Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
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The radiologist as an independent “third party” to the patient and clinicians in the era of generative AI
No full textRadiologists are crucial in the diagnostic workflow. They must maintain an independent perspective, being a “third party” to the patients and referral clinicians. This is important when documenting the absence of relevant abnormalities or providing information that contradicts the self-reported symptoms and/or the impression of the colleagues, as well as in the case of incidental findings that impact patient management. Appropriate communication is the outcome of this professional independence, becoming more and more important in the current era of application of generative artificial intelligence to the radiological world. In fact, while radiological reports could be improved by our smart use of large language models, patients are already using such tools to understand their meaning and practical implications
Testi e corpi di reclusi. Le morfologie del carcere di Antoine Volodine (a partire da Antonio Gramsci)
Get PDFQuesto contributo esamina Le post-exotisme en dix leçons, leçon onze di Antoine Volodine (1998), opera di finzione ascrivibile alla letteratura carceraria, facendo riferimento alle Lettere dal carcere (1926-1937) di Antonio Gramsci. Le Lettere di Gramsci rappresentano per l’analisi un modello esemplare di scrittura carceraria, capace di far emergere alcuni nuclei morfologici che affiorano come topoi nelle storie di detenzione sia finzionali sia non finzionali, in particolare la narrazione 1) del corpo incarcerato; 2) dell’esperienza alterata dello spazio e del tempo; 3) dell’esperienza onirica e immaginativa; 4) delle modalità e strategie di comunicazione tra detenuti
La gestione delle acque da parte della famiglia dei Valperga di Masino fra l’Ottocento e i primi anni del Novecento
Get PDFIl lavoro analizza l'evoluzione della gestione delle acque nel territorio canavesano attraverso il caso della famiglia dei Valperga di Masino, utilizzando una metodologia storica basata sull'analisi di documenti archivistici. Nella prima parte, si esamina il quadro normativo sabaudo riguardante le risorse idriche a partire dalla prima edizione delle Regie Costituzioni. Infatti, a seguito dell'affermazione del potere centrale, i Savoia cercarono di operare una centralizzazione, benché mediata e difficile. Ad esempio, le Regie Costituzioni del 1729 estendevano il concetto di demanialità a tutte le acque e a tutti i corsi d'acqua, regolamentando l'uso privato tramite concessioni regie. Nella seconda parte si illustrano due diversi modelli di gestione delle risorse idriche: in un primo momento la famiglia esercitava un controllo diretto e monopolistico sul territorio e sulle risorse idriche, in linea con le politiche feudali sabaude; verso la fine del XVIII secolo la famiglia assunse un ruolo di mero concessionario. L'ultima parte della tesi analizza, sembra sulla base dei documenti archivistici, la progressiva erosione delle prerogative feudali dei Valperga, evidenziando come le trasformazioni politiche e amministrative abbiano ridotto il loro ruolo nella gestione delle risorse idriche, riflettendo un più ampio processo di modernizzazione e centralizzazione di quel potere sovrano che si stava affermando
Chat digitali per il contrasto delle povertà relazionali: apprendimenti dalla valutazione quali-quantitativa di un intervento sociale
No full textLa catastrofe trionfante chiamata Neoliberismo
No full textRecensione al libro di Angelo d'Orsi, Catastrofe neoliberista. Il regime che ha devastato le nostre vite (Lad 2024
Daratumumab for PRCA after HCT: study and practical considerations from the EBMT Transplant Complications Working Party
No full text: Pure red cell aplasia (PRCA) is a relevant complication after ABO-mismatched allogeneic hematopoietic cell transplantation (HCT). No standard treatment exists, and practice is heterogenous. In this study, we took advantage of an international collaboration to describe characteristics and outcomes of patients receiving daratumumab for PRCA following first allogeneic HCT. We identified 45 patients meeting these criteria (median patient age, 56 years). The median time from HCT to PRCA was 55 days (IQR, 36-116) and all patients were transfusion-dependent at time of daratumumab start. Daratumumab was first-line treatment in 16 patients (36%), most patients (67%) received daratumumab intravenously, and median time from PRCA diagnosis and daratumumab start was 88 days (IQR, 59-219). Incidence of transfusion independence was 69% (95% confidence interval [CI], 52-80%) at 6 months and 80% (95% CI, 62-90%) at 12 months. Incidences of hemoglobin and reticulocyte recoveries were respectively 56 and 78% at 6 months and 65 and 83% at 12 months. Survival at 12 months was 81%, and of 8 deaths, 7 were GVHD- or infection-related. One death was associated with hemolytic anemia. This is the first international and largest study on the use of daratumumab for PRCA after allogeneic HCT, showing high response rates superior to that reported for other treatments. Seven incidents of severe adverse events (mostly infections) underscore the need for close monitoring, proactive management, and comparative studies to determine the role for daratumumab for PRCA. Last, based on these data and a comprehensive literature review, we provide practical consideration for modern PRCA treatment
Paclitaxel activates SOCE/ICRAC in dorsal root ganglion neurons: implications for paclitaxel-induced peripheral neuropathy
