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Superconducting parametric amplifiers offer the capability to amplify feeble signals with extremely low levels of added noise, potentially reaching quantum-limited amplification. This characteristic makes them essential components in the realm of high-fidelity quantum computing and serves to propel advancements in the field of quantum sensing. In particular, Traveling-Wave Parametric Amplifiers (TWPAs) may be especially suitable for practical applications due to their multi-Gigahertz amplification bandwidth, a feature lacking in Josephson Parametric Amplifiers (JPAs), despite the latter being a more established technology. This paper presents recent developments of the DARTWARS (Detector Array Readout with Traveling Wave AmplifieRS) project, focusing on the latest prototypes of Kinetic Inductance TWPAs (KITWPAs). The project aims to develop a KITWPA capable of achieving 20 dB of amplification. To enhance the production yield, the first prototypes were fabricated with half the length and expected gain of the final device. In this paper, we present the results of the characterization of one of the half-length prototypes. The measurements revealed an average amplification of approximately 9 dB across a 2 GHz bandwidth for a KITWPA spanning 17 mm in length. [ABSTRACT FROM AUTHOR]

Maladaptation is steadily increasing its presence in agenda and debates about climate change and its impacts. The term denotes actions undertaken, at the individual or collective level, to defend against the adverse effects of climate change or environmental degradation, but that ultimately exacerbate the underlying risk factors. In this paper, we investigate the effects of maladaptation in terms of well-being and inequality in a two-population (North–South) evolutionary model. While agents in the South often face higher vulnerability to environmental degradation and limited defense mechanisms compared to their Northern counterparts, the latter stand to endure greater economic losses, in absolute terms. Our model demonstrates that the diffusion of maladaptive choices could result in a Pareto-dominated steady state, influencing inequality levels positively or negatively based on the scale of maladaptation impacts relative to the existing environmental degradation. These findings stress the imperative of integrating environmental risk studies with maladaptive effects and dynamics. Additionally, they advocate for international discourse not only on climate change mitigation but also on adaptive measures among countries. [ABSTRACT FROM AUTHOR]

Purpose: Data from recently trials have provided practice-changing recommendations in management of the axilla in early breast cancer (eBC). However, further controversies have been raised, resulting in heterogeneous diffusion of these recommendations. Our purpose was to obtain a better homogeneity. Material and methods: In 2021, the Tuscan Breast Network (TBN) established a consensus with the aim to update recommendations in this area. We performed a literature review on axillary management in eBC patients which led to an expert Delphi consensus aiming to explore the gray areas, build consensus and propose evidence-based suggestions for an appropriate management. Thereafter, we investigate their implementation in clinical practice. Results: (1) DCIS patients should have SLN biopsy only in case of mastectomy or in conservative surgery if tumor is in a location that would preclude future nodal sampling or in case of a mass; (2) ALND may be omitted for 1–2 positive SLN patients undergoing BCS in T1-2 tumors with 1–2 SLN positive, eligible for whole-breast irradiation and adjuvant systemic therapies; (3) consider the option of RNI in patients with 1–3 positive lymph nodes and one or more high-risk characteristics; (4) the population identified in 2) should NOT undergo lymph node irradiation as an alternative to axillary surgery and (5) patients with clinically (pre-operatively) positive axilla, or undergoing primary systemic therapy, or outside the criteria reported in 2) must receive additional ALND and/or RT as per local policy. Conclusion: This consensus provided a practical tool to stimulate local and national breast surgical and radiotherapy protocols. [ABSTRACT FROM AUTHOR]

The recent emergence of low-cost virtual reality technologies, like 360° videos and images is attracting the attention of researchers suggesting it could be the next significant step in technological innovation. The birth of 360° videos and images is quite young, it goes back to the middle of the nineteenth century and then spread more and more in many areas. In recent years, 360° videos and images have grown in popularity because they provide a great number of advantages compared to traditional virtual reality computer-generated technology. The aim of this research is to map scientific works in the area of 360° technology using advanced scientometric techniques. We collected all the existent articles about 360° contents in the Scopus database, and the resultant dataset contained 3319 records. The bibliographic record encompassed all categories of scientific articles retrieved from Scopus, considering parameters such as countries, institutions, journals, authors, citation counts, and publication years. The network and cluster analysis of the literature showed a composite panorama characterized by changes and evolutions over time of the use of 360° contents. We discuss these aspects in the main areas of application with an emphasis on the future expected 360° capacities, increases, and challenges. As already happened with the advent of virtual reality, the future of 360° technology will be an increasing shift from engineering to clinical use, by improving the use and the development of scientific applications in clinical areas and by modifying social communication and interaction among people. [ABSTRACT FROM AUTHOR]

Imaging of the larynx and hypopharynx is frequently requested to assess the extent of neoplasms beyond the field of view of endoscopic evaluation. The combination of optical and cross-sectional imaging allows tumors to be classified according to AJCC/UICC guidelines. A thorough understanding of laryngeal and hypopharyngeal anatomy is crucial to guide the radiological eye along the possible pathways of the spread of diseases and to guide differential diagnoses. Computed tomography (CT) has been the first cross-sectional imaging technique used to evaluate the larynx and hypopharynx; its spatial resolution combined with volumetric capability and the use of injectable contrast medium made CT the working horse in the assessment of neoplastic and inflammatory diseases. In the last two decades, magnetic resonance (MR) supported CT in the most challenging cases, when the optimal contrast resolution due to the multisequence portfolio is needed to assess the neoplastic involvement of laryngeal cartilages, paraglottic space(s), and extra laryngeal spread. The aim of this paper is to give a comprehensive radiological overview of larynx and hypopharynx complex anatomy, combining in vivo images, anatomical sections, and images of ex vivo specimens. [ABSTRACT FROM AUTHOR]

Over the last two decades, awe has attracted the attention of an increasing number of researchers. The use of virtual reality has been identified as one of the most effective techniques for eliciting awe, in addition to more personalized methods for inducing emotion, such as autobiographical recall. However, previous measures of awe were unable to uncover the hidden structure of this experience. Awe experience scale (AWE-S) has been validated as a comprehensive measure of contingent awe in English, providing new opportunities for analysis. In this two-phases study, we investigated whether the latent structure of the experience of awe evoked by the autobiographical recall technique (Study 1) overlapped with that induced by exposing participants to a validated virtual reality awe-eliciting training (Study 2). The original English AWE-S structure held both in autobiographical recall induction and virtual reality-based elicitation. Despite evidence of overlap between English and Italian structures, low correlations were found between Italian trait measures used to test the concurrent validity of the AWE-S in the Italian sample and AWE-S state dimensions. This study highlights cultural differences in awe experience, trait, and state variations, and provides new insights into the standardized induction of this emotion through simulated environments. [ABSTRACT FROM AUTHOR]

