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NOVITA' IN TEMA DI ARCHIVIAZIONE
No full textCommento ragionato e criticità degli artt. 31-36 della legge n. 103 del 201
Efficacy and Safety of Immunosuppressive Agents for Thyroid Eye Disease
No full textPurpose: To determine the reliability of 3 scales for assessing soft tissue inflammatory and congestive signs associated with thyroid eye disease.
Methods: This was a multicentered prospective observational study, recruiting 55 adults with thyroid eye disease from 9 international centers. Six thyroid eye disease soft tissue features were measured; each sign graded using 3 scales (presence/absence [0-1], 3-point scale [0-2], and percentage [0-100]). Each eye was graded twice by 2 independent raters. Accuracy (fraction of agreement) was calculated between the 2 trials for each rater (intrarater reliability) and between raters for all trials (interrater reliability) to determine the most sensitive scale for each feature that maintained a threshold of agreement greater than 0.70. Trial, intrarater reliability, and interrater reliability were determined by accuracy measurement of agreement for each inflammatory/congestive feature.
Results: Fifty-five patients had 218 assessments for 6 thyroid eye disease metrics. The intrarater reliability for each feature was consistently better than the interrater reliabilities. Using an agreement of 0.70 or better, for the interrater tests, conjunctival and eyelid edema could be reliably measured using the 0-1 or 0-2 scale while conjunctival and eyelid redness could only be reliably measured with the binary 0-1 scale. Caruncular edema and superior conjunctival redness could not be measured reliably between 2 raters with any scale. The percentage scale had poor agreement unless slippage intervals of >20% were allowed on either side of the measurements.
Conclusions: Of the specific periocular soft tissue inflammatory features measured between raters in the Clinical Activity Score and Vision, Inflammation, Strabismus, Appearance scales, edema of the eyelids and conjunctiva could reliably be measured by both 0-1 and 0-2 scales, erythema of the eyelid and bulbar conjunctiva could reliably be measured only by the 0-1 scale, and the other parameters of superior bulbar erythema and caruncular edema were not reliably measured by any scal
Analisi elettorale di un cambiamento "radicale". Chi ha vinto e chi ha perso
No full textIl capitolo offre un'analisi dettagliata dell'esito delle elezioni politiche del 2018 attraverso una comparazione sincronica tra diverse aree del paese e un esame diacronico del consenso alle principali forze politiche dal dopoguerra fino agli anni più recenti. In particolare nella seconda parte del capitolo viene analizzata la crescita elettorale dei partiti anti-establishment e la sua conseguenza per la strutturazione del sistema partitico italiano
Progettare per abitare: strategia e tattiche per affrontare il mutamento
No full textIl contributo affronta il tema del progetto per l’abitare resiliente secondo una prospettiva strategica nel tentativo di individuare e definire nuovi paradigmi di riferimento per assecondare i mutamenti in atto nella politiche e nelle pratiche abitative. La resilienza costituisce una strategia che incorpora fluidamente l’incertezza e il mutamento, con manifeste influenze sulle scelte del processo costruttivo e gestionale della sua risultante lungo il proprio ciclo di vita, per affrontare traiettorie indeterminabili a priori. Dal punto di vista semantico significa pertanto caratterizzare in maniera decisa il progetto come predittivo, non del fenomeno, in quanto stato fisico, ma del cambiamento, integrando l’anticipazione della possibile trasformazione e giungere a una risultante progettuale sistemica, adattiva e reattiva al fenomeno trasformativo. In questo senso, l’idea di resilienza ridefinisce alcuni caratteri peculiari del progetto dell’abitare, facendo progredire la staticità della costruzione verso una dimensione spaziale dinamica, ad “assetto variabile”, assecondata da un sistema edilizio articolato, aperto, molteplice, con un elevato livello di variabilità dei suoi elementi tecnologici e ambientali, che assume il carattere di “meccanismo”
Platelet count does not predict bleeding in cirrhotic patients: Results from the PRO-LIVER Study
No full textOBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients
Assessment of Lung Cancer Risk on the Basis of a Biomarker Panel of Circulating Proteins
No full textThere is an urgent need to improve lung cancer risk assessment because current screening criteria miss a large proportion of cases
A review of past and present summer primary production processes in the Ross Sea in relation to changing ecosystems
