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Introduction: COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time. Methods: Consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann–Whitney U test for continuous variables. Results: A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop −12% versus −3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36). Conclusions: Our study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts.

A study of phase transitions of photochromic p,p’-n-alkylazobenzenes compounds was carried out by means of adiabatic scanning calorimetry (ASC) and photopyroelectric calorimetry (PPE) techniques, yielding accurately the temperature dependence of the enthalpy and of the specific heat capacity across the observed phase transitions, and the corresponding enthalpy of transition values. In addition, polarization microscopy imaging of the sample texture was performed together with the PPE calorimetric evaluations to establish the nature of the involved phases. By performing PPE calorimetric evaluations during UV irradiation of the samples, the influence of the photoinduced trans to cis isomerization of the nAB molecules on the occurrence of the phase transitions was assessed.

Purpose CyberKnife can perform fiducial-free lung tracking, even when the target is visible from only one of the double imaging view, thanks to the Lung-Optimized-Treatment package. However, the uncertainty along the blind view (out-of-plane direction) must be taken into account in margin definition. The goal was to determine the accuracy of target localization in 1-view treatments (33% of all lung cases at Centro Diagnostico Italiano). Methods The actual tumor position, stored in logfiles from 2-view treatments, was projected using a geometric relation onto both image planes for each of 26 patients’ data. In the same plots exhale and inhale planned tumor positions, extracted from TPS and based on breath-hold TC, were novelty represented preserving metric with respect to imaging center. Actual vs. planned positions were compared through a home-made software in Matlab able to calculate also the extra-margin to estimated ITV which would have been necessary to cover the 95% of target positions for the 95% of patient population in case of 1-view treatment. The program was validated using data from 1-view and 2-view lung treatments with XLT Phantom (CIRS). Results The validation test confirmed the reliability of the technique. Expansions were equal to 5 mm and 7 mm for lesions in superior and inferior lobe respectively. The method proved to overestimate margins due to imaging sampling algorithm, data dependence on 2-view cases and the small amount of patients. However, results showed clearly that biphasic TC acquired in breath-hold way was rarely a good model for breath amplitude and breath center position in relation to spine alignment center. Conclusions This graphic comparison method is a useful tool to check localization accuracy of CyberKnife system for 1-view treatments and identify movement error components. It could be employed in clinical workflow to get patient-related information for customized margin definition.

We report results from the first search for sterile neutrinos mixing with active neutrinos through a reduction in the rate of neutral-current interactions over a baseline of 810\,km between the NOvA detectors. Analyzing a 14-kton detector equivalent exposure of 6.05$\times$10$^{20}$ protons-on-target in the NuMI beam at Fermilab, we observe 95 neutral-current candidates at the Far Detector compared with $83.5 \pm 9.7 \mbox{(stat.)} \pm 9.4 \mbox{(syst.)}$ events predicted assuming mixing only occurs between active neutrino species. No evidence for $\nu_{\mu} \rightarrow \nu_{s}$ transitions is found. Interpreting these results within a 3+1 model, we place constraints on the mixing angles $\theta_{24}, Comment: 8 pages, 4 figures

This Letter reports new results on muon neutrino disappearance from NOvA, using a 14 kton detector equivalent exposure of $6.05\times10^{20}$ protons-on-target from the NuMI beam at the Fermi National Accelerator Laboratory. The measurement probes the muon-tau symmetry hypothesis that requires maximal mixing ($\theta_{23} = \pi/4$). Assuming the normal mass hierarchy, we find $\Delta m^2 = (2.67 \pm 0.11)\times 10^{-3}$ eV$^2$ and $\sin^2 \theta_{23}$ at the two statistically degenerate values $0.404^{+0.030}_{-0.022}$ and $0.624^{+0.022}_{-0.030}$, both at the 68% confidence level. Our data disfavor the maximal mixing scenario with 2.6 $\sigma$ significance., Comment: 7 pages, 3 figures

