Search

Background: Extensive-stage small-cell lung cancer (ES-SCLC) treatment has recently been revolutionized by the advent of immune checkpoint inhibitors. This survey was conducted to evaluate the current pattern of care among Italian clinicians, in particular about the integration with radiation therapy (RT). Methods: In June 2023, 225 Italian cancer care professionals were invited to complete a 21-question web-based survey about ES-SCLC management through personal contacts and the Italian Association for Radiotherapy and Clinical Oncology (AIRO) network. Results: We received 90 responses; the majority were radiation oncologists (89%) with more than 10 years of experience (51%). The preferred management of ES-SCLC in patients with a good performance status was concomitant chemo-immunotherapy (84%). Almost all respondents recommended prophylactic cranial irradiation (PCI) (85%), taking into account age and thoracic response; PCI was performed mainly between the end of chemotherapy and before starting immunotherapy (37%), with a three-dimensional conformal technique (46%). Furthermore, 83% of respondents choose to deliver thoracic RT in the case of both an intrathoracic and extrathoracic response, with an RT schedule of 30 Gy/10 fractions. Stereotactic RT is increasingly being used in oligoprogressions. Conclusions: Our analysis showed the variability of real-world management of ES-SCLC. Future clinical trials and developments are needed to improve the multidisciplinary treatment of these patients.

Purpose of the article: The aim of this multicenter observational study is to report data from real world on the use of bimekizumab in patients aged ≥ 65 years with moderate-to-severe plaque psoriasis. Elderly patients are poorly represented in clinical trials on bimekizumab for plaque psoriasis, and real-world studies are important to guide clinical choices.Materials and methods: A retrospective multicenter study was conducted in 33 dermatological outpatient clinics in Italy. Patients aged ≥ 65 years, with moderate-to-severe plaque psoriasis and treated with bimekizumab were enrolled. No exclusion criteria were applied. Bimekizumab was administered following the Italian Guidelines for the management of plaque psoriasis and according to the summary of product characteristics, in adult patients who were candidates for systemic treatments. Overall, 98 subjects were included, and received bimekizumab up to week 36. Clinical and demographic data were collected before the initiation of treatment with bimekizumab. At baseline and each dermatological examination (4, 16, and 36 weeks), clinical outcomes were measured by the following parameters: (1) PASI score; (2) site-specific (scalp, palmoplantar, genital, nail) Psoriasis Global Assessment (PGA). At each visit, the occurrence of any adverse events (AEs) was recorded, including serious AEs and AEs leading to bimekizumab discontinuation.Results: The mean PASI score was 16.6 ± 9.4 at baseline and significantly decreased to 4.3 ± 5.2 after 4 weeks (p

AbstractPurpose Tildrakizumab is a selective inhibitor of IL-23 approved for the treatment of moderate-to-severe plaque psoriasis in two dosages. We conducted a 16-week multicenter retrospective study to compare the effectiveness and safety of tildrakizumab 200 mg versus tildrakizumab 100 mg in patients with a high disease burden or high body weight.Materials and methods Our retrospective study included 134 patients treated with tildrakizumab 200 mg and 364 patients treated with tildrakizumab 100 mg from 28 Italian Dermatology Units affected by moderate-to-severe plaque psoriasis. The patients had a body weight above 90 kg or a high disease burden (Psoriasis Area and Severity Index [PASI] ≥ 16 or the involvement of difficult-to-treat areas). We evaluated the effectiveness of tildrakizumab at the week-16 visit in terms of PASI90, PASI100 and absolute PASI ≤ 2.Results After 16 weeks of treatment with tildrakizumab 200 mg, PASI90 was reached by 57.5% of patients and PASI100 by 39.6% of patients. At the same time point, 34.3% and 24.2% of patients treated with tildrakizumab 100 mg achieved PASI90 and PASI100, respectively.Conclusions Our data suggest that tildrakizumab 200 mg has better effectiveness than tildrakizumab 100 mg in patients with a body weight ≥ 90 kg and a high disease burden.

Despite improvements in the awareness and acceptance of lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse (LGBTQ+) individuals, the LGBTQ+ community continues to experience discrimination, which can result in adverse health outcomes. In particular, LGBTQ+ youth have an increased risk of experiencing depression, substance abuse, and suicide. Societal stigma and rejection, bullying, and familial disapproval all contribute to these health disparities. In recognition of these inequities, an interprofessional team of biomedical faculty members, staff, and trainees from the Louisiana State University Health Science Center (LSUHSC) in New Orleans developed the needs-assessment evaluation, the Gender and Sexual Minority Youth Outreach Survey (GSMYO) for high school students. Health science centers have access to resources and experienced personnel who can provide support and education to high school students, teachers, and administrative staff. However, it is important to first determine the high schools’ specific needs, attitudes towards LGBTQ+ acceptance, and their current resources. Faculty, staff, and trainees from the LSUHSC Science Youth Initiative (SYI) and the LSUHSC LGBTQ+ Organization, Tiger Pride, administered the short, anonymous survey to adolescents attending Southeast Louisiana high schools. English Language Learner (ELL) students received the survey in Spanish. Results from the GSMYO needs-assessment survey are presented. Other health science centers may adapt the presented survey to develop needs-based LGBTQ+ high school programs to address the educational and health inequities in their own communities, regardless of location or demographic region.

Abstract Metastatic breast cancer leads to poor prognoses and worse outcomes in patients due to its invasive behavior and poor response to therapy. It is still unclear what biophysical and biochemical factors drive this more aggressive phenotype in metastatic cancer; however recent studies have suggested that exposure to fluid shear stress in the vasculature could cause this. In this study a modular microfluidic platform capable of mimicking the magnitude of fluid shear stress (FSS) found in human vasculature was designed and fabricated. This device provides a platform to evaluate the effects of FSS on MCF-7 cell line, an estrogen receptor positive (ER+) breast cancer cell line, during circulation in the vessels. Elucidation of the effects of FSS on MCF-7 cells was carried out utilizing two approaches: single cell analysis and bulk analysis. For single cell analysis, cells were trapped in a microarray after exiting the serpentine channel and followed by immunostaining on the device (on-chip). Bulk analysis was performed after cells were collected in a microtube at the outlet of the microfluidic serpentine channel for western blotting (off-chip). It was found that cells exposed to an FSS magnitude of 10 dyn/cm2 with a residence time of 60 s enhanced expression of the proliferation marker Ki67 in the MCF-7 cell line at a single cell level. To understand possible mechanisms for enhanced Ki67 expression, on-chip and off-chip analyses were performed for pro-growth and survival pathways ERK, AKT, and JAK/STAT. Results demonstrated that after shearing the cells phosphorylation of p-AKT, p-mTOR, and p-STAT3 were observed. However, there was no change in p-ERK1/2. AKT is a mediator of ER rapid signaling, analysis of phosphorylated ERα was carried out and no significant differences between sheared and non-sheared populations were observed. Taken together these results demonstrate that FSS can increase phosphorylation of proteins associated with a more aggressive phenotype in circulating cancer cells. These findings provide additional information that may help inform why cancer cells located at metastatic sites are usually more aggressive than primary breast cancer cells.

Immunization is a preventive measure of crucial importance. As with any other medication, side effects are a possibility and include the rare occurrence of severe infections, such as osteomyelitis. We report an unusual case of pediatric osteomyelitis following vaccination and provide a review of similar reports submitted to the Vaccine Adverse Event Report System (VAERS), aiming to explore the association between the vaccination procedure and the occurrence of osteomyelitis in childhood. A previously healthy infant, with no history of trauma or infection, presented with hyperpyrexia, swelling, and functional impairment in the left leg and was eventually diagnosed with osteomyelitis of the left femur. An edema was noted at the site of the injection that he received days before for immunization purposes. The infection required surgical drainage and a four-week-long intravenous antibiotic treatment, and the patient was discharged upon showing improved clinical conditions. Forty-seven reports of similar cases submitted to VAERS between 1994 and 2023 were collected, and several cases from the literature, including a case of femoral osteomyelitis in a newborn vaccinated against Hepatitis B, attributed to improper injection technique. Another case was reported in a 15-year-old girl, which aligned with six similar cases of osteomyelitis in adolescents following HPV vaccines collected from VAERS. Despite the small sample number, the findings that in 77% of cases the infection was localized in the vaccinated limb and that symptoms appeared on average 4.3 days (IQR 1.0–5.7 days) post-vaccination suggest a possible link to the injection procedure and highlight the need to adhere to recommendations regarding skin preparation and the selection of the appropriate needle length and injection site.

(1) Background/Objectives: Nail psoriasis (NP) is a chronic and difficult-to-treat disease, which causes significant social stigma and impairs the patients’ quality of life. Moreover, nail psoriasis is a true therapeutic challenge for clinicians. The presence of nail psoriasis can be part of a severe form of psoriasis and can have predictive value for the development of psoriatic arthritis. Our real-world-evidence multicenter study aims to evaluate the efficacy of bimekizumab in nail psoriasis. (2) Methods: A retrospective analysis of a multicenter observational study included 834 patients affected by moderate-to-severe psoriasis, in 33 Dermatologic Units in Italy, treated with bimekizumab from December 2022 to September 2023. Clinimetric assessments were based on Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and Physician’s Global Assessment of Fingernail Psoriasis (PGA-F) for the severity of nail psoriasis at 0, 12, 24, and 36 weeks. (3) Results: Psoriatic nail involvement was present in 27.95% of patients. The percentage of patients who achieved a complete clearance of NP in terms of PGA-F 0 was 31.7%, 57%, and 88.5% at week 4, 16, and 36, respectively. PASI 100 was achieved by 32.03% of patients at week 4, by 61.8% at week 16, and by 78.92% of patients at week 36. The mean baseline PASI was 16.24. The mean DLQI values for the entire group of patients at baseline, at week 4, at week 16, and at week 36 were 14.62, 3.02, 0.83, and 0.5, respectively. (4) Conclusions: Therapies that promote the healing of both the skin and nails in a short time can also ensure a lower risk of subsequently developing arthritis which is disabling over time. Bimekizumab proved to be particularly effective to treat NP, with a fast response in terms of complete clearance, with over 88.5% of patients free from NP after 36 weeks. The findings of our real-world study showed that patients with moderate-to-severe PsO and concomitant NP had significantly faster and more substantial improvements in NP up to 36 weeks with respect to previous research findings. Considering the rapid healing of the nail, the dual inhibition of IL17 A and F might have a great value in re-establishing the dysregulation of keratin 17 at the nail level.

Regarding secondary aerosols, in addition to the significant contribution of anthropogenic gases such as NOx and SO2, atmospheric ammonia (NH3) plays a crucial role as the primary basic gaseous species capable of neutralizing acidic compounds. This acid–base reaction is responsible for the formation of ammonium nitrate (NH4NO3), constituting up to 60% of PM10 within the Po River basin in Italy. Ion chromatographic analyses performed on offline samples indicate that this secondary inorganic species exhibits minimal concentration variability over the Po Valley because of limited air circulation due to orography and mesoscale air circulation. Therefore, investigating gaseous precursors becomes crucial. From the northern to the southern part of Lombardy—the region at the center of the basin—NH3 emission amounts account for 2.5, 11.1, and 27.7 t/y/km2, mainly due to agriculture and livestock activities (∼97%). To study NH3 temporal and spatial variability, the Environmental Protection Agency of Lombardy Region has been monitoring NH3 concentrations across its territory since 2007, with 10 active monitoring sites. Annual and seasonal cycles are presented, along with a focus on different stations, including urban, low-mountain background, high-impact livestock, and rural background, highlighting the impact of various sources. Measurements indicate that within the Po basin, NH3 concentrations can reach up to 700 µg/m3 (as an hourly average) in proximity to the main gaseous NH3 source. Instrument intercomparisons among online monitors and passive vials, as well as different online monitors, are presented. Therefore, this paper provides crucial data to understand the formation of secondary inorganic aerosols in one of the most important hotspot sites for air pollution.

In the United States, great inequities exist within the science, technology, engineering, and math (STEM) fields in individuals who self-identify as belonging to underrepresented groups (e.g., from socioeconomically disadvantaged backgrounds, people with disabilities, and Black/African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander). Underrepresentation in STEM careers has been documented to be due to a lack of qualified and diverse teaching personnel, limited access to resources in disadvantaged schools, and implicit bias within US institutions. In recognition of these inequities, an interprofessional team of biomedical faculty members and diversity, equity and inclusion (DEI) educators from the Louisiana State University Health Science Center (LSUHSC) in New Orleans developed and implemented a STEM educational training pipeline for elementary, middle, and high school (K-12), undergraduate, and medical students, with accompanying DEI training for LSUHSC mentors and staff to mitigate implicit bias and promote a welcoming environment for participants from different backgrounds. Our findings focus on one social determinant of health: access and quality of education. Other institutions can implement a program as described in the present study to address the educational and health inequities in their own communities.

The Monte Carlo Command Line application (MCCL) is an open-source software package that provides Monte Carlo simulations of radiative transport through heterogeneous turbid media. MCCL is available on GitHub through our virtualphotonics.org website, is actively supported, and carries extensive documentation. Here, we describe the main technical capabilities, the overall software architecture, and the operational details of MCCL.

Introduction With many US states and localities enacting policies that restrict flavored e-cigarette sales, evaluation of these restrictions is critical to inform future efforts. This study analyzed both survey and retail scanner data to assess early-stage impacts of flavored tobacco sales restrictions in Massachusetts and New York State on e-cigarettes sales and product use among young people. Methods This study uses state-level e-cigarette retail sales data and survey data from youth and young adults (aged 13–24 years). Cross-sectional surveys were conducted at two time points in Massachusetts (both post policy implementation) and New York (pre and post policy implementation); retail sales data in both states were analyzed from 2019 through 2020 and compared to sales in control states. Results E-cigarette unit sales decreased significantly following the implementation of statewide restrictions on flavored e-cigarettes in both Massachusetts and New York State (p

Background: Very few data are available in the literature regarding tuberculosis (TB) hospitalization, and few studies have reported the clinical characteristics and comorbidities of admitted patients and burden and cost of hospitalization. In our study, we described the occurrence of TB hospital admissions in the southern Italian region of Sicily over 13 years (2009–2021), explored the characteristics of patients with TB, and determined the comorbidities associated with mortality. Method: Data on the hospital discharge of all patients with TB hospitalized in all Sicilian hospitals were retrospectively collected from hospital standard discharge forms. Age, sex, nationality, length of hospital stay, comorbidities, and TB localization were evaluated using univariate analysis according to in-hospital mortality. The factors associated with mortality were included in the logistic regression model. Results: In Sicily, 3745 people were hospitalized for TB, with 5239 admissions and 166 deaths from 2009 to 2021. Most hospitalizations involved Italian-born people (46.3%), followed by African-born people (32.8%) and Eastern European-born people (14.1%). The average hospitalization cost was EUR 5259 ± 2592, with a median length of stay of 16 days (interquartile range, 8–30) days. Multivariate analysis showed that the development of acute kidney failure (adjusted odds ratio [aOR]=7.2, p

Recent studies indicate that mass concentration alone is not the best parameter to assess the toxicity and the health effects of particulate matter (PM). Indeed, the chemical composition of the particles plays an important role, and oxidative potential (OP) measurements are being proposed as an alternative way to assess toxicity. The European Union (EU) is currently proposing a draft of the new air quality directive which includes OP measurements but does not specify the methods and/or protocols of analysis. In this light, the purpose of this study was to evaluate the feasibility of two literature assays, namely ascorbic acid (AA) and dithiothreitol (DTT), for routine PM analysis by testing urban PM filters from a one-year sampling campaign conducted by ARPA Lombardia. Indoor PM samples were also tested to emphasize the importance of monitoring closed spaces in which people spend most of their time. Following the optimization of the DTT assay, both methods proved to be suitable for large-scale PM analysis. The results show that the oxidative strength of urban PM is constant throughout the year for the outdoor samples (OPAA: 0.067–0.39 nmol min−1 m−3; OPDTT: 0.033–0.109 nmol min−1 m−3), indicating the need for routine OP monitoring. Instead, indoor areas were characterized by particles with a lower oxidative capacity (OPAA: 5.40–24 pmol min−1 m−3; OPDTT: 9.7–32 pmol min−1 m−3), driven both by lower concentrations and a different chemical composition. All the data collected highlight the need to add this parameter as part of the chemical characterization of PM, moving in the same direction as the new EU air quality directive.

For a Positive Matrix Factorization (PMF) aerosol source apportionment (SA) studies there is no standard procedure to select the most appropriate chemical components to be included in the input dataset for a given site typology, nor specific recommendations in this direction. However, these choices are crucial for the final SA outputs not only in terms of number of sources identified but also, and consequently, in the source contributions estimates. In fact, PMF tends to reproduce most of PM mass measured independently and introduced as a total variable in the input data, regardless of the percentage of PM mass which has been chemically characterized, so that the lack of some specific source tracers (e.g. levoglucosan) can potentially affect the results of the whole source apportionment study. The present study elaborates further on the same concept, evaluating quantitatively the impact of lacking specific sources’ tracers on the whole source apportionment, both in terms of identified sources and source contributions. This work aims to provide first recommendations on the most suitable and critical components to be included in PMF analyses in order to reduce PMF output uncertainty as much as possible, and better represent the most commons PM sources observed in many sites in Western countries. To this aim, we performed three sensitivity analyses on three different datasets across EU, including extended sets of organic tracers, in order to cover different types of urban conditions (Mediterranean, Continental, and Alpine), source types, and PM fractions. Our findings reveal that the vehicle exhaust source resulted to be less sensitive to the choice of analytes, although source contributions estimates can deviate significantly up to 44 %. On the other hand, for the detection of the non-exhaust one is clearly necessary to analyze specific inorganic elements. The choice of not analysing non-polar organics likely causes the loss of separation of exhaust and non-exhaust factors, thus obtaining a unique road traffic source, which provokes a significant bias of total contribution. Levoglucosan was, in most cases, crucial to identify biomass burning contributions in Milan and in Barcelona, in spite of the presence of PAHs in Barcelona, while for the case of Grenoble, even discarding levoglucosan, the presence of PAHs allowed identifying the BB factor. Modifying the rest of analytes provoke a systematic underestimation of biomass burning source contributions. SIA factors resulted to be generally overestimated with respect to the base case analysis, also in the case that ions were not included in the PMF analysis. Trace elements were crucial to identify shipping emissions (V and Ni) and industrial sources (Pb, Ni, Br, Zn, Mn, Cd and As). When changing the rest of input variables, the uncertainty was narrow for shipping but large for industrial processes. Major and trace elements were also crucial to identify the mineral/soil factor at all cities. Biogenic SOA and Anthropogenic SOA factors were sensitive to the presence of their molecular tracers, since the availability of OC alone is unable to separate a SOA factor. Arabitol and sorbitol were crucial to detecting fungal spores while odd number of higher alkanes (C27 to C31) for plant debris.

Abstract Introduction Cardiac arrhythmias, including ventricular tachycardia (VT), stand as a significant threat to health, often leading to mortality and sudden cardiac death. While conventional treatments for VT exhibit efficacy, cases of refractory VT pose challenges. Stereotactic Arrhythmia Radioablation (STAR) offers a novel approach, delivering precise high‐dose radiation to well‐defined targets with minimal collateral damage. This study explores the potential of STAR as an alternative therapy, especially for high‐risk patients or those with refractory VT. Methods This research reviews ongoing studies and preliminary investigations into the evaluation of the efficacy and safety of STAR. The method involves targeted radiation delivery, assessing reductions in VT recurrence and the early safety profile in refractory VT patients. However, given STAR's early stage and limited clinical evidence, cautious interpretation is advised. Results Preliminary findings indicate a reduction in VT recurrence with STAR, suggesting promise as a therapeutic option. Early safety profiles are encouraging, but definitive statements on efficacy and safety require further investigation. Positive initial outcomes underscore the need for additional data and long‐term studies. Conclusion Stereotactic Arrhythmia Radioablation is recently emerging as a promising treatment for refractory VT. While early results are encouraging, careful interpretation is needed, due to STAR's early stages. Ongoing investigations are critical for a comprehensive understanding of its long‐term efficacy and tolerability. This review provides fundamental insights into STAR's background, principles, pre‐treatment procedures, clinical implications, and toxicity, setting the stage for future research in this evolving therapeutic field.