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Livorno, in In piazza per il suffragio. La mobilitazione per la riforma elettorale del 1882, a cura di S. Botta, F. Cammarano, G.L. Fruci, Ancona, affinità elettive
No full textIs Direct Transpedicular C2 Fixation (Judet Approach) a Timeless Technique to Learn for C2 Fractures?
No full textLe moule et le modèle: l’expérience et la norme dans la Lettre sur les aveugles et De l’interprétation de la nature
No full textIn Diderot’s works, the category of the model emerges—between the late 1740s and early 1750s—within the framework of an inquiry into nature and its productions. The Lettre sur les aveugles and De l’interprétation de la nature serve, in this respect, as a genuine philosophical laboratory, in which Diderot tests his conceptual tools by exploring their conditions and domains of application. This investigation of nature reconfigures, at various levels, the problem of the transition from case to rule: whether in the relationship between individual and species, in questions of generation, or in the status of anomalies, what is consistently at stake is the model. To shed light on this dynamic, I will show how Diderot constructs a conceptual constellation that, in dialogue with Buffon’s natural philosophy and, to some extent, that of Maupertuis, explores the multiple forms of the model and its processes of production. The moule and the prototype thus emerge as attempts to conceptualize the variable and dynamic relations of a norm that arises from the case and becomes visible only through it.Dans les ouvrages de Diderot, la catégorie de modèle émerge, entre la fin des années 1740 et le début des années 1750, dans le cadre d’une enquête sur la nature et ses productions. La Lettre sur les aveugles et L’Interprétation de la nature constituent à cet égard un véritable laboratoire philosophique, où Diderot met à l’épreuve ses outils conceptuels en en explorant les conditions et les domaines d’application. Cette investigation de la nature reconfigure à différents niveaux le problème du passage du cas à la règle : qu’il s’agisse des rapports entre l’individu et l’espèce, des questions de la génération ou du statut des anomalies, c’est toujours le modèle qui se trouve interrogé. Afin de mettre en lumière cette dynamique, je montrerai comment Diderot construit une constellation conceptuelle qui, en dialogue avec la philosophie naturelle de Buffon et, en partie, de Maupertuis, explore les formes diverses du modèle et de sa production : le moule et le prototype deviennent ainsi des tentatives pour penser les rapports variables et dynamiques d’une norme issue du cas et rendue visible par lui
Efficacy and Safety of Lenvatinib Versus Sorafenib in Recurrent HCC After Liver Transplant: A Multi‐Center Real‐World Study
No full textIntroduction: Liver transplantation (LT) indications for hepatocellular carcinoma (HCC) have broadened, increasing the need for systemic therapy in post-transplant recurrence. Because of the risks of graft rejection and uncertain efficacy, immunotherapy remains controversial, making tyrosine kinase inhibitors (TKIs) such as lenvatinib and sorafenib the preferred first-line treatments. However, their comparative efficacy in this setting remains unclear, warranting further research. Methods: We conducted a retrospective, multicenter study of HCC recurrence after LT treated with either lenvatinib or sorafenib as first-line systemic treatment. Primary objectives were to compare overall survival (OS), progression-free survival (PFS) and treatment response assessed per RECIST 1.1. A meta-analysis incorporating prior studies was carried out to enhance the robustness of findings. Safety was evaluated as the rate of adverse events onset graded as per CTCAE v5.0. Results: In a cohort of 64 patients (lenvatinib: 40, sorafenib: 24), lenvatinib significantly improved median OS (19.5 vs. 11.4 months, HR 0.31, p = 0.003), as confirmed in a meta-analysis with another recent report (HR 0.43, p = 0.0012). Although PFS was longer with lenvatinib (7.3 vs. 4.6 months), the difference was not significant (HR 0.91, p = 0.73). Both treatments had comparable safety profiles, with lenvatinib linked to higher hypertension and proteinuria rates, and sorafenib associated with more hand-foot syndrome and diarrhea. Conclusions: This study provides real-world evidence that lenvatinib confers superior overall survival over sorafenib in recurrent HCC post-LT, with manageable toxicity. As LT indications expand, these findings support lenvatinib as a preferred first-line treatment. Further prospective studies are needed to confirm these results and optimize post-LT treatment strategies
Bradleyite, Na3Mg(PO4)(CO3), inclusion in diamond: Structure and significance
No full textBradleyite, a sodium phosphate-magnesium carbonate, Na3Mg(PO4)(CO3), occurs in sedimentary salt rocks and in igneous, carbonatitic, and kimberlitic rocks. In this paper, we present the characteristics of a bradleyite sample found in a new geological environment as an inclusion in a diamond from the Córigo Sorriso placer deposit in Mato Grosso State, Brazil, where other unusual mineral inclusions in diamond were earlier identified. Bradleyite is part of a polymineral inclusion, comprising a porous aggregate of grains <150 nm in size, hosted within a dolomite crystal. The studied bradleyite is characterized by the highest MgO+FeO concentrations and the lowest Na content among bradleyites from other localities. It demonstrates significant variability in composition, particularly Na (28.75–37.84 mass % Na2O). Nitrogen was also detected by EDS analysis. We report for the first time the ab initio crystal structure of natural bradleyite. It has monoclinic symmetry, with cell parameters a = 8.684 Å, b = 6.804 Å, c = 5.074 Å, and β = 90.34°. The structure was solved ab initio and refined using dynamical scattering theory in space group P21/m, confirming the model obtained from powder XRD analysis of synthetic analogs. The final structure model converged to a formula Na3(Mg0.86Fe0.14)(PO4)(CO3), Z = 2. Bradleyite is a polygenetic mineral. In continental salt deposits, it forms under atmospheric pressure during sedimentation. In deep-formed igneous rocks, such as kimberlites and carbonatites, bradleyite occurs as a product of late-stage crystallization of carbonatitic melt and as a primary-crystallized phase in deep-seated minerals, such as olivine, ilmenite, chrome spinel, and magnetite. Our findings demonstrate its stability in diamond and diamond-forming environments and that it may be considered a product of crystallization from a primary melt inclusion
