Scaling behaviour of braided active channels: a Taylor’s power law approach

none9At a channel (reach) scale, braided channels are fluvial, geomorphological, complex systems that are characterized by a shift of bars during flood events. In such events water flows are channeled in multiple and mobile channels across a gravel floodplain that remain in unmodified conditions. From a geometrical point of view, braided patterns of the active hydraulic channels are characterized by multicursal nature with structures that are spatially developed by either simple- and multi-scaling behavior. Since current studies do not take into account a general procedure concerning scale measurements, the latter behavior is still not well understood. The aim of our investigation is to analyze directly, through a general procedure, the scaling behavior of hydraulically active channels per transect and per reach analyzed. Our generalized stochastic approach is based on Taylor’s law, and the theory of exponential dispersion distributions. In particular, we make use of a power law, based on the variance and mean of the active channel fluctuations. In this way we demonstrate that the number of such fluctuations with respect to the unicursal behavior of the braided rivers, follows a jump-process of Poisson and compound Poisson–Gamma distributions. Furthermore, a correlation is also provided between the scaling fractal exponents obtained by Taylor’s law and the Hurst exponents.Samuele De Bartolo, Stefano Rizzello, Ennio Ferrari, Ferdinando Frega, Gaetano Napoli, Raffaele Vitolo, Michele Scaraggi, Carmine Fallico, Gerardo SeverinoDE BARTOLO, Samuele; Rizzello, Stefano; Ferrari, Ennio; Frega, Ferdinando; Napoli, Gaetano; Vitolo, Raffaele; Scaraggi, Michele; Fallico, Carmine; Severino, Gerard

Sex-based heterogeneity in non-small cell lung cancer (NSCLC) and response to immune checkpoint inhibitors (ICIs): a narrative review

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Asbestos exposure as an additional risk factor for small duct intrahepatic cholangiocarcinoma: a pilot study

: Intrahepatic cholangiocarcinoma (iCCA) is a rare malignancy, recently classified in small duct and large duct morphological subtypes. Growing evidence suggests asbestos as a putative risk factor for iCCA, albeit no correlation between asbestos and iCCA morphology has been investigated so far. The aim of the present study was to assess the relationship between asbestos exposure and iCCA morphological subtype. Forty patients with surgically removed iCCA were prospectively enrolled: asbestos exposure was assessed according to the Italian National Mesothelioma Register questionnaire. From the surgical iCCA specimens the main histopathological variables were collected, including the small duct (sd-iCCA, 32 patients) and large duct subtypes (ld-iCCA, 8 patients). Five sd-iCCA cases had a definite/probable occupational exposure to asbestos, while no cases of ld-iCCA were classified as being occupationally exposed (definite/probable). Other kind of asbestos exposure (i.e. possible occupational, familial, environmental) were recorded in 16 sd-iCCA and 3 ld-iCCA. Cases with unlikely exposure to asbestos were 11 sd-iCCA (35.5%) and 5 ld-iCCA (62.5%). In conclusion, these findings seem to indicate that sd-iCCA might be more frequently associated to asbestos exposure rather than ld-iCCA, suggesting that asbestos fibres might represent a parenchymal, rather than a ductal risk factor for iCCA. This pilot study must be confirmed by further case-control studies or large independent cohorts

Real-world impact of the introduction of chemo-immunotherapy in extended small cell lung cancer: a multicentric analysis

BackgroundRecent clinical trials demonstrated longer survival in extended small cell lung cancer (SCLC) patients treated with immunotherapy in addition to chemotherapy. However, the magnitude of benefit is modest and the impact in real-world setting has to be fully established.MethodsWe collected clinical data and radiological imaging of patients affected by extended or relapsing SCLC and consecutively treated according to clinical practice between 2016 and 2023. As primary end-point, we compared pre-defined outcome indicators before and after the introduction of chemo-immunotherapy (May 2020): 6-month and 12-month progression free survival (PFS) rate, 12-month and 18-month overall survival (OS). Among those who were treated after May 2020, patients who did not receive immunotherapy according to treating physician’s choice were included in the analysis to minimize clinical selection bias.ResultsThe analysis included 214 patients: 132 (61.7%) were treated in an Academic cancer center and 82 (38.3%) in two community hospitals; 104 were treated before May 2020. Median PFS of the overall study population was 4.8 months (95% confidence interval [95% CI]: 4.4-5.4), median OS was 7.1 months (95% CI: 6.3-7.7). Estimated PFS and OS were significantly longer in patients treated after May 2020 with hazard ratio (HR) for PFS and OS of 0.61 (95% CI: 0.46-0.81, p < 0.001) and 0.70 (95% CI: 0.52-0.93, p = 0.015), respectively. 6-month PFS rate increased from 27% to 40% (p = 0.04) while 12-months PFS raised from 1% to 11% (p = 0.003). 12-month and 18-month OS rate increased from 15% to 28% (p = 0.03) and from 2.1% to 12% (p = 0.009), respectively. After May 2020 the median number of hospitalization days per patient decreased significantly and the incidence of severe AEs was similar. Among patients treated with chemo-immunotherapy, the onset of immune-related AEs was associated with improved PFS and OS (HR 0.55, 95% CI: 0.35-0.89, p = 0.012 and HR 0.47, 95%CI 0.28-0.77, p = 0.002, respectively).ConclusionsThe real-world analysis shows a meaningful improvement of outcome indicators after the introduction of chemo-immunotherapy, with reduction of the duration of hospitalization, thus supporting the use of chemo-immunotherapy and the need for further biomarker research

Therapeutic perspectives for brain metastases in non-oncogene addicted non-small cell lung cancer (NSCLC): Towards a less dismal future?

