53 research outputs found

    Cooperazione interistituzionale nelle Pubbliche Amministrazioni: l'Ufficio intercomunale

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    Nell'ambito dello scenario istituzionale caratterizzato da profonde trasformazioni (si pensi ad esempio alla riforma del titolo V della Costituzione), l'innovazione nella pubblica amministrazione risulta assumere un importanza rilevante. Gli Enti Locali dovranno prepararsi ed adeguarsi a ricevere le funzioni e le responsabilita' derivanti dall'attuazione della riforma. In questo quadro di riferimento si inserisce il presente progetto che individua come idea forza la collaborazione inter-istituzionale come fattore decisivo nella valorizzazione e nell'uso strategico delle risorse turistico culturali del territorio preso in esame. L'area analizzata e' quella dell'alto Casertano, nello specifico i nove Comuni che hanno dimostrato una buona propensione alla collaborazione: Alife, Castello del Matese, Gallo Matese, Letino, Piedimonte Matese, San Gregorio Matese, San Potito Sannitico, Sant'Angelo d'Alife e Valle Agricola. L'idea progetto consiste nella stipulazione di una convenzione tra questi Comuni al fine di istituire un ufficio intercomunale per la gestione associata di diverse funzioni che risultano essere fondamentali per un maggiore coordinamento istituzionale. Il progetto e' strutturato secondo il seguente schema: analisi del cambiamento istituzionale risorse culturali come fattore di sviluppo analisi del quadro di riferimento territoriale analisi swot formulazione della strategia e degli obiettivi idea forza idea progetto aspetti tecnic

    Targeting DNA Damage Response and Replication Stress in Pancreatic Cancer

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    Background and aims: Continuing recalcitrance to therapy cements pancreatic cancer (PC) as the most lethal malignancy, which is set to become the second leading cause of cancer death in our society. The study aim was to investigate the association between DNA damage response (DDR), replication stress and novel therapeutic response in PC to develop a biomarker driven therapeutic strategy targeting DDR and replication stress in PC. Methods: We interrogated the transcriptome, genome, proteome and functional characteristics of 61 novel PC patient-derived cell lines to define novel therapeutic strategies targeting DDR and replication stress. Validation was done in patient derived xenografts and human PC organoids. Results: Patient-derived cell lines faithfully recapitulate the epithelial component of pancreatic tumors including previously described molecular subtypes. Biomarkers of DDR deficiency, including a novel signature of homologous recombination deficiency, co-segregates with response to platinum (P < 0.001) and PARP inhibitor therapy (P < 0.001) in vitro and in vivo. We generated a novel signature of replication stress with which predicts response to ATR (P < 0.018) and WEE1 inhibitor (P < 0.029) treatment in both cell lines and human PC organoids. Replication stress was enriched in the squamous subtype of PC (P < 0.001) but not associated with DDR deficiency. Conclusions: Replication stress and DDR deficiency are independent of each other, creating opportunities for therapy in DDR proficient PC, and post-platinum therapy

    The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: a genotypic analysis.

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    Background: Molecular diagnostics are considered the most promising route to achievement of rapid, universal drug susceptibility testing for Mycobacterium tuberculosis complex (MTBC). We aimed to generate a WHO-endorsed catalogue of mutations to serve as a global standard for interpreting molecular information for drug resistance prediction. Methods: In this systematic analysis, we used a candidate gene approach to identify mutations associated with resistance or consistent with susceptibility for 13 WHO-endorsed antituberculosis drugs. We collected existing worldwide MTBC whole-genome sequencing data and phenotypic data from academic groups and consortia, reference laboratories, public health organisations, and published literature. We categorised phenotypes as follows: methods and critical concentrations currently endorsed by WHO (category 1); critical concentrations previously endorsed by WHO for those methods (category 2); methods or critical concentrations not currently endorsed by WHO (category 3). For each mutation, we used a contingency table of binary phenotypes and presence or absence of the mutation to compute positive predictive value, and we used Fisher's exact tests to generate odds ratios and Benjamini-Hochberg corrected p values. Mutations were graded as associated with resistance if present in at least five isolates, if the odds ratio was more than 1 with a statistically significant corrected p value, and if the lower bound of the 95% CI on the positive predictive value for phenotypic resistance was greater than 25%. A series of expert rules were applied for final confidence grading of each mutation. Findings: We analysed 41 137 MTBC isolates with phenotypic and whole-genome sequencing data from 45 countries. 38 215 MTBC isolates passed quality control steps and were included in the final analysis. 15 667 associations were computed for 13 211 unique mutations linked to one or more drugs. 1149 (7·3%) of 15 667 mutations were classified as associated with phenotypic resistance and 107 (0·7%) were deemed consistent with susceptibility. For rifampicin, isoniazid, ethambutol, fluoroquinolones, and streptomycin, the mutations' pooled sensitivity was more than 80%. Specificity was over 95% for all drugs except ethionamide (91·4%), moxifloxacin (91·6%) and ethambutol (93·3%). Only two resistance mutations were identified for bedaquiline, delamanid, clofazimine, and linezolid as prevalence of phenotypic resistance was low for these drugs. Interpretation: We present the first WHO-endorsed catalogue of molecular targets for MTBC drug susceptibility testing, which is intended to provide a global standard for resistance interpretation. The existence of this catalogue should encourage the implementation of molecular diagnostics by national tuberculosis programmes. Funding: Unitaid, Wellcome Trust, UK Medical Research Council, and Bill and Melinda Gates Foundation

    Ultraviolet

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    Florescence

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    Up To The Light

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    Excursions

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    January: Songs And Chamber Music Of Mark Rimple

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