Reduced Rate of Hospital Admissions for ACS during Covid-19 Outbreak in Northern Italy

To address the coronavirus (Covid-19) pandemic,1 strict social containment measures have been adopted worldwide, and health care systems have been reorganized to cope with the enormous increase in the numbers of acutely ill patients.2,3 During this same period, some changes in the pattern of hospital admissions for other conditions have been noted. The aim of the present analysis is to investigate the rate of hospital admissions for acute coronary syndrome (ACS) during the early days of the Covid-19 outbreak

Gene Expression Comparison between Alcohol-Exposed Versus Not Exposed Pancreatic Ductal Adenocarcinoma Patients Reveals a Peculiar TGFβ-Related Phenotype: An Exploratory Analysis

Background: Over the past few decades, there has been much debate and research into the link between alcohol consumption and the development and progression of pancreatic ductal ade- nocarcinoma (PDAC). Objectives: To contribute to the ongoing discussion and gain further insights into this topic, our study analysed the gene expression differences in PDAC patients based on their alcohol consumption history. Methods: To this end, we interrogated a large publicly available da- taset. We next validated our findings in vitro. Results: Our findings revealed that patients with a history of alcohol consumption showed significant enrichment in the TGFβ-pathway: a signaling pathway implicated in cancer development and tumor progression. Specifically, our bioinformatic dissection of gene expression differences in 171 patients with PDAC showed that those who had consumed alcohol had higher levels of TGFβ-related genes. Moreover, we validated the role of the TGFβ pathway as one of the molecular drivers in producing massive stroma, a hallmark feature of PDAC, in patients with a history of alcohol consumption. This suggests that inhibition of the TGFβ pathway could serve as a novel therapeutic target for PDAC patients with a history of alcohol con- sumption and lead to increased sensitivity to chemotherapy. Our study provides valuable insights into the molecular mechanisms underlying the link between alcohol consumption and PDAC pro- gression. Conclusions: Our findings highlight the potential significance of the TGFβ pathway as a therapeutic target. The development of TGFβ-inhibitors may pave the way for developing more effective treatment strategies for PDAC patients with a history of alcohol consumption

Association between outer retinal alterations and microvascular changes in intermediate stage age-related macular degeneration: an optical coherence tomography angiography study

AIMS: To investigate associations between changes in retinal vessels and alterations detected by spectral domain optical coherence tomography (SD-OCT) scans in intermediate stage age-related macular degeneration (AMD). METHODS: Thirty eyes of 30 patients with intermediate dry AMD were enrolled in the study. Of the cohort study, 15 eyes (changes-AMD group) showed OCT changes preceding the development of drusen-associated atrophy. A control group of healthy subjects was selected for statistical comparisons. All patients underwent an ophthalmologic evaluation, including OCT angiography (OCTA) and SD-OCT scans. Main outcome measures were superficial vessel density, deep vessel density, macular thickness. RESULTS: Foveal macular thickness was 215.2\ub132.9\u2005\u3bcm in changes-AMD patients and was significantly thinner than no changes-AMD patients (248.3\ub123.3\u2005\u3bcm, p=0.002) and healthy subjects (268.1\ub119.2\u2005\u3bcm, p<0.0001). Furthermore, in the parafoveal area, the thicknesses of both the inner retina and the outer retina were reduced in the changes-AMD group, after comparison with the two other groups. Parafoveal superficial vascular plexus flow density was 43.3\ub12.7% in changes-AMD patients and was decreased compared with the no changes-AMD group (48.7\ub13.3%, p=0.003) and healthy controls (50.4\ub16.1%, p=0.001). A direct correlation of the superficial plexus flow density with the inner retina parafoveal macular thickness (R2=0.761, p=0.028) was found. CONCLUSIONS: We demonstrated an association between SD-OCT signs and retinal blood supply in patients with intermediate AMD and we showed that patients with signs predicting development of geographic atrophy have a reduced flow in superficial vascular plexus and damage of the inner and the outer retina

