Retained versus removed copper intrauterine device during pregnancy: An updated systematic review and meta-analysis.

Introduction: Intrauterine devices (IUDs) are highly effective contraceptives. Despite their effectiveness, pregnancies can occur during IUD use, and the management of such cases, particularly when the pregnancy is desired, remains controversial.

Material And Methods: We conducted a systematic review and meta-analysis to evaluate outcomes in women who unintentionally conceived while using IUDs and chose to continue their pregnancies.

Feedbacks Regulating the Salinization of Coastal Landscapes.

The impact of saltwater intrusion on coastal forests and farmland is typically understood as sea-level-driven inundation of a static terrestrial landscape, where ecosystems neither adapt to nor influence saltwater intrusion. Yet recent observations of tree mortality and reduced crop yields have inspired new process-based research into the hydrologic, geomorphic, biotic, and anthropogenic mechanisms involved. We review several negative feedbacks that help stabilize ecosystems in the early stages of salinity stress (e.

Linguistic profile automated characterisation in pluripotential clinical high-risk mental state (CHARMS) conditions: methodology of a multicentre observational study.

Introduction: Language is usually considered the social vehicle of thought in intersubjective communications. However, the relationship between language and high-order cognition seems to evade this canonical and unidirectional description (ie, the notion of language as a simple means of thought communication). In recent years, clinical high at-risk mental state (CHARMS) criteria (evolved from the Ultra-High-Risk paradigm) and the introduction of the Clinical Staging system have been proposed to address the dynamicity of early psychopathology.

Design and Performance of an Adsorption Bed with Activated Carbons for Biogas Purification.

Organic waste can be efficiently converted into energy using highly efficient energy systems, such as SOFCs coupled to the anaerobic digestion process. SOFC systems fed by biogenous fuels, such as biogas or syngas, suffer long-term stability due to trace compound impacts. It follows that, a mandatory gas cleaning section is needed to remove these pollutants at lower concentrations.

EPSILoN: A Prognostic Score for Immunotherapy in Advanced Non-Small-Cell Lung Cancer: A Validation Cohort.

Background: Beyond programmed death ligand 1 (PD-L1), no other biomarkers for immunotherapy are used in daily practice. We previously created EPSILoN (Eastern Cooperative Oncology Group performance status (ECOG PS), smoking, liver metastases, lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR)) score, a clinical/biochemical prognostic score, in 154 patients treated with second/further-line immunotherapy. This study's aim was to validate EPSILoN score in a different population group.

Biomimetic and mesoporous nano-hydroxyapatite for bone tissue application: a short review.

In the last decades, many research groups have experimented the synthesis of hydroxyapatite (HA) for bone tissue application obtaining products with different shapes and dimensions. This review aims to summarise and critically analyse the most used methods to prepare physiologic-like nano-HA, in the form of plates or rods, similar to the HA present in the human bones. Moreover, mesoporous HA has gained increasing interest in the biomedical field due its pecualiar structural features, such as high surface area and accessible mesoporous volume, which is known to confer enhanced biological behaviour and the possibility to act as nanocarriers of functional agents for bone-related therapies.

Osteoporosis-related variations of trabecular bone properties of proximal human humeral heads at different scale lengths.

Osteoporosis (OP) is a skeletal disorder responsible for the weakening of the bone structure and, consequently, for an increased fracture risk in the elderly population. In the past, bone mineral density (BMD) variation was considered the best OP indicator, but recently the focus has shifted toward the variation of microstructural bone parameters. This work is based on the characterisation of 8-mm cylindrical biopsies harvested from proximal humeral heads belonging to healthy and osteoporotic patients, in order to assess the OP-related variations of bone properties at different scale lengths.

Low Baseline Serum Sodium Concentration Is Associated with Poor Clinical Outcomes in Metastatic Non-Small Cell Lung Cancer Patients Treated with Immunotherapy.

Background: A consistent percentage of patients with metastatic non-small cell lung cancer (NSCLC) derives no or only marginal benefit from immunotherapy (IO).

Objective: Since serum sodium has been linked to both prognosis in NSCLC and modulation of immune cells activity, we aimed to assess the association between low baseline serum sodium concentration (≤ 135 mEq/L) and clinical outcomes of patients with metastatic NSCLC treated with IO.

Patients And Methods: We included metastatic NSCLC patients treated with checkpoint inhibitors in our department from April 2013 to April 2018 with available baseline serum sodium concentration.

The Incorporation of Strontium to Improve Bone-Regeneration Ability of Mesoporous Bioactive Glasses.

Over the recent years, mesoporous bioactive glasses (MBGs) gained interest as bone regeneration systems, due to their excellent bioactivity and ability to release therapeutic molecules. In order to improve the bone regeneration ability of MBGs, the incorporation of Sr ions, due to its recognized pro-osteogenenic potential, represents a very promising strategy. In this study, MBGs based on the SiO₂⁻CaO system and containing different percentages (2 and 4 mol %) of strontium were prepared by two synthesis methods, in the form of microspheres and nanoparticles.

