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Cyber-Attacks and Countermeasures at the Perception Layer for Electromedical Devices in Community-Based Care: A Systematic Review
No full textSafety Profile of Intravitreal Dexamethasone Implant to Manage Diabetic Macular Edema: A Systematic Review of Real-World Studies
No full textIntroduction: With increasing experience using intravitreal dexamethasone implant (DEX-i), it has become a first-line therapy in patients with diabetic macular edema (DME), due mainly to its good efficacy profile. However, this treatment is not devoid of adverse events (AEs), which are predominantly transient and should be considered when administering it. Methods: This systematic review without meta-analysis adhered to the guidelines delineated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Systematic electronic searches were conducted in the PubMed, MEDLINE, Embase, and Google Scholar databases to identify real-world evidence (RWE) studies assessing the safety profile of DEX-i in patients with DME, covering the period from January 1, 2014, to March 1, 2024. Results: This review included 76 RWE that evaluated the safety of DEX-i. Regarding intraocular pressure (IOP)-related AEs, these AEs were very heterogeneous and have included different definitions. The incidence of IOP-related AEs varied significantly from study to study, from 2% to almost 60%. In general, the peak IOP increase was typically observed 60 days post-DEX-i injection, followed by a decrease in the subsequent months. In most patients, these IOP-related AEs were successfully and efficiently managed with topical IOP-lowering medication, although some patients required additional treatments (i.e., laser or surgery). Regarding cataract development rates, the results were conflicting, with some studies showing rates =40%, while others reported rates of 0% or less than 5%. Additionally, current evidence showed the beneficial effects of DEX-i in eyes with DME that underwent cataract surgery. Other serious ocular AEs related to DEX-i were rare; indeed, the reported incidence rate of endophthalmitis ranged between 0.07% and 0.3%. Conclusions: Overall, the main DEX-i-related AEs were elevation of IOP and cataract. Episodes of ocular hypertension were usually transient and successfully controlled with topical treatment. Additionally, repeated treatment with DEX-i in the same eye was not associated with IOP-related AEs, but it was with cataractrelated AEs. 2025 S. Karger AG, Base
Sinestesie
No full textIl saggio si propone di analizzare gli aspetti narratologici innovativi
proposti nella descrizione della dei conbats nei romanzi in lingua d’oc.
Particolare attenzione è dedicata alla figura del cavaliere e alla rappresentazione
dei combattimenti che, nei testi analizzati, assume funzioni e significati diversi
rispetto alle fonti oitaniche da cui gli autori, per lo più anonimi, prendono
ispirazione, adeguando le loro narrazioni ad un pubblico nuovo ed eterogeneo.The essay aims to analyse the innovative narratological aspects
proposed in the description of conbats in Languedoc novels. Particular attention
is devoted to the figure of the knight and the representation of the fights that,
in the texts analysed, assume different functions and meanings compared to
the Oitanic sources from which the authors, mostly anonymous, take their
inspiration, adapting their narratives to a new and heterogeneous audience
La forza della parola in Texaco di Patrick Chamoiseau
No full textThis study aims to examine the linguistic dimension of a work whose narrative is set against the geographical
backdrop of Martinique, where a contrast arises between the urbanized Fort-de-France and
the “spontaneous” Texaco suburb – a diverse melting pot of ethnicities that strongly resists the imposed
process of urbanization.
In this long conflict between action, subordination and reaction, the power of the word emerges as the
only, true, weapon against city conquest – in Creole “En-ville”.
The work entitled Texaco by Patrick Chamoiseau is named after the working-class neighbourhood of
Fort-de-France, known for the events surrounding the oil company of the same name.
For us, the linguistic innovations in Chamoiseau’s narration become a key to understanding the multiplicities,
conflicts and spontaneities, elements that highlight the representations of a world of its own,
complex, as well as the gap between neighbourhood and city.