CENTAURO: An Explainable AI Approach for Customer Loyalty Prediction in Retail Sector

Customer loyalty is a crucial factor for retail business success. This paper illustrates an AI approach, named CENTAURO, to learn customer loyalty prediction models that may help retailers to run powerful loyalty programs and take better decisions. In particular, the proposed approach learns a classification model from the Recency, Frequency and Monetary (RFM) value of historical customer shopping data. For this purpose, the RFM model is extended to monitor Recency, Frequency and Monetary both over time and over the various categories of products purchased. Experiments performed with a benchmark dataset explore the performance of the extended RFM model in combination with several classification algorithms (e.g., Logistic Regression, Multi-Layer Perceptron, Random Forest, Decision Tree and XGBoost). Finally, we use an eXplainable Artificial Intelligence (XAI) technique – SHAP – to explore the effect of RFM values on the customer loyalty profile learned through the classification model

Lahar events in the last 2000 years from Vesuvius eruptions-Part 3:Hazard assessment over the Campanian Plain

In this study we present a novel general methodology for probabilistic volcanic hazard assessment (PVHA) for lahars. We apply the methodology to perform a probabilistic assessment in the Campanian Plain (southern Italy), focusing on syn-eruptive lahars from a reference size eruption from Somma-Vesuvius. We take advantage of new field data relative to volcaniclastic flow deposits in the target region (Di Vito et al., 2024b) and recent improvements in modelling lahars (de' Michieli Vitturi et al., 2024). The former allowed defining proper probability density functions for the parameters related to the flow initial conditions, and the latter allowed computationally faster model runs. In this way, we are able to explore the effects of uncertainty in the initial flow conditions on the invasion of lahars in the target area by sampling coherent sets of values for the input model parameters and performing a large number of simulations. We also account for the uncertainty in the position of lahar generation by running the analysis on 11 different catchments threatening the Campanian Plain. The post-processing of the simulation outputs led to the production of hazard curves for the maximum flow thickness reached on a grid of points covering the Campanian Plain. By cutting the hazard curves at selected threshold values, we produce a portfolio of hazard maps and probability maps for the maximum flow thickness. We also produce hazard surface and probability maps for the simultaneous exceeding of pairs of thresholds in flow thickness and dynamic pressure. The latter hazard products represent, on one hand, a novel product in PVHA for lahars and, on the other hand, a useful means of impact assessment by assigning a probability to the occurrence of lahars that simultaneously have a relevant flow thickness and large dynamic pressure.</p

Lahar events in the last 2,000 years from Vesuvius eruptions. Part 3: Hazard assessment over the Campanian Plain

In this study we present a novel general methodology for probabilistic volcanic hazard assessment (PVHA) for lahars. We apply the methodology to perform a probabilistic assessment in the Campanian Plain (southern Italy), focusing on syn-eruptive lahars from a reference size eruption from Somma–Vesuvius. We take advantage of new field data relative to volcaniclastic flow deposits in the target region (Di Vito et al., 2024b) and recent improvements in modelling lahars (de’ Michieli Vitturi et al., 2024). The former allowed defining proper probability density functions for the parameters related to the flow initial conditions, and the latter allowed computationally faster model runs. In this way, we are able to explore the effects of uncertainty in the initial flow conditions on the invasion of lahars in the target area by sampling coherent sets of values for the input model parameters and performing a large number of simulations. We also account for the uncertainty in the position of lahar generation by running the analysis on 11 different catchments threatening the Campanian Plain. The post-processing of the simulation outputs led to the production of hazard curves for the maximum flow thickness reached on a grid of points covering the Campanian Plain. By cutting the hazard curves at selected threshold values, we produce a portfolio of hazard maps and probability maps for the maximum flow thickness. We also produce hazard surface and probability maps for the simultaneous exceeding of pairs of thresholds in flow thickness and dynamic pressure. The latter hazard products represent, on one hand, a novel product in PVHA for lahars and, on the other hand, a useful means of impact assessment by assigning a probability to the occurrence of lahars that simultaneously have a relevant flow thickness and large dynamic pressure

