Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
Not a member yet
52951 research outputs found
Sort by
Risk Factors for Valvulopathy Among Childhood Cancer Survivors
No full textImportance Substantial improvements in childhood cancer survival have created a critical need to address serious long-term health complications, such as valvular heart disease (VHD). Objective To identify treatment-related risk factors for VHD in a large European cohort of long-term childhood cancer survivors. Design, Setting, and Participants This nested case-control study used data from the PanCareSurFup (PanCare Childhood and Adolescent Cancer Survivor Care and Follow-Up Studies) and ProCardio cohorts, including detailed radiation dose reconstruction and chemotherapy exposure, for childhood cancer survivors from 7 European countries, diagnosed between 1940 and 2009, who survived at least 5 years after cancer diagnosis. Case patients, defined as having symptomatic VHD, were matched with controls 1:2 by subcohort, sex, age at cancer diagnosis, and calendar year of initial diagnosis. Data were analyzed from October 2023 to June 2025. Exposures Doses were calculated by performing a whole-body dosimetric reconstruction using a voxel-based anthropomorphic phantom with more than 200 delineated anatomic structures or substructures. Cumulative dose to cytotoxic agents was also assessed. Main Outcome and Measure Development of symptomatic VHD (grade ≥3 per the Common Terminology and Criteria for Adverse Events, version 4.03). Results Of the 225 cases, 136 participants (60.4%) were male, and 195 (86.7%) were diagnosed with VHD beyond 20 years from childhood cancer. Survivors receiving a mean heart radiation therapy (RT) dose of 5 to less than 15 Gy had an increased risk of VHD (odds ratio [OR], 4.7; 95% CI, 2.1-10.7) compared to those without heart RT, with higher risk when more than half of the heart was exposed. The heart RT dose response appeared exponential, with the OR being 104.1 (95% CI, 27.8-389.6) for mean heart dose of 30 Gy or more, increasing considerably with follow-up from 6.0 (95% CI, 1.4-26.5) after 5 to 19 years to 71.4 (95% CI, 20.4-250.0) after 30 or more years. Cumulative anthracycline doses of 400 mg/m2 or higher were also associated with increased VHD risk (OR, 3.8; 95% CI, 1.4-10.3), showing an exponential dose-response pattern. Cumulative exposure to platinum agents was associated with VHD risk in a linear manner. No statistically significant associations were found for other chemotherapy agents or radiation to the spleen. Conclusion and Relevance In this case-control study, heart RT, anthracyclines, and platinum agents were associated with increased VHD risk in childhood cancer survivors. Risks from both RT and anthracyclines were amplified with age and follow-up, underscoring the need for long-term cardiac surveillance
Out of the single‐neuron straitjacket: Neurons within assemblies change selectivity and their reconfiguration underlies dynamic coding
Get PDFAbstract: We investigated cell assemblies in the frontal cortex of macaques during two discrimination tasks. Focusing on the period of goal-action transformation, we extracted spikes fired during assembly activation from the full neural activity and showed that the contribution of a neuron to assembly coding, when it co-ordinates with other assembly neurons, differs from its coding in isolation. Neurons, with their flexible participation to multiple assemblies, contributed to the encoding of new information not encoded by the neurons alone. Even non-discriminative neurons acquired selectivity as part of the collective activity of the assemblies. Thus, neurons in their assemblies process distinct information for various purposes as a chess simul master, playing on multiple chessboards. The reconfiguration of the participation of the neurons into different assemblies in the goal-action transformation process translated into a dynamic form of coding, whereas minimal reconfiguration was associated with the static goal coding of the memory period. (Figure presented.). Key points: Traditionally, the coding properties of a neuron are studied using all its activity (full-spikes), irrespective of its co-ordination with different groups of neurons. With an assembly centered approach, we can determine the neuron's coding properties not in absolute terms, but relative to the assembly of neurons with which it co-ordinates. When neurons are studied in different assemblies—focusing only on the spikes fired during assembly coordination (assembly-spikes)—they can contribute to the coding of different variables. The coding flexibility of the same neuron in multiple assemblies increases the amount of information it can contribute to encoding compared to isolated neurons. Dynamic coding, as opposed to static coding, as observed during the goal-action transformation process, can be explained by an increase in the reconfiguration of active assemblies, with neurons contributing to the coding of different variables in different epochs, depending on which assembly is active
