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The present work aims at quantifying how, and how much, the uncertainties on the components and material parameters of a wireless power transfer (WPT) system for the static charge of electric vehicles affect the overall efficiency and functionality of the final produced device. With the aim of considering the perspective of a possible industrial developer, the parameters selected for the uncertainty quantification are chosen to be the capacitance values of the compensation capacitors and the electromagnetic material parameters used for the construction of the magnetic structure of a WPT system, i.e. the parameters of the elements to be purchased. The analysis is based on a standard system among the ones provided by the current SAE J2954 recommended practice.

This case report shows, for the first time, a patient experiencing a complete response after one dose of avelumab following extensive disease progression with prior electrochemotherapy (ECT) treatment. We suggest that ECT may help to establish a tumor microenvironment favorable to immunotherapy. Merkel cell carcinoma (MCC) is a highly aggressive skin cancer with seldom durable chemotherapy responses. ECT has recently emerged as a potential treatment option for several malignancies, including MCC. Avelumab, an anti-programmed cell death-ligand 1 (PD-L1) monoclonal antibody, became the first approved treatment for patients with metastatic MCC. ECT has been shown to activate the immune response, but it is still unknown how ECT may affect patient’s response to subsequent immunotherapy. We report a case of a patient with MCC who presented with a rapidly growing skin nodule of the right cheek and experienced extensive disease progression following surgical debulking and ECT treatment. The patient received a flat dose of 800 mg avelumab intravenously every 2 weeks showing complete tumor regression after only one dose. Immunohistochemical analysis of surgical and post-ECT biopsies collected from the primary lesion revealed tumor expression of programmed cell death protein-1 (PD-1), but not PD-L1. Analysis of the tumor samples also revealed no expression of Merkel cell polyomavirus (MCPyV). Comparison of the biopsies showed a decrease in myeloid and T-cell markers after ECT but an increase in major histocompatibility complex (MHC) class I expression on tumor cells. Additionally, the patient experienced an increase in neutrophil-to-lymphocyte ratio and lactate dehydrogenase values post-ECT, which subsequently decreased with avelumab treatment. As of 30 October 2019, the patient was still receiving avelumab treatment and had an ongoing complete response. In this case report, a patient with PD-L1-negative and MCPyV-negative MCC who had disease progression following ECT experienced complete tumor regression with avelumab treatment, suggesting, for the first time to our knowledge, that ECT may help to establish a tumor microenvironment favorable to immunotherapy via a potential abscopal effect. Tumor-intrinsic PD-1 expression and modulation of MHC class I antigens after ECT may contribute to the clinical efficacy of avelumab in this context.

Pertussis vaccination of parents and household contacts (‘cocooning’) to protect newborn infants is an established strategy in many countries, although uptake may be low. Many aspects may influence such decision-making. We conducted a cross-sectional survey (NCT01890447) of households and other close contacts of newborns aged ≤6 months (or of expectant mothers in their last trimester) in Spain and Italy, using an adaptive discrete-choice experiment questionnaire. Aims were to assess the relative importance of attributes influencing vaccine adoption, and to estimate variation in vaccine adoption rates and the impact of cost on vaccination rates. Six hundred and fifteen participants (Spain, n = 313; Italy, n = 302) completed the survey. Of 144 available questionnaire scenarios, the most frequently selected (14% of respondents in both countries) were infant protection by household vaccination at vaccination center, recommendation by family physician and health authorities, with information available on leaflets and websites. The attribute with highest median relative importance was ‘reduction in source of infection’ in Spain (23.1%) and ‘vaccination location’ in Italy (18.8%). Differences between other attributes were low in both countries, with media attributes showing low importance. Over 80% of respondents indicated a definite or probable response to vaccine adoption (at no-cost) with estimated probability of adoption of 89–98%; applying vaccine costs (25€ per person) would reduce the probability of uptake by 7–20% in definite/probable respondents. Awareness of these determinants is helpful in informing Health Authorities and healthcare practitioners implementing a cocooning strategy for those populations where maternal immunization is not a preferred option.

A parametric model order reduction method combined with a polynomial spectral approximation is applied for the first time to a Volume Integral Equation method accelerated by a low-rank matrix compression technique. Such an approach allows for drastically reducing the computational cost required by uncertainty quantifications in electromagnetic problems. Moreover, the proposed numerical tool can be adopted for computing stochastic information (e.g. mean, variance, probability density function) of any electromagnetic quantity of interest, in order to test the reliability of industrial devices with uncertainties on the material parameters. Conductive, dielectric, and magnetic media which exhibit uncorrelated and correlated random material parameters are considered by the proposed method.

Recently, significant progress in the field of organic photovoltaic cells was obtained by substituting new electron acceptor molecules to the fullerene, which was attributed to the fact that the fullerene absorption is quite small. Nevertheless, we demonstrate in the present work that, in the case of inverted cells, i.e. when the transparent bottom electrode is used as cathode, the contribution of fullerene to the Jsc short-circuit current of the cells, if not dominant, is not negligible; and that mainly in the short wavelength spectral range. The experimental results are confirmed by an optical simulation. Due to this significant contribution to Jsc, the light transmission of the transparent electrode towards the UV-part of the spectrum is crucial for inverse cell performances. When a transparent conductive electrode based on an alternative dielectric/metal/dielectric structure is substituted to ITO, such as ZnS/Ag/TiO2, the study allows to obtain promising results, although there is a loss of performance due to the decrease of transmission of TiO2 below 400 nm in wavelength. [ABSTRACT FROM AUTHOR]

The electrical and optical properties of MoO3/Ag/MoO3 multilayer structures have been studied using the Ag deposition rate and layer thicknesses as parameters. When the silver film is deposited at 0.20 nm/s rate, the silver layer thickness necessary to achieve the percolation threshold of the resistivity ρ towards conductive structures is 10 nm. Below 10 nm, the films are semiconductor and above the films are conductors. In the present work, the variation of the thicknesses of top and bottom MoO3 layers is shown to strongly modify the optical properties of the multilayer structures. By using a Ag thickness of 10 nm, we demonstrate an increasing of the transmittance of the MoO3/Ag/MoO3 structures by optimizing the MoO3 layers thicknesses. When the MoO3 bottom layer is 20 nm thick, and the MoO3 top layer is 35 nm, the maximum transmission is 86% at the wavelength of 465 nm, while the averaged transmission in the visible range (350 nm-800 nm) is 70%. The best measured conductivity, σ = 1.1 × 105 (Ω cm)-1, corresponds also to this MoO3 (20 nm)/Ag (10 nm)/MoO3 (35 nm) structure. A good qualitative agreement between the theoretical calculations of the variation of the optical transmittance and reflectance of the MoO3/Ag/MoO3 structures is also highlighted. [ABSTRACT FROM AUTHOR]

Li-O2 batteries represent a promising rechargeable battery candidate to answer the energy challenges our world is facing, thanks to their ultrahigh theoretical energy density. However, the poor cycling stability of the Li-O2 system and, overall, important safety issues due to the formation of Li dendrites, combined with the use of organic liquid electrolytes and O2 cross-over, inhibit their practical applications. As a solution to these various issues, we propose a composite gel polymer electrolyte consisting of a highly cross-linked polymer matrix, containing a dextrin-based nanosponge and activated with a liquid electrolyte. The polymer matrix, easily obtained by thermally activated one pot free radical polymerization in bulk, allows to limit dendrite nucleation and growth thanks to its cross-linked structure. At the same time, the nanosponge limits the O2 cross-over and avoids the formation of crystalline domains in the polymer matrix, which, combined with the liquid electrolyte, allows a good ionic conductivity at room temperature. Such a composite gel polymer electrolyte, tested in a cell containing Li metal as anode and a simple commercial gas diffusion layer, without any catalyst, as cathode demonstrates a full capacity of 5.05 mAh cm−2 as well as improved reversibility upon cycling, compared to a cell containing liquid electrolyte.

The chemical composition of Romanian table grape varieties was determined to evaluate their phenolic and aroma profiles because they are factors useful for the variety characterization and consumer acceptance. Two white table grapes (‘Aromat de Iaşi’ and ‘Timpuriu de Cluj’) and two red table grapes (‘Napoca’ and ‘Someşan’) were studied. The phenolic composition of berry skins and seeds was determined using spectrophotometric methods. The profile of anthocyanins and hydroxycinnamoyl tartaric acids (HCTs), and the content of trans-resveratrol were determined in the skins using high-performance liquid chromatographic (HPLC) methods. Free volatile compounds were quantified by gas chromatography/mass spectrometry (GC/MS). A different phenolic and aromatic composition was found in the varieties studied. Among white grapes, ‘Aromat de Iaşi’ stands out for the great number of aroma compounds, and ‘Timpuriu de Cluj’ showed high contents of polyphenols, particularly oligomeric flavanols in skins and seeds (1,171 and 1,189 mg kg-1, respectively) and total skin HCTs (181.6 mg kg-1). The red variety ‘Napoca’ had high contents of total anthocyanins (380 mg kg-1) and total skin HCTs (183.2 mg kg-1), and it is characterized by high percentages of acylated anthocyanin derivatives (28.5%) and trans-caffeoyltartaric acid forms (58.8%). ‘Someşan’ grapes showed high contents of free volatile compounds, particularly of 1-hexanol, (Z)-3-hexen-1-ol and (E)-2-hexenoic acid (167.0, 59.4 and 167.0 µg kg-1). These results may contribute to the knowledge of Romanian table grapes perspective and to a better exploitation of these varieties.

Dielectric/Metal/Dielectric structures can be used as substituent to transparent conductive electrodes. The dielectric used is often a transition metal oxide such as MoO 3-x and the metal is Ag. In the present work we propose to substitute Cu to Ag. The difficulty with Cu is its high diffusion rate into MoO 3-x . In order to prevent this negative effect we used Cu:Ni alloy as metal layer. If using such alloy is efficient to reduce Cu diffusion, it works well only with WO 3-x and not with MoO 3-x . We show that after deposition of the alloy only 0.5 at% of Ni is present in Cu films. This small atomic concentration makes it possible to preserve the electrical and optical properties of the metal films but limits its control of Cu diffusion in time. Therefore it is necessary to use an oxide, here WO 3-x , which also limits the diffusion of metals. By adding these two effects due to the alloy and the oxide it is possible to form Dielectric/Metal/Dielectric structures with quite stable properties. These WO 3- x /Cu:Ni/WO 3- x structures can be used as anodes in organic photovoltaic cells. The different behaviors of the structures according to whether they use WO 3-x or MoO 3-x are discussed in terms of thin film porosity. [ABSTRACT FROM AUTHOR]

Aims: Fourier Transform-Near Infrared (FT-NIR) spectrum and instrumental texture parameters were assessed as total phenol content and extractability predictors in intact grape seeds. Methods and results:The study was carried out on Cabernet-Sauvignon seeds from grapes harvested at six different advanced physiological stages throughout ripening and calibrated by flotation to reduce the in-field heterogeneity inside each sample. Among the instrumental mechanical properties tested (i. e., break force, break energy, Young’s modulus of elasticity and deformation index), the seed Young’s modulus of elasticity showed an increase during the first four weeks of ripening. This parameter also showed significant correlations with phenol content and extractability, although with low R coefficients. These correlations highlighted that the springier seed tissues greatly increase phenol extractability. Nevertheless, the best prediction of seed phenol content, performed directly on intact seeds, was found using FT-NIR spectroscopy in transmittance mode. The standard error of prediction for total phenol content was less than 8 %, while that for phenol extractability was worse. Conclusion: On the basis of these results, the two analytical methods could be applied in oenology for the rapid monitoring of seed phenolic maturity. Significance and impact of the study: The phenolic composition of grapes at the harvest time is a key factor determining their quality, and thus the quality of the finished wine. The chemical methods used for the determination of seed phenol content and extractability are generally slow because they require a preliminary extraction. Therefore, a rapid evaluation of these parameters could be highly interesting for the oenological sector.

Aims: The aim of this work was to evaluate the kinetics of anthocyanin extraction in berries of cv Brachetto and Nebbiolo, having the same level of total soluble solids, but with different skin hardness. Methods and results: A puncture test was carried out on berries calibrated according to their density, estimated by flotation in different salt solutions. For each variety, two groups of berries of different skin hardness were selected: soft (< medium value) and hard (> medium value). Spectrophotometric and HPLC methods were used to evaluate the kinetics of anthocyanin extraction in a hydroalcoholic buffer solution. In each of the examined cultivars, the grapes with a higher break skin force produced extracts with a higher content in total anthocyanin. The anthocyanin profile of extracts of Brachetto hard skin is characterized by a higher content of acetyl-glucosides. Conclusion: Texture analysis, which is fast and inexpensive, turned out to be an excellent analytical technique to verify skin hardness measurements. The break skin force proved to be a mechanical parameter able to estimate the extractability of anthocyanins with adequate reliability. Significance and impact of study: The possibility of having an easy way to determine maturity index able to estimate the extractability of phenol compounds with sufficient reliability, can be a valuable tool for the enological community.

In this work, we investigate silver (Ag) nanoparticle-related plasmonic effect on light absorption in Si substrate. Ag nanoparticles (Ag-NPs) deposited on top of Si were used to capture and couple incident light into these structures by forward scattering. We demonstrate that we can control nanoparticle size and shape while varying deposition time and annealing parameters. By the increase of the total time of the reaction process, morphology of Ag-NPs evolutes affecting the number and the width of surface plasmon resonance peaks, whereas for changed annealing parameters (temperature and time), the effect is more pronounced on the broadening and the position of peaks. Specific morphology of Ag-NPs can exhibit an interesting enhancement of optical properties which enables plasmon-related application in photovoltaic solar cells. [ABSTRACT FROM AUTHOR]

Abstract: MoO3/Ag/MoO3(MAM) multilayer structures were deposited by vacuum evaporation on polyethylene terephthalate (PET) substrate. We demonstrate that, as in the case of glass substrate, the sheet resistance of such structures depends significantly on the Ag film deposition rate. When it is deposited between 0.2 and 0.4nm/s, an Ag thickness of 11nm allows achieving sheet resistance of 13Ω/sq and an averaged transmission of 74%. A study of the influence of the PET substrate on the optimum MoO3 thicknesses was done. A good qualitative agreement between the theoretical calculations of the variation of the optical transmittance of the MoO3/Ag/MoO3 structures is obtained. The optimum MAM structures MoO3 (17.5nm)/Ag (11nm)/MoO3 (35nm) has a factor of merit FM =4.21 10−3 (Ω/sq)−1. Proven by the scotch test the MAM structures exhibit a good adhesion to the PET substrates. The MAM structures were also submitted to bending tests. For outer bending, the samples exhibit no variation of their resistance value, while for inner bending there is a small increase of the resistance of the MAM structures. However this increasing is smaller than that exhibited by Indium Tin Oxide. When the PET/MAM structures are used as anode in organic photovoltaic cells, it is shown that the need to use thicker Ag films inside the multilayer and to cover the MAM with Au to obtain promising Current density vs Voltage characteristics is due to the heating of the PET substrate during the deposition process. [Copyright &y& Elsevier]

The advanced understanding of the complete degradation phenomena is crucial in order to develop robust optics for FEL. Under very harsh Synchrotron Radiation conditions, results show that multiscale wavelength damages could be observed, inducing local crystalline structure modifications of the high optical index material with a severe increase of the surface roughness. [Copyright &y& Elsevier]

6H-SiC samples were amorphised by multiple Al implantations at room temperature, in order to study the annealing process. The paper deals with the influence of specific annealing conditions, such as furnace atmosphere and heating rate, on SiC reordering and Al profile. Below a certain deposited nuclear energy, solid phase epitaxy is possible and leads to recrystallisation under precise conditions (high heating rate, silicon partial pressure prescribed). Above it, material etching and dopant losses are observed, even though annealing has proven to be efficient for avoiding surface impairment (due to a specific cleaning process). [Copyright &y& Elsevier]

