Integrated Imaging and Spectroscopic Analysis of Painted Fresco Surfaces Using Terahertz Time-Domain Technique

Terahertz time-domain (THz-TD) imaging plays an increasingly significant role in the study of solid-state materials by enabling the simultaneous extraction of spectroscopic composition and surface topography in the far-infrared region (3–300 cm^-1). However, when applied to works of art in reflection configuration, significant challenges arise, including weak signal intensity, multiple signal losses, and surface distortion. This study proposes a practical solution to overcome these limitations and conducts an integrated imaging and spectroscopic analysis on painted fresco surfaces, allowing for the retrieval of surface thicknesses, material distribution, and pigment spectroscopic signals. The study addresses the issue of surface geometrical distortion, which hampers the accurate determination of the THz phase signal. By tackling this challenge, this work successfully determines the absorption coefficient for each point on the surface and retrieves spectroscopic signatures. Additionally, the temporal deconvolution technique is employed to separate different layers of the sample and differentiate between outer and inner surface topography. The objective of this study is to demonstrate the advantages and limitations of THz-TD imaging in determining surface thicknesses, material distribution, and pigment spectroscopic signals. The results obtained highlight the potential of THz-TD imaging in investigating painted works of art, offering new possibilities for routine analysis in the field of cultural heritage preservation

Integrated Care for Heart Failure in Primary Care

Chronic heart failure (CHF or simply HF) is a complex clinical syndrome that involves more than 2% of the general population and over 10% of the older people. For people with reduced ventricular function (the classical HFrEF phenotype), the guideline-directed medical therapy (GDMT) (e.g., Ace-inhibitors, beta-blockers, diuretics, rehabilitation or implantable ventricular devices) demonstrated to be efficacious in reducing hospitalisations and prolonging survival. Vice-versa, the HF with preserved ejection fraction (diastolic HF or HFpEF phenotype) is a much more complex syndrome, in which co-morbidities (such as COPD, depression, anemia, and diabetes, CAD) play a significant role in the decompensation episodes

The impact of the SARS-CoV-2 pandemic on the workloads of UPMC advanced radiotherapy centers in Italy

GOALS The Advanced Radiotherapy Centers of UPMC San Pietro FBF of Rome (CC#1) and UPMC Villa Maria of Mirabella Eclano (CC#2) conducted a study to review variations in department workloads and workflows experienced during the pandemic. The potential relation between these variations and the new procedures introduced to prevent and contain the COVID-19 infection was also studied. MATERIALS AND METHODS The data used were obtained from reports present in the ARIA® system (v. 15.1 Varian Medical Systems, Palo Alto, CA, U.S.A.). To examine the workloads was used the Downtime, an indicator that directly quantifies the inactivity of the department, derived from the ratio between the daily stand-by time of the LINACs (TrueBeam STx®, Varian Medical Systems, Palo Alto, CA, U.S.A.) and the mean number of treatments performed every day. In order to examine the workflows and possible delays, we measured the time between the treatments ("Therapy intervals"). RESULTS The Downtime average at CC#1 slightly increased from 3.1% in 2019 to 3.8% in 2020. However, the monthly analysis shows significant reduction (March-April-May) and increase (November-December) peaks. At CC#2, the 2020 Downtime trend was fairly consistent (average value: 3.3%), with an increase during the first wave of the pandemic. The "5-10 min" Therapy intervals at CC#1, reviewed comparing the March-April-May 2020 quarter with 2019, were higher in the first months and lower in May; the "10-15 min" intervals were stable; the ">20 min" intervals slightly increased in March 2020. At CC#2, the trend in 2020 decreased during the months of higher health care emergency and increased during the summer months. CONCLUSIONS The fact that the trends of the indicators show peaks only during the periods of major health care emergency indicates an impact of the pandemic, both on the workload and on the workflow. However, they also highlight the staff's ability to rapidly adapt to the new procedures, without affecting the overall performance of the both centers

Cytotoxic Effect of Progesterone, Tamoxifen and Their Combination in Experimental Cell Models of Human Adrenocortical Cancer