The Utility of Intranasal Corticosteroids in Association With Dupilumab for Chronic Rhinosinusitis With Nasal Polyposis: A Real‐Life Multicenter Study by a Tuscany Group
No full textObjective: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory condition often associated with other type-2 diseases. Dupilumab, a monoclonal antibody targeting IL-4Rα, has revolutionized the treatment of severe CRSwNP. Traditionally, intranasal corticosteroids (INCS) are used in association with Dupilumab, but their necessity remains uncertain. Methods: This real-life, multicentric observational study was conducted across seven centers in Tuscany, Italy, involving 123 patients with severe, uncontrolled type-2 CRSwNP treated with Dupilumab (300 mg/2 weeks) from January 2021 to December 2022. Parameters assessed included Sinonasal Outcome Test-22 (SNOT-22), Nasal Polyps Score (NPS), Sniffin' Sticks identification test (SSIT-16), and Lund-Mackay scores (LMS), along with blood eosinophil counts and adherence to INCS. Statistical analyses were performed to compare outcomes between INCS adherent and non-adherent groups. Results: A total of 123 patients, 53 men and 70 women with a mean age of 56.6 years were included. Significant improvements were observed in SNOT-22, NPS, SSIT, and LMS over 12 months. INCS adherence was incomplete in 23.8% of patients. Initially, non-adherent patients demonstrated a faster SNOT-22 reduction, while adherent patients showed better NPS and SSIT improvements early on. By 12 months, differences between groups were not statistically significant. No demographic or clinical factors predicted INCS adherence. Conclusion: Dupilumab is effective in managing type-2 CRSwNP, potentially without INCS. While INCS may hasten initial improvements, long-term outcomes are comparable with or without their use. Future randomized controlled trials are necessary to further clarify INCS's role in combination with Dupilumab
The role of parental overcontrol in psychological distress of vulnerable narcissists: The burden of shame
No full textPsychological distress can have a wide range of negative consequences, and the central role played by parental overcontrol in its occurrence has been widely demonstrated. It is also well-established that narcissistic vulnerability results from parental overcontrol and is characterized by intense shame experiences, which, in turn, favors psychological distress. However, no studies have examined these variables simultaneously, integrating them in a theoretical-based model. Therefore, this study aims to build on previous evidence by exploring whether parental overcontrol can lead to the onset of depression, anxiety and stress through the serial mediating role of narcissistic vulnerability and shame proneness. A convenience sample of 643 participants (68%F; Mage = 29.87 ± 13.00) was recruited. The assessed structural model produced adequate fit to the data. Results showed the significant role played by maternal – but not paternal – overcontrol in the onset of vulnerable narcissistic traits and that shame proneness, particularly bodily shame, fosters the three facets of psychological distress in such individuals. Clinicians dealing with individuals with high vulnerable traits could help them reduce their distress by working on the level of narratives relating to experiences of maternal overcontrol perceived during childhood and feelings of shame expressed, especially when connected to one's own body
Isoreticular Metal–Organic Frameworks Pillared by Monovalent Anions
No full textThree isoreticular anion pillared metal–organic frameworks were synthesized using CuX2(X = BF4–, ClO4–, NO3–) salts and the 1,1′-(2-(trifluoromethyl)-1,4-phenylene)bis(1H-imidazole) ligand (bibCF3). Single-crystal X-ray diffraction reveals that these peculiar materials, of the general formula [Cu(bibCF3)2X]·X, feature bidentate monovalent anions acting as pillars between square layers designed by metal ions and organic linkers and extraframework anions located in the channel-like pores. The materials display remarkable thermal and chemical stability and promising CO2adsorption performance, dependent on the nature of the anion
Association of candidate surrogate endpoints with overall survival in advanced biliary tract cancer
No full textBackground & Aims: Surrogate endpoints are increasingly used in biliary tract cancer (BTC) trials. While this may expedite drug approval and decrease costs, surrogate endpoints may not always correlate with an overall survival (OS) advantage. We aimed to explore the association of progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) with OS at the trial-and patient-level. Methods: For the trial-level analysis, we performed a systematic review of Pubmed/MEDLINE, Embase, Cochrane, clinicaltrials. gov and conference proceedings for phase II-III trials in advanced BTC. We used a weighted linear regression to measure the correlation of OS with PFS, ORR and DCR. For the patient-level analysis, we analyzed patients included in five randomized trials and three real-world datasets. The protocol is registered with PROSPERO, CRD42023398279. Results: For the trial-level analysis, we included 41 studies, involving 88 treatment arms and 7,817 patients. The coefficient of determination (R2) of the model was 0.71 (95% CI 0.56-0.86) for PFS, 0.01 (0-0.08) for ORR and 0.39 (0.14-0.64) for DCR. Predefined subgroup analysis showed consistent results. For the patient-level analysis, we included a total of 2,506 patients, 783 in randomized trials (first-line 512, second-line 271) and 1,723 in routine clinical care (first-line chemotherapy 773, first-line chemotherapy-durvalumab 628, second-line chemotherapy 322). Across the distinct datasets, the correlation coefficient ranged from 0.73 to 0.86 for PFS. A responder analysis found no association between response and survival. Conclusion: PFS shows a moderate correlation with OS both at the trial-and patient-level, while ORR and DCR show a low correlation. Whilst PFS is currently the best candidate surrogate marker for OS, our results highlight the need for novel endpoints in this field. (c) 2025 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver