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Research suggests that COVID-19-related restrictions affected individuals’ ability to engage in relationship maintenance behaviors and have led to poorer romantic relationship quality. Poor relationship quality may be especially problematic for lesbian, gay, bisexual, transgender, queer or questioning, and otherwise non-heterosexual or-cisgender (LGBTQ+) college students, who often lack family support and are at greater risk for mental health issues. We used a social exchange theory lens to examine correlates of relationship satisfaction for LGBTQ+ college students during the early months of the pandemic. The analytic sample consists of 175 LGBTQ+ students ( Mage = 20.5) who completed an online survey and reported being in a romantic relationship. Our findings demonstrate that LGBTQ+ students with more supportive partners were more satisfied with their relationships. These results can inform clinicians how to better support LGBTQ+ college couples when they experience relationship stress.

The concept of rebalanced hemostasis in cirrhosis challenges the policy of transfusing plasma or platelets before invasive procedures in patients with prolonged PT or severe thrombocytopenia. Recent guidelines recommend against plasma transfusion and suggest avoiding/minimizing platelet transfusions.We assessed how hepato-gastroenterologists manage prolonged PT/INR or severe thrombocytopenia before invasive procedures.On May 2021, AISF members were sent a questionnaire addressing the PT/INR and platelet thresholds required before invasive procedures, the use of other markers of bleeding risk or other hemostatic treatments and the burden of pre-emptive plasma and platelet transfusions.Of 62 respondents, 94% and 100% use PT/INR and platelet count to assess bleeding risk, respectively. Only 37% and 32% require less conservative PT/INR or platelet counts thresholds for low-risk procedures, respectively. As for those applying single thresholds, 68% require PT/INR1,5 and 86% require platelet counts ≥50 × 10the survey indicates lack of compliance with guidelines that advise against plasma and platelet transfusions before invasive procedures and the need for prospective studies and inter-society consensus workshops.

The entry-inhibitor Bulevirtide (BLV) received conditional approval by EMA in July 2020 for the treatment of adult patients with compensated chronic hepatitis Delta. However, the effectiveness and safety of BLV administered as monotherapy beyond 48 weeks in difficult to treat HDV cirrhotic patients is presently unknown. Here we describe the first patients with HDV-related compensated cirrhosis who were treated with BLV (10 mg/day as a starting dose) for up to three years as compassionate use. Patients were also monitored for HBcrAg and HBV-RNA levels and HDV and HBV specific T-cells markers. In the patient who stopped BLV at week 48 after achieving a virological and biochemical response, the initial virological and biochemical rebound was followed by ALT normalization coupled with low HDV-RNA and HBsAg levels. In the two patients treated continuously for 3 years, virological and biochemical responses were maintained throughout the treatment period even after dose reduction. In a patient with advanced compensated cirrhosis, liver function tests significantly improved, esophageal varices disappeared, and histological/lab features of autoimmune hepatitis resolved. Overall, no safety issues were recorded, as bile salt increase was asymptomatic. While serum HBV-RNA levels remained undetectable in all patients, HBcrAg levels showed a progressive, yet modest decline during long-term BLV-treatment. No HDV-specific Interferon-γ producing T-cells were detected, neither after HDV reactivation (after BLV withdrawn in Patient 1) nor during 3 years of BLV treatment. In conclusion, this report shows that continuous administration of BLV monotherapy for three years provides excellent virological and clinical response in HDV cirrhotic patients who had contraindications to IFN-based therapies. LAY SUMMARY: HDV-RNA levels became undetectable, and ALT normalized in all three patients treated with Bulevirtide (BLV). Virological and biochemical responses were maintained even after dose reduction.- Improvement of liver function tests, regression of esophageal varices and recovery of HDV-related autoimmune disease were documented in the male cirrhotic patient long-term treated with BLV.- An asymptomatic increase of bile acids was the only drug-related clinical adverse event.

