Efficacy of 1998 <i>vs</i> 2006 first-line antiretroviral regimens for HIV infection: an ordinary clinics retrospective investigation

Purpose: The evidence suggesting increased HAART efficacy over time comes from randomized trials or cohort studies. This retrospective multicenter survey aimed to assess the variation over time in the efficacy and tolerability of first-line HAART regimens in unselected patients treated in ordinary clinical settings. Methods: Retrospective analysis of data of all patients starting first-line HAART regimens in 1998 and 2006 at adhering centers in the Italian CISAI group. Results: For the 543 patients included, mean age was 39.1 ± 9.8y in 1998 and 41.0 ± 10.7y in 2006 (p=0.03), with a similar proportion of males. Baseline mean log10 HIV-RNA was 4.56 ± 0.97 copies/mL in 1998 vs 4.91 ± 0.96 copies/mL in 2006 (p&lt;0.001); baseline mean CD4 T-cell counts were 343 ± 314/mm3 in 1998 vs 244 ± 174/mm3 in 2006 (p&lt;0.001). The following outcomes were significantly improved at 48w in 2006: proportion with undetectable HIV-RNA (86.3% vs 58.0%; p&lt;0.001); mean increase in CD4 T-cells count (252 ± 225 vs 173 ± 246; p&lt;0.001); HAART modification (20.1% vs 29.2%; p=0.02); HAART interruption (7.3% vs 14.6%; p=0.01); proportion reporting optimal adherence (92.2% vs 82.7%, p=0.03). No differences were observed in the prevalence of grade 3-4 WHO toxicities (26.4% vs 26.6%; p=0.9). Multivariate logistic regression showed that being treated in 1998 remained an independent predictor of virological failure after several adjustments, including adherence. Conclusions: Our data from patients not included in clinical trials or cohort studies provide an additional line of evidence that the effectiveness of HAART significantly improved in 2006. Treated patients, however, were significantly older and more frequently late HIV presenters in 2006 than in 1998.</br

Results from CHIPIX-FE0, a Small Scale Prototype of a New Generation Pixel Readout ASIC in 65nm CMOS for HL-LHC

CHIPIX65-FE0 is a readout ASIC in CMOS 65nm designed by the CHIPIX65 project for a pixel detector at the HL-LHC, consisting of a matrix of 64x64 pixels of dimension 50x50 μm2. It is fully functional, can work at low thresholds down to 250e− and satisfies all the specifications. Results confirm low-noise, fast performance of both the synchronous and asynchronous front-end in a complex digital chip. CHIPIX65-FE0 has been irradiated up to 600 Mrad and is only marginally affected on analog performance. Further irradiation to 1 Grad will be performed. Bump bonding to silicon sensors is now on going and detailed measurements will be presented. The HL-LHC accelerator will constitute a new frontier for particle physics after year 2024. One major experimental challenge resides in the inner tracking detectors, measuring particle position: here the dimension of the sensitive area (pixel) has to be scaled down with respect to LHC detectors. This paper describes the results obtained by CHIPIX65-FE0, a readout ASIC in CMOS 65nm designed by the CHIPIX65 project as small-scale demonstrator for a pixel detector at the HL-LHC. It consists of a matrix of 64x64 pixels of dimension 50x50 um2 pixels and contains several pieces that are included in RD53A, a large scale ASIC designed by the RD53 Collaboration: two out of three front-ends (a synchronous and an asynchronous architecture); several building blocks; a (4x4) pixel region digital architecture with central local buffer storage, complying with a 3 GHz/cm2 hit rate and a 1 MHz trigger rate maintaining a very high efficiency (above 99%). The chip is 100% functional, either running in triggered or trigger-less mode. All building-blocks (DAC, ADC, Band Gap, SER, sLVS-TX/RX) and very front ends are working as expected. Analog performance shows a remarkably low ENC of 90e-, a fast-rise time below 25ns and low-power consumption (about 4μA/pixel) in both synchronous and asynchronous front-ends; a very linear behavior of CSA and discriminator. No significant cross talk from digital electronics has been measured, achieving a low threshold of 250e-. Signal digitization is obtained with a 5b-Time over Threshold technique and is shown to be fairly linear, working well either at 80 MHz or with higher frequencies of 300 MHz obtained with a tunable local oscillator. Irradiation results up to 600 Mrad at low temperature (-20°C) show that the chip is still fully functional and analog performance is only marginally degraded. Further irradiation will be performed up to 1 Grad either at low or room temperature, to further understand the level of radiation hardness of CHIPIX65-FE0. We are now in the process of bump bonding CHIPIX65-FE0 to 3D and possibly planar silicon sensors during spring. Detailed results will be presented in the conference paper

