The Role of Constraints in a Segregation Model: The Symmetric Case

In this paper we study the effects of constraints on the dynamics of an adaptive segregation model introduced by Bischi and Merlone (2011). The model is described by a two dimensional piecewise smooth dynamical system in discrete time. It models the dynamics of entry and exit of two populations into a system, whose members have a limited tolerance about the presence of individuals of the other group. The constraints are given by the upper limits for the number of individuals of a population that are allowed to enter the system. They represent possible exogenous controls imposed by an authority in order to regulate the system. Using analytical, geometric and numerical methods, we investigate the border collision bifurcations generated by these constraints assuming that the two groups have similar characteristics and have the same level of tolerance toward the members of the other group. We also discuss the policy implications of the constraints to avoid segregation

Oxidative Molecular Mechanisms Underlying Liver Diseases: From Systems Biology to the Personalized Medicine

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Irrational beliefs and their role in specific and non-specific eating disorder symptomatology and cognitive reappraisal in eating disorders

Background: Research on which specific maladaptive cognitions characterize eating disorders (ED) is lacking. This study explores irrational beliefs (IBs) in ED patients and controls and the association between IBs and ED-specific and non-specific ED symptomatology and cognitive reappraisal. Methods: 79 ED outpatients with anorexia nervosa, bulimia nervosa, or other specified feeding or eating disorders and 95 controls completed the Attitudes and Beliefs Scale-2 (ABS-2) for IBs. ED outpatients also completed the Eating Disorder Inventory-3 (EDI-3) for ED-specific (EDI-3-ED Risk) and non-specific (EDI-3-General Psychological Maladjustment) symptomatology; General Health Questionnaire (GHQ) for general psychopathology; Emotion Regulation Questionnaire (ERQ) for cognitive reappraisal. Results: Multivariate analysis of variance with post hoc comparisons showed that ED outpatients exhibit greater ABS-2-Awfulizing, ABS-2-Negative Global Evaluations, and ABS-2-Low Frustration Tolerance than controls. No differences emerged between ED diagnoses. According to stepwise linear regression analyses, body mass index (BMI) and ABS-2-Awfulizing predicted greater EDI-3-ED Risk, while ABS-2-Negative Global Evaluations and GHQ predicted greater EDI-3-General Psychological Maladjustment and lower ERQ-Cognitive Reappraisal. Con-clusion: Awfulizing and negative global evaluation contribute to better explaining ED-specific and non-specific ED symptoms and cognitive reappraisal. Therefore, including them, together with BMI and general psychopathology, when assessing ED patients and planning cognitive–behavioral treatment is warranted

INCREASE OF REPORTS OF SUSPECTED ADVERSE DRUG REACTIONS IN ONCOLOGY

Objective: The information of safety of antineoplastic agents derives solely from clinical studies that have a number of limitations, such as the number of patients enrolled, selected case studies, follow-up of short duration; therefore, it is not possible to identify the complete profile of safety and possible side effects of the drugs under study. ADRs monitoring and reporting programmes aim to identifying and quantifying the risks associated with the use of drugs provided in a hospital setting. The main objectives of this study were to evaluate the ADRs that occurred during hospitalization for chemotherapy in 7 cancer centers, and to facilitate the development of a monitoring system of pharmacovigilance. Methods: An observational study was conducted in 7 cancer centers in the Emilia Romagna region over a period of 2 years, from January 2012 to January 2014. This study was based on an analysis of ADRs reported. Several parameters were utilised in the data evaluation, including drug and reaction characteristics. Results: From January 2012 to January 2014 No. 884 ADRs were included in National Network of pharmacovigilance. The highest ADR rate (57.4%) was found in the adult females with a mean age of 62. The oncology drug most frequently reported were taxanes and platinum derivates. Conclusion: The results obtained will contribute to the development of strategies for the pharmacovigilance service in 7 cancer centers, which will improve the quality of ADR reporting and ensure safer oncology drug use

Prognostic role of serum concentrations of high-sensitivity C-reactive protein in patients with metastatic colon rectal cancer: Results from the ITACa trial

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Electrophoretic deposition of bilayer composite films based on CoFe2O4 and Nb-doped PZT