Risk of brain metastases (BM) affects a remarkable number of non-small cell lung cancer (NSCLC) patients, impacting on their quality of life (QoL) and prognosis. While tyrosine-kinase inhibitors (TKIs) showed interesting intracranial control rates in oncogene-addicted NSCLC, BM still represent an unmet need for the counterpart without driver gene mutations. For these patients, new treatment options include anti-angiogenic drugs and immune-checkpoint inhibitors, possibly combined with standard chemotherapy, even though the benefit on BM has not been clearly defined. A multidisciplinary team including neurosurgeons, medical and radiation oncologists is needed in order to integrate systemic and loco-regional strategies at the right time point. Ad-hoc designed clinical trials are slowly emerging for previously treated patients with uncontrolled BM. The aim of this review is to offer a detailed and updated picture of possible approaches for non oncogene-addicted NSCLC patients having BM, in order to support clinicians in their daily practice

Lung Cancer (LC) in HIV Positive Patients: Pathogenic Features and Implications for Treatment

The human immunodeficiency virus (HIV) infection continues to be a social and public health problem. Thanks to more and more effective antiretroviral therapy (ART), nowadays HIV-positive patients live longer, thus increasing their probability to acquire other diseases, malignancies primarily. Senescence along with immune-system impairment, HIV-related habits and other oncogenic virus co-infections increase the cancer risk of people living with HIV (PLWH); in the next future non-AIDS-defining cancers will prevail, lung cancer (LC) in particular. Tumor in PLWH might own peculiar predictive and/or prognostic features, and antineoplastic agents’ activity might be subverted by drug-drug interactions (DDIs) due to concurrent ART. Moreover, PLWH immune properties and comorbidities might influence both the response and tolerability of oncologic treatments. The therapeutic algorithm of LC, rapidly and continuously changed in the last years, should be fitted in the context of a special patient population like PLWH. This is quite challenging, also because HIV-positive patients have been often excluded from participation to clinical trials, so that levels of evidence about systemic treatments are lower than evidence in HIV-uninfected individuals. With this review, we depicted the epidemiology, pathogenesis, clinical-pathological characteristics and implications for LC care in PLWH, offering a valid focus about this topic to clinicians

Squamous cell carcinomas of the lung and of the head and neck: New insights on molecular characterization

Squamous cell carcinomas of the lung and of the head and neck district share strong association with smoking habits and are characterized by smoke-related genetic alterations. Driver mutations have been identified in small percentage of lung squamous cell carcinoma. In parallel, squamous head and neck tumors are classified according to the HPV positivity, thus identifying two different clinical and molecular subgroups of disease. This review depicts different molecular portraits and potential clinical application in the field of targeted therapy, immunotherapy and chemotherapy personalization

Fare cose con la filosofia. Pratiche filosofiche nella consulenza individuale e nella formazione

Questo libro nasce dell’esigenza di esplorare, approfondire e ampliare lo studio interdisciplinare dell’agire umano nei nuovi spazio di senso e di pratica che stanno emergendo in molteplici contesti della vita e del lavoro contemporanei. La società attuale è in profonda trasformazione. Stiamo assistendo ad una pluralità di cambiamenti che investono in modo radicale il nostro rapporto alla conoscenza e al pensiero. La trasformazione della società moderna in società planetaria, la crescita del contenuto cognitivo dei processi di lavoro, l’emergere di forme nuove di democrazia cognitiva sono solo alcuni dei processi che stanno cambiando profondamente lo spazio di senso e di azione della nostra vita quotidiana. Viviamo in una situazione storica e sociale inedita: la modernità è stata il luogo di nascita dei diritti civili e umani, della democrazia, della denuncia dei privilegi, ma anche il luogo dove la tendenza egualitaria promuove la responsabilità individuale e lo spirito di iniziativa. In questo universo tendenzialmente egualitario e caratterizzato da spazi di libertà crescenti, i rapporti tra gli individui sono sempre più esposti ai rischi e alle opportunità di una libertà che è al tempo stesso vincolo ed opportunità. La liberazione prometeica delle risorse individuali spinge i tracciati biografici a svilupparsi in percorsi sempre più ricchi e per questo più intricati e complessi. Ne consegue l’incremento del fabbisogno di riflessività tanto nel rapporto degli individui a se stessi quanto nel rapporto di questi alle sfere dell’agire professionale e personale. Lo scenario che si presenta davanti a noi è promettente: nuove opportunità di crescita economica, di sviluppo sociale, professionale, di riduzione della disoccupazione e della povertà, di miglioramento della qualità di vita. Ma queste opportunità di crescita non portano a nessun futuro, se non vengono accolti criticamente anche quei nodi problematici di senso e di azione che la società contemporanea, con il suo enorme progresso, sta mettendo in cantiere. Nelle nostre pratiche quotidiane affiorano nuove domande, nuovi modi di esercitare la conoscenza e il sapere sull’uomo. La complessità delle situazioni e i modi nuovi in cui la conoscenza interviene a regolarne gli sviluppi richiedono forme nuove di riflessione e controllo. Nuovi aspetti dell’esperienza umana del tutto inediti e trasversali ai singoli rami del sapere umano chiedono di essere investigati. Si tratta di sfide che, allo stato attuale, trovano le scienze umane impreparate in quanto troppo occupate al dissodamento disciplinato dei propri campi. La conoscenza umana rischia così di essere abbandonata ad una deriva specialistica e settoriale incapace di far fronte agli enormi interrogativi sull’uomo e sull’esistenza che i mutamenti contemporanei suscitano in modo incessante. E’ necessario un nuovo apprendistato per una nuova e più complessa conoscenza sull’uomo e sui modi in cui la conoscenza e il pensiero mediano i rapporti dell’uomo a se stesso, agli altri e al proprio agire