Spazio allo Spazio

“Spazio allo Spazio", active since 2010, involves students aged 5 to 20. This educational project was launched by a group of Italian teachers from the Lower Secondary School Fermi in Villasanta who believed Space exploration could be an efficient way to convey the idea that the extraordinary experience of the astronaut, who on the International Space Station must acquire new skills and be able to dominate a challenging and unpredictable context, similar to a disabled person's routine in daily life. This was a winning choice because gradually international institutions promoted similar initiatives. The central theme of space exploration is used to promote values of sustainability, equity and diversity, allowing students to become acquainted with the world of astronauts while facing subjects related to integration and disability. Several national and international universities and institutions, at the forefront of scientific research, have contributed to this project. The main topics of the project are: 1) Space exploration: the astronaut's experience is the starting point for lessons, cultural exchanges, lectures and interdisciplinary strategies to raise awareness about humans in space, the international cooperation for the International Space Station, physical training, technical, scientific and cultural preparation. 2) Career orientation: meetings with experts in different fields, from Science, Technology, Engineering, Mathematics to Arts and Physical Education, help students achieve better knowledge of themselves, their potential and limits acquiring skills in scientific research methodology in a multilingual environment. 3) Inclusion: as astronauts experience the limits of gravity and disability in Space, students can face their limits, through experiences of adapted physical activity, addressing issues related to the integration and insertion of people with different skills in school and society. 4) Team building: starting from the example of collaboration which takes place in space missions and scientific research, students are encouraged to experience teamwork. This is true for the teachers too, thanks to the strengthening of cooperative teaching, in the sharing of resources and good practices as well as in the implementation of innovative forms of communication and multimedia documentation. The project aims at making students able to face new and more advanced educational challenges and cognitive objectives, developing work strategies by transferring already tested approaches and processes to new situations. This is noticeable in the more self-conscious choices that former students have made about their future. An example is illustrated by an ex-student who directed his training path in the Science and Engineering fiel

The first continental stratotype for four successive isotope stages of the Middle Pleistocene for the northern Mediterranean Basin: the Vallo di Diano, Campania, Italy)(French with abridged English

peer reviewedA 207 m long core was taken from the deposits of a palaeolake of a tectonic basin in the southern Apennines (Italy). Two glacial-interglacial cycles were recognized by palynological studies and variation of oxygen isotope ratio. Fourteen major tephra beds are present. The results of the multidisciplinary research place the studied sequence within the Middle Pleistocene.Une carotte de 207 m de longueur a été extraite des dépôts d'un paléolac d'origine tectonique de l'Apennin méridional (Italie). Deux cycles glaciaire-interglaciaire y ont été mis en évidence par la palynologie et les variations des rapports isotopiques de l'oxygène. Quatorse téphras sont présentes. L'ensemble des données permet de placer la séquence étudie dans le Pléistocène moyen

Multicenter Validation of a Deep Learning Detection Algorithm for Focal Cortical Dysplasia

International audienceBackground and Objective To test the hypothesis that a multicenter-validated computer deep learning algorithm detects MRI-negative focal cortical dysplasia (FCD). Methods We used clinically acquired 3-dimensional (3D) T1-weighted and 3D fluid-attenuated inversion recovery MRI of 148 patients (median age 23 years [range 2–55 years]; 47% female) with histologically verified FCD at 9 centers to train a deep convolutional neural network (CNN) classifier. Images were initially deemed MRI-negative in 51% of patients, in whom intracranial EEG determined the focus. For risk stratification, the CNN incorporated bayesian uncertainty estimation as a measure of confidence. To evaluate performance, detection maps were compared to expert FCD manual labels. Sensitivity was tested in an independent cohort of 23 cases with FCD (13 ± 10 years). Applying the algorithm to 42 healthy controls and 89 controls with temporal lobe epilepsy disease tested specificity. Results Overall sensitivity was 93% (137 of 148 FCD detected) using a leave-one-site-out cross-validation, with an average of 6 false positives per patient. Sensitivity in MRI-negative FCD was 85%. In 73% of patients, the FCD was among the clusters with the highest confidence; in half, it ranked the highest. Sensitivity in the independent cohort was 83% (19 of 23; average of 5 false positives per patient). Specificity was 89% in healthy and disease controls. Discussion This first multicenter-validated deep learning detection algorithm yields the highest sensitivity to date in MRI-negative FCD. By pairing predictions with risk stratification, this classifier may assist clinicians in adjusting hypotheses relative to other tests, increasing diagnostic confidence. Moreover, generalizability across age and MRI hardware makes this approach ideal for presurgical evaluation of MRI-negative epilepsy. Classification of Evidence This study provides Class III evidence that deep learning on multimodal MRI accurately identifies FCD in patients with epilepsy initially diagnosed as MRI negative

