187,697 research outputs found
UNRESECTABLE HEPATOCELLULAR CARCINOMA:META-ANALYSIS OD ARTERIAL EMBOLIZATION
No full text. Radiology. 2002 Jul;224(1):47-54.
Transarterial chemoembolization for unresectable hepatocellular carcinoma:
meta-analysis of randomized controlled trials.
Cammà C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, Andreone P,
Craxì A, Cottone M.
National Council of Research, Istituto Metodologie Diagnostiche Avanzate,
Palermo, Italy. [email protected]
Comment in
Radiology. 2003 May;227(2):611-2; author reply 612-3.
Radiology. 2004 Jan;230(1):300-1; author reply 301-2.
PURPOSE: To review the available evidence of chemoembolization for unresectable
hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: Computerized bibliographic searches with MEDLINE and
CANCERLIT databases from 1980 through 2000 were supplemented with manual
searches, with the keywords "hepatocellular carcinoma," "liver cell carcinoma,"
"randomized controlled trial [RCT]," and "chemoembolization." Studies were
included if patients with unresectable HCC were enrolled and if they were RCTs in
which chemoembolization was compared with nonactive treatment (five RCTs) or if
different transarterial modalities of therapy (13 RCTs) were compared. Data were
extracted from each RCT according to the intention-to-treat method. Five of the
RCTs with a nonactive treatment arm were combined by using the random-effects
model, whereas all 18 RCTs were pooled from meta-regression analysis.
RESULTS: Chemoembolization significantly reduced the overall 2-year mortality
rate (odds ratio, 0.54; 95% CI: 0.33, 0.89; P =.015) compared with nonactive
treatment. Analysis of comparative RCTs helped to predict that overall mortality
was significantly lower in patients treated with transarterial embolization (TAE)
than in those treated with transarterial chemotherapy (odds ratio, 0.72; 95% CI:
0.53, 0.98; P =.039) and that there is no evidence that transarterial
chemoembolization is more effective than TAE (odds ratio, 1.007; 95% CI: 0.79,
1.27; P =.95), which suggests that the addition of an anticancer drug did not
improve the therapeutic benefit.
CONCLUSION: In patients with unresectable HCC, chemoembolization significantly
improved the overall 2-year survival compared with nonactive treatment, but the
magnitude of the benefit is relatively small
Sustainable Energy Communities: Developing New Representations and Practices for the Italian Context
No full textPublic discourses on sustainable energy ideally fall within the area of a triangle defined by social representations of energy, energy governance and users. Therefore, full sustainability requires consumers to become citizens actively involved in participatory decision-making processes, renewable and diffused energy production and management (Devine-Wright, 2007).
Drawing on these premises, ACCESI project aims to identify psychosocial factors that foster or hinder the development of proper sustainable energy communities in Italy. In the first phase of the project we explored how sustainable energy is socially constructed in Italian parliamentary debates and national press (years 2009-2012) (Sarrica, Brondi & Cottone, in press). The second phase of the project - that is the focus of this contribution - aims to deepen positive case studies in the management of energy issues. A qualitative mixed-method approach was adopted: texts from local political debates and newspapers, semi-structured interviews with key informants, visual and ethnographic data were collected and analysed.
Results show that the proposed ‘triangular interpretative model’ of sustainable energy fits also local discourses on the issue: representations of energy, governance and users almost exclusively cover the contents of the discourses on sustainable energy. Production technologies enter these discourses crosswise and in unexpected ways. However, different interpretations of active cooperation between policy makers, stakeholders and citizens change the way in which representations of energy, management and citizens are put in relation one with the others: structural and cultural changes towards sustainability are enacted mainly when participation moves directly from the citizens
Partecipazione pubblica e accettabilità sociale nel cambiamento del sistema energetico: un’analisi socio-psicologica
No full textLeaving home, family support and intergenerational ties in Italy: Some regional differences
No full textIn Italy conditions at leaving home are characterized by high age at exit, high proximity with parents and widespread intergenerational support, showing important regional differences. According to the "familistic" approach such conditions spread from strong intergenerational ties. Proximity and support are considered proxies of ties’ strength so that different regional proximity and support correspond to different ties’ intensities. The study aims at analyzing similarities and differences about parent-child ties, proximity and support in selected Italian regions, Liguria, Umbria, Sicily and Sardinia. Results show important differences among regions with respect to proximity and support, suggesting different intensity of intergenerational ties.family ties, intergenerational proximity, intergenerational support, regional comparison
Intersoggettività a scuola. Proposta metodologica per l’analisi dei posizionamenti narrativi degli insegnanti
No full textLa qualità del clima scolastico è costruita e mantenuta nell’incontro quotidiano tra attori sociali, dunque curarsi delle relazioni a scuola favorisce l’incremento del benessere degli individui. Spesso, tuttavia, ci si trova sprovvisti degli strumenti concreti per affrontare problematiche relazionali. Con questo lavoro presentiamo un metodo per la valutazione e la comprensione delle relazioni sociali degli insegnanti di scuola primaria discutendo i risultati di una indagine sul campo.
Sono stati intervistati quindici insegnanti di un Istituto Comprensivo della provincia di Padova e l’incontro con ciascuno di essi è stato strutturato combinando due metodi, la diffusa intervista narrativa e l’analisi del repertorio delle posizioni personali. La procedura adottata si è rivelata efficace e in grado di portare alla luce la struttura sociale percepita dagli insegnanti
The project ACCESI: Socio-constructivist analysis of the Italian sustainable energy communities
No full text
Incidence of HSV and HPV with azathioprine
No full textIBd
Incidence of HSV and HPV
with azathioprine
Mario Cottone and Sara Renna
severe infections are an established risk of immunosuppressive therapy;
however, the risk of opportunistic infections in patients with IBd who
receive immunosuppressive therapy has so far only been studied
retrospectively. the increased incidence of herpes flares and development
or worsening of viral warts in patients with IBd who receive azathioprine
has now been demonstrated for the first time in a prospective study.
the rate of opportunistic infections
in patients with iBD is dependent on the
patient’s nutritional status, degree of innate
immune system activity, whether the
patient has undergone surgery and their
use of immunosuppressive drugs or biological
therapy.1 severe infections are a
welldocumented
risk in patients who are
treated with immunosuppressive therapy;2
however, use of immunosuppressants
as maintenance therapy in patients with
iBD is becoming increasingly common.
in a 2004–2005 crosssectional
study of
20,000 patients with iBD, conducted in
France, >50% of patients with Crohn’s
disease and approximately 25% of patients
with ulcerative disease had received the
immuno suppressant azathioprine.3
infections with varicellazoster
virus and
herpes simplex virus (Hsv) are common,
nonfatal conditions characterized by a unilateral,
painful, vesicular rash in a dermatomal
distribution. Patients with iBD are
hypothesized to be at increased risk of
these viral infections because of diseaserelated
alterations in immune function
and frequent use of immunosuppressive
medications. Data on infection with human
papillomavirus (HPv) species in patients
with iBD are scarce but seem to show
an increased incidence of this infection
in such patients.4 Different studies have
used various metho dological approaches
to evaluate the risk of these three viral
infections in patients with iBD but no
studies have evaluated the incidence of all
three viruses.
Korelitz et al.5 reported the incidence of
varicellazoster
infection in patients with
iBD who were treated with 6mercaptopurine
to be 2.2%. However, the researchers
did not provide a comparison with the
incidence of this infection in a control
population, which limits the conclusions
that can be drawn.
a case–control study by toruner et al.1
sought to identify the factors associated
with iBD and infection by comparing 100
consecutive patients with iBD who had
opportunistic infections to patients with
iBD who did not have a history of opportunistic
infection. although the relative
risk of infection was greatest in patients
>50 years of age (compared with those
≤24 years of age) and was independent
of immuno suppressant treatment, use of
cortico steroids, azathioprine and infliximab
was also associated with a significantly
increased risk of opportunistic infection.
the researchers reported a higher incidence
of varicellazoster,
Candida albicans and
Hsv infections in patients who received
immunosuppressant treatment than in
those who did not receive this therapy, but
did not provide values for the risk of any
single infection.