Background: Moderate hypofractionated radiotherapy is a treatment option for the cure of localized prostate cancer (PCa) patients based on the results of randomized prospective trials, but there is a clinical concern about the relatively short length of follow-up, and real-world results on outcome and toxicity based on cutting-edge techniques are lacking. The objective of this study is to present the long-term results of a large multicentric series. Materials and methods: We retrospectively evaluated 1325 PCa patients treated with daily volumetric image-guided hypofractionated radiotherapy between 2007 and 2020 in 16 Centers. For survival endpoints, we used Kaplan–Meier survival curves and fitted univariate and multivariable Cox's proportional hazards regression models to study the association between the clinical variables and each survival type. Results: At the end of the follow-up, 11 patients died from PCa. The 15-year values of cancer-specific survival (CSS) and biochemical relapse-free survival (b-RFS) were 98.5% (95%CI 97.3–99.6%) and 85.5% (95%CI 81.9–89.4%), respectively. The multivariate analysis showed that baseline PSA, Gleason score, and the use of androgen deprivation therapy were significant variables for all the outcomes. Acute gastrointestinal (GI) and genitourinary (GU) toxicities of grade ≥ 2 were 7.0% and 16.98%, respectively. The 15-year late grade ≥ 2 GI and GU toxicities were 5% (95%CI 4–6%) and 6% (95%CI 4–8%), respectively. Conclusion: Real-world long-term results of this multicentric study on cutting-edge techniques for the cure of localized PCa demonstrated an excellent biochemical-free survival rate of 85.5% at 15 years, and very low rates of ≥ G3 late GU and GI toxicity (1.6% and 0.9% respectively), strengthening the results of the available published trials. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this survey was to evaluate the current state-of-art of pre-TAVI imaging in a large radiological professional community. Methods: Between December 2022 and January 2023 all members of the Italian Society of Medical and Interventional Radiology (SIRM) were invited by the CT PRotocol Optimization group (CT-PRO group) to complete an online 24-item questionnaire about pre-TAVI imaging. Results: 557 SIRM members participated in the survey. The greatest part of respondents were consultant radiologists employed in public hospitals and 84% claimed to routinely perform pre-TAVI imaging at their institutions. The most widespread acquisition protocol consisted of an ECG-gated CT angiography (CTA) scan of the aortic root and heart followed by a non-ECG-synchronized CTA of the thorax, abdomen, and pelvis. Contrast agent administration was generally tailored on the patient's body weight with a preference for using high concentration contrast media. The reports were commonly written by radiologists with expertise in cardiovascular imaging, and included all the measurements suggested by current guidelines for adequate pre-procedural planning. About 60% of the subjects affirmed that the Heart Team is present at their institutions, however only 7% of the respondents regularly attended the multidisciplinary meetings. Conclusions: This survey defines the current pre-TAVI imaging practice in a large radiological professional community. Interestingly, despite the majority of radiologists follow the current guidelines regarding acquisition and reporting of pre-TAVI imaging studies, there is still a noteworthy absence from multidisciplinary meetings and from the Heart Team. [ABSTRACT FROM AUTHOR]

Purpose: Inborn errors of IFN-γ immunity underlie Mendelian susceptibility to mycobacterial disease (MSMD). Twenty-two genes with products involved in the production of, or response to, IFN-γ and variants of which underlie MSMD have been identified. However, pathogenic variants of IFNG encoding a defective IFN-γ have been described in only two siblings, who both underwent hematopoietic stem cell transplantation (HCST). Methods: We characterized a new patient with MSMD by genetic, immunological, and clinical means. Therapeutic decisions were taken on the basis of these findings. Results: The patient was born to consanguineous Turkish parents and developed bacillus Calmette-Guérin (BCG) disease following vaccination at birth. Whole-exome sequencing revealed a homozygous private IFNG variant (c.224 T > C, p.F75S). Upon overexpression in recipient cells or constitutive expression in the patient's cells, the mutant IFN-γ was produced within the cells but was not correctly folded or secreted. The patient was treated for 6 months with two or three antimycobacterial drugs only and then for 30 months with subcutaneous recombinant IFN-γ1b plus two antimycobacterial drugs. Treatment with IFN-γ1b finally normalized all biological parameters. The patient presented no recurrence of mycobacterial disease or other related infectious diseases. The treatment was well tolerated, without the production of detectable autoantibodies against IFN-γ. Conclusion: We describe a patient with a new form of autosomal recessive IFN-γ deficiency, with intracellular, but not extracellular IFN-γ. IFN-γ1b treatment appears to have been beneficial in this patient, with no recurrence of mycobacterial infection over a period of more than 30 months. This targeted treatment provides an alternative to HCST in patients with complete IFN-γ deficiency or at least an option to better control mycobacterial infection prior to HCST. [ABSTRACT FROM AUTHOR]

Determining the mass of neutrinos is one of the most compelling topics in particle physics. HOLMES, an experiment for a direct measurement of the neutrino mass, is addressing this subject through a calorimetric approach, exploiting arrays of Low-Temperature Transition-Edge Sensor Detectors (TESs) loaded with 163 Ho. The experiment has entered its first phase in 2023, implanting approximately 1 Bq per pixel in an array of 64 detectors. In this work, I present the measurement made before this stage, in order to determine the expected background arising from natural radioactivity and cosmic rays. The significance of this background depends on the activity per pixel, which has yet to be defined based on the result of the first phase. [ABSTRACT FROM AUTHOR]

Interaction of intense lasers with nm thick targets provides an attractive regime for the acceleration of ions of all types. Acceleration of heavy ions however is undermined in the presence of low charge contaminant species due to their higher charge-to-mass ratio. Here we show narrow-band acceleration of very heavy Au ions from ~15 nm Au foils driven by a sub-Petawatt laser, with spectral peaks of 1.5 ± 0.5 GeV at fluxes on the order of 1012 particles per steradian. 3D and 2D particle-in-cell simulations show a complex interplay between different acceleration mechanisms at different stages of the interaction, suggesting the spectrally peaked Au ion bunches stem from strong radiation pressure acceleration on a heavy-ion dominant plasma in the moments just before transparency, followed by an efficient acceleration due to transparency-enhanced mechanisms. Acceleration of heavy ions is difficult in presence of low charge contaminants due to their high charge-to-mass ratio. The authors use ultra-thin Au foils to efficiently accelerate both contaminants and heavy ions, discussing the interplay between distinct acceleration mechanisms at different stages of interaction via particle-in-cell simulations. [ABSTRACT FROM AUTHOR]

The response of older people to the COVID-19 pandemic has attracted much attention as they are at increased risk of adverse outcomes. A longitudinal study has shown that improvement in global cognitive, executive and language functioning in healthy older adults enrolled at the University of the Third Age appears to play a protective role against emotional dysregulation and mood changes during the pandemic. To date, no study has examined emotional dysregulation through COVID-19-related images using facial electromyographic recordings in healthy older adults. Therefore, we aimed to analyze the relationships between zygomaticus and corrugator reactivity, neuropsychological measures, and the affective dimensions of arousal, dominance, and valence. The results showed an unexpected association between higher zygomaticus activity and higher levels of apathy, depression, and anxiety. In contrast, increased contracture of the corrugator was associated with poorer performance on cognitive tests (global cognition, memory, executive functions) and physical status, i.e., walking speed. These results are consistent with the reappraisal of emotional stimuli in response to the challenges of the pandemic. Interestingly, COVID-19-related stimuli triggered the activation of bottom-up affectivity strategies associated with higher mood levels and interacted with top-down factors that play an important role in the dysregulation of cognitive control. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the performance of Ultrasonography (US) and Magnetic Resonance Imaging (MRI) in assessing the Lateral Periarticular Space (LPAS) of Temporomandibular Joints (TMJs) in patients with Juvenile Idiopathic Arthritis (JIA). Methods: The LPAS width was evaluated in two different patient groups. In the JIA group, including 29 children (13 ± 2.8 years) with JIA, the LPAS width was measured with both MRI and US. In the healthy group, including 28 healthy children (12.6 ± 2.5 years), the LPAS width was measured only with US. Comparisons of LPAS width based on patient groups and TMJ contrast enhancement in MRI were evaluated by applying the Mann–Whitney U test. Correlation and agreement between MRI and US measurements in JIA group were tested using Spearman rank correlation and Bland–Altman method. Results: The LPAS width was significantly greater in the JIA group than in the healthy group. In the JIA group, the LPAS width was significantly greater in TMJs with moderate/severe enhancement than those with mild enhancement. A positive significant correlation between MRI and US measurements of LPAS width was found in the JIA group. In the same group, Bland–Altman method showed a good level of agreement between MRI and US measurements. Conclusion: Although, US cannot replace MRI in the evaluation of TMJ in patients with JIA, US could be used as a supplementary imaging method to MRI in assessing the TMJ disease. [ABSTRACT FROM AUTHOR]