Progesterone (Pg) and estrogen (E) receptors (PgRs and ERs) are expressed in normal and neoplastic adrenal cortex, but their role is not fully understood. In literature, Pg demonstrated cytotoxic activity on AdrenoCortical Carcinoma (ACC) cells, while tamoxifen is cytotoxic in NCI-H295R cells. Here, we demonstrated that in ACC cell models, ERs were expressed in NCI-H295R cells with a prevalence of ER-β over the ER-α.Metastasis-derived MUC-1 and ACC115m cells displayed a very weak ER-α/β signal, while PgR cells were expressed, although at low level. Accordingly, these latter were resistant to the SERM tamoxifen and scarcely sensitive to Pg, as we observed a lower potency compared to NCI-H295R cells in cytotoxicity (IC50: MUC-1 cells: 67.58 µM (95%CI: 63.22-73.04), ACC115m cells: 51.76 µM (95%CI: 46.45-57.67) and cell proliferation rate. Exposure of NCI-H295R cells to tamoxifen induced cytotoxicity (IC50: 5.43 µM (95%CI: 5.18-5.69 µM) mainly involving ER-β, as their nuclear localization increased after tamoxifen: Δ A.U. treated vs untreated: 12 h: +27.04% (p < 0.01); 24 h: +36.46% (p < 0.0001). This effect involved the SF-1 protein reduction: Pg: -36.34 ± 9.26%; tamoxifen: -46.25 ± 15.68% (p < 0.01). Finally, in a cohort of 36 ACC samples, immunohistochemistry showed undetectable/low level of ERs, while PgR demonstrated a higher expression. In conclusion, ACC experimental cell models expressed PgR and low levels of ER in line with data obtained in patient tissues, thus limiting the possibility of a clinical approach targeting ER. Interestingly, Pg exerted cytotoxicity also in metastatic ACC cells, although with low potency. Keywords: ACC cell lines; ACC primary cells; adrenocortical carcinoma; estrogen receptors; progesterone receptors; tamoxifen

Impatto della pandemia da SARS-CoV-2 sui workload di due centri UPMC di radioterapia ad alta specializzazione in Italia

OBIETTIVI I Centri di Radioterapia UPMC San Pietro FBF di Roma (CC#1) e UPMC Villa Maria di Mirabella Eclano (CC#2) hanno condotto uno studio con l’obiettivo di analizzare le variazioni avvenute durante la pandemia sui workload e i workflow di reparto. È stato, inoltre, ricercato l’eventuale nesso tra queste e l’introduzione di nuove procedure per la prevenzione e il contenimento del contagio da Covid-19. MATERIALI E METODI I dati utilizzati sono stati ricavati da reports presenti nel sistema ARIA (V.15.1 Varian Medical System, CA, Palo Alto, USA). Per esaminare i workload è stato utilizzato il Downtime, un indicatore che quantifica direttamente l'inattività del reparto, ricavato dal rapporto tra il tempo di standby giornaliero dei LINAC (TrueBeam STx®, Varian Medical System, CA, Palo Alto, USA) e la media di trattamenti giornalieri effettuati. Per esaminare workflow ed eventuali ritardi tra le attività, sono stati valutati gli intervalli di tempo tra una terapia e la successiva (Intervalli di terapia). RISULTATI Il Downtime nel CC#1 ha subìto un leggero aumento del valore medio dal 3.1% del 2019 al 3.8% del 2020, tuttavia l’analisi mensile mostra consistenti picchi di riduzione (marzo-aprile-maggio) e di incremento (novembre-dicembre). Per il CC#2 il trend del Downtime nel 2020 è abbastanza regolare (valore medio del 3,3%), con un incremento durante la prima ondata della pandemia. Gli Intervalli di terapia di “5-10 min” nel CC#1, analizzati confrontando il trimestre marzo-aprile-maggio 2020 col 2019, risultano maggiori per i primi mesi e ridotti a maggio; quelli di “10-15” min risultano stabili; quelli “&gt;20 min” sono leggermente aumentati a marzo 2020. Per il CC#2 il trend nel 2020 decresce nei mesi di maggiore emergenza sanitaria e incrementa nei mesi estivi. CONCLUSIONI Il fatto che i trend degli indicatori utilizzati abbiano dei picchi esclusivamente in corrispondenza dei periodi di maggiore emergenza sanitaria, è indice di un certo impatto – sia in termini di workload che di workflow – della pandemia, ma anche della capacità del personale di adattarsi in breve tempo alle nuove procedure da eseguire, senza inficiare sul rendimento generale dei Centri

MicroRNAs’ crucial role in salivary gland cancers’ onset and prognosis

Simple Summary: Salivary gland cancers are incredibly heterogeneous, both in the physical onset and in the aggressiveness. Setting up a novel diagnostic and prognostic detection method based on the noninvasive microRNAs’ profiling might represent a goal for the clinical management of those particular malignancies, saving precious time for the patients. Abstract: Salivary gland cancer (SGC) is an uncommon and heterogeneous disease that accounts for around 8.5% of all head and neck cancers. MicroRNAs (miRNAs) consist of a class of highly conserved, short, single-stranded segments (18–25 nucleotides) of noncoding RNA that represent key gene-transcription regulators in physiological and pathological human conditions. However, their role in SGC development and progression is not completely clear. This review aims to compile and summarize the recent findings on the topic, focusing on the prognostic and diagnostic value of the major modulated and validated microRNAs in SGC. Their differential expression could possibly aid the clinician in delivering an early diagnosis, therapeutic strategy and precision medicine

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research