Bioactive Glass-Ceramic Foam Scaffolds from 'Inorganic Gel Casting' and Sinter-Crystallization.

Highly porous bioactive glass-ceramic scaffolds were effectively fabricated by an inorganic gel casting technique, based on alkali activation and gelification, followed by viscous flow sintering. Glass powders, already known to yield a bioactive sintered glass-ceramic (CEL2) were dispersed in an alkaline solution, with partial dissolution of glass powders. The obtained glass suspensions underwent progressive hardening, by curing at low temperature (40 °C), owing to the formation of a C-S-H (calcium silicate hydrate) gel.

Supporting a distributed execution of clinical guidelines.

Clinical guidelines (GL) play an important role in medical practice: the one of optimizing the quality of patient care on the basis of evidence based medicine. In order to achieve this goal, the interaction between different agents, who cooperate in the execution of the same GL, is a crucial issue. As a matter of fact, in many cases (e.

Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review.

Background And Aims: Ascertainment bias (AB) indicates a bias of an evaluation centre in estimating the prevalence/incidence of a disease due to the specific expertise of the centre. The aim of our study was to evaluate classification of different types of dementia in new cases appearing in secondary and tertiary centres, in order to evidence possible occurrence of AB in the various (secondary to tertiary) dementia centres.

Methods: To assess the mechanism of AB, the rates of new cases of the different forms of dementia reported by different centres were compared.

Supporting human interaction and human resources coordination in distributed clinical guidelines.

Clinical guidelines (GL) play an important role in medical practice: the one of optimizing the quality of patient care on the basis of the best and most recent evidence based medicine. In order to achieve this goal, the interaction between different actors, who cooperate in the execution of the same GL, is a crucial issue. As a matter of fact, in many cases (e.

Adopting model checking techniques for clinical guidelines verification.

Objectives: Clinical guidelines (GLs) are assuming a major role in the medical area, in order to grant the quality of the medical assistance and to optimize medical treatments within healthcare organizations. The verification of properties of the GL (e.g.

Applying artificial intelligence to clinical guidelines: the GLARE approach.

We present GLARE, a domain-independent system for acquiring, representing and executing clinical guidelines (GL). GLARE is characterized by the adoption of Artificial Intelligence (AI) techniques in the definition and implementation of the system. First of all, a high-level and user-friendly knowledge representation language has been designed.

GLARE: a domain-independent system for acquiring, representing and executing clinical guidelines.

We briefly describe GLARE, a domain-independent system to acquire, represent and execute clinical guidelines, which as been developed since 1997 in a joint cooperation between Computer Sciences Departments and Az. Ospedaliera S. Giovanni Battista in Turin, one of the largest hospitals in Italy.

Clinical guidelines contextualization in GLARE.

The adaptation of clinical guidelines to specific contexts is a fundamental task to promote guideline dissemination and use. Several aspects of contextualization need to be faced, including the adaptation of guidelines to local resource availability and (for computer-based guideline approaches) to local software environment. We show how a computer-based approach can help in such a challenging task.

Extending temporal databases to deal with telic/atelic medical data.

Objective: In this paper, we aim at defining a general-purpose data model and query language coping with both "telic" and "atelic" medical data.

Background: In the area of Medical Informatics, there is an increasing realization that temporal information plays a crucial role, so that suitable database models and query languages are needed to store and support it. However, despite the wide range of approaches in the area, in this paper we show that a relevant class of medical data cannot be properly dealt with.

[Pathophysiological and therapeutic implications of nitric oxide in hepatology].

The L-arginine/nitric oxide (NO) pathway has been recognized as a main regulator of several cell functions. Accordingly, there is an increasing number of pathophysiological conditions in which a precise knowledge of NO status could prove helpful in understanding the mechanisms involved in disease development, prevention and treatment. These include several hepatic disorders, such as liver cirrhosis and associated hyperdynamic circulation with portal hypertension, ischaemia-reperfusion injury occurring during liver transplantation, and chronic cholestatic conditions.

The GLARE approach to clinical guidelines: main features.

In this paper, we present GLARE, a domain-independent prototypical system for acquiring, representing and executing clinical guidelines. GLARE has been built within a 7-year project with Azienda Ospedaliera San Giovanni Battista in Turin (one of the largest hospitals in Italy) and has been successfully tested on clinical guidelines in different domains, including bladder cancer, reflux esophagitis, and heart failure. GLARE is characterized by the adoption of advanced Artificial Intelligence (AI) techniques, to support medical decision making and to manage temporal knowledge.

A context-adaptable approach to clinical guidelines.

One of the most relevant obstacles to the use and dissemination of clinical guidelines is the gap between the generality of guidelines (as defined, e.g., by physicians' committees) and the peculiarities of the specific context of application.

Temporal consistency checking in clinical guidelines acquisition and execution: the GLARE's approach.

GLARE (GuideLine Acquisition, Representation and Execution) is a domain-independent system for the acquisition, representation and execution of clinical guidelines. Temporal constraints play an important role within clinical guidelines (e.g.