First Measurements of a Prototype of a New Generation Pixel Readout ASIC in 65 nm CMOS for Extreme Rate HEP Detectors at HL-LHC

A first prototype of a readout ASIC in CMOS 65nm for a pixel detector at High Luminosity LHC is described. The pixel cell area is 50x50 um2 and the matrix consists of 64x64 pixels. The chip was designed to guarantee high efficiency at extreme data rates for very low signals and with low power consumption. Two different analogue front-end designs, one synchronous and one asynchronous, were implemented, both occupying an area of 35x35 um2. ENC value is below 100e- for an input capacitance of 50 fF and in-time threshold below 1000e-. Leakage current compensation up to 50 nA with power consumption below 5 uW. A ToT technique is used to perform charge digitization with 5-bit precision using either a 40 MHz clock or a local Fast Oscillator up to 800 MHz. Internal 10-bit DAC's are used for biasing, while monitoring is provided by a 12-bit ADC. A novel digital architecture has been developed to ensure above 99.5% hit efficiency at pixel hit rates up to 3 GHz/cm2, trigger rates up to 1 MHz and trigger latency of 12.5 us. The total power consumption per pixel is below 5uW. Analogue dead-time is below 1%. Data are sent via a serializer connected to a CMOS-to-SLVS transmitter working at 320 MHz. All IP-blocks and front-ends used are silicon-proven and tested after exposure to ionizing radiation levels of 500-800 Mrad. The chip was designed as part of the Italian INFN CHIPIX65 project and in close synergy with the international CERN RD53 and was submitted in July 2016 for production. Early test results for both front-ends regarding minimum threshold, auto-zeroing and low-noise performance are high encouraging and will be presented in this paper

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p&lt;0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p&lt;0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p&lt;0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p&lt;0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic

Mechanical stability of the CMS strip tracker measured with a laser alignment system

Peer reviewe

HIGH DENSITY ANALOG CIRCUITS FOR SEMICONDUCTOR PIXEL DETECTORS

The research activity carried out in this work is relevant to the design and characterization of high density analog circuits for semiconductor pixel detectors. This activity has been developed in the framework of the CERN RD53 collaboration, whose aim is the design of the next generation of hybrid pixel readout chips for the ATLAS and CMS phase 2 pixel upgrades. In this work, the development of two IP blocks is presented and discussed. In particular, a rad-hard bandgap voltage reference and a differential IO link have been designed and characterized. They will be included in the RD53A demonstrator chip, in particular, in the monitoring and IO sections

Printable beam-based lattices: A novel geometry generation algorithm and thermo-mechanical characterization via Asymptotic Homogenization

