Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
Not a member yet
52951 research outputs found
Sort by
Primary biliary cholangitis (PBC): evolving approaches and expert perspectives
No full textIntroduction: Primary biliary cholangitis (PBC) is a rare, chronic autoimmune cholestatic liver disease causing progressive destruction of intrahepatic bile ducts. Predominantly affecting women aged 35 to 70, PBC may remain asymptomatic for years before symptoms such as pruritus, fatigue, or sicca symptoms manifest. If untreated, PBC can progress to cirrhosis, liver failure and need for transplantation, significantly impacting life expectancy. Areas covered: Ursodeoxycholic acid (UDCA) remains the only approved first-line therapy. The recent withdrawal of obeticholic acid (OCA) from the European market, the only available second-line agent since 2016, highlighting the need for alternative options. The recent European Medicine Agency (EMA) approval of new peroxisome proliferator-activated receptor (PPAR) agonists is promising for patients with suboptimal response to UDCA. A literature review was conducted to map the patient journey and examine current treatments. Expert opinion: A panel of Italian expert hepatologists was involved to explore unmet needs along the patient journey and define clinical priorities. Focus areas included response monitoring, treatment evaluation timing, symptoms management - particularly pruritus and fatigue - and care of comorbid and high-risk patients. Many patients live with indolent disease, but some may require a more structured pathway, where emerging treatments can be an important turning point
Search for vector-like leptons with long-lived particle decays in the CMS muon system in proton-proton collisions at = 13 TeV
No full textA first search is presented for vector-like leptons (VLLs) exclusively decaying into a light long-lived pseudoscalar boson and a standard model τ lepton. The pseudoscalar boson is assumed to have a mass below the τ+τ− threshold, so that it decays exclusively into two photons. It is identified using the CMS muon system. The analysis is carried out using a data set of proton-proton collisions at a center-of-mass energy of 13 TeV collected by the CMS experiment in 2016–2018, corresponding to an integrated luminosity of 138 fb−1. Selected events contain at least one pseudoscalar boson decaying electromagnetically in the muon system and at least one hadronically decaying τ lepton. No significant excess of data events is observed compared to the background expectation. Upper limits are set at 95% confidence level on the vector-like lepton production cross section as a function of the VLL mass and the pseudoscalar boson mean proper decay length. The observed and expected exclusion ranges of the VLL mass extend up to 700 and 670 GeV, respectively, depending on the pseudoscalar boson lifetime
Partial vs. radical nephrectomy in pT3a renal cancer: Cancer-specific mortality according to fat invasion pattern
No full textIntroduction Within the SEER database (2010–2021), we tested for differences in cancer-specific mortality (CSM) between partial (PN) vs. radical (RN) nephrectomy in patients with pT3a renal cell carcinoma with either perinephric fat invasion (PFI) or sinus fat invasion (SFI). Patients and Methods Separate propensity score matching (PSM), multivariable competing risk regression (mCRR) analyses and cumulative incidence plots addressed CSM in patients with PFI and subsequently in patients with SFI, according to PN vs. RN. Subgroup analyses focused on patients with additional adverse pathological features: tumor size '4 cm, high nuclear grade or sarcomatoid dedifferentiation. Results Of 9,664 pT3aN0M0 RCC patients with fat invasion, 4379 (45.3%) had exclusive PFI vs. 4398 (45.5%) had exclusive SFI. In PFI patients, 1,321 (30.2%) patients underwent PN vs. 3,058 (69.8%) RN. After 1:1 PSM, 5-years CSM rates were 8.2 vs. 9.3% in PN vs. RN patients. In mCRR, PN vs. RN did not affect CSM (HR 0.99, P = 0.9), even in patients with additional adverse pathological features. In SFI patients, 395 (9.0%) patients underwent PN vs. 4003 (91.0%) RN. After 1:3 PSM, 5-years CSM rates were 7.5 vs. 10.3% in PN vs. RN patients. In mCRR, PN vs. RN did not affect CSM (HR 0.74, P = 0.2), even in patients with additional adverse pathological features. Conclusion PN does not predispose patients to a survival disadvantage in presence of either PFI or SFI, even in those with additional adverse pathological features defined as tumor size '4 cm, high nuclear grade or sarcomatoid dedifferentiation
The global epidemiology of acute kidney injury: challenges and opportunities
No full textAcute kidney injury (AKI) is a devastating complication of acute illness that affects adults and children across multiple settings worldwide and is associated with the development and progression of chronic kidney disease, increased mortality and increased resource utilization. Over the past two decades, standardization of criteria for AKI diagnosis and staging and the publication of multicentre studies have led to improved understanding of the AKI spectrum and provided insights into the heterogeneity of patient characteristics, processes of care and the environmental and sociodemographic factors that influence care delivery and outcomes. Substantial advances have been made in the utilization of electronic health records, biomarkers and care bundles — structured sets of evidence-based treatment practices — to improve the clinical management of AKI. The emerging fields of artificial intelligence and digital health may also provide ways to reduce the burden of this disease. However, these developments have occurred mainly in high-income countries and have yet to improve care delivery or outcomes in low-resource regions. Progress in the development of specific treatments for AKI is limited, and important gaps in knowledge and clinical practice remain, particularly in relation to the 5R framework (risk, recognition, response, renal support and rehabilitation) for managing AKI. An urgent need exists to address the wide variation and inequities in AKI management worldwide
Myeloid metabolism and its role in immunotherapy of cancer
