Proposal of early CT morphological criteria for response of liver metastases to systemic treatments in gastroenteropancreatic neuroendocrine tumors:Alternatives to RECIST

RECIST 1.1 criteria are commonly used with computed tomography (CT) to evaluate the efficacy of systemic treatments in patients with neuroendocrine tumors (NETs) and liver metastases (LMs), but their relevance is questioned in this setting. We aimed to explore alternative criteria using different numbers of measured LMs and thresholds of size and density variation. We retrospectively studied patients with advanced pancreatic or small intestine NETs with LMs, treated with systemic treatment in the first-and/or second-line, without early progression, in 14 European expert centers. We compared time to treatment failure (TTF) between responders and non-responders according to various criteria defined by 0%, 10%, 20% or 30% decrease in the sum of LM size, and/or by 10%, 15% or 20% decrease in LM density, measured on two, three or five LMs, on baseline (≤1 month before treatment initiation) and first revaluation (≤6 months) contrast-enhanced CT scans. Multivariable Cox proportional hazard models were performed to adjust the association between response criteria and TTF on prognostic factors. We included 129 systemic treatments (long-acting somatostatin analogs 41.9%, chemotherapy 26.4%, targeted therapies 31.8%), administered as first-line (53.5%) or second-line therapies (46.5%) in 91 patients. A decrease ≥10% in the size of three LMs was the response criterion that best predicted prolonged TTF, with significance at multivariable analysis (HR 1.90; 95% CI: 1.06–3.40; p =.03). Conversely, response defined by RECIST 1.1 did not predict prolonged TTF (p =.91), and neither did criteria based on changes in LM density. A ≥10% decrease in size of three LMs could be a more clinically relevant criterion than the current 30% threshold utilized by RECIST 1.1 for the evaluation of treatment efficacy in patients with advanced NETs. Its implementation in clinical trials is mandatory for prospective validation. Criteria based on changes in LM density were not predictive of treatment efficacy. Clinical Trial Registration: Registered at CNIL-CERB, Assistance publique hopitaux de Paris as “E-NETNET-L-E-CT” July 2018. No number was assigned. Approved by the Medical Ethics Review Board of University Medical Center Groningen.</p

A parallel implementation for optimal lambda-calculus reduction

In this paper we present a parallel implementation of Lévy's optimal reduction for the λ-calculus [11]. In a similar approach to Lamping's one in [10], we base our work on a graph reduction technique known as directed virtual reduction [3] which is actually a restriction of Danos-Regnier virtual reduction [4]. The parallel implementation relies on a strategy for directed virtual reduction, namely half combustion, which we introduce in this paper. We embed in the implementation both a message aggregation technique, allowing a reduction of the communication overhead, and a fair policy for distributing dynamically originated load among processors. The aggregation technique is mandatory as the granularity of the computation is fine. Through this technique we obtain a linear speedup close to 80% of the ideal one on a shared memory multiprocessor. This result points out the viability of parallel implementations for optimal reduction

Scheduling vs communication in PELCR

PELCR is an environment for, lambda-terms reduction on parallel/distributed computing systems. The computation performed in this environment is a distributed graph rewriting and a major optimization to achieve efficient execution consists of a message aggregation technique exhibiting the potential for strong reduction of the communication overhead. In this paper we discuss the interaction between the effectiveness of aggregation and the schedule sequence of rewriting operations. Then we present a Priority Based (BP) scheduling algorithm well suited for the specific aggregation technique. Results on a classical benchmark A-term demonstrate that PB allows PELCR to achieve up to 88% of the ideal speedup while executing on a shared memory parallel architecture

Supporting function calls within PELCR

In [M. Pedicini and F. Quaglia. A parallel implementation for optimal lambda-calculus reduction PPDP '00: Proceedings of the 2nd ACM SIGPLAN international conference on Principles and practice of declarative programming, pages 3-14, ACM, 2000, M. Pedicini and F. Quaglia. PELCR: Parallel environment for optimal lambda-calculus reduction. CoRR, cs.LO/0407055, accepted for publication on TOCL, ACM, 2005], PELCR has been introduced as an implementation derived from the Geometry of Interaction in order to perform virtual reduction on parallel/distributed computing systems. In this paper we provide an extension of PELCR with computational effects based on directed virtual reduction [V. Danos, M. Pedicini, and L. Regnier. Directed virtual reductions. In M. Bezem D. van Dalen, editor, LNCS 1258, pages 76-88. EACSL, Springer Verlag, 1997], namely a restriction of virtual reduction [V. Danos and L. Regnier. Local and asynchronous beta-reduction (an analysis of Girard's EX-formula). LICS, pages 296-306. IEEE Computer Society Press, 1993], which is a particular way to compute the Geometry of Interaction [J.-Y. Girard. Geometry of interaction 1: Interpretation of system F. In R. Ferro, et al. editors Logic Colloquium '88, pages 221-260. North-Holland, 1989] in analogy with Lamping's optimal reduction [J. Lamping. An algorithm for optimal lambda calculus reduction. In Proc. of 17th Annual ACM Symposium on Principles of Programming Languages. ACM, San Francisco, California, pages 16-30, 1990]. Moreover, the proposed solution preserves scalability of the parallelism arising from local and asynchronous reduction as studied in [M. Pedicini and F. Quaglia. PELCR: Parallel environment for optimal lambda-calculus reduction. CoRR, cs.LO/0407055, accepted for publication on TOCL, ACM, 2005]. © 2006 Elsevier B.V. All rights reserved

Dell'assenza e della dichiarazione di morte presunta

Il contributo concerne il commento degli articoli 48-73 cod. civ., riferiti alla scomparsa della persona, assenza, dichiarazione di morte presunta e alle ragioni eventuali che competono alla persona di cui si ignora l'esistenza o di cui è stata dichiarata la morte presunta: si analizzano i presupposti e gli effetti (personali e patrimoniali) delle varie situazioni di scomparsa della persona fisica (in particolare l'immissione nel possesso temporaneo o definitivo, le conseguenze sul matrimonio, presunzione di concepimento, il ritorno dello scomparso), i mezzi di tutela, i rispettivi procedimenti e i rapporti tra i vari istituti suddetti

Evaluation of the Performance of ACR TI-RADS Also Considering Those Nodules with No Indication of FNAC: A Single-Center Experience

Background: Several US risk stratification score systems (RSSs) have been developed to standardize a thyroid nodule risk of malignancy. It is still a matter of debate which RSS is the most reliable. The purpose of this study is to evaluate: (1) the concordance between the American College of Radiology TI-RADS (ACR TI-RADS) and fine needle aspiration cytology (FNAC), (2) the cancer rate in the ACR TI-RADS categories, (3) the characteristics of nodules evaluated by FNAC even if not formally indicated according to ACR TI-RADS (‘not indicated FNACs”). Methods: From January 2021 to September 2022, patients attending the Endocrinology Unit of the CTO Hospital of Rome for evaluation of thyroid nodules were included. Results: 830 nodules had negative cytology, belonging to TIR2 and TIR1C. One hundred and thirteen nodules were determined to be suspicious for or consistent with malignancy belonging to TIR3B/TIR4/TIR5. Of this last group, 94% were classified as TR4/TR5 nodules. In total, 87/113 underwent surgery. Among these, 73 had histologically proven cancer, 14 turned out to be benign. “Not indicated FNACs” was 623. Among these, 42 cancers were present. Conclusions: This study confirmed the diagnostic power of ACR TI-RADS. In addition, these data suggest revising the ACR TI-RADS indication to FNAC, especially for TR4