Convolutional neural networks (CNNs) have been widely applied in the computer vision community to solve complex problems in image recognition and analysis. We describe an application of the CNN technology to the problem of identifying particle interactions in sampling calorimeters used commonly in high energy physics and high energy neutrino physics in particular. Following a discussion of the core concepts of CNNs and recent innovations in CNN architectures related to the field of deep learning, we outline a specific application to the NOvA neutrino detector. This algorithm, CVN (Convolutional Visual Network) identifies neutrino interactions based on their topology without the need for detailed reconstruction and outperforms algorithms currently in use by the NOvA collaboration., 23 pages, 12 figures

AIMS To evaluate the feasibility of a cardiac surgery registry and to describe patients' characteristics, type of procedures performed, incidence of postoperative complications with short and middle-term mortality. METHODS A database with clinical information and details on cardiac surgical operations was implemented by Puglia Health Regional Agency to collect data of each cardiac surgery procedure performed in the seven adult cardiac surgery centres of the region. Health regional agency personnel guaranteed data accuracy and quality control procedures. Mortality after the discharge was evaluated for residents in Puglia by linking clinical data to the Health Information System. RESULTS From January 2011 to December 2012, 6429 operations were performed. All operations were included in the registry with very high completeness of collected data (95.3% per patient). The majority of the operations performed were coronary artery bypass graft alone (41.1%), valve surgery alone (26.2%), coronary artery bypass graft and valve surgery (11.4%), or valve with other surgery (11.8%). During a median follow-up of 12 months (interquartile range 6-18 months), 211 deaths were detected after the discharge. Overall, cumulative mortality from the operation was 8.2% at 6 months and 9.5% at 12 months. CONCLUSION Implementation of a regional clinical registry of cardiac surgery is feasible with a great level of accuracy and the evaluation of mid-term mortality overcomes the limited value of hospital mortality. An accurate cardiac surgery registry elicits epidemiologic evaluations, comparisons between expected and observed mortality, incidence of postoperative complications and encourages a reliable public reporting.

Results There were no differences in mean values between Group A and Group B for: Age, BMI, LVEF, CPB time, Cross-clamp time, Number of anastomoses / patients. Group A and Group B were significantly different in terms of ventilation time ( 13,47+/-18,2 h vs 8,4+/-6,3h, p

BACKGROUND The Third National Health and Nutrition Examination Survey suggested some Mexican American children are at risk of zinc deficiency. OBJECTIVE We measured the effects of zinc and micronutrients or of micronutrients alone on indexes of cell-mediated immunity and antiinflammatory plasma proteins. DESIGN Subjects (n = 54) aged 6-7 y were randomly assigned and treated in double-blind fashion in equal numbers with 20 mg Zn (as sulfate) and micronutrients or with micronutrients alone 5 d/wk for 10 wk. RESULTS Before treatment the mean +/- SD plasma zinc was 14.9 +/- 1.7 micromol/dL and the range was within the reference; hair zinc was 1.78 +/- 0.52 micromol/g and 41.6% were < or =1.68 micromol/g; serum ferritin was 25.7 +/- 18.6 microg/L and 50.0% were < or =20 microg/L. The zinc and micronutrients treatment increased the lymphocyte ratios of CD4(+) to CD8(+) and of CD4(+)CD45RA(+) to CD4(+)CD45RO(+), increased the ex vivo generation of interleukin-2 (IL-2) and interferon-gamma (IFN-gamma), decreased the generation of interleukin-10 (IL-10), and increased plasma interleukin-1 receptor antagonist (sIL-1ra) and soluble tumor necrosis factor receptor 1 (sTNF-R1). Micronutrients alone increased the ratio of CD4(+) to CD8(+) but not of CD4(+)CD45RA(+) to CD4(+)CD45RO(+), increased IFN-gamma but had no effect on IL-2 or IL-10, and increased sIL-1ra but not sTNF-R1. Efficacy of zinc and micronutrients was greater than micronutrients alone for all indexes except the ratio of CD4(+) to CD8(+), which was affected similarly. CONCLUSIONS Before treatment, concentrations of hair zinc in 41.6% of subjects and serum ferritin in 50% were consistent with the presence of zinc deficiency. The greater efficacy of the zinc and micronutrients treatment compared with micronutrients alone supports this interpretation.

