Progression-free survival as a surrogate endpoint of overall survival in patients with metastatic colorectal cancer

Background: In many clinical trials designed to assess the efficacy of anticancer treatments, overall survival (OS) is often used as a primary endpoint despite its several points of weakness. Methods: This study evaluated the role of progression-free survival (PFS) in the first three lines of treatment as a potential surrogate endpoint of OS in patients with metastatic colorectal cancer (MCRC). One hundred and twenty patients with MCRC were enrolled in this study. The median PFS of the first-, second-, and third-lines of treatment and the OS were evaluated. The correlation between the time to progression and the OS was analyzed. The median PFS of the three lines of treatment were 8.5, 5, and 3 months, respectively. Results: The median OS was 32.4 months. A modest correlation was found between the PFS to the first-line treatment with Folfox\u2013avastin and OS. Similar data were obtained with the second-line treatment. However, no correlation was found between the PFS and OS during the third-line treatment. The regression analysis revealed that PFS is predictive of OS. Conclusion: In brief, the PFS of the first- and second-lines of treatment could be a good candidate as a surrogate endpoint of OS in patients with MCRC

Cost analysis of planned out-of-hospital births in Italy

Background and aim: In Italy, the main birthplace is a hospital, and only a few women choose an out-of-hospital setting. This study assessed the costs related to delivery in different birthplaces in Italy. Methods: The cost analysis considered direct and amortizable costs associated with mother-child care in physiological conditions. An analysis of the hospital births considered the Diagnoses-Related Groups 373 and 391. To estimate the cost of the births assisted privately by freelance midwives, an evaluation based on an experts’ opinion was carried out. Results: Childbirth hospital care in Italy amounts to € 1832.00, and birth in an out-of-hospital setting accredited with the National Health System has a full cost of € 1345.19 in the ‘maternity home’ and € 909.60 at home. The average cost of the birth in ‘private maternity homes’ amounted to € 3260.00, while at-home births amounted to € 2910.00. Conclusions: Any accreditation of out-of-hospital settings by the NHS would considerably reduce the waste of economic resources compared to hospital childbirth. (www.actabiomedica.it

Dietary interventions in blood pressure lowering: Current evidence in 2020

Dietary modification is one of the cornerstones in the treatment of arterial hypertension (AH). Current American and European guidelines recommend people to ingest fruit, vegetables, whole grains, and low-fat dairy products as well as to decrease the consumption of red meat, sugar, and trans fats. This review aimed to summarize available evidence on dietary patterns associated with lower blood pressure (BP). Research has shown that the Dietary Approach to Stop Hypertension (DASH) diet can lower BP equally effectively or even more significantly than some antihypertensive drugs. The Mediterranean diet also leads to a considerable reduction in BP. Vegans and vegetarians have been shown to have a lower prevalence of AH than omnivores. Caloric restriction may decrease BP in normotensive, prehypertensive, and hypertensive populations. Blood pressure can also be lowered by certain nutraceuticals (such as beetroot juice, magnesium, vitamin C, catechin-rich beverages, or soy isoflavones). Diet effects on BP are mediated by body weight loss, amelioration of inflammation, increased insulin sensitivity, and antihypertensive properties of some individual nutrients. There is robust evidence that vegetarian and vegan diets have the ability to reduce BP. The presence of the so-called floor effect makes these diets usable in normo- and prehypertensive people at high risk of developing AH. However, the dietary and nutraceutical approach to BP lowering cannot substitute drug treatment when the latter is needed

High-speed data transfer with FPGAs and QSFP+ modules

We present test results and characterization of a data transmission system based on a last generation FPGA and a commercial QSFP+ (Quad Small Form Pluggable +) module. QSFP+ standard defines a hot-pluggable transceiver available in copper or optical cable assemblies for an aggregated bandwidth of up to 40 Gbps. We implemented a complete testbench based on a commercial development card mounting an Altera Stratix IV FPGA with 24 serial transceivers at 8.5 Gbps, together with a custom mezzanine hosting three QSFP+ modules. We present test results and signal integrity measurements up to an aggregated bandwidth of 12 Gbps.Comment: 5 pages, 3 figures, Published on JINST Journal of Instrumentation proceedings of Topical Workshop on Electronics for Particle Physics 2010, 20-24 September 2010, Aachen, Germany(R Ammendola et al 2010 JINST 5 C12019

