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Applications of Traveling Salesman Problem Solvers for Path Planning of Parallel Robots
No full textIn industrial settings, for instance in pick-and-place operations, a robot may be required to visit some target points. In some tasks, such as spot soldering, the visiting order can be chosen freely: this allows us to optimize the motion, by finding the shortest path that visits all points before returning to the starting one. This is an instance of the Traveling Salesman Problem (TSP), a classic problem in operations research, for whose solution several algorithms and software libraries are available. The TSP is commonly applied in mobile robotics, for example in drones, and to serial robot arms. Here, we apply the TSP to parallel robots, where the base is connected to the end-effector (EE) by multiple kinematic chains. We show how to define the TSP in this case to minimize the motion time, assumed to be proportional to the largest absolute variation in joint coordinates. We then show that this is not equivalent to minimizing the distance traveled by the EE. We also compare the performance of different solvers on an example problem and for an example planar parallel robot, in terms of the time for converging to a solution. We consider both heuristic methods, which are generally fast but may not always find the optimal solution, and exact solvers, which can be used as a reference. This can improve the efficiency of industrial parallel robots, coherently with the objectives of the UN Sustainable Development Goal (SDG) 7
Fetal Surgery for Congenital Heart Diseases: A Systematic Review and Single-Arm Meta-analysis
No full textIntroduction: Congenital heart diseases (CHD) are the most common congenital anomalies, and fetal cardiac interventions (FCI) have been developed to improve perinatal outcomes. We aimed to conduct a systematic review and meta-analysis of observational studies to evaluate the effects of FCI on CHD. Methods: We searched PubMed/Medline, Embase, and the Cochrane Central Register of Controlled Trials from inception to April 2025 without language restrictions. References of included studies and prior reviews were also screened. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; ID CRD42024599628). Eligible studies included observational cohorts evaluating intrauterine procedures for CHD. Data were synthesized using random effects models in RStudio (version 4.2.2), and study quality was assessed with the Newcastle–Ottawa Quality Assessment Form for Cohort Studies (NOS). Results: Twelve studies including 485 fetuses with CHD were analyzed. The pooled overall survival rate after fetal cardiac intervention was 57.4% (95% confidence interval [CI] 39.8–73.3), with survival ranging from 20.0% to 90.2% across studies. The pooled perinatal mortality rate was 31.5% (95% CI 21.0–44.2), with estimates ranging from 9.8% to 66.7%. Substantial heterogeneity was observed for both outcomes (I2 > 75%). Conclusion: FCI for CHD are associated with moderate overall survival but substantial perinatal mortality. Standardized protocols, refined patient selection, and multicenter collaboration are needed to improve outcomes and guide clinical decision-making
Effectiveness and Safety of Mechanical Thrombectomy in Mild Stroke due to Large-Vessel Occlusion: Insights from the ASSIST Registry
No full textBACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is effective for acute ischemic stroke, yet its indication in mild stroke remains unclear. This study evaluates the effectiveness and safety of MT in patients with low NIHSS scores and assesses the impact of different MT strategies on procedural success and clinical outcomes. MATERIALS AND METHODS: Data from the ASSIST Registry were analyzed. We categorized patients with large-vessel occlusion of the anterior circulation into mild (NIHSS #5) and moderate-severe (NIHSS .5) stroke groups. Baseline characteristics, procedural parameters, angiographic and imaging outcomes, clinical outcomes, and safety end points were compared. Within the mild stroke subgroup, outcomes were compared between different MT techniques. RESULTS: Among 1360 patients with large-vessel occlusion, 122 had minor ischemic strokes (9%). Patients with mild stroke had high rates of excellent functional outcomes (mRS 0–1) at 90 days (77.1%) and functional independence (mRS 0–2) (85.7%). Procedural success rates were similar between NIHSS groups, while safety outcomes, except mortality, were comparable. No statistically significant