A pharmacoeconomic analysis of the use of single MMC instillation in low risk NMIBC in Italy

BACKGROUND: Bladder cancer accounts for 5-10% of all cancers in Europe and up to 85% patients presents a noninvasive tumor, whose treatment of choice is the transurethral bladder resection (TURB) paired with adjuvant intravesical chemotherapy or immunotherapy. Despite several clinical trials showed that this treatment is safe and decreases recurrences by 17% to 44% this practice is limited for many reasons. The study objective is to analyze the economical advantages of the single immediate post operative Mitomycin C instillation in Non Muscle-invasive Bladder Cancer (NMIBC) low-risk patients.METHODS: A cost-benefit analysis was performed evaluating the economical gain that would raised from a scenario with a single immediate post operative mitomycin C instillation in each low-risk NMIBC patient who underwent to TURB. Net present value and cost-benefit ratio were calculated and sensitivity analyses were performed. Base case analysis was performed considering tumor recurrence rate reduction of 11.7% and a TURB costs of 2,167.0 €, while sensitivity analyses were performed using a recurrence rate reduction of 19.2% and 15.0% and a TURB cost of 2,472.93 €. The discount rate was 2%.RESULTS: The single immediate post operative instillation of mitomycin C resulted to be cost-beneficial with a cost-benefit ratio that goes from 0.48 to 0.79 when compared to TURB alone raising a Net Present Value that goes from 660,284.39 € to 2,650,530.79 €.CONCLUSION: This study demonstrates that even assuming conservative parameters for recurrence rates reduction, a single immediate post operative mitomycin C instillation in low risk NMIBC patients would lower not only the recurrence rate but also the caring cost for bladder cancer

Chronicle of an epidemic in the shadow of the pandemic : clinical case communication

La sífilis es una enfermedad causada por la espiroqueta de Treponema pallidum que muestra un amplio espectro clínico. Sus manifestaciones clínicas principalmente se observan en la piel y las mucosas; sin embargo, su mimetismo con otras enfermedades complica a menudo su diagnóstico y retrasa su tratamiento. Este artículo ilustra las lesiones observadas en un paciente con sífilis secundaria, con la finalidad de difundir su aspecto clínico que permita una fácil sospecha diagnóstica, así como mostrar la mejor forma para corroborar los diagnósticos.Syphilis is a disease caused by Treponema pallidum spirocheta that shows a broad clinical spectrum. Its clinical manifestations are mainly observed in the skin and mucous membranes; however, his mimicry with other diseases often complicates his diagnosis and delays his treatment. This article illustrates the lesions observed in a patient with secondary syphilis, in order to spread their clinical appearance that allows easy diagnostic suspicion, as well as show the best way to corroborate diagnoses.Fil: Echeverría, Naomy. Universidad Nacional de La PlataFil: Krause, Martina. Universidad Nacional de La PlataFil: Ulibarrie, Federico . Universidad Nacional de La PlataFil: Cimatti, Pablo. Universidad Nacional de La PlataFil: Alamo, Geordina . Universidad Nacional de La PlataFil: Colombo, Carolina . Universidad Nacional de La Plat

Climate change and local development

Se describe un proyecto que incluye características de la economía familiar, costumbres y tradiciones de pequeños productores de una comuna rural en la provincia de Tucumán. Considera dos líneas de acción: acciones sustentables y fortalecimiento de la asociación entre los habitantes, orientadas a la adaptación al cambio climático en una localidad donde el bosque nativo tiene una fuerte presencia. Los objetivos son: potenciar la coexistencia con el bosque, promover capacidades de la población introduciendo tecnologías amigables con el ambiente, obras de infraestructura y diversificación agrícola que fortalezcan las economías familiares, incorporando innovaciones que faciliten la mejora de la calidad de vida y la adaptación al cambio climático, fortaleciendo la sustentabilidad. El proyecto consta de los siguientes sub-proyectos: Desarrollo forestal integrado; Captación y aprovechamiento del agua para desarrollos productivos; Arquitectura sustentable y uso racional de energía; Fortalecimiento de actividades productivas sustentables; y Turismo campesino y promoción de la asociatividad.A project that includes characteristics of the household economy and traditions of small farmers in a rural commune in the province of Tucuman is described. It considers two lines of action: sustainable actions and strengthening the partnership between inhabitants, aimed at adapting to climate change at a location where the native forest has a strong presence. The objectives are: to promote coexistence with the forest, promote skills of the population by introducing environmentally friendly technologies, infrastructure and agricultural diversification that strengthen family economies, incorporating innovations that facilitate the improvement of quality of life and adaptation climate change, strengthening sustainability. The project consists of the following sub-projects: Integrated Forestry Development; Collection and utilization of water for productive development; Sustainable architecture and rational use of energy; Strengthening sustainable productive activities; and Peasant tourism and promotion of partnership.Eje: Sustentabilidad y accesibilidad (Comunicaciones).Facultad de Arquitectura y Urbanism

