Prognostic and Predictive Role of Neutrophil to lymphocyte Ratio in Second Line Immunotherapy of Non-small Cell Lung Cancer

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An articulatory account of rhotic variation in Tuscan Italian: synchronized UTI and EPG data

Rhotic variation in a spoken variety of Tuscan Italian is investigated. The paper takes a multi-level articulatory approach, based on real-time synchronization and analysis of acoustic, electropalatographic (EPG) and ultrasound tongue imaging (UTI) data. Contrary to the expectations based on the received dialectological literature, it emerges that speakers produce various alveolar variants: taps, trills, fricatives and approximant realizations. To examine the factors that may constrain the variation of /r/, a multiple correspondence analysis is carried out. The result is that there are significant associations between the phonetic properties of /r/ variants and their preferred contexts of occurrence. A particular focus is then placed on the articulatory properties of the singleton-geminate distinction. It is shown that the length contrast is maintained but contrary to expectations trills are not primarily used for geminates. Instead, each speaker differentiates the singleton from the geminate according to a variety of production strategies

Intervention review. Corticosteroids for the long-term treatment in multiple sclerosis

Background: Short term high dose corticosteroid treatment improves symptoms and short term disability after an acute exacerbation of multiple sclerosis (MS) but it is unknown whether its long-term use can reduce the accumulation of disability.Objectives: To determine the efficacy and safety of long-term corticosteroid use in MS.Search strategy: We searched the following bibliographic databases: CENTRAL (Issue 1, 2007), MEDLINE (1966 to February 2007) and EMBASE (1980 to February 2007). In an effort to identify further published, unpublished and ongoing trials we searched reference lists and contacted trial authors and one pharmaceutical company.Selection criteria: We considered controlled, randomised trials (RCTs), with or without blinding, of long term treatment (i.e. longer than 6 months) of any type of corticosteroid in MS, irrespective of disease course.Data collection and analysis: Reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information.Main results: Three trials, all classified at high risk of bias, contributed to this review (Miller 1961; BPSM 1995; Zivadinov 2001) resulting in a total of 183 participants (91 treated). Corticosteroid therapy did not reduce the risk of being worse at the end of follow-up (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.26 to 1.02) but there was a substantial heterogeneity between studies (I(2): 78.4%). I. v. periodic high dose methylprednisolone (MP) was associated with a significant reduction in the risk of disability progression at 5 years in relapsing-remitting (RR) MS (OR 0.26, 95% CI 0.10 to 0.66), while oral continuous low dose prednisolone was not associated with any risk reduction in disability progression at 18 months (OR 1.23, 95% CI 0.43 to 3.56). Risk of experiencing at least one exacerbation at end of follow-up was not significantly reduced with corticosteroid treatment (OR 0.36; 95% CI 0.10 to 1.25).Only one study recorded adverse events: in one patient i. v. MP was discontinued after the fourth pulse when he developed acute glomerulonephritis; a second patient was removed from the study after the fifth i. v. MP pulse because of severe osteoporosis.Authors' conclusions: There is no enough evidence that long-term corticosteroid treatment delays progression of long term disability in patients with MS. Since one study at high risk of bias showed that the administration of pulsed high dose i. v. MP is associated with a significant reduction in the risk of long term disability progression in patients with RR MS, an adequately powered, high quality RCT is needed to investigate this finding.Plain language summaryThe long-term use of anti-inflammatory corticosteroids for treating multiple sclerosisMultiple sclerosis is an inflammatory disease affecting the brain and spinal cord. It results in episodes of neurological deficit which recover (relapses) as well as accumulation of sustained disability with the passage of time. Corticosteroids are potent anti-inflammatory drugs. It is postulated that long-term use of steroids may reduce the accumulation of disability. The reviewers found three studies addressing this issue. A meta-analysis showed a trend towards a beneficial effect of long-term corticosteroids on accumulation of disability; however only two small studies contributed to this result. It was not possible to reliably comment on the effect of long-term corticosteroids on the frequency of relapses. Side effects were poorly documented. Therefore rigorous randomised controlled trials of this treatment are warranted

An EPG + UTI study of Italian /r/

This paper describes a system for the acquisition, real-time synchronization and analysis of acoustic, electropalatographic (EPG) and ultrasonographic (UTI) data. Simultaneous data on linguo-palatal contact and tongue sagittal profiles are captured for rhotic consonants produced by a native speaker of Italian. Three anterior variants of /r/ ([\u27e], [\u279\u31d] and [\u279]) are shown to be realized with an apical tongue gesture, but different vowel-related coarticulation patterns. The paper discusses the implication of the proposed analysis for a coherent investigation of lingual and linguo-palatal dynamics

An articulatory account of rhotic variation in Tuscan Italian: synchronized UTI and EPG data