Characteristics of emerging adulthood may make college students less likely to engage in COVID-protective behaviors, a public health concern given that lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) students may be particularly vulnerable to complications related to COVID-19. To identify individual and contextual factors related to COVID-protective behaviors among a sample of LGBTQ+ college students in the United States, we examined differences in COVID-protective and -risk behaviors by gender identity, living arrangement, statewide stay at home orders, and political liberalism of the student’s current state. Although engagement in COVID-protective behaviors was high overall, students who identified as men, did not live with a parent, lived in a state without a stay at home order, and/or lived in a less liberal state engaged in fewer COVID-protective behaviors and more frequent COVID-risk behaviors. Findings underscore the importance of clear public health messaging around COVID-protective behaviors that targets especially vulnerable college students.

The waste-to-energy (WTE) incinerator plant located in the Turin area (Italy) started to recover energy from the combustion of municipal solid waste in 2013. A health surveillance program was implemented to evaluate the potential health effects on the population living near the plant. This program included a longitudinal biomonitoring to evaluate temporal changes of some environmental pollutants, including polycyclic aromatic hydrocarbons (PAHs), in residents living in areas near the Turin incinerator (exposed group, E) compared to those observed in subjects living far from the plant (not exposed group, NE). Ten monohydroxy-PAHs (OH-PAHs), consisting in the principal metabolites of naphthalene, fluorine, phenanthrene, and pyrene, were analyzed in urines collected from the E and NE subjects after one (T

Tra i lavori di Cesa-Bianchi nell'ambito della psicologia dello sviluppo e dell'educazione, sono di particolare interesse i suoi contributi sul tema dello sviluppo atipico, sul rapporto che intrattiene il divenire del pensiero con il linguaggio nella crescita del bambino e, infine, sulle sue ultime riflessioni e indicazioni in tema di formazione del docente e dell'educatore. Particolarmente sensibile all'approccio piagetiano e maturazionista, Cesa-Bianchi non ha mancato di accogliere nella sua riflessione teorica, quanto nella ricerca scientifica, le sollecitazioni che provenivano dalla cultura post-piagetiana sin dalla prima metà del XX secolo, spingendo la sua attenzione alle dimensioni bio-psico-sociali dello sviluppo umano. Il presente lavoro ripercorre alcuni temi cardine del contributo di Cesa-Bianchi e dei suoi stretti collaboratori evidenziandone le correlazioni con lo scenario scientifico nazionale e internazionale.

Objectives To assess the feasibility and safety of a repeated SHort course Accelerated RadiatiON therapy (SHARON) regimen in the palliative setting of Head and Neck (H&N) cancer in older adults. Material and Methods Patients with histological confirmed H&N cancers, age ≥ 80 years, expected survival >3 months, and Eastern Cooperative Oncology Group (ECOG) performance status of ≤3 were enrolled. Patients were treated in cohorts of six patients: a total dose of 20 Gy was delivered in 2 consecutive days with a twice-daily fractionation (5 Gy per fraction) and at least 8-h interval. If no Grade 3 toxicity was registered, a second enrollment started with another cohort of six patients to whom were administered two cycles (total dose of 40 Gy). The primary endpoint was to evaluate the feasibility of the two cycles of treatment. Secondary endpoints were evaluation of symptoms control rate, symptoms-free survival (SFS), and Quality of Life (QoL) scores. Results Seventeen consecutive patients (median age: 85 years) were treated. Nine patients were treated with one cycle and 8 patients with two cycles. No G3 toxicity was reported in either cohort. With a median follow-up time of 4 months, 3-month SFS in the first and second cohorts was 83.3%, and 87.5%, respectively. The overall palliative response rate was 88%. Among 13 patients reporting pain, 8 (61.5%) showed an improvement or resolution of their pain. Conclusion Repeated short course accelerated radiotherapy in a palliative setting of H&N cancers is safe and well-tolerated in older adults.

Children’s behaviours during bullying episodes are associated with both interpersonal-situational variables (e.g., social status indices) and personal-dispositional variables (e.g., emotional competence). The aim of the present study was to investigate–in a group of 202 kindergarteners (age range: 3–6years)–the relationships between participants’ roles in bullying and their: 1) empathy and emotion comprehension skills; 2) social preference and social impact, while also examining the effects of their sex and age. Our main finding was that prosocial behaviours were positively related to social preference status and emotional skills; while hostile behaviours were negatively related to social preference status and positively related to social impact. Outsiders had low social impact among peers and poor emotional skills. Children who experienced victimization more frequently were markedly the least preferred in the peer group. We conclude that social impact and social preference are separate factors and play distinct roles in peer relationships from early childhood onwards.