differences were observed in treatment techniques within the mild stroke subgroup. Significant predictors of early neurologic deterioration (END) in patients with mild stroke were the total number of passes (OR, 1.49; 95% CI, 1.01–2.19; P 1⁄4 .04) and total procedural time (OR, 1.02; 95% CI, 1.01–1.04; P 1⁄4 .01). Patients with END were more likely to have an unfavorable functional outcome (mRS 3–6) at 90 days (89% versus 6%, P, .001). CONCLUSIONS: MT is effective and safe in patients with mild stroke. Procedural success did not vary among MT techniques in mild stroke. The total number of passes predict END, which suggests a causal pathway that requires further exploration
Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry
No full textBackground: Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment. Methods: Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents. Demographics, clinical presentation, radiographic characteristics, procedural complications, and outcomes were assessed. Results: A total of 168 patients with 168 unruptured DACA aneurysms were treated between January 2018 and December 2022. One hundred and twenty-five were women (74.4%) and the median age was 61 (IQR 52-67) years. The most common morphology was saccular (91.7%), with branch involvement in 61.9% of cases. Median parent vessel diameter was 1.9 mm (IQR 1.7-2.2) and stents were successfully deployed in 99.4% of cases. In 96.4% a single stent was implanted, while 3.6% of cases required two stents. Median imaging follow-up was 16.5 (IQR 7-24) months. At last follow-up the rate of occlusion (O'Kelly-Marotta scale C or D) was 82.1%. Symptomatic thromboembolic or hemorrhagic complications occurred in 5.3% of patients and the mortality rate was 0.6%. The rate of retreatment was 1.2%. Conclusions: Flow-diverting stents are a reasonably safe and effective treatment option for unruptured DACA aneurysms
Form, Core, and Capitalist Dynamics. Challenging the Marginalist Paradigm with Marx, Sraffa, and Keynes
No full textTotal Body Irradiation in Haematopoietic Stem Cell Transplantation: A Comprehensive Literature Review and Institutional Experience from the Policlinico of Catania
No full textBackground and Objectives: Total body irradiation (TBI) remains a cornerstone of conditioning for allogeneic haematopoietic stem-cell transplantation (HSCT). Whereas early research debated the need for irradiation, contemporary investigations focus on optimising dose, fractionation and delivery techniques. Material and Methods: We synthesised six decades of evidence, spanning from single-fraction cobalt treatments to modern helical tomotherapy and intensity-modulated total-marrow/lymphoid irradiation (TMI/TMLI). To complement the literature, we reported our institutional experience on 77 paediatric and adult recipients treated with conventional extended-source-to-skin-distance TBI at the University Hospital Policlinico “G. Rodolico–San Marco” between 2015 and 2025. Results: According to literature data, fractionated myeloablative schedules, typically 12 Gy in 6 fractions, provide superior overall survival and lower rates of severe graft-versus-host disease (GVHD) compared with historical single-dose regimens. Conversely, reduced-intensity protocols of 2–4 Gy broaden HSCT eligibility for older or comorbid patients with acceptable toxicity. Conformal planning reliably decreases mean lung dose without compromising engraftment, and early-phase trials are testing selective escalation to 16–20 Gy or omission of TBI in molecularly favourable cases. With regard to our institutional retrospective series, 92% of patients completed a 12-Gy regimen with only transient grade 1–2 nausea, fatigue or hypotension; all transplanted patients engrafted, and no grade ≥ 3 radiation pneumonitis occurred. Conclusions: Collectively, the published evidence and our experience support TBI as an irreplaceable component of HSCT conditioning and suggest that coupling it with advanced imaging, organ-sparing dosimetry and molecular response monitoring can deliver safer, more personalised therapy in the coming decade
Callidus auceps: galateo del dono e manierismo nel dittico di Paolino di Nola a Gestidio
No full textIl trasporto marittimo nazionale - Estratto dal volume Il Traporto di persone e il turismo organizzato
No full textIl contributo esamina la disciplina sulla cessione del contratto nel trasporto marittimo di persone sia alla luce della normativa di diritto positivo che dell'evoluzione tecnologica circa le modalità di circolazione dei contratti