Anatomical and Functional Changes of the Retina and the Choroid after Resolved Chronic CSCR

BACKGROUND: To investigate anatomical/functional changes after oral eplerenone therapy for chronic central serous chorioretinopathy (CCSC) in successfully treated eyes and fellow eyes and assess timing of foveal subretinal fluid (SRF) resolution. METHODS: Twenty-one eyes of 21 patients suffering from CCSC with monolateral foveal SRF successfully treated with oral eplerenone were enrolled in this retrospective study (group 1). The fellow eyes (21 eyes; group 2), healthy or affected by CCSC, without foveal SRF were considered in the analysis. A control healthy group was enrolled as well (healthy controls; n = 21). Main outcome measures during follow-up included changes of best corrected visual acuity (BCVA, logMAR), central macular thickness (CMT; \ub5m), SRF (\ub5m), subfoveal choroidal thickness (SFCT; \ub5m), superficial capillary plexus density (SCPD, %), deep capillary plexus density (DCPD, %), and choriocapillaris density (CCD, %) and percentage of eyes showing foveal SRF resolution at different time points. RESULTS: Functional and anatomical parameters significantly improved during the study in group 1. BCVA increased significantly (p &lt; 0.001), while CMT, SFCT, and SRF decreased significantly (p &lt; 0.001; p &lt; 0.001, and p = 0.037, respectively). SCPD, DCPD, and CCD did not show any statistically significant difference during follow-up. In 71.4% of eyes, resolution of SRF was observed within 60 days and in the remaining 28.6%, at 120 days. In fellow eyes, SFCT decreased significantly (p &lt; 0.001), whilst all other parameters did not modify. CONCLUSIONS: Eplerenone treatment in chronic CSCR potentially improves recovery of retinal and choroidal morphology as well as visual acuity gain. A complete resolution of foveal SRF was observed in all eyes during a 4-month follow-up, with most eyes healing at 2 months. KEYWORDS: choriocapillaris density; chronic central serous chorioretinopathy; eplerenone therapy; optical coherence tomography angiography; subfoveal choroidal thickness; superficial capillary plexus densit

THE PORTRAIT OF “MRS GREYSH”: AN UNUSUAL PRESENTATION OF ALKAPTONURIA

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Tailoring neoadjuvant treatment of HR-positive/HER2-negative breast cancers: Which role for gene expression assays?

Neoadjuvant chemotherapy (NACT) for breast cancer (BC) increases surgical and conservative surgery chances. However, a significant proportion of patients will not be eligible for conservative surgery following NACT because of large tumor size and/or low chemosensitivity, especially for hormone receptor (HR)-positive/ human epidermal growth factor receptor 2 (HER2)-negative tumors, for which pathological complete response rates are lower than for other BC subtypes. On the other hand, for luminal BC neoadjuvant endocrine therapy could represent a valid alternative. Several gene expression assays have been introduced into clinical practice in last decades, in order to define prognosis more accurately than clinico-pathological features alone and to predict the benefit of adjuvant treatments. A series of studies have demonstrated the feasibility of using core needle biopsy for gene expression risk testing, finding a high concordance rate in the risk result between biopsy sample and surgical samples. Based on these premises, recent efforts have focused on the utility of gene expression signatures to guide therapeutic decisions even in the neoadjuvant setting. Several prospective and retrospective studies have investigated the correlation between gene expression risk score from core needle biopsy before neoadjuvant therapy and the likelihood of 1) clinical and pathological response to neoadjuvant chemotherapy and endocrine therapy, 2) conservative surgery after neoadjuvant chemotherapy and endocrine therapy, and 3) survival following neoadjuvant chemotherapy and endocrine therapy. The purpose of this review is to provide an overview of the potential clinical utility of the main commercially available gene expression panels (Oncotype DX, MammaPrint, EndoPredict, Prosigna/PAM50 and Breast Cancer Index) in the neoadjuvant setting, in order to better inform decision making for luminal BC beyond the exclusive contribution of clinico-pathological features