The 48-Hour Protocol on Deaths Following Traumatic Events at the Hospital of Novara in Eastern Piedmont, Italy: A Review of the Effectiveness of Reporting to the Judicial Authority
No full textIn the past decades, the autopsy rate has been declining worldwide, including in Italy, especially of judicial autopsies, partially losing sight of the pivotal
importance of autopsy in detecting the cause and the manner of death.1-4 Indeed, discrepancies between clinical diagnosis and hospital autopsy are quite high.5,6
This study aims to review the effectiveness of the “48-hours protocol” in operation at the hospital “Maggiore della Carità” of Novara. This protocol states that after the
death of a patient with a traumatic event in their past medical history, a notification of death must be sent to the Judicial Authority, which must be made aware that, after
a time of 48-hours, a non-judicial autopsy is planned, giving the time to decide if the autopsy should be changed into a judicial one or not.
The review was made on all cases in which the “48h protocol” came into effect, in the years 2017, 2020, and 2023. Out of the 127 medical death records, 116 were
correctly reported as 48-hour protocols. A total of 107 autopsies were carried out, among which 103 were hospital ones, and only 4 were judicial ones. The most
documented traumatic events were falls at home, followed by road traffic accidents. Over 46% of the autopsy results totally or partially differed from clinical diagnosis
made in the hospital.
The interpretation of the results of this study suggests three conclusions: first, the autopsy is pivotal to correctly detect the cause of death in traumatic deaths; second, the
Judicial Authority does not make enough and proper use of the “48-hours protocol,” underestimating the role of judicial autopsies; and third, that the protocol might be
too superficially used.
Therefore, some changes to the protocol should be made in order to have a better communication to the Public Prosecutor’s Office, maybe adding more specific
information to the reports sent to hopefully increase the authorities’ interest.
Once these details have been refined, and the usefulness of this protocol validated, it would also be desirable to disseminate it to other prosecutors’ offices to raise awareness
of the issue throughout Italy
Search for long-lived heavy neutral leptons in proton-proton collision events with a lepton-jet pair associated with a secondary vertex at = 13 TeV
No full textA search for long-lived heavy neutral leptons (HNLs) using proton-proton collision data corresponding to an integrated luminosity of 138 fb−1 collected at s = 13 TeV with the CMS detector at the CERN LHC is presented. Events are selected with a charged lepton originating from the primary vertex associated with the proton-proton interaction, as well as a second charged lepton and a hadronic jet associated with a secondary vertex that corresponds to the semileptonic decay of a long-lived HNL. No excess of events above the standard model expectation is observed. Exclusion limits at 95% confidence level are evaluated for HNLs that mix with electron and/or muon neutrinos. Limits are presented in the mass range of 1–16.5 GeV, with excluded square mixing parameter values reaching as low as 2 × 10−7. For masses above 11 GeV, the presented limits exceed all previous results in the semileptonic decay channel, and for some of the considered scenarios are the strongest to date
Exploring Anti-Neoplastic Activity of Chitosan Nanobubbles Decorated with ICOS-Fc and Loaded with Paclitaxel in a Human and Murine Model of Melanoma
