One-year efficacy of a lifestyle behavioural intervention on physical and mental health in people with severe mental disorders: results from a randomized controlled trial

This multicentric randomized controlled trial (RCT), carried out in six Italian University mental health sites, aims to test the efficacy of a six-month psychosocial intervention (LYFESTYLE) on Body Mass Index (BMI), body weight, waist circumference, fasting glucose, triglycerides, cholesterol, Framingham and HOmeostasis Model Assessment of insulin resistance (HOMA-IR) indexes in patients with schizophrenia, bipolar disorder, and major depression. Moreover, the efficacy of the intervention has also been tested on several other physical and mental health domains. Patients were randomly allocated to receive the six-month experimental intervention (LIFESTYLE) or a behavioural control intervention. All enrolled patients were assessed at baseline and after one year. We recruited 401 patients (206 in the experimental and 195 in the control group) with a diagnosis of schizophrenia or other psychotic disorder (29.9%), bipolar disorder (43.3%), or major depression (26.9%). At one year, patients receiving the experimental intervention reported an improvement in body mass index, body weight, waist circumference, HOMA-IR index, anxiety and depressive symptoms and in quality of life. Our findings confirm the efficacy of the LIFESTYLE intervention in improving physical and mental health-related outcomes in patients with severe mental illnesses after one year.

A critical analysis of the CFD-DEM simulation of pharmaceutical aerosols deposition in upper intra-thoracic airways: Considerations on air flow

A well-corroborated numerical methodology ensuring reproducibility in the modeling of pharmaceutical aerosols deposition in the respiratory system via CFD-DEM simulations within the RANS framework is currently missing. Often, inadequately clarified assumptions and approximations and the lack of evidences on their quantitative impact on the simulated deposition phenomenology, make a direct comparison among the different theoretical studies and the limited number of experiments a very challenging task. Here, with the ultimate goal of providing a critical analysis of some crucial computational aspects of aerosols deposition, we address the issues of velocity fluctuations propagation in the upper intra-thoracic airways and of the persistence of secondary flows using the SimInhale reference benchmark. We complement the investigation by describing how methodologies used to drive the flow through a truncated lung model may affect numerical results and how small discrepancies are observed in velocity profiles when comparing simulations based on different meshing strategies.

Upgrades of Genetic Programming for Data-Driven Modeling of Time Series

In many engineering fields and scientific disciplines, the results of experiments are in the form of time series, which can be quite problematic to interpret and model. Genetic programming tools are quite powerful in extracting knowledge from data. In this work, several upgrades and refinements are proposed and tested to improve the explorative capabilities of symbolic regression (SR) via genetic programming (GP) for the investigation of time series, with the objective of extracting mathematical models directly from the available signals. The main task is not simply prediction but consists of identifying interpretable equations, reflecting the nature of the mechanisms generating the signals. The implemented improvements involve almost all aspects of GP, from the knowledge representation and the genetic operators to the fitness function. The unique capabilities of genetic programming, to accommodate prior information and knowledge, are also leveraged effectively. The proposed upgrades cover the most important applications of empirical modeling of time series, ranging from the identification of autoregressive systems and partial differential equations to the search of models in terms of dimensionless quantities and appropriate physical units. Particularly delicate systems to identify, such as those showing hysteretic behavior or governed by delayed differential equations, are also addressed. The potential of the developed tools is substantiated with both a battery of systematic numerical tests with synthetic signals and with applications to experimental data.

FLT3-targeted therapy restores GATA1 pathway function in NPM1/FLT3-ITD mutated acute myeloid leukaemia

One-third of newly diagnosed adult acute myeloid leukaemia (AML) carry FLT3 mutations, which frequently occur together with nucleophosmin (NPM1) mutations and are associated with worse prognosis. FLT3 inhibitors are widely used in clinics with limitations due to drug resistance. AML cells carrying FLT3 mutations in both mouse models and patients present low expression of GATA1, a gene involved in haematopoietic changes preceding AML. Here, we show that FLT3 inhibition induces cellular responses and restores the GATA1 pathway and functions in NPM1/FLT3-ITD mutated AML, thus providing a new mechanism of action for this drug.