Artery of Percheron (AOP) stroke is a rare event. We describe an AOP stroke involving both thalami and the midbrain, resulting in a multifunctional clinical impairment. Intensive inpatient multidisciplinary rehabilitation favored the recovery of motor deficits, together with the improvement of cognitive dysfunctions. MRI assessment in the chronic post-stroke phase showed structural and functional reorganization in response to the extended thalamic tissue damage and absence of revascularization. Thalamo-cortical networks involving frontal and prefrontal regions, as well as parietal areas were disrupted, whereas increased functional thalamo-occipital connectivity was found. This report sheds light on brain reorganization following AOP stroke after rehabilitation..

The finding of mirror neurons (MNs) has provided a biological substrate to a new concept of cognition, relating data on actions and perceptions not only to integrate perception in action planning and execution but also as a neural mechanism supporting a wide range of cognitive functions. Here we first summarize data on MN localization and role in primates, then we report findings in normal human subjects: functional magnetic resonance imaging and neurophysiological studies sustain that MNs have a role in motor learning and recognizing actions and intentions of others, and they also support an embodied view of language, empathy, and memory. Then, we detail the results of literature searching on MNs and embodied cognition in Parkinson's disease (PD), frontotemporal dementia (FTD)/amyotrophic lateral sclerosis (ALS), and in mild cognitive impairment (MCI)/Alzheimer's disease (AD). In PD the network of MN could be altered, but its hyperactivation might support motor and cognitive performances at least in early stages. In the ALS/FTD continuum, preliminary evidence points out to an involvement of the MN network, which could explain language and inter-subjectivity deficits shown in patients affected by these clinical entities. In the MCI/AD spectrum, a few recent studies suggest a possible progressive involvement from posterior to anterior areas of the MN network, with the brain putting in place compensatory mechanisms in early stages. Reinterpreting neurodegenerative diseases at the light of the new views about brain organization stemming from the discovery of MN could help to better comprehend clinical manifestations and open new pathways to rehabilitation.

Purpose Patients with locally advanced and metastatic esophageal cancer are usually affected by cancer-related symptoms, which worsen their performance status and quality of life. The aim of this study was to determine the efficacy of short-course accelerated radiation therapy for symptomatic palliation in a low resourced setting where only a 2-dimensional radiation therapy (RT) technique was available. Methods and Materials A phase II trial based on Simon’s 2-stage design was planned. A total dose of 12 Gy in 4 fractions, twice per day, over 2 days, ≥8 hours apart, using a 2-dimensional conventional RT technique was delivered with a Cobalt 60 unit (Equinox, Best Theratronics, Ottawa, Ontario). Symptoms were graded using the International Atomic Energy Agency scoring system. Results A total of 17 patients were treated (male/female = 10/7; median age, 50.0 years; range, 27-78 years; histology: 6 adenocarcinomas and 11 squamous cell carcinomas; tumor site: 4 gastresophageal junction and 13 esophagus). The most frequent baseline symptoms were dysphagia or regurgitation (100%), odynophagia (76%), and chest or back pain (53%). At 1 month after RT, all patients were alive with palliative response rates (complete plus partial) for dysphagia, regurgitation, odynophagia, and chest or back pain of 76%, 82%, 69%, and 56%, respectively. No patients presented acute ≥G3 toxicity. Conclusions Short-course accelerated radiation therapy treatment, planned and delivered using a conventional 2-dimensional RT technique, was effective and well tolerated for the symptomatic palliation of locally advanced or metastatic esophageal cancer. This schedule may be useful for RT centers in developing countries to reduce treatment times, costs, and patient waiting times before treatment.

The LHC experiments are undergoing important upgrades for the High Luminosity LHC project. Experiments will be required to operate under three times higher instantaneous luminosity and higher levels of radiation when compared to LHC Run2. The integrated luminosity will increase by a factor ten. To cope with these conditions resistive Micromegas chambers were chosen by the ATLAS experiment as one of the technologies for the upgrade of the first forward muon stations. This paper describes the results of two prototype Micromegas detectors that were installed in the CERN Gamma Irradiation Facility with the aim to evaluate the detector performance under high-rate irradiation and to assess ageing effects over a 2.5 year long irradiation period and an accumulated charge in excess of 0.3 C/cm$^2$.