Rhotic variation in a spoken variety of Tuscan Italian is investigated. The paper takes a multi-level articulatory approach, based on real-time synchronization and analysis of acoustic, electropalatographic (EPG) and ultrasound tongue imaging (UTI) data. Contrary to the expectations based on the received dialectological literature, it emerges that speakers produce various alveolar variants: taps, trills, fricatives and approximant realizations. To examine the factors that may constrain the variation of /r/, a multiple correspondence analysis is carried out. The result is that there are significant associations between the phonetic properties of /r/ variants and their preferred contexts of occurrence. A particular focus is then placed on the articulatory properties of the singleton-geminate distinction. It is shown that the length contrast is maintained but contrary to expectations trills are not primarily used for geminates. Instead, each speaker differentiates the singleton from the geminate according to a variety of production strategies

Paleo-environmental record of polycyclic aromatic hydrocarbons and polychlorobiphenyls at the peripheral site GV7 in Victoria Land (East Antarctica)

In this paper we investigated the presence of Polycyclic Aromatic Hydrocarbons and Polychlorobiphenyls in a 50-m deep snow/firn core collected at the peripheral site GV7 in East Antarctica during the 2013–2014 XXIX Italian expedition. The concentration depth profile was obtained on the basis of the total concentration of fourteen PAHs and seven PCBs individually determined by gas chromatography triple quadrupole mass spectrometry. Both classes of pollutants showed synchronized concentration vs time profile throughout the whole period of time covered by the snow/firn core (1892–2012). A correlation between major explosive volcanic eruptions and the concentration maxima of the pollutants was found. PAH maximum (9 ng/L) was about twice the background level (5 ng/L). PCBs showed a similar but more limited trend with barely visible volcanic maxima. This concurrence highlights the contribution of the major explosive volcanic events to the global contamination level for PAHs, as expected, but also for PCBs whose industrial production and use began in 1930. Excluding the maximum values, PAHs and PCBs showed an increase in the period 1956–1986: PCBs from about 0.05 to 0.21 ng/l (400% increase), and PAHs from about 3.5 to 7.8 ng/l (100% increase). Finally, in the last decade (2000–2010) the trend of these pollutants was different: (i) PCBs constantly decrease (from 0.15 ng/L to 0.10 ng/L), thanks to the implemented restriction on their production and on their use only in closed systems in many countries; (ii) PAHs remains practically constant around 6.5 ng/L

Headache in progressive facial hemiatrophy (Parry-Romberg syndrome): A paradigmatic case and systematic review of the literature

Background Parry-Romberg syndrome is a neuro-cutaneous disease characterized by progressive hemifacial atrophy. Although common, headache in this population is scarcely reported in the literature. Objective To evaluate the clinical features of headache in pediatric and adult patients with Parry-Romberg syndrome, and to discuss diagnostic and treatment approaches of headache in Parry-Romberg syndrome. Methods We conducted a systematic review in accordance with PRISMA guidelines. We searched the MEDLINE database to identify eligible studies and identified patients with Parry-Romberg syndrome and headache. We further reported a paradigmatic case with a complex headache disorder and described its management and outcome. Results We identified 74 articles, 41 of which were included in the analysis. A total of 52 patients (55.8% female) were included for data analysis. The main age at onset of headache was 20 years (SD 15.2; range 3-56). A diagnosis of migraine was made in 53.9%. Abnormal brain imaging was found in 82.2% of patients. Conclusion Long-term follow-up of patients is required, because headache may develop (and evolve) at any time over the course of the disease. Primary and secondary headaches often co-occur in patients with Parry-Romberg syndrome. Further research into the underlying etiopathogenesis and therapeutic targets would be recommended

Circulating programmed death ligand-1 (cPD-L1) in non-smallcell lung cancer (NSCLC)

Background: This study aimed at investigating feasibility of programmed death ligand-1 (PD-L1) testing in plasma samples of advanced NSCLC patients receiving first-line treatment, assessing whether circulating (c)PD-L1 levels were modified by the therapy and whether baseline cPD-L1 levels were associated with patients' clinical responses and survival outcome. Methods: Peripheral blood samples were collected from 16 healthy volunteers and 56 newly diagnosed NSCLC patients before and at 12th week during the course of first-line therapy. The level of PD-L1 was measured in plasma samples using the human (PD-L1/CD274) ELISA kit (CUSABIO, MD, USA). The Mann Whitney test or Fisher's test were used for comparisons. Survival analysis was performed using Kaplan Meyer method, providing median and p-value. Results: Baseline median cPD-L1 was 42.21 pg/ml (range 12.00-143.49) in NSCLC patients and 37.81 pg/ml (range 9.73-90.21) in healthy control cohort (p = 0.78). Median cPD-L1 increased in patients treated with first-line chemotherapy (63.20 pg/ml vs 39.34 pg/ml; p = 0.002), with no changes in patients exposed to nonchemotherapy drugs (42.39 pg/ml vs 50.67 pg/ml; p = 0.398). Time to progression and overall survival were 4.4 vs 6.9 months (p = 0.062) and 8.8 vs 9.3 months (p = 0.216) in cPD-L1 positive vs cPD-L1 negative patients. Baseline cPD-L1 levels increased with the ascending number of metastatic sites, even if the association was not statistically significant (p = 0.063). Conclusions: This study showed that cPD-L1 testing is feasible, with chemotherapy influencing PD-L1 plasma levels. The possibility of using such test for predicting or monitoring the effect of immunotherapy or combination of chemotherapy and immunotherapy warrant further investigations