An environmental policy to foster virtuous behaviour does not automatically establish a social norm in a population; that is, the policy might not be socially acceptable or enforceable. Some agents feel compelled to abide by environmental social norms and embrace them, but others do not. Some might want to imitate their peers, while others might prefer not to conform and play the role of a maverick. In this model, we describe the heterogeneity of preferences by proposing a taxonomy of five possible agent types that enrich the traditional triplet presented in the literature. We then employ a random matching model to study how a social norm spreads within a population when its composition changes. Considering three relevant population compositions (scenarios), we show that what is most important for the successful diffusion of social norms is not whether, but why agents abide by it. [ABSTRACT FROM AUTHOR]

Purpose: Persistent nonsolid nodules (NSNs) usually exhibit an indolent course and may remain stable for several years; however, some NSNs grow quickly and require surgical excision. Therefore, identifying quantitative features capable of early discrimination between growing and nongrowing NSNs is becoming a crucial aspect of radiological analysis. The main purpose of this study was to evaluate the performance of an open-source software (ImageJ) to predict the future growth of NSNs detected in a Caucasian (Italian) population. Material and methods: We retrospectively selected 60 NSNs with an axial diameter of 6–30 mm scanned with the same acquisition-reconstruction parameters and the same computed tomography (CT) scanner. Software-based analysis was performed on thin-section CT images using ImageJ. For each NSNs, several quantitative features were extracted from the baseline CT images. The relationships of NSN growth with quantitative CT features and other categorical variables were analyzed using univariate and multivariable logistic regression analyses. Results: In multivariable analysis, only the skewness and linear mass density (LMD) were significantly associated with NSN growth, and the skewness was the strongest predictor of growth. In receiver operating characteristic curve analyses, the optimal cutoff values of skewness and LMD were 0.90 and 19.16 mg/mm, respectively. The two predictive models that included the skewness, with or without LMD, exhibited an excellent power for predicting NSN growth. Conclusion: According to our results, NSNs with a skewness value > 0.90, specifically those with a LMD > 19.16 mg/mm, should require closer follow-up due to their higher growth potential, and higher risk of becoming an active cancer. [ABSTRACT FROM AUTHOR]

EXecutive-functions Innovative Tool 360° (EXIT 360°) is an original 360° instrument for an ecologically valid and multicomponent evaluation of executive functioning. This work aimed to test the diagnostic efficacy of EXIT 360° in distinguishing executive functioning between healthy controls (HC) and patients with Parkinson's Disease (PwPD), a neurodegenerative disease in which executive dysfunction is the best-defined cognitive impairment in the early stage. 36 PwPD and 44 HC underwent a one-session evaluation that involved (1) neuropsychological evaluation of executive functionality using traditional paper-and-pencil tests, (2) EXIT 360° session and (3) usability assessment. Our findings revealed that PwPD made significantly more errors in completing EXIT 360° and took longer to conclude the test. A significant correlation appeared between neuropsychological tests and EXIT 360° scores, supporting a good convergent validity. Classification analysis indicated the potential of the EXIT 360° for distinguishing between PwPD and HC in terms of executive functioning. Moreover, indices from EXIT 360° showed higher diagnostic accuracy in predicting PD group membership compared to traditional neuropsychological tests. Interestingly, EXIT 360° performance was not affected by technological usability issues. Overall, this study offers evidence that EXIT 360° can be considered an ecological tool highly sensitive to detect subtle executive deficits in PwPD since the initial phases of the disease. [ABSTRACT FROM AUTHOR]

Supercomputers are the most powerful computing machines available to society. They play a central role in economic, industrial, and societal development. While they are used by scientists, engineers, decision-makers, and data-analyst to computationally solve complex problems, supercomputers and their hosting datacenters are themselves complex power-hungry systems. Improving their efficiency, availability, and resiliency is vital and the subject of many research and engineering efforts. Still, a major roadblock hinders researchers: dearth of reliable data describing the behavior of production supercomputers. In this paper, we present the result of a ten-year-long project to design a monitoring framework (EXAMON) deployed at the Italian supercomputers at CINECA datacenter. We disclose the first holistic dataset of a tier-0 Top10 supercomputer. It includes the management, workload, facility, and infrastructure data of the Marconi100 supercomputer for two and half years of operation. The dataset (published via Zenodo) is the largest ever made public, with a size of 49.9TB before compression. We also provide open-source software modules to simplify access to the data and provide direct usage examples. [ABSTRACT FROM AUTHOR]

Older adults have been reported to have increased susceptibility to the adverse effects of SARS-CoV-2 infection, such as fatal outcomes, cognitive decline, and changes in physical and/or mental health. However, few studies have examined neuropsychological changes by comparing measurements before and during the pandemic in healthy older people. In addition, no longitudinal studies have examined whether older adults may have responded positively to the pandemic. We examined these issues through a 2-year neuropsychological study before and during the pandemic period. Results showed that scores before and during the pandemic were the same in memory and attention, whereas global cognitive, executive, and language functions improved. Participants also showed no longitudinal changes in depression, hypomania, and disinhibition, while apathy and, to a lesser extent, anxiety increased significantly. To examine possible signs of pandemic-related emotional (dys)regulation, subjects were shown images at follow-up that recalled the most dramatic lockdown phase while heart rate variability was recorded. Higher apathy was predicted by poorer global cognitive performance, increased anxiety, and emotional dysregulation as measured by a higher ratio of low-to-high frequency heart rate variability. Thus, preserved global cognition appears to play a protective role against the effects of pandemic-related anxiety and emotional dysregulation on apathy. [ABSTRACT FROM AUTHOR]

Nuclear fusion between protons and boron-11 nuclei has undergone a revival of interest thanks to the rapid progress in pulsed laser technology. Potential applications of such reaction range from controlled nuclear fusion to radiobiology and cancer therapy. A laser-driven fusion approach consists in the interaction of high-power, high-intensity pulses with H- and B-rich targets. We report on an experiment exploiting proton-boron fusion in CN-BN targets to obtain high-energy alpha particle beams (up to 5 MeV) using a very compact approach and a tabletop laser system with a peak power of ~10 GW, which can operate at high-repetition rate (up to 1 kHz). The secondary resonance in the cross section of proton-boron fusion (~150 keV in the center-of-mass frame) is exploited using a laser-based approach. The generated alpha particles are characterized in terms of energy, flux, and angular distribution using solid-state nuclear-track detectors, demonstrating a flux of ~105 particles per second at 10 Hz, and ~106 per second at 1 kHz. Hydrodynamic and particle-in-cell numerical simulations support our experimental findings. Potential impact of our approach on future spread of ultra-compact, multi-MeV alpha particle sources driven by moderate intensity (1016-1017 W/cm2) laser pulses is anticipated. Revived interest in proton-boron fusion has been fuelled by new laser matter interaction schemes with several possible applications. The authors report on a tabletop laser experiment that observes proton-boron fusion with an emphasis on the secondary cross-section peak around 150 keV. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic exposed significant vulnerabilities in systems of production and consumption. In particular, the economic and social implications of the pandemic highlighted the urgent need for more sustainable and less impactful practices of food production and consumption. Through a systematic literature review, this paper seeks to assess how the pandemic affected the phenomenon of food waste, with the aim of assessing whether the pandemic stimulated changes amongst food system actors, especially consumers. The findings indicate that consumers generally reported behavioural changes during the pandemic and claimed to have adopted sustainable practices that could contribute to reducing food waste. The results also reflect the rapid diffusion of practices such as food delivery during the pandemic, which requires further investigation in terms of its effects on the environment. Simultaneously, supply–demand shocks and disruptions were reported in the areas of production, processing, and retailing, suggesting the occurence of ripple effects. A call is made for greater resilience in the food system, through the adoption of sustainable and less impactful practices, supported by policy. [ABSTRACT FROM AUTHOR]

Introduction: The survival benefit of inguinal lymph node dissection (ILND) vs no ILND in patients with squamous cell carcinoma of the penis (SCCP) and the absence of lymph node invasion is unclear. We addressed this uncertainty within the Surveillance, Epidemiology and End Results (SEER 2000–2018) database. Material and methods: We identified lymph node negative SCCP patients who either underwent ILND (pN0) or clinical examination only (cN0). We tested for the effect of ILND vs no ILND on cancer-specific mortality (CSM) in Kaplan–Meier plots, univariable and multivariable Cox regression analyses, in a pT stage-specific fashion, before and after 1:3 propensity score matching (PSM). Sensitivity analyses were conducted according to historical and contemporary treatment periods as well as geographic regions. Results: Of 2520 SCCP patients, 369 (15%) underwent ILND (pN0) vs 2151 (85%) did not (cN0). The pN0 vs cN0 distribution according to pT stages was as follows: 80 (7%) vs 1092 (93%) in pT1b, and 289 (21%) vs 1059 (79%) in pT2-3. At 36 months, CSM-free survival in pT2-3 stage was 89% in ILND vs 74% in no ILND patients (multivariable hazard ratio: 0.42, CI 0.30–0.60, p < 0.001). This result was confirmed in sensitivity analyses, and after 1:3 PSM. The same analyses could not be completed in pT1b stage due to insufficient number of observations and events. Conclusions: In pT2-3 stage SCCP, a significantly lower CSM was recorded in lymph node negative patients treated with ILND than in their clinical lymph node negative counterparts who did not undergo ILND. [ABSTRACT FROM AUTHOR]

Objectives: While chest radiograph (CXR) is the first-line imaging investigation in patients with respiratory symptoms, differentiating COVID-19 from other respiratory infections on CXR remains challenging. We developed and validated an AI system for COVID-19 detection on presenting CXR. Methods: A deep learning model (RadGenX), trained on 168,850 CXRs, was validated on a large international test set of presenting CXRs of symptomatic patients from 9 study sites (US, Italy, and Hong Kong SAR) and 2 public datasets from the US and Europe. Performance was measured by area under the receiver operator characteristic curve (AUC). Bootstrapped simulations were performed to assess performance across a range of potential COVID-19 disease prevalence values (3.33 to 33.3%). Comparison against international radiologists was performed on an independent test set of 852 cases. Results: RadGenX achieved an AUC of 0.89 on 4-fold cross-validation and an AUC of 0.79 (95%CI 0.78–0.80) on an independent test cohort of 5,894 patients. Delong's test showed statistical differences in model performance across patients from different regions (p < 0.01), disease severity (p < 0.001), gender (p < 0.001), and age (p = 0.03). Prevalence simulations showed the negative predictive value increases from 86.1% at 33.3% prevalence, to greater than 98.5% at any prevalence below 4.5%. Compared with radiologists, McNemar's test showed the model has higher sensitivity (p < 0.001) but lower specificity (p < 0.001). Conclusion: An AI model that predicts COVID-19 infection on CXR in symptomatic patients was validated on a large international cohort providing valuable context on testing and performance expectations for AI systems that perform COVID-19 prediction on CXR. Key Points: • An AI model developed using CXRs to detect COVID-19 was validated in a large multi-center cohort of 5,894 patients from 9 prospectively recruited sites and 2 public datasets. • Differences in AI model performance were seen across region, disease severity, gender, and age. • Prevalence simulations on the international test set demonstrate the model's NPV is greater than 98.5% at any prevalence below 4.5%. [ABSTRACT FROM AUTHOR]

The assessment of the absolute ν mass scale is a crucial challenge in today's particle physics and cosmology. The only experimental method which can provide a model-independent measurement is the investigation of endpoint distortion in beta/electron capture spectra. 163 Ho is a good choice thanks to its low electron capture Q value (about 2.8 keV), the proximity of the end-point to resonance M1 and its half-life (4570 years). The HOLMES experiment will exploit a calorimetric measurement of 163 Ho decay spectrum deploying a large set of cryogenic micro-calorimeters containing implanted 163 Ho. In order to get the best experimental sensitivity, it is crucial to combine high activity with very small undetected pileup contribution. Therefore, the main tasks of the experiment consist of: the development of about 1000 fast (3 μ s time resolution) cryogenic micro-calorimeters characterized by extraordinary energy resolution (down to few eV); the embedding of 163 Ho source inside the calorimeters, avoiding to spoil detectors' thermodynamical properties (mainly heat capacity) and preventing pileup issues. Moreover, it is also necessary to avoid contamination from other radionuclides, mainly 166 m Ho. Finally, an efficient high-bandwidth multiplexed readout has to be developed. The commissioning of the first implanted array is currently ongoing; the first data acquisition is expected to start in fall 2022. Here, the status of the experiment and the first results of detector commissioning will be discussed. [ABSTRACT FROM AUTHOR]

The HOLMES experiment aims to directly measure the ν mass studying the 163 Ho electron capture decay spectrum developing arrays of TES-based microcalorimeters implanted with O(300 Bq/detector) Ho atoms. The embedding of the source inside detectors is a crucial step of the experiment. Because the 163 Ho production process (neutron irradiation of a 162 Er sample) is not perfectly free from impurities, Ho source must be separated from a lot of contaminants. A chemical processing removes every species other than Ho, but it is not sufficient to remove all isotope-related background sources: Indeed, 166 m Ho beta decay can produce fake signal in the region of interest. For this reason, a dedicated implantation system was set up. It is designed to achieve the separation power better than 5 σ at 163/166 a.m.u. allowing an efficient Ho ions implantation inside microcalorimeter absorbers. Its main components are a 50 kV sputter-based ion source, a magnetic dipole and a target chamber. A specially designed co-evaporation system was designed to "grow" the gold microcalorimeter absorber during the implantation process, increasing the maximum achievable activity which can be implanted. The machine performances were evaluated by means of calibration runs using 63 Cu/ 65 Cu and Mo beams. A special care was given to the study of the more effective way to populate source plasma with Ho ions obtained from different Ho compounds by sputtering process. In this work, the machine development and commissioning are described. [ABSTRACT FROM AUTHOR]

