CT-based tumour response criteria compared after combined treatment for liver metastases of colorectal cancer

open6noPurpose: The aim of this analysis is to compare different tumour response criteria (TRC) after chemotherapy combined with bevacizumab in liver metastases from colorectal cancer (mCRC) to ascertain the best early prognostic indicator of response. Methods and Materials: 103 target liver metastases from 65 mCRC patients treated with chemoterapy plus bevacizumab were examined at the Istituto Oncologico Veneto IOV-IRCSS (March 2008-January 2013). All patients had baseline CT and at least one follow-up scan. Tumour response was retrospectively analyzed by two radiologists using RECIST1.1, modified Choi, and Chun morphologic criteria. Tumour response, classified as good (complete or partial response) or poor (stable or progressive disease), was compared with progression-free survival (PFS) at first follow-up (t1) and time of best response. Interobserver agreement and concordance between TRC were measured. Results: At t1, 32.31% showed a good response according to RECIST1.1 (median PFS 11.1), 84.62% according to Choi (median PFS 10.8). These percentages rose to 49.23% (median PFS 12.1) and 87.69% (median PFS 10.8), respectively, at the time of best response. According to Chun, 67.69% showed a good response at the time of best response (median PFS 10.8). The Choi criteria detected a higher proportion of good responders at t1, showing a better correlation with PFS; all methods correlated with PFS at the time of best response. Conclusion: The Choi criteria proved more consistent in the early detection of response in mCRC treated with chemotherapy plus bevacizumab, underscoring the importance of using these criteria in the early assessment of response to combined treatment.openopenVarotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, F.Varotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, Fabi

Dandy-Walker malformation: is the "tail sign" the key sign?

OBJECTIVE.To demonstrate the value of the "tail sign" in the assessment of Dandy-Walker Malformation (DWM). METHODS: A total of 31fetal MRI, performed before 24 weeks of gestation after second-line US examination between May 2013 and September 2014, were examined retrospectively. All MRI examinations were performed using a 1.5 Tesla magnet without maternal sedation. RESULTS: MRI diagnosed 15/31 cases of Dandy-Walker Malformation, 6/31 cases of vermian partial caudal agenesis, 2/31 of vermian hypoplasia, 4/31 of vermian malrotation, 2/31 of Walker-Warburg Syndrome, 1/31 of Blake pouch cyst, 1/31 of rhombencephalosynapsis. All data were compared with fetopsy results, Fetal MR after the 30th week or postnatal MRI; the follow up depended on the maternal decision to terminate or continue pregnancy. In our review study we found the presence of the "tail sign"; this sign was visible only in Dandy-Walker Malformation and Walker-Warburg Syndrome. CONCLUSION: The "tail sign" could be helpful in the difficult differential diagnosis between Dandy Walker, vermian malrotation, vermian hypoplasia and vermian partial agenesis

Nuclear data requirements for the ADS conceptual design EFIT: Uncertainty and sensitivity study

In this paper, we assess the impact of activation cross-section uncertainties on relevant fuel cycle parameters for a conceptual design of a modular European Facility for Industrial Transmutation (EFIT) with a “double strata” fuel cycle. Next, the nuclear data requirements are evaluated so that the parameters can meet the assigned design target accuracies. Different discharge burn-up levels are considered: a low burn-up, corresponding to the equilibrium cycle, and a high burn-up level, simulating the effects on the fuel of the multi-recycling scenario. In order to perform this study, we propose a methodology in two steps. Firstly, we compute the uncertainties on the system parameters by using a Monte Carlo simulation, as it is considered the most reliable approach to address this problem. Secondly, the analysis of the results is performed by a sensitivity technique, in order to identify the relevant reaction channels and prioritize the data improvement needs. Cross-section uncertainties are taken from the EAF-2007/UN library since it includes data for all the actinides potentially present in the irradiated fuel. Relevant uncertainties in some of the fuel cycle parameters have been obtained, and we conclude with recommendations for future nuclear data measurement programs, beyond the specific results obtained with the present nuclear data files and the limited available covariance information. A comparison with the uncertainty and accuracy analysis recently published by the WPEC-Subgroup26 of the OECD using BOLNA covariance matrices is performed. Despite the differences in the transmuter reactor used for the analysis, some conclusions obtained by Subgroup26 are qualitatively corroborated, and improvements for additional cross sections are suggested