Get PDFPaclitaxel (PTX) is one of the most widely used antineoplastic drugs for the treatment of solid cancers. Its mechanism of action involves binding to β-tubulin subunits, leading to the stabilization of microtubule polymers and subsequent cell cycle arrest. Despite its efficacy, PTX is associated with significant adverse effects, most notably peripheral neurotoxicity and neuropathic pain, which represent the primary dose-limiting side effects. In sensory neurons, PTX affects multiple molecular pathways, with early alterations in excitability and calcium signaling following acute drug exposure. To investigate these mechanisms, we employed a combination of calcium imaging, electrophysiological techniques, and pharmacological approaches to explore the role of ORAI channels in the excitability and calcium dynamics of mouse dorsal root ganglion neurons. Our findings reveal that acute exposure to low doses of PTX triggers IP3-dependent calcium release and activates a store-operated calcium entry through STIM-ORAI dependent ICRAC. Moreover, acute PTX application induced the activation of a sustained calcium inward current, Vm depolarization and triggered action potential firing that was strongly attenuated by ICRAC inhibition. Molecular analyses further revealed a significant upregulation of Orai1, Orai2, and Stim2 mRNA levels, accompanied by elevated ORAI1 protein expression, in a rat model of paclitaxel-induced peripheral neuropathy. These results suggest that ORAI and STIM proteins represent promising molecular targets for developing therapies aimed at mitigating the side effects of PTX
Ethical and religious factors in the choices of healthcare professionals
Get PDFHealthcare professionals occupy a unique position, where personal beliefs, social values and professional ethics intersect. The interaction of factors, such as those mentioned above, is particularly relevant when, for example, they can influence and/or alter the lives of patients during the provision of
healthcare and health services.
The study aims to examine how religious and ethical considerations, even if «unconscious», can influence the decisions of healthcare professionals.The primary goal of the paper is to understand the depth of ethical and religious considerations in healthcare professionals’ decision-making processes.
Utilizing a comprehensive dataset of healthcare workers’ responses, the research, as of now, employs quantitative analyses to uncover patterns and differences between believers and
non-believers.
Despite a majority of believing healthcare professionals reporting that their religious faith has not strongly influenced their work choice, the nuanced data analysis reveals a different narrative. The findings reveal significant variances in motivations, with ethical considerations and religious beliefs
profoundly affecting career choices.
This article represents a preliminary exploration of the ways in which personal faith and ethical beliefs shape these pivotal decisions within the healthcare sector.
The results of this study have the potential to inform educational programs, policy frameworks, and institutional supports designed to navigate the complex ethical landscapes healthcare workers encounter.
This study endeavours to provide a nuanced perspective that respects thecomplexity of individual healthcare professionals’ motivations and experiences, while also considering the ethical implications of their faith-influenced decisions
Clinical impact of immunoglobulin light chain rearrangements in chronic lymphocytic leukemia
Get PDFChronic lymphocytic leukemia (CLL) is the most common leukemia in adult patients in the western world and is a highly heterogeneous disease. Some patients have an indolent disease and may never require treatment, whereas others have an aggressive disease and eventually transform into aggressive lymphoma, namely Richter syndrome (RS). This study aims to investigate the clinical impact of immunoglobulin light chain (IGL) rearrangements in CLL patients. Using a training-validation approach with two independent cohorts, it explores the prognostic significance of IGLV mutational status and their association with time to first treatment (TTFT), aiming to refine prognostic models for early-stage CLL. The training cohort included 573 unselected CLL patients, while the validation cohort consisted of 343 Rai 0 CLL patients. The study identifies that 99% sequence identity to the germline serves as an optimal cut-off for defining IGLV mutational status. Patients with unmutated (UM) IGLV genes had a significantly shorter TTFT compared to those with mutated (M) IGLV genes, a finding consistent across both cohorts, confirming that UM-IGLV was associated with poorer prognosis, with a 10-year treatment-free probability of 32.4% in the training cohort versus 73.2% for M-IGLV patients. Similar results were validated, with a 7-year treatment-free probability of 42.0% versus 73.7% for UM and M-IGLV patients, respectively. Additionally, the study evaluated the combined mutational status of IGHV and IGLV genes, finding that concordant UM status for both genes predicted the poorest TTFT outcomes, while concordant M status showed the best outcomes. The findings suggest that integrating IGLV mutational status with existing prognostic markers, such as IGHV status, provides a more refined risk stratification model. This study highlights the role of IGLV mutational status in early treatment decisions for CLL patients, offering a robust biomarker for clinical practice
