a promising tool for patients with extreme jaw atrophy. The high patient expectations were met without complications.

Subperiosteal implants (SIs) were first developed by Dahl in 1941 for oral rehabilitation in case of severe jaw atrophy. Over time, this technique was abandoned due to the high success rate of endosseous implants. The emergence of patient-specific implants and modern dentistry allowed a revisitation of this 80-year-old concept resulting in a novel “high-tech” SI implant. This study evaluates the clinical outcomes in forty patients after maxillary rehabilitation with an additively manufactured subperiosteal jaw implant (AMSJI®). The oral health impact profile-14 (OHIP-14) and numerical rating (NRS) scale were used to assess patient satisfaction and evaluate oral health. In total, fifteen men (mean age: 64.62 years, SD ± 6.75 years) and twenty-five women (mean age: 65.24 years, SD ± 6.77 years) were included, with a mean follow-up time of 917 days (SD ± 306.89 days) after AMSJI installation. Patients reported a mean OHIP-14 of 4.20 (SD ± 7.10) and a mean overall satisfaction based on the NRS of 52.25 (SD ± 4.00). Prosthetic rehabilitation was achieved in all patients. AMSJI is a valuable treatment option for patients with extreme jaw atrophy. Patients enjoy treatment benefits resulting in high patient satisfaction rates and impact on oral health.

Chyluria occurs in all its forms with milky urine, recurrent episodes of acute urinary retention, left renal colic and proteinuria. In non-parasitic or iatrogenic diseases, it is secondary to communicate between the cisterna system of the chyli and the lymphatics of the calyx system of the left urinary tract with a retrograde passage of a kilo and its appearance in the urine which therefore take on a milky appearance [1, 2]. Sometimes, episodically, especially after the ingestion of a high-fat meal, the quantity of kilo is so abundant that it can cause obstruction of the upper urinary tract and of the bladder, resulting in renal colic or acute urinary retention that may require their unblocking with double J stent or bladder catheter [3, 4]. After conservative attempts with a fat-free diet or with the parenteral diet, in case of their failure, surgery must be performed by performing a para-aortic and renal hilum lymphadenectomy and, in severe cases, with intraperitonealization of the kidney and left ureter. This is the case of the patient reported below and successfully treated recently with an innovative “open” surgical technique.

Additively manufactured subperiosteal jaw implants (AMSJI) are patient-specific, 3D-printed, titanium implants that provide an alternative solution for patients with severe maxillary bone atrophy. The aim of this study was to evaluate the bony remodeling of the maxillary crest and supporting bone using AMSJI. Fifteen patients with a Cawood-Howell Class V or greater degree of maxillary atrophy were evaluated using (cone beam) computed tomography scans at set intervals: one month (T1) and twelve months (T2) after definitive masticatory loading of bilateral AMSJI implants in the maxilla. The postoperative images were segmented and superimposed on the preoperative images. Fixed evaluation points were determined in advance, and surface comparison was carried out to calculate and visualize the effects of AMSJITM on the surrounding bone. A total mean negative bone remodeling of 0.26 mm (SD 0.65 mm) was seen over six reference points on the crest. Minor bone loss (mean 0.088 mm resorption, SD 0.29 mm) was seen at the supporting bone at the wings and basal frame. We conclude that reconstruction of the severely atrophic maxilla with the AMSJI results in minimal effect on supporting bone. Reduced stress shielding with a biomechanically tuned subperiosteal implant does not induce radiographically significant crestal bone atrophy. ispartof: JOURNAL OF CLINICAL MEDICINE vol:10 issue:16 ispartof: location:Switzerland status: published

Public transport services are currently executing or planning a fundamental transition from traditional buses to electric buses. During this transition phase, the public transport offering is fulfilled with a mixed fleet across multiple bus terminals, which poses operational challenges for optimal vehicle scheduling, a problem not yet addressed in literature. As researchers in Transport Engineering and Operational Research at the University of Luxembourg, in collaboration with the Roma Tre University, we support the Ministry of Transport of Luxembourg and Volvo buses by modelling and simulating this transition phase, to help them managing and solving such challenges. In this work we develop a mixed-integer linear programming (MILP) formulation of the problem and implement a time-based decomposition framework, through which we can optimize real-life daily instances. This method is tested on the main urban bus lines that connect Central Station, Luxembourg Airport and ten other major terminals within Luxembourg City, providing (near) optimal solutions that explicitly consider the energy constraints arising from electric bus operations, while establishing an advantageous trade-off between delaying trips, to implement quick-charging of electric buses, and performing the same trip with costlier traditional buses. The results show a consistent decrease of operational costs as the percentage of e-buses in the fleet increases.

This paper seeks traffic signal control policies which maximise long-run network throughput when demand is within network capacity and also when demand is beyond network capacity. The paper considers smooth versions of two well-known responsive traffic signal control policies: the P 0 policy (see Smith, 1979b, 1980 or Smith et al., 2015) and the maxpressure or MP policy (see Varaiya, 2013a). The paper gives two simple example networks where both of these smooth responsive traffic control policies give rise to decreasing throughput for increasing demands; when these demands are beyond the network capacity. The paper then suggests a simple modification of the two responsive traffic control policies and shows that the two modified policies do maximise the long run throughput of the two signal-controlled networks; both when a steady input demand D is within network capacity and also when a steady demand exceeds network capacity. The modified version of P 0 is as follows: for a certain positive number K, for D ⩽ K use responsive policy P 0 , and for D > K use the green-times generated by P 0 when D = K . Thus in this modification the green-time proportions generated by responsive P 0 are frozen as demand passes through K; and remain fixed for all demands D which exceed K. The paper shows that the above modification when applied to a continuous version of MP also maximises throughput in both networks for all values of the steady demand D. Finally the paper considers a signal controlled network with route choice. It is shown that if routes are chosen by travellers in their own best interests then the continuous version of MP does not always maximise throughput, even if the constant input demand D is within the network capacity, but P 0 does always maximise throughput, even when the constant input demand D is beyond the network capacity.

Holding has been extensively used as control strategy to regulate public transport operations, especially to maintain even headways and prevent buses of the same line to bunch up. Applying holding to multiple lines requires however to deal with the transition between corridor and branching segments. In this study, we introduce a holding criterion for network configurations with lines that operate jointly along a common corridor and then diverge to individual branches serving different urban areas. The proposed holding decision rule accounts for all different passenger groups in the overlapping segment and considers the transition to individual line operation. The holding rule is evaluated using simulation for different demand levels and compositions and is compared with state-of-the-art control schemes for a real-world network. Results show that the proposed multi-line control yields performance improvements along the shared transit corridor as well as at the line level. The performance of the control scheme is affected by the demand composition and we provide indications regarding the conditions under which multi-line control is advisable.

This chapter presents an integrated management approach exploiting the potentials of the new Cooperative Intelligent Transportation Systems (C-ITS) to meet the requirements of the next generation Public Transport (PT). This approach considers the additional complexity of electrification—for instance electric busses need to periodically recharge during operation using dedicated infrastructure. This not only can impact service level, but also extend operating costs with complex electric charges. We develop new strategies explicitly optimizing the interactions within the PT ecosystem consisting of vehicles, traffic signals, and e-bus charging infrastructure. To achieve these goals, we rely on vehicle control rather than on the use of transit signal priority, which in congested urban scenarios can have negative effects on overall traffic performance. The main research challenges are in formulating and solving complex multi-objective optimization problems and real-time control. The proposed system is tested and evaluated in simulation showing the benefits of electrified and cooperative bus systems.

Introduction: We described our rationale and experiences with the use of cutting jigs for vertical ostectomy in cases of terminal maxillary dentition when edentulation and an additively manufactured subperiosteal jaw implant (AMSJI®) are planned. Material and Methods: Our experience covers 15 patients treated by four clinicians. We tabulated our criteria for planning and manufacturing vertical and horizontal ostectomy guides. Results: In order to guarantee accurate osteotomy, titanium guides are preferable to guides made of polymer. The most important consideration is to avoid acute angles in the buccal arms of the AMSJI®. It is up to the surgeon whether to screw-fix the ostectomy guides or to use handles to maintain their position. Discussion: Guided ostectomy has the potential to extend the use of AMSJI® to cases where teeth have yet to be removed or where the contours of the residual bone are not favorable. The use of guided ostectomy in such cases lessens the time between edentulation and implantation and improves the design of the implants.

Gonadotropin-releasing hormone (GnRH) is the focus of the scientific debate for the treatment of hypogonadotropic hypogonadism. Sexual maturation and reproductive function depend on the pulsatile secretion of GnRH that are mainly congenital and may or may not be associated with other genetic anomalies or syndromes. Clinical manifestations include a wide range of metabolic, endocrine, and psychologic dysfunctions. The following manuscript focuses on the effects of GnRH therapy on fertility and cognitive abilities, aiming to investigate the current level of evidence for this treatment regimen. Current literature has been reviewed with the aim of highlighting the key findings on these two aspects.

In transit corridors, multiple lines share a sequence of consecutive stops to provide higher joint frequency in higher demand areas. A key challenge is to coordinate the transition from single line to joint operation. A holding control strategy aimed at minimizing passenger travel times is introduced for lines merging into a shared corridor, accounting for the coordination of vehicle arrivals from the merging lines as well as the regularity of each line. The criterion is tested using an artificial network and a real-world network to analyze the impact of demand distribution and compare cooperative versus single line control. We illustrate how the real-time strategy yields overall passenger gains, depending on the composition of different user groups. Results are assessed based on operation and passenger performance indicators and show that coordination is achieved. When combined with joint control in the common part, the proposed approach achieves consistent network-wide travel time benefits.

Coordination and integration of different traffic control policies have been of considerable interest in research in the last decades and, recently, have been object of large scale implementation trials. In the setting of peri-urban motorway systems, coordination of various kinds of controllers must however be accompanied by accurate prediction of both propagation of flows and queues in the network, as well as the users’ response in terms of route choice. In this paper, we showcase through a real-life case study how coordination and prediction are both essential when performing hybrid urban-motorway control. Simulation results of a Model Predictive Control application are compared to simpler local control approaches, and the impact of coordinated intersection control and, additionally, Ramp Metering is evaluated.