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Summary Background A wait-and-see policy (WS) does not appear to modify the long-term prognosis of advanced-stage follicular lymphomas (FL), while irradiation of limited stages some times causes complications and does not avert distant relapses. Consequently, we decided to test WS in a selected su bset of the localized FL, i.e., patients in complete remission (CR) after the initial lymph node biopsy (stage I0). Patients and methods Forty-three previously untreated patients were diagnosed with stage I0 FL and 26 of them were included in the WS. Their median age was 60.3 years; 19 were male and 24 female. All histological slides were reviewed and confirmed the diagnosis of FL. Median followup was 6.3 years (y). Results Thirteen of the 26 untreated patients are still relapse-free, while six relapsed locally only (median: 4.2 years after diagnosis), and reattained CR with radiotherapy. Seven patients relapsed at distant sites (median: 1 year after diagnosis). No localized relapses were observed in the treated group, but there were 7 distant relapses. Conclusions The use of use in stage I0 FL did not appear to modify the prognosis of these patients. Furthermore, we observed two distinct patterns of relapse (local and distant) that are difficult to differentiate at onset.

This report describes the clinical and pathological features and evolution of 2 cases of locally advanced undifferentiated liposarcoma. In each case, a tumor differentiation was noted after induction chemotherapy, which otherwise determined in both patient a dramatic tumor response. This may be explained by heterogenicity of the primary tumors, which may include several cell contingents with different responses to chemotherapy. This constitutes a potential impediment to the efficacy of induction or adjuvant chemotherapy.

Between 1973 and 1977, 48 patients less than 65 years old with non-Hodgkin's malignant lymphoma (NHML) of poor prognosis (+/- high grade malignancy, +/- clinical stages III or IV, +/- first or repeated relapse) were included in a prospective clinical trial. After complete remission (CR), obtained with chemotherapy and radiotherapy, patients were randomized to receive bacillus Calmette-Guérin (BCG) or no further therapy. BCG was administered in weekly scarifications up to 3 years. Forty-three patients are assessable. Twenty-four patients have relapsed: nine out of 21 in the BCG group, and 15 out of 22 in the control group. There is a significant difference in favor of the BCG group in disease-free survival (P = .03). Twenty-one patients have died, 18 from NHML: seven in the BCG group, and 11 in the control group. There is a significant difference in favor of the BCG group for overall survival at 10 years (P = .05). A multivariate analysis points out BCG as a significant prognostic factor. Adjuvant BCG may improve particularly disease-free survival and overall survival for patients with clinical stages I and II or intermediate- and high-grade malignancy. These results suggest that in patients less than 65 years old with NHML of poor prognosis, BCG may significantly increase disease-free survival and overall survival.

The paper focuses on the definition, calibration and testing of a simulation model that is able to represent multimodal choice behaviours for electric vehicles. Taking into account the interchange between public transport and electric private mobility, the model estimates the parking demand at the Park & Ride sites equipped with charging stations. The model is based on a data-driven approach, in which mainly Floating Car Data and open data of public transport have derived the explanatory variables. Specifically, a machine learning method (Random Forest) has been used to calibrate and test the model in the real case of the metropolitan area of Rome (Italy). We first perform a stability analysis, letting the parameters of the model vary. We then carry out a sensitivity analysis on the variables that can affect the user propensity to adopt the Park & Ride. Finally, we profile and test an incentive policy to boost the choice of Park & Ride. Results suggest that the model succeeds in simulating Park & Ride by electric vehicles and, therefore, it can be extremely valuable for planning financial support to the multimodal travel choice and forecasting vehicle-to-grid scenarios.

BACKGROUND: Cardiovascular risk factor research has recently broadened its focus based on new data indicating the benefits of low risk, i.e. favorable levels of all major risk factors. The aims of this study were to assess further the relation of low risk to coronary heart disease risk, and implications for prevention. DESIGN: We conducted a prospective population-based Italian study, of 7438 men and 13 009 women aged 35-69 years, with a mean follow-up of 10.4 years and validated first coronary events. METHODS: Baseline coronary heart disease risk was classified into three categories: low risk; unfavorable but not high risk; and high risk. To analyze the relation of these risk profiles to coronary heart disease incidence, age-adjusted, sex-averaged coronary heart disease incidence was calculated for persons free of coronary heart disease and stroke, stratified as baseline low risk, unfavorable but not high risk or high risk. To assess the independent relationship of individual risk factors to coronary heart disease incidence, multivariate proportional hazards models were computed for combinations of risk factors. RESULTS: Only 2.7% of participants met low risk criteria; 81.4% were high risk. Age-adjusted coronary heart disease incidence for the whole cohort was 37.1 out of 10000 person-years (men 59.0; women 15.3). No coronary heart disease events occurred in low-risk men, only two in low-risk women. For women and men who were not high risk, the age-sex standardized coronary heart disease rate was 62% lower than for high-risk participants. Blood pressure, need for antihypertensive medication, smoking, hyperglycemia, diabetes, total and high-density lipoprotein cholesterol were independently related to coronary heart disease risk. CONCLUSIONS: Favorable levels of all modifiable readily measured risk factors - rare among Italian adults - assure minimal coronary heart disease risk. Population-wide prevention is needed, especially improved lifestyles, to increase the proportion of the population at low risk. © 2006 The European Society of Cardiology.