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Introduction: During the COVID-19 pandemic, ocrelizumab (OCR) infusions for MS patients were often re-scheduled because of MS center's disruption and concerns regarding immunosuppression. The aim of the present study was to assess changes in OCR schedule during the first wave of pandemic in Italy and to evaluate the effect of delayed infusion on clinical/radiological endpoints. Methods: Data were extracted from the Italian MS Register database. Standard interval dosing was defined as an infusion interval ≤ 30 weeks, while extended interval dosing was defined as an infusion interval > 30 weeks at the time of the observation period. Clinico-demographics variables were tested as potential predictors for treatment delay. Time to first relapse and time to first MRI event were evaluated. Cumulative hazard curves were reported along their 95% confidence intervals. A final sample of one-thousand two patients with MS from 65 centers was included in the analysis: 599 pwMS were selected to evaluate the modification of OCR infusion intervals, while 717 pwRMS were selected to analyze the effect of infusion delay on clinical/MRI activity. Results: Mean interval between two OCR infusions was 28.1 weeks before pandemic compared to 30.8 weeks during the observation period, with a mean delay of 2.74 weeks (p < 0.001). No clinico-demographic factors emerged as predictors of infusion postponement, except for location of MS centers in the North of Italy. Clinical relapses (4 in SID, 0 in EID) and 17 MRI activity reports (4 in SID, 13 in EID) were recorded during follow-up period. Discussion: Despite the significant extension of OCR infusion interval during the first wave of pandemic in Italy, a very small incidence of clinical/radiological events was observed, thus suggesting durable efficacy of OCR, as well as the absence of rebound after its short-term suspension. [ABSTRACT FROM AUTHOR]

This paper aims to describe the outcomes of the Main10ance project, which focused on developing an integrated HBIM-GIS platform to support the maintenance and conservation plans for the historic built heritage. The pilot case is the UNESCO complex of the Sacri Monti, located in northern Italy and Switzerland, which consists of groups of chapels and architectural artifacts holding significant historical and cultural value. Given their importance, specific maintenance plans involving multiple stakeholders and specialists are required. This study focuses on creating a unified system that semantically and spatially describes the architectural elements of the case study and the surrounding context and indoor assets. After a 3D integrated metric survey and the related data processing, parametric 3D models were created in a BIM environment, and a spatial database was developed to incorporate both geometric and alphanumeric entities. The database enables interoperability among different actors and domains, gathering heritage-related information crucial for restoration and conservation purposes. Additionally, the custom 4MAIN10ANCE web platform was developed with different levels of details (LODs), enabling the retrieval of both 2D and 3D data and establishing connections between the BIM models of the chapels and associated information. [ABSTRACT FROM AUTHOR]

Background: Anxiety, depression and reduction of quality of life (QoL) are common in people with multiple sclerosis (pwMS). Fear of getting sick from COVID-19, government's lockdown and the imposed social distancing might have had an impact on psychological distress and QoL. Objectives: The aim of our study was to investigate anxiety, depression and QoL changes in pwMS during SARS-CoV-2 outbreak and lockdown in Italy. Methods: 67 pwMS with a previous (less than 6 months) neuropsychological evaluation before SARS-CoV-2 outbreak (T0) were re-evaluated at the time of the outbreak and lockdown in Italy (T1). They underwent a clinical and neurological evaluation and completed the State-Trait Anxiety Inventory (STAI-Y1), the Beck Depression Inventory second edition (BDI-II), and Multiple Sclerosis Quality of Life-54 (MsQoL-54) at T0 and T1. Benjamini–Hochberg procedure was applied to control the false discovery rate. Results: BDI-II and STAI-Y1 scores did not change between T0 and T1. At T1, MsQoL-54 scores were higher on the satisfaction with sexual life and the social function subscales, and lower on the limitation due to emotional problems subscale. Conclusions: This is the first study that evaluated mood and QoL levels before and during the lockdown due to COVID-19 pandemic in pwMS. No worsening of anxiety and depression levels was found. Contrariwise some improvements were noted on QoL, the most reliable regarding the sexual satisfaction and the social function. [ABSTRACT FROM AUTHOR]