Full text linkThe proper functioning of the immune system requires an adequate balance between myeloid and lymphoid populations. Tumor growth alters this balance, also through the dramatic expansion of immunosuppressive myeloid populations, which block specific immunity, fueling tumor growth and dissemination and limiting the effectiveness of antitumor therapies, including immunotherapy. Tumors alter the expansion and functions of myeloid cells by acting locally in the tumor microenvironment, as well as on myeloid progenitors, through the manipulation of metabolic traits that govern their functions. The understanding of these metabolic alterations and their clinical translation is expected to offer new valid therapeutic options
Search for pair production of heavy particles decaying to a top quark and a gluon in the lepton+jets final state in proton–proton collisions at
No full textA search is presented for the pair production of new heavy resonances, each decaying into a top quark (t) or antiquark and a gluon (g). The analysis uses data recorded with the CMS detector from proton–proton collisions at a center-of-mass energy of 13TeV at the LHC, corresponding to an integrated luminosity of 138fb-1. Events with one muon or electron, multiple jets, and missing transverse momentum are selected. After using a deep neural network to enrich the data sample with signal-like events, distributions in the scalar sum of the transverse momenta of all reconstructed objects are analyzed in the search for a signal. No significant deviations from the standard model prediction are found. Upper limits at 95% confidence level are set on the product of cross section and branching fraction squared for the pair production of excited top quarks in the t∗→tg decay channel. The upper limits range from 120 to 0.8fb for a t∗with spin-1/2 and from 15 to 1.0fb for a t∗with spin-3/2. These correspond to mass exclusion limits up to 1050 and 1700GeV for spin-1/2 and spin-3/2 t∗particles, respectively. These are the most stringent limits to date on the existence of t∗→tg resonances
Rethinking the ‘Average-Vulnerable’ Dichotomy: The Case for Emphasizing Elderly Vulnerability in the UCPD
No full textThe European population is ageing, and this demographic shift presents
significant challenges for private law. Current legal frameworks lack elderly-specific
protections, limiting the ability to effectively safeguard older individuals. Although
scholarly interest in ageing is growing, the legal concept of vulnerability in EU consumer
law still does not adequately recognize the elderly as a distinctively vulnerable group.
Marketing and behavioral research – including recent EU-level reports – have identified
older consumers as exhibiting a unique set of vulnerabilities. Building on this evidence,
the article proposes alternative legal approaches that move beyond the current reluc-
tance to treat the elderly as a specifically protected category. The article concludes that
extending greater legal protection to elderly individuals would mark a crucial step
toward a more inclusive society – especially in the face of rapid demographic change
Search for the Rare Decay (Formula presented) in Proton-Proton Collisions at (Formula presented)
No full textA search for the rare decay (Formula presented) is reported using proton-proton collision events at (Formula presented) collected by the CMS detector in 2022-2023, corresponding to an integrated luminosity of (Formula presented). This is the first analysis to use a newly developed inclusive dimuon trigger, expanding the scope of the CMS flavor physics program. The search uses (Formula presented) mesons obtained from (Formula presented) decays. No significant excess is observed. A limit on the branching fraction of (Formula presented) at 95% confidence level is set. This is the most stringent upper limit set on any flavor changing neutral current decay in the charm sector
Understanding the Tumor Microenvironmental Mechanisms Driving Immunotherapy Resistance in Colorectal Cancer Liver Metastases
No full textColorectal cancer (CRC) is the second deadliest cancer worldwide, being the presence of metastasis, mainly in the liver, a major contributor to high mortality rates in affected patients. The tumor microenvironment (TME)—comprisedofinteracting endothelial, stromal, and immune cells—plays a critical role in creating a supportive niche for tumor cell colonization and immune evasion and, thus, the establishment of metastases. The liver’s intrinsic nature further facilitates the development of immune tolerance, mediated by regulatory T cells, myeloid-derived suppressor cells, and soluble factors such as anti-inflammatory cytokines, which together dampen antitumor immune responses. This immunosuppressive milieu contributes significantly to resistance to immune checkpoint inhibitors, limiting the efficacy of immunotherapy in metastatic CRC. Deciphering the complex crosstalk between metastatic CRC cells and TME within the liver is essential for developing novel, effective immunotherapeutic approaches. Several strategies to overcome this lack of response are under research, including combination therapies, novel compounds, and approaches that target TME components. The scope of this review is to synthesize recent advances in the characterization of the hepatic metastatic microenvironment and emerging therapeutic approaches aimed at overcoming immune resistance in CRC liver metastases
Multiplicity dependence of charm baryon and charm meson production in pPb collisions at sNN=8.16TeV
No full textMeasurements of the production yields of charm baryons (Λc+) and charm mesons (D0) in proton-lead collisions at a nucleon-nucleon center-of-mass energy of 8.16 TeV are presented. The data were collected in 2016 with the CMS experiment and correspond to an integrated luminosity of 186 nb−1. The Λc+ baryon is reconstructed from the decay channel Λc+→KS0p, while the D0 meson is reconstructed via D0→K−π+. The Λc+ baryon and D0 meson yields are extracted in several charged-particle multiplicity classes. No strong multiplicity dependence of the Λc+-to-D0 yield ratio is observed, unlike the observed strange baryon to strange meson yield ratio of Λ/Λ ̅ to KS0, which shows a strong multiplicity dependence. This observation indicates different mechanisms for the multiplicity evolution of hadronization processes for charm and strange quarks and provides new constraints to the understanding of heavy flavor production and collectivity in small collision systems