The rapid convergence of Information and Communication Technologies(ICT),driven by advancements in 5G/6G networks,cloud computing,Artificial Intelligence(AI),and the Internet of Things(IoT),is reshaping modern digital...The rapid convergence of Information and Communication Technologies(ICT),driven by advancements in 5G/6G networks,cloud computing,Artificial Intelligence(AI),and the Internet of Things(IoT),is reshaping modern digital ecosystems.As massive,distributed data streams are generated across edge devices and network layers,there is a growing need for intelligent,privacy-preserving AI solutions that can operate efficiently at the network edge.Federated Learning(FL)enables decentralized model training without transferring sensitive data,addressing key challenges around privacy,bandwidth,and latency.Despite its benefits in enhancing efficiency,real-time analytics,and regulatory compliance,FL adoption faces challenges,including communication overhead,heterogeneity,security vulnerabilities,and limited edge resources.While recent studies have addressed these issues individually,the literature lacks a unified,cross-domain perspective that reflects the architectural complexity and application diversity of Convergence ICT.This systematic review offers a comprehensive,cross-domain examination of FL within converged ICT infrastructures.The central research question guiding this review is:How can FL be effectively integrated into Convergence ICT environments,and what are the main challenges in implementing FL in such environments,along with possible solutions?We begin with a foundational overview of FL concepts and classifications,followed by a detailed taxonomy of FL architectures,learning strategies,and privacy-preserving mechanisms.Through in-depth case studies,we analyse FL’s application across diverse verticals,including smart cities,healthcare,industrial automation,and autonomous systems.We further identify critical challenges—such as system and data heterogeneity,limited edge resources,and security vulnerabilities—and review state-of-the-art mitigation strategies,including edge-aware optimization,secure aggregation,and adaptive model updates.In addition,we explore emerging directions in FL research,such as energy-efficient learning,federated reinforcement learning,and integration with blockchain,quantum computing,and self-adaptive networks.This review not only synthesizes current literature but also proposes a forward-looking road map to support scalable,secure,and sustainable FL deployment in future ICT ecosystems.展开更多
Background Out-of-hospital patients presenting with atypical chest pain and complete left bundle branch block(LBBB)have to be stratified for the presence of coronary artery disease and the risk of developing heart fai...Background Out-of-hospital patients presenting with atypical chest pain and complete left bundle branch block(LBBB)have to be stratified for the presence of coronary artery disease and the risk of developing heart failure(HF).We investigated the pro-gnostic role of coronary CT-angiography(CTA)and echocardiographic global longitudinal strain(GLS)in those patients in a mid-term follow-up.Methods Out-of-hospital patients with LBBB underwent echocardiography and a 64-slice CT angiography were evaluated ret-rospectively.Development of HF or a cardiovascular death were the events scheduled.Results Seventy-eight patients(32 female;mean age:66.0±10.4 years were enrolled.During a follow-up of 33 months(IQR:17-77),one patient(1.5%)experienced a cardiovascular death,14 patients(17.9%)required urgent outpatient visits due to acute de-compensated HF(12 hospitalizations).Echocardiography showed a slightly reduced left ventricular ejection fraction(LVEF)(50.0%±9.8%)and GLS within the normal range(-16.2%±4.1%).CTA analysis showed coronary stenosis>50%in 28 patients(35.9%).A high Agatston score(>100)was observed in 29.5%.Notably,25 patients(32.1%)were diagnosed with left main coron-ary artery disease and 15 patients(16.7%)underwent revascularization during the follow up.Significant associations were ob-served between events and LVEF(P=0.001),diastolic dysfunction grade≥2(P=0.02),GLS(P<0.001),multiple coronary stenos-is(P=0.04)and Agatston score(P=0.05).Multivariate analysis confirmed the relationships with LVEF(R^(2)=0.89,P<0.001),dia-stolic dysfunction(R^(2)=3.30,P=0.04),GLS(R^(2)=1.43,P<0.001),and Agatston score(R^(2)=1.01,P=0.05).Conclusions In patients with complete LBBB,CTA and GLS identified those at a high risk of development HF.展开更多
BACKGROUND Surgical treatment of complex fractures of the distal femur in the elderly is controversial.Osteoporosis and pre-existent osteoarthritis are common comorbidities in the elderly which add to the need for ear...BACKGROUND Surgical treatment of complex fractures of the distal femur in the elderly is controversial.Osteoporosis and pre-existent osteoarthritis are common comorbidities in the elderly which add to the need for early walking and rapid restoration of function and also pose significant obstacles to achievement of satisfactory results with standard fixation techniques.Recently,several authors have suggested that primary arthroplasty could be a viable alternative option to standard fixation techniques in selected patients with complex distal femur fractures.AIM To present our experience with 11 cases of distal femur fractures treated with knee arthroplasty and large femoral resection in a population of patients over the age of 85.METHODS Data from 11 consecutive patients(10 females,1 male)presenting with acute intra-articular supracondylar or intercondylar distal femur fractures and with pre-existent primary osteoarthritis who were treated with primary knee arthroplasty were recorded.We collected standard demographic data,comorbidities and patient reported outcomes including Visual Analogical Scale(VAS),Oxford Knee Score(OKS)and Barthel’s Index.Post-operative joint range of motion(ROM)and standard radiographic data were also collected.RESULTS At a mean follow-up of 23.2 mo,all of the implants were well-positioned and osteointegrated.Furthermore,all the patients were alive and walking either independently or with walking aids.There was a marked improvement in pain(VAS 4.5 postop vs 1.9 at the last follow-up),OKS score(29.5 postop vs 36.81 at the last follow-up),ROM(96.2°postop vs 102°at the last follow-up)and restoration of pre-injury ambulatory status(average Barthel Index 77.3).The radiographic evaluations showed good restoration of the articular geometry.No deaths and no complications were recorded.CONCLUSION In conclusion,we believe that knee megaprosthesis in the case of complex fractures of the distal femur is a valid surgical choice.This is particularly true in elderly patients with severe osteoporosis and pre-existing osteoarthritis.It is important to note that this surgery should be performed by surgeons with proven experience in prosthetic hip and knee surgery and that a scrupulous selection of the cases is completed.展开更多
BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone...BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone,the synthesis or not of the metatarsal head,the possible association with lateral soft tissues release(LSTR)and osteotomy of the base of the first phalanx.AIM To evaluate the role of LSTR on percutaneous HV correction,evaluating functional and radiographical results.METHODS From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study.The technique provides no internal fixation(WOS).Patients were divided into the LSTR group and no LSTR group(LSTR N).This surgical procedure(LSTR)was reserved for insufficient HV angle(HVA)correction during fluoroscopic control.Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors(first practitioners).Clinical evaluation was performed before surgery,6 mo after surgery,and 48 mo follow-up.American Orthopaedic Foot and Ankle Society(AOFAS)and visual analog scale(VAS)score was used to evaluate pain and function,and complications were recorded.In addition,the incidence of relapses and the degree of joint range of motion(ROM)with the association with the LSTR(capsule,adductor tendon,phalanx-sesamoid ligament,and the deep transverse metatarsal ligament)were evaluated.Radiological parameters included HVA and intermetatarsal angle(IMA).Patient satisfaction was assessed.Student t-test and Fisher exact test were used to assess statistical analysis.RESULTS From our study it is clear that no differences in term of HVA,VAS,IMA correction,rate of complications,and AOFAS score were found between groups,while a significant improvement of the same variables was found in each group between pre and postoperative values.A significant improvement in ROM at 6 mo(P=0.018)and 48 mo(P=0.02)of follow-up was found in LSTR N group.Complications were rare in both groups.CONCLUSION LSTR procedure on percutaneous HV correction seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.展开更多
Although fairy rings are widely observed,little is known about the community processes associated with them.Here,we studied fairy rings in a natural grassland in northern Mongolia by sampling soils outside(future stag...Although fairy rings are widely observed,little is known about the community processes associated with them.Here,we studied fairy rings in a natural grassland in northern Mongolia by sampling soils outside(future stage),directly under(present stage),and within(past stage)the rings,to represent different time stages during the expansion of fairy rings.Soil DNA was extracted for amplicon sequencing of the fungal ITS1 region.The present stage had reduced fungal diversity and different fungal communities toward the other stages.Most strikingly,there was an increase in the pathogenic fungus Gibberella baccata in the present stage of most rings and the saprotrophic fairy ring fungus Lepista luscina in several.However,no mushrooms of Lepista had been recorded from any of these rings during several years of observation.Known fairy ring fungi were not found in the present stage of every ring,even in some known rings to have previously displayed mushrooms of such species.It is possible that these fungi occurred or were more abundant at the unsampled leading edge of the ring.The increase in G.baccata is intriguing,but its importance,if any,is unclear.It is also unclear whether consortia of fungi or other microbes might be present in these rings.The absence or low abundance of the previously reported fairy ring fungal species suggests that their presence is transient,with rapid replacement by other fungi.No differences in soil parameters were found between the fairy ring stages,except for aluminum.There is a need for broader sampling,including analysis of non-fungal biota,to understand the functional diversity of fairy ring fungi and the consequences for plant communities.展开更多
Despite new therapeutic options,patients with heart failure(HF)still progress to advanced stage.In particular,patients who developed a severe left ventricular(LV)systolic and/or diastolic dysfunction with higher degre...Despite new therapeutic options,patients with heart failure(HF)still progress to advanced stage.In particular,patients who developed a severe left ventricular(LV)systolic and/or diastolic dysfunction with higher degree of NYHA class,recurrent hospitalizations for HF and showing a severe impairment of exercise capacity were defined as“advanced HF”.[1]Levosimendan was recently approved in order to treat patients hospitalized for acute decompensated HF(ADHF)with severe systolic dysfunction.The pharmacolo-gical effects of levosimendan consists of inotropy,vasodilatation and cardioprotection increasing of calcium sensitivity.[2]These effects should be mon-itored with echocardiography.[3]In particular,in ad-vanced HF patients,levosimendan showed positive effects in reducing mortality and three months hos-pitalization;about quality of life and symptoms im-provement,levosimendan showed contrasting ef-fect among the studies on advanced HF patients available.展开更多
Quantitative precipitation estimation and rainfall monitoring based on meteorological data, potentially provides continuous, high-resolution and large-coverage data, are of high practical use: Think of hydrogeological...Quantitative precipitation estimation and rainfall monitoring based on meteorological data, potentially provides continuous, high-resolution and large-coverage data, are of high practical use: Think of hydrogeological risk management, hydroelectric power, road and tourism. Both conventional long-range radars and rain-gauges suffer from measurement errors and difficulties in precipitation estimation. For efficient monitoring operation of localized rain events of limited extension and of small basins of interest, an unrealistic extremely dense rain gauge network should be needed. Alternatively C-band or S-band meteorological long range radars are able to monitor rain fields over wide areas, however with not enough space and time resolution, and with high purchase and maintenance costs. Short-range X-band radars for rain monitoring can be a valid compromise solution between the two more common rain measurement and observation instruments. Lots of scientific efforts have already focused on radar-gauge adjustment and quantitative precipitation estimation in order to improve the radar measurement techniques. After some considerations about long range radars and gauge network, this paper presents instead some examples of how X-band mini radars can be very useful for the observation of rainfall events and how they can integrate and supplement long range radars and rain gauge networks. Three case studies are presented: A very localized and intense event, a rainfall event with high temporal and spatial variability and the employ of X-band mini radar in a mountainous region with narrow valleys. The adaptability of such radar devoted to monitor rain is demonstrated.展开更多