Clinical Effects of Xanthine Oxidase Inhibitors in Hyperuricemic Patients.

open5noThis review aims to critically present the available clinical evidence supporting the treatment of chronic hyperuricemia with xanthine oxidase inhibitors. For this reason, the studies published on uric acid (UA)-lowering drugs in the English language from 2000 to August 2019 have been carefully reviewed. The terms "serum uric acid," "xanthine oxidase," "allopurinol," "febuxostat," and "topiroxostat" were incorporated into an electronic search strategy, alone and in combinations, in both MEDLINE (National Library of Medicine, Bethesda, MD) and the Cochrane Register of Controlled Trials (The Cochrane Collaboration, Oxford, UK). Even if new urate-lowering drugs seem of particular efficacy for acute treatment of refractory hyperuricemia, their use is supported by relatively small clinical evidence. On the contrary, large long-term clinical trials have demonstrated that xanthine oxidase inhibitors (XOIs, namely, allopurinol and febuxostat) are effective, safe, and relatively well-tolerated in most of the patients. They have mainly been tested in the elderly, in patients affected by chronic diseases such as heart failure and cancer, and in patients taking a large number of drugs, confirming their safety profile. Recent data also show that they could exert some positive effects on vascular health, renal function, and glucose metabolism. Their cost is also low. In conclusion, XOIs remain the first choice of UA-lowering drug for chronic treatment.openCicero AFG, Fogacci F, Cincione RI, Tocci G, Borghi C.Cicero AFG, Fogacci F, Cincione RI, Tocci G, Borghi C

APEnet+: high bandwidth 3D torus direct network for petaflops scale commodity clusters

We describe herein the APElink+ board, a PCIe interconnect adapter featuring the latest advances in wire speed and interface technology plus hardware support for a RDMA programming model and experimental acceleration of GPU networking; this design allows us to build a low latency, high bandwidth PC cluster, the APEnet+ network, the new generation of our cost-effective, tens-of-thousands-scalable cluster network architecture. Some test results and characterization of data transmission of a complete testbench, based on a commercial development card mounting an Altera FPGA, are provided.Comment: 6 pages, 7 figures, proceeding of CHEP 2010, Taiwan, October 18-2

A rare case of extra-intramedullary dorsal tanycitic ependymoma, radically removed with intraoperative neurophysiological monitoring

Introduction: Tanycitic dorsal extra and intramedullary ependymoma is a rare form of tumor. From the histological point of view, these tumors show several aspects that make difficult the differential diagnosis from schwannomas and pilocytic astrocytomas. Tanycytic variant, often occurs in the thoracic tract of the spinal cord, and it is constituted by tanycites, that are typical elongated and bipolar cells that give to the tumor fibrillary aspects. Tanycitic variant has been recently characterized as a variant of ependymoma, since the 2000 World Health Organization (WHO) system. Case presentation: A 57 years old woman presented with intractable back pain often radiating to the left leg. Neurological exam revealed mild weakness in left tight flexion. No sensory or sphincterial disturbances were present. A dorso-lumbar Magnetic Resonance Imaging (MRI)with contrast medium showed a well-demarked T12 intradural extramedullary lesion, suggestive for schwannoma. The tumor was radically removed, with an excellent neurological outcome, and was then characterized as a grade II tanycitic ependymoma. Conclusion: To differentiate the diagnosis between extramedullary ependymomas and schwannomas, meningiomas or astrocytomas is necessary a histopathological examination and a close follow up period is recommended since the tumor could evolve into higher grade. Neurophysiological monitoring is necessary for a satisfactory neurological outcome

A rare case of extra-intramedullary dorsal tanycitic ependymoma, radically removed with intraoperative neurophysiological monitoring