No full textBackground: Paclitaxel (PTX) is an anti-neoplastic drug that inhibits not only melanoma cell proliferation but also migration and angiogenesis. ICOS-Fc is a recombinant molecule that triggers ICOS ligand (ICOSL) on tumor cells and cells of the tumor microenvironment and inhibits tumor growth, angiogenesis, and metastasis. This study investigated the effects of chitosan nanobubbles loaded with low doses of PTX and surface decorated with ICOS-Fc (ICOS-Fc-NB-PTX) in inhibiting in vitro and in vivo melanoma cell growth and invasiveness. Methods: Preparation and characterization of nanoformulations, as well as in vitro drug release studies, were carried out. Nanoformulations were studied both in vitro and in vivo. In melanoma cells, viability, migration, and invasion assays were analyzed. For the in vivo experiments, C57BL/6 Wild-type (WT) male mice were injected subcutaneously with D4M-3A cells, a murine melanoma cell line engineered to carry the BRAFV600E mutation. After treatments, in vivo tumor growth, proliferation, and angiogenesis markers were studied. Results: In vitro tests showed the great ability of ICOS-Fc-NB-PTX to inhibit cell viability, migration, and invasion. These results were confirmed in vivo, where the tumors of mice treated with ICOS-Fc-NB-PTX displayed decreased growth accompanied by downregulation of the proliferation marker Ki-67 and reduced development of CD31+ blood vessels. Conclusions: In conclusion, the ICOS-Fc-NB-PTX formulation deserves to be further analyzed as a highly effective combination for melanoma, exerting multifaceted anti-tumor activities
Review of top quark mass measurements in CMS
No full textThe top quark mass is one of the most intriguing parameters of the standard model (SM). Its value indicates a Yukawa coupling close to unity, and the resulting strong ties to Higgs physics make the top quark mass a crucial ingredient for understanding essential aspects of the electroweak sector of the SM. This review offers the first comprehensive overview of the top quark mass measurements performed by the CMS Collaboration using the data collected at centre-of-mass energies of 7, 8, and 13 TeV. Moreover, a detailed description of the top quark event reconstruction is provided and dedicated studies of the dominant uncertainties in the modelling of the signal processes are discussed. The interpretation of the experimental results on the top quark mass in terms of the SM Lagrangian parameter is challenging and is a focus of an ongoing discussion in the theory community. The CMS Collaboration has performed two main types of top quark mass measurements, addressing this challenge from different perspectives: highly precise ‘direct’ measurements, based on reconstructed top quark decay products and relying exclusively on Monte-Carlo simulations, as well as ‘indirect’ measurements, where the simulations are employed to determine parton-level cross sections that are compared to fixed-order perturbative calculations. Recent mass extractions using Lorentz-boosted top quarks open a new avenue of measurements based on top quark decay products contained in a single particle jet, with promising prospects for accurate theoretical interpretations
The effect of chronic kidney disease on adverse in-hospital outcomes after partial nephrectomy
No full textIntroduction: Preoperative chronic kidney disease (CKD) frequently affects patients with renal cell carcinoma undergoing partial nephrectomy (PN). However, the association between CKD and adverse in-hospital outcomes after PN has not been thoroughly investigated. Methods: Descriptive analyses, 1:2 propensity score matching (PSM) and multivariable logistic and Poisson regression models were used within the National Inpatient Sample (2006–2019) PN patients. CKD severity was stratified as mild (stage II) vs. moderate (stage III) vs. severe (stage IV/V). Results: Of 33,639 PN patients, 3,473 (10.4%) had CKD, classified as mild (1,821, 5.4%), moderate (1,343, 4.0%), and severe (309, 0.9%). In PN patients, overall CKD rate increased from 4.3–14.1% (2006–2019, EAPC: + 7.2%, p < 0.001). Any CKD in PN patients was associated with higher rates of adverse in-hospital outcomes in 14 of 15 categories, including acute kidney injury (+ 26.2%), overall complications (+ 22.6%), and prolonged length of stay (+ 13.5%, all p < 0.001). After detailed multivariable adjustment, any CKD in PN independently predicted higher rates of adverse in-hospital outcomes in 14 of 15 examined categories, with the odds ratio (OR) ranging from 8.13 for dialysis for acute kidney failure, 6.70 for acute kidney injury, and 2.6 for overall complications (all p < 0.001). Similar observations were made in analyses that relied on specific CKD severity (mild, moderate and severe). Conclusion: CKD patients invariably exhibited higher rates of adverse in-hospital outcomes after PN. In consequence, they should be given special attention for preoperative optimization, especially when CKD is either moderate or severe