Introduction &amp, Aim: Anti-tissue transglutaminase antibody (tTGA) titer is used during the follow-up of celiac patients to evaluate gluten-free diet (GFD) responsiveness. However, no clear data are available on this issue. The aim of this study was to evaluate tTGA significance during celiac disease (CD) monitoring. Methods: From January 2017 to January 2020, consecutive CD patients on a GFD with persistent positive tTGA were enrolled. Antibody titres were evaluated on a yearly basis from CD diagnosis to the last follow-up. Urinary gluten detection tests, duodenal histology and capsule enteroscopy (CE) were performed. A tTGA-positive cohort was compared with a control group composed of 212 treated CD patients with negative tTGA. Results: 65 patients (12% males, median age at enrollment and CD diagnosis, 37 (14–86) and 31 (1–76), respectively, median follow up 4 (1–26) years) presented with positive tTGA during follow-up. Overall, the tTGA titres were 3 (1–79) fold increased (ULN). Three different tTGA trends were recognized: (I) 36 (55%) patients with a progressive titresdecrease, (II) 16 (25%) patients with a fluctuating behavior, (III) 13 (20%) patients with a steady state or increased titres. tTGA+ patients did not present with different clinical and demographic parameters. Duodenal atrophy was present in 10% vs 36% of the tTGA positive vs negative group (p &lt, 0.005), respectively. Gluten detection results were positive in 3 (8%) cases, all in the III group. In tTGA+ patients, CE did not identify any CD-related complications. Conclusions: tTGA positivity during CD follow up did not present a relevant clinical significance without association with autoimmune comorbidities and mucosal damage.

Alexithymic traits, which entail finding it difficult to recognize and describe one’s own emotions, are linked with poor trait emotional intelligence and difficulties in identifying and managing stressors. There is evidence that alexithymia may have detrimental consequences for well-being and health, beginning in adolescence. In this cross-sectional study, we investigated the prevalence and incidence of alexithymia in teenage girls, testing the statistical power of trait emotional intelligence (TEI) and student burnout to discriminate between high- and low-alexithymic subjects. A sample of 884 female high school students (mean age 16.2 years, age range: 14-19) attending three Italian academic-track high schools (social sciences and humanities curriculum) completed self-report measures of alexithymia, school burnout, and TEI. Main descriptive statistics and correlational analysis preceded the discriminant analysis. The mean alexithymia scores suggest a high prevalence of alexithymia in female adolescents; as expected, this trait was negatively correlated with TEI and positively associated with school burnout. Participants with high vs low alexithymia profiles were discriminated by a combination of TEI and burnout scores. High scores for the emotionality and self-control dimensions of TEI were strongly associated with membership of the low alexithymia group; high scores for the emotional exhaustion dimension of school burnout were indicative of membership of the high alexithymia group. These findings suggest crucial focuses for educational intervention: efforts to reduce the risk of emotional exhaustion and school burnout should especially concentrate on enhancing emotional awareness and self-control skills, both strongly associated with low levels of alexithymia.

The paper aims to present a curriculum for a parent training course on preventing violence against children (VAC). The training course was developed into a multi-site cross-national project framework involving five European countries (Italy, Turkey, Greece, Lithuania, and Spain). A needs analysis was conducted in each local context by using semi-structured in-depth interviews. Sixty-two parents have been reached, and the interviews were analyzed using a bottom-up exploratory research approach and thematic analysis. The meta-synthesis of the data highlighted the need for standardized cultural- sensitive training programs based on more information about child development and VAC and strategies to address children's behaviors positively. According to the needs analysis, four modules (M) were designed: Information on children's rights and protection (M1), Self-reflection: parental perception and children protection (M2), Positive parenting and relational skills (M3), and Conclusion and assessment (M4). The contribution will offer an example of curriculum design for the prevention of VAC to help to disseminate and promote a new awareness on the topic and the importance of supporting parents as a first step in the prevention of VAC.

Objective: To assess the accuracy of noninvasive parameters, fecal calprotectin (FC), increased bowel wall thