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BACKGROUND: Cranioplasty (CP) is supposed to improve the functional outcome of severe acquired brain injury (sABI) patients with decompressive craniectomy (DC). However, ongoing controversies exist regarding its indications, optimum materials, timing, complications, and relationships with hydrocephalus (HC). For these reasons, an International Consensus Conference (ICC) on CP in traumatic brain injury (TBI) was held in June 2018 to issue some recommendations. AIM: The aims of this study were: to investigate cross-sectionally before the ICC the prevalence of DC/CP in sABI inpatients admitted to neu- rorehabilitation units in Italy; to assess the perception of Italian clinicians working in the sABI neurorehabilitation settings on the management of inpatients with DC/CP during their rehabilitation stay. DESIGN: Cross-sectional. SETTING AND POPULATION: Physiatrists or neurologists working in 38 Italian rehabilitation centers involved in the care of sABI, giving a pooled sample of 599 inpatients. METHODS: Survey questionnaire consisting of 21 closed-ended questions with multiple-choice answers. Sixteen questions regarded the respondents' opinions and experiences regarding the clinical and management aspects of patients. Survey data were collected via e-mail between April and May 2018. RESULTS: About 1/3 of the 599 inpatients had either a DC (18.9%) or a CP (13.5%). TBI and cerebral hemorrhage were strongly associated with DC/CP, although the association was much stronger for TBI. Significant discrepancies were uncovered between some of the recommendations of the ICC and the corresponding perceptions of the respondents, especially regarding the clinical management of patients (i.e., CP timing). Clear guidelines were perceived as the most crucial factor in improving clinical pathways. CONCLUSIONS: Early collaboration between the neurosurgical and the neurorehabilitation teams is crucial to optimize all clinical and organizational factors, which could expedite CP and minimi

PURPOSE: Synthetic data are artificial data generated without including any real patient information by an algorithm trained to learn the characteristics of a real source data set and became widely used to accelerate research in life sciences. We aimed to (1) apply generative artificial intelligence to build synthetic data in different hematologic neoplasms; (2) develop a synthetic validation framework to assess data fidelity and privacy preservability; and (3) test the capability of synthetic data to accelerate clinical/translational research in hematology. METHODS: A conditional generative adversarial network architecture was implemented to generate synthetic data. Use cases were myelodysplastic syndromes (MDS) and AML: 7,133 patients were included. A fully explainable validation framework was created to assess fidelity and privacy preservability of synthetic data. RESULTS: We generated MDS/AML synthetic cohorts (including information on clinical features, genomics, treatment, and outcomes) with high fidelity and privacy performances. This technology allowed resolution of lack/incomplete information and data augmentation. We then assessed the potential value of synthetic data on accelerating research in hematology. Starting from 944 patients with MDS available since 2014, we generated a 300% augmented synthetic cohort and anticipated the development of molecular classification and molecular scoring system obtained many years later from 2,043 to 2,957 real patients, respectively. Moreover, starting from 187 MDS treated with luspatercept into a clinical trial, we generated a synthetic cohort that recapitulated all the clinical end points of the study. Finally, we developed a website to enable clinicians generating high-quality synthetic data from an existing biobank of real patients. CONCLUSION: Synthetic data mimic real clinical-genomic features and outcomes, and anonymize patient information. The implementation of this technology allows to increase the scientific

