Search results for: Gabriella De Angelis

Authors: Angelis P. Barlampas

Abstract:

Objective: The confusion of terms is a common practice in many situations of the everyday life. But, in some circumstances, such as in medicine, the precise meaning of a word curries a critical role for the health of the patient. Fahr disease and Fahr syndrome are often falsely used interchangeably, but they are two different conditions with different physical histories of different etiology and different medical management. A case of the seldom Fahr disease is presented, and a comparison with the more common Fahr syndrome follows. Materials and method: A 72 years old patient came to the emergency department, complaining of some kind of non specific medal disturbances, like anxiety, difficulty of concentrating, and tremor. The problems had a long course, but he had the impression of getting worse lately, so he decided to check them. Past history and laboratory tests were unremarkable. Then, a computed tomography examination was ordered. Results: The CT exam showed bilateral, hyperattenuating areas of heavy, dense calcium type deposits in basal ganglia, striatum, pallidum, thalami, the dentate nucleus, and the cerebral white matter of frontal, parietal and iniac lobes, as well as small areas of the pons. Taking into account the absence of any known preexisting illness and the fact that the emergency laboratory tests were without findings, a hypothesis of the rare Fahr disease was supposed. The suspicion was confirmed with further, more specific tests, which showed the lack of any other conditions which could probably share the same radiological image. Differentiating between Fahr disease and Fahr syndrome. Fahr disease: Primarily autosomal dominant Symmetrical and bilateral intracranial calcifications The patient is healthy until the middle age Absence of biochemical abnormalities. Family history consistent with autosomal dominant Fahr syndrome :Earlier between 30 to 40 years old. Symmetrical and bilateral intracranial calcifications Endocrinopathies: Idiopathic hypoparathyroidism, secondary hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism ,pseudopseudohypoparathyroidism, e.t.c The disease appears at any age There are abnormal laboratory or imaging findings. Conclusion: Fahr disease and Fahr syndrome are not the same illness, although this is not well known to the inexperienced doctors. As clinical radiologists, we have to inform our colleagues that a radiological image, along with the patient's history, probably implies a rare condition and not something more usual and prompt the investigation to the right route. In our case, a genetic test could be done earlier and reveal the problem, and thus avoiding unnecessary and specific tests which cost in time and are uncomfortable to the patient.

Keywords: fahr disease, fahr syndrome, CT, brain calcifications

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Authors: Gabriella Jorge, Carlos A. Pérez, Hanna Friberg, Sara Söderlund, Jan Lagerlöf

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Fusarium Head Blight (FHB) is one of the most important Fusarium-caused diseases, which affects cereals with serious detrimental effects on yield and grain quality worldwide. Earthworms have been suggested as an alternative to control this disease, which requires a combination of preventive methods to reduce level of damage, although it has been proven that their effect is species dependent. Our objective was to evaluate the effect of the earthworms Aporrectodea longa and Lumbricus rubellus, on the inoculum of Fusarium graminearum on wheat straw. To test this we kept earthworms in vessels with soil, and F. graminearum-inoculated straw covering the surface, under controlled conditions for 6 weeks. Two factors were evaluated with a complete factorial design: earthworms (three levels: without earthworms, A. longa, and L. rubellus), and straw (two levels: inoculated with the pathogen, and sterile). The presence of L. rubellus significantly (P<0.05) reduced the amount of inoculated straw at the soil surface 31% after 6 weeks, while the presence of A. longa, most found in quiescence, did not have any significant effect on the amount of straw when compared to the control. After incubation, F. graminearum was detected by qPCR, only in the surface straw in those treatments inoculated with the pathogen but without earthworms. None of the treatments showed presence of Fusarium in the buried straw, soil or earthworm casts. Both earthworm species decreased in body weight during incubation, most likely due to the decrease in soil water content during the experiment, from 25% to 20%, and/or inadequate food supply, since no other source of food was added. However, this reduction in weight occurred indistinctly of the presence or not of Fusarium (P<0.05). This indicates that both species, of different ecological groups, anecic and epigeic, can reduce F. graminearum inoculum present in wheat straw, while their growth is not negatively affected by this pathogen. These promising results place A. longa, and L. rubellus as potential biocontrol agents of this fungal plant pathogen responsible for Fusarium Head Blight disease in wheat, although further ongoing experiments are needed to confirm the repeatability of these results.

Keywords: Aporrectodea longa, biological control, fungal plant pathogen, Lumbricus rubellus, qPCR, wheat straw

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Authors: Eszter Kulcsar, Agnes Takacs, Gabriella B. Kiss, Peter Prakfalvi

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The Karancs Mountain is part of the Miocene Inner Carpathian Volcanic Belt and is located in N-NE Hungary, along the Hungarian-Slovakian border. The 14 Ma old andesitic-dacitic units are surrounded by Oligocene sedimentary units (sandstone, siltstone). The host rocks of the mineralisation are siliceous and/or argillaceous volcanic units, quartz veins, hydrothermal breccia, and strongly silicified vuggy rocks, found in the various altered volcanic units. The hydrothermal breccia consists of highly silicified vuggy quartz clasts in quartz matrix. The hydrothermal alteration of the host units shows structural control at the deeper levels. The main ore minerals are galena, pyrite, marcasite, sphalerite, hematite, magnetite, arsenopyrite, anglesite and argentite The mineralisation was first mentioned in 1944 and the first exploration took place between 1961 and 1962 in the area. The first ore geological studies were performed between 1984-1985. The exploration programme was limited only to surface sampling; no drilling programme was performed. Petrographical and preliminary fluid inclusion studies were performed on calcite samples from a galena-bearing vein. Despite the early discovery of the mineralisation, no detailed description is available, thus its size, characteristics, and origin have remained unknown. The aim of this study is to examine the mineralisation, describe the characteristics in detail and to test the possible gold content of the various quartz veins and breccias. Finally, we also investigate the potential relation of the hydrothermal mineralisation to the surrounding similar mineralisations with similar ages (e.g. W-Mátra Mountains in Hungary, Banska Bystrica, Banska Stiavnica in Slovakia) in order to place the mineralisation within the volcanic-hydrothermal evolution of the Miocene Inner Carpathian Belt. As first steps, the study includes field mapping, traditional petrological and ore microscopy; X-ray diffraction analysis; SEM-EDS and EMPA studies on ore minerals, to obtain mineral chemical information. Fluid inclusion petrography and microthermometry and micro-Raman-spectroscopy studies are also planned on quartz-hosted inclusions to investigate the physical and chemical properties of the ore-forming fluid.

Keywords: epithermal, Karancs Mountain, Hungary, Miocene Inner Carpathian volcanic belt, polimetallic ore deposit

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Authors: Natasha Gabriella, Josef-Peter Schöggl, Alfred Posch

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Being a mature industry, pulp and paper industry (PPI) possess strength points coming from its existing infrastructure, technology know-how, and abundant availability of biomass. However, the declining trend of the wood-based products sales sends a clear signal to the industry to transform its business model in order to increase its profitability. With the emerging global attention on bio-based economy and circular economy, coupled with the low price of fossil feedstock, the PPI starts to integrate biorefinery as a value-added business model to keep the industry’s competitiveness. Nonetheless, biorefinery as an innovation exposes the PPI with some barriers, of which the uncertainty of the promising product becomes one of the major hurdles. This study aims to assess factors that affect the diffusion and development of forest biorefinery in the PPI, including drivers, barriers, advantages, disadvantages, as well as the most promising bio-based products of forest biorefinery. The study examines the identified factors according to the layer of business environment, being the macro-environment, industry, and strategic group level. Besides, an overview of future state of the identified factors is elaborated as to map necessary improvements for implementing forest biorefinery. A two-phase Delphi method is used to collect the empirical data for the study, comprising of an online-based survey and interviews. Delphi method is an effective communication tools to elicit ideas from a group of experts to further reach a consensus of forecasting future trends. Collaborating a total of 50 experts in the panel, the study reveals that influential factors are found in every layers of business of the PPI. The politic dimension is apparent to have a significant influence for tackling the economy barrier while reinforcing the environmental and social benefits in the macro-environment. In the industry level, the biomass availability appears to be a strength point of the PPI while the knowledge gap on technology and market seem to be barriers. Consequently, cooperation with academia and the chemical industry has to be improved. Human resources issue is indicated as one important premise behind the preceding barrier, along with the indication of the PPI’s resistance towards biorefinery implementation as an innovation. Further, cellulose-based products are acknowledged for near-term product development whereas lignin-based products are emphasized to gain importance in the long-term future.

