Safety of Rapid Daratumumab Infusion: A Retrospective, Multicenter, Real-Life Analysis on 134 Patients With Multiple Myeloma

Background: The anti-CD38 monoclonal antibody daratumumab is the backbone of most anti-multiple myeloma (MM) regimens. To mitigate the risk of infusion-related reactions (IRRs), intravenous daratumumab administration requires 7 hours for the first infusion and 3.5-4 hours thereafter, thus making daratumumab-containing regimens burdensome for patients and health care resources. Preliminary data suggest that a rapid (90-minute) infusion of daratumumab is safe and does not increase IRRs. The rapid schedule was adopted by our centers since 2019. Methods: We conducted an observational multi-center, real-life study to assess the safety of rapid daratumumab infusion protocol from the third administration in relapsed MM patients receiving daratumumab alone or in combination with lenalidomide-dexamethasone or bortezomib-dexamethasone. The primary endpoint was the safety of the rapid infusion protocol, particularly in terms of IRRs. Results: A total of 134 MM patients were enrolled. IRRs occurred in 7 (5%) patients and were mostly mild (6/7 of grade 1-2), with only 1 patient experiencing a grade 3 IRR. Due to the IRRs, 5 (3.7%) patients discontinued the rapid infusions and resumed daratumumab at the standard infusion rate, while 1 patient permanently discontinued daratumumab. In 4/7 patients (57%), IRRs occurred while resuming rapid daratumumab infusions after a temporary interruption (2-4 months). No other adverse event was considered related to the rapid infusion protocol. Conclusions: Our findings confirmed the safety of rapid daratumumab infusions starting from the third administration. In case of prolonged daratumumab interruption, it is advisable to resume infusions at the standard rate (3.5 hours) before switching to the rapid infusion

Geological and Hydrogeological Characterization of Springs in a DSGSD Context (Rodoretto Valley – NW Italian Alps)

As continuous groundwater monitoring in the upper sector of Rodoretto Valley (Germanasca Valley, Italian Western Alps) is hampered by logistical problem of data collection during winter and spring months, the only tools currently available to derive hydrogeological information are non-continuous and non-long-term dataset of spring discharge (Q), temperature (T) and electrical conductivity (EC). In order to quantity aquifer groundwater reserve, available Q dataset of a small mountain spring (Spring 1 CB) was investigated by applying the analytical solutions developed by Boussinesq (J Math Pure Appl 10:5–78, 1904) and Maillet (Essais dı’hydraulique souterraine et fluviale, vol 1. Herman et Cie, Paris, 1905); T and EC datasets were also used to provide qualitative information about the nature of the aquifer that supplies the spring. The outcomes of the elaborations highlighted the limits of applicability of these methods in the presence of a non-continuous Q dataset: both Boussinesq (J Math Pure Appl 10:5–78, 1904) and Maillet (Essais dı’hydraulique souterraine et fluviale, vol 1. Herman et Cie, Paris, 1905) estimated that discharge values as a function of recession time were found to be consistently lower than the available discharge ones and the estimated groundwater volumes stored over time above the spring level turned out to be underestimated. Continuous (hourly value) and long-term Q, EC and T values are, therefore, needful to correctly quantify and to make a proper management of groundwater resources in mountain areas

Frontal networks in adults with autism spectrum disorder.

It has been postulated that autism spectrum disorder is underpinned by an 'atypical connectivity' involving higher-order association brain regions. To test this hypothesis in a large cohort of adults with autism spectrum disorder we compared the white matter networks of 61 adult males with autism spectrum disorder and 61 neurotypical controls, using two complementary approaches to diffusion tensor magnetic resonance imaging. First, we applied tract-based spatial statistics, a 'whole brain' non-hypothesis driven method, to identify differences in white matter networks in adults with autism spectrum disorder. Following this we used a tract-specific analysis, based on tractography, to carry out a more detailed analysis of individual tracts identified by tract-based spatial statistics. Finally, within the autism spectrum disorder group, we studied the relationship between diffusion measures and autistic symptom severity. Tract-based spatial statistics revealed that autism spectrum disorder was associated with significantly reduced fractional anisotropy in regions that included frontal lobe pathways. Tractography analysis of these specific pathways showed increased mean and perpendicular diffusivity, and reduced number of streamlines in the anterior and long segments of the arcuate fasciculus, cingulum and uncinate--predominantly in the left hemisphere. Abnormalities were also evident in the anterior portions of the corpus callosum connecting left and right frontal lobes. The degree of microstructural alteration of the arcuate and uncinate fasciculi was associated with severity of symptoms in language and social reciprocity in childhood. Our results indicated that autism spectrum disorder is a developmental condition associated with abnormal connectivity of the frontal lobes. Furthermore our findings showed that male adults with autism spectrum disorder have regional differences in brain anatomy, which correlate with specific aspects of autistic symptoms. Overall these results suggest that autism spectrum disorder is a condition linked to aberrant developmental trajectories of the frontal networks that persist in adult life

Digital Workflows for Cultural Tourism

The concept of resource management in relation to cultural heritage relies on the documentation and recording as its fundamental core. A consistent approach to document heritage sites is necessary for any conservation and monitoring actions as well as planning, design, communication and promotion project, because without baseline records, no direction can be taken. This contribution focuses on exploring the role of digital revolution in heritage recording techniques and tools as well as data processing workflows and information visualization to support the conservation and stewardship of cultural heritage sites. The case study of the Cultural Heritage site of Bagan, Myanmar, has been selected to illustrate how heritage documentation practices are approached from local, national, and international perspectives, and the results that can be obtained from each. The potential of this kind of digital records for cultural tourism promotion and management are then discussed