Combining an SSRI with an anticonvulsant in depressed patients with dysphoric mood: an open study

BACKGROUND: Several patients with unipolar depression present with prominent dysphoric mood. We aimed at examining the effectiveness of the combination of an SSRI with an anticonvulsant in such patients. METHODS: Thirty-five newly admitted outpatients with substantial anger, irritability, aggressiveness or hostility who were diagnosed a DSM-IV unipolar depressive disorder were rated on the Hamilton Depression Rating Scale (HDRS), the Clinical Global Improvement (CGI) scale, and a scale for the rapid dimensional assessment (SVARAD), were prescribed an SSRI and an anticonvulsant (usually valproate), and were followed up for 12 weeks. Repeated measures analysis of variance was used to test for within-subject changes in scale scores over time. RESULTS: Thirty-two and 23 patients attended the follow-up visits 4 and 12 weeks later, respectively. Significant decreases (p < .001) were observed in HDRS total score, HDRS and SVARAD anxiety factors, HDRS and SVARAD core depression factors, and SVARAD anger/irritability factor. Adjusting for age or gender did not change the results. Most patients (82%) were rated as improved or much improved on the CGI. CONCLUSION: Although our study has several limitations, we observed a remarkable improvement in most unipolar depressed outpatients with dysphoric mood treated with an SSRI and an anticonvulsant. The effectiveness of anticonvulsants might be linked to their action on symptoms of aggression and behavioural activation

A 1 m3^3 Gas Time Projection Chamber with Optical Readout for Directional Dark Matter Searches: the CYGNO Experiment

The aim of the CYGNO project is the construction and operation of a 1~m$^3$ gas TPC for directional dark matter searches and coherent neutrino scattering measurements, as a prototype toward the 100-1000~m$^3$ (0.15-1.5 tons) CYGNUS network of underground experiments. In such a TPC, electrons produced by dark-matter- or neutrino-induced nuclear recoils will drift toward and will be multiplied by a three-layer GEM structure, and the light produced in the avalanche processes will be readout by a sCMOS camera, providing a 2D image of the event with a resolution of a few hundred micrometers. Photomultipliers will also provide a simultaneous fast readout of the time profile of the light production, giving information about the third coordinate and hence allowing a 3D reconstruction of the event, from which the direction of the nuclear recoil and consequently the direction of the incoming particle can be inferred. Such a detailed reconstruction of the event topology will also allow a pure and efficient signal to background discrimination. These two features are the key to reach and overcome the solar neutrino background that will ultimately limit non-directional dark matter searches.Comment: 5 page, 7 figures, contribution to the Conference Records of 2018 IEEE NSS/MI

Long-term outcome of re-irradiation for recurrent or second primary head and neck cancer: A multi-institutional study of AIRO-Head and Neck working group

Background To report the long-term outcome of patients undergoing re-irradiation (re-RT) for a recurrent or second primary head and neck cancer (RSPHNCs) in seven Italian tertiary centers, while testing the Multi-Institution Reirradation (MIRI) recursive partitioning analysis (RPA) recently published. Methods We retrospectively analyzed 159 patients. Prognostic factors for overall survival (OS) selected by a random forest model were included in a multivariable Cox analysis. To externally validate MIRI RPA, we estimated the Kaplan-Meier group-stratified OS curves for the whole population. Results Five-year OS was 43.5% (median follow-up: 49.9 months). Nasopharyngeal site, no organ dysfunction, and re-RT volume <36 cm(3) were independent factors for better OS. By applying the MIRI RPA to our cohort, a Harrell C-Index of 0.526 was found indicating poor discriminative ability. Conclusion Our data reinforce the survival benefit of Re-RT for selected patients with RSPHNC. MIRI RPA was not validated in our population

First evidence of luminescence in a He/CF4_4 gas mixture induced by non-ionizing electrons

Optical readout of Gas Electron Multipliers (GEM) provides very interesting performances and has been proposed for different applications in particle physics. In particular, thanks to its good efficiency in the keV energy range, it is being developed for low-energy and rare event studies, such as Dark Matter search. So far, the optical approach exploits the light produced during the avalanche processes in GEM channels. Further luminescence in the gas can be induced by electrons accelerated by a suitable electric field. The CYGNO collaboration studied this process with a combined use of a triple-GEM structure and a grid in an He/CF$_4$ (60/40) gas mixture at atmospheric pressure. Results reported in this paper allow to conclude that with an electric field of about 11~kV/cm a photon production mean free path of about 1.0~cm was found

