107187 research outputs found
Sort by
Atrial Fibrillation and Takotsubo Syndrome: A Propensity-Matched Analysis From the GEIST and ATHERO-AF Registries
No full textThe contribution of citizens to threatened plant conservation
No full textThere is growing recognition of the importance of citizens in biodiversity conservation, particularly in the Mediterranean Basin-a global biodiversity hotspot and cradle of several civilizations-where human actions have influenced the introduction, extinction, and relocation of plant species, determining their current distribution. This research aimed to understand the role of citizens in conserving flora of conservation interest in Sardinia. We used questionnaires administered to individual citizens to investigate whether their activities included intentional movements of endemic and threatened plants for conservation purposes (namely translocations). We documented 68 translocations; 69.5% of these were directly confirmed in the field, involving 22 plants, mainly woody and endemic to the island. Most of them were introductions and were successful, with 73.53% having live individuals surviving and 67.65% also having reproductive plants. Although our analysis covers a limited period of time and probably provides only a small snapshot of the total, these data reveal an important contribution of citizens to the practical conservation actions for threatened plants. To our knowledge, this constitutes the first attempt to quantify such contributions and suggests that the undocumented, spontaneous initiatives of citizens may far outnumber institutional efforts in both quantity and effectiveness. The contribution of citizens may represent a crucial component of regional biodiversity strategies if integrated and valued in more inclusive conservation strategies
Real life use of ravulizumab in Italian patients with paroxysmal nocturnal hemoglobinuria: evidence from the REACTION observational study
No full textRavulizumab is a second-generation C5i engineered from eculizumab to achieve immediate, complete, and sustained inhibition of terminal complement activity in PNH. The REACTION observational cohort study describes the effectiveness and tolerability of ravulizumab in Italian patients who were previously treated with eculizumab. Eighty-one PNH patients were enrolled in this study. The primary endpoint was the percentage change in lactate dehydrogenase (LDH) from baseline to the end of observation (52 weeks follow-up). Among secondary endpoints, transfusion avoidance, breakthrough hemolysis (BTH) and patients' quality of life (QoL) were evaluated. The median (25-75 percentiles) percentage change in LDH at 52 weeks follow-up was -2.6 (-11.5-13.4) U/L, with 92.3% of the patients presenting LDH within or < 1.5 × upper limit of normal (ULN). Overall, 20 (25.0%) patients required transfusion during the eculizumab period and 15 (18.8%) during the ravulizumab. Seven BTH events were observed, 5 during eculizumab period and 2 (triggered by other medical conditions) during ravulizumab, suggesting the reduction of pharmacokinetic BTH during ravulizumab treatment. EORTC-QLQ-C30 and FACIT-Fatigue scores were similar to the general population, and patients' preference indicated ravulizumab as the favorite treatment. The REACTION study confirmed the effectiveness of ravulizumab in maintaining stable disease and hemolysis control in the real-world setting. Clinical trial registration. NCT05274633, 02-Mar-2022
Inter-rater reliability of CTCAE assessments with or without EORTC patient-reported outcome data in a mixed cancer population: a multinational, open-label, randomised controlled trial
No full textBackground: The Common Terminology Criteria for Adverse Events (CTCAE) is the standard for provider-based rating of adverse events in oncology, but its reliability for symptomatic adverse events is low. Patient-reported outcome (PRO) data might improve the inter-rater reliability of CTCAE assessments. We investigated whether providers' access to PRO data enhances the inter-rater reliability of CTCAE ratings and the detection of symptomatic adverse events.
Methods: This multinational, open-label, randomised controlled trial was done in 11 hospitals in ten countries. Adults (aged ≥18 years) with any cancer diagnosis receiving chemotherapy, immunotherapy, or radiotherapy of curative or palliative intent were eligible. Patients were randomly assigned (1:1) to the intervention group (in which providers saw patients' PRO data as they were doing CTCAE assessments) or the control group (in which providers did not have access to PRO data) within each centre through a minimisation algorithm and a weighted cutoff; no additional stratification factors were applied. Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and 16 additional items from the EORTC Item Library, covering 17 symptomatic adverse events. Two independent providers (oncologists or trained nurses) did CTCAE ratings. The primary endpoint was the inter-rater reliability of CTCAE ratings, expressed as intraclass correlation coefficients (ICCs), for all patients with complete assessments. The trial was registered at ClinicalTrials.gov (NCT04066868) and is now closed.
Findings: Between Feb 10, 2020, and Dec 6, 2024, a total of 1067 patients were enrolled (538 in the control group and 529 in the intervention group), with full data from 512 patients in the control group and 501 in the intervention group included in the analysis. Median age was 59 years (IQR 46-68); 558 (55·1%) of 1013 were female and 455 (44·9%) were male. Most had good functional status (403 [79%] of 512 had ECOG 0-1 in the control group and 371 [74%] of 501 in the intervention group). The most common cancer types were haematological (control group: 137 [27%] of 512; intervention group: 131 [26%] of 501), breast (control group: 118 [23%]; intervention group: 107 [21%]), and gastrointestinal (control group: 98 [19%]; intervention group: 89 [18%]). Inter-rater reliability was significantly higher in the intervention group for 13 of 17 symptomatic adverse events, with the largest differences for memory impairment (ICC 0·176; p<0·0001), irritability (0·161; p<0·0001), concentration impairment (0·157; p<0·0001), depression (0·126; p=0·0012), and anxiety (0·109; p=0·0018). There was no significant difference for pain, rash, and peripheral sensory neuropathy and the reliability was significantly higher in the control group than the intervention group for diarrhoea (ICC -0·066; p=0·013).
Interpretation: Availability of PRO data to providers for CTCAE rating improves the consistency of provider-based symptomatic adverse event detection in patients with cancer. PRO data supports reliable assessment of treatment-related toxicity, highlighting the value of integrating PRO data into clinical evaluations within cancer trials
Binary Structure of Pāṇini’s Treatment of Syntax
No full textPāṇini’s treatment of syntax is a domain that is still in need of further study. It is well known that Pāṇini makes almost no use of the notion of vākya, even though he is aware of it. On the contrary, to account for a certain number of syntactic phenomena (whether case syntax or sentence syntax), Pāṇini makes use of a set of tools that he in fact shares with the description of morphological phenomena. In this article, we wish to underline the fluidity with which Pāṇini handles these two categories by means of the same two basic operations (affixation and substitution) and the same series of semantic-syntactic relations. On the contrary, the metarule A 2.1.1 and the heading rule A 2.3.1—partially read here in an innovative manner—seem to be more markedly related to syntax and might have governed Pāṇini’s whole syntactic system
Semiotic problem framing: a new framework to guide students and teachers in conceptual understanding and teaching of physics
No full textProblem solving in physics requires more than applying formulas: it involves describing and modeling phenomena, connecting mathematics with physics, and justifying reasoning choices. This process, known as problem framing, has been extensively studied in its cognitive and epistemic dimensions, but its semiotic aspects – how visuals, symbols, language, and metaphors shape understanding – remain underexplored. Physics relies on multiple representational modes that must be coordinated to construct meaning, and semiotics plays a central role in this integration. In this theoretical paper, we propose a new framework – the Semiotic Problem Framing – that explicitly incorporates semiotics into existing problem framing in physics. SPF highlights how students mobilize and shift across linguistic, visual, symbolic, and metaphorical resources in problem solving. For students, it offers a guide to structure reasoning and develop representational fluency; for teachers, it provides a diagnostic tool to scaffold and monitor learning processes. SPF enables analysis of reasoning patterns and error types not captured in previous frameworks, and suggests new directions for instructional design in physics education