Arterial stiffness and wave reflections are widely used in observational studies to analyse the determinants of haemodynamic changes observed in various clinical conditions and to understand the pathogenesis of their ...Arterial stiffness and wave reflections are widely used in observational studies to analyse the determinants of haemodynamic changes observed in various clinical conditions and to understand the pathogenesis of their cardiovascular complications. A large number of publications and several reviews documented the changes in arterial stiffness and wave reflections after various interventions, either non-pharmacological or pharmacological.展开更多
Vascular aging in large arteries plays an important role in contributing to cardiovascular morbidity and mortality.[1]Structural changes include an increase in wall thickness,intima-media thickening ratio is widely at...Vascular aging in large arteries plays an important role in contributing to cardiovascular morbidity and mortality.[1]Structural changes include an increase in wall thickness,intima-media thickening ratio is widely attributed to sub-clinical atherosclerosis and it is independently associated with future cardiovascular events.[1]展开更多
In this paper,we show the difference between management and leadership through a case study,by presenting a management situation in a company and by studying the facts in this situation,the events in this situation,th...In this paper,we show the difference between management and leadership through a case study,by presenting a management situation in a company and by studying the facts in this situation,the events in this situation,the analysis of these facts and events,and the learned lessons from this case study.We analyze in this case study the managerial situation especially for a manager X in our case study,who had some flaws in his style of management leaking of leadership.We learn some general and specific lessons in relation to our studied managerial situation.Our analysis proposes multiple improvements of this managerial situation especially for the manager X by combining his management skills with his leadership skills.We show through this case study the main differences between the management and the leadership.Also,we illustrate in this paper the interest to combine leadership skills with management skills for the manager X in our studied managerial situation and to adapt the management styles for the manager X according to the managerial situation.展开更多
We report for the first time the occurrence of heteroplasmy in Grey Partridge(Perdix perdix)revealed by means of two mitochondrial fragments.The possible serious biological and management implications of this exceptio...We report for the first time the occurrence of heteroplasmy in Grey Partridge(Perdix perdix)revealed by means of two mitochondrial fragments.The possible serious biological and management implications of this exception to unilateral inheritance of mtDNA were underlined.展开更多
Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our obje...Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our objective was to identify clinical, haematological or immunological parameters as predictors of mortality in patients with MF. Methods: We conducted a retrospective study on a prevalent cohort of 124 patients with MF hospitalized at IDI-IRCCS, Rome, Italy, from 1983 to 2001. We calculated the proportion of patients surviving (Kaplan-Meier product-limit estimates) 5 and 10 years after first hospital admission, and hazard ratios (HR) from the Cox proportional hazards model. Results: Patients’survival was linked to age and staging (lower survival in older patients and in patients with staging IIB-IV). Higher numbers of white blood cells (WBC) and neutrophils, lower numbers of CD8+lymphocytes, low haematocrit and lower levels of albumin were significantly associated with a lower survival probability. When simultaneously accounting for age and staging, CD8+[HR = 3.02, 95%confidence interval (CI) 1.01-9.07 for CD8+< 250 vs. ≥600 cells μL-1] and WBC (HR = 2.59, 95%CI 0.96-6.96 for WBC ≥9000 vs. < 6000 cells μL-1) were associated with survival. In addition, we observed an exceedingly high risk of death (HR = 12.40, 95%CI 3.11-49.43) for patients with a combination of WBC ≥9000 and CD8+< 600 cells μL-1 vs. WBC < 9000 and CD8+≥600 cells μL-1). Conclusions: The measurement of CD8+cells and WBC in MF seems to be a promising criterion to predict survival, and possibly to support treatment decisions and inclusion of patients in randomized controlled trials.展开更多
Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psor...Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psoriasis. Objectives: T o investigate the prevalence of symptoms experienced by patients with different clinical types of psoriasis. Methods: The study was carried out in patients hosp italized for psoriasis between February 2000 and February 2002 at the inpatient wards of the Istituto Dermopatico dell’Immacolata, Rome, Italy. Symptoms were evaluated using the symptoms scale of Skindex- 29. Clinical severity was assess ed by the dermatologists using the Psoriasis Area and Severity Index (PASI), and by the patients completing the self-administered PASI. Psychiatric morbidity was evaluated using the 12- item General Health Questionnaire. Results: In tota l, 936 eligible patients were analysed. The proportions of patients experiencing symptoms often or always in the 4 weeks before hospitalization were: 63.8% it ching, 59.7% irritation, 46.1% burning/stinging, 39% sensitivity, 26% pa in (from 10% in guttate psoriasis to 50% in arthropathic)- , 25.4% bleedi ng (17% pustular, 19% localized plaque, 36% palmoplantar), and 23.9% bot hered by water (from 8.5% in the guttate form to 68% in palmoplantar). The p revalence of all symptoms was significantly higher in women and tended to increa se with clinical severity. Conclusions: Our study provides evidence of the high frequency of a number of symptoms in different subgroups of psoriasis patients d etermined by their sociodemographic characteristics, clinical type and disease s everity. Symptoms represent a serious disabling factor in patients affected by p soriasis, including those with low levels of psychological distress. Dermatologi sts should include symptoms in the evaluation of disease severity both in clinic al practice and in clinical trials.展开更多