The magnetoelectric (ME) composites with piezoelectric and magnetostrictive material are of interest in the smart manufacturing and mechatronics fields as actuators/transducers, sensors, antennas, filters, non-volatile memories, etc. Spinel cobalt ferrite (CFO), a highly magnetostrictive material and niobium-doped lead zirconate titanate (PZTN), a piezoelectric perovskite phase are chosen as constituent phases for ME composite. The production process is designed in order to avoid the chemical reaction between the piezoelectric and magnetostrictive materials, to prevent the formation of percolation chains of the magnetostrictive phase, and to maximize the mechanical coupling at the interface between the two phases. In this view, the electrophoretic deposition (EPD) is a low cost and flexible technique to shape nanoparticles into multilayered heterostructures. The combination of different materials by EPD, showing promising ME coupling, can be regarded as a useful, preliminary approach in the search of novel ME materials for many applications, potentially with great industrial and technological benefits. In this work, composite bilayer CFO/PZTN thick films were deposited on platinum coated alumina by EPD from ethanol-based colloidal suspensions. Good adhesion and compaction of the green film were achieved by optimization of deposition voltage and time, and high density of the film and minimized interphase reactions occurred after sintering. The chemical activity between the two layers was controlled through the batches composition and it could lead to the synthesis of complex engineered structures. The deposited volume, the mixing of dielectric and magnetic phases and the density and ordering of the films have been verified by electron scanning microscopy after heat treatment. The ferroelectric, piezoelectric and magnetic properties were tested on the sintered films

The perceived ability of gastroenterologists, hepatologists and surgeons can bias medical decision making

Medical errors are a troubling issue and physicians should be careful to scrutinize their own decisions, remaining open to the possibility that they may be wrong. Even so, doctors may still be overconfident. A survey was here conducted to test how medical experience and self-confidence can affect physicians working in the specific clinical area. Potential participants were contacted through personalized emails and invited to contribute to the survey. The \u201crisk-intelligence\u201d test consists of 50 statements about general knowledge in which participants were asked to indicate how likely they thought that each statement was true or false. The risk-intelligence quotient (RQ), a measure of self-confidence, varies between 0 and 100. The higher the RQ score, the better the confidence in personal knowledge. To allow for a representation of 1000 physicians, the sample size was calculated as 278 respondents. A total of 1334 individual emails were sent to reach 278 respondents. A control group of 198 medical students were also invited, of them, 54 responded to the survey. The mean RQ (SD)of physicians was 61.1 (11.4) and that of students was 52.6 (9.9). Assuming age as indicator of knowledge, it was observed that physicians 6434 years had a mean RQ of 59.1 (10.1); those of 35\u201342 years had 61.0 (11.0); in those of 43\u201351 years increased to 62.9 (12.2); reached a plateau of 63.0 (11.5) between 52\u201359 years and decreased to 59.6 (12.1) in respondents 6560 years (r2:0.992). Doctors overestimate smaller probabilities and under-estimate higher probabilities. Specialists in gastroenterology and hepato-biliary diseases suffer from some degree of self-confidence bias, potentially leading to medical errors. Approaches aimed at ameliorating the self-judgment should be promoted more widely in medical education

Defining and predicting textbook outcomes for perihilar cholangiocarcinoma: analysis of factors improving achievement of desired postoperative outcomes

BACKGROUND: Definition of textbook outcome (TO), defined as a single indicator combining the most advantageous short-term outcomes, is still lacking for perihilar cholangiocarcinoma (PHC). The primary endpoint of the present study is to analyze the rate of achievement of a disease-specific TO for PHC within a high volume tertiary referral centre. Secondary endpoints are to identify predictive factors of TO-achievement and to analyze the impact of achieving TO on long-term results. METHODS: Between 2010 and 2022, a total of 237 patients undergoing combined liver and biliary resection for PHC at tertiary referral centre were included. Disease-specific TO were defined as: no 90-day mortality, no postoperative complications, no readmission, no intraoperative transfusions and resection margins. A logistic regression model was developed to identify predictors associated with TO-achievement. Kaplan-Meier curves were designed to determine TO's impact on survival. RESULTS: TO was achieved in 60 (25.3%) patients. At multivariate logistic regression, preoperative biliary drainage [odds ratio (OR) 2.90 (1.13-3.40), P =0.026], high prognostic nutritional index [OR 7.11 (6.71-9.43), P =0.007[ and minimally invasive approach [OR 3.57 (2.31-3.62), P =0.013] were identified as independent predictors of TO. High ASA score [OR 0.38 (0.17-0.82), P =0.013] decreased the odds of TO. A significant improvement in both overall survival and disease-free survival was associated to TO fulfilment. CONCLUSION: Since the achievement of TO correlates with better disease-free and overall survival, every effort should be made to ameliorate modifiable aspects prior to surery: management within referral centres with dedicated experience in biliary tract cancer and preoperative optimization protocol may positively contribute to improve postoperative outcomes, increasing the chance to obtain TO. Moreover, the implementation of advanced minimally invasive programs plays as well