National Benchmarking of Childhood Cancer Survival by Stage at Diagnosis in Italy (BENCHISTA-ITA): Study Protocol
No full textBACKGROUND: survival rates for childhood cancers have significantly improved over recent decades, with 5-year survival now approaching 90% for many types. However, documented variations in survival across European countries and Italian regions highlight the need to address inequalities. One of the most critical prognostic factors is the extent of tumour spread at diagnosis (tumour stage). OBJECTIVES: the BENCHISTA-ITA aims to enhance understanding of regional differences in childhood cancer survival and to promote the widespread adoption of the Toronto Guidelines (TG) by Italian cancer registries for the most common solid paediatric tumours. DESIGN: the study will examine stage distribution and survival for nine solid paediatric cancers: medulloblastoma, neuroblastoma, Wilms tumour, retinoblastoma, and ependymoma (age: 0-14 years), as well as astrocytoma, osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma (age: 0-19 years). SETTING AND PARTICIPANTS: the study will include all children under 15 or 20 years (depending on the tumour type) diagnosed between 01.01.2013 and 31.12.2017, with relevant histological codes. Participating Italian cancer registries will assign tumour stage at diagnosis using the Toronto Guidelines. STATISTICAL ANALYSIS: the statistical power to detect differences in stage distribution and survival rates among regions is limited by the number of incident cases per tumour type and region. Therefore, analyses will be descriptive, with 95% confidence intervals. Overall survival for each tumour type will be estimated using the Kaplan-Meier method. CONCLUSIONS: BENCHISTA-ITA represents an important step toward a more complete and standardized registration of childhood cancers in Italy. The results may support targeted interventions to reduce inequalities and improve outcomes for paediatric patients
Search for medium effects using jet axis decorrelation in inclusive jets from PbPb collisions at = 5.02 TeV
No full textThe jet axis decorrelation in inclusive jets is studied using lead-lead (PbPb) collisions at a center-of-mass energy per nucleon pair of 5.02 TeV. The jet axis decorrelation is defined as the angular difference between two definitions of the jet axis. It is obtained by applying two recombination schemes on all the constituents of a given jet reconstructed by the anti-kT sequential algorithm with a distance parameter of R = 0.4. The data set, corresponding to an integrated luminosity of 0.66 nb−1, was collected in 2018 with the CMS detector at the CERN LHC. The jet axis decorrelations are examined across collision centrality selections and intervals of jet transverse momentum. A centrality dependent evolution of the measured distributions is observed, with a progressive narrowing seen in more central events. This narrowing could result from medium-induced modification of the internal jet structure or reflect color charge effects in energy loss. This new measurement probes jet substructure in previously unexplored kinematic domains and show great promise for providing new insights on the color charge dependence of energy loss to jet-quenching models
Measurement of the and tH production rates in the H → decay channel using proton-proton collision data at = 13 TeV
No full textAn analysis of the production of a Higgs boson (H) in association with a top quark-antiquark pair (tt ̄H) or a single top quark (tH) is presented. The Higgs boson decay into a bottom quark-antiquark pair (H → bb ̄) is targeted, and three different final states of the top quark decays are considered, defined by the number of leptons (electrons or muons) in the event. The analysis utilises proton-proton collision data collected at the CERN LHC with the CMS experiment at s = 13 TeV in 2016–2018, which correspond to an integrated luminosity of 138 fb−1. The observed tt ̄H production rate relative to the standard model expectation is 0.33 ± 0.26 = 0.33 ± 0.17(stat) ± 0.21(syst). Additionally, the tt ̄H production rate is determined in intervals of Higgs boson transverse momentum. An upper limit at 95% confidence level is set on the tH production rate of 14.6 times the standard model prediction, with an expectation of 19.3−6.0+9.2. Finally, constraints are derived on the strength and structure of the coupling between the Higgs boson and the top quark from simultaneous extraction of the tt ̄H and tH production rates, and the results are combined with those obtained in other Higgs boson decay channels