Purpose: Myelodysplastic syndromes (MDS) are heterogeneous myeloid neoplasms in which a risk-adapted treatment strategy is needed. Recently, a new clinical-molecular prognostic model, the Molecular International Prognostic Scoring System (IPSS-M) was proposed to improve the prediction of clinical outcome of the currently available tool (Revised International Prognostic Scoring System [IPSS-R]). We aimed to provide an extensive validation of IPSS-M. Methods: A total of 2,876 patients with primary MDS from the GenoMed4All consortium were retrospectively analyzed. Results: IPSS-M improved prognostic discrimination across all clinical end points with respect to IPSS-R (concordance was 0.81 v 0.74 for overall survival and 0.89 v 0.76 for leukemia-free survival, respectively). This was true even in those patients without detectable gene mutations. Compared with the IPSS-R based stratification, the IPSS-M risk group changed in 46% of patients (23.6% and 22.4% of subjects were upstaged and downstaged, respectively).In patients treated with hematopoietic stem cell transplantation (HSCT), IPSS-M significantly improved the prediction of the risk of disease relapse and the probability of post-transplantation survival versus IPSS-R (concordance was 0.76 v 0.60 for overall survival and 0.89 v 0.70 for probability of relapse, respectively). In high-risk patients treated with hypomethylating agents (HMA), IPSS-M failed to stratify individual probability of response; response duration and probability of survival were inversely related to IPSS-M risk.Finally, we tested the accuracy in predicting IPSS-M when molecular information was missed and we defined a minimum set of 15 relevant genes associated with high performance of the score. Conclusion: IPSS-M improves MDS prognostication and might result in a more effective selection of candidates to HSCT. Additional factors other than gene mutations can be involved in determining HMA sensitivity. The definition of a minimum set of relevan

BACKGROUND: Sex is a major source of diversity among patients and a sex-informed approach is becoming a new paradigm in precision medicine. We aimed to describe sex diversity in myelodysplastic syndromes in terms of disease genotype, phenotype, and clinical outcome. Moreover, we sought to incorporate sex information into the clinical decision-making process as a fundamental component of patient individuality. METHODS: In this multicentre, observational cohort study, we retrospectively analysed 13 284 patients aged 18 years or older with a diagnosis of myelodysplastic syndrome according to 2016 WHO criteria included in the EuroMDS network (n=2025), International Working Group for Prognosis in MDS (IWG-PM; n=2387), the Spanish Group of Myelodysplastic Syndromes registry (GESMD; n=7687), or the Düsseldorf MDS registry (n=1185). Recruitment periods for these cohorts were between 1990 and 2016. The correlation between sex and genomic features was analysed in the EuroMDS cohort and validated in the IWG-PM cohort. The effect of sex on clinical outcome, with overall survival as the main endpoint, was analysed in the EuroMDS population and validated in the other three cohorts. Finally, novel prognostic models incorporating sex and genomic information were built and validated, and compared to the widely used revised International Prognostic Scoring System (IPSS-R). This study is registered with ClinicalTrials.gov, NCT04889729. FINDINGS: The study included 7792 (58·7%) men and 5492 (41·3%) women. 10 906 (82·1%) patients were White, and race was not reported for 2378 (17·9%) patients. Sex biases were observed at the single-gene level with mutations in seven genes enriched in men (ASXL1, SRSF2, and ZRSR2 p<0·0001 in both cohorts; DDX41 not available in the EuroMDS cohort vs p=0·0062 in the IWG-PM cohort; IDH2 p<0·0001 in EuroMDS vs p=0·042 in IWG-PM; TET2 p=0·031 vs p=0·035; U2AF1 p=0·033 vs p<0·0001) and mutations in two genes were enriched in women (DNMT3A p<0·000

PURPOSEMyelodysplastic syndromes (MDS) are heterogeneous myeloid neoplasms in which a risk-adapted treatment strategy is needed. Recently, a new clinical-molecular prognostic model, the Molecular International Prognostic Scoring System (IPSS-M) was proposed to improve the prediction of clinical outcome of the currently available tool (Revised International Prognostic Scoring System [IPSS-R]). We aimed to provide an extensive validation of IPSS-M.METHODSA total of 2,876 patients with primary MDS from the GenoMed4All consortium were retrospectively analyzed.RESULTSIPSS-M improved prognostic discrimination across all clinical end points with respect to IPSS-R (concordance was 0.81 v 0.74 for overall survival and 0.89 v 0.76 for leukemia-free survival, respectively). This was true even in those patients without detectable gene mutations. Compared with the IPSS-R based stratification, the IPSS-M risk group changed in 46% of patients (23.6% and 22.4% of subjects were upstaged and downstaged, respectively).In patients treated with hematopoietic stem cell transplantation (HSCT), IPSS-M significantly improved the prediction of the risk of disease relapse and the probability of post-transplantation survival versus IPSS-R (concordance was 0.76 v 0.60 for overall survival and 0.89 v 0.70 for probability of relapse, respectively). In high-risk patients treated with hypomethylating agents (HMA), IPSS-M failed to stratify individual probability of response; response duration and probability of survival were inversely related to IPSS-M risk.Finally, we tested the accuracy in predicting IPSS-M when molecular information was missed and we defined a minimum set of 15 relevant genes associated with high performance of the score.CONCLUSIONIPSS-M improves MDS prognostication and might result in a more effective selection of candidates to HSCT. Additional factors other than gene mutations can be involved in determining HMA sensitivity. The definition of a minimum set of relevant genes may

