A Bayesian approach for the assessment of shallow and deep aquifers susceptibility to point sources contamination in the Province of Milan, Italy

In densely populated areas, urban and industrial activities are responsible for groundwater quality deterioration due to point sources contamination (Kuroda and Fukushi, 2008). In the Province of Milan (Northern Italy), the available water-quality data indicate the occurrence of high PCE+TCE and chromium concentrations in the unconfined shallow as well as in the confined deep aquifers. To cope with this problem, statistical methods can represent reliable tools to provide key information for groundwater management and protection

A Bayesian approach for the assessment of shallow and deep aquifers susceptibility to point sources contamination in the Province of Milan, Italy

In densely populated areas, urban and industrial activities are responsible for groundwater quality deterioration due to point sources contamination (Kuroda and Fukushi, 2008). In the Province of Milan (Northern Italy), the available water-quality data indicate the occurrence of high PCE+TCE and chromium concentrations in the unconfined shallow as well as in the confined deep aquifers. To cope with this problem, statistical methods can represent reliable tools to provide key information for groundwater management and protection

Concurrent Endometrial Cancer in Women with Atypical Endometrial Hyperplasia: What Is the Predictive Value of Patient Characteristics? †

Background: The rate of concurrent endometrial cancer (EC) in atypical endometrial hyperplasia (AEH) can be as high as 40%. Some patient characteristics showed associations with this occurrence. However, their real predictive power with related validation has yet to be discovered. The present study aimed to assess the performance of various models based on patient characteristics in predicting EC in women with AEH. Methods: This is a retrospective multi-institutional study including women with AEH undergoing definitive surgery. The women were divided according to the final histology (EC vs. no-EC). The available cases were divided into a training and validation set. Using k-fold cross-validation, we built many predictive models, including regressions and artificial neural networks (ANN). Results: A total of 193/629 women (30.7%) showed EC at hysterectomy. A total of 26/193 (13.4%) women showed high-risk EC. Regression and ANN models showed a prediction performance with a mean area under the curve of 0.65 and 0.75 on the validation set, respectively. Among the best prediction models, the most recurrent patient characteristics were age, body mass index, Lynch syndrome, diabetes, and previous breast cancer. None of these independent variables showed associations with high-risk diseases in women with EC. Conclusions: Patient characteristics did not show satisfactory performance in predicting EC in AEH. Risk stratification in AEH based mainly on patient characteristics may be clinically unsuitable

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic

Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer

Outcomes after intensive chemotherapy for secondary and myeloid-related changes acute myeloid leukemia patients aged 60 to 75 years old: a retrospective analysis from the PETHEMA registry

Treatment options for patients with secondary acute myeloid leukemia (sAML) and AML with myeloid-related changes (AMLMRC) aged 60 to 75 years are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard "3+7" regimens. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60 to 75 years treated with intensive chemotherapy, reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS was 7.6 months (95% confidence interval [CI]: 6.7-8.5) and event-free survival (EFS) 2.7 months (95% CI: 2-3.3), without differences between intensive chemotherapy regimens and AML type. Multivariate analyses identified age ≥70 years, Eastern Cooperative Oncology Group performance status ≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), autologous HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351

Outcomes after intensive chemotherapy for secondary and myeloid-related changes acute myeloid leukemia patients aged 60 to 75 years old: a retrospective analysis from the PETHEMA registry

© 2024 Ferrata Storti Foundation Published under a CC BY-NC license.Treatment options for patients with secondary acute myeloid leukemia (sAML) and AML with myeloid-related changes (AMLMRC) aged 60 to 75 years are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard "3+7" regimens. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60 to 75 years treated with intensive chemotherapy, reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS was 7.6 months (95% confidence interval [CI]: 6.7-8.5) and event-free survival (EFS) 2.7 months (95% CI: 2-3.3), without differences between intensive chemotherapy regimens and AML type. Multivariate analyses identified age ≥70 years, Eastern Cooperative Oncology Group performance status ≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), autologous HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351.This study was partially supported by the Jazz Pharmaceuticals and Cooperative Research Thematic Network (RTICC) grant RD12/0036/014 (ISCIII & ERDF).Peer reviewe

Effects of urban changes on groundwater vulnerability, a case study in Lombardy (Italy)

Urban sprawl is one of the most important types of land-use changes currently affecting Europe with important impacts on groundwater quality. The area of the Po Plain in northern Italy is one of the most populated areas in Europe and can be considered as a representative area to study urban sprawl impacts on groundwater quality. The identification of areas where groundwater is characterized by a degradation of the water quality is required by two European Union Directives (2000/60/EC and 2006/118/EC). Here, we present a time-dependent groundwater vulnerability assessment of the Po Plain area of Lombardy region, concerning the period 2001\u20132011. Three different variables have been selected, and compared to each other, in order to investigate the evolution of urban nitrate non-point sources: urbanization derived from satellite scatterometer data (QuikSCAT-DSM data), population density changes calculated using two successive national censuses (database ISTAT) and land-use changes derived from photo-interpretation of aerial imageries (database DUSAF). Four other variables, considered not being time-dependent for the purpose of this study, have been identified to represent the geological and hydrogeological conditions of the study area: soil protective capacity, groundwater depth, groundwater velocity and hydraulic conductivity of the vadose zone. Groundwater vulnerability is assessed through the spatial statistical method Weights of Evidence (WofE). WofE enables observations of the individual role and the combined effect of both urban change and geological factors considered in the analysis in relation to the change of nitrate concentration in the decade 2001\u20132011. Time-dependent groundwater vulnerability maps for the study area have been produced and compared