This study describes the technical-systemic and conceptual-informative interoperability tests for the integration of a Historic Building Information Modeling (HBIM) model in a 3D Geographic Information System (GIS) environment aimed to provide complete and useful documentation for multiscale analyses on cultural heritage particularly exposed to risks. The case study of the San Lorenzo Church in Norcia (Italy) has been chosen given the urgent need to update the existing documentation for its protection and conservation issues, due to the extensive damage suffered after the series of earthquakes that occurred in central Italy starting from summer 2016. Different tests to evaluate two levels of conceptual interoperability (technical and semantic) when importing the HBIM model into a GIS environment were performed, whether with commercial software or with open source ones (ArcGIS Pro and QGIS, respectively). A data integration platform (Feature Manipulation Engine, FME) has been used for converting the IFC (Industry Foundation Classes) data format into the GML (Geography Markup Language) format, in order to obtain a unique and unified model and vocabulary for the 3D GIS project, structured with different levels of detail, according to CityGML standard. Finally, as HBIM-GIS integration is considered, the loss of geometric and informative data has been taken into account and evaluated. [ABSTRACT FROM AUTHOR]

The adoption of High Temperature Superconductors (HTS) tapes is becoming a suitable and interesting alternative to copper for windings in transformers, thanks to the improvement in performance and the lowering of costs. Of course, optimized designs, different with respect to usual layouts, must be considered, due to the additional requirements of HTS tapes, such as minimization of orthogonal magnetic fields and consideration of additional losses in the HTS. In the framework of a scientific cooperation among some Italian Universities and private companies, a test model for a 10 KVA transformer with HTS secondary windings has been developed, and validated against a demonstrative prototype, manufactured during the project. In the paper, the device model performance is assessed, with particular care to the HTS losses modeling, and some comparisons to the experimental results are presented. [ABSTRACT FROM AUTHOR]

Context: The dramatic rise in the incidence of thyroid cancer over the last 30 years is largely attributable to the increasing diagnosis of papillary microcarcinomas (mPTCs). Current guidelines endorse an observational management approach in properly selected cases., Objective: To evaluate the feasibility of active surveillance in mPTC in Italy, its impact on real life, and to identify risk factors of progression., Design and Setting: In 2014 we started a prospective-observational study of active surveillance in mPTC patients., Patients: Included patients demonstrated a single Thy4 or Thy5 thyroid nodule, with largest diameter ≤1.3 cm, and no suspicious laterocervical lymph nodes by neck ultrasonography. Of 185 eligible subjects, 50.3% (93/185) enrolled in the observational management protocol while the others opted for surgery and were excluded from this analysis., Intervention: Enrolled patients were followed with neck ultrasound at 6- to 12-month intervals. Disease progression was defined as the appearance of abnormal lymph nodes or nodule enlargement during follow-up. In these cases, patients were directed to surgery., Results: Three patients (3/93, 3%) showed clinical progression and required surgery. Another 19 patients (19/93, 20%) decided to transition to surgical intervention even though there was no evidence of disease progression. All operated patients had excellent response to initial treatment despite the delayed surgery., Conclusions: Within an Italian medical context, active surveillance appears to be a feasible and safe alternative to immediate surgery in healthy mPTC patients. Only 3% of mPTC demonstrated disease progression during a median follow-up of 19 months (range 6-54) and importantly demonstrated excellent outcomes after surgical intervention in a short-term follow-up., (© Endocrine Society 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Medullary thyroid carcinoma (MTC) is a rare disease that can be inherited or sporadic; its pathogenesis is related to activating mutations in the RET gene., Design: This study describes our 20-year experience regarding RET genetic screening in MTC., Patients and Methods: We performed RET genetic screening in 1556 subjects, 1007 with an apparently sporadic MTC, 95 with a familial form and 454 relatives of RET-positive patients with MTC., Results: A germline RET mutation was found in 68 of 1007 (6·7%) patients with sporadic MTC, while 939 patients with MTC were negative for germline RET mutations. We then identified a total of 137 gene carriers (GC). These subjects initiated a clinical evaluation for the diagnosis of MEN 2. A total of 139 MEN 2 families have been followed: 94 FMTC, 33 MEN 2A and 12 MEN 2B. Thirty-three different germline RET mutations were identified. Codon 804 was the most frequently altered codon particularly in FMTC (32/94, 34%), while codon 634 was the most frequently altered codon in MEN 2A (31/33, 94%); MEN 2B cases were exclusively associated with an M918T mutation at exon 16., Conclusions: Our 20-year study demonstrated that RET genetic screening is highly specific and sensitive, and it allows the reclassification as hereditary of apparently sporadic cases and the identification of GC who require an adequate follow-up. We confirmed that FMTC is the most prevalent MEN 2 syndrome and that it is strongly correlated with noncysteine RET mutations. According to these findings, a new paradigm of follow-up of hereditary MTC cases might be considered in the next future., (© 2014 John Wiley & Sons Ltd.)