Beam-based lattices have gained significant popularity in engineering applications due to their ease of production using additive manufacturing [1,2,3]. However, the design of the unit cell geometry is mostly based on intuition rather than on proper geometrical algorithms: this leads to confusion in the classification of the cell types, as authors propose different names for the same type of cell. In our work, a novel geometric algorithm is introduced for the generation of beam-based cubic unit cells of the Oh symmetry group. This algorithm enables the creation of complex unit cells that are self-connecting, providing structural integrity to the lattice, by the variation of two geometrical parameters. Typically, such unit cells are challenging to design, but our algorithm simplifies the process and proposes a new taxonomy based on the selected geometrical parameters. The variation of the geometrical variables determines the categorization, and four distinct classes of cells are suggested. Additionally, thermo-mechanical analysis of the static effective properties is performed for each class of unit cells using the Asymptotic Homogenization method [4,5], implemented in a Finite Element Method (FEM) framework. The results are presented as gridded data, available on a GitHub repository, and depend on the unit cell's volume fraction, Poisson's ratio (variable within the thermodynamically admissible range 0 &lt; ν &lt; 0.5), and the geometrical parameters of the unit cell class. The effective parameters are normalized with respect to the solid bulk properties, thus behaving as purely geometrical properties of the unit cell class. These parameters act as scaling functions on the bulk properties and can be readily utilized in optimization schemes for enhancing the static performance of lattices. Overall, these findings provide a valuable tool for real-world engineering applications

Beam-based lattices: A novel geometry generation algorithm and thermo-mechanical characterization via Asymptotic Homogenization

For their ease of production through additive manufacturing, beam-based lattices have been extensively used in engineering applications. However, a rigorous methodology for the generation of unit-cell geometry is not exhaustively treated in the literature and geometrical intuition, rather than proper algorithms, is usually employed for design. This fact also confuses the taxonomy, as authors suggest different names for the same cell type. In this talk, a novel geometrical algorithm for the generation of beam-based cubic unit cells with spherical inertia ellipsoid and thermal conductivity tensor is presented. The algorithm allows the production of complex but self-connecting - that impart structural integrity to the lattice - unit cells that otherwise are difficult to devise and suggests a novel taxonomy based on the parameters adopted. Under this categorization, classes of unit cells are defined by the variation of a single geometrical variable. Furthermore, a thermo-mechanical characterization of the static effective properties is presented for each cell class by means of a FEM implementation of the Asymptotic Homogenization method. The results are presented as gridded data, made available on GitHub repository, dependent on the unit cell’s volume fraction (solid-to-void ratio), on the Poisson’s ratio (spanning in the thermodynamically admissible range for conventional materials 0 &lt; ν &lt; 0.5), and on the class of geometrical parameter of the cell. The effective parameters are normalized with respect to the solid bulk properties, thus becoming purely geometrical properties of the unit cell family, and act as scaling functions on the bulk properties. These results can be readily implemented in any optimization scheme for the optimization of the static performance of lattices, providing a useful tool for real-world engineering applications

Stability and oligomerization of recombinant GadX, a transcriptional activator of the Escherichia coli glutamate decarboxylase system

One of the most important strategies that enteric bacteria adopt for maintaining the cytoplasmic pH neutral under acid stress involves the glutamate decarboxylase (Gad) system. The system works by the concerted action of a cytoplasmic, pyridoxal 5'-phosphate-dependent glutamate decarboxylase and a transmembrane antiporter, which imports glutamate and exports gamma-aminobutyrate (GABA), the decarboxylation product, thereby providing local buffering of the extracellular environment. Herein, we provide a preliminary biochemical characterization of GadX, an activator of the Gad system belonging to the AraC/XylS family of bacterial transcriptional regulators. The GadX protein has been purified as a chimeric MalE-GadX with a yield of 15-20 mg/l of bacterial culture. The fusion protein is fairly stable, although a conformational change occurs upon storage, which reduces the binding affinity by a factor of 2, without affecting the binding pattern. Partial removal of the MalE moiety from the fusion protein triggers the formation of a species which is likely to be a heterodimer, or a higher oligomer, of the type GadX/MalE-GadX. This experimental evidence is in line with the well-known tendency of AraC/XylS-like proteins to dimerize via their N-terminal domain. (C) 2003 Elsevier Science B.V. All rights reserved