Hepatectomy Versus Sorafenib in Advanced Non-Metastatic Hepatocellular Carcinoma: A Real-Life Multicentric Weighted Comparison

Objective: The aim of the study was to compare surgery (SURG) vs sorafenib (SOR) regarding the overall survival (OS) and progression-free survival (PFS) in a real-world clinical scenario. Background data: The treatment for advanced non-metastatic hepatocellular carcinoma (HCC) belonging to the Barcelona Clinic Liver Cancer stage C (BCLC C) is still controversial. Methods: BCLC C patients without extra-hepatic spread and tumoral invasion of the main portal trunk were considered. Surgical patients were obtained from the HE.RC.O.LE.S. Register, while sorafenib patients were obtained from the ITA.LI.CA register The inverse probability weighting (IPW) method was adopted to balance the confounders between the two groups. Results: Between 2008 and 2019, 478 patients were enrolled: 303 in SURG and 175 in SOR group. ECOG-PS, presence of cirrhosis, steatosis, Child-Pugh grade, HBV and HCV, alcohol intake, collateral veins, bilobar disease, localization of the tumor thrombus, number of nodules, alpha-fetoprotein, age, and Charlson Comorbidity index were weighted by IPW to create two balanced pseudo-populations: SURG=374 and SOR=263. After IPW, 1-3-5 years OS was 83.6%, 68.1%, 55.9% for SURG, and 42.3%, 17.8%, 12.8% for SOR (p < 0.001). Similar trends were observed after subgrouping patients by ECOG-PS =0 and ECOG-PS >0, and by the intra-hepatic location of portal vein invasion. At Cox regression, sorafenib treatment (HR 4.436; 95%CI 3.19-6.15; p < 0.001) and Charlson Index (HR 1.162; 95%CI 1.06-1.27; p = 0.010) were the only independent predictors of mortality. PFS at 1-3-5 years were 65.9%, 40.3%, 24.3% for SURG and 21.6%, 3.5%, 2.9% for SOR (p = 0.007). Conclusions: In BCLC C patients without extra-hepatic spread but with intra-hepatic portal invasion, liver resection, if feasible, was followed by better OS and PFS compared with sorafenib

Hepatectomy Versus Sorafenib in Advanced Nonmetastatic Hepatocellular Carcinoma: A Real-life Multicentric Weighted Comparison

Objective: The aim of the study was to compare SURG vs SOR regarding the OS and progression-free survival (PFS) in a real-world clinical scenario. Background data: The treatment for advanced nonmetastatic HCC belonging to the Barcelona Clinic Liver Cancer stage C (BCLC C) is still controversial. Methods: BCLC C patients without extrahepatic spread and tumoral invasion of the main portal trunk were considered. Surgical patients were obtained from the HE.RC.O.LE.S. Register, whereas sorafenib patients were obtained from the ITA.LI.CA register The inverse probability weighting (IPW) method was adopted to balance the confounders between the 2 groups. Results: Between 2008 and 2019, 478 patients were enrolled: 303 in SURG and 175 in SOR group. Eastern Cooperative Oncological Group Performance Status (ECOG-PS), presence of cirrhosis, steatosis, Child-Pugh grade, hepatitis B virus and hepatitis C virus, alcohol intake, collateral veins, bilobar disease, localization of the tumor thrombus, number of nodules, alpha-fetoprotein, age, and Charlson Comorbidity index were weighted by IPW to create two balanced pseudo-populations: SURG = 374 and SOR = 263. After IPW, 1-3-5 years OS was 83.6%, 68.1%, 55.9% for SURG, and 42.3%, 17.8%, 12.8% for SOR (P < 0.001). Similar trends were observed after subgrouping patients by ECOG-PS = 0 and ECOG-PS >0, and by the intrahepatic location of portal vein invasion. At Cox regression, sorafenib treatment (hazard ratio 4.436; 95% confidence interval 3.19-6.15; P < 0.001) and Charlson Index (hazard ratio 1.162; 95% confidence interval 1.06-1.27; P = 0.010) were the only independent predictors of mortality. PFS at 1-3-5 years were 65.9%, 40.3%, 24.3% for SURG and 21.6%, 3.5%, 2.9% for SOR (P = 0.007). Conclusions: In BCLC C patients without extrahepatic spread but with intrahepatic portal invasion, liver resection, if feasible, was followed by better OS and PFS compared with sorafenib