Gupta et al.6 carried out a similar but
larger study, in which the incidence of
varicellazoster
infections in 7,823 patients
with Crohn’s disease and 1,930 patients with
ulcerative colitis was compared with its
Practice points
■ The incidence of opportunistic infections,
for example with varicella-zoster virus
and human papillomavirus species,
are increased in patients with iBD who
receive immunosuppressant therapy
■ Concomitant treatment of the
opportunistic infection or suspension of
immunosuppressive medication are two
possible therapeutic strategies
■ vaccination for human papillomavirus
species is recommended for women
with iBD
© 2009 Macmillan Publishers Limited. All rights reserved
nature reviews | gastroenterology & hepatology volume 6 | auGust 2009 | 445
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incidence in 79,563 individuals without
iBD. Patients with Crohn’s disease or
ulcerative colitis had a higher risk of
varicellazoster
infection than indivi duals
in the control group. in a nested, case–
control study, 185 patients with Crohn’s
disease and varicellazoster
infections
and 266 patients with ulcerative colitis and
varicellazoster
infections were compared
with 1,787 patients with iBD but without
varicellazoster
infection. Patients who
received immuno suppressant medications
had a greater risk of varicellazoster
infection than those who did not receive
such therapy. the unadjusted and adjusted
odds ratios for receipt of a prescription
for azathioprine or 6mercapto
purine and
varicellazoster
infection were both 3.1.
unfortunately, this study did not investigate
the incidence of other opportunistic
infections, such as Hsv.
the studies described above are all
retrospec tive and are, therefore, constrained
by the usual limitations of this study type.
retrospective analyses of safety data cannot
accurately assess the true incidence of
benign infections because they are transient
conditions. such analyses, therefore,
rely on accurate recall of information by the
patient and can result in an underestimation
of incidence of infection. thus, the information
available from case–control studies
is of limited value; no direct way exists to
estimate the incidence or prevalence of
disease, nor the attributable or excess risk
of particular groups of patients.
the study by seksik et al.7 is the first
prospec tive study to investigate the
incidence of opportunistic infection in
patients with iBD who receive azathioprine
therapy. in this study, 230 patients with
iBD received either azathioprine (n = 169)
or nonimmuno suppressive therapy (n = 61).
the patients underwent a comprehensive
skin examination and completed a questionnaire
every 3–6 months, and the number
of opportunistic infections, including ear,
nose, and throat infections, bronchitis and
oral or genital Hsv flares was recorded.
the incidence of Hsv flares was significantly
greater in the group of patients who
received azathioprine than in patients
who did not do so (1.0 ± 2.6 versus 0.2 ± 0.8
per year, P = 0.04). similarly, significantly
more patients who received azathioprine
treatment experienced newonset
or
worsening viral warts (17.2% versus 3.3%
P = 0.004). these findings are in line with
those from other studies that have reported
an increased incidence of warts in immunosuppressed
patients—an observation that
was initially reported in renal transplant
recipients.8 Contrary to other studies in
the literature,1,5,6,9 however, seksik et al. did
not show an increase in the incidence of
varicellazoster
or cytomegalovirus infection
in patients with iBD who received
immunosuppressant therapy.
what are the implications of seksik et al.’s
findings? a detailed history of herpes infection
should be collected before immunosuppressive
treatment is initiated in
patients with iBD. However, no agreement
exists on what to do when an Hsv or other
infection is diagnosed during immunosuppressive
therapy. viget et al.10 suggest
that immunosuppressant therapy should
be withdrawn as soon as possible after the
identification of an opportunistic infection,
but seksik et al. suggest azathio prine
treatment should be maintained and concomitant
treatment with antiHsv
drugs
should be initiated. no data on the risk
of anogenital cancer related to persistent
HPv infection exist; therefore, in the case
of warts, suspension of immuno suppressive
treatment is advisable.
importantly, the findings from this
study suggest that gynecological examination
and cervical cancer screening should
be planned for women with iBD before
and after immuno suppressant treatment.
