Evaluation of Road Roughness and Road Deterioation

There are two road condition survey methods commonly used, the roughness-based equipment such as NAASRA and the distress and severity type road evaluation method as presented by ASTM D-6433. The objective of the study is to evaluate the relationship between road condition obtained from roughness type equipment and road distress. To achieve the objective, a condition survey using the two methods were performed on two road segments in the East Java Provincial road system. Data obtained from the field was evaluated to obtain International Roughness Index (from NAASRA) and Present Condition Index value (from field condition survey). The results show that the two methods provide a comparable result when the distress type is of un-even surface such as rutting and bumping. A slight different result is observed when the major distress occurred in the road is of crack-type such as fatigue and block cracking

Maintenance bevacizumab beyond first-line paclitaxel plus bevacizumab in patients with Her2-negative hormone receptor-positive metastatic breast cancer. Efficacy in combination with hormonal therapy

Background: Data on efficacy of bevacizumab (B) beyond first-line taxane -including regimen (BT) as first-line treatment are lacking. Although preclinical results that anti-angiogenic agents combined with hormonal therapy (HT) could be active, no clinical data exist about combination of maintenance Bevacizumab (mBev) with HT.Methods: Thirty-five patients who experienced a response after first-line BT, were given mBev at the dose of 15 mg/kg every 3 weeks. Among 30 pts with hormonal receptor-positive metastatic breast cancer (MBC), 20 (66.6%) received HT with mBev (mHTBev). Objective of the study was the outcome and safety of mBev and in two groups of patients receiving HT or not.Results: Complete response and partial response was achieved/maintained in 4 (11.4%) and 13 (37.1%) patients, respectively (overall response rate: 48.5%). Clinical benefit was obtained on 23 patients (65.7%). Median of mBev PFS and clinical benefit were 6.8 months (95% CI: 0.8-12.7) and 17.1 months (95% CI :12.2-21.9), respectively. Median PFS of patients who received mHTBev was longer than mBev without HT (13 months and 4.1 months, respectively, p = 0.05). The most common severe toxicities were proteinuria (11.4%) and hypertension (8.5%). No additional toxicity was observed with HTBev.Conclusion: Maintenance bevacizumab with or without anti-hormonal therapy in patients with hormone receptor positive breast cancer is tolerable and associated with long-term clinical outcome; these results encourage the strategy of prolonging bevacizumab until progression in combination with anti-hormonal agents

Hydrological control of soil thickness spatial variability on the initiation of rainfall-induced shallow landslides using a three-dimensional model

Thickness and stratigraphic settings of soils covering slopes potentially control susceptibility to initiation of rainfall-induced shallow landslides due to their local effect on slope hydrological response. Notwithstanding the relevance of the assessment of hazard to shallow landsliding at a distributed scale by approaches based on a coupled modelling of slope hydrological response and slope stability, the spatial variability of soil thickness and stratigraphic settings are factors poorly considered in the literature. Under these premises, this paper advances the well-known case study of rainfall-induced shallow landslides involving ash-fall pyroclastic soils covering the peri-Vesuvian mountains (Campania, southern Italy). In such a unique geomorphological setting, the soil covering is formed by alternating loose ash-fall pyroclastic deposits and paleosols, with high contrasts in hydraulic conductivity and total thickness decreasing as the slope angle increases, thus leading to the establishment of lateral flow and an increase of pore water pressure in localised sectors of the slope where soil horizon thickness is less. In particular, we investigate the effects, on hillslope hydrological regime and slope stability, of irregular bedrock topography, spatial variability of soil thickness and vertical hydraulic heterogeneity of soil horizons, by using a coupled three-dimensional hydrological and a probabilistic infinite slope stability model. The modelling is applied on a sample mountain catchment, located on Sarno Mountains (Campania, southern Italy), and calibrated using physics-based rainfall thresholds derived from the literature. The results obtained under five simulated constant rainfall intensities (2.5, 5, 10, 20 and 40 mm h−1) show an increase of soil pressure head and major failure probability corresponding to stratigraphic and morphological discontinuities, where a soil thickness reduction occurs. The outcomes obtained from modelling match the hypothesis of the formation of lateral throughflow due to the effect of intense rainfall, which leads to the increase of soil water pressure head and water content, up to values of near-saturation, in narrow zones of the slope, such as those of downslope reduction of total soil thickness and pinching out of soil horizons. The approach proposed can be conceived as a further advance in the comprehension of slope hydrological processes at a detailed scale and their effects on slope stability under given rainfall and antecedent soil hydrological conditions, therefore in predicting the most susceptible areas to initiation of rainfall-induced shallow landslides and the related I-D rainfall thresholds. Results obtained demonstrate the occurrence of a slope hydrological response depending on the spatial variability of soil thickness and leading to focus slope instability in specific slope sectors. The approach proposed is conceived to be potentially exportable to other slope environments for which a spatial modelling of soil thickness would be possible

