Quality of Life in elderly patients with cancer

The incidence of most types of cancers is age-dependent and the progressive ageing is rapidly increasing the number of elderly people who need treatment for cancer. Elderly patients present peculiar characteristics that make the choice of the correct treatment more difficult and these patients are often undertreated. Moreover, elderly patients are largely underrepresented in cancer treatment trials, and this makes the experimental evidence on this topic even weaker. Health-related Quality of Life (QOL) has been considered as one of the hard end-points for clinical cancer research, and treatment of elderly cancer patients represents a typical situation where its assessment can be particularly useful, because the expected toxicity of treatment could be relevant in the discussion of the treatment choice. However, QOL assessment in the elderly is complicated by several unresolved methodological problems (higher frequency of illiteracy, worse compliance with the questionnaires, concomitant diseases, use of instruments not validated in the aged population). Conduct of clinical trials dedicated to elderly patients is now encouraged but there are few published studies. Advanced non-small-cell lung cancer is one of the fields with the largest amount of research on QOL in elderly patients. The ELVIS study demonstrated the efficacy of single-agent chemotherapy, both in terms of QOL and of survival. The MILES study, in which combination chemotherapy was not superior than single agents, showed that baseline QOL is a strong prognostic indicator in these patients. QOL of patients with breast cancer has been another important field in clinical research over the last decades, and interest on this topic in elderly patients is growing, from loco-regional to palliative treatment. In conclusion, some steps have been done in clinical cancer research dedicated to elderly patients, and the role of QOL assessment in this setting is important. However, many methodological problems must be resolved, in order to obtain reliable and useful results. A QOL assessment could also be useful for elderly patients in clinical practice, where it could improve patient-clinician communication: a wider application of properly selected instruments should be recommended

Homogeneous to Bubbling Regime Transition in Gas- and Liquid-Fluidized Beds Through DEM-CFD Simulations

DEM-CFD simulations are carried out for the water fluidization of 200 micron glass ballotini and air fluidization of cohesionless alumina 70 micron powders. In the first case, homogeneous expansion is found throughout the whole investigated range of water velocity. Alumina powders exhibits a transition to bubbling regime at a voidage value in very good agreement with results of the theory of particle bed stability. The simulated kinematic and dynamic wave propagation velocities are in good agreement with theoretical predictions

Coarse-Grain DEM Modelling in Fluidized Bed Simulation: A Review

In the last decade, a few of the early attempts to bring CFD-DEM of fluidized beds beyond the limits of small, lab-scale units to larger scale systems have become popular. The simulation capabilities of the Discrete Element Method in multiphase flow and fluidized beds have largely benefitted by the improvements offered by coarse graining approaches. In fact, the number of real particles that can be simulated increases to the point that pilot-scale and some industrially relevant systems become approachable. Methodologically, coarse graining procedures have been introduced by various groups, resting on different physical backgrounds. The present review collects the most relevant contributions, critically proposing them within a unique, consistent framework for the derivations and nomenclature. Scaling for the contact forces, with the linear and Hertz-based approaches, for the hydrodynamic and cohesive forces is illustrated and discussed. The orders of magnitude computational savings are quantified as a function of the coarse graining degree. An overview of the recent applications in bubbling, spouted beds and circulating fluidized bed reactors is presented. Finally, new scaling, recent extensions and promising future directions are discussed in perspective. In addition to providing a compact compendium of the essential aspects, the review aims at stimulating further efforts in this promising field

Hierarchical k-nearest neighbours classification and binary differential evolution for fault diagnostics of automotive bearings operating under variable conditions

International audienc

Penetrating Planets: Schelling and the Anthrobscene

In this paper I will analyze the early recurrences of the concept of Anthrobscene, as proposed in media studies by Jussi Parikka, in the aesthetics of Friedrich Wilhelm Joseph von Schelling, as advanced especially in “On the Relationship of the Plastic Arts to Nature” of 1807. This work is established within the broader debate on the concept of Anthropocene, which, as known, identifies the human being as the main cause of impact on the Earth system in the era we are living. In the first part, I will introduce this concept in a critical way, to then compare it, in the second part, to the elements of Schellingian thought relevant to this debate. Finally, in the last part, after briefly explaining the new conceptual elements embedded in the term ‘Anthrobscene’, I will analyze Shelling’s Rede of 1807, in order to reclaim his aesthetics as properly anthrobscenic

Risk-based clustering for near misses identification in integrated deterministic and probabilistic safety analysis

In integrated deterministic and probabilistic safety analysis (IDPSA), safe scenarios and prime implicants (PIs) are generated by simulation. In this paper, we propose a novel postprocessing method, which resorts to a risk-based clustering method for identifying Near Misses among the safe scenarios. This is important because the possibility of recovering these combinations of failures within a tolerable grace time allows avoiding deviations to accident and, thus, reducing the downtime (and the risk) of the system. The postprocessing risk-significant features for the clustering are extracted from the following: (i) the probability of a scenario to develop into an accidental scenario, (ii) the severity of the consequences that the developing scenario would cause to the system, and (iii) the combination of (i) and (ii) into the overall risk of the developing scenario. The optimal selection of the extracted features is done by a wrapper approach, whereby a modified binary differential evolution (MBDE) embeds a K-means clustering algorithm. The characteristics of the Near Misses scenarios are identified solving a multiobjective optimization problem, using the Hamming distance as a measure of similarity. The feasibility of the analysis is shown with respect to fault scenarios in a dynamic steam generator (SG) of a nuclear power plant (NPP)

A visual interactive method for prime implicants identification

We propose a visual interactive method for the identification of the Prime Implicants (PIs) of dynamic non-coherent systems. Visual interactive methods integrate mathematical and symbolic models with runtime interaction and real-time graphic display, which allow visualizing the underlying physical relationships among process parameters. The proposed method is based on a parallel coordinates data mining tool that relies on an innovative pruning procedure which, on the basis of a proper selection of characteristic features of the accident sequences, retrieves the PIs among the whole set of Implicants in terms of process parameters values and/or components failure states. The method is exemplified on an artificial case study and, then, applied for the dynamic reliability analysis of the Airlock System (AS) of a CANDU reactor