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Total and Regional Changes in Body Composition in Metastatic Hormone-sensitive Prostate Cancer Patients Randomized to Receive Androgen Deprivation + Enzalutamide ± Zoledronic Acid. The BONENZA Study
No full textBACKGROUND AND OBJECTIVE: The reduction of lean body mass (LBM) and the increase of fat body mass (FBM) caused by androgen deprivation therapy (ADT) administered to prostate cancer patients are well known to lead to an increased risk of sarcopenia. The effects of the addition of androgen receptor pathway inhibitors (ARPIs) to ADT on body composition have not been studied thoroughly. METHODS: BONENZA (NCT03336983) is a prospective phase 2 trial in which metastatic hormone-sensitive prostate cancer patients were randomized to receive ADT plus enzalutamide with (EZ arm) or without (E arm) the addition of zoledronic acid. Total and regional body composition parameters were evaluated by dual-energy x-ray absorptiometry (DXA) scans at baseline and after 18 mo of therapy. KEY FINDINGS AND LIMITATIONS: Eighty-nine patients (46 from the EZ arm and 43 from the E arm) had paired DXA evaluation at both time points. After 18 mo of therapy, FBM increased by +22.8% (p 40.8%, 3.5% of patients had an ALMI of <5.5, and the ALMI/FBM ratio decreased by -23.9% (p < 0.001). Age and baseline LBM influenced these body composition changes significantly, with younger patients (<70 yr) and those with higher baseline LBM experiencing more marked changes. CONCLUSIONS AND CLINICAL IMPLICATIONS: Body composition undergoes a significant change with the addition of ARPIs to ADT, with an increase in FBM and a reduction in LBM, which are twice as high as those expected with ADT alone. DXA has been proved to be a reliable tool for monitoring body composition, and an assessment of district variations can aid in implementing individual-supervised physical exercise to prevent the risk of sarcopenic obesity
Timely Diagnosis of Discrete-Event Systems
No full textA major problem afflicting decision support systems based on automated diagnosis is a possibly large number of diagnoses explaining the observations, which may jeopardize the task of diagnosticians, owing to the cognitive overload raised by an overwhelming number of faulty scenarios to examine before undertaking effective recovery actions. This criticality is exacerbated when the recovery actions are expected to be performed automatically by an artificial agent in real-time, even in the order of milliseconds, like in an autonomous vehicle or in a defense system. To make diagnosis in the specific domain of discrete-event systems (DESs) viable in critical, real-time applications, a Timely Diagnosis Engine is presented, which is based on a parsimony principle: given a
set of diagnoses implied by the observations, only minimal diagnoses are elicited as candidates, on the grounds that each minimal diagnosis is more likely than any non-minimal diagnosis that is a superset of it. Experimental results indicate that the search space of the diagnosis engine is reduced considerably, owing to the pruning of the trajectories of the DES that are not bound to generate
minimal diagnoses, thereby resulting in a considerable reduction not only in the number of candidates but also in processing time
Design of a Peltier cell based take-home kit for control education
No full textIn this paper we present a take-home kit that can be used for control education. In particular, the design of a Peltier cell system is explained as well as its use to teach basic control concepts. The kit is made by simple components so that it can be easily replicated at a low cost. Temperature control algorithms are implemented in Matlab/Simulink by means of an Arduino board. Illustrative examples of the application of the tool are given in order to show how it can improve the teaching process
Preface: Thematic Session SM12 on Plasticity, Viscoplasticity and Creep of the 26th International Congress of Theoretical and Applied Mechanics (ICTAM2024)
No full textBrescia’s Old Carmine District: The impact of planning and conservation decisions on the area’s built and social environment in the 1970s and 1980s
No full textThis chapter presents the preliminary results of a study of the interventions promoted by the Municipality of Brescia for the recovery of the Carmine district. This district, the old part of the his tori cal centre, has traditionally experienced the most severe problems of physical and social dereliction, forcing economically disadvantaged social groups to reside in unhealthy conditions. Using the urban planning instrument of the “recovery plan”, since the mid-1970s the City Council has directly promoted and carried out a massive public intervention, combining the objective of preserving the district’s heritage with that of improving the quality of life in the district. The interventions included the renovation of old, unhealthy dwellings on the verge of collapse, while the restoration of other buildings, including monuments, led to the creation of new services (offices and town halls, community and school centres, spaces for cultural associations, furnished green spaces, etc.). Over time, the public initiatives for the area’s rehabilitation generated a chain reaction, resulting in the emergence of several private projects that accelerated the recovery process. The decision of the University of Brescia to renovate a series of imposing monumental buildings and monastic complexes to house the university’s law and economics centres and the rectorate gave Carmine’s redevelopment process a decisive boost in the 1980s, while other