Despite being common, depression often goes undetected in patients with skin diseases. Our aim was to examine and compare the performance of three depression screeners. We studied dermatological inpatients aged 18- 65...Despite being common, depression often goes undetected in patients with skin diseases. Our aim was to examine and compare the performance of three depression screeners. We studied dermatological inpatients aged 18- 65 years. They completed the questionnaires Primary Care Screener for Affective Disorders (PC- SAD), Patient Health Questionnaire (PHQ) and General Health Questionnaire (GHQ- 12) and were administered a standardized psychiatric interview (SCID- 1) by a mental health professional, who was unaware of the questionnaire answers. The analysis was performed on 141 patients with complete data (79% of all eligible patients, 89% of all patients who agreed to participate). The prevalence of the main forms of depression, major depressive disorder and dysthymic disorder, was 8.4% and 6.3% , respectively. For major depressive disorder, the sensitivity and specificity of the questionnaires were as follows: PC- SAD, 73% and 88% ; PHQ, 55% and 91% ; GHQ- 12, 73% and 78% . For dysthymic disorder, the sensitivity and specificity were as follows: PC- SAD, 56% and 95% ; PHQ, 44% and 90% ; GHQ- 12, 56% and 76% . The small sample size suggests caution in drawing conclusions about the relative merits of these screeners. Although both the GHQ and the PHQ are short and easily hand scored, the first is a generic screener for psychiatric morbidity that is not specific for depression, while the second displayed modest sensitivity. The PC- SAD, with short average administration time, acceptable sensitivity and high specificity, might be particularly useful in settings where the technology for computer automated scoring is available. Although screening programmes might be useful, they should be supplemented by quality improvement programmes and by the development of consultation- liaison services.展开更多
Melkersson-Rosenthal syndrome (MRS) is a complex neuromucocutaneous disorder characterized by localized orofacial oedema and cranial nerve dysfunction, frequently associated with minor signs, including furrowed tongue...Melkersson-Rosenthal syndrome (MRS) is a complex neuromucocutaneous disorder characterized by localized orofacial oedema and cranial nerve dysfunction, frequently associated with minor signs, including furrowed tongue. Complete forms are rare where a smono-and oligosymptomatic variants are more common. A 71-year-old man presented with a 2-year history of relapsing and progressively persistent oedema of the right eyelids and periorbital region. A fissured tongue and telangiectatic rosacea had been present since the age of 50 and 60 years, respectively. The patient was also affected by essential hypertension and diabetes mellitus. A skin biopsy showed a marked upper dermal oedema, and small epithelioid cell granulomas arranged in perivascular and perilymphatic location. Collections of small epithelioid cells were occasionally observed within lymphatic spaces. No acid-fast bacteria, fungi or foreign bodies were detected. Intralesional corticosteroids induced transient improvement, whereas minocycline, clofazimine and dapsone have been ineffective. MRS may present with unilateral eyelid and periorbital swelling. Differential diagnoses of such cases may include a variety of cutaneous, ophthalmic and systemic diseases.展开更多
AIM:To evaluate if indolent B cell-non Hodgkin's lymphoma(B-NHL) and diffuse large B-cell lymphoma(DLBCL) in hepatitis C virus(HCV) positive patients could have different biological and clinical characteristics re...AIM:To evaluate if indolent B cell-non Hodgkin's lymphoma(B-NHL) and diffuse large B-cell lymphoma(DLBCL) in hepatitis C virus(HCV) positive patients could have different biological and clinical characteristics requiring different management strategies.METHODS:A group of 24 HCV related B-NHL patients(11 indolent,13 DLBCL) in whom the biological and clinical characteristics were described and confronted.Patients with DLBCL were managed with the standard of care of treatment.Patients with indolent HCV-related B-NHL were managed with antiviral treatment pegylated interferon plus ribavirin and their course observed.The outcomes of the different approaches were compared.RESULTS:Patients with DLBCL had a shorter duration of HCV infection and a higher prevalence of HCV genotype 1 compared to patients with indolent B-NHL in which HCV genotype 2 was the more frequent genotype.Five of the 9 patients with indolent HCV-relatedB-NHL treated with only antiviral therapy,achieved a complete response of their onco-haematological disease(55%).Seven of the 13 DLBCL patients treated with immunochemotheraphy obtained a complete response(54%).CONCLUSION:HCV genotypes and duration of HCV infection differed between B-NHL subtypes.Indolent lymphomas can be managed with antiviral treatment,while DLBCL is not affected by the HCV infection.展开更多
The Dermatology Life Quality Index (DLQI) is one of the most frequently used questionnaires to evaluate the impact of dermatological diseases on patients’ lives. This study aimed to assess the reliability and validit...The Dermatology Life Quality Index (DLQI) is one of the most frequently used questionnaires to evaluate the impact of dermatological diseases on patients’ lives. This study aimed to assess the reliability and validity of the instrument and to test its unidimensionality in a large sample of patients with psoriasis (n=976) hospitalized at IDI- IRCCS, Rome, Italy. Nine hundred patients completed the DLQI, the Psoriasis Disability Index (PDI) and the Skindex- 29 (response rate 92% ). The internal consistency of the DLQI was high (Cronbach’ s alpha= 0.83). Evidence of convergent validity was provided by high (r=0.64- 0.81) correlations between the DLQI, the PDI, and the functioning and emotions scales of Skindex- 29. Exploratory factor analysis indicated the presence of four different principal common factors. Confirmatory factor analysis showed a clear second- order factor structure, with a homogeneous second- order factor underlying the four primary- surface factors. This study confirms that the DLQI is a reliable and valid instrument to assess patient- perceived impact of skin disease. Also, it supports the unidimensionality of the DLQI and hence corroborates the common practice of using the total score.展开更多