HPv vaccination is safe, immunogenic
and highly effective against infection with
specific species of HPv. Predictive data
also indicate that implementation of HPv
vaccination within a national screening
program is likely to be more costeffective
than current clinical practice methods.
the increasing incidence of HPv infection
in young women with iBD also indicates
that, in the future, emphasis may be placed
on the new generation of recombinant
HPv vaccines.
Dipartimento di Medicina, Pneumologia e
Fisiologia della Nutrizione, Università di
Palermo, Palermo, Italy (M. Cottone, S. Renna).
Correspondence: M. Cottone, Dipartimento di
Medicina, Pneumologia e Fisiologia della
Nutrizione, Università di Palermo. Ospedale V.
Cervello, Via Trabucco 180, 90146 Palermo,
Italy
[email protected]
doi:10.1038/nrgastro.2009.110
competing interests
The authors declare no competing interests.
1. Toruner, M. et al. Risk factors for opportunistic
infections in patients with inflammatory bowel
disease. Gastroenterology 134, 929–936
(2008).
2. Lichtenstein, G. R. et al. serious infections and
mortality in association with therapies for
Crohn’s disease: TReAT registry. Clin.
Gastroenterol. Hepatol. 4, 621–630 (2006).
3. Beaugerie, L. et al. The use of
immunomodulators and biologics in
inflammatory bowel diseases (iBD): a crosssectional
French nationwide cohort 2004–
2005 [Abstract]. Gastroenterology
130 (4 suppl. 2), A2 (2006).
4. Kane, s., Khatibi, B. & Reddy, D. Higher
incidence of abnormal Pap smears in women
with inflammatory bowel disease. Am. J.
Gastroenterol. 103, 631–636 (2008).
5. Korelitz, B. i., Fuller, s. R., warman, J. i. &
Goldberg, M. D. shingles during the course of
treatment with 6-mercaptopurine for
inflammatory bowel disease. Am. J.
Gastroenterol. 94, 424–426 (1999).
6. Gupta, G., Lautenbach, e. & Lewis, J. D.
incidence and risk factors for herpes zoster
among patients with inflammatory bowel
disease. Clin. Gastroenterol. Hepatol. 4,
1483–1490 (2006).
7. seksik, P. et al. incidence of benign upper
respiratory tract infections, Hsv and HPv
cutaneous infections in inflammatory bowel
disease patients treated with azathioprine.
Aliment. Pharmacol. Ther. 29, 1106–1113
(2009).
8. spencer, e. s. & Andersen, H. K. viral
infections in renal allograft recipients treated
with long-term immunosuppression. Br. Med. J.
2, 829–830 (1979).
9. warman, J. i., Korelitz, B. i., Fleisher, M. R. &
Janardhanam, R. Cumulative experience with
short- and long-term toxicity to
6-mercaptopurine in the treatment of Crohn’s
disease and ulcerative colitis. J. Clin.
Gastroenterol. 37, 220–225 (2003).
10. viget, n., vernier-Massouille, G., salmon-
Ceron, D., Yazdanpanah, Y. & Colombel, J. F.
Opportunistic infections in patients with
inflammatory bowel disease: prevention and
diagnosis. Gut 57, 549–558 (2008).
Credit: CDC images
© 2009 Macmillan Publishers Limited. All rights reserve
Structural Knowledge Extraction and Representation in Sensory Data
No full textDuring the last decades the availability of increasingly cheaper technology for pervasive monitoring has boosted the creation of systems able to automatically comprehend the events occurring in the monitored area, in order to plan a set of actions to bring the environment closer to the user's preferences.