Climate change and local development

Se describe un proyecto que incluye características de la economía familiar, costumbres y tradiciones de pequeños productores de una comuna rural en la provincia de Tucumán. Considera dos líneas de acción: acciones sustentables y fortalecimiento de la asociación entre los habitantes, orientadas a la adaptación al cambio climático en una localidad donde el bosque nativo tiene una fuerte presencia. Los objetivos son: potenciar la coexistencia con el bosque, promover capacidades de la población introduciendo tecnologías amigables con el ambiente, obras de infraestructura y diversificación agrícola que fortalezcan las economías familiares, incorporando innovaciones que faciliten la mejora de la calidad de vida y la adaptación al cambio climático, fortaleciendo la sustentabilidad. El proyecto consta de los siguientes sub-proyectos: Desarrollo forestal integrado; Captación y aprovechamiento del agua para desarrollos productivos; Arquitectura sustentable y uso racional de energía; Fortalecimiento de actividades productivas sustentables; y Turismo campesino y promoción de la asociatividad.A project that includes characteristics of the household economy and traditions of small farmers in a rural commune in the province of Tucuman is described. It considers two lines of action: sustainable actions and strengthening the partnership between inhabitants, aimed at adapting to climate change at a location where the native forest has a strong presence. The objectives are: to promote coexistence with the forest, promote skills of the population by introducing environmentally friendly technologies, infrastructure and agricultural diversification that strengthen family economies, incorporating innovations that facilitate the improvement of quality of life and adaptation climate change, strengthening sustainability. The project consists of the following sub-projects: Integrated Forestry Development; Collection and utilization of water for productive development; Sustainable architecture and rational use of energy; Strengthening sustainable productive activities; and Peasant tourism and promotion of partnership.Eje: Sustentabilidad y accesibilidad (Comunicaciones).Facultad de Arquitectura y Urbanism

Climate change and local development

Se describe un proyecto que incluye características de la economía familiar, costumbres y tradiciones de pequeños productores de una comuna rural en la provincia de Tucumán. Considera dos líneas de acción: acciones sustentables y fortalecimiento de la asociación entre los habitantes, orientadas a la adaptación al cambio climático en una localidad donde el bosque nativo tiene una fuerte presencia. Los objetivos son: potenciar la coexistencia con el bosque, promover capacidades de la población introduciendo tecnologías amigables con el ambiente, obras de infraestructura y diversificación agrícola que fortalezcan las economías familiares, incorporando innovaciones que faciliten la mejora de la calidad de vida y la adaptación al cambio climático, fortaleciendo la sustentabilidad. El proyecto consta de los siguientes sub-proyectos: Desarrollo forestal integrado; Captación y aprovechamiento del agua para desarrollos productivos; Arquitectura sustentable y uso racional de energía; Fortalecimiento de actividades productivas sustentables; y Turismo campesino y promoción de la asociatividad.A project that includes characteristics of the household economy and traditions of small farmers in a rural commune in the province of Tucuman is described. It considers two lines of action: sustainable actions and strengthening the partnership between inhabitants, aimed at adapting to climate change at a location where the native forest has a strong presence. The objectives are: to promote coexistence with the forest, promote skills of the population by introducing environmentally friendly technologies, infrastructure and agricultural diversification that strengthen family economies, incorporating innovations that facilitate the improvement of quality of life and adaptation climate change, strengthening sustainability. The project consists of the following sub-projects: Integrated Forestry Development; Collection and utilization of water for productive development; Sustainable architecture and rational use of energy; Strengthening sustainable productive activities; and Peasant tourism and promotion of partnership.Eje: Sustentabilidad y accesibilidad (Comunicaciones).Facultad de Arquitectura y Urbanism

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Physics case for an LHCb Upgrade II - Opportunities in flavour physics, and beyond, in the HL-LHC era

The LHCb Upgrade II will fully exploit the flavour-physics opportunities of the HL-LHC, and study additional physics topics that take advantage of the forward acceptance of the LHCb spectrometer. The LHCb Upgrade I will begin operation in 2020. Consolidation will occur, and modest enhancements of the Upgrade I detector will be installed, in Long Shutdown 3 of the LHC (2025) and these are discussed here. The main Upgrade II detector will be installed in long shutdown 4 of the LHC (2030) and will build on the strengths of the current LHCb experiment and the Upgrade I. It will operate at a luminosity up to 2×1034 cm−2s−1, ten times that of the Upgrade I detector. New detector components will improve the intrinsic performance of the experiment in certain key areas. An Expression Of Interest proposing Upgrade II was submitted in February 2017. The physics case for the Upgrade II is presented here in more depth. CP-violating phases will be measured with precisions unattainable at any other envisaged facility. The experiment will probe b → sl+l−and b → dl+l− transitions in both muon and electron decays in modes not accessible at Upgrade I. Minimal flavour violation will be tested with a precision measurement of the ratio of B(B0 → μ+μ−)/B(Bs → μ+μ−). Probing charm CP violation at the 10−5 level may result in its long sought discovery. Major advances in hadron spectroscopy will be possible, which will be powerful probes of low energy QCD. Upgrade II potentially will have the highest sensitivity of all the LHC experiments on the Higgs to charm-quark couplings. Generically, the new physics mass scale probed, for fixed couplings, will almost double compared with the pre-HL-LHC era; this extended reach for flavour physics is similar to that which would be achieved by the HE-LHC proposal for the energy frontier