Keywords: forest biorefinery, pulp and paper, bio-based product, Delphi method

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Authors: Angelis P. Barlampas

Abstract:

Introduction: The term phantom lung mass describes the ovoid collection of fluid within the interlobular fissure, which initially creates the impression of a mass. The problem of correct differential diagnosis is great, especially in plain radiography. A case is presented with three nodular pulmonary foci, the shape, location, and density of which, as well as the presence of chronic loculated pleural effusions, suggest the presence of multiple phantom tumors of the lung. Purpose: The aim of this paper is to draw the attention of non-experienced and non-specialized physicians to the existence of benign findings that mimic pathological conditions and vice versa. The careful study of a radiological examination and the comparison with previous exams or further control protect against quick wrong conclusions. Methods: A hospitalized patient underwent a non-contrast CT scan of the chest as part of the general control of her situation. Results: Computed tomography revealed pleural effusions, some of them loculated, increased cardiothoracic index, as well as the presence of three nodular foci, one in the left lung and two in the right with a maximum density of up to 18 Hounsfield units and a mean diameter of approximately five centimeters. Two of them are located in the characteristical anatomical position of the major interlobular fissure. The third one is located in the area of the right lower lobe’s posterior basal part, and it presents the same characteristics as the previous ones and is likely to be a loculated fluid collection, within an auxiliary interlobular fissure or a cyst, in the context of the patient's more general pleural entrapments and loculations. The differential diagnosis of nodular foci based on their imaging characteristics includes the following: a) rare metastatic foci with low density (liposarcoma, mucous tumors of the digestive or genital system, necrotic metastatic foci, metastatic renal cancer, etc.), b) necrotic multiple primary lung tumor locations (squamous epithelial cancer, etc. ), c) hamartomas of the lung, d) fibrotic tumors of the interlobular fissures, e) lipoid pneumonia, f) fluid concentrations within the interlobular fissures, g) lipoma of the lung, h) myelolipomas of the lung. Conclusions: The collection of fluid within the interlobular fissure of the lung can give the false impression of a lung mass, particularly on plain chest radiography. In the case of computed tomography, the ability to measure the density of a lesion, combined with the provided high anatomical details of the location and characteristics of the lesion, can lead relatively easily to the correct diagnosis. In cases of doubt or image artifacts, comparison with previous or subsequent examinations can resolve any disagreements, while in rare cases, intravenous contrast may be necessary.

Keywords: phantom mass, chest CT, pleural effusion, cancer

Procedia PDF Downloads 55

Authors: Angelis P. Barlampas

Abstract:

Learning Objectives: The purpose of this study is to inform briefly the reader about the applications of AI in chest radiology. Background: Currently, there are 190 FDA-approved radiology AI applications, with 42 (22%) pertaining specifically to thoracic radiology. Imaging findings OR Procedure details Aids of AI in chest radiology1: Detects and segments pulmonary nodules. Subtracts bone to provide an unobstructed view of the underlying lung parenchyma and provides further information on nodule characteristics, such as nodule location, nodule two-dimensional size or three dimensional (3D) volume, change in nodule size over time, attenuation data (i.e., mean, minimum, and/or maximum Hounsfield units [HU]), morphological assessments, or combinations of the above. Reclassifies indeterminate pulmonary nodules into low or high risk with higher accuracy than conventional risk models. Detects pleural effusion . Differentiates tension pneumothorax from nontension pneumothorax. Detects cardiomegaly, calcification, consolidation, mediastinal widening, atelectasis, fibrosis and pneumoperitoneum. Localises automatically vertebrae segments, labels ribs and detects rib fractures. Measures the distance from the tube tip to the carina and localizes both endotracheal tubes and central vascular lines. Detects consolidation and progression of parenchymal diseases such as pulmonary fibrosis or chronic obstructive pulmonary disease (COPD).Can evaluate lobar volumes. Identifies and labels pulmonary bronchi and vasculature and quantifies air-trapping. Offers emphysema evaluation. Provides functional respiratory imaging, whereby high-resolution CT images are post-processed to quantify airflow by lung region and may be used to quantify key biomarkers such as airway resistance, air-trapping, ventilation mapping, lung and lobar volume, and blood vessel and airway volume. Assesses the lung parenchyma by way of density evaluation. Provides percentages of tissues within defined attenuation (HU) ranges besides furnishing automated lung segmentation and lung volume information. Improves image quality for noisy images with built-in denoising function. Detects emphysema, a common condition seen in patients with history of smoking and hyperdense or opacified regions, thereby aiding in the diagnosis of certain pathologies, such as COVID-19 pneumonia. It aids in cardiac segmentation and calcium detection, aorta segmentation and diameter measurements, and vertebral body segmentation and density measurements. Conclusion: The future is yet to come, but AI already is a helpful tool for the daily practice in radiology. It is assumed, that the continuing progression of the computerized systems and the improvements in software algorithms , will redder AI into the second hand of the radiologist.