Recent advances in non-metastatic breast cancer radiation therapy significantly reshaped our views on modern dose and fractionation schedules. Especially the advent of hypofractionation and partial breast irradiation defined a new concept of treatment optimization, that should strongly include both patient and tumour characteristics in the physician's decision-making process. Unfortunately, hypofractionation for breast cancer radiation therapy needed long time to enter the routine practice during the last decades despite the level-1 evidence published over time. Hereby we present the Italian Association for Radiotherapy and Clinical Oncology (AIRO) Breast Cancer Group position statements for postoperative breast cancer radiation therapy volume, dose, and fractionation to harmonically boost routine clinical practice implementation following evidence-based data. [ABSTRACT FROM AUTHOR]

Aims: The prevention of pulmonary toxicity is an important goal for patient candidate to radiation therapy for lung cancer. There is a lack of evidence on the role of exercise training for patients with unresectable stage III lung cancer candidated to radical treatment. The aim of this study was to evaluate the feasibility of a home-based pulmonary rehabilitation (PR) program and to identify reliable tools in terms of respiratory function, exercise capacity and quality of life. Methods: Patients' recruitment lasted from April 2020 till February 2022. The PR program was proposed concomitantly to radiation therapy to the first 20 patients (interventional group, IG), and the other 20 patients were identified as an observational group (OG). All patients were assessed at baseline (T0) and after 8 weeks (T2) with 6 minute walking test (6MWT), modified Borg Scale (mBORG), SF-36 questionnaire (SF-36) and pulmonary function test (PFT); after 4 weeks (T1), only SF-36 was administered. Results: A decrease of 13.8 m in the walked-distance was registered in the OG between T0 and T2 (p = 0.083). Instead, an increase of 56.6 m in the distance walked was recorded in the IG between T0 and T2 (p ≤ 0.001). In the OG, the mBORG scores showed a negative trend. On the contrary, in the IG, these scores showed a slight improvement. In the OG, all the items of SF-36 scores decreased between T0 and T1. In the IG, an increased trend from T0 to T2 was observed for all the items of SF-36. No clinically significant variations were detected from baseline to T2 in both groups regarding PFT. Conclusion: The 6MWT, mBORG and SF-36 resulted as useful tools to assess the role of a PR program. A significant gain in functional exercise capacity and a prevention of the physiological impairment of QoL during radio(chemo)therapy was registered. [ABSTRACT FROM AUTHOR]

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible disease. Surgical results have been well described in the literature, but only a few studies investigated the subjective outcome. This study aimed to investigate the patient's expectations about surgery, the perceived improvement after treatment, and its impact on the quality of life (QoL). Methods: A new dedicated survey was created to investigate subjectively different aspects of the treatment pathway of iNPH (diagnosis, symptoms, expectations from surgery, surgical operation, surgical results, and postoperative QoL), together with the SF-12 and EQ-5D as validated, standardized tools. Results: Forty-five patients were included. Forty-three percent of cases received the diagnosis after at least 1 year, with symptoms worsening in 73%, and frustration in 93%. Reaching a diagnosis was important for 100% of patients, with high expectations from surgery; 86% of them hoped to return to a normal life. Seventy-two percent of patients reported a significant postoperative improvement (walking 68%, mood 57%). Memory and incontinence did not improve in 64% of cases. Subjectively, QoL improved in 72% of cases. The SF-12 score is comparable to controls >75 years, but lower than the 65–75 years group. The EQ-5D index was 0.66 (lower than those of the 65–75 years group = 0.823, and >75 years group = 0.724). Pain and discomfort, instead, were lower compared to the healthy population (43% vs 56%). The idea of having an implanted device and of long-term follow-up is not worrying for 80% of patients; approximately two-thirds of them reported a regained control of their lives. Conclusions: The importance of early diagnosis and patients' perspective, alongside clinical evaluation, is highlighted. The self-reported evaluations on symptoms and QoL, along with the balance between postoperative worries and benefits, should be discussed preoperatively with patients and relatives, and included postoperatively to comprehensively assess the surgical outcome. [ABSTRACT FROM AUTHOR]

Reducing noise to the quantum limit over a large bandwidth is a fundamental requirement for future applications operating at millikelvin temperatures, such as the neutrino mass measurement, the next-generation X-ray observatory, the CMB measurement, the dark matter and axion detection, and the rapid high-fidelity readout of superconducting qubits. The read out sensitivity of arrays of microcalorimeter detectors, resonant axion-detectors, and qubits, is currently limited by the noise temperature and bandwidth of the cryogenic amplifiers. The Detector Array Readout with Traveling Wave Amplifiers project has the goal of developing high-performing innovative traveling wave parametric amplifiers with a high gain, a high saturation power, and a quantum-limited or nearly quantum-limited noise. The practical development follows two different promising approaches, one based on the Josephson junctions and the other one based on the kinetic inductance of a high-resistivity superconductor. In this contribution, we present the aims of the project, the adopted design solutions and preliminary results from simulations and measurements. [ABSTRACT FROM AUTHOR]

As the Intergovernmental Panel on Climate Change (2018) testifies, the world is a long way from halting climate change, let alone reverting it. The existence of adaptation and mitigation technologies did not prove sufficient, their adoption being respectively faulted or hindered by the presence of externalities. In this work, we study how externalities, whether positive or negative, lead the system away from Pareto-dominant (social optimum) states, towards Pareto-dominated ones. We show that adoption gaps, i.e. differences between socially optimum vs current adoption shares, of both (mal)adaptation and mitigation technologies are caused by the externalities emitted. In particular, over-adoption may occur for maladaptive technologies, whereas under-adoption may occur in case of mitigation. We employ a model with two regions at different stages of development and also derive relevant considerations on possible counterproductive effects of green policies and environmental dumping. [ABSTRACT FROM AUTHOR]

We analyse the international dimension of the EU Emissions Trading System (EU ETS) over the past two decades and in the foreseeable future by reviewing facts and economic theory. The facts mainly concern the international climate change regime and the EU's relevant experience in international cooperation. Club theory shows how incentives can be created for cooperation on climate mitigation. The linkage of the EU ETS to the Kyoto flexible mechanisms had mixed results: it promoted emissions trading abroad, but the inflow of credits into the EU ETS added to a large market surplus and the environmental integrity of certain credits was problematic. Looking ahead, the ability of the EU ETS to reduce foreign emissions may grow. Key will be whether competitiveness and distributional effects are successfully addressed. The Carbon Border Adjustment Mechanism might help the EU reduce the risk of carbon leakage while incentivising emission reductions in countries exporting to the EU. The EU's focus on reducing domestic emissions only, suggests we will probably not see new international linkages this decade. However, it cannot be excluded that the EU will revisit its decision and relax the domestic constraint. [ABSTRACT FROM AUTHOR]

Purpose: to compare observed overall survival vs age-adjusted lifetable (LT) derived life expectancy (LE) in metastatic urothelial bladder cancer (MBCa) patients according to race/ethnicity. Methods: We identified Caucasian, African American, Hispanic/Latino and Asian metastatic urothelial bladder cancer patients from 2004 to 2011 within the Surveillance, Epidemiology and End Results database. Social Security Administration tables were used to compute 5 year LE. LT-derived LE was compared to observed overall survival OS. Additionally, we relied on Poisson regression plots to display cancer-specific mortality (CSM) relative to other-cause mortality (OCM) for each race/ethnicity. Results: Overall, 2286 MBCa patients were identified. Of those, 1800 (79%) were Caucasian vs 212 (9.3%) African American vs 189 (8.3%) Hispanic/Latino vs 85 (3.7%) Asians. The median age at diagnosis was 71 years for Asians vs 70 for Caucasians vs 67 for Hispanic/Latinos vs 67 for African Americans. African Americans showed the biggest difference between observed OS and LT-predicted LE at five years (− 83.8%), followed by Hispanic/Latinos (− 81%), Caucasians (− 77%) and Asian patients (− 69%). In Poisson regression plots, Hispanic/Latinos displayed the highest cancer-specific mortality rate (88%), while African/Americans showed the highest other cause mortality rate (12%). Conversely, Asian patients displayed the lowest CSM rate (83%) and second lowest OCM rate (7%). Conclusions: African Americans showed the least favorable survival profile in MBCa, despite being youngest at diagnosis. Contrarily, Asians displayed the best survival profile in MBCa, despite being oldest at diagnosis. [ABSTRACT FROM AUTHOR]