Introduction: Tanycitic dorsal extra and intramedullary ependymoma is a rare form of tumor. From the histological point of view, these tumors show several aspects that make difficult the differential diagnosis from schwannomas and pilocytic astrocytomas. Tanycytic variant, often occurs in the thoracic tract of the spinal cord, and it is constituted by tanycites, that are typical elongated and bipolar cells that give to the tumor fibrillary aspects. Tanycitic variant has been recently characterized as a variant of ependymoma, since the 2000 World Health Organization (WHO) system. Case presentation: A 57 years old woman presented with intractable back pain often radiating to the left leg. Neurological exam revealed mild weakness in left tight flexion. No sensory or sphincterial disturbances were present. A dorso-lumbar Magnetic Resonance Imaging (MRI)with contrast medium showed a well-demarked T12 intradural extramedullary lesion, suggestive for schwannoma. The tumor was radically removed, with an excellent neurological outcome, and was then characterized as a grade II tanycitic ependymoma. Conclusion: To differentiate the diagnosis between extramedullary ependymomas and schwannomas, meningiomas or astrocytomas is necessary a histopathological examination and a close follow up period is recommended since the tumor could evolve into higher grade. Neurophysiological monitoring is necessary for a satisfactory neurological outcome

NaNet: a Low-Latency, Real-Time, Multi-Standard Network Interface Card with GPUDirect Features

While the GPGPU paradigm is widely recognized as an effective approach to high performance computing, its adoption in low-latency, real-time systems is still in its early stages. Although GPUs typically show deterministic behaviour in terms of latency in executing computational kernels as soon as data is available in their internal memories, assessment of real-time features of a standard GPGPU system needs careful characterization of all subsystems along data stream path. The networking subsystem results in being the most critical one in terms of absolute value and fluctuations of its response latency. Our envisioned solution to this issue is NaNet, a FPGA-based PCIe Network Interface Card (NIC) design featuring a configurable and extensible set of network channels with direct access through GPUDirect to NVIDIA Fermi/Kepler GPU memories. NaNet design currently supports both standard - GbE (1000BASE-T) and 10GbE (10Base-R) - and custom - 34~Gbps APElink and 2.5~Gbps deterministic latency KM3link - channels, but its modularity allows for a straightforward inclusion of other link technologies. To avoid host OS intervention on data stream and remove a possible source of jitter, the design includes a network/transport layer offload module with cycle-accurate, upper-bound latency, supporting UDP, KM3link Time Division Multiplexing and APElink protocols. After NaNet architecture description and its latency/bandwidth characterization for all supported links, two real world use cases will be presented: the GPU-based low level trigger for the RICH detector in the NA62 experiment at CERN and the on-/off-shore data link for KM3 underwater neutrino telescope

GPU-based Real-time Triggering in the NA62 Experiment

Over the last few years the GPGPU (General-Purpose computing on Graphics Processing Units) paradigm represented a remarkable development in the world of computing. Computing for High-Energy Physics is no exception: several works have demonstrated the effectiveness of the integration of GPU-based systems in high level trigger of different experiments. On the other hand the use of GPUs in the low level trigger systems, characterized by stringent real-time constraints, such as tight time budget and high throughput, poses several challenges. In this paper we focus on the low level trigger in the CERN NA62 experiment, investigating the use of real-time computing on GPUs in this synchronous system. Our approach aimed at harvesting the GPU computing power to build in real-time refined physics-related trigger primitives for the RICH detector, as the the knowledge of Cerenkov rings parameters allows to build stringent conditions for data selection at trigger level. Latencies of all components of the trigger chain have been analyzed, pointing out that networking is the most critical one. To keep the latency of data transfer task under control, we devised NaNet, an FPGA-based PCIe Network Interface Card (NIC) with GPUDirect capabilities. For the processing task, we developed specific multiple ring trigger algorithms to leverage the parallel architecture of GPUs and increase the processing throughput to keep up with the high event rate. Results obtained during the first months of 2016 NA62 run are presented and discussed