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Additional file 3: figure 3.: fused FDG-PET/CT images of a 67-year old male with a T4aN3 oropharyngeal cancer: Tref assessment negative for residual tumor according to all scales

Additional file 4: figure 4. fused FDG-PET/CT images of a 69-year old male with a T4aN2b laryngeal cancer: Nref assessment negative for residual tumor according to all scales

Additional file 2: figure 2. overall survival (Kaplan Meyer method)

Purpose Response assessment to definitive non-surgical treatment for head and neck squamous cell carcinoma (HNSCC) is centered on the role of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET-CT) 12 weeks after treatment. The 5-point Hopkins score is the only qualitative system available for standardized reporting, albeit limited by suboptimal positive predictive value (PPV). The aim of our study was to explore the feasibility and assess the diagnostic accuracy of an experimental 6-point scale (“Cuneo score”). Methods We performed a retrospective, multicenter study on HNSCC patients who received a curatively-intended, radiation-based treatment. A centralized, independent qualitative evaluation of post-treatment FDG-PET/CT scans was undertaken by 3 experienced nuclear medicine physicians who were blinded to patients’ information, clinical data, and all other imaging examinations. Response to treatment was evaluated according to Hopkins, Cuneo, and Deauville criteria. The primary endpoint of the study was to evaluate the PPV of Cuneo score in assessing locoregional control (LRC). We also correlated semi-quantitative metabolic factors as included in PERCIST and EORTC criteria with disease outcome. Results Out of a total sample of 350 patients from 11 centers, 119 subjects (oropharynx, 57.1%; HPV negative, 73.1%) had baseline and post-treatment FDG-PET/CT scans fully compliant with EANM 1.0 guidelines and were therefore included in our analysis. At a median follow-up of 42 months (range 5-98), the median locoregional control was 35 months (95% CI, 32-43), with a 74.5% 3-year rate. Cuneo score had the highest diagnostic accuracy (76.5%), with a positive predictive value for primary tumor (Tref), nodal disease (Nref), and composite TNref of 42.9%, 100%, and 50%, respectively. A Cuneo score of 5-6 (indicative of residual disease) was associated with poor overall survival at multivariate analysis (HR 6.0; 95% CI, 1.88-19.18; p = 0.002). In addition, nodal progressive disease according to PERCIST criteria was associated with worse LRC (OR for LR failure, 5.65; 95% CI, 1.26-25.46; p = 0.024) and overall survival (OR for death, 4.81; 1.07-21.53; p = 0.04). Conclusions In the frame of a strictly blinded methodology for response assessment, the feasibility of Cuneo score was preliminarily validated. Prospective investigations are warranted to further evaluate its reproducibility and diagnostic accuracy.

Additional file 6: material. FDG-PET/CT analysis

Additional file 1: figure 1. progression-free survival (Kaplan Meyer method)

Additional file 5: table 1. positive predictive value and corresponding 95% CI of composite TNref for specific scores. PPV: positive predictive value

In the first decades of the twentieth century, an evident reduction of the infant mortality rate occurred in Italy. In previous studies, less attention has been devoted to the effects of individual bio-demographic and socioeconomic components on infant mortality. We use micro data from births, deaths and marriages civil registers of Granarolo, an Italian rural municipality close to Bologna, from 1900 to 1939. We are able to reconstruct some typical bio-demographic characteristics and the socio-economic status of parents. In these terms, the analysis includes: parity, age of the mother, previous birth interval and child survival, father’s occupations and literacy, season and year of birth. Cox and Piecewise constant exponential models are used to estimate the effects of the selected predictors. We found that still in the first four decades of the twentieth century rural daily wagers experienced a lower level in infant survivor, whereas the upper class registered significantly higher ones.

The paper investigates spatio-temporal trends in health disparities through an empirical example. We deal with geographical health pattern in Italy from 1991 to 2010, starting from infant mortality data available at the provincial level and assessing the existent disparity among macro-regions (the conventional Northern, Central and Southern macro-regions). After a discussion concerning suitable inequality indices and their decompositions when dealing with small area data, we propose a model-based approach that allows to properly tackle sampling variability. Results give evidences of persisting spatial disparity in infant mortality along time., REVSTAT-Statistical Journal, Vol. 13 No. 1 (2015): REVSTAT-Statistical Journal

This article deals with the possible existence of deliberate fertility control before the fertility transition. The timing of the fertility response to economic stress, as measured by fluctuations in grain prices, is used as a measure of deliberate, but non-parity specific, control. Birth histories from six German villages (1766–1863), including information on occupation of the husband, are used together with community-wide grain price series in a micro-level event-history analysis. The results show a negative fertility response to grain prices both in the year immediately following the price change, and with a 1-year lag. The response was also highly different between socioeconomic groups, with the most pronounced effects among the unskilled laborers. Moreover, the response in this group was very rapid, already present 3–6 months after the price change. As all involuntary fertility responses to economic hardship (e.g., malnutrition, spousal separation, and spontaneous abortion) come with a considerable time lag, the existence of such a rapid response among the lower social groups suggests that individual agency (deliberate control) was an important aspect of reproductive behavior also before the fertility transition. Cet article s'intéresse à l'existence possible d'un contrôle volontaire des naissances avant la transition de la fécondité. Le calendrier de l'évolution de la fécondité en fonction de la tension économique, mesurée par les fluctuations du prix des céréales, est utilisé comme mesure de contrôle volontaire des naissances, mais non lié à la parité. Des histoires génésiques comprenant la catégorie professionnelle du père, provenant de six villages allemands (1766-1863), sont utilisées en association avec des séries temporelles des prix des céréales au niveau communautaire pour effectuer une analyse biographique au niveau individuel. Les résultats indiquent une évolution négative de la fécondité en fonction du prix des céréales, à la fois dans l'année qui suit le changement de prix et l'année d’après. Cette évolution était très variable en fonction du groupe social, avec un effet maximal parmi les travailleurs non qualifiés. De plus, la réaction dans ce dernier groupe était très rapide, car déjà visible 3 à 6 mois après le changement de prix. Sachant que toutes les modifications involontaires de fécondité face aux difficultés économiques (par exemple à la malnutrition, aux ruptures conjugales, et aux avortements spontanés) ne se produisent qu'après un délai très long, l'existence d'une réaction si rapide parmi les groupes sociaux les plus défavorisés laisse penser que l'initiative individuelle (contrôle volontaire) était déjà, avant la transition de la fécondité, un aspect important du comportement reproducteur.