Objective141: To evaluate the association between different components of smoking history and the clinical severity of psoriasis. Design: A hospital-based cross-sectional study. Setting: Inpatient wards of a hospital ...Objective141: To evaluate the association between different components of smoking history and the clinical severity of psoriasis. Design: A hospital-based cross-sectional study. Setting: Inpatient wards of a hospital for skin diseases in Rome, Italy.Patients: A total of 818 adults with psoriasis. Main Outcome Measure: The Psoriasis Area and Severity Index was used to assess the clinical severity of psoriasis between February 21, 2000, and February 19, 2002. Results: After adjustment for potential confounders (sex, age, body mass index, psychological distress, family history of psoriasis, duration of psoriasis disease, and alcohol consumption), high intensity of smoking (>20 cigarettes daily) vs a lower level of consumption (≤ 10 cigarettes daily) was associated with a more than 2-fold increased risk of clinically more severe psoriasis (odds ratio [OR], 2.2;95% confidence interval [CI], 1.2- 4.1). Cigarette-years, measured as the product of the intensity and duration (years) of smoking, significantly increased the risk of clinically more severe psoriasis after adjustment for confounding factors (OR,1.3; 95% CI, 1.0- 1.6, for a 600-U increase in cigarette-years).Separate analyses for men and women showed that the effect of cigarette-years was stronger for women (OR, 1.8; 95% CI, 1.2- 2.6, for a 400-U increase in cigarette-years) than for men (OR,1.2; 95% CI, 0.9- 1.6, for a 700-U increase in cigarette-years).Conclusion: Smoking is associated with the clinical severity of psoriasis and highlights the importance of smoking cessation in patients with psoriasis.展开更多
文摘The rapid convergence of Information and Communication Technologies(ICT),driven by advancements in 5G/6G networks,cloud computing,Artificial Intelligence(AI),and the Internet of Things(IoT),is reshaping modern digital ecosystems.As massive,distributed data streams are generated across edge devices and network layers,there is a growing need for intelligent,privacy-preserving AI solutions that can operate efficiently at the network edge.Federated Learning(FL)enables decentralized model training without transferring sensitive data,addressing key challenges around privacy,bandwidth,and latency.Despite its benefits in enhancing efficiency,real-time analytics,and regulatory compliance,FL adoption faces challenges,including communication overhead,heterogeneity,security vulnerabilities,and limited edge resources.While recent studies have addressed these issues individually,the literature lacks a unified,cross-domain perspective that reflects the architectural complexity and application diversity of Convergence ICT.This systematic review offers a comprehensive,cross-domain examination of FL within converged ICT infrastructures.The central research question guiding this review is:How can FL be effectively integrated into Convergence ICT environments,and what are the main challenges in implementing FL in such environments,along with possible solutions?We begin with a foundational overview of FL concepts and classifications,followed by a detailed taxonomy of FL architectures,learning strategies,and privacy-preserving mechanisms.Through in-depth case studies,we analyse FL’s application across diverse verticals,including smart cities,healthcare,industrial automation,and autonomous systems.We further identify critical challenges—such as system and data heterogeneity,limited edge resources,and security vulnerabilities—and review state-of-the-art mitigation strategies,including edge-aware optimization,secure aggregation,and adaptive model updates.In addition,we explore emerging directions in FL research,such as energy-efficient learning,federated reinforcement learning,and integration with blockchain,quantum computing,and self-adaptive networks.This review not only synthesizes current literature but also proposes a forward-looking road map to support scalable,secure,and sustainable FL deployment in future ICT ecosystems.
文摘Background Out-of-hospital patients presenting with atypical chest pain and complete left bundle branch block(LBBB)have to be stratified for the presence of coronary artery disease and the risk of developing heart failure(HF).We investigated the pro-gnostic role of coronary CT-angiography(CTA)and echocardiographic global longitudinal strain(GLS)in those patients in a mid-term follow-up.Methods Out-of-hospital patients with LBBB underwent echocardiography and a 64-slice CT angiography were evaluated ret-rospectively.Development of HF or a cardiovascular death were the events scheduled.Results Seventy-eight patients(32 female;mean age:66.0±10.4 years were enrolled.During a follow-up of 33 months(IQR:17-77),one patient(1.5%)experienced a cardiovascular death,14 patients(17.9%)required urgent outpatient visits due to acute de-compensated HF(12 hospitalizations).Echocardiography showed a slightly reduced left ventricular ejection fraction(LVEF)(50.0%±9.8%)and GLS within the normal range(-16.2%±4.1%).CTA analysis showed coronary stenosis>50%in 28 patients(35.9%).A high Agatston score(>100)was observed in 29.5%.Notably,25 patients(32.1%)were diagnosed with left main coron-ary artery disease and 15 patients(16.7%)underwent revascularization during the follow up.Significant associations were ob-served between events and LVEF(P=0.001),diastolic dysfunction grade≥2(P=0.02),GLS(P<0.001),multiple coronary stenos-is(P=0.04)and Agatston score(P=0.05).Multivariate analysis confirmed the relationships with LVEF(R^(2)=0.89,P<0.001),dia-stolic dysfunction(R^(2)=3.30,P=0.04),GLS(R^(2)=1.43,P<0.001),and Agatston score(R^(2)=1.01,P=0.05).Conclusions In patients with complete LBBB,CTA and GLS identified those at a high risk of development HF.