Experiments aiming at high sensitivities usually demand for a very high statistics in order to reach more precise measurements. However, for those exploiting Low Temperature Detectors (LTDs), a high source activity may represent a drawback, if the events rate becomes comparable with the detector characteristic temporal response. Indeed, since commonly used optimum filtering approaches can only process LTDs signals well isolated in time, a non-negligible part of the recorded experimental data-set is discarded and hence constitute the dead-time. In the presented study we demonstrate that, thanks to the matrix optimum filtering approach, the dead-time of an experiment exploiting LTDs can be strongly reduced. [ABSTRACT FROM AUTHOR]

Purpose: To compare cancer-specific mortality (CSM) and overall mortality (OM) between immediate radical cystectomy (RC) and Bacillus Calmette–Guérin (BCG) immunotherapy for T1 squamous bladder cancer (BCa). Methods: We retrospectively analysed 188 T1 high-grade squamous BCa patients treated between 1998 and 2019 at fifteen tertiary referral centres. Median follow-up time was 36 months (interquartile range: 19–76). The cumulative incidence and Kaplan–Meier curves were applied for CSM and OM, respectively, and compared with the Pepe–Mori and log-rank tests. Multivariable Cox models, adjusted for pathological findings at initial transurethral resection of bladder (TURB) specimen, were adopted to predict tumour recurrence and tumour progression after BCG immunotherapy. Results: Immediate RC and conservative management were performed in 20% and 80% of patients, respectively. 5-year CSM and OM did not significantly differ between the two therapeutic strategies (Pepe–Mori test p = 0.052 and log-rank test p = 0.2, respectively). At multivariable Cox analyses, pure squamous cell carcinoma (SqCC) was an independent predictor of tumour progression (p = 0.04), while concomitant lympho-vascular invasion (LVI) was an independent predictor of both tumour recurrence and progression (p = 0.04) after BCG. Patients with neither pure SqCC nor LVI showed a significant benefit in 3-year recurrence-free survival and progression-free survival compared to individuals with pure SqCC or LVI (60% vs. 44%, p = 0.04 and 80% vs. 68%, p = 0.004, respectively). Conclusion: BCG could represent an effective treatment for T1 squamous BCa patients with neither pure SqCC nor LVI, while immediate RC should be preferred among T1 squamous BCa patients with pure SqCC or LVI at initial TURB specimen. [ABSTRACT FROM AUTHOR]

Chronic granulomatous disease (CGD) is a rare inborn error of immunity (IEI), characterized by a deficient phagocyte killing due to the inability of NADPH oxidase to produce reactive oxygen species in the phagosome. Patients with CGD suffer from severe and recurrent infections and chronic inflammatory disorders. Onset of CGD has been rarely reported in neonates and only as single case reports or small case series. We report here the cases of three newborns from two different kindreds, presenting with novel infectious and inflammatory phenotypes associated with CGD. A girl with CYBA deficiency presented with necrotizing pneumonia, requiring a prolonged antibiotic treatment and resulting in fibrotic pulmonary changes. From the second kindred, the first of two brothers developed a fatal Burkholderia multivorans sepsis and died at 24 days of life. His younger brother had a diagnosis of CYBB deficiency and presented with Macrophage Activation Syndrome/Hemophagocytic Lympho-Histiocytosis (MAS/HLH) without any infection, that could be controlled with steroids. We further report the findings of a review of the literature and show that the spectrum of microorganisms causing infections in neonates with CGD is similar to that of older patients, but the clinical manifestations are more diverse, especially those related to the inflammatory syndromes. Our findings extend the spectrum of the clinical presentation of CGD to include unusual neonatal phenotypes. The recognition of the very early, potentially life-threatening manifestations of CGD is crucial for a prompt diagnosis, improvement of survival and reduction of the risk of long-term sequelae. [ABSTRACT FROM AUTHOR]

Purpose: Given the absence of standardized planning approach for clinically node-positive (cN1) prostate cancer (PCa), we collected data about the use of prophylactic pelvic irradiation and nodal boost. The aim of the present series is to retrospectively assess clinical outcomes after this approach to compare different multimodal treatment strategies in this scenario. Methods: Data from clinical records of patients affected by cN1 PCa and treated in six different Italian institutes with prophylactic pelvic irradiation and boost on pathologic pelvic lymph nodes detected with CT, MRI or choline PET/CT were retrospectively reviewed and collected. Clinical outcomes in terms of overall survival (OS) and biochemical relapse-free survival (b-RFS) were explored. The correlation between outcomes and baseline features (International Society of Urological Pathology-ISUP pattern, total dose to positive pelvic nodes ≤ / > 60 Gy, sequential or simultaneous integrated boost (SIB) administration and definitive vs postoperative treatment) was explored. Results: ISUP pattern < 2 was a significant predictor of improved b-RFS (HR = 0.3, 95% CI 0.1220–0.7647, P = 0.0113), while total dose < 60 Gy to positive pelvic nodes was associated with worse b-RFS (HR = 3.59, 95% CI 1.3245–9.741, P = 0.01). Conversely, treatment setting (postoperative vs definitive) and treatment delivery technique (SIB vs sequential boost) were not associated with significant differences in terms of b-RFS (HR = 0.85, 95% CI 0.338–2.169, P = 0.743, and HR = 2.39, 95% CI 0.93–6.111, P = 0.067, respectively). Conclusion: Results from the current analysis are in keeping with data from literature showing that pelvic irradiation and boost on positive nodes are effective approaches. Upfront surgical approach was not associated with better clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively estimate the impact of radiotherapy as a progression-directed therapy (PDT) in oligoprogressive metastatic castration-resistant prostate cancer (mCRPC) patients under androgen receptor-target therapy (ARTT). Materials and methods: mCRPC patients are treated with PDT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events v4.0. Survival analysis was performed using the Kaplan–Meier method; univariate and multivariate analyses were performed. Results: Fifty-seven patients were analyzed. The median follow-up after PDT was 25.2 months (interquartile, 17.1–44.5). One-year NEST-free survival, r-PFS and OS were 49.8%, 50.4% and 82.1%, respectively. At multivariate analysis, polymetastatic condition at diagnosis of metastatic hormone-sensitive prostate cancer (mHSPC) (HR 2.82, p = 0.004) and PSA doubling time at diagnosis of mCRPC (HR 2.76, p = 0.006) were associated with NEST-free survival. The same variables were associated with r-PFS (HR 2.32, p = 0.021; HR 2.24, p = 0.021). One patient developed late grade ≥ 2 toxicity. Conclusion: Our study shows that radiotherapy in oligoprogressive mCRPC is safe, is effective and seems to prolong the efficacy of ARTT in patients who otherwise would have gone systemic treatment switch, positively affecting disease progression. Prospective trials are needed. [ABSTRACT FROM AUTHOR]