Impact of sublingual immunotherapy on seasonal asthma and skin reactivity in children allergic to Parietaria pollen treated with inhaled fluticasone propionate

Immunotherapy is a recognized treatment for allergic respiratory diseases

Health-related quality of life and functional changes in DMD:A 12-month longitudinal cohort study

Family caregivers of people with amyotrophic lateral sclerosis (ALS) live stressful lives in which they spend most of their time caring for their loved ones and managing difficult situations, thereby reducing the time spent in taking care of themselves. This situation may last several years. Previous literature has widely highlighted that this situation reduces caregivers' quality of life and increases their psychological distress and risk of health problems, but there is a lack of studies that focus on psychological interventions for these situations. This qualitative study examined a pilot experience of two mutual support groups for family caregivers of people with ALS. The aim was to identify caregivers' needs, the prominent aspects of their experience, and to understand whether and how this intervention strategy might help them. Six partners (four men and two women) and six adult children (five women and one man) participated in the groups, which were conducted in northern Italy. After the support groups finished, participants underwent semi-structured interviews. The authors conducted a content analysis of the transcripts of the interviews and the 20 group sessions. The thematic areas identified were "caregiving," "being the son/daughter of a person with ALS," "being the partner of a person with ALS," "group experience" and "group evaluation." The caregiving experience was profoundly different depending on whether the caregiver was a son/daughter or a partner of a patient with ALS. Moreover, comparison with peers and mutual support helped participants to better cope with ALS and its consequences, to improve their care for their relatives and to overcome typical caregiver isolation. These results suggest the usefulness of involving communities in caregiver support in order to create new networks and activate personal and social resources for well-being

Dermoscopy and methyl aminolevulinate: A study for detection and evaluation of field cancerization

Actinic keratosis (AK) is a keratinocyte intraepidermal neoplasia UV light – induced that frequently appears in sun-exposed areas of the skin. Although historically AK was de fi ned as “ precancerous ” , actually it is considered as the earliest stage of squamous cell carcinoma (SCC) in situ. Since AKs can progress into invasive SCC, their treatment isrecommended. AKsrarely developasa singlelesion;usually multiplelesions commonly affect anen- tire area of chronically actinic damaged skin. This has led to the concept of “ fi eld cancerization ” , an area chroni- cally sun-exposed that surrounds peripherally visible lesions, in which are individualized subclinical alterations. One of the main principles endpoint in the management of AKs is the evaluation and the treatment of fi eld cancerization. In this view, in order to detect and quantify fi eld cancerization, we employed a method based on the topical application of methyl aminolevulinate (MAL) and the detection of the fl uorescence emitted by its metabolite Protoporphyrin IX (PpIX); then, considering the extension and the intensity of measured fl uores- cence, we create a score of fi eld cancerization. The results show that patients underwent to daylight PDT had a reduction of total score, from T0 to T2. Whereas in the group untreated we observed a stability of total score or a slightly worse. So, the method and the score used allows to evaluate with a good approximation the dimension of fi eld cancerization and show the modi fi cation of it after treatment

Prospective study on nanoparticle albumin-bound paclitaxel in advanced breast cancer. Clinical results and biological observations in taxane-pretreated patients