Given the rapidly increasing demand for flexible and inexpensive optoelectronic devices, it is necessary to find a substitute for ITO (Indium Tin Oxide). Among the considered alternatives, we have chosen in the present work Dielectric/Metal/Dielectric (D/M/D) trilayer structures deposited under vacuum. In these D/M/D structures, when Ag is the metal, highly performing and stable Transparent Conductive Electrodes (TCEs) are obtained. When Ag is replaced by Cu, which is far less expensive, results are not similar due to the tendency of Cu to diffuse into the transition metal oxides. Therefore we improve the stability of the new TCEs by using the Cu alloy Cu:Ag in ZnS/M/WO 3 structures. The best results were obtained when M = Cu:Ag (16 nm)/Ag (1 nm). Flexible and quite stable TCEs were obtained. These new TCEs are conductive and transparent with a figure of merit of 6.5 x 10−3Ω−1 and a quite small Root Mean Squared Roughnessis (RMS = 1.1 nm). Therefore, they were introduced as anode in organic photovoltaic cells (OPVs). In the same time, ZnS/Ag/TiO 2 TCE were probed. These ZnS/Ag/TiO 2 structures were transparent and conductive with optical and electrical performances similar to those of ITO, but, when used as anode, the OPVs performances were limited by the presence of Ag at the surface of the structures. In the other hand, the results obtained with ZnS/M/WO 3 structures were very promising with an open circuit voltage, Voc, and a short circuit current, Jsc, whose values are slightly higher than those obtained with ITO. Nevertheless the fill factor FF is sensibly smaller, which is attributed to the presence of some Cu at the surface of the electrode. Image 1 • ZnS/Ag/TiO2 and ZnS/Metal/WO3 can be used as transparent conducive electrode. • Cu:Ag (5 at.%) alloy stabilizes properties of ZnS/Metal/WO3 structures. • ZnS/Ag/TiO2 modeling permits to estimate the optimum thickness of the different layers. • Organic solar cells using these ITO free electrodes achieve promising performances. [ABSTRACT FROM AUTHOR]

Pertussis vaccination of parents and household contacts ('cocooning') to protect newborn infants is an established strategy in many countries, although uptake may be low. Many aspects may influence such decision-making. We conducted a cross-sectional survey (NCT01890447) of households and other close contacts of newborns aged ≤6 months (or of expectant mothers in their last trimester) in Spain and Italy, using an adaptive discrete-choice experiment questionnaire. Aims were to assess the relative importance of attributes influencing vaccine adoption, and to estimate variation in vaccine adoption rates and the impact of cost on vaccination rates. Six hundred and fifteen participants (Spain, n = 313; Italy, n = 302) completed the survey. Of 144 available questionnaire scenarios, the most frequently selected (14% of respondents in both countries) were infant protection by household vaccination at vaccination center, recommendation by family physician and health authorities, with information available on leaflets and websites. The attribute with highest median relative importance was 'reduction in source of infection' in Spain (23.1%) and 'vaccination location' in Italy (18.8%). Differences between other attributes were low in both countries, with media attributes showing low importance. Over 80% of respondents indicated a definite or probable response to vaccine adoption (at no-cost) with estimated probability of adoption of 89-98%; applying vaccine costs (25€ per person) would reduce the probability of uptake by 7-20% in definite/probable respondents. Awareness of these determinants is helpful in informing Health Authorities and healthcare practitioners implementing a cocooning strategy for those populations where maternal immunization is not a preferred option.

An antireflecting micro-structured interface, working in the resonance domain, and made from a bi-periodic array of semi-spherical hollowing-out in a silicon substrate is presented. Its parameters such as sphere radius and position of sphere centers from the surface are optimized numerically. A simple and robust process is described allowing such kind of antireflective surfaces to be fabricated for the infrared range. Spectral and angular reflectance measurement demonstrates the efficiency of the antireflective micro-structured interface which can easily be adapted for the visible range and for photovoltaic applications by a simple homothetic modification of the micro-structure typical dimensions.

Background and Aim of the Study: The aim of this study was to evaluate the early and mid-term off-pump coronary artery bypass surgery (OPCAB) results in a single surgical unit, assessing the impact of completeness of revascularization., Methods: Three hundred and twelve patients underwent OPCAB between August 2000 and January 2005. In-hospital data were collected prospectively for all patients undergoing OPCAB. Complete revascularization (CR) was derived by comparing significantly stenotic vessels at cardiac catheterization with surgically grafted coronary vessels. Grafting of all the significantly stenotic coronary vessels was considered CR. In-hospital outcomes were compared between patients with CR and incomplete revascularization (IR). A multivariate analysis based on the Cox proportional hazards regression model was performed., Results: Patients receiving IR (105 patients, 43.7%) presented a worse preoperative risk profile then those having CR (mean Euroscore 6.8 +/- 2.9 vs. 4.3 +/- 2.8, p < 0.0001). IR was not associated with a higher incidence of early adverse events. Five-year freedom from death and major adverse cardiac events (MACE) were 0.88 (0.02 SE) and 0.86 (0.03 SE), respectively. Complete revascularization was protective for mid-term unstable angina recurrence [heart rate (HR) = 0.24, 95% confidence interval (CI) 0.10 to 0.58], acute myocardial infarction (HR = 0.25, 95% CI 0.09 to 0.73), all-cause repeat revascularization (HR = 0.35, 95% CI 0.13 to 0.90), and MACE (HR = 0.2, 95% CI 0.1 to 0.5)., Conclusion: Our study suggests that, although incomplete revascularization may not result in increased short-term morbidity and mortality, it increases the incidence of mid-term MACE.