Aim: To compare cancer-specific mortality (CSM) rates between radical prostatectomy (RP) vs. external beam radiotherapy (RT) in patients with ductal carcinoma (DC) of the prostate. Materials and methods: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004–2016), we identified 369 DC patients, of whom 303 (82%) vs. 66 (18%) were treated with RP vs. RT, respectively. Kaplan–Meier plots and uni- and stepwise multivariate Cox regression models addressed CSM in the unmatched population. After propensity score matching (PSM) and inverse probability of treatment weighting (IPTW), Kaplan–Meier curve and Cox regression models tested the effect of RP vs RT on CSM. Results: Overall, RT patients were older, harbored higher PSA values, higher clinical T and higher Gleason grade groups. 5-year CSM rates were respectively 4.2 vs. 10% for RP vs. RT (HR 0.40, 95% CI 0.16–0.99, p = 0.048, favoring RP). At step-by-step multivariate Cox regression, after adding possible confounders, the central tendency of the HR for RP vs. RT approached 1. PSM resulted into 124 vs. 53 patients treated respectively with RP vs. RT. After PSM, as well as after IPTW, the protective effect of RP was no longer present (HR 1.16, 95% CI 0.23–5.73, p = 0.9 and 0.97, 95% CI 0.35–2.66, p = 0.9, respectively). Conclusions: Although CSM rate of ductal carcinoma RP patients is lower of that of RT patients, this apparent benefit disappears after statistical adjustment for population differences. [ABSTRACT FROM AUTHOR]

Environ Resource Econ. 2021; 80: 1-20. 10.1007/s10640-021-00576-8 4 Gersbach H, Hummel N, Winkle R. Long-Term Climate Treaties with a Refunding Club. For over a decade, at its annual conference the European Association of Environmental and Resource Economists (EAERE) has awarded a prize generously donated by Springer, for the best paper published within its journal Environmental and Resource Economics (ERE). Bans on discarding fish are a feature of EU fisheries policy that have created some controversy. [Extracted from the article]

Purpose: Chest imaging modalities play a key role for the management of patient with coronavirus disease (COVID-19). Unfortunately, there is no consensus on the optimal chest imaging approach in the evaluation of patients with COVID-19 pneumonia, and radiology departments tend to use different approaches. Thus, the main objective of this survey was to assess how chest imaging modalities have been used during the different phases of the first COVID-19 wave in Italy, and which diagnostic technique and reporting system would have been preferred based on the experience gained during the pandemic. Material and Methods: The questionnaire of the survey consisted of 26 questions. The link to participate in the survey was sent to all members of the Italian Society of Medical and Interventional Radiology (SIRM). Results: The survey gathered responses from 716 SIRM members. The most notable result was that the most used and preferred chest imaging modality to assess/exclude/monitor COVID-19 pneumonia during the different phases of the first COVID-19 wave was computed tomography (51.8% to 77.1% of participants). Additionally, while the narrative report was the most used reporting system (55.6% of respondents), one-third of participants would have preferred to utilize structured reporting systems. Conclusion: This survey shows that the participants' responses did not properly align with the imaging guidelines for managing COVID-19 that have been made by several scientific, including SIRM. Therefore, there is a need for continuing education to keep radiologists up to date and aware of the advantages and limitations of the chest imaging modalities and reporting systems. [ABSTRACT FROM AUTHOR]

Preterm very low birth weight infants (VLBWi) are known to be at greater risk of adverse neurodevelopmental outcome. Identifying early factors associated with outcome is essential in order to refer patients for early intervention. Few studies have investigated neurodevelopmental outcome in Italian VLBWi. The aim of our longitudinal study is to describe neurodevelopmental outcome at 24 months of corrected age in an eleven-year cohort of 502 Italian preterm VLBWi and to identify associations with outcome. At 24 months, Griffiths' Mental Developmental Scales were administered. Neurodevelopmental outcome was classified as: normal, minor sequelae (minor neurological signs, General Quotient between 76 and 87), major sequelae (cerebral palsy; General Quotient ≤ 75; severe sensory impairment). 75.3% showed a normal outcome, 13.9% minor sequelae and 10.8% major sequelae (3.8% cerebral palsy). Male gender, bronchopulmonary dysplasia, abnormal neonatal neurological assessment and severe brain ultrasound abnormalities were independently associated with poor outcome on multivariate ordered logistic regression. Rates of major sequelae are in line with international studies, as is the prevalence of developmental delay over cerebral palsy. Analysis of perinatal complications and the combination of close cUS monitoring and neurological assessment are still essential for early identification of infants with adverse outcome. [ABSTRACT FROM AUTHOR]

Objectives: To report outcomes of stereotactic body radiotherapy (SBRT) in metastatic castration-resistant prostate cancer (mCRPC) patients with oligoprogression (≤ 5 metastases) during first-line treatment with androgen receptor-targeted therapy (ARTT). Patients and methods: Retrospective multi-institutional analysis of mCRPC patients treated with SBRT to oligoprogressive lesions during ARTT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Survival analysis was performed using the Kaplan–Meier method, univariate and multivariate analysis (MVA) were performed. Results: Data from 34 patients were analyzed. Median NEST-free survival, r-PFS, and OS were 16.97, 13.47, and 38.3 months, respectively. At MVA, factors associated with worse NEST-free survival and r-PFS were polymetastatic burden at diagnosis of metastatic hormone-sensitive disease (hazard ratio [HR] 3.66, p = 0.009; HR 3.03, p = 0.034), PSA ≤ 7 ng/ml at mCRPC diagnosis (HR 0.23, p = 0.017; HR 0.19, p = 0.006) and PSADT ≤ 3 months at mCRPC diagnosis (HR 3.39, p = 0.026; HR 2.79, p = 0.037). Polymetastatic state at mHSPC diagnosis was associated with a decreased OS (HR 4.68, p = 0.029). No patient developed acute or late grade ≥ 2 toxicity. Conclusion: Our results suggest that SBRT in oligoprogressive mCPRC is safe, effective and seems to prolong the efficacy of the ongoing systemic treatment positively affecting disease progression. Prospective trials are needed. [ABSTRACT FROM AUTHOR]

Objective: We aim to demonstrate that a chest X-ray (CXR) scoring system for COVID-19 patients correlates with patient outcome and has a prognostic value. Methods: This retrospective study included CXRs of COVID-19 patients that reported the Brixia score, a semi-quantitative scoring system rating lung involvement from 0 to 18. The highest (H) and lowest (L) values were registered along with scores on admission (A) and end of hospitalization (E). The Brixia score was correlated with the outcome (death or discharge). Results: A total of 953 patients met inclusion criteria. In total, 677/953 were discharged and 276/953 died during hospitalization. A total of 524/953 had one CXR and 429/953 had more than one CXR. H-score was significantly higher in deceased (median, 12; IQR 9–14) compared to that in discharged patients (median, 8; IQR 5–11) (p < 0.0001). In 429/953 patients with multiple CXR, A-score, L-score, and E-score were higher in deceased than in discharged patients (A-score 9 vs 8; p = 0.039; L-score 7 vs 5; p < 0.0003; E-score 12 vs 7; p < 0.0001). In the entire cohort, logistic regression showed a significant predictive value for age (p < 0.0001, OR 1.13), H-score (p < 0.0001, OR 1.25), and gender (p = 0.01, male OR 1.67). AUC was 0.863. In patients with ≥ 2 CXR, A-, L-, and E-scores correlated significantly with the outcome. Cox proportional hazards regression indicated age (p < 0.0001, HR 4.17), H-score (< 9, HR 0.36, p = 0.0012), and worsening of H-score vs A score > 3 (HR 1.57, p = 0.0227) as associated with worse outcome. Conclusions: The Brixia score correlates strongly with disease severity and outcome; it may support the clinical decision-making, particularly in patients with moderate-to-severe signs and symptoms. The Brixia score should be incorporated in a prognostic model, which would be desirable, particularly in resource-constraint scenarios. Key Points: • To demonstrate the importance of the Brixia score in assessing and monitoring COVID-19 lung involvement. • The Brixia score strongly correlates with patient outcome and can be easily implemented in the routine reporting of CXR. [ABSTRACT FROM AUTHOR]