No full textWe analyse primary production processes during austral summer 1996 and 2001 in different environmental conditions such as ice-free waters and extensive ice-covered areas. Spatio-temporal distribution of phytoplankton biomass and functional groups along with photosynthetic parameters are presented. Production vs irradiance (PvsE) experiments were performed using 14C incubations at several stations and three or four different depths to define the eco-physiology of phytoplankton communities. The results of the oceanographic campaign conducted in ice-free waters of the Ross Sea (summer 1996) emphasize that these ecosystems are characterized by high nutrient low chlorophyll (HNLC) conditions due to limiting factors (eg. Fe). Conversely, the results of the oceanographic cruise in extensively packice-covered areas (summer 2001) indicate that the average phytoplankton biomass (estimated from Chla) was about three times the values recorded in ice-free conditions, but the primary production was relatively lower. In fact, in situ primary production and PvsE experiments over few days show that high primary production values occurred in most of the area, but only within the first five meters of the water column and the melting pack ice. Notwithstanding some high values of phytoplankton biomass during the 2001 campaign, water column stability, similar irradiance levels along the water column, photosynthetic capacity was suppressed in deeper layers, indicating a low carrying capacity of the pelagic ecosystem due to iron limitation, as shown by low values of the photo-chemical efficiency of photosystem II (PSII), variable fluorescence and maximal fluorescence ratio (Fv/Fm). In contrast with a very high variability in phytoplankton biomass at several temporal and spatial scales, photosynthetic parameters (PB max , α, Ek) varied within narrow ranges. Relevant changes in phytoplankton abundance and species composition are reported in this study although the environmental factors that drive these changes in primary production processes and prevalence of principal functional groups of phytoplankton communities compared to the past (1996 and 2001) are still unknown. The effect of these changes on the carrying capacity of Ross Sea ecosystems, carbon export and the potentially new asset of the food web will need to be determined
The Italian autism network (ITAN): A resource for molecular genetics and biomarker investigations
No full textBackground: A substantial genetic component accounts for Autism Spectrum Disorders (ASD) aetiology, with some rare and common genetic risk factors recently identified. Large collections of DNAs from thoroughly characterized ASD families are an essential step to confirm genetic risk factors, identify new variants and investigate genotype-phenotype correlations. The Italian Autism Network aimed at constituting a clinical database and a biorepository of samples derived from ASD subjects and first-degree relatives extensively and consistently characterized by child psychiatry centers in Italy.
Methods: The study was approved by the ethical committee of the University of Verona, the coordinating site, and by the local ethical committees of each recruiting site. Certified staff was specifically trained at each site for the overall study conduct, for clinical protocol administration and handling of biological material. A centralized database was developed to collect clinical assessment and medical records from each recruiting site. Children were eligible for recruitment based on the following inclusion criteria: age 4-18 years, at least one parent or legal guardian giving voluntary written consent, meeting DSM-IV criteria for Autistic Disorder or Asperger's Disorder or Pervasive Developmental Disorder NOS. Affected individuals were assessed by full psychiatric, neurological and physical examination, evaluation with ADI-R and ADOS scales, cognitive assessment with Wechsler Intelligence Scale for Children or Preschool and Primary, Leiter International Performance Scale or Griffiths Mental Developmental Scale. Additional evaluations included language assessment, the Krug Asperger's Disorder Index, and instrumental examination such as EEG and structural MRI. DNA, RNA and plasma were collected from eligible individuals and relatives. A central laboratory was established to host the biorepository, perform DNA and RNA extraction and lymphocytes immortalisation.
Discussion: The study has led to an extensive collection of biological samples associated with standardised clinical assessments from a network of expert clinicians and psychologists. Eighteen sites have received ADI/ADOS training, thirteen of which have been actively recruiting. The clinical database currently includes information on 812 individuals from 249 families, and the biorepository has samples for 98% of the subjects. This effort has generated a highly valuable resource for conducting clinical and genetic research of ASD, amenable to further expansion.
Keywords: Autism Spectrum disorders; Biomarkers; Biorepository; Genetics