Waminoa spp. are acoel flatworms mainly found as ectosymbionts on scleractinian corals. Although Waminoa could potentially represent a threat to their hosts, not enough information is available yet regarding their ecology and effect on the coral. Here, the Waminoa sp.–coral association was analyzed in Singapore reefs to determine the prevalence, host range, and preference, as well as the flatworm abundance on the coral surface. Moreover, the impact of Waminoa sp. on the expression of putative immune-and stress-response genes (C-type lectin, C3, Hsp70 and Actin) was exam-ined in the coral Lobophyllia radians. The association prevalence was high (10.4%), especially in sites with lower sedimentation and turbidity. Waminoa sp. showed a wide host range, being found on 17 coral genera, many of which are new association records. However, only few coral genera, mostly characterized by massive or laminar morphologies appeared to be preferred hosts. Waminoa sp. individuals displayed variable patterns of coral surface coverage and an unequal distribution among different host taxa, possibly related to the different coral growth forms. A down-regulation of the expression of all the analyzed genes was recorded in L. radians portions colonized by Waminoa individuals compared to those without. This indicated that Waminoa sp. could affect components of the immune system and the cellular homeostasis of the coral, also inhibiting its growth. Therefore, Waminoa sp. could represent a potential further threat for coral communities already subjected to multiple stressors.

Il contributo analizza il ruolo delle skills richieste nel mercato del lavoro italiano usando un nuovo dataset creato combinando dati provenienti da fonti aziendali ed esterne. Da un punto di vista metodologico, una Conjoint analysis e` stata implementata ai dati per stimare le utilita parziali legate alle competenze pi ` u` richieste definendone la migliore combinazione desiderata in un’ottica di reclutamento. In particolare, i profili dei lavoratori reclutati da The Adecco Group in Italia nel periodo 2016-2021 sono stati analizzati alla ricerca di trend e dinamiche negli ultimi anni, In this paper, the roles of the most requested skills for getting a job in Italian Labour market are investigated using a new data set created by combining information from business and external sources. From a methodological point of view, a Conjoint analysis is performed to estimate the partial utilities for the most requested skills and their importance in defining the best combinations of skills to match job requirements. In particular, the profiles of workers recruited by The Adecco Group in Italy in the period 2016-2021 have been analysed detecting dynamics and movements during last years.

Brownian thermal noise associated with highly reflective coatings is a fundamental limit for several precision experiments, including gravitational-wave detectors. Research is currently ongoing to find coatings with low thermal noise that also fulfill strict optical requirements such as low absorption and scatter. We report on the optical and mechanical properties of ion-beam-sputtered magnesium fluoride thin films and we discuss the application of such coatings in current and future gravitational-wave detectors.

Il contributo analizza il ruolo delle skills richieste nel mercato del lavoro italiano usando un nuovo dataset creato combinando dati provenienti da fonti aziendali ed esterne. Da un punto di vista metodologico, una Conjoint analysis e` stata implementata ai dati per stimare le utilita parziali legate alle competenze pi ` u` richieste definendone la migliore combinazione desiderata in un’ottica di reclutamento. In particolare, i profili dei lavoratori reclutati da The Adecco Group in Italia nel periodo 2016-2021 sono stati analizzati alla ricerca di trend e dinamiche negli ultimi anni, In this paper, the roles of the most requested skills for getting a job in Italian Labour market are investigated using a new data set created by combining information from business and external sources. From a methodological point of view, a Conjoint analysis is performed to estimate the partial utilities for the most requested skills and their importance in defining the best combinations of skills to match job requirements. In particular, the profiles of workers recruited by The Adecco Group in Italy in the period 2016-2021 have been analysed detecting dynamics and movements during last years.