文摘BACKGROUND Surgical treatment of complex fractures of the distal femur in the elderly is controversial.Osteoporosis and pre-existent osteoarthritis are common comorbidities in the elderly which add to the need for early walking and rapid restoration of function and also pose significant obstacles to achievement of satisfactory results with standard fixation techniques.Recently,several authors have suggested that primary arthroplasty could be a viable alternative option to standard fixation techniques in selected patients with complex distal femur fractures.AIM To present our experience with 11 cases of distal femur fractures treated with knee arthroplasty and large femoral resection in a population of patients over the age of 85.METHODS Data from 11 consecutive patients(10 females,1 male)presenting with acute intra-articular supracondylar or intercondylar distal femur fractures and with pre-existent primary osteoarthritis who were treated with primary knee arthroplasty were recorded.We collected standard demographic data,comorbidities and patient reported outcomes including Visual Analogical Scale(VAS),Oxford Knee Score(OKS)and Barthel’s Index.Post-operative joint range of motion(ROM)and standard radiographic data were also collected.RESULTS At a mean follow-up of 23.2 mo,all of the implants were well-positioned and osteointegrated.Furthermore,all the patients were alive and walking either independently or with walking aids.There was a marked improvement in pain(VAS 4.5 postop vs 1.9 at the last follow-up),OKS score(29.5 postop vs 36.81 at the last follow-up),ROM(96.2°postop vs 102°at the last follow-up)and restoration of pre-injury ambulatory status(average Barthel Index 77.3).The radiographic evaluations showed good restoration of the articular geometry.No deaths and no complications were recorded.CONCLUSION In conclusion,we believe that knee megaprosthesis in the case of complex fractures of the distal femur is a valid surgical choice.This is particularly true in elderly patients with severe osteoporosis and pre-existing osteoarthritis.It is important to note that this surgery should be performed by surgeons with proven experience in prosthetic hip and knee surgery and that a scrupulous selection of the cases is completed.
文摘BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone,the synthesis or not of the metatarsal head,the possible association with lateral soft tissues release(LSTR)and osteotomy of the base of the first phalanx.AIM To evaluate the role of LSTR on percutaneous HV correction,evaluating functional and radiographical results.METHODS From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study.The technique provides no internal fixation(WOS).Patients were divided into the LSTR group and no LSTR group(LSTR N).This surgical procedure(LSTR)was reserved for insufficient HV angle(HVA)correction during fluoroscopic control.Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors(first practitioners).Clinical evaluation was performed before surgery,6 mo after surgery,and 48 mo follow-up.American Orthopaedic Foot and Ankle Society(AOFAS)and visual analog scale(VAS)score was used to evaluate pain and function,and complications were recorded.In addition,the incidence of relapses and the degree of joint range of motion(ROM)with the association with the LSTR(capsule,adductor tendon,phalanx-sesamoid ligament,and the deep transverse metatarsal ligament)were evaluated.Radiological parameters included HVA and intermetatarsal angle(IMA).Patient satisfaction was assessed.Student t-test and Fisher exact test were used to assess statistical analysis.RESULTS From our study it is clear that no differences in term of HVA,VAS,IMA correction,rate of complications,and AOFAS score were found between groups,while a significant improvement of the same variables was found in each group between pre and postoperative values.A significant improvement in ROM at 6 mo(P=0.018)and 48 mo(P=0.02)of follow-up was found in LSTR N group.Complications were rare in both groups.CONCLUSION LSTR procedure on percutaneous HV correction seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.
基金supported by the PIRE Mongolia project funded by the U.S.National Science Foundation(OISE 0729786)supported by the Taylor Family-Asia Foundation Endowed Chair in Ecology and Conservation Biology,Mongoliasupported by a grant funded by the National Research Foundation of Korea(Nos.NRF-2018R1C1B6007755,NRF-2022R1F1A1066643)。
文摘Although fairy rings are widely observed,little is known about the community processes associated with them.Here,we studied fairy rings in a natural grassland in northern Mongolia by sampling soils outside(future stage),directly under(present stage),and within(past stage)the rings,to represent different time stages during the expansion of fairy rings.Soil DNA was extracted for amplicon sequencing of the fungal ITS1 region.The present stage had reduced fungal diversity and different fungal communities toward the other stages.Most strikingly,there was an increase in the pathogenic fungus Gibberella baccata in the present stage of most rings and the saprotrophic fairy ring fungus Lepista luscina in several.However,no mushrooms of Lepista had been recorded from any of these rings during several years of observation.Known fairy ring fungi were not found in the present stage of every ring,even in some known rings to have previously displayed mushrooms of such species.It is possible that these fungi occurred or were more abundant at the unsampled leading edge of the ring.The increase in G.baccata is intriguing,but its importance,if any,is unclear.It is also unclear whether consortia of fungi or other microbes might be present in these rings.The absence or low abundance of the previously reported fairy ring fungal species suggests that their presence is transient,with rapid replacement by other fungi.No differences in soil parameters were found between the fairy ring stages,except for aluminum.There is a need for broader sampling,including analysis of non-fungal biota,to understand the functional diversity of fairy ring fungi and the consequences for plant communities.
文摘Despite new therapeutic options,patients with heart failure(HF)still progress to advanced stage.In particular,patients who developed a severe left ventricular(LV)systolic and/or diastolic dysfunction with higher degree of NYHA class,recurrent hospitalizations for HF and showing a severe impairment of exercise capacity were defined as“advanced HF”.[1]Levosimendan was recently approved in order to treat patients hospitalized for acute decompensated HF(ADHF)with severe systolic dysfunction.The pharmacolo-gical effects of levosimendan consists of inotropy,vasodilatation and cardioprotection increasing of calcium sensitivity.[2]These effects should be mon-itored with echocardiography.[3]In particular,in ad-vanced HF patients,levosimendan showed positive effects in reducing mortality and three months hos-pitalization;about quality of life and symptoms im-provement,levosimendan showed contrasting ef-fect among the studies on advanced HF patients available.
文摘Quantitative precipitation estimation and rainfall monitoring based on meteorological data, potentially provides continuous, high-resolution and large-coverage data, are of high practical use: Think of hydrogeological risk management, hydroelectric power, road and tourism. Both conventional long-range radars and rain-gauges suffer from measurement errors and difficulties in precipitation estimation. For efficient monitoring operation of localized rain events of limited extension and of small basins of interest, an unrealistic extremely dense rain gauge network should be needed. Alternatively C-band or S-band meteorological long range radars are able to monitor rain fields over wide areas, however with not enough space and time resolution, and with high purchase and maintenance costs. Short-range X-band radars for rain monitoring can be a valid compromise solution between the two more common rain measurement and observation instruments. Lots of scientific efforts have already focused on radar-gauge adjustment and quantitative precipitation estimation in order to improve the radar measurement techniques. After some considerations about long range radars and gauge network, this paper presents instead some examples of how X-band mini radars can be very useful for the observation of rainfall events and how they can integrate and supplement long range radars and rain gauge networks. Three case studies are presented: A very localized and intense event, a rainfall event with high temporal and spatial variability and the employ of X-band mini radar in a mountainous region with narrow valleys. The adaptability of such radar devoted to monitor rain is demonstrated.