The NOvA experiment is a long-baseline neutrino oscillation experiment utilizing the NuMI beam generated at Fermilab. The experiment will measure the oscillations within a muon neutrino beam in a 300 ton Near Detector located underground at Fermilab and a functionally-identical 14 kiloton Far Detector placed 810 km away. The detectors are liquid scintillator tracking calorimeters with a fine-grained cellular structure that provides a wealth of information for separating the different particle track and shower topologies. Each detector has its own challenges with the Near Detector seeing multiple overlapping neutrino interactions in each event and the Far Detector having a large background of cosmic rays due to being located on the surface. A series of pattern recognition techniques have been developed to go from event records, to spatially and temporally separating individual interactions, to vertexing and tracking, and particle identification. This combination of methods to achieve the full event reconstruction will be discussed.

The NuMI Off-axis Neutrino Experiment (NOvA) is designed to study neutrino oscillations in the NuMI beam at Fermilab. Neutrinos at the Main Injector (NuMI) is currently being upgraded to provide 700 kW for NOvA. A 14 kt Far Detector in Ash River, MN and a functionally identical 0.3 kt Near Detector at Fermilab are positioned 810 km apart in the NuMI beam line. The fine granularity of the NOvA detectors provides a detailed representation of particle trajectories. The data volume associated with such granularity, however, poses problems for analyzing data with ease and speed. NOvA has developed a data summary file structure which discards the full event record in favor of higher-level reconstructed information. A general- purpose framework for neutrino oscillation measurements has been developed for analysis of these data summary files. We present the design methodology for this new file format as well as the analysis framework and the role it plays in producing NOvA physics results.

During operations, NOvA produces between 5,000 and 7,000 raw files per day with peaks in excess of 12,000. These files must be processed in several stages to produce fully calibrated and reconstructed analysis files. In addition, many simulated neutrino interactions must be produced and processed through the same stages as data. To accommodate the large volume of data and Monte Carlo, production must be possible both on the Fermilab grid and on off-site farms, such as the ones accessible through the Open Science Grid. To handle the challenge of cataloging these files and to facilitate their off-line processing, we have adopted the SAM system developed at Fermilab. SAM indexes files according to metadata, keeps track of each file's physical locations, provides dataset management facilities, and facilitates data transfer to off-site grids. To integrate SAM with Fermilab's art software framework and the NOvA production workflow, we have developed methods to embed metadata into our configuration files, art files, and standalone ROOT files. A module in the art framework propagates the embedded information from configuration files into art files, and from input art files to output art files, allowing us to maintain a complete processing history within our files. Embedding metadata in configuration files also allows configuration files indexed in SAM to be used as inputs to Monte Carlo production jobs. Further, SAM keeps track of the input files used to create each output file. Parentage information enables the construction of self-draining datasets which have become the primary production paradigm used at NOvA. In this paper we will present an overview of SAM at NOvA and how it has transformed the file production framework used by the experiment.

The purpose of this study was to deter mine the effect of food restriction on age-related changes in serum 1,25-dihydroxyvitamin D and PTH, two important regulators of Ca metabolism. Starting at 6 wk, male F344 rats were fed a purified diet either ad libitum (non-re stricted) or 60% of ad libitum (restricted). Rats from each group were killed at 5, 13, 22 and 28 mo of age. Dietary restriction increased the median lifespan from 24 to 31 mo. It delayed the rapid decrease in serum 1,25-dihydroxy vitamin D from 1.5-5.0 mo in the non-restricted group to 5-13 mo in the restricted group. It also completely sup pressed the marked rise in serum PTH which occurred at 22 and 28 mo in the non-restricted group. Dietary restric tion had these effects even though both groups of animals consumed the same amount of Ca per gram body weight. Diet had no effect on serum Ca and P, except at 28 mo. These effects of dietary restriction on serum 1,25-dihy droxyvitamin D and PTH may result in altered Ca metab olism in dietary restricted F344 rats. J. Nutr. 118: 1360- 1365, 1988.