Waminoa spp. are acoel flatworms mainly found as ectosymbionts on scleractinian corals. Although Waminoa could potentially represent a threat to their hosts, not enough information is available yet regarding their ecology and effect on the coral. Here, the Waminoa sp.–coral association was analyzed in Singapore reefs to determine the prevalence, host range, and preference, as well as the flatworm abundance on the coral surface. Moreover, the impact of Waminoa sp. on the expression of putative immune-and stress-response genes (C-type lectin, C3, Hsp70 and Actin) was exam-ined in the coral Lobophyllia radians. The association prevalence was high (10.4%), especially in sites with lower sedimentation and turbidity. Waminoa sp. showed a wide host range, being found on 17 coral genera, many of which are new association records. However, only few coral genera, mostly characterized by massive or laminar morphologies appeared to be preferred hosts. Waminoa sp. individuals displayed variable patterns of coral surface coverage and an unequal distribution among different host taxa, possibly related to the different coral growth forms. A down-regulation of the expression of all the analyzed genes was recorded in L. radians portions colonized by Waminoa individuals compared to those without. This indicated that Waminoa sp. could affect components of the immune system and the cellular homeostasis of the coral, also inhibiting its growth. Therefore, Waminoa sp. could represent a potential further threat for coral communities already subjected to multiple stressors.

In this work we report on the extensive characterization of amorphous silicon carbide (a-SiC) coatings prepared by physical deposition methods. Our investigation is performed within the perspective application of a-SiC as an optical material for high-precision optical experiments and, in particular, in gravitational wave interferometry. We compare the results obtained with two different sputtering systems [a standard radio frequency (rf) magnetron sputtering and an ion-beam sputtering] to grasp the impact of two different setups on the repeatability of the results. After a thorough characterization of structural, morphological, and compositional characteristics of the prepared samples, we focus on a detailed study of the optical and mechanical losses in those materials. Mechanical losses are further investigated from a microscopic point of view by comparing our experimental results with molecular dynamic simulations of the amorphous SiC structure: first we define a protocol to generate a numerical model of the amorphous film, capturing the main features of the real system; then we simulate its dynamical behavior upon deformation in order to obtain its mechanical response.

BACKGROUND: Literature shows that occurrence of comorbidities in people with severe acquired brain injury (sABI) is a common problem in rehabilitation stay. Consequently, patients could require an increase of interventions for diagnosis and treatment of clinical conditions, with a reduction of the rehabilitative take in charge for both clinical and organizational aspects. AIM: The first aim was to evaluate the rate of clinical conditions of sABI patients at admission in rehabilitation and the types of rehabilitative interventions performed in the first week; second objective was to explore the impact of clinical conditions on real rehabilitative take in charge. DESIGN: Cross sectional study. SETTING: Inpatient rehabilitation centers. POPULATION: The study included data from 586 sABI patients. METHODS: Collected data regarded anamnestic information, functional status assessed by means of Glasgow Outcome Scale, Levels of cognitive functioning, Early Rehabilitation Barthel Index, comorbidities at admission and type of rehabilitative interventions carried out in first week of rehabilitation stay. Spearman correlation coefficients were applied to detect possible correlations between the number of treatments in first week and clinical variables; through a multiple regression analysis the effect of patient’s characteristics on rehabilitative take in charge was explored. RESULTS: Data from the sABI patients: mean age 55.1±17.1 years; etiology of sABI was vascular in 315 patients (53.8%), anoxic in 83 (14.2%), neoplastic in 17 (2.9%), infectious in 15 (2.6%), traumatic in 150 (25.6%); 6 subjects (1%) presented a mixed etiology. Need of cardiorespiratory monitoring, pressure sores, infections or presence of multi drug resistant bacteria were the most frequent comorbidities. Passive mobilization, sitting positioning, arousal/awareness stimulation, evaluation and management of dysphagia were the interventions most frequently carried out in the first week. The regression analysi