Keywords: artificial intelligence, chest imaging, nodule detection, automated diagnoses

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Authors: Marielle Hanley, Brandon Takahashi, Gerry Hanley, Gabriella Hancock

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Safety harnesses and their protocols are very common within the construction industry, and the Occupational Safety and Health Administration has provided extensive guidelines with protocols being constantly updated to ensure the highest level of safety within construction sites. There is also extensive research on harnesses that are meant to keep people in place in moving vehicles, such as seatbelts. Though this research is comprehensive in these areas, the findings and recommendations are not generally applicable to other industry sectors where harnesses are used, such as the entertainment industry. The focus of this case study is on the design and use of harnesses used by theme park employees wearing elaborate costumes in parades and performances. The key factors of posture, kinesthetic factors, and harness engineering interact in significantly different ways when the user is performing repetitive choreography with 20 to 40 lbs. of apparatus connected to harnesses that need to be hidden from the audience’s view. Human factors and ergonomic analysis take into account the required performers’ behaviors, the physical and mental preparation and posture of the performer, the design of the harness-embedded costume, and the environmental conditions during the performance (e.g., wind) that can determine the physical stresses placed on the harness and performer. The uniqueness and expense of elaborate costumes frequently result in one or two costumes created for production, and a variety of different performers need to fit into the same costume. Consequently, the harnesses should be adjustable if they are to minimize the physical and cognitive loads on the performer, but they are frequently more a “one-size fits all”. The complexity of human and technology interactions produces a range of detrimental outcomes, from muscle strains to nerve damage, mental and physical fatigue, and reduced motivation to perform at peak levels. Based on observations conducted over four years for this case study, a number of recommendations to institutionalize the human factors and ergonomic analyses can significantly improve the safety, reliability, and quality of performances with harness-embedded costumes in the entertainment industry. Human factors and ergonomic analyses can be integrated into the engineering design of the performance costumes with embedded harnesses, the conditioning and training of the performers using the costumes, the choreography of the performances within the staged setting and the maintenance of the harness-embedded costumes. By applying human factors and ergonomic methodologies in the entertainment industry, the industry management and support staff can significantly reduce the risks of injury, improve the longevity of unique performers, increase the longevity of the harness-embedded costumes, and produce the desired entertainment value for audiences.

Keywords: ergonomics in entertainment industry, harness-embedded costumes, performer safety, injury prevention

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Authors: Angelis P. Barlampas

Abstract:

An 89 years old woman came to the emergency department complaining of long-lasting headaches and nausea. A CT examination was performed, and a homogeneous midline anterior cranial fossa lesion was revealed, which was situated near the base and measured 2,4 cm in diameter. The patient was allergic, and an i.v.c injection could not be done on the spot, and neither could an MRI exam because of metallic implants. How could someone narrow down the differential diagnosis? The interhemispheric meningioma is usually a silent midline lesion with no edema, and most often presents as a homogeneous, solid type, isodense, or slightly hyperdense mass ( usually the smallest lesions as this one ). Of them, 20-30% have some calcifications. Hyperostosis is typical for meningiomas that abut the base of the skull but is absent in the current case, presumably of a more cephalad location that is borderline away from the bone. Because further investigation could not be done, as the patient was allergic to the contrast media, some other differential options should be considered. Regarding the site of the lesion, the most common other entities to keep in mind are the following: Metastasis, tumor of skull base, abscess, primary brain tumors, meningioma, giant aneurysm of the anterior cerebral artery, olfactory neuroblastoma, interhemispheric meningioma, giant aneurysm of the anterior cerebral artery, midline lesion. Appearance will depend on whether the aneurysm is non-thrombosed, or partially, or completely thrombosed. Non-contrast: slightly hyperdense, well-defined round extra-axial mass, may demonstrate a peripheral calcified rim, olfactory neuroblastoma, midline lesion. The mass is of soft tissue attenuation and is relatively homogeneous. Focal calcifications are occasionally present. When an intracranial extension is present, peritumoral cysts between it and the overlying brain are often present. Final diagnosis interhemispheric meningioma (Known from the previous patient’s history). Meningiomas come from the meningocytes or the arachnoid cells of the meninges. They are usually found incidentally, have an indolent course, and their most common location is extra-axial, parasagittal, and supratentorial. Other locations include the sphenoid ridge, olfactory groove, juxtasellar, infratentorial, intraventricular, pineal gland area, and optic nerve meningioma. They are clinically silent entities, except for large ones, which can present with headaches, changes in personality status, paresis, or symptomatology according to their specific site and may cause edema of the surrounding brain tissue. Imaging findings include the presence of calcifications, the CSF cleft sign, hyperostosis of adjacent bone, dural tail, and white matter buckling sign. After i.v.c. injection, they enhance brightly and homogenously, except for large ones, which may exhibit necrotic areas or may be heavily calcified. Malignant or cystic variants demonstrate more heterogeneity and less intense enhancement. Sometimes, it is inevitable that the needed CT protocol cannot be performed, especially in the emergency department. In these cases, the radiologist must focus on the characteristic imaging features of the unenhanced lesion, as well as in previous examinations or a known lesion history, in order to come to the right report conclusion.

Keywords: computed tomography, emergency radiology, metastasis, tumor of skull base, abscess, primary brain tumors, meningioma, giant aneurysm of the anterior cerebral artery, olfactory neuroblastoma, interhemispheric meningioma

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Authors: Gabriella Zarlenga, Martha L. Hall

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Introduction: Premature infants are at risk for neurodevelopmental deficits and hospital readmissions, which can increase the financial burden on the health care system and families. Kangaroo care (skin-to-skin contact) is a practice that can improve preterm infant health outcomes. Preterm infants can acquire adequate body temperature, heartbeat, and breathing regulation through lying directly on the mother’s abdomen and in between her breasts. Due to some infant’s condition, kangaroo care is not a feasible intervention. The purpose of this proof-of-concept research project is to create a device which simulates skin-to-skin contact for pre-term infants not eligible for kangaroo care, with the aim of promoting baby’s health outcomes, reducing the incidence of serious neonatal and early childhood illnesses, and/or improving cognitive, social and emotional aspects of development. Methods: The study design is a proof-of-concept based on a three-phase approach; (1) observational study and data analysis of the standard of care for 2 groups of pre-term infants, (2) design and concept development of a novel device for pre-term infants not currently eligible for standard kangaroo care, and (3) prototyping, laboratory testing, and evaluation of the novel device in comparison to current assessment parameters of kangaroo care. A single center study will be conducted in an area hospital offering Level III neonatal intensive care. Eligible participants include newborns born premature (28-30 weeks of age) admitted to the NICU. The study design includes 2 groups: a control group receiving standard kangaroo care and an experimental group not eligible for kangaroo care. Based on behavioral analysis of observational video data collected in the NICU, the device will be created to simulate mother’s body using electrical components in a thermoplastic polymer housing covered in silicone. It will be designed with a microprocessor that controls simulated respiration, heartbeat, and body temperature of the 'simulated caregiver' by using a pneumatic lung, vibration sensors (heartbeat), pressure sensors (weight/position), and resistive film to measure temperature. A slight contour of the simulator surface may be integrated to help position the infant correctly. Control and monitoring of the skin-to-skin contact simulator would be performed locally by an integrated touchscreen. The unit would have built-in Wi-Fi connectivity as well as an optional Bluetooth connection in which the respiration and heart rate could be synced with a parent or caregiver. A camera would be integrated, allowing a video stream of the infant in the simulator to be streamed to a monitoring location. Findings: Expected outcomes are stabilization of respiratory and cardiac rates, thermoregulation of those infants not eligible for skin to skin contact with their mothers, and real time mother Bluetooth to the device to mimic the experience in the womb. Results of this study will benefit clinical practice by creating a new standard of care for premature neonates in the NICU that are deprived of skin to skin contact due to various health restrictions.

Keywords: kangaroo care, wearable technology, pre-term infants, medical design

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