These systems must inevitably process a great amount of raw data - sensor measurements - and need to summarize them in a high-level representation to accomplish their tasks. An implicit requirement is the need to learn from experience, in order to be able to capture the hidden structure of the data, in terms of relations between its key components. The availability of large collections of data, however, has increased the
awareness that "measuring" does not seamlessly translate into "understanding", and more data does not entail more knowledge. Scientific literature documents a massive use of Statistical Machine Learning in almost all data analysis and data mining applications, aiming at minimizing the need for a-priori knowledge. A remarkable drawback of such algorithms, however, is their failure to effortlessly provide insight about the most significant features of the data, as they typically just provide optimal parameter settings for a "black-box".
In this thesis, it is claimed that structure is the key to handle the complexity of acquiring knowledge from unstructured data in real-life scenarios.
A shift in perspective will allow to tackle with the unaddressed goal of representing knowledge by means of the structure inferred from the collected samples; more specifically, the suggestion is to state this process within the framework of formal languages and automata borrowing concepts and methods from Algorithmic Learning Theory.
In this context, knowledge extraction may be turned into structural pattern identification, letting syntactic models emerge from data itself.
In order to prove the soundness of this proposal, three different case studies will be presented, exploiting statistical learning, syntactical methods and formal languages, respectively. The third approach will be particularly useful to highlight the advantage of building intrinsically recursive models, which give multi-scale - more natural - representations; as a result, the computational burden that characterizes the huge volume of data will be lessened. Moreover, the task of designing reliable and efficient automatic systems for knowledge extraction can be alleviated by using such human-understandable models.During the last decades the availability of increasingly cheaper technology for pervasive monitoring has boosted the creation of systems able to automatically comprehend the events occurring in the monitored area, in order to plan a set of actions to bring the environment closer to the user's preferences.
These systems must inevitably process a great amount of raw data - sensor measurements - and need to summarize them in a high-level representation to accomplish their tasks. An implicit requirement is the need to learn from experience, in order to be able to capture the hidden structure of the data, in terms of relations between its key components. The availability of large collections of data, however, has increased the
awareness that "measuring" does not seamlessly translate into "understanding", and more data does not entail more knowledge. Scientific literature documents a massive use of Statistical Machine Learning in almost all data analysis and data mining applications, aiming at minimizing the need for a-priori knowledge. A remarkable drawback of such algorithms, however, is their failure to effortlessly provide insight about the most significant features of the data, as they typically just provide optimal parameter settings for a "black-box".
In this thesis, it is claimed that structure is the key to handle the complexity of acquiring knowledge from unstructured data in real-life scenarios.
A shift in perspective will allow to tackle with the unaddressed goal of representing knowledge by means of the structure inferred from the collected samples; more specifically, the suggestion is to state this process within the framework of formal languages and automata borrowing concepts and methods from Algorithmic Learning Theory.
In this context, knowledge extraction may be turned into structural pattern identification, letting syntactic models emerge from data itself.
In order to prove the soundness of this proposal, three different case studies will be presented, exploiting statistical learning, syntactical methods and formal languages, respectively. The third approach will be particularly useful to highlight the advantage of building intrinsically recursive models, which give multi-scale - more natural - representations; as a result, the computational burden that characterizes the huge volume of data will be lessened. Moreover, the task of designing reliable and efficient automatic systems for knowledge extraction can be alleviated by using such human-understandable models
Nouvelle publication : Ph. Rousseau & R. Saetta Cottone (dirs.)
No full textPhilippe Rousseau & Rossella Saetta Cottone (dirs.), Diego Lanza lecteur des oeuvres de l'Antiquité. Poésie, philosophie, histoire de la philologie, Villeneuve d'Ascq, Presses universitaires du Septentrion (coll. "Cahiers de philologie, vol. 29, série Apparat critique), 2013. 333 p. ISBN : 978-2-7574-04444-7. sommaire Figure critique majeure des études de philologie classique en Italie, Diego Lanza a renouvelé en profondeur l'approche des oeuvres de la littérature grecque ancienne. Ses trava..
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