Prognostic factors of survival in patients treated with nab-paclitaxel plus gemcitabine regimen for advanced or metastatic pancreatic cancer: A single institutional experience.

The objectives of this study were to evaluate the effectiveness of nab-paclitaxel plus gemcitabine (NAB-P/GEM) regimen in an unselected population of patients with advanced inoperable or metastatic pancreatic cancer (PC), and to identify the prognostic factors influencing overall survival (OS). EXPERIMENTAL DESIGN: Patients with age < 85 years, ECOG-performance status (PS) < 3, and adequate renal, hepatic and hematologic function were eligible. NAB-P (125 mg/m2) and GEM (1000 mg/m2) day 1,8,15 every 4 weeks were employed for 3-6 cycles or until highest response. RESULTS: Overall, 147 cycles (median 4, range 1-11 cycles) were administered on thirty-seven consecutive patients (median 66 years old, range 40-82) treated. The median overall progression-free survival and OS were 6.2 and 9.2 months, respectively. The G 3-4 dose-limiting toxicity were neutropenia (20.7%), severe anemia (17.2%), and cardiovascular toxicity (10.3%). PS, number of cycles, baseline CA 19-9 and LDH serum levels, were found to be significantly related to OS. The multivariate analysis showed that both number of cycles (HR = 9.14, 95% CI 1.84-45.50, p = 0.001) and PS (HR = 13.18, 95% CI 2.73-63.71, p = 0.001) were independently associated with OS. CONCLUSION: NAB-P/GEM regimen should be used in all patients with advanced or metastatic PC, with the exception of those with serious contraindications to chemotherapy, such as severe renal or hepatic impairment or major cardiovascular diseases

How national decarbonisation scenarios can affect building refurbishment strategies

Energy transition is radically changing national energy systems. Nevertheless, the dynamics of this transformation are not considered by end-users in the design of building systems. The present work aims at assessing how the renewable share increase, in both electricity and gas grids, can affect building energy performance. To do this, building energy performance indicators, taking into account growing renewable shares, have been proposed. Four national decarbonisation scenarios have been considered. In a case-study in Italy, conventional boilers, heat pumps, combined heat and power plants and hybrid systems have been analysed. Heat pumps turn out to be the best option if the renewable penetration in the power grid is higher than 40%. The substitute natural gas deployment can increase the competitiveness of cogeneration systems, but not enough to represent the best configuration. National decarbonisation scenarios significantly affect the primary energy and emissions savings of building refurbishment strategies. Conventional indicators, taking primary energy factors as fixed, lead to correct assessment for the reference year, but are unable to describe the actual building energy performance over the system lifetime. Depending on the scenario, the average specific primary energy consumption ranges in 17% and 55% lower than the one assessed with conventional analyses

Heading towards 100% of renewable energy sources fraction. A critical overview on smart energy systems planning and flexibility measures

The growing penetration of non-programmable energy sources will largely contribute to intensify the renewable capacity firming issues. Providing a higher systems flexibility, i.e. the ability to match the supply and the demand sides as much as possible, is the main challenge to cope with, by adopting new energy planning paradigms. In this framework, different combined strategies, aiming at efficiently integrating that large amount of variable RES (VRES), have to be implemented. In the recent years, the Smart Energy Systems (SES) concept has been introduced to overcome the single-sector approach, promoting a holistic and integrated vision. By that approach, it is possible to exploit synergies between different energy sectors so as to identify the best technical options to globally reduce the primary fossil energy consumption. Starting from a quantitative and qualitative analysis of the most recent international studies dealing with the SES approach, the aim of this paper is to critically review and analyse the role of the main potential flexibility measures applied in the energy planning sector. In detail, Power-to-X and Demand Side Management (DSM) application have been considered, highlighting strengths and weaknesses of such strategies to accomplish the ambitious target of 100% renewable. From this literature review, it emerges how a single strategy adoption is not enough to guarantee the required flexibility level for the whole energy system. Indeed, the best configuration can be attained by integrating different options matching all the external constraints

Adsorption gas Heat Pump fuelled with hydrogen enriched natural gas blends: The analytical simulation model development and validation

This study deals with the implementation of an analytical model to simulate the energy performance associated to a commercial Gas adsorption Heat Pump, when H2NG (Hydrogen Enriched Natural Gas) blends are used as fuel. In detail, a water source heat pump manufactured by Robur (GAHP-WS) has been used as a reference device for building the simulation model within the MATLAB-Simulink environment. Thereafter, the simulation results have been validated by the experimental campaign, testing on field and in actual operating conditions the heat pump. Specifically, the model has been developed by implementing the WaterAmmonia mass and energy balances for each component. It is able to evaluate fuel consumption, efficiency in terms of GUE, required thermal power from the cold heat sink as well as the water outlet temperature at the evaporator, once the heating load is used as the main input. The experimental campaign for the model calibration and validation has been carried out over the winter season. Additionally, the heat pump performance has been detected when it operates to supply hot water at 60 °C and 55 °C, and it is fuelled with growing hydrogen fractions, starting from 0% vol., 5% vol. up to 10% vol. In the end, the standard errors as well as the relative ones affecting the main output parameters have computed for the validation process. From the outcomes it emerges that the average relative standard error related to all load conditions is lower than 2.5% for natural gas operation. On the contrary, it ranges between 2.5% and 4% when H2NG at 5% and 10% by volume have been burnt