文摘Arterial stiffness and wave reflections are widely used in observational studies to analyse the determinants of haemodynamic changes observed in various clinical conditions and to understand the pathogenesis of their cardiovascular complications. A large number of publications and several reviews documented the changes in arterial stiffness and wave reflections after various interventions, either non-pharmacological or pharmacological.
文摘Vascular aging in large arteries plays an important role in contributing to cardiovascular morbidity and mortality.[1]Structural changes include an increase in wall thickness,intima-media thickening ratio is widely attributed to sub-clinical atherosclerosis and it is independently associated with future cardiovascular events.[1]
文摘In this paper,we show the difference between management and leadership through a case study,by presenting a management situation in a company and by studying the facts in this situation,the events in this situation,the analysis of these facts and events,and the learned lessons from this case study.We analyze in this case study the managerial situation especially for a manager X in our case study,who had some flaws in his style of management leaking of leadership.We learn some general and specific lessons in relation to our studied managerial situation.Our analysis proposes multiple improvements of this managerial situation especially for the manager X by combining his management skills with his leadership skills.We show through this case study the main differences between the management and the leadership.Also,we illustrate in this paper the interest to combine leadership skills with management skills for the manager X in our studied managerial situation and to adapt the management styles for the manager X according to the managerial situation.
文摘We report for the first time the occurrence of heteroplasmy in Grey Partridge(Perdix perdix)revealed by means of two mitochondrial fragments.The possible serious biological and management implications of this exception to unilateral inheritance of mtDNA were underlined.
文摘Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our objective was to identify clinical, haematological or immunological parameters as predictors of mortality in patients with MF. Methods: We conducted a retrospective study on a prevalent cohort of 124 patients with MF hospitalized at IDI-IRCCS, Rome, Italy, from 1983 to 2001. We calculated the proportion of patients surviving (Kaplan-Meier product-limit estimates) 5 and 10 years after first hospital admission, and hazard ratios (HR) from the Cox proportional hazards model. Results: Patients’survival was linked to age and staging (lower survival in older patients and in patients with staging IIB-IV). Higher numbers of white blood cells (WBC) and neutrophils, lower numbers of CD8+lymphocytes, low haematocrit and lower levels of albumin were significantly associated with a lower survival probability. When simultaneously accounting for age and staging, CD8+[HR = 3.02, 95%confidence interval (CI) 1.01-9.07 for CD8+< 250 vs. ≥600 cells μL-1] and WBC (HR = 2.59, 95%CI 0.96-6.96 for WBC ≥9000 vs. < 6000 cells μL-1) were associated with survival. In addition, we observed an exceedingly high risk of death (HR = 12.40, 95%CI 3.11-49.43) for patients with a combination of WBC ≥9000 and CD8+< 600 cells μL-1 vs. WBC < 9000 and CD8+≥600 cells μL-1). Conclusions: The measurement of CD8+cells and WBC in MF seems to be a promising criterion to predict survival, and possibly to support treatment decisions and inclusion of patients in randomized controlled trials.
文摘Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psoriasis. Objectives: T o investigate the prevalence of symptoms experienced by patients with different clinical types of psoriasis. Methods: The study was carried out in patients hosp italized for psoriasis between February 2000 and February 2002 at the inpatient wards of the Istituto Dermopatico dell’Immacolata, Rome, Italy. Symptoms were evaluated using the symptoms scale of Skindex- 29. Clinical severity was assess ed by the dermatologists using the Psoriasis Area and Severity Index (PASI), and by the patients completing the self-administered PASI. Psychiatric morbidity was evaluated using the 12- item General Health Questionnaire. Results: In tota l, 936 eligible patients were analysed. The proportions of patients experiencing symptoms often or always in the 4 weeks before hospitalization were: 63.8% it ching, 59.7% irritation, 46.1% burning/stinging, 39% sensitivity, 26% pa in (from 10% in guttate psoriasis to 50% in arthropathic)- , 25.4% bleedi ng (17% pustular, 19% localized plaque, 36% palmoplantar), and 23.9% bot hered by water (from 8.5% in the guttate form to 68% in palmoplantar). The p revalence of all symptoms was significantly higher in women and tended to increa se with clinical severity. Conclusions: Our study provides evidence of the high frequency of a number of symptoms in different subgroups of psoriasis patients d etermined by their sociodemographic characteristics, clinical type and disease s everity. Symptoms represent a serious disabling factor in patients affected by p soriasis, including those with low levels of psychological distress. Dermatologi sts should include symptoms in the evaluation of disease severity both in clinic al practice and in clinical trials.
文摘Despite being common, depression often goes undetected in patients with skin diseases. Our aim was to examine and compare the performance of three depression screeners. We studied dermatological inpatients aged 18- 65 years. They completed the questionnaires Primary Care Screener for Affective Disorders (PC- SAD), Patient Health Questionnaire (PHQ) and General Health Questionnaire (GHQ- 12) and were administered a standardized psychiatric interview (SCID- 1) by a mental health professional, who was unaware of the questionnaire answers. The analysis was performed on 141 patients with complete data (79% of all eligible patients, 89% of all patients who agreed to participate). The prevalence of the main forms of depression, major depressive disorder and dysthymic disorder, was 8.4% and 6.3% , respectively. For major depressive disorder, the sensitivity and specificity of the questionnaires were as follows: PC- SAD, 73% and 88% ; PHQ, 55% and 91% ; GHQ- 12, 73% and 78% . For dysthymic disorder, the sensitivity and specificity were as follows: PC- SAD, 56% and 95% ; PHQ, 44% and 90% ; GHQ- 12, 56% and 76% . The small sample size suggests caution in drawing conclusions about the relative merits of these screeners. Although both the GHQ and the PHQ are short and easily hand scored, the first is a generic screener for psychiatric morbidity that is not specific for depression, while the second displayed modest sensitivity. The PC- SAD, with short average administration time, acceptable sensitivity and high specificity, might be particularly useful in settings where the technology for computer automated scoring is available. Although screening programmes might be useful, they should be supplemented by quality improvement programmes and by the development of consultation- liaison services.
文摘Melkersson-Rosenthal syndrome (MRS) is a complex neuromucocutaneous disorder characterized by localized orofacial oedema and cranial nerve dysfunction, frequently associated with minor signs, including furrowed tongue. Complete forms are rare where a smono-and oligosymptomatic variants are more common. A 71-year-old man presented with a 2-year history of relapsing and progressively persistent oedema of the right eyelids and periorbital region. A fissured tongue and telangiectatic rosacea had been present since the age of 50 and 60 years, respectively. The patient was also affected by essential hypertension and diabetes mellitus. A skin biopsy showed a marked upper dermal oedema, and small epithelioid cell granulomas arranged in perivascular and perilymphatic location. Collections of small epithelioid cells were occasionally observed within lymphatic spaces. No acid-fast bacteria, fungi or foreign bodies were detected. Intralesional corticosteroids induced transient improvement, whereas minocycline, clofazimine and dapsone have been ineffective. MRS may present with unilateral eyelid and periorbital swelling. Differential diagnoses of such cases may include a variety of cutaneous, ophthalmic and systemic diseases.
文摘AIM:To evaluate if indolent B cell-non Hodgkin's lymphoma(B-NHL) and diffuse large B-cell lymphoma(DLBCL) in hepatitis C virus(HCV) positive patients could have different biological and clinical characteristics requiring different management strategies.METHODS:A group of 24 HCV related B-NHL patients(11 indolent,13 DLBCL) in whom the biological and clinical characteristics were described and confronted.Patients with DLBCL were managed with the standard of care of treatment.Patients with indolent HCV-related B-NHL were managed with antiviral treatment pegylated interferon plus ribavirin and their course observed.The outcomes of the different approaches were compared.RESULTS:Patients with DLBCL had a shorter duration of HCV infection and a higher prevalence of HCV genotype 1 compared to patients with indolent B-NHL in which HCV genotype 2 was the more frequent genotype.Five of the 9 patients with indolent HCV-relatedB-NHL treated with only antiviral therapy,achieved a complete response of their onco-haematological disease(55%).Seven of the 13 DLBCL patients treated with immunochemotheraphy obtained a complete response(54%).CONCLUSION:HCV genotypes and duration of HCV infection differed between B-NHL subtypes.Indolent lymphomas can be managed with antiviral treatment,while DLBCL is not affected by the HCV infection.
文摘The Dermatology Life Quality Index (DLQI) is one of the most frequently used questionnaires to evaluate the impact of dermatological diseases on patients’ lives. This study aimed to assess the reliability and validity of the instrument and to test its unidimensionality in a large sample of patients with psoriasis (n=976) hospitalized at IDI- IRCCS, Rome, Italy. Nine hundred patients completed the DLQI, the Psoriasis Disability Index (PDI) and the Skindex- 29 (response rate 92% ). The internal consistency of the DLQI was high (Cronbach’ s alpha= 0.83). Evidence of convergent validity was provided by high (r=0.64- 0.81) correlations between the DLQI, the PDI, and the functioning and emotions scales of Skindex- 29. Exploratory factor analysis indicated the presence of four different principal common factors. Confirmatory factor analysis showed a clear second- order factor structure, with a homogeneous second- order factor underlying the four primary- surface factors. This study confirms that the DLQI is a reliable and valid instrument to assess patient- perceived impact of skin disease. Also, it supports the unidimensionality of the DLQI and hence corroborates the common practice of using the total score.
文摘Objective141: To evaluate the association between different components of smoking history and the clinical severity of psoriasis. Design: A hospital-based cross-sectional study. Setting: Inpatient wards of a hospital for skin diseases in Rome, Italy.Patients: A total of 818 adults with psoriasis. Main Outcome Measure: The Psoriasis Area and Severity Index was used to assess the clinical severity of psoriasis between February 21, 2000, and February 19, 2002. Results: After adjustment for potential confounders (sex, age, body mass index, psychological distress, family history of psoriasis, duration of psoriasis disease, and alcohol consumption), high intensity of smoking (>20 cigarettes daily) vs a lower level of consumption (≤ 10 cigarettes daily) was associated with a more than 2-fold increased risk of clinically more severe psoriasis (odds ratio [OR], 2.2;95% confidence interval [CI], 1.2- 4.1). Cigarette-years, measured as the product of the intensity and duration (years) of smoking, significantly increased the risk of clinically more severe psoriasis after adjustment for confounding factors (OR,1.3; 95% CI, 1.0- 1.6, for a 600-U increase in cigarette-years).Separate analyses for men and women showed that the effect of cigarette-years was stronger for women (OR, 1.8; 95% CI, 1.2- 2.6, for a 400-U increase in cigarette-years) than for men (OR,1.2; 95% CI, 0.9- 1.6, for a 700-U increase in cigarette-years).Conclusion: Smoking is associated with the clinical severity of psoriasis and highlights the importance of smoking cessation in patients with psoriasis.