We present a novel technique, called DSVP (Discrimination through Singular Vectors Projections), to discriminate spurious events within a dataset. The purpose of this paper is to lay down a general procedure which can be tailored for a broad variety of applications. After describing the general concept, we apply the algorithm to the problem of identifying nearly coincident events in low temperature microcalorimeters in order to push the time resolution close to its intrinsic limit. In fact, from simulated datasets it was possible to achieve an effective time resolution even shorter than the sampling time of the system considered. The obtained results are contextualized in the framework of the HOLMES experiment, which aims at directly measuring the neutrino mass with the calorimetric approach, allowing to significally improve its statistical sensitivity. [ABSTRACT FROM AUTHOR]

Purpose: Today plastic is the most used material for food packaging, but its incorrect disposal is creating environmental issues to oceans, soil and air. Someone believes that the solution is to ban plastic and substitute it with glass packaging. Is it the right choice? This study aims at comparing the environmental impact of bottles made of PET, R-PET, non-returnable glass and returnable glass in order to understand which is the most environmental friendly packaging solution. Methods: A literature analysis on the environmental impact of glass and PET bottles is carried out, taking into account their production, transport and disposal phase. Then, an environmental assessment of PET, R-PET, glass and returnable glass bottles, used to package 1 l of pasteurized milk, has been carried out using the life cycle assessment methodology and a new indicator. Inventory data were provided by an important milk processing and packaging factory located in Italy. Results were estimated using some relevant impact categories of the ReCiPe 2016 MidPoint (H) method, then a marine litter indicator (MLI) has been proposed in order to evaluate the polluting potential of milk bottles dispersed into the Mediterranean Sea. Results and discussion: LCA results show that R-PET bottle gives the lowest contribution to global warming, stratospheric ozone depletion, terrestrial acidification, fossil resource scarcity, water consumption and human carcinogenic toxicity, followed by PET bottle, returnable glass bottle, and finally non-returnable glass bottle. Glass is the worst packaging option because of high energy demand in the bottle production and its weight and in the transport phase. Some improvements can be obtained with returnable glass, but even if we consider that a bottle could be reused eight times, results are not comparable to the PET or R-PET bottles used only once. However, according to the MLI, returnable glass bottles become the first option, because a lot of plastic bottles could potentially be dispersed into the sea. Conclusions: The substitution of plastic with glass does not help to reduce the GWP and others LCI categories, while could contribute to reduce the marine litter: overall it is important to dispose correctly packaging materials, investing in recycling and reusing. In particular, great improvements can be obtained using bottles made with recycled materials, as R-PET. In conclusion, it is necessary to disadvantage waste dispersion, giving incentives to returnable packaging and raising people awareness of environmental problems. [ABSTRACT FROM AUTHOR]

Aim: To investigate the actual attitude of Radiation Oncologists in the prescription of hormonal therapy in prostate cancer (PC) with or without Radiation Therapy (RT). Materials and methods: In 2019, a survey named Prescription of Radiation Oncologists ACtual Attitude including 18 items was sent to all Italian Radiation Oncologists of the Italian Association of Radiotherapy and Clinical Oncology. The first 4 items were about the Radiation Oncology Centers characteristics and years of practice of the respondents. The remaining 14 items concerned the setting in which hormone therapy was prescribed in PC patients (radical, postprostatectomy/oligometastatic state), the kind of drug, the choice modality (Multidisciplinary Group/autonomy decision) and other factors. Results: A total of 127 questionnaires were returned, mainly by Northern Italy Radiation Oncology Centres (44.9%), and by experienced Radiation Oncologists (78%), who declared to prescribe independently hormone therapy in 85.8% of cases. The Androgen deprivation therapy (ADT) prescription in castration naive PC was made independently by 56.7% of respondents and associated with radical RT, postoperative or salvage RT according to various risk factors. In castration-sensitive oligorecurrent PC, the majority (51.2%) administered ADT only if local ablative treatment was not feasible, while in metastatic castration resistant disease novel hormone therapy use was established in almost half of cases within multidisciplinary board. Radiation Oncologists could prescribe these drugs independently in 64% of cases. Conclusion: Our survey established the prescription attitude of ADT and new hormonal agents (abiraterone, enzalutamide, apalutamide) by Italian Radiation Oncologists and highlighted the importance of expertise in global PC management. [ABSTRACT FROM AUTHOR]

Aims: 68Ga-Prostate-specific membrane antigen (PSMA) PET/CT is widely used in patients with biochemical recurrence (BCR) after radical prostatectomy. We collected data about patients staged with PSMA PET/CT after BCR (PSA < 1 ng/ml) in four different institutes. Impact of baseline features (Gleason score, risk classification, PSA at recurrence, PSA doubling time and time to recurrence) was explored to understand predictive factors of (PSMA) PET/CT positivity. Impact of restaging on following treatment approaches was reported. Results: 92 patients were included. PSMA PET/CT detection rate was 56.5% and low-volume disease (≤ 3 non-visceral lesions) was detected in 52.2% of patients. After positive scan, 13.5% of patients still lies on observation, ADT alone was administered in 30.8% of cases, Stereotactic body RT (SBRT) alone was delivered to 44.2% of patients and 11.5% of patients underwent concomitant SBRT and ADT. Seven patients underwent conventional salvage prostate bed RT. Chi-squared test showed a higher rate of positive PSMA PET/CT for patients with Gleason score > 7 (p = 0.004) and TTR < 29.5 months (p = 0.003). Conclusions: PSMA PET/CT showed a high detection rate. This influenced clinical management in a significant percentage of patients, allowing treatment tailoring on the basis of imaging. [ABSTRACT FROM AUTHOR]

Developing compact ion accelerators using intense lasers is a very active area of research, motivated by a strong applicative potential in science, industry and healthcare. However, proposed applications in medical therapy, as well as in nuclear and particle physics demand a strict control of ion energy, as well as of the angular and spectral distribution of ion beam, beyond the intrinsic limitations of the several acceleration mechanisms explored so far. Here we report on the production of highly collimated ( ∼ 0. 2 ∘ half angle divergence), high-charge (10s of pC) and quasi-monoenergetic proton beams up to ∼ 50 MeV, using a recently developed method based on helical coil targetry. In this concept, ions accelerated from a laser-irradiated foil are post-accelerated and conditioned in a helical structure positioned at the rear of the foil. The pencil beam of protons was produced by guided post-acceleration at a rate of ∼ 2 GeV/m, without sacrificing the excellent beam emittance of the laser-driven proton beams. 3D particle tracing simulations indicate the possibility of sustaining high acceleration gradients over extended helical coil lengths, thus maximising the gain from such miniature accelerating modules. [ABSTRACT FROM AUTHOR]