Clinical outcome and drug expenses of intravitreal therapy for diabetic macular edema: A retrospective study in Sardinia, Italy

Background: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (ADRs), and intravitreal drug expenses were assessed. Methods: All DME patients treated with Ranibizumab, Aflibercept, Dexamethasone implant, and Fluocinolone Acetonide implant at the Sassari University Hospital, Italy, between January 2017 and June 2020 were included. Central macular thickness (CMT) and best corrected visual acuity (BCVA) were measured. ADRs and drug expenses were analyzed. Results: Two-hundred thirty-one DME patients (mean age: 65 years) received intravitreal agents. Mean CMT and BCVA were 380 μm and 0.5 LogMAR at baseline, 298 μm and 0.44 logMAR after one year (p = 0.04), and 295 μm and 0.4 logMAR at the end of the follow-up period. A total of 1501 intravitreal injections were given; no major ADRs were reported. Treatment cost was €915,000 (€261,429/year). Twenty non-responders to Ranibizumab or Afliber-cept were switched to a Dexamethasone implant. In these patients, mean CMT and BCVA were 468 µm and 0.5 LogMar at the time of switching and 362 µm and 0.3 LogMar at the end of the follow-up (p = 0.00014 and p = 0.08, respectively). Conclusion: Results confirm that Ranibizumab, Afliber-cept, and Dexamethasone implant are effective and safe in DME treatment. A switch to Dexame-thasone implant for patients receiving Aflibercept or Ranibizumab with minimal/no clinical benefit should be considered

Silicon carbide for future intense luminosity nuclear physics investigations

Silicon carbide (SiC) is one of the compound semiconductor which has been considered as a potential alternative to Silicon for the fabrication of radiation hard particles detectors. Material, detectors implementation and possible application in the future INFN projects has been discussed

Recent results on heavy-ion direct reactions of interest for 0νββ decay at INFN - LNS

Neutrinoless double beta decay of nuclei, if observed, would have important implications on fundamental physics. In particular it would give access to the effective neutrino mass. In order to extract such information from 0νββ decay half-life measurements, the knowledge of the Nuclear Matrix Elements (NME) is of utmost importance. In this context the NUMEN and the NURE projects aim to extract information on the NME by measuring cross sections of Double Charge Exchange reactions in selected systems which are expected to spontaneously decay via 0νββ. In this work an overview of the experimental challenges that NUMEN is facing in order to perform the experiments with accelerated beams and the research and development activity for the planned upgrade of the INFN-LNS facilities is reported.Consejo Europeo de Investigación (ERC), Fondo Europeo Programa de investigación e innovación Horizonte 2020 de la Unión n.º 714625)

Numerical simulations on laser absorption enhancement in hybrid metallo-dielectric nanostructured targets for future nuclear astrophysics experiments

The linear electromagnetic interaction between innovative hybrid metallo-dielectric nanostructured targets and laser in visible and IR range is investigated through numerical simulations. The obtained results rely on the optimization of a target based on metallic nanowires (NWs) to enhance light absorption in the visible range of the electromagnetic spectrum. The NWs are grown within the ordered nanoholes of an alumina substrate, thus, forming a plasmonic lattice with triangular symmetry. The remaining volume of the nanoholes on top of the NWs is sealed with a transparent layer of aluminum oxide that is suitable to be chemically modified for containing about 25% of deuterium atoms. The study presented here is carried out within the framework of a scientific program named PLANETA (Plasmonic Laser Absorption on Nano-Engineered Targets) aiming at investigating new laser–matter interaction schemes in the ns domain and for nuclear fusion purposes, involving especially the D–D reaction

The new fragment in-flight separator at INFN-LNS

An upgrade project of the Superconducting Cyclotron has been underway at INFN-LNS since 2019. One of the goals of this project is to deliver RIBs (Radioactive Ion Beams) of high intensity. To reach this aim, a dedicated facility consisting of a new fragment separator FRAISE (FRAgment In-flight SEparator) is ongoing, exploiting primary beams with a power up to approximate to 2-3 kW. The high intensity achievable with FRAISE requires the use of suitable diagnostics and tagging systems, able to operate also in a strong radioactive environment. In this framework, an R&D program has been started to develop the FRAISE facility, the diagnostics system and the tagging device; the latter will be especially useful in the CHIMERA multidetector beam line. The present contribution discusses the status of the R&D program, with particular focus on the RIBs available thanks to the use of FRAISE