One hundred and fifty-five cases of intervertebral disk infection were collected both from the literature and from the authors' records. Five clinical symptom complexes characterize the syndrome. These are back, hip-leg, meninges, abdomen, and irritable child. Many cases were misdiagnosed initially because of the similarity of symptoms to those of other conditions. The disease is peculiar to children, probably because of a special blood supply to the disk which atrophies with age. Treatment is empirical.

The behaviour of thin composite laminates (unidirectional, cross-ply and angle-ply) under compressive loads has been examined in cases where multiple delaminations are present. The problem is solved using the Finite Element Method (FEM) both with linear analyses, based on the eigenvalues research problem, and with nonlinear analyses, based on incremental-iterative procedures. In particular, the role of the delamination length, of the angle of the plies and of the stacking sequence on the critical load is investigated. Results are compared with those found in literature derived from experimental or numerical 2D analyses.

In advanced non-small-cell lung carcinomas epidermal growth factor receptor (EGFR) and KRAS testing is often performed on cytology. Liquid-based cytology (LBC), which eliminates the need for slide preparation by clinicians, may be very useful. In 42 LBC DNA was extracted twice. One sample was obtained directly from CytoLyt solution, whereas the other DNA sample was derived after smear preparation and laser capture microdissection (LCM) of Papanicolaou-stained cells. EGFR and KRAS mutational analyses were performed by direct sequencing. On CytoLyt-derived DNA four EGFR (9%) and five KRAS (12%) gene mutations were found. When direct sequencing was performed after LCM, the rate of cases that displayed either EGFR or KRAS mutations increased from 21% to 40%. Although time-consuming, LCM makes direct sequencing highly sensitive even on LBC preparations containing only a few cells.

Clinical trial results indicate that lenalidomide, an immunomodulatory drug, is a promising treatment in relapsed/refractory non-Hodgkin lymphoma (NHL). This retrospective multicenter study was conducted in patients with relapsed/refractory NHL treated with lenalidomide monotherapy through a Named Patient Program in Italy. Principal endpoints were overall response rate (ORR), safety and overall survival (OS). The ORR in 64 evaluable patients was 42.2\% and was similar among patients receiving 10, 15 or 25 mg/day lenalidomide. Response rates in patients with mantle cell, diffuse large B-cell and follicular lymphoma were 45.5\%, 42.1\% and 20\%, respectively. Among patients who responded to most recent prior therapy, ORR was 50.0\% versus 36.8\% in patients with refractory NHL. Mean duration of response in patients receiving any lenalidomide dose was 10.5 months; 1-year progression-free survival and OS were 50.3\% and 82.6\%, respectively. These findings suggest that lenalidomide is effective and safe for heavily pretreated patients with NHL in the clinical setting.

Currently, there is a trend towards an increasing use of liquid-based cytology (LBC) to diagnose non-small cell lung cancer. In this study, to detect epidermal growth factor receptor mutations, different molecular techniques were applied to LBC samples with and without laser capture microdissection (LCM). In 58 LBCs, DNA was extracted twice. One sample was obtained directly from CytoLyt solution, whereas the other DNA sample was derived after slide preparation and LCM of Papanicolaou-stained cells. The rate of mutant cases obtained by direct sequencing was discordant between CytoLyt-derived (10.3\%) and LCM-derived (17.2\%) DNA. However, the same mutant rate (17.2\%) was achieved on the matched samples by high-resolution melting analysis, fragment and TaqMan assays. Thus, LCM and direct sequencing may be replaced by more sensitive non-sequencing methods directly performed on CytoLyt-derived DNA, an easier and faster approach to improve epidermal growth factor receptor testing standardisation on LBCs.