Directional dark matter searches with the CYGNO project

The goal of the CYGNO project is to deploy at Laboratori Nazionali del Gran Sasso (LNGS) an high resolution Time Projection Chamber (TPC) with Gas Electron Multipliers (GEMs) amplification and optical 3D readout of an Helium/Fluorine based gas mixture for directional Dark Matter (DM) searches at low 1-10 GeV WIMP masses. The determination of the incoming direction of WIMP particles can in fact offer not only additional handles for discrimination of the annoying backgrounds, but especially an unique key for a positive, unambiguous identification of a DM signal

Head and neck radiotherapy amid the COVID‑19 pandemic: practice recommendations of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Abstract Management of patients with head and neck cancers (HNCs) is challenging for the Radiation Oncologist, especially in the COVID-19 era. The Italian Society of Radiotherapy and Clinical Oncology (AIRO) identified the need of practice recommendations on logistic issues, treatment delivery and healthcare personnel’s protection in a time of limited resources. A panel of 15 national experts on HNCs completed a modified Delphi process. A five-point Likert scale was used; the chosen cut-offs for strong agreement and agreement were 75% and 66%, respectively. Items were organized into two sections: (1) general recommendations (10 items) and (2) special recommendations (45 items), detailing a set of procedures to be applied to all specific phases of the Radiation Oncology workflow. The distribution of facilities across the country was as follows: 47% Northern, 33% Central and 20% Southern regions. There was agreement or strong agreement across the majority (93%) of proposed items including treatment strategies, use of personal protection devices, set-up modifications and follow-up re-scheduling. Guaranteeing treatment delivery for HNC patients is well-recognized in Radiation Oncology. Our recommendations provide a flexible tool for management both in the pandemic and post-pandemic phase of the COVID-19 outbreak

CYGNO: a gaseous TPC with optical readout for dark matter directional search

The CYGNO project has the goal to use a gaseous TPC with optical readout to detect dark matter and solar neutrinos with low energy threshold and directionality. The CYGNO demonstrator will consist of 1 m 3 volume filled with He:CF 4 gas mixture at atmospheric pressure. Optical readout with high granularity CMOS sensors, combined with fast light detectors, will provide a detailed reconstruction of the event topology. This will allow to discriminate the nuclear recoil signal from the background, mainly represented by low energy electron recoils induced by radioactivity. Thanks to the high reconstruction efficiency, CYGNO will be sensitive to low mass dark matter, and will have the potential to overcome the neutrino floor, that ultimately limits non-directional dark matter searches

Performance of an Optically Read-Out Time Projection Chamber with ultra-relativistic electrons

The Time Projection Chamber (TPC) is an ideal candidate to finely study the charged particle ionization in a gaseous medium. Large volumes TPCs can be readout with a suitable number of channels offering a complete 3D reconstruction of an ultra-relativistic charged particle track, that is the sequence of its energy releases in the TPC gas volume. Moreover, He-based TPCs are very promising to study keV energy particles as nuclear recoils, opening the possibility for directional searches of Dark Matter (DM) and the study of Solar Neutrinos (SN). In this paper we report the analysis of the data acquired with a small TPC prototype (named LEMOn) built by the CYGNO collaboration that was exposed to a beam of 450 MeV electrons at the Beam Test Facility of National Laboratories of Frascati. LEMOn is operated with a He-CF4 mixture at atmospheric pressure and is based on a Gas Electron Multipliers amplification stage that produces visible light collected by a sub-millimeter position resolution scientific CMOS camera. This type of readout - in conjunction with a fast light detection - allows a 3D reconstruction of the electrons tracks. The electrons are leaving a trail of segments of ionizations corresponding to a few keV energy release each. Their study leads to predict a keV energy threshold and 1-10 mm longitudinal and 0.1-0.3 mm transverse position resolution for nuclear recoils, very promising for the application of optically readout TPC to DM searches and SN measurements