Active shape correction of a thin glass/plastic X-ray mirror

Optics for future X-ray telescopes will be characterized by very large aperture and focal length, and will be made of lightweight materials like glass or plastic in order to keep the total mass within acceptable limits. Optics based on thin slumped glass foils are currently in use in the NuSTAR telescope and are being developed at various institutes like INAF/OAB, aiming at improving the angular resolution to a few arcsec HEW. Another possibility would be the use of thin plastic foils, being developed at SAO and the Palermo University. Even if relevant progresses in the achieved angular resolution were recently made, a viable possibility to further improve the mirror figure would be the application of piezoelectric actuators onto the non-optical side of the mirrors. In fact, thin mirrors are prone to deform, so they require a careful integration to avoid deformations and even correct forming errors. This however offers the possibility to actively correct the residual deformation. Even if other groups are already at work on this idea, we are pursuing the concept of active integration of thin glass or plastic foils with piezoelectric patches, fed by voltages driven by the feedback provided by X-rays, in intra-focal setup at the XACT facility at INAF/OAPA. In this work, we show the preliminary simulations and the first steps taken in this project

Factors influencing choice of chemotherapy in metastatic colorectal cancer (mCRC)

Management of metastatic colorectal cancer requires a multimodal approach and must be performed by an experienced, multidisciplinary expert team. The optimal choice of the individual treatment modality, according to disease localization and extent, tumor biology, and patient clinical characteristics, will be one that can maintain quality of life and long-term survival, and even cure selected patients. This review is an overview of the different therapeutic approaches available in metastatic colorectal cancer, for the purpose of defining personalized therapeutic algorithms according to tumor biology and patient clinical features

Determination of Region of Influence Obtained by Aircraft Vertical Profiles Using the Density of Trajectories from the HYSPLIT Model

Aircraft atmospheric profiling is a valuable technique for determining greenhouse gas fluxes at regional scales (104–106 km2). Here, we describe a new, simple method for estimating the surface influence of air samples that uses backward trajectories based on the Lagrangian model Hybrid Single-Particle Lagrangian Integrated Trajectory Model (HYSPLIT). We determined “regions of influence” on a quarterly basis between 2010 and 2018 for four aircraft vertical profile sites: SAN and ALF in the eastern Amazon, and RBA and TAB or TEF in the western Amazon. We evaluated regions of influence in terms of their relative sensitivity to areas inside and outside the Amazon and their total area inside the Amazon. Regions of influence varied by quarter and less so by year. In the first and fourth quarters, the contribution of the region of influence inside the Amazon was 83–93% for all sites, while in the second and third quarters, it was 57–75%. The interquarter differences are more evident in the eastern than in the western Amazon. Our analysis indicates that atmospheric profiles from the western sites are sensitive to 42–52.2% of the Amazon. In contrast, eastern Amazon sites are sensitive to only 10.9–25.3%. These results may help to spatially resolve the response of greenhouse gas emissions to climate variability over Amazon

Intermittent docetaxel chemotherapy as first-line treatment for metastatic castration-resistant prostate cancer patients

Aims: The intermittent administration of chemotherapy is a means of preserving patients' quality of life (QL). The aim of this study was to verify whether the intermittent administration of docetaxel (DOC) improves the patients' QL. Patients &amp; methods: All patients received DOC 70 mg/m every 3 weeks for eight cycles. The patients were randomized to receive DOC continuously or with a fixed 3-month interval after the first four DOC courses. Results: The study involved 148 patients. There was no difference in QL between the groups receiving intermittent or continuous treatment. Intermittence had no detrimental effects on disease control. Conclusion: Although feasible and not detrimental, our results showed that true intermittent chemotherapy in metastatic castration-resistant prostate cancer patients failed to improve the patients' QL

Violent behavior of patients living in psychiatric residential facilities: A comparison of male patients with different violence histories

People with severe mental disorders and a history of violence are often seen as a difficult-to-manage segment of the population. In addition, this group is usually characterized by a high risk of crime recidivism, and poor compliance with community and aftercare programs. To investigate a sample of male patients living in Residential Facilities (RFs) with a history of violent behavior against people and to compare their characteristics with those of never-violent residents; to analyze the associations between aggressive behaviors in the last two years and a history of previous violence; and, to assess the predictors of aggressive behaviors. This study is part of a prospective observational cohort study which involved 23 RFs in Northern Italy. A comprehensive set of sociodemographic, clinical, and treatment-related information was gathered, and standardized assessments were administered to each participant. Also a detailed assessment of aggressive behaviors in the past two years was carried out. The study involved 268 males: 81 violent and 187 never-violent. Compared to never-violent patients, violent patients were younger, with a higher proportion of personality disorders, and have displayed an increased number of aggressive behaviors in the last two years. The presence of a history of violent behavior in the past significantly increases the probability of committing aggressive acts in the future