Study of a Geometric Score to Identify the Increased Risk of Local Failure after SBRT for Locally Advanced Pancreatic Cancer (LAPC)

PURPOSE/OBJECTIVE(S)

A previous analysis on an institutional cohort of LAPC patients, treated with intensive induction chemotherapy followed by SBRT, proved that local failures (LFs) predominantly occurred within the RT field. This suggests a specific efficacy of a complete covering of the macroscopic (GTV) aggressive disease with high doses (i.e., simultaneous boost [SIB] doses). Still, this is often not feasible due to the proximity of extremely radiosensitive organs at risk (OARs), which forces the use of "Simultaneous Integrated Protection" (SIP), limiting the dose to safe values in a portion of the GTV. This analysis aimed to quantitatively assess the role of GTV size and incomplete GTV covering with SIB in increasing the risk of LF.

MATERIALS/METHODS

We included 51 consecutive LAPC pts treated with SBRT (Nov 2016 - Nov 2019): 30 Gy in 5 fractions to the tumor PTV, 50 Gy SIB to the region of vessel abutment/encasement, 25 Gy SIP to the overlap between tumor PTV, and the Planning OAR volumes. We used univariate/multivariable survival analysis (UVA/MVA, Cox regression, Kaplan-Meier Curves, Log-Rank test) to assess the association of LF with the GTV size and the amount of the GTV which the SIB did not cover. Specifically, we defined a set of incomplete GTV-covering levels: GTV75 (= yes if less than 75% of the GTV was included in the 50 Gy SIB isodose), GTV70, GTV50 and GTV30. Variables with p≤0.2 at UVA were included for MVA assessment. MVA models were considered relevant if their likelihood was significantly higher when compared to UVA.

RESULTS

With a median follow-up of 17 months (range 1.4-47) 12 pts experienced LF. The GTV size (p = 0.007, risk factor for LF, Hazard Ratio [HR] 1.04 for 1 cc increase in GTV size) and GTV70 (p = 0.2, risk factor, HR = 3.73 for GTV70 = yes) were selected at UVA and included in MVA. To build a simple decision tool, we dichotomized the GTV size as below/above 25 cc (selected from Youden Index on the ROC curve): HR = 9.3 if GTV>25 cc. We used dichotomized GTV size and GTV70 to build a 3-level Geometric Score for the prediction of the risk of LF: [Low Risk (LR)] if "GTV<25cc AND GTV70 = no"; [Intermediate Risk (IR)] if "GTV>25cc OR GTV70 = yes"; [High Risk (HiR)] if "GTV>25cc AND GTV70 = yes". Pts classified at HiR had a significantly higher probability of LF: HR = 6.9 (95% CI 1.5-32.9) compared to LR, and HR = 13.2 (95% CI 3.6-48.4) when compared to IR. 10/12 LFs are in the HiR group.

CONCLUSION

A large GTV size, coupled with an incomplete (<70%) covering of GTV from the SIB, highly increases the risk of LF: 62% actuarial probability in the HiR group vs 7% in the LR/IR groups. Full coverage of the GTV with SIB would be of clinical relevance for pts with large macroscopic tumors. The Geometric Score could be used to select pts that would effectively benefit from online tumor tracking (e.g., with an MRI-Linac), allowing a reduction of the SIP volume and a consequent decrease in the amount of GTV left uncovered by the SIB.

Italian validation of Arizona Sexual Experience (ASEX) on patients suffering from psychotic spectrum disorders

Introduction

Many forms of mental disorders, especially psychotic disorders are characterized also by a worsening of sexual functioning. Sexual dysfunction has been shown to significantly correlate with a longer duration of untreated psychosis and with heavier psychotic symptomatology.

Objectives

The aim of this study is to validate the Italian version of the Arizona Sexual Experience (ASEX), a very handy and reliable tool to assess sexual dysfunction, in a population of people suffering from psychotic spectrum disorders.

Methods

Seventy-three psychiatric patients were recruited and assessed for mental illness and sexual functioning. We administered the Italian version of ASEX, adequately translated by two expert bilinguals. After 15 days we administered once again the test for test-retest reliability.

Results

Validation of ASEX revealed Cronbach’s coefficients >0.70 in both single items as in the total score. In addition, the test-retest reliability revealed Pearson’s coefficients >0.50 in the various domains. Confirmatory factor analysis revealed good fit indexes for the two factors model of ASEX (SRMR=0.54; CFI=0.974; RMSEA=0.135).

Conclusions

This study represents the first validation in the Italian psychiatric context of a very useful specific tool for the sexual assessment in people suffering from mental illness. Our analysis revealed good psychometric characteristics in terms of confirmatory factor analysis, internal consistency, and test-retest reliability.