One-proton transfer reaction for the O 18 + Ti 48 system at 275 MeV

Single-nucleon transfer reactions are processes that selectively probe single-particle components of the populated many-body nuclear states. In this context, recent efforts have been made to build a unified description of the rich nuclear spectroscopy accessible in heavy-ion collisions. An example of this multichannel approach is the study of the competition between successive nucleon transfer and charge exchange reactions, the latter being of particular interest in the context of single and double beta decay studies. To this extent, the one-proton pickup reaction Ti48(O18,F19)Sc47 at 275 MeV was measured for the first time, under the NUMEN experimental campaign. Differential cross-section angular distribution measurements for the F19 ejectiles were performed at INFN-LNS in Catania by using the MAGNEX large acceptance magnetic spectrometer. The data were analyzed within the distorted-wave and coupled-channels Born approximation frameworks. The initial and final-state interactions were described adopting the São Paulo potential, whereas the spectroscopic amplitudes for the projectile and target overlaps were derived from shell-model calculations. The theoretical cross sections are found to be in very good agreement with the experimental data, suggesting the validity of the optical potentials and the shell-model description of the involved nuclear states within the adopted model space

The NUMEN heavy ion multidetector for a complementary approach to the neutrinoless double beta decay

Neutrinos are so far the most elusive known particles, and in the last decades many sophisticated experiments have been set up in order to clarify several questions about their intrinsic nature, in particular their masses, mass hierarchy, intrinsic nature of Majorana or Dirac particles. Evidence of the Neutrinoless Double-Beta Decay (NDBD) would prove that neutrinos are Majorana particles, thus improving the understanding of the universe itself. Besides the search for several large underground experiments for the direct experimental detection of NDBD, the NUMEN experiment proposes the investigation of a nuclear mechanism strongly linked to this decay: the Double Charge Exchange reactions (DCE). As such reactions share with the NDBD the same initial and final nuclear states, they could shed light on the determination of the Nuclear Matrix Elements (NMEs), which play a relevant role in the decay. The physics of DCE is described elsewhere in this issue, while the focus of this paper will be on the challenging experimental apparatus currently under construction in order to fulfil the requirements of the NUMEN experiment. The overall structure of the technological improvement to the cyclotron, along with the newly developed detection systems required for tracking and identifying the reaction products and their final excitation level are described

The NUMEN heavy ion multidetector for a complementary approach to the neutrinoless double beta decay

Neutrinos are so far the most elusive known particles, and in the last decades many sophisticated experiments have been set up in order to clarify several questions about their intrinsic nature, in particular their masses, mass hierarchy, intrinsic nature of Majorana or Dirac particles. Evidence of the Neutrinoless Double-Beta Decay (NDBD) would prove that neutrinos are Majorana particles, thus improving the understanding of the universe itself. Besides the search for several large underground experiments for the direct experimental detection of NDBD, the NUMEN experiment proposes the investigation of a nuclear mechanism strongly linked to this decay: the Double Charge Exchange reactions (DCE). As such reactions share with the NDBD the same initial and final nuclear states, they could shed light on the determination of the Nuclear Matrix Elements (NMEs), which play a relevant role in the decay. The physics of DCE is described elsewhere in this issue, while the focus of this paper will be on the challenging experimental apparatus currently under construction in order to fulfil the requirements of the NUMEN experiment. The overall structure of the technological improvement to the cyclotron, along with the newly developed detection systems required for tracking and identifying the reaction products and their final excitation level are described

Recent results on heavy-ion direct reactions of interest for 0νββ decay at INFN LNS

Neutrinoless double beta decay of nuclei, if observed, would have important implications on fundamental physics. In particular it would give access to the effective neutrino mass. In order to extract such information from 0νββ decay half-life measurements, the knowledge of the Nuclear Matrix Elements (NME) is of utmost importance. In this context the NUMEN and the NURE projects aim to extract information on the NME by measuring cross sections of Double Charge Exchange reactions in selected systems which are expected to spontaneously decay via 0νββ. In this work an overview of the experimental challenges that NUMEN is facing in order to perform the experiments with accelerated beams and the research and development activity for the planned upgrade of the INFN-LNS facilities is reported