buildings in the district were converted into student accommodation. Since the early 2000s, the Municipality of Brescia has promoted another redevelopment plan, the “Carmine Project”, which has completed the trans formation of the once notorious district, not only physically and functionally, but also socially, turning it into the most culturally vibrant and multi-ethnic area of the city. Approximately fifty years after the initial radical interventions in the district, this essay aims to reflect upon the motivations, strategies, and outcomes of this physical and social regeneration project, focusing on the initial phase of the 1970s and 1980s. The study begins with the observation that research conducted thus far on the Carmine district has predominantly focused on more contemporary projects and issues, such as the substantial influx of non-EU migrants that impacted the area from the 1990s onwards. Indeed, aside from a few brief accounts published in the 1980s by the very technicians and experts involved in the project (Lombardi, 1982; Ponzoni, Testi, 1985; Lombardi, 1989), a more comprehensive and in-depth analysis of the intervention and its outcomes is currently lacking
Il suicidio assistito per pazienti con depressione grave. Un’opzione inaccettabile che gli psichiatri devono combattere fermamente
No full textThe debate on assisted suicide for patients suffering from severe depression raises complex issues spanning clinical, ethical, scientific, medico-legal, and cultural domains. This position paper asserts that such an option is unacceptable in the context of depressive illness, even in its most severe and treatment-resistant forms. Depression is not an irreversible or terminal condition: there are multiple therapeutic options available, including spontaneous and late remissions, and suicidal ideation must be seen as a core symptom of the disorder, not as a rational choice. Scientifically, there are no reliable biomarkers to define the “incurability” of depression, and prognosis is often uncertain. Ethically, the principle of non-maleficence prohibits physicians from contributing to a patient’s death, while the vulnerability of individuals with severe depression impairs their decision-making capacity. From a medico-legal standpoint, it is extremely difficult to assess competence in such contexts with any degree of certainty. Culturally and symbolically, psychiatry must reaffirm its healing mandate and resist dangerous shifts that could legitimize stigma or suicidal contagion. In conclusion, psychiatrists cannot and must not adopt the role of facilitators of death. Instead, they are called to provide care, instil hope, and protect patients, even in the most challenging clinical scenarios
Codice amministrativo
No full textIl codice raccoglie le principali fonti del diritto amministrativo, compresi l'ambiente, i beni culturali, l'edilizia e l'urbanistica e l'immigrazione
Suprachoroidal injection of triamcinolone acetonide as adjuvant to surgical treatment of epiretinal membrane
No full textBackground: To analyse the effect of suprachoroidal injection (SChI) of triamcinolone acetonide (TA) on macular thickness (CRT), ectopic inner foveal layer thickness (EIFL-T) and best corrected visual acuity (BCVA) in pseudophakic patients undergoing vitrectomy for epiretinal membrane (iERM) compared to intravitreal injection of TA (IVTA). Methods: Prospective matched comparison of patients undergoing vitrectomy for Govetto stage 3 and 4 iERM. 25 eyes receiving IVTA (G-1) were compared to 23 eyes receiving SChI-TA (G-2) during vitrectomy. Primary outcome was change in BCVA, CRT, EIFL-T before surgery and 1, 3 and 6 months after surgery. Secondary outcome was the incidence of cystoid macular edema (CME). Results: Six months after surgery, G2 had a greater mean reduction in CRT (−222 μm vs −131 μm) and EIFL-T (−200 μm vs −104 μm) than G1. BCVA improved more in G2 than in G1 (p = 0.02). Foveal depression reformed in 43% of cases in G-2 and 16% of cases in G-1. Incidence of postoperative CME was 16% in G-1 and 4.3% in G-2. Conclusions: During vitrectomy for iERM, SChI-TA was more effective than IVTA in reducing CRT and EIFL-T and improving BCVA. SChI-TA was effective in preventing postoperative CME. SChI-TA treatment was safe and reproducible and did not affect postoperative IOP. Trial registration NP6289—June 18th, 2024 (retrospectively registered)
Spatial and temporal evaluations of the liquid argon purity in ProtoDUNE-SP
No full textLiquid argon time projection chambers (LArTPCs) rely on highly pure argon to ensure that ionization electrons produced by charged particles reach readout arrays. ProtoDUNE Single-Phase (ProtoDUNE-SP) was an approximately 700-ton liquid argon detector intended to prototype the Deep Underground Neutrino Experiment (DUNE) Far Detector Horizontal Drift module. It contains two drift volumes bisected by the cathode plane assembly, which is biased to create an almost uniform electric field in both volumes. The DUNE Far Detector modules must have robust cryogenic systems capable of filtering argon and supplying the TPC with clean liquid. This paper will explore comparisons of the argon purity measured by the purity monitors with those measured using muons in the TPC from October 2018 to November 2018. A new method is introduced to measure the liquid argon purity in the TPC using muons crossing both drift volumes of ProtoDUNE-SP. For extended periods on the timescale of weeks, the drift electron lifetime was measured to be above 30 ms using both systems. A particular focus will be placed on the measured purity of argon as a function of position in the detector