Disclosure

No significant relationships.

Sexuality in breast cancer survivors: sexual experiences, emotions, and cognitions in a group of women under hormonal therapy

BACKGROUND

Earlier diagnosis and improved treatments have led to better outcomes in breast cancer, making quality of life a key issue. Sexuality represents a pillar of quality of life, although it is often neglected by both healthcare providers and patients when it comes to cancer. This study aims to explore the differences in sexual functioning, distress, psychopathology, emotions, and cognitions between breast cancer patients under hormonal treatment and controls.

METHODS

Seventy-nine women (age range between 24 and 69 years) in hormonal therapy for breast cancer completed a self-reported protocol. A matched control group of 103 women was randomly extracted from an Italian general population database. Eight self-report questionnaires exploring biopsychosocial factors were administered.

RESULTS

The current study showed an impaired sexuality in breast cancer patients compared to controls. Breast cancer women under hormonal treatment were characterized by diminished or absent sexual activity (chi² = 36.16; p < 0.001), lower level of sexual functioning in all areas except for pain (F_(1,180) = 8.1; p < 0.01), higher sexual (F_(1,180) = 10.08; p < 0.001) and psychological distress (F_(1,180) = 6.23; p < 0.05), higher scores in Difficulties in Identifying Feelings (F_(1,180) = 7.31; p < 0.01) and Externally Oriented Thinking (F_(1,180) = 6.64; p < 0.05), higher level of negative emotions related to sexuality (F_(1,180) = 11.13; p < 0.001), and more rigid cognition towards peculiar aspects of sexuality, such as Failure Disengagement Thoughts (F_(1,180) = 22.01; p < 0.001) and Age related Beliefs (F_(1,180) = 5.7; p < 0.05).

CONCLUSIONS

Health care providers do not usually assess those issues in their routine practice, so that sexuality remains an unmet need with remarkable effects on general health and quality of life.

Suicidality and relation with dissociation and alexithymia in PNES and conversion disorder

Introduction

Amongst different subtypes of Conversion Disorder (CD), DSM-V lists the Psychogenic Non-epileptic seizures (PNES). PNES are defined as episodes that visually resemble epileptic seizures but, etiologically, they are not due to electrical discharges in the brain.

Objectives

Our study aims to explore the differences between PNES and other CDs. In particular, we studied the suicidality and its correlations with dissociation and alexithymia.

Methods

Patients, recruited from the Psychiatry and Clinical Psychology Unit of the Fondazione Policlinico Tor Vergata, Rome, Italy, were diagnosed with PNES (n=22) and CD (n=16) using the DSM-5 criteria. Patients underwent the following clinical assessments: HAM-D, BDI, DES, BHS, TAS, CTQ.

Results

PNES showed significantly higher scores than CD in all assessments, except for BDI-somatic (p=0.39), BHS-feeling (p=0.86), and the presence of childhood trauma. PNES also showed significantly higher suicidality (p = 0.003). By controlling for the confounding factor “depression”, in PNES suicidality (and in particular the BHS-loss of motivation) appears to be correlated with DES-total score (p = 0.008), DES-amnesia (p = 0.002) and DES -derealization-depersonalization (p = 0.003). On the other hand, in CDs, the BHS-total score shows a correlation with the TAS-total score (p = 0.03) and BHS-Feelings with TAS-Externally-Oriented Thinking (p = 0.035), while only the BHS-Loss of motivation appears correlated with DES-Absorption (p = 0.011).

Conclusions

Our study shows significant differences between PNES and CD, in several symptomatologic dimensions, including suicidality. Indeed, in PNES suicidality appears to be related to dissociation, while in CDs it appears mainly to be correlated with alexithymia.

Suicidality in post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD)

Introduction

International Classification of Diseases 11th Revision (ICD-11) has inserted complex post-traumatic stress disorder (cPTSD) as a clinically distinct disorder, different from PTSD. The diagnosis of cPTSD has the same requirements for the one of PTSD, in addition to disturbances of self-organization (DSO – e.g., disturbances in relationships, affect dysregulation, and negative self-concept).

Objectives

This study aimed to explore suicidality in PTSD and cPTSD. We examined also the association between clinical dimensions of hopelessness (feelings, loss of motivation, future expectations) and other symptomatologic variables.