Prevalence and incidence of bronchiectasis in Italy

BACKGROUND: The understanding of the epidemiology of bronchiectasis is still affected by major limitations with very few data published worldwide. The aim of this study was to estimate the epidemiological burden of bronchiectasis in Italy in the adult population followed-up by primary care physicians. METHODS: This study analyzed data coming from a large primary care database with 1,054,376 subjects in the period of time 2002-2015. Patients with bronchiectasis were selected by the use of International Statistical Classification of Diseases, 9th revision, Clinical Modification codes (ICD-9-CM). RESULTS: Patients with bronchiectasis were more likely to have a history of tuberculosis (0.47% vs. 0.06%, p\u2009<\u20090.0001), had higher rates of asthma (16.6% vs. 6.2%, p\u2009<\u20090.0001), COPD (23.3% vs. 6.4%, p\u2009<\u20090.0001) and rheumatoid arthritis (1.9% vs. 0.8%, p\u2009<\u20090.0001). The prevalence and incidence of bronchiectasis in primary care in Italy in 2015 were 163 per 100,000 population and 16.3 per 100,000 person-years, respectively. Prevalence and incidence increased with age and overall rates were highest in men over 75\u2009years old. Prevalence and incidence computed after the exclusion of patients with a diagnosis of either asthma or COPD is 130 per 100,000 and 11.1 cases per 100,000 person-years, respectively. CONCLUSIONS: Bronchiectasis is not a rare condition in Italian adult population. Further studies are needed to confirm our results and provide a better insight on etiology of bronchiectasis in Italy

Heuristic Learning as a Method for Improving Students’ Teamwork Skills in Physical Education

Transversal skills are the knowledge, skills, and personal qualities that are currently needed to meet the demands of the working world and everyday life. Schools have the task of equipping students with these skills, working not only on disciplinary goals but also on operational–behavioral goals. In 2018, the European Union adopted new recommendations on eight key competencies for lifelong learning and asked schools to implement new methods to develop these recommendations. To be successful, it is necessary to stimulate students’ development of these competences, which are also called soft skills, from the earliest years of the school experience. Physical education (PE) is called upon to make its contribution. In Italy, the two teaching methods used during PE classes are prescriptive teaching and heuristic learning. It is not clear which of the two methods is the most effective in improving soft skills, especially the skills involved in teamwork. The objective of this article was to compare the effects of these two teaching methods on students’ teamwork skills during PE classes in primary schools. After verifying the normality of the data, a Student’s t-test for dependent samples was performed to assess pre-test and post-test differences in each of two groups, while a Student’s t-test for independent samples was performed to compare the two groups after 3 months. Heuristic learning proved to be the most effective method for improving teamwork skills. The results may make an important contribution to future teacher training on the most effective teaching methods for developing students’ soft skill

From Ivacaftor to Triple Combination: A Systematic Review of Efficacy and Safety of CFTR Modulators in People with Cystic Fibrosis

Over the last years CFTR (cystic fibrosis transmembrane conductance regulator) modulators have shown the ability to improve relevant clinical outcomes in patients with cystic fibrosis (CF). This review aims at a systematic research of the current evidence on efficacy and tolerability of CFTR modulators for different genetic subsets of patients with CF. Two investigators independently performed the search on PubMed and included phase 2 and 3 clinical trials published in the study period 1 January 2005\u201331 January 2020. A final pool of 23 papers was included in the systematic review for a total of 4219 patients. For each paper data of interest were extracted and reported in table. In terms of lung function, patients who had the most beneficial effects from CFTR modulation were those patients with one gating mutation receiving IVA (ivacaftor) and patients with p.Phe508del mutation, both homozygous and heterozygous, receiving ELX/TEZ/IVA (elexacaftor/tezacaftor/ivacaftor) had the most relevant beneficial effects in term of lung function, pulmonary exacerbation decrease, and symptom improvement. CFTR modulators showed an overall favorable safety profile. Next steps should aim to systematize our comprehension of scientific data of efficacy and safety coming from real life observational studie

Multi-technique characterization and thermal degradation study of epoxy modified resins designed for multifunctional applications

Tetraglycidyl methylene dianiline (TGMDA) was mixed with 1,4-Butanediol diglycidyl ether (BDE) (in a 4:1 mass ratio) and with a stoichiometric amount of the curing agent diaminodiphenyl sulfone which was solubilized at 120 °C for 20 min in the liquid mixture TGMDA + BDE. The so obtained unfilled epoxy resin matrix, denoted as ER, was blended with glycidyl polyhedral oligomeric silsesquioxane and carbon nanotubes in suitable proportions to obtain binary and ternary mixtures. Characterization of the formulated materials was performed using different experimental techniques, such as Dynamic mechanical analysis, Thermogravimetry (TG), Field emission scanning electron microscopy. Furthermore, the investigation of the flame behavior was carried out by the limiting oxygen index and mass loss calorimeter measurements. Direct current measurements and investigation by Tunneling atomic force microscopy of the conductive nanodomain map allowed the evaluation of the electrical properties of the developed nanofilled systems. The TG data related to thermal decomposition of ER and its binary and ternary mixtures were processed according to isoconversional kinetic analysis by assuming a non-Arrhenian behavior of the temperature function, and lifetime prediction was estimated at suitable relatively low temperatures and possible relation between the thermal stability and the presence of each component was discussed. This method of kinetic analysis paves the way for the possibility of evaluating in a more realistic way, on the basis of thermal stability, the potential application of structural resins with primary load functions in contact with hot areas of aeronautical aircraft engines