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The coffee leaf miner (Leucoptera coffeella) is a key pest in coffee-producing regions in Brazil. The objective of this work was to evaluate the potential of machine learning algorithms to identify coffee leaf miner infestation by considering the assessment period and Sentinel-2 satellite images generated on the Google Earth Engine platform. Coffee leaf miner infestation in the field was measured monthly from 2019 to 2023. Images were selected from the Sentinel-2 satellite to determine 13 vegetative indices. The selection of images and calculations of the vegetation indices were carried out using the Google Earth Engine platform. A database was generated with information on coffee leaf miner infestation, vegetation indices, and assessment times. The database was separated into training data and testing data. Nine machine learning algorithms were used, including Linear Discriminant Analysis, Random Forest, Support Vector Machine, k-nearest neighbors, and Logistic Regression, and a principal component analysis was conducted for each algorithm. After optimizing the hyperparameters, the testing data were used to validate the model. The best model to estimate miner infestation was RF, which had an accuracy of 0.86, a kappa index of 0.64, and a precision of 0.87. The developed models were capable of monitoring coffee leaf miner infestation.

Objectives Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level.Design Mixed-method cross-sectional survey.Participants, setting and measures The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method.Results The framework analysis of qualitative data of 141 participants identified 6 key ‘frames’ exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences.Conclusions This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.

A form of rural tourism in expansion is horse tourism. Equitourism is a form of hiking that allows for an intimate and natural use of landscapes and local territories. Equestrian tourism today no longer represents a small elite market niche, as it has become a true form of pastime for an increasing number of users. Trail planning and management need to consider the changes that are already occurring, as well as those that are predicted to lie ahead. The key trends that are expected to have an impact on recreational horse trail planning and management are highlighted in this research. Many of these trends have been emerging over decades and have rapidly increased due to the impacts of the COVID-19 pandemic. In recent years, in many Italian regions, especially in Tuscany, thanks to the enhancement of the Tuscan equestrian routes, projects for the promotion of equestrian tourism have been developed. In this work the methodology applied was based on the identification of an appropriate database created in the GIS context and specifically coded for equestrian tourism. The aim is to guarantee the creation of an innovative and functional product to meet the needs of this sustainable tourism sector, providing information capable of facilitating the end user, who, through their GPS, georeferenced images and maps, will have the possibility of planning and traveling the horse trail in complete safety. The final result of this research (the first case study in Italy) is the creation of a modern and complete information database of a horse trail that can be managed using GIS.

Objectives: Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail. Methods: We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy. Results: The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. Conclusion: These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.

In ER+ breast cancer, usually seen as the low immunogenic type, the main mechanisms favouring the immune response or tumour growth and immune evasion in the tumour microenvironment (TME) have been examined. The principal implications of targeting the oestrogen-mediated pathways were also considered. Recent experimental findings point out that anti-oestrogens contribute to the reversion of the immunosuppressive TME. Moreover, some preliminary clinical data with the hormone-immunotherapy association in a metastatic setting support the notion that the reversion of immune suppression in TME is likely favoured by the G0-G1 state induced by anti-oestrogens. Following immune stimulation, the reverted immune suppression allows the boosting of the effector cells of the innate and adaptive immune response. This suggests that ER+ breast cancer is a molecular subtype where a successful active immune manipulation can be attained. If this is confirmed by a prospective multicentre trial, which is expected in light of the provided evidence, the proposed hormone immunotherapy can also be tested in the adjuvant setting. Furthermore, the different rationale suggests a synergistic activity of our proposed immunotherapy with the currently recommended regimen consisting of antioestrogens combined with cyclin kinase inhibitors. Overall, this lays the foundation for a shift in clinical practice within this most prevalent molecular subtype of breast cancer.

Brazil stands out among coffee-growing countries worldwide. The use of precision agriculture to monitor coffee plants after transplantation has become an important step in the coffee production chain. The objective of this study was to assess how coffee plants respond after transplanting seedlings grown in different containers, based on multispectral images acquired by Unmanned Aerial Vehicles (UAV). The study was conducted in Santo Antônio do Amparo, Minas Gerais, Brazil. The coffee plants were imaged by UAV, and their height, crown diameter, and chlorophyll content were measured in the field. The vegetation indices were compared to the field measurements through graphical and correlation analysis. According to the results, no significant differences were found between the studied variables. However, the area transplanted with seedlings grown in perforated bags showed a lower percentage of mortality than the treatment with root trainers (6.4% vs. 11.7%). Additionally, the vegetation indices, including normalized difference red-edge, normalized difference vegetation index, and canopy planar area calculated by vectorization (cm2), were strongly correlated with biophysical parameters. Linear models were successfully developed to predict biophysical parameters, such as the leaf area index. Moreover, UAV proved to be an effective tool for monitoring coffee using this approach.

Brazil is the largest producer and exporter of coffee beans in the world. Given this relevance, it is important to monitor the crop to prevent attacks by pests. This study aimed to detect leaf miner (Leucoptera coffeella) infestation in a newly planted crop based on vegetation indices (VI) derived from aerial images obtained by a multispectral camera embedded in a remotely piloted aircraft (RPA) using random forest (RF). The study was conducted on the Cafua farm in the municipality of Lavras in southern Minas Gerais. The images were collected using a multispectral camera attached to a remotely piloted aircraft (RPA). Collections were carried out on 30 July 2019 (infested crop) and 16 December 2019 (post chemical control). The RF package in R software was used to classify the infested and healthy plants. The t test revealed significant differences in band means between healthy and infested plants, favouring higher means in healthy plants. VI also exhibited significant differences, with EXR being higher in infested plants and GNDVI, GOSAVI, GRRI, MPRI, NDI, NDRE, NDVI and SAVI showing higher averages in healthy plants, indicating distinct spectral responses and light absorption patterns between the two states of the plant. Due to the spectral differences between the classes, it was possible to classify the infested and healthy plants, and the RF algorithm performed very well.

A retrospective survey was conducted in hematologic centres of the Rete Ematologica Lombarda (REL) on 529 older AML patients seen between 2020–2022. Compared to 2008–2016, the use of intensive chemotherapy (ICT) decreased from 40% to 18.1% and of hypomethylating agents (HMAs) from 19.5% to 13%, whereas the combination of Venetoclax/HMA, initially not available, increased from 0% to 36.7%. Objective treatment-specific fitness criteria proposed by SIE/SIES/GITMO in 2013 allow an appropriate choice between ICT and HMAs by balancing their efficacy and toxicity. Venetoclax/HMA, registered for patients unfit to ICT, has a unique toxicity profile because of prolonged granulocytopenia and increased infectious risk. Aiming at defining specific fitness criteria for the safe use of Venetoclax/HMA, a preliminary investigation was conducted among expert REL hematologists, asking for modifications of SIE/SIES/GITMO criteria they used to select candidates for Venetoclax/HMA. While opinions among experts varied, a general consensus emerged on restricting SIE/SIES/GITMO criteria for ICT-unfit patients to an age limit of 80–85, cardiac function > 40%, and absence of recurrent lung infections, bronchiectasis, or exacerbating COPD. Also, the presence of an adequate caregiver was considered mandatory. Such expert opinions may be clinically useful and may be considered when treatment-specific fitness criteria are updated to include Venetoclax/HMA.

Photogrammetric data are systematically used in several segments. Products such as Digital Terrain Models (DTMs) provide detailed surface information, however the geometric reliability of these products is questionable compared to data collected by topographic survey by GNSS RTK. The present research assesses the quality of DTMs obtained using an Unmanned Aerial Vehicle (UAV) with different parameters, overlap percentages, and flight directions, comparing the results to those of the topography method Global Navigation Satellite System – Real-Time Kinematic (GNSS RTK). Were done twelve flight plans with different overlaps (90x90, 80x80, 80x60, 70x50, 70x30, and 60x40%) and directions (transverse and longitudinal to the planting line). The parameters of height (Above Ground Land- AGL) and speed were fixed at 90 m and 3 m/s respectively and a Ground Sample Distance (GSD) of 0,1 m is obtained for all flights. Overall, the flight with 70x50% overlap in the transverse direction generated the best results, with a total processing time of 12 minutes and 17 seconds (about 1.5 hours faster than 90x90%), an Root Mean Square Error (RMSE) 0.589 m, and meets the minimum overlap required by 60X30% aerophotogrammetry; furthermore, the results did not differ statistically from the high overlaps of 90x90% and 80x80%.

In recent years, unmanned aerial vehicles (UAVs) have been increasingly used to monitor and assess air quality. The interest in the application of UAVs in monitoring air pollutants and greenhouse gases is evidenced by the recent emergence of sensors with the most diverse specifications designed for UAVs or even UAVs designed with integrated sensors. The objective of this study was to conduct a comprehensive review based on bibliometrics to identify dynamics and possible trends in scientific production on UAV-based sensors to monitor air quality. A bibliometric analysis was carried out in the VOSViewer software (version 1.6.17) from the Scopus and Web of Science reference databases in the period between 2012 and 2022. The main countries, journals, scientific organizations, researchers and co-citation networks with greater relevance for the study area were highlighted. The literature, in general, has grown rapidly and has attracted enormous attention in the last 5 years, as indicated by the increase in articles after 2017. It was possible to notice the rapid development of sensors, resulting in smaller and lighter devices, with greater sensitivity and capacity for remote work. Overall, this analysis summarizes the evolution of UAV-based sensors and their applications, providing valuable information to researchers and developers of UAV-based sensors to monitor air pollutants.

The use of new technologies to monitor and evaluate the management of coffee crops allowed for a significant increase in productivity. Precision coffee farming has leveraged the development of this commodity by using remote sensing and Unmanned Aerial Vehicles (UAVs). However, the success of coffee farming in the country also resulted from management practices, including liming management in the soils. This study aimed to evaluate the response of coffee seedlings transplanted to areas subjected to deep liming in comparison to conventional (surface) liming, using vegetation indices (VIs) generated by multispectral images acquired using UAVs. The study area was overflown bimonthly by UAVs to measure the plant height, crown diameter, and chlorophyll content in the field. The VIs were generated and compared with the data measured in the field using linear time graphs and a correlation analysis. Linear regression was performed to predict the biophysical parameters as a function of the VIs. A significant difference was found only in the chlorophyll content. Most indices were correlated with the biophysical parameters, particularly the green chlorophyll index (GCI) and the canopy area calculated via vectorization. Therefore, UAVs proved to be effective coffee monitoring tools and can be recommended for coffee producers.

Abstract The poor prognosis of acute T‐cell lymphoblastic leukemia (T‐ALL) and T‐cell lymphoblastic lymphoma (T‐LBL) in older adults and patients with relapsed/refractory illness is an unmet clinical need, as there is no defined standard of care and there are few treatment options. Abnormally elevated CD38 expression in T‐ALL and T‐LBL is associated with tumor expansion and disease development, making CD38 a potential target for anti‐T‐ALL and T‐LBL treatment. Isatuximab is a monoclonal antibody that binds to a specific epitope on CD38. The purpose of the study was to assess the efficacy and safety of isatuximab monotherapy in a phase 2, multicenter, one‐arm, open‐label study in patients with relapsed or refractory T‐ALL or T‐LBL (Clinical Trials.gov identifier NCT02999633). The primary endpoint was to assess the efficacy of isatuximab by overall response rate (ORR). An interim analysis based on the efficacy and safety of isatuximab in the first 19 patients enrolled was scheduled, however only 14 patients were enrolled in the study. No patient achieved complete response (CR) or CR with incomplete peripheral recovery. Most patients (11 [78.6%]) developed progressive disease and had progressive disease as their best response. A total of 10 (71.4%) patients had treatment emergent adverse events considered treatment‐related, with infusion reactions as the most frequent drug‐related TEAE, occurring in 8 (57.1%) patients. Despite the low efficacy of isatuximab in the current study, it is likely that the use of immunotherapy medication in T‐ALL will be expanded through logically targeted approaches, together with advances in the design of T‐cell therapy and clinical experience and will provide restorative options beyond chemotherapy and targeted treatments.

Reference evapotranspiration (ET0) is one important agrometeorological parameter for hydrological studies and climate risk zoning. ET0 calculation by the FAO Penman–Monteith method requires several input data. However, the availability of climate data has been a problem in many places around the world, so the study of scenarios with different combinations of climate data has become essential. The aim of this study was to evaluate the performance of artificial neural network (ANN), random forest (RF), support vector machine (SVM), and multiple linear regression (MLR) approaches to estimate monthly mean ET0 with different input data combinations and scenarios. Three scenarios were evaluated: at the state level, where all climatological stations were used (Scenario I–SI), and at the regional level, where the Minas Gerais state was divided according to the climatic classifications of Thornthwaite (Scenario II–SII) and Köppen (Scenario III–SIII). ANN and RF performed better in ET0 estimation among the models evaluated in the SI, SII, and SIII scenarios with the following data combinations: (i) latitude, longitude, altitude, month, mean, maximum and minimum temperature, and relative humidity and (ii) latitude, longitude, altitude, month, mean temperature, and relative humidity. SVM and MLR models are recommended for all scenarios in situations with limited climatic data where only air temperature and relative humidity data are available. The results and information presented in this study are important for the agricultural chain and water resources in Minas Gerais state.

Octogenarian patients with diffuse large B-cell lymphoma are managed mainly with palliation, but recent improvement in their overall condition makes potentially curative treatment a possibility. Studies have shown that half of selected octogenarians may be cured using reduced-dose anthracycline chemoimmunotherapy. However, patients aged >85 (late octogenarians [LO]) were underrepresented, and selection criteria were poorly defined. We analyzed the clinical characteristics and outcomes of LO enrolled in the FIL Elderly Project in terms of the treatment received (palliative vs. curative) and of their simplified geriatric assessment (sGA), then compared them with early octogenarians (EO) aged 80- 84 and with those aged 65-79 classified as UNFIT or FRAIL according to sGA enrolled in the same study. Of the 1,163 patients, 370 were >80 and 129 LO. Clinical characteristics were similar between LO and EO, but LO more frequently received palliation (50% vs. 23%; P=0.001) and had worse 2-year overall survival (OS) (48% vs. 63%; P=0.001) and 2-year progression-free survival (PFS) (43% vs. 56%; P=0.01). Patients receiving anthracycline did better than patients receiving palliation (P

Abstract Background Diffusion‐weighted whole‐body MRI (DW‐MRI) is increasingly used in the management of multiple myeloma (MM) patients, but data regarding the prognostic role of DW‐MRI imaging response after treatment are lacking. The Myeloma Response Assessment and Diagnosis System (MY‐RADS) imaging recommendations recently proposed the criteria for response assessment category (RAC) with a 5‐point scale in order to standardize response assessment after therapy, but this score still needs to be validated. Methods We investigated the prognostic role of RAC criteria in 64 newly diagnosed MM patients after autologous stem cell transplantation (ASCT), and we combined the results of MY‐RADS with those of minimal residual disease (MRD) assessment by multiparametric flow cytometry (MFC). Results Superior post‐ASCT PFS and OS were observed in patients with complete imaging response (RAC1), with respect to patients with imaging residual disease (RAC≥2): median PFS not reached (NR) versus 26.5 months, p = 0.0047, HR 0.28 (95% CI: 0.12–0.68); 3‐year post‐ASCT OS 92% versus 69% for RAC1 versus RAC ≥2, respectively, p = 0.047, HR 0.24 (95% CI: 0.06–0.99). Combining MRD and imaging improved prediction of outcome, with double‐negative and double‐positive features defining groups with excellent and dismal PFS, respectively (PFS NR vs. 10.6 months); p = 0.001, HR 0.07 (95%CI: 0.01–0.36). Conclusion The present study supports the applicability of MY‐RADS recommendations after ASCT; RAC criteria were able to independently stratify patients and to better predict their prognosis and the combined use of DW‐MRI with MFC allowed a more precise evaluation of MRD.

The number of patients with bone metastasis increases as medical management and surgery improve the overall survival of patients with cancer. Bone metastasis can cause skeletal complications, including bone pain, pathological fractures, spinal cord or nerve root compression, and hypercalcemia. Before initiation of treatment for bone metastasis, it is important to exclude primary bone malignancy, which would require a completely different therapeutic approach. It is essential to select surgical methods considering the patient’s prognosis, quality of life, postoperative function, and risk of postoperative complications. Therefore, bone metastasis treatment requires a multidisciplinary team approach, including radiologists, oncologists, and orthopedic surgeons. Recently, many novel palliative treatment options have emerged for bone metastases, such as stereotactic body radiation therapy, radiopharmaceuticals, vertebroplasty, minimally invasive spine stabilization with percutaneous pedicle screws, acetabuloplasty, embolization, thermal ablation techniques, electrochemotherapy, and high-intensity focused ultrasound. These techniques are beneficial for patients who may not benefit from surgery or radiotherapy.

This document illustrates the results of a discussion of two multi-disciplinary expert panels on pricing and reimbursement of medicines. Experts work in different organizations. The discussion focused on comparator(s), endpoint(s), negotiation of prices of new medicines and/or indications to include in the List 648, as well as the role of cost-effectiveness in the price and reimbursement negotiation. The debate took place during the fourth edition of the Seminari di Mogliano, organized on the 30th of September/1st of October, 2021. The two panels agreed on a general need to enhance interaction among the different stakeholders, in the early assessment and negotiation phases, and to increase the transparency/reproducibility of the decisions taken. The experts have also emphasized the need (i) to improve clarity in the evaluation of additional therapeutic value and the place in therapy with respect to comparators and how comparators are identified; (ii) to create work groups to identify the most appropriate endpoint(s), for each therapeutic area and level of unmet needs; (iii) to provide for a systematic use of cost-effectiveness when an added therapeutic value is delivered by a new medicine. With regard to the 648 List, the experts advocated for an overall reorganization of the current rules governing the special uses of drugs.

Studies of patients with schizophrenia and offenders with severe mental disorders decision-making performance have produced mixed findings. In addition, most earlier studies have assessed decision-making skills in offenders or people with mental disorders, separately, thus neglecting the possible additional contribution of a mental disorder on choice patterns in people who offend.This study aimed to fill this gap by comparing risk-taking in patients with schizophrenia spectrum disorders (SSD), with and without a history of serious violent offending assessing whether, and to what extent, risk-taking represents a significant predictor of group membership, controlling for their executive skills, as well as for socio-demographic and clinical characteristics.Overall, 115 patients with a primary diagnosis of SSD were recruited: 74 were forensic patients with a lifetime history of severe interpersonal violence and 41 were patients with SSD without such a history. No significant group differences were observed on psychopathological symptoms severity. Forensic generally displayed lower scores than non-forensic patients in all cognitive subtests of the Brief Assessment of Cognition in Schizophrenia (except for the “token motor” and the “digit sequencing” tasks) and on all the six dimensions of the Cambridge Gambling Task, except for “Deliberation time”, in which forensic scored higher than non-forensic patients. “Deliberation time” was also positively, although weakly correlated with “poor impulse control”.Identifying those facets of impaired decision-making mostly predicting offenders' behaviour among individuals with mental disorder might inform risk assessment and be targeted in treatment and rehabilitation protocols.

Viticulture began growing in Brazil in recent years, and this growth is due to the introduction of new techniques and improvements used in vine planting, especially the use of plastic covering in the vineyard. Thus, this study aimed to evaluate the economic viability of plastic covering installation, as well as the quality of grapes produced by two cultivars, in order to compare these results with those obtained by a conventional cultivation system. The experiment was performed at an experimental farm producing grapes in southern Brazil. The grape cultivars Niagara Branca and Niagara Rosada were studied and cultivated with and without plastic covering. Data related to the costs of vineyard planting, establishment, and seasonal management, in addition to the grape revenue, were assessed. Additionally, the grape yield and quality were evaluated. The analysis of return indicators showed that the net present value was higher for the plastic-covered system, which indicates greater profitability and consequent viability of the investment. Moreover, the grape quality varied according to the cultivar and production system. In this context, it is recommended to use the cultivar Niagara Rosada for production in a plastic covering system.

This study aimed to explore the influence of flight altitude, density, and distribution of ground control points (GCPs) on the digital terrain model (DTM) in surveys conducted by unmanned aerial vehicles (UAVs). A total of 144 photogrammetric projects consisting of 399 aerial photos were carried out in a 2 ha area. These photogrammetric projects involved six GCP distributions (edge, center, diagonal, parallel, stratified, and random), six GCP densities, and four flight altitudes (30, 60, 90, and 120 m). The response surface methodology was used to find interference factors and total root-mean-square error (RMSEt) as well. The 60 m flight altitude presented was the most efficient. Central GCP distribution was observed to have low precision. Using stratified and random edge distributions, 10 GCPs are recommended to achieve geometric precision below 0.07 m at any flight height. However, for studies requiring up to 0.07 m precision, the best distribution was parallel with 4 GCPs at any altitude. Diagonal positioning of the GCPs showed RMSEt values below 0.11 m with 4 GCPs at any altitude. A good distribution of GCPs was found to be important, but the density of GCPs per image was more relevant when obtaining a lower RMSEt.

Abstract Emergence of clones carrying point mutations in the BCR‐ABL1 kinase domain (KD) is a common mechanism of resistance to tyrosine kinase inhibitor (TKI)‐based therapies in Philadelphia chromosome‐positive (Ph+) acute lymphoblastic leukemia (ALL). Sanger sequencing (SS) is the most frequently used method for diagnostic BCR‐ABL1 KD mutation screening, but it has some limitations—it is poorly sensitive and cannot robustly identify compound mutations. Next‐generation sequencing (NGS) may overcome these problems. NSG is increasingly available and has the potential to become the method of choice for diagnostic BCR‐ABL1 KD mutation screening. A group discussion within an ad hoc constituted Panel of Experts has produced a series of consensus‐based statements on the potential value of NGS testing before and during first‐line TKI‐based treatment, in relapsed/refractory cases, before and after allo‐stem cell transplantation, and on how NGS results may impact on therapeutic decisions. A set of minimal technical and methodological requirements for the analysis and the reporting of results has also been defined. The proposals herein reported may be used to guide the practical use of NGS for BCR‐ABL1 KD mutation testing in Ph+ ALL.

The capture-recapture method is widely used by epidemiologists to estimate the size of hidden populations using incomplete and overlapping lists of subjects. Closed populations, heterogeneity of inclusion probabilities and dependence between lists are taken into consideration in this work. The main objective is to propose a new parameterization for the Poisson log linear odel (LLM) to treat continuous covariates in their original measurement scale. The analytic estimate of the confidence bounds of the hidden population is also provided. Proposed model was applied to simulated and real capture-recapture data and compared with the multinomial conditional logit model (MCLM). The proposed model is very similar to the MCLM in dealing with continuous covariates and the analytic confidence interval performs better than the bootstrap estimate in case of small sample size.

Leaf area is a component of crop growth and yield prediction models. Few studies have used the structure from motion (SfM) algorithm, which is based on the principles of traditional stereophotogrammetry, to obtain the leaf area index (LAI). Thus, the objective of this study was to follow the evolution of the LAI and percentage of land cover (%COV) in coffee plants, using pre-established equations and plant measurements obtained from generated 3-D point clouds, combined with the application of the SfM algorithm to digital images recorded by a camera coupled to an unmanned aerial vehicle (UAV). The experiment was conducted in a coffee plantation located in southeastern Brazil. A rotary wing UAV containing a conventional camera was used. The images were collected once per month for 12 months. Image processing was performed using PhotoScan software. Regression analysis and spatial analysis were performed using R and GeoDa software, respectively. The resulting %COV data had R2 and RMSE values of 89% and 3.41, respectively, while those for LAI had R2 and RMSE of 88% and 0.47, respectively. Significant %COV results were obtained in the months of January, February, and March of 2018. There was significant autocorrelation for the LAI values from January to May 2018, with most blocks in the central and center-west regions presenting LAI values > 3.0. It was possible to monitor the temporal and spatial behavior of the LAI and %COV, allowing for the conclusion that this methodology generated results that are consistent with the literature.

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease, including one-third of cases overexpressing MYC and BCL2 proteins (double expressor lymphoma, DEL) and 5-10% of patients with chromosomal rearrangements of MYC, BCL2 and/or BCL-6 (double/triple-hit lymphomas, DH/TH). TP53 mutations are detected in 20- 25% of DEL. We report the efficacy of dose-adjusted EPOCH and rituximab (DA-EPOCH-R) in a series of 122 consecutive patients, including DEL (n=81, 66%), DEL-MYC (n=9, 7%), DEL-BCL2 (n=13, 11%), or high-grade lymphomas (DH/TH) (n=19, 16%). Central nervous system (CNS) prophylaxis included intravenous methotrexate (n=66), intrathecal chemotherapy (IT) (n=40) or no prophylaxis (n=16). Sixty-seven patients (55%) had highintermediate or high International Prognostic Index (IPI) and 30 (25%) had high CNS-IPI. The 2-year progression-free survival (PFS) and overall survival (OS) for the entire study population were 74% and 84%, respectively. There was a trend for inferior OS for DH/TH (2-year OS: 66%, P=0.058) as compared to all the others. The outcome was significantly better for the IPI 0-2 versus IPI 3-5 (OS: 98% vs. 72%, P=0.002). DA-EPOCH-R did not overcome the negative prognostic value of TP53 mutations: 2-year OS of 62% versus 88% (P=0.036) were observed for mutated as compared to wild-type cases, respectively. Systemic CNS prophylaxis conferred a better 2-year OS (94%) as compared to IT or no prophylaxis (76% and 65%, respectively; P=0.008). DA-EPOCH-R treatment resulted in a favorable outcome in patients with DEL and DEL with single rearrangement, whereas those with multiple genetic alterations such as DEL-DH/TH and TP53 mutated cases still have an inferior outcome.

The mapping of pastures can serve to increase productivity and reduce deforestation, especially in Amazon Biome regions. Therefore, in this study, we aimed to explore precision agriculture technologies for assessing the spatial variations of soil pH and biomass indicators (i.e., Dry Matter, DM; and Green Matter, GM). An experiment was conducted in an area cultivated with Panicum maximum (Jacq.) cv. Mombaça in a rotational grazing system for dairy buffaloes in the eastern Amazon. Biomass and soil samples were collected in a 10 m × 10 m grid, with a total of 196 georeferenced points. The data were analyzed by semivariogram and then mapped by Kriging interpolation. In addition, a variability analysis was performed, applying both the Normalized Difference Vegetation Index (NDVI) and Normalized Difference Water Index (NDWI) derived from satellite remote sensing data. The Kriging mapping between DM and pH at 0.30 m depth demonstrated the best correlation. The vegetative index mapping showed that the NDVI presented a better performance in pastures with DM production above 5.42 ton/ha−1. In contrast, DM and GM showed low correlations with the NDWI. The possibility of applying a variable rate within the paddocks was evidenced through geostatistical mapping of soil pH. With this study, we contribute to understanding the necessary premises for utilizing remote sensing data for pasture variable analysis.

The prognosis of acute myeloid leukemia depends on genetic aberrations, particularly NPM1 and FLT3-ITD mutations. The targeted drugs’ availability has renewed interest in FLT3 mutations, but the impact of these genetic alterations using these treatments is yet to be confirmed. Our objective was to evaluate the results obtained with the intensified NILG-AML 01/00 protocol (ClinicalTrials.gov Identifier: NCT 00400673) in 171 unselected patients (median age, 54.5 years, range 15–74) carrying the FLT3 (ITD or TKD) and/or NPM1 mutations. The CR rate and 5-y survival were 88.3% and 58% +/− 4, respectively, significantly higher in the NPM1-mutated (CR 93.9%, p: 0.0001; survival 71% +/− 6, p: 0.0017, respectively). In isolated ITD patients, the CR was lower (66.7%, p: 0.0009), and the 3 years-relapse-free survival worse (24%, p: NPM1-co-mutated patients. Our data indicate that a high dose of ARAC plus idarubicin consolidation exerts a strong anti-leukemic effect in NPM1-mutated patients both with the FLT3 wild-type and mutated AML, while in the NPM1 wild-type and FLT3-mutated, the therapeutic effect remains unsatisfactory. New strategies incorporating target therapy with second-generation inhibitors will improve these results and their addition to this aggressive chemotherapeutic program merits testing.

The potential drug-drug interactions of midostaurin may impact the choice of antifungal (AF) prophylaxis in FLT3-positive acute myeloid leukemia (AML) patients. To evaluate the incidence of invasive fungal diseases (IFD) during the treatment of FLT3-mutated AML patients and to correlate it to the different AF prophylaxis strategies, we planned a multicenter observational study involving 15 SEIFEM centers. One hundred fourteen patients treated with chemotherapy + midostaurin as induction/reinduction, consolidation or both were enrolled. During induction, the incidence of probable/proven and possible IFD was 10.5% and 9.7%, respectively; no statistically significant difference was observed according to the different AF strategy adopted. The median duration of neutropenia was similar in patients with or without IFD. Proven/probable and possible IFD incidence was 2.4% and 1.8%, respectively, during consolidation. Age was the only risk factor for IFD (OR, 95% CI, 1.10 [1.03–1.19]) and complete remission achievement after first induction the only one for survival (OR, 95% CI, 5.12 [1.93–13.60]). The rate of midostaurin discontinuation was similar across different AF strategies. The IFD attributable mortality during induction was 8.3%. In conclusion, the 20.2% overall incidence of IFD occurring in FLT3-mutated AML during induction with chemotherapy + midostaurin, regardless of AF strategy type, was noteworthy, and merits further study, particularly in elderly patients.

Plant nurseries usually control weed growth with N-(phosphonomethyl) glycine treatment. Some studies have suggested potential impacts of this treatment on both the environment and users. A possible ecological alternative is the use of ground wood particles for mulching. However, the production of the required wood particles for use in potted plants is challenging. In this article, the classical chipping and sieving process is compared with a new proposed process involving chipping and refining phases. The two processes were applied to wood logs (spruce) from the forests of the Tosco-Emiliano Apennine. The tests were performed over a week using the machinery available at the Mo.To.R.E. (Montagna Toscana Ricerca Energie) consortium. Although the results achieved were based on preliminary evaluations, they indicated the potential superiority of the new process in terms of both economic and ecological efficiency. These findings can pave the way to the development of optimized processes aimed at a significant reduction in the use of chemical herbicides for weed control.

The aim of this study was to compare three different soil-sampling methods used in Precision Agriculture and their environmental impact in the agricultural production environment. The sampling methods used were: management zones by elevation (MZA), grid sampling (GS), and sampling oriented by apparent soil electrical conductivity (OS). It was tested in three different fields. When the recommendations were compared, a significant difference among the suggested dosages was observed, indicating the need to improve the soil-sampling techniques, since there were doubts about input deficits or overdoses, regardless of the technology studied. The GS method was the most environmentally viable alternative for P compared to other methods and the OS presented as the better option for K and N. However, the use of soil sensors has been shown to be a viable technology that needs further improvement in order to improve productivity and, hence, economic and environmental gains.

Packaging waste is cause of serious concern. Each year hundreds of millions of tons of packaging are produced, therefore solutions that drastically reduce the environmental impact are urgently needed. While the recycling of metal, wood, paper and cardboard packaging have been subjected to significant improvement, however for some plastics, an efficient recycling or disposal has not been achieved so far. The European Union has implemented regulatory actions to legislate packaging and packaging waste by setting relevant short to medium-term targeting the recycling and disposal rate. In the last decade, the world global trend of the eco-sustainable packaging market is heading in this direction. The aim of this research is to develop an innovative and sustainable composite material for the production of tertiary packaging based on the combination of natural fibers and biodegradable biopolymers. In particular, the experimental application entailed the creation of prototypes consisting of straw and the biodegradable plastic Mater-Bi® which is named NeoPalea. The new material was prototyped to verify its physical characteristics and to determine its potential use for replacing current not-biodegradable packaging. The results show a good match with the characteristics of current polymers, suggesting the proposed material as a potential substitute for packaging applications.

The implantation of coffee crop plantations requires cartographic data for dimensioning areas and planning the planting line. Digital terrain models (DTMs) obtained from remotely piloted aircraft (RPA) can contribute to efficient data collection for topography making this technique applicable to precision coffee projects. Aiming to achieve efficiency in the collection, processing and photogrammetric products quality, flight configurations and image processing were evaluated. Two hundred sixty-five points obtained by Global Navigation Satellite System (GNSS) receivers characterized the topographic surface. Then eighteen flight missions were carried out by RPA in the configurations of altitude above ground level (AGL) and frontal and lateral image overlay. In addition, different point cloud formats evaluated the image processing (time) efficiency in DTM. Flights performed at 120 m AGL and 80 × 80% overlap showed higher assertiveness and efficiency in generation DTMs. The 90 m AGL flight showed great terrain detail, causing significant surface differences concerning the topography obtained by GNSS. An increase in image overlap requires longer processing times, not contributing linearly to the geometric quality of orthomosaic. Slope ranges up to 20% are considered reliable for precision coffee growing projects; above 20% overestimates the slope values of the land. Changes in flight settings and image processing are satisfactory for precision coffee projects. Image overlap reduction was significant in reducing the processing time without influencing the quality of the DTMs. In addition, image processing performed in shallow point clouds did not interfere with the DTMs quality.

Automatic milking systems (AMS) have aroused worldwide interest recently. The first installation was by the company Lely in a project in the Netherlands (its homeland) in 1992. But nowadays, AMS represents a growing reality due to lobby for labor issues, rising costs, difficulty finding well-trained workers, and/ or difficulty keeping people on farms. This work aimed to present a review of the literature on AMS, beginning with a brief history of the evolution of the technology, showing advantages and limitations of its use, and ultimately giving some suggestions. The understanding of the technical functioning and operational running can help farmers and technicians in decision making on the adoption of the new technology. Besides workforce reduction and labor quality promotion, AMS has potential to improve feed conversion to milk, milk quality (with lower SCC), and cow productivity, as well as providing useful data and parameters for better farm management. Potential limitations include high investment costs, changes in milk composition (solids, free fatty acids), and increased risk of ketosis in cows.

MYC translocations, a hallmark of Burkitt lymphoma, occur in 5-15% of diffuse large B-cell lymphoma, and have a negative prognostic impact. Numerical aberrations of MYC have also been detected in these patients, but their incidence and prognostic role are still controversial. We analyzed the clinical impact of MYC increased copy number on 385 patients with diffuse large B-cell lymphoma screened at diagnosis for MYC, BCL2, and BCL6 rearrangements. We enumerated the number of MYC copies, defining as amplified those cases with an uncountable number of extra-copies. The prevalence of MYC translocation, increased copy number and amplification was 8.8%, 15%, and 1%, respectively. Patients with 3 or 4 gene copies, accounting for more than 60% of patients with MYC copy number changes, had a more favorable outcome compared to patients with >4 copies or translocation of MYC, and were not influenced by the type of treatment received as first-line. Stratification according to the number of MYC extra-copies showed a negative correlation between an increasing number of copies and survival. Patients with >7 copies or the amplification of MYC had the poorest prognosis. Patients with >4 copies of MYC showed a similar, trending towards worse prognosis compared to patients with MYC translocation. The survival of patients with >4 copies, translocation or amplification of MYC seemed to be superior if intensive treatments were used. Our study underlines the importance of fluorescence in situ hybridization testing at diagnosis of diffuse large B-cell lymphoma to detect the rather frequent and clinically significant numerical aberrations of MYC.

BackgroundThe achievement of recovery is related to the notion of developing personal potential and restoring a legitimate social role, even against the backdrop of mental illness limitations. It is still difficult to fully understand this highly subjective and dynamic process. Therefore, in order to test the recovery process, specific tools, still only marginally used in our country, are needed.AimsThe Italian Study on Recovery is the first study aimed at confirming the validity of the Italian version of the Recovery Assessment Scale (RAS), an instrument developed with the goal of detecting recovery among patients.MethodThis multicentric research involved several Mental Health Services from various parts of Italy. The first phase of the study consisted in the administration of the Italian translation of RAS, previously used in a pilot study conducted in 2009. RAS was administered to 219 patients diagnosed with psychosis, whose mental disorder lasted for at least 5 years.ResultsFindings supported the good psychometric properties of the Italian version of RAS, demonstrating its capability of identifying patients matching the “in recovery” operational criteria.ConclusionsIn consideration of the results highlighting the good psychometric properties of RAS, the present study may contribute to the diffusion of instruments to be included in Mental Health Service planning in the Italian context, in order to start a recovery-oriented transformation.

Abstract. Invasive fungal diseases (IFDs) remain a major clinical issue in patients with hematological malignancies (HMs). To confirm the efficacy and safety of the new azole isavuconazole (ISV) in a clinical care setting, we planned a multicenter retrospective study; we collected data on all possible/probable/proven IFDs in patients with HMs treated with ISV in 17 centers. Between July 2016 and November 2018, 128 patients were enrolled, and 122 were fully evaluable. ISV was employed as the 1st line therapy in 43 (35%) patients and as a subsequent therapy in 79 (65%) patients. The response rate was 82/122 patients (67.2%); it was similar when using ISV as a 1st or 2nd line treatment (60.5% vs 70.9%, respectively; p = 0.24). In multivariate analysis, both female sex (OR: 2.992; CI: 1.22–7.34) and induction phase of treatment (OR: 3.953; CI: 1.085–14.403) were predictive of a favorable response. At a median follow-up of 5 months, 43 (35.2%) patients were dead; the 1-year overall survival (OS) was 49.9%. In multivariate analysis, the response to ISV (OR: 0.103; CI: 0.041–0.262) and IFD refractoriness to previous antifungals (OR: 3.413; CI: 1.318–8.838) were statistically significant for OS. Adverse events (AEs) were reported in 15/122 patients (12.3%); grade 3–4 AEs were reported in 5 (4%) and led to ISV discontinuation. Our study confirms the safety and tolerability of ISV, also in diseases other than acute leukemia. Phase of hematological disease, gender and refractoriness to previous antifungals are the main predictive factors for the aforementioned response and outcome.

The use of sensor technologies to monitor cows’ behavior is becoming commonplace in the context of dairy production. This study aimed at validating a commercial collar-based sensor system, the AFICollar® (Afimilk, Kibbutz Afikim, Israel), designed to monitor dairy cattle feeding and ruminating behavior. Additionally, the performances of two versions of the software for behavior classification, the current software AFIfarm® 5.4 and the updated version AFIfarm® 5.5, were compared. The study involved twenty Holstein-Friesian cows fitted with the collars. To evaluate the sensor performance under different feeding scenarios, the animals were divided into four groups and fed three different types of feed (total mixed ration, long hay, animals allowed to graze). Recordings of hourly rumination and feeding time produced by the sensor were compared with visual observation by scan sampling at 1 minute intervals using Spearman correlation, concordance correlation coefficient (CCC), Bland–Altman plots and linear mixed models for assessing the precision and accuracy of the system. The analyses confirmed that the updated software version V5.5 produced better detection performance than the current V5.4. The updated software version produced high correlations between visual observations and data recorded by the sensor for both feeding (r = 0.85, CCC = 0.86) and rumination (r = 0.83, CCC = 0.86). However, the limits of agreement for both behaviors remained quite wide (feeding: −19.60 min/h, 17.46 min/h; rumination: −15.80 min/h, 15.00 min/h). Type of feed did not produce significant effects on the agreement between visual observations and sensor recordings. Overall, the results indicate that the system can provide farmers with adequately accurate data on feeding and rumination time, and can be used to support herd management decisions. Despite all this, the precision of the system remained relatively limited, and should be improved with further developments in the classification algorithm.

Precision coffee-growing technologies contribute to increased yield, operational efficiency, and final product quality. In addition, they strengthen coffee growing in the global agricultural scenario, which makes this activity increasingly competitive. Scientific research is essential for technological development and offering security regarding its application. For relevant research identification, bibliometric revision methods expose the best studies and their relationships with countries and authors, providing a complete map of research directions. This study identified the main contributions and contributors to academic research generation about precision coffee growing from 2000 to 2021. Bibliometric analysis was performed in VOSViewer software from the referential bases Scopus and Web of Science that identified 150 articles. Based on the number of citations, publications about precision coffee-growing showed Brazilian institutions at the top of the list, and Brazil’s close relationships with North American and South African institutions. Geostatistical analysis, remote sensing and spatial variability mapping of cultivation areas were used in most experimental research. A trend in research exploring machine learning technologies and autonomous systems was evident. The identification of the main agents of scientific development in precision coffee growing contributes to objective advances in the development and application of new management systems. Overall, this analysis represents wide precision coffee growing research providing valuable information for farmers, policymakers, and researchers.

The System Operator (SO), also known as Nine Boxes or Multiscreen, is classically used for analysing the undesired situation according to different perspectives. However, its logic can be suitably exploited also for other kinds of tasks. In such a context, this paper shows an alternative application of the SO. In particular, the new proposed SO approach allows us to formulate alternative problems, i.e., different from the central one, although referring to the same problem-solving task. By applying the proposed procedure to a real case study, this paper shows that the tool can be used for problem analysis and formulation purposes, aimed at better clarifying the problem-solving task. The case study concerns a preliminary set of experiments performed to evaluate the possibility of obtaining angular shapes by bending tiles made by a specific compostable composite material. The suggestions obtained using the proposed SO approach allowed us to find potentially valid solutions, thus paving the way for further validation tests. In particular, tests are still needed to validate the actual potentialities of the proposed SO. Additionally, further and more comprehensive tests are required to validate the solutions inferred in this study concerning the compostable tiles.

The objective of this study was to characterize and evaluate the temperature and humidity index (THI) of New Zealand white (NZW) rabbits kept in a rabbit house using geostatistical techniques. Furthermore, we sought to evaluate its relationship with respiratory frequency (RF) and ear surface temperature (EST). The experiment was conducted at the Federal University of Lavras, Brazil. A total of 52 NZW rabbits were used. For the characterization of the thermal environment, the dry bulb temperature (tdb, °C), relative humidity (RH, %), and dew point temperature (tdp, °C) were collected at 48 points in the rabbit house at 6:00 a.m., 12:00 p.m., and 6:00 p.m. for seven days. The RF and EST of the animals was monitored. Subsequently, the THI was calculated and the data were analyzed using geostatistical tools and kriging interpolation. In addition, the RF and EST data were superimposed on the rabbit house’s THI data maps. The magnitude of the variability and structure of the THI inside the rabbit house were characterized and the heterogeneity was visualized. Critical THI points inside the rabbit house and in locations where animals with high RF and ESTs were housed were identified, thus providing information about improving the production environment.

Mechanized operations on terrain slopes can still lead to considerable errors in the alignment and distribution of plants. Knowing slope interference in semi-mechanized planting quality can contribute to precision improvement in decision making, mainly in regions with high slope. This study evaluates the quality of semi-mechanized coffee planting in different land slopes using a remotely piloted aircraft (RPA) and statistical process control (SPC). In a commercial coffee plantation, aerial images were collected by a remotely piloted aircraft (RPA) and subsequently transformed into a digital elevation model (DEM) and a slope map. Slope data were subjected to variance analysis and statistical process control (SPC). Dependent variables analyzed were variations in distance between planting lines and between plants in line. The distribution of plants on all the slopes evaluated was below expected; the most impacted was the slope between 20–25%, implementing 7.8% fewer plants than projected. Inferences about the spacing between plants in the planting row showed that in slopes between 30–40%, the spacing was 0.53 m and between 0 and 15% was 0.55 m. This denotes the compensation of the speed of the operation on different slopes. The spacing between the planting lines had unusual variations on steep slopes. The SCP quality graphics are of lower quality in operations between 30–40%, as they have an average spacing of 3.65 m and discrepant points in the graphics. Spacing variations were observed in all slopes as shown in the SCP charts, and possible causes and implications for future management were discussed, contributing to improvements in the culture installation stage.

The objective of this study was to evaluate the potential of the practical application of unmanned aerial vehicles and RGB vegetation indices (VIs) in the monitoring of a coffee crop. The study was conducted in an experimental coffee field over a 12-month period. An RGB digital camera coupled to a UAV was used. Nine VIs were evaluated in this study. These VIs were subjected to a Pearson correlation analysis with the leaf area index (LAI), and subsequently, the VIs with higher R2 values were selected. The LAI was estimated by plant height and crown diameter values obtained by imaging, which were correlated with these values measured in the field. Among the VIs evaluated, MPRI (0.31) and GLI (0.41) presented greater correlation with LAI; however, the correlation was weak. Thematic maps of VIs in the evaluated period showed variability present in the crop. The evolution of weeds in the planting rows was noticeable with both VIs, which can help managers to make the decision to start crop management, thus saving resources. The results show that the use of low-cost UAVs and RGB cameras has potential for monitoring the coffee production cycle, providing producers with information in a more accurate, quick and simple way.

The development of approaches to determine the spatial variability of nitrogen (N) into coffee leaves is essential to increase productivity and reduce production costs and environmental impacts associated with excessive N applications. Thus, this study aimed to assess the potential of the Random Forest (RF) machine learning method applied to vegetation indices (VI) obtained from Remotely Piloted Aircraft (RPA) images to measure the N content in coffee plants. A total of 10 VI were obtained from multispectral images by a camera attached to a rotary-wing RPA. The RGB orthomosaic was used to determine sampling points at the crop area, which were ranked by N levels in the plants as deficient, critical, or sufficient. The chemical analysis of N content in the coffee leaves, as well as the VI values in sample points, were used as input parameters for the image training and its classification by the RF. The suggested model has shown global accuracy and a kappa coefficient of up to 0.91 and 0.86, respectively. The best results were achieved using the Green Normalized Difference Vegetation (GNDVI) and Green Optimized Soil Adjusted Vegetation Index (GOSAVI). In addition, the model enabled the evaluation of the spatial distribution of N in the coffee trees, as well as quantification of N deficiency in the crop for the whole area. The GNDVI and GOSAVI allowed the verification that 22% of the entire crop area had plants with N deficiency symptoms, which would result in a reduction of 78% in the amount of N applied by the producer.

Objective: To assess the effectiveness of a cognitive-behavioral therapy-based intervention (Superwellness Program) on weight gain compared with a treatment-as-usual (TAU) approach in patients treated with antipsychotics, and to evaluate the relationship between body mass index (BMI) variation and clinical variables. Method: Eighty-five patients treated with antipsychotics were allocated across two groups, experimental (n=59) and control (n=26). The Superwellness Program (experimental group) consisted of 32 twice-weekly 1-hour sessions, conducted by a psychologist and a nutritionist/nurse, concurrently with moderate food intake and moderate physical activity plans. Sociodemographic, clinical, and biological variables were collected at baseline, at the end of intervention (16 weeks), and after 6 months. Results: BMI change from baseline differed significantly between the experimental and control groups, with a larger decrease in the experimental group (F = 5.5, p = 0.021). Duration of illness moderated the effect of treatment on BMI (p = 0.026). No significant (p = 0.499) effect of intervention during the follow-up period was found. Interestingly, the intervention indirectly induced a significant (p = 0.024) reduction in metabolic risk by reducing BMI. Conclusion: A cognitive-behavioral therapy-based intervention could be useful in reducing weight in a clinical population taking antipsychotics, with consequent benefit to physical and mental health.

Chronic myeloid leukemia (CML) is characterized by the constitutive tyrosine kinase activity of the oncoprotein BCR-ABL1 in myeloid progenitor cells that activates multiple signal transduction pathways leading to the leukemic phenotype. The tyrosine-kinase inhibitor (TKI) nilotinib inhibits the tyrosine kinase activity of BCR-ABL1 in CML patients. Despite the success of nilotinib treatment in patients with chronic-phase (CP) CML, a population of Philadelphia-positive (Ph+) quiescent stem cells escapes the drug activity and can lead to drug resistance. The molecular mechanism by which these quiescent cells remain insensitive is poorly understood. The aim of this study was to compare the gene expression profiling (GEP) of bone marrow (BM) CD34+/lin- cells from CP-CML patients at diagnosis and after 12 months of nilotinib treatment by microarray, in order to identify gene expression changes and the dysregulation of pathways due to nilotinib action. We selected BM CD34+/lin- cells from 78 CP-CML patients at diagnosis and after 12 months of first-line nilotinib therapy and microarray analysis was performed. GEP bioinformatic analyses identified 2,959 differently expressed probes and functional clustering determined some significantly enriched pathways between diagnosis and 12 months of nilotinib treatment. Among these pathways, we observed the under expression of 26 genes encoding proteins belonging to the cell cycle after 12 months of nilotinib treatment which led to the up-regulation of chromosome replication, cell proliferation, DNA replication, and DNA damage checkpoint at diagnosis. We demonstrated the under expression of the ATP-binding cassette (ABC) transporters ABCC4, ABCC5, and ABCD3 encoding proteins which pumped drugs out of the cells after 12 months of nilotinib. Moreover, GEP data demonstrated the deregulation of genes involved in the JAK-STAT signaling pathway. The down-regulation of JAK2, IL7, STAM, PIK3CA, PTPN11, RAF1, and SOS1 key genes after 12 months of nilotinib could demonstrate the up-regulation of cell cycle, proliferation and differentiation via MAPK and PI3K-AKT signaling pathways at diagnosis.

Patients infected with human immunodeficiency virus are at increased risk for developing both non Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL). Even if this risk has decreased for NHL after the introduction of combination antiretroviral therapy (cART), they remain the most common AIDS-related cancer in the developed world. They are almost always of B-cell origin, and some specific lymphoma types are more common than others. Some of these lymphoma types can occur in both HIV-uninfected and infected patients, while others preferentially develop in the context of AIDS. HIV-associated lymphoma differ from lymphoma in the HIV negative population in that they more often present with advanced disease, systemic symptoms, and extranodal involvement and are frequently associated with oncogenic viruses (EBV and/or HHV-8). Before the introduction of cART, most of these patients could not tolerate the treatment strategies routinely employed in the HIV-negative population. The widespread use of cART has allowed for the delivery of full-dose and dose-intensive chemotherapy regimens with improved outcomes that nowadays can be compared to those seen in non-HIV infected patients. However, a great deal of attention should be paid to opportunistic infections and other infectious complications, cART-chemotherapy interactions, and potential cumulative toxicity. In the context of relatively sparse prospective and randomized trials, the optimal treatment of AIDS-related lymphomas remains a challenge, particularly in patients with severe immunosuppression. This paper will address epidemiology, pathogenesis, and therapeutic strategies in HIV-associated NHL and HL.

Obesity is a psychosomatic condition characterized by a complex interaction of biological and psychological factors and a large body of research has aimed to identify variables limiting efficacy and determining high attrition rates in weight loss programs. In this study, we used the Diagnostic Criteria for Psychosomatic Research (DCPR), designed to broaden the clinician’s perspective on patients’ problems by providing additional clinical information not found in the more traditional psychiatric classification, to predict psychosomatic variables that may limit efficacy and determine attrition in clinical interventions with people with obesity. We evaluated 82 consecutive participants with obesity at baseline for psychopathology, psychosomatic correlates, psychological distress, and eating-related symptoms before entering a weight loss program. Regression models were used to assess attrition and outcome at a 6-month follow-up and per-protocol and intention-to-treat analyses were performed. DPCR alexithymia significantly predicted attrition (OR = 6.9), and unsuccessful weight-loss (OR = 11.3). These findings suggest that the identification of psychosomatic factors, in addition to psychological and psychopathological factors, may predict adherence to weight-loss programs.