Background: The aim of this study was to evaluate the midterm results of the initial phase of off-pump coronary artery bypass (OPCAB) surgery adoption in a single surgical unit, assessing the impact of procedural volume., Methods: Study participants were 312 patients who underwent OPCAB during the period between August 2000 and January 2005 at S. Croce Hospital. Of these patients, 126 patients with an indication selected for comorbidities or 1-vessel disease underwent OPCAB performed by 4 low-volume surgeons, and 186 unselected patients underwent OPCAB performed by a single high-volume surgeon., Results: OPCAB performed by low-volume surgeons was associated with less complete revascularization and less arterial conduit use. Early result analysis showed a low rate of in-hospital or 30-day adverse events. The 5-year survival was 0.88 (0.02 SE). OPCAB performance by a high-volume surgeon and complete revascularization were shown have a protective effect for midterm major adverse cardiac events (respectively, hazard ratio = 0.28, 95% confidence interval 0.11-0.74 and hazard ratio = 0.33, 95% confidence interval 0.15-0.73)., Conclusion: Our study on the initial phase of OPCAB adoption suggests a benefit on midterm outcome from surgery performed by a high-volume surgeon.

This paper aims at modeling bi-periodic micro-structured silicon surfaces exhibiting broadband antireflection properties in the infrared range using Rigorous Coupled-Wave Analysis (RCWA). These structures of pyramidal shape, which typical dimensions are smaller than the wavelength, are not in the Effective Medium Theory (EMT) validity domain. The influence of various opto-geometrical parameters such as period, depth, shape of the pattern is examined. The antireflective properties of such bi-periodic patterned surfaces are then discussed using the photonic crystal theory and photonic band diagrams description. Correlations between the density of Bloch modes, their localizations with respect to the incident medium light line and the surface reflectance are presented.

Background and Objectives: We explored the predictive value on therapy outcome of an early evaluation of treatment response by 18F-fluorodeoxyglucose position emission tomography (18F-FDG-PET) scan performed after two courses of conventional standard-dose chemotherapy in advanced-stage Hodgkin's disease., Design and Methods: One hundred and eight patients with newly-diagnosed Hodgkin's disease in stage IIA with adverse prognostic factors, or in stage IIB through IVB, were re-staged with FDG-PET after two cycles of ABVD (PET-2). The end-point of the study was the predictive value of PET-2 on 2-year progression-free survival and 2-year failure-free survival. No treatment variation based only on PET-2 results was allowed., Results: Eighty-eight patients attained complete remission (CR) while 20 showed disease progression during therapy or within 6 months after having reached CR; one patient relapsed. PET-2 was positive in 20 patients: 17 progressed during therapy, one relapsed and two remained in CR. By contrast, 85/88 (97%) patients with a negative PET-2 remained in CR; three progressed or relapsed early after the end of the chemotherapy. Thus, the positive predictive value of a PET-2 was 90% and the negative predictive value was 97%. The sensitivity, specificity and overall accuracy of PET-2 were 86%, 98% and 95%, respectively. The 2-year probability of failure-free survival for PET-2 negative and for PET-2 positive patients was 96% and 6%, respectively (log rank test = 116.7, p < 0.01)., Interpretation and Conclusions: 18F-FDG-PET scan performed after two courses of conventional standard-dose chemotherapy in advanced-stage Hodgkin's disease was able to predict treatment outcome in 103/108 (95%) of the patients.

A population-based epidemiological study that concerns the estimate of incidence rates of Hodgkin's Disease (HD) and Non Hodgkin's Lymphoma (NHL) in a Central Italy area was performed. All the new cases of HD and NHL diagnosed from 1982 till 1994 in the target population were collected by multiple information sources. The temporal trend of incidence rates and their relation with age, gender and histological variant were analyzed. In the considered period 95 cases of HD and 297 cases of NHL were collected. Constant age-adjusted incidence rates of HD were observed, while an increasing trend of NHL incidence rates was observed especially for cases at presentation in stage III and IV and for histotypes G, H and I. The investigations carried out on patients with HD have shown that this condition prevails in women in the younger age groups, while in men presentation occurs more frequently at an advanced age. Moreover the authors have confirmed previous reports of a distinctly increased incidence of nodular sclerosis in contrast to the other three histological variants which do not show a juvenile peak but a gradual increase in incidence with advancing age. The epidemiological features of NHL's observed correspond to the standard incidence rates obtained in Europe and throughout the world. NHL's appear to be a pathological entity typical of elderly patients: however high-grade NHL's, in contrast to low-grade NHL's, was present with increased frequency also in childhood and in patients under the age of 30.

The aim of this pilot study was to investigate if chemotherapy (CT) followed by the combination of interferon-beta (IFN-beta), retinoids, and tamoxifen could be effective in the treatment of metastatic breast cancer (MBC). Thirty-six patients with stage IV carcinoma of the breast were treated with six courses of cyclophosphamide, 5-fluorouracil, 4-epidoxorubicin, vincristine, and prednisone every 3 weeks (FECPV), followed by two courses of non-cross-resistant drugs, methotrexate, mitomycin C, and mitoxantrone (MMM). Treatment was continued, in responders, with low dose IFN-beta, retinyl palmitate, and tamoxifen until relapse of the disease occurred. Among 36 evaluable patients, 23 achieved a clinical response (64 %) (95 % confidence interval [c.i.] 46 %-79 %), 7 had stable disease (19%), and 6 (17%) progressed. Leukopenia occurred in 15 patients, thrombocytopenia in 6, and anemia in 11. Sixteen patients had nausea/vomiting, stomatitis was observed in 9, and diarrhea occurred in 3. Toxicity from maintenance therapy was mild and mainly hepatic. Median response duration was 31 months (range 5-107). Median overall survival was 32 months (9-108). Our study shows that this combined approach for the treatment of MBC is feasible, with an acceptable toxicity.

This phase I randomized study was designed in order to verify if the sequential administration of filgrastim, a granulocyte colony-stimulating factor (G-CSF), and molgramostim, a granulocyte-macrophage colony-stimulating factor (GM-CSF), was superior to filgrastim alone in improving tolerance of dose-intensified carboplatin (CBDCA), cyclophosphamide (CTX), and etoposide (VP-16). A group of 10 heavily pretreated patients with stage IV disease and no therapeutic option were enrolled into the study. They received two courses of the same chemotherapy with CTX and VP-16 at doses of 1,500 mg/m2 and 400 mg/m2, respectively. CBDCA doses were escalated from 450 to 600 mg/m2. After chemotherapy each patient was allocated randomly to receive either 14 days of G-CSF (arm A) or 7 days of G-CSF followed by 7 days of GM-CSF (arm B). Crossover in the second chemotherapy course was accomplished. Both G-CSF and GM-CSF were given 5 microg/kg/day, subcutaneously. Twenty chemotherapy courses are evaluable, 10 in each arm. Absolute neutrophil count < 1 x 10(3)/microl was observed for 54 days in arm A vs. 68 days in arm B (P < 0.02); platelet (PLT) count < 20 x 10(3)/microl, 57 days vs. 30 days (P < 0.01); days of hospitalization 35 vs. 16 (P < 0.38); PLT transfusion, 107 vs. 58 (P < 0.01); packed red blood cell unit transfusions, 15 vs. 5 (P < 0.13). Seven patients had responses. These data indicate that dose-intensified chemotherapy may be delivered without bone marrow or peripheral stem cell support, with acceptable toxicity, and that, while G-CSF alone shortens days of neutropenia, the combination of the two cytokines shortens the time of thrombocytopenia and decreases the number of PLT transfusions.

The prognosis for patients with metastatic breast cancer, progressing after anthracycline-based cytotoxic therapy, is poor, and new treatment strategies are needed. Carboplatin (CBDCA), etoposide (VP-16), and cyclophosphamide (CTX) combination therapy has proved activity against a wide variety of tumors. This study was undertaken to evaluate the activity and toxicity of standard doses of CBDCA, VP-16, and CTX administered as salvage chemotherapy in a group of patients with metastatic breast cancer previously treated with two chemotherapy regimens, including anthracyclines. Thirty patients received an average 3.5 courses of the following treatment: CBDCA, 300 mg/m2, and CTX, 500 mg/m2, on day 1; VP-16, 60 mg/m2, on days 2, 3, and 4. Thirteen patients (43%) achieved an objective response, seven (23%) stabilized, while 10 (34%) progressed. The median response duration was 11.5 months (range, 1-19); the median overall survival from protocol entry was 9.1 months (range, 1.5-26). Gastrointestinal toxicity was noted in six patients, and hematologic toxicity of grade 3-4 was found in 11 patients. The combination of CTX, CBDCA, and VP-16 at this dose and schedule is active as salvage treatment of patients with breast cancer. Even when the toxicity was severe, responders had good symptom palliation with a substantial improvement in performance status.

Background/aims: Prognostic studies on cirrhosis are needed, since several attempts to obtain better survival predictors than the empirically derived Child-Pugh's score have failed., Methods: Four hundred and ninety-four consecutive in-patients with cirrhosis at the first episode of decompensation (ascites, jaundice, encephalopathy) and/or of digestive haemorrhage from ruptured oesophageal varices were followed from admission (1983-1989) to 1993, studying the relationship between 26 prognostic variables and survival. Three prognostic models were constructed using Cox's regression model and the Receiver Operating Characteristic (ROC) analysis was used to compare their predictive ability., Results: During follow-up 351 patients died (median cumulative survival 1.82 years). Child-Pugh's score (explicative variable of the first Cox's model), albumin and encephalopathy among the 5 Child-Pugh variables (second model), and oesophageal varices haemorrhage and 3 biochemical indexes among the 7 significant variables on univariate analysis (third model) correlated with survival. The area under the ROC curve of the first model did not significantly differ from that for the other 2 models., Conclusions: The Child-Pugh's score is still the best and simplest index for assessing the prognosis of liver cirrhosis.

We evaluated the role of low-dose alpha-2b interferon, added to chemotherapy, for advanced colorectal cancer; we randomized patients, to either a combination chemotherapy of 5-fluorouracil (5-FU) and high-dose folinic acid (HDFA) or the same regimen plus interferon. Between January 1990 and March 1992, 100 untreated patients (PTS) with advanced colorectal cancer, 53 men and 47 women, with an ECOG performance status (PS) of < or = 3, were randomized to either HDFA 200 mg/m2 iv bolus and 5FU 370 mg/m2 in 15-min iv infusion days 1-5 every 4 weeks (arm A), or the same chemotherapy plus IFN 3 x 10(6) IU subcutaneously three times a week in chemotherapy intervals (arm B). A total of 97 PTS are evaluable for response, toxicity, and survival; 3 PTS are not evaluable in arm B for major protocol violations. PTS characteristics were well balanced in both arms for age (median, 64 years), disease-free survival, and disease site. ECOG PS was 0 in 28% of PTS in arm A and in 13% in arm B. Response rates were as follows: arm A, 40%; and arm B, 23%. Median time to failure was as follows: 10.2 months arm A versus 9 months arm B. Median survival was as follows: 13.3 months arm A versus 10.9 months arm B. Grade 3 haematological toxicity was 9% of PTS in both arms. Gastrointestinal toxicity was as follows: 17% arm A versus 22% arm B. The cost of drugs expressed per m2/month was $60 in arm A and $390 in arm B. The results show that IFN at the schedule and doses employed adds no benefit to the combination of 5FU/HDFA.

Our aims were to design a reproducible method of measuring life-time alcohol consumption in patients with cirrhosis, and to assess the risk of liver decompensation associated with alcohol intake using a case-control design and a multivariate analysis. We studied 439 patients ("cases") with decompensated cirrhosis, and 233 with compensated cirrhosis ("controls"). Mean life-time daily amount and duration of alcohol intake were measured by a standardized questionnaire, whose reproducibility, assessed by interviewing 75 relatives, was 70% for daily alcohol intake and 84% for duration of intake. Better reproducibility was found by re-interviewing patients at discharge from hospital. Daily alcohol intake was significantly higher in males, younger patients and patients with liver decompensation. After stratification according to the average life-time daily alcohol intake, we found a significant increase in the risk of liver decompensation from 125 g ethanol intake per day onwards. No association was found between duration of alcohol intake and risk of liver decompensation. We conclude that alcohol intake can be reliably and reproducibly measured: in patients with cirrhosis, increased alcohol intake is associated with increased risk of liver decompensation, with a significant dose-effect above a daily intake of 125 g ethanol.