The analysis of neologisms and metaphors contributes to a profound understanding of the composite and
variegated nature of Antilles creole, Chamoiseau’s main focus
Radiomics for Preoperative Assessment of Pituitary Adenoma Consistency with T2-Weighted MRI: A Multicenter Study
No full textIntroduction Pituitary adenoma (PA) consistency significantly influences the outcomes of endoscopic endonasal surgery. Radiomics represents a promising tool for objective and quantitative assessment using T2-weighted magnetic resonance imaging (MRI). Methods A multicenter retrospective database was collected (2012-2023), including 394 patients with preoperative T2-weighted MRI and histologically confirmed PAs after endoscopic endonasal surgical removal. Tumor segmentation was performed manually on coronal T2-weighted images using ITK-SNAP software. Radiomic features were extracted with Pyradiomics. A 60:40 dataset split was used to train an Extra Trees classifier, and recursive feature elimination was used to select features. Model performance was assessed using sensitivity, specificity, and the area under the curve of receiver operating characteristic (AUC-ROC) curve metrics. Results From 1,106 extracted radiomic features, 65 were identified as most predictive following variance and correlation filtering. The sensitivity, specificity, and accuracy of the ET classifier were 74%, 74%, and 63% (+/- 10%), respectively. The AUC-ROC curve was 0.59. Conclusion Despite its moderate accuracy and AUC-ROC curve, the ET model showed promising performance to predict preoperative PA consistency, underlying the power of radiomics-driven models in PA surgical planning
Cancer detection via one-shot learning:integrating gene expression and genomic mutation analysis
No full textBackground. Cancer is a complex disease influenced by numerous concurrent genetic factors that result in diverse tumor microenvironments (TMEs) across different cancer types. Large-scale genomic projects, such as The Cancer Genome Atlas, have underscored the need for molecular classification of cancer to enable more precise therapeutic strategies. Yet, traditional machine learning (ML) approaches currently face several limitations. First, while effective, they predominantly rely on gene expression data and often overlook critical genomic alterations such as copy number alterations, single nucleotide polymorphisms, and other mutational profiles, limiting the scope of biomarker discovery. Most importantly, they are usually limited by the need of large sample sizes. Results Building on the hypothesis that type-agnostic representations integrating gene expression with genomic mutations can comprehensively characterize TMEs and capture the similarity or dissimilarity between samples of the same or different types, we propose a novel ML-based method for cancer detection using a one-shot learning framework implemented through Siamese Neural Networks. Our method redefines cancer detection as a similarity-based classification task, allowing the model to generalize to unseen cancer types, a critical advantage in genomics where data scarcity and frequent updates pose significant challenges. To enhance interpretability, we introduce a robust explainability technique founded on SHapley Additive exPlanations(SHAP) values, to provide clear insights into the contributions of gene expression and mutational data, enabling a deeper understanding of the key factors driving cancer detection decisions. Conclusions Our experimental results show that integrating mutational profiles with gene expression data allows for more accurate cancer type detection and reveals significant mutation patterns. These findings indicate that the proposed method has the potential to significantly enhance cancer type detection by leveraging a more comprehensive understanding of TMEs. Beyond merely classifying cancer types, the proposed SHAP-based explainability technique enables the identification and the analysis of key biomarkers relevant for immunotherapy success, thereby addressing limitations of existing approaches
Clinical Impact of Graft Cryopreservation on Allogeneic Stem Cell Transplantation: An Italian, Registry-Based Study on Behalf of the “Gruppo Italiano Per Il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare” (GITMO)
No full textThe coronavirus disease 2019 (COVID-19) pandemic created major challenges for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Scientific societies and authorities recommended cryopreserving grafts before starting conditioning regimens, despite limited data on the clinical impact. The Italian Group for Bone Marrow Transplantation (GITMO) conducted a registry-based study involving 3492 patients who underwent allo-HSCT between March 2018 and September 2021. The cryopreserved cohort (n = 976) included patients who received cryopreserved grafts during the pandemic and was compared to the historical cohort (n = 2516). Graft cryopreservation was associated with a lower day 30 incidence of neutrophil and platelet engraftment (adjusted sHR = 0.8 and 0.7, p = 0.031 and p < 0.001, respectively) and delayed hematopoietic recovery. However, primary graft failure rates at day +30 were similar in the cryo and historical cohort (4% vs. 5%, respectively; p = 0.337), also after adjustment (RR = 1.19, p = 0.518). Day 100 incidence of grade II-IV acute GVHD was comparable between the two groups (adjusted sHR = 1.2, p = 0.194). Regarding chronic GVHD incidence, we found that it was higher in patients aged < 18 years in the cryo group (adjusted sHR = 3.9, p = 0.002), but lower in those aged 18-55 years (adjusted sHR = 0.7, p = 0.008). Cumulative incidence of relapse did not differ between historical and cryo cohort (adjusted sHR 1.0. p = 0.943), as well as non-relapse mortality (adjusted sHR 1.1, p = 0.196) and relapse-free survival (adjusted sHR = 1.1, p = 0.197). However, a shorter overall survival was observed in the cryopreserved group (adjusted HR = 1.2, p = 0.038). Transplant centers should carefully balance the benefits and drawbacks of cryopreservation in allo-HSCT