Methods

The sample, recruited at the Fondazione Policlinico Tor Vergata, Rome, Italy, consisted of 189 subjects, 132 diagnosed with PTSD, and 57 with cPTSD, according to the ICD-11 criteria. Participants underwent the following clinical assessments: Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90), Dissociative Experience Scale (DES), Beck Hopelessness Scale (BHS).

Results

cPTSD showed significantly higher BHS-total (p = 0.01) and BHS-loss of motivation subscale (p <0.001) scores than PTSD. Besides, cPTSD showed significantly higher scores in all clinical variables except for the IES-intrusive subscale. By controlling for the confounding factor “depression”, suicidality in cPTSD (and in particular the BHS-total) appears to be correlated with IES-total score (p = 0.042) and with DES-Absorption (p = 0.02). Differently, no such correlations are found in PTSD.

Conclusions

Our study shows significant symptomatologic differences between PTSD and cPTSD, including suicidality. Indeed, suicidality in cPTSD appears to be correlated with the “loss of motivation” dimension, which fits well within the ICD-11 criteria of DSO.

Disclosure

No significant relationships.

Childhood family stress and adult resilience in a sample of depressed patients

BACKGROUND

The aim of this study is to explore the effect of childhood family stress on depression, personal, and social resilience in depressed patients.

METHODS

We assessed childhood family stress (RFQ), depression (BSI, depression subscale), and resilience (RSA) in 152 depressed patients, 70 males, and 82 females. We calculated the 33rd and 66th percentiles of RFQ scores to divide the sample among Low, Medium, and High RFQ subgroups. A one-way ANOVA has been carried out to explore the differences between the variables in the subgroups. Finally, two regression analyses with depression, as the dependent variable, and resilience, divided for stress-sensitive and no stress-sensitive factors as independent variables, have been implemented.

RESULTS

The one-way ANOVA showed that the Low subgroup had a positive profile, the Medium had an intermediate profile, while the High had a negative one for depression, personal (structured style and social competence), and interpersonal (social resources) resilience. The other factors (perception of self, planned future, and family cohesion) did not show differences in the subgroups, suggesting they are no stress sensitive. Regression analysis showed that no stress-sensitive factors have a constant and significant predictive value for depression in all subgroups; while, stress-sensitive ones showed a growing predictive value for depression from Low to Medium, but not in High, suggesting a ceiling effect.

LIMITATIONS

The use of self-report measures, the cross-sectional nature of the study, and the lack of a non-clinical and/or outpatient samples.

CONCLUSIONS

This study provides a contribution to the understanding of the effect of childhood family stress on adult resilience and depression.

Super-high magnification dermoscopy can aid the differential diagnosis between melanoma and atypical naevi

BACKGROUND

Dermoscopy is the most widely used noninvasive imaging technique for the clinical diagnosis of melanoma (MM). Super-high (× 400) magnification dermoscopy (D400) has recently been developed; compared with traditional dermoscopy, it can reveal additional features, down to the identification of single melanocytes in the skin.

OBJECTIVES

To evaluate which structures are visible at D400 and to compare them in atypical naevi and MMs.

METHODS

A prospective observational multicentre study was conducted. We enrolled patients who were identified as having atypical melanocytic skin lesions by clinical and/or × 20 magnification dermoscopy (D20) examination, and who were assigned to either excision or follow-up. Lesions were imaged by videodermoscopy at D20 and D400. The presence of pigmented cells and their features were assessed at D400.

RESULTS

In total, there were 79 patients with 57 naevi and 31 MMs. Of the total 88 lesions, 63 (71.6%) were given a histological diagnosis, while the others were followed up for ≥ 12 months, during which they showed no change and were all diagnosed as naevi. Pigmented cells were identified in > 90% of the lesions at D400. Compared with naevi, MMs had a higher frequency of scattered, large, irregular (in shape and size), dendritic/roundish, violet/blue pigmented cells under D400 (P < 0.001). Moreover, dots (P < 0.01), out-of-focus blue structureless areas (P < 0.01) and vessels (P < 0.001) were also more frequent in MMs than in naevi at D400.

CONCLUSIONS

This study showed that D400 can reveal many elements not otherwise visible in traditional D20 dermoscopy, such as pigmented cells and their morphology, which could be useful for the diagnosis of MM.

Malignant transformation of a clinically and histologically healed lichenoid lesion after amalgam removal: A case report and literature review

Lichenoid contact lesions (LCLs) frequently develop in close contact with amalgam restorations and may regress after amalgam removal, especially when patch testing is positive to amalgam components. However, established criteria to define true LCLs healing are missing and clinical disappearance of the lesion may not always correspond to a complete regression of histological lichenoid tissue reaction. Similarly to other lichenoid lesions of the oral cavity, LCLs are included among potentially malignant disorders although its malignant transformation remains controversial. As a result, with no clear indications for neoplastic risk assessment, the management of patients with LCLs may be challenging. The present report describes the unusual case of an oral squamous cell carcinoma (OSCC) arising in the same site where 6 years before an amalgam-associated LCL had clinically and histologically healed after restoration replacement. A review of the few literature reports of amalgam-associated LCLs developing to OSCC is also provided.

AB0611 STRAIN ANALYSIS OF THE RIGHT VENTRICLE USING 2D-SPECKLE TRACKING ECHOCARDIOGRAPHY IN A COHORT OF PATIENTS WITH SYSTEMIC SCLEROSIS

Background:

Systemic Sclerosis (SSc) is a rare and life-threatening connective tissue disease with multiple organ impairment. Cardio-pulmonary involvement is common: pulmonary fibrosis, pulmonary hypertension (PH), and electrical disorders are the most serious complications and causes of increased mortality.

Objectives:

We evaluated features related with the onset and development of PH in a cohort of SSc patients. We further studied ecocardiographic abnormalities, by means of 2D-speckle tracking echocardiography (STE) with specific reference to the right ventricular strain measure (RV-strain).

Methods:

We analyzed data from 50 SSc patients (pts) referred to our University-based Rheumatology Centre and SSc Unit from January 2007 to June 2019 (F/M 45/5; lc/dcSSc 45/5; mean age 59.20±14.357 years; mean disease duration 12.08±8.75 years). All pts underwent general and cardio-pulmonary assessment in our Cardio-Rheumatology Clinic. The following parameters were considered: blood exams, in particular inflammation indexes, uric acid test and serum autoantibodies; pulmonary function tests; high resolution scan of the lungs (HRCT); standard electrocardiogram (ECG) and RV-strain measured by 2D-STE. These examinations were performed according to clinical picture and current methodologies. We compared SSc subjects with (10/50) and without (40/50) PH diagnosis during follow-up regardless of treatments.

Results:

SSc pts with PH didn’t show significant alterations concerning RV-strain if compared with pts without PH (p=0.707). Nevertheless, RV-strain value was modified in relation to TAPSE alterations in all pts but this data correlated with right ventricular dilatation only in PH subjects. Furthermore, interesting significant values about dilatation of right and left atria (p=0.007, p=0.048), dilatation of inferior vena cava (p=0.037) and right ventricle (p=0.023) were observed. Left ventricular hypertrophy (p=0.012) as well as valvular insufficiencies (mitral and aortic) were more frequent in PH group too (p=0.016). These pts showed higher incidence of skin ulcers (p=0.0001), higher values of blood pressure (p=0.004), elevated uric acid levels (p=0,027) and anti-centromere antibodies positivity (p=0.0001).

Conclusion:

Our research provides further evidence of the prognostic value of echocardiographic findings in SSc subjects, with focus on PH. Population enlargement is ongoing in order to identify more accurate results about RV-strain, considering the efficacy of PH treatments on cardiac contractility. Speckle tracking echocardiography proves to be a sensitive, low-cost, non-invasive and reliable tool to detect early cardiac impairment in Ssc, full of potential future prospects.

Disclosure of Interests:

None declared

Heavy metal bioaccumulation in honey bee matrix, an indicator to assess the contamination level in terrestrial environments

The most significant risk factor for organisms living in an environment contaminated by heavy metals is the metal bioavailability. Therefore, an efficient ecotoxicological approach to metal contamination is the measure of bioaccumulation level in target organisms. In this work, we characterized the heavy metal bioaccumulation in honey bees, Apis mellifera ligustica, collected at 35 sites from Umbria (Central Italy). The comparison of our data with selected Italian investigations revealed metal bioaccumulation in honey bee matrix of the same order of magnitude, with Cd showing a higher variability. To generalize the results, we developed a Honeybee Contamination Index (HCI) based on metal bioaccumulation in honey bees. An application of the HCI to the present dataset revealed cases of low (sixteen sites), intermediate (eighteen sites), and high (one site) metal contaminations. The comparison of HCI values from the Umbrian dataset with values calculated for other Italian and European metadata showed that most of the Umbrian sites fell in the portion of low and intermediate contamination conditions. HCI represented a reliable tool that provided a piece of concise information on metal contamination in terrestrial environments. Parallel to this effort, we have determined, the metal concentrations in the airborne particulate matter (PM₁₀) at three regional background-monitoring stations in Umbria. These stations are representative of the average air quality of the areas of the investigated apiaries. A comparative analysis of metal enrichment factors in PM₁₀, and honey bees suggested that the contamination in the bees was related to the PM₁₀ values only to a minor extent. On the other side, a clear enrichment of metals such as Cd, Mn, Zn, and Cu in the honey bees appeared to depend on very local conditions and was probably related to the use of pesticides and fertilizers, and the resuspension of the locally contaminated soils and agriculture residues.

Comparison of cheeses from goats fed 7 forages based on a new health index

This study proposed the General Health Index of Cheese (GHIC) as an indicator for the presence of health-promoting compounds in cheese and compared the antioxidant capacity and phenolic and fatty acid contents of cheeses from goats consuming 7 forage species. Ninety-one homogeneous Red Syrian goats were randomly assigned to 1 of 7 feeding treatments (Festuca arundinacea, Hordeum vulgare, Triticosecale, Pisum sativum, Trifolium alexandrinum, Vicia sativa, and Vicia faba minor). The housed goat groups received the scheduled forage ad libitum. Forage species affected the antioxidant capacity, the phenolic and fatty acid contents, the Health Promoting Index, and the GHIC. Trifolium alexandrinum, Triticosecale, and Hordeum vulgare showed a clear advantage in terms of beneficial fatty acids content in goat cheese. Cheese from the Triticosecale group also showed a high antioxidant capacity value even if its polyphenol content was intermediate compared with others. Trifolium alexandrinum and Triticosecale had the highest value of the new index GHIC. This comparison suggests that there are important differences in fatty acid profile and polyphenol content among cheeses from goats fed grasses and legumes commonly used in the Mediterranean area. In this first approach, GHIC index, which combines the positive components found in cheese, seems to be a useful tool to provide an indication concerning the general health value of the product.

A Standardized Aspiration-First Approach for Thrombectomy to Increase Speed and Improve Recanalization Rates

BACKGROUND AND PURPOSE

Direct aspiration is a recognized technique for revascularization in large-vessel ischemic strokes. There is ongoing debate regarding its efficacy compared with stent retrievers. Every delay in achieving revascularization and a decrease in reperfusion rates reduces the likelihood of patients achieving functional independence. We propose a standardized setup technique for aspiration-first for all anterior circulation thrombectomy procedures for increasing speed and recanalization rates.

MATERIALS AND METHODS

We analyzed 127 consecutive patients treated by a standardized approach to thrombectomy with an intention to perform aspiration-first compared with 127 consecutive patients treated with a stent retriever-first approach. Key time metrics evaluated included groin to first angiogram, first angiogram to reperfusion, groin to first reperfusion, and length of the procedure. The degree of successful recanalization (TICI 2b-3) and the number of passes were compared between the 2 groups.

RESULTS

In 127 patients who underwent the standardized technique, the median time from groin puncture to first reperfusion was 18 minutes compared with 26 minutes (P < .001). The duration of the procedure was shorter compared with the stent retriever group (26 minutes in the aspiration first group versus 47 minutes, P < .001) and required fewer passes (mean, 2.4 versus 3.1; P < .05). A higher proportion of patients had a TICI score of 2b-3 in the aspiration-first group compared with stent retriever group (96.1% versus 85.8%, P < .005).

CONCLUSIONS

Our study highlights the increasing speed and recanalization rates achieved with fewer passes in a standardized approach to thrombectomy with an intention to attempt aspiration-first. Any attempt to reduce revascularization time and increase successful recanalization should be used.

PHYSICAL CHARACTERISATION OF FOUR DIFFERENT COMMERCIAL DIGITAL BREAST TOMOSYNTHESIS SYSTEMS

The aim of this article was to characterise the performance of four different digital breast tomosynthesis (DBT) systems in terms of dose and image quality parameters. One of them, GE Pristina, has never been tested before. Average glandular doses were measured both in DBT and 2D full field digital mammography mode. Several phantoms were employed to perform signal difference to noise ratio, slice sensitivity profile, slice to slice incrementation, chest wall offset, z-axis geometry, artefact spread function, low contrast detectability, contrast detail evaluations, image uniformity and in-plane MTF in chest wall-nipple and in tube-travel directions. There are many differences in DBT systems explored: the angular range, detector type, reconstruction algorithms, and the presence or not of the grid. Even if it is not simple to calculate a global figure of merit, the analysis of all the collected data can be useful in a contest of a quality assurance program to define a set of values that could be used as benchmarks.

Resummation of Diagrammatic Series with Zero Convergence Radius for Strongly Correlated Fermions

We demonstrate that a summing up series of Feynman diagrams can yield unbiased accurate results for strongly correlated fermions even when the convergence radius vanishes. We consider the unitary Fermi gas, a model of nonrelativistic fermions in three-dimensional continuous space. Diagrams are built from partially dressed or fully dressed propagators of single particles and pairs. The series is resummed by a conformal-Borel transformation that incorporates the large-order behavior and the analytic structure in the Borel plane, which are found by the instanton approach. We report highly accurate numerical results for the equation of state in the normal unpolarized regime, and reconcile experimental data with the theoretically conjectured fourth virial coefficient.

Contact and Momentum Distribution of the Unitary Fermi Gas

A key quantity in strongly interacting resonant Fermi gases is the contact C, which characterizes numerous properties such as the momentum distribution at large momenta or the pair correlation function at short distances. The temperature dependence of C was measured at unitarity, where existing theoretical predictions differ substantially even at the qualitative level. We report accurate data for the contact and the momentum distribution of the unitary gas in the normal phase, obtained by bold diagrammatic Monte Carlo and Borel resummation. Our results agree with experimental data within error bars and provide crucial benchmarks for the development of advanced theoretical treatments and precision measurements.

Improvement of the shadow tracking setup as a method to measure the velocities values of dark dust in order to reduce the risks of radioactive releases or explosions

The mobilisation of dust is a key security issue in nuclear and industrial plants because it can provoke both explosions (in particular temperature and pressure conditions) and dangerous radioactive releases. This work is focused on the tungsten dust resuspension inside small tank for aerosol removal and DUST (STARDUST)-Upgrade, an experimental facility used to reproduce different conditions typical of the loss of vacuum accidents. In this paper, the authors present the facility and the materials used to mount the experimental setup together with the methods and algorithms implemented to track the dust velocity vectors. Tungsten dust is also analyzed through scanning electron microscopy and X-ray diffraction to find some correlation between the variation of the dust morphology, due to the different experimental conditions, with the dust mobilisation paths. The materials and methods together with the experimental results are analyzed and discussed to demonstrate the implementation with the shadow tracking setup presented in the previous facility STARDUST.

Inflammatory and oxidative stress biomarkers in alkaptonuria: data from the DevelopAKUre project

OBJECTIVE

The aim of this work was to assess baseline serum levels of established biomarkers related to inflammation and oxidative stress in samples from alkaptonuric subjects enrolled in SONIA1 (n = 40) and SONIA2 (n = 138) clinical trials (DevelopAKUre project).

METHODS

Baseline serum levels of Serum Amyloid A (SAA), IL-6, IL-1β, TNFα, CRP, cathepsin D (CATD), IL-1ra, and MMP-3 were determined through commercial ELISA assays. Chitotriosidase activity was assessed through a fluorimetric method. Advanced Oxidation Protein Products (AOPP) were determined by spectrophotometry. Thiols, S-thiolated proteins and Protein Thiolation Index (PTI) were determined by spectrophotometry and HPLC. Patients' quality of life was assessed through validated questionnaires.

RESULTS

We found that SAA serum levels were significantly increased compared to reference threshold in 57.5% and 86% of SONIA1 and SONIA2 samples, respectively. Similarly, chitotriosidase activity was above the reference threshold in half of SONIA2 samples, whereas CRP levels were increased only in a minority of samples. CATD, IL-1β, IL-6, TNFα, MMP-3, AOPP, thiols, S-thiolated protein and PTI showed no statistically significant differences from control population. We provided evidence that alkaptonuric patients presenting with significantly higher SAA, chitotriosidase activity and PTI reported more often a decreased quality of life. This suggests that worsening of symptoms in alkaptonuria (AKU) is paralleled by increased inflammation and oxidative stress, which might play a role in disease progression.

CONCLUSIONS

Monitoring of SAA may be suggested in AKU to evaluate inflammation. Though further evidence is needed, SAA, chitotriosidase activity and PTI might be proposed as disease activity markers in AKU.