Background: There is a deep need to improve the care of metastatic breast cancer (MBC) patients, since even today it remains an incurable disease. Taxanes are considered the most effective cytotoxic drugs for the treatment of MBC, both in monotherapy and in combined schedules, but the need for synthetic solvents contributes to the severe toxicities and may have a negative impact on the efficacy. Nanoparticle albumin-bound paclitaxel (Nab-paclitaxel) is a colloidal suspension of paclitaxel and human serum albumin initially developed to avoid the toxicities associated with conventional taxanes. Patients and methods: The aim of this prospective, single-center open-label, noncomparative study was to evaluate the efficacy and safety of nab-paclitaxel in MBC patients pretreated with taxanes. The patients were treated with nab-paclitaxel as a single agent, 260 mg/m2 on day 1 of each 3-week cycle or 125 mg/m2 weekly. The primary endpoint was the overall response rate (ORR). Secondary objectives were duration of response, clinical benefit rate, progression-free survival (PFS), overall survival, and safety. Results: A total of 42 patients (median age 48 years, median Eastern Cooperative Oncology Group performance status 0, triple-negative MBC 19%, all pretreated with a taxane-based therapy, mainly in advanced disease) were enrolled in the study. The ORR was 23.8%, including one complete response (2.4%) and nine partial responses (21.4%); the disease control rate was 50%. The median duration of response was 7.2 months. After a median follow-up of 9 months, the median PFS was 4.6 months. ORR and PFS were similar irrespective of the previous chemotherapy lines, metastatic sites, and biomolecular expression. Nab-paclitaxel was well tolerated, and the most frequent treatment-related toxicities were mild to moderate (grades 1–2). Conclusion: This real-life study shows that nab-paclitaxel has a significant antitumor activity and a manageable safety profile in patients pretreated with taxanes and experiencing a treatment failure after at least one line of chemotherapy

Solitary Necrotic Nodule of the Liver: Different Pathological Findings Express a Different Histogenesis

Solitary necrotic nodule of the liver is a rare benign lesion the histogenesis of which is still debated. We here report the case of a patient who underwent laparoscopic cholecystectomy for gallstones and who was accidentally found to have a solitary necrotic nodule of 2 cm in the fifth segment of the liver. On the basis of the histological findings, the hypothesis that different pathogenetic mechanisms could be involved in the histogenesis of this lesion is discussed

MicroRNA deregulation in thyroid cancer

In cancer microRNAs are often dysregulated with their expression patterns being correlated with clinically relevant tumor characteristics. Recently, microRNAs were shown to be directly involved in cancer initiation and progression. Despite the large amount of data showing strong correlations between cancer phenotype and microRNAs aberrant expression, very little is known about the molecular mechanisms inducing such deregulation. Thyroid carcinomas comprise a heterogeneous group of neoplasms with distinctive clinical and pathological characteristics. Activating mutations in Ras genes are frequently found in poorly differentiated and in anaplastic thyroid carcinomas. We have recently shown that oncogenic activation of Ras is able to change the expression of several microRNAs in thyroid epithelial cells. One of the top aberrantly expressed ones is miR-21, a microRNA prevoiusly reported overexpressed in a wide variety of cancers and causally linked to cellular proliferation, survival and migration. By using an inducible Ras oncogene we demonstrated that constitutively active Ras induce overexpression of miR-21 at very early times after its activation, and that such overexpression is maintained at later times as well as in chronically Ras-transformed cells. Analysis of a panel of thyroid tumors with different hystotypes revealed that miR-21 is overexpressed mainly in anaplastic carcinomas, thus correlating with the most aggressive phenotype. Interestingly, this induction seems to be cell-type specific, since the inducible Ras oncogene is unable to increase miR-21 levels in cultured fibroblasts. Moreover, our data show that at least two different Ras downstream pathways are necessary to induce miR-21 expression. We then asked if the ability of Ras in inducing miR-21 overexpression is verified in vivo. To answer this question we analyzed the expression of this microRNA in a mouse model of Ras-induced lung tumorigenesis, showing that Ras constitutive activation is able to increase miR-21 levels in normal lung and that the Ras-initiated lung cancer progression is accompained by a further increase in miR-21 expression. Taken together, our data strongly suggest that the oncogenic activation of Ras could be responsible for the increased expression of miR-21 frequently observed in human cancers