A computer-aided detection (CAD) system for the selection of lung nodules in computer tomography (CT) images is presented. The system is based on region growing (RG) algorithms and a new active contour model (ACM), implementing a local convex hull, able to draw the correct contour of the lung parenchyma and to include the pleural nodules. The CAD consists of three steps: (1) the lung parenchymal volume is segmented by means of a RG algorithm; the pleural nodules are included through the new ACM technique; (2) a RG algorithm is iteratively applied to the previously segmented volume in order to detect the candidate nodules; (3) a double-threshold cut and a neural network are applied to reduce the false positives (FPs). After having set the parameters on a clinical CT, the system works on whole scans, without the need for any manual selection. The CT database was recorded at the Pisa center of the ITALUNG-CT trial, the first Italian randomized controlled trial for the screening of the lung cancer. The detection rate of the system is 88.5% with 6.6 FPs/CT on 15 CT scans (about 4700 sectional images) with 26 nodules: 15 internal and 11 pleural. A reduction to 2.47 FPs/CT is achieved at 80% efficiency.

BackgroundThe use of point-of-care ultrasonography (POC US) in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED) when performed by paediatricians under the remote guidance of radiologists (TELE POC).MethodsChildren aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC); by the same radiologist (UNBLIND RAD); by an independent blinded radiologist (BLIND RAD). Tele-radiology was implemented using low cost “commercial off-the-shelf” (COTS) equipment and open-source software. Data were prospectively collected on predefined templates.ResultsFifty-two children were enrolled, for a total of 170 ultrasound findings. Sensitivity, specificity, positive and negative predictive values of TELE POC were: 93.8, 99.7, 96.8, 99.4 when compared to UNBLIND RAD and 88.2, 99.7, 96.8, 98.7 when compared to BLIND RAD. The inter-observers agreement between the paediatricians and either the unblind or blind radiologist was excellent (k = 0.93). The mean duration of TELE POC was 6.3 minutes (95% CI 4.1 to 8.5). Technical difficulties occurred in two (3.8%) cases. Quality of the transmission was rated as fair, good, very good and excellent in 7.7%, 15.4%, 42.3% and 34.6% of cases respectively, while in no case was it rated as poor.ConclusionsPOC US performed by paediatricians in ED guided via tele-radiology by an expert radiologist (TELE POC) produced reliable and timely diagnoses. Findings of this study, especially for the rarer conditions under evaluation, need further confirmation. Future research should investigate the overall benefits and the cost savings of using tele-ultrasound to perform US “at children’s bedsides”, under remote guidance of expert radiologists.

The possibility of ensuring the energy needed by a country is a fundamental requirement for the economic growth and social welfare of that country. The fulfillment of this need is particularly challenging for those countries that are characterized by a low level of energy self-sufficiency. The evaluation of energy security needs to consider different dimensions and is of the utmost importance as a benchmark to conceive and implement different policies. The assessment of the level of security should rely on science-based models that are able to track the rapidly evolving geopolitical scenarios, and to provide detailed information and quantitative indexes to policy decision makers. In this paper, an overarching methodology is outlined to evaluate energy security, in which its external and internal dimensions are considered and integrated: the security of the energy supply from abroad (external) and the security of national energy infrastructures (internal). Attention is then focused on the external dimension, and two indexes are defined, by means of a probabilistic approach, in terms of the expected value of supply and economic impacts. The methodology is then applied to the Italian case, considering different geopolitical scenarios, and conclusions are provided about the energy security of the country.

The measurement of the polarization of the Cosmic Microwave Background (CMB) radiation is one of the current frontiers in cosmology. In particular, the detection of the primordial divergence-free component of the polarization field, the B-mode, could reveal the presence of gravitational waves in the early Universe. The detection of such a component is at the moment the most promising technique to probe the inflationary theory describing the very early evolution of the Universe. We present the updated performance forecast of the Large Scale Polarization Explorer (LSPE), a program dedicated to the measurement of the CMB polarization. LSPE is composed of two instruments: LSPE-Strip, a radiometer-based telescope on the ground in Tenerife-Teide observatory, and LSPE-SWIPE (Short-Wavelength Instrument for the Polarization Explorer) a bolometer-based instrument designed to fly on a winter arctic stratospheric long-duration balloon. The program is among the few dedicated to observation of the Northern Hemisphere, while most of the international effort is focused into ground-based observation in the Southern Hemisphere. Measurements are currently scheduled in Winter 2022/23 for LSPE-SWIPE, with a flight duration up to 15 days, and in Summer 2022 with two years observations for LSPE-Strip. We describe the main features of the two instruments, identifying the most critical aspects of the design, in terms of impact on the performance forecast. We estimate the expected sensitivity of each instrument and propagate their combined observing power to the sensitivity to cosmological parameters, including the effect of scanning strategy, component separation, residual foregrounds and partial sky coverage. We also set requirements on the control of the most critical systematic effects and describe techniques to mitigate their impact. LSPE will reach a sensitivity in tensor-to-scalar ratio of σ r < 0.01, set an upper limit r < 0.015 at 95% confidence level, and improve constraints on other cosmological parameters.