Clonal hematopoiesis of indeterminate potential (CHIP) is associated with increased risk of cancers and inflammation-related diseases. This phenomenon becomes common in persons aged ≥80 years, in whom the implications of CHIP are not well defined. We performed a mutational screening in 1794 persons aged ≥80 years and investigated the relationships between CHIP and associated pathologies. Mutations were observed in one-third of persons aged ≥80 years and were associated with reduced survival. Mutations in JAK2 and splicing genes, multiple mutations (DNMT3A, TET2, and ASXL1 with additional genetic lesions), and variant allele frequency ≥0.096 had positive predictive value for myeloid neoplasms. Combining mutation profiles with abnormalities in red blood cell indices improved the ability of myeloid neoplasm prediction. On this basis, we defined a predictive model that identifies 3 risk groups with different probabilities of developing myeloid neoplasms. Mutations in DNMT3A, TET2, ASXL1, or JAK2 were associated with coronary heart disease and rheumatoid arthritis. Cytopenia was common in persons aged ≥80 years, with the underlying cause remaining unexplained in 30% of cases. Among individuals with unexplained cytopenia, the presence of highly specific mutation patterns was associated with myelodysplastic-like phenotype and a probability of survival comparable to that of myeloid neoplasms. Accordingly, 7.5% of subjects aged ≥80 years with cytopenia had presumptive evidence of myeloid neoplasm. In summary, specific mutational patterns define different risk of developing myeloid neoplasms vs inflammatory-associated diseases in persons aged ≥80 years. In individuals with unexplained cytopenia, mutational status may identify those subjects with presumptive evidence of myeloid neoplasms.

High-Purity Germanium (HPGe) detectors continue to be a fundamental tool in nuclear gamma spectroscopy. The tracking of the gamma interactions inside the HPGe crystals is opening a new era in the use of these detectors for both basic science and applications, but they have also shown that new R&D is necessary for the production of even better and more reliable highly segmented detectors. In this work, we present recent results obtained in the framework of a multidisciplinary research program in HPGe detector technologies and we discuss the influence of these studies on the use of HPGe detectors.

High-Purity Germanium (HPGe) detectors continue to be a fundamental tool in nuclear gamma spectroscopy. The tracking of the gamma interactions inside the HPGe crystals is opening a new era in the use of these detectors for both basic science and applications, but they have also shown that new R&D is necessary for the production of even better and more reliable highly segmented detectors. In this work, we present recent results obtained in the framework of a multidisciplinary research program in HPGe detector technologies and we discuss the influence of these studies on the use of HPGe detectors.

The effects of different passivation methods applied to the same planar high-purity germanium gamma radiation detector have been studied. By means of the scanning with a low-energy collimated gamma source, it has been found that the surface passivation gives rise to a dead layer below the intrinsic Ge surface, whose thickness and distribution are strongly dependent on the passivation type. Measured bulk detector properties like the peak-to-Compton ratio and efficiency have shown a dependence on the passivation and an influence of the passivation type on the depletion voltage, whilst the optimal energy resolution has been the same for all the passivations.

The effects of different passivation methods applied to the same planar high-purity germanium gamma radiation detector have been studied. By means of the scanning with a low-energy collimated gamma source, it has been found that the surface passivation gives rise to a dead layer below the intrinsic Ge surface, whose thickness and distribution are strongly dependent on the passivation type. Measured bulk detector properties like the peak-to-Compton ratio and efficiency have shown a dependence on the passivation and an influence of the passivation type on the depletion voltage, whilst the optimal energy resolution has been the same for all the passivations.

Il capitolo mette in evidenza le caratteristiche salienti dei principali approcci della teoria economica dedicata al federalismo

It has been proved that the co-deposition of a proper amount of titanium can significantly improve the properties of sputter-deposited MoS2 coatings, leading to the deposition of coatings, which are harder, much more wear resistant and also less sensitive to atmospheric water vapour during tribological testing. The MoS2/Ti coatings, studied here by the authors, also give excellent industrial results in a wide range of applications. In this paper the mechanical and micro-structural properties of MoS2 coatings containing titanium with molar fractions up to 0.44 are studied. The mechanical properties are tested with pin-on-disk and reciprocating wear tests (multipass) in different experimental conditions. Frictional force and friction coefficient against a number of cycles are recorded. Coatings composition is determined by Rutherford and non-Rutherford backscattering (RBS) and coating thickness is measured by cross-section scanning electron microscopy (SEM). Structural analysis is carried out using X-ray diffraction (XRD). The mechanical properties are presented as a function of the Ti content and the optimal titanium concentration is determined. Other metals like Cr, W, Zr and Mo are also investigated. The composition of MoS2/metal composite coatings of the same quality of the MoS2/Ti films (‘optimized’ coatings) is studied by RBS.

It has been proved that the co-deposition of a proper amount of titanium can significantly improve the properties of sputter-deposited MoS2 coatings, leading to the deposition of coatings, which are harder, much more wear resistant and also less sensitive to atmospheric water vapour during tribological testing. The MoS2/Ti coatings, studied here by the authors, also give excellent industrial results in a wide range of applications. In this paper the mechanical and micro-structural properties of MoS2 coatings containing titanium with molar fractions up to 0.44 are studied. The mechanical properties are tested with pin-on-disk and reciprocating wear tests (multipass) in different experimental conditions. Frictional force and friction coefficient against a number of cycles are recorded. Coatings composition is determined by Rutherford and non-Rutherford backscattering (RBS) and coating thickness is measured by cross-section scanning electron microscopy (SEM). Structural analysis is carried out using X-ray diffraction (XRD). The mechanical properties are presented as a function of the Ti content and the optimal titanium concentration is determined. Other metals like Cr, W, Zr and Mo are also investigated. The composition of MoS2/metal composite coatings of the same quality of the MoS2/Ti films (‘optimized’ coatings) is studied by RBS.

It has been proved that the co-deposition of a proper amount of titanium can significantly improve the properties of sputter-deposited MoS2 coatings, leading to the deposition of coatings, which are harder, much more wear resistant and also less sensitive to atmospheric water vapour during tribological testing. The MoS2/Ti coatings, studied here by the authors, also give excellent industrial results in a wide range of applications. In this paper the mechanical and micro-structural properties of MoS2 coatings containing titanium with molar fractions up to 0.44 are studied. The mechanical properties are tested with pin-on-disk and reciprocating wear tests (multipass) in different experimental conditions. Frictional force and friction coefficient against a number of cycles are recorded. Coatings composition is determined by Rutherford and non-Rutherford backscattering (RBS) and coating thickness is measured by cross-section scanning electron microscopy (SEM). Structural analysis is carried out using X-ray diffraction (XRD). The mechanical properties are presented as a function of the Ti content and the optimal titanium concentration is determined. Other metals like Cr, W, Zr and Mo are also investigated. The composition of MoS2/metal composite coatings of the same quality of the MoS2/Ti films (‘optimized’ coatings) is studied by RBS.

It has been proved that the co-deposition of a proper amount of titanium can significantly improve the properties of sputter-deposited MoS2 coatings, leading to the deposition of coatings, which are harder, much more wear resistant and also less sensitive to atmospheric water vapour during tribological testing. The MoS2/Ti coatings, studied here by the authors, also give excellent industrial results in a wide range of applications. In this paper the mechanical and micro-structural properties of MoS2 coatings containing titanium with molar fractions up to 0.44 are studied. The mechanical properties are tested with pin-on-disk and reciprocating wear tests (multipass) in different experimental conditions. Frictional force and friction coefficient against a number of cycles are recorded. Coatings composition is determined by Rutherford and non-Rutherford backscattering (RBS) and coating thickness is measured by cross-section scanning electron microscopy (SEM). Structural analysis is carried out using X-ray diffraction (XRD). The mechanical properties are presented as a function of the Ti content and the optimal titanium concentration is determined. Other metals like Cr, W, Zr and Mo are also investigated. The composition of MoS2/metal composite coatings of the same quality of the MoS2/Ti films (‘optimized’ coatings) is studied by RBS.

We report on a female patient with G syndrome. The clinical expression is relatively severe and includes 2 manifestations not previously reported, ie, agenesis of the corpus callosum and umbilical hernia. These new findings support the notion that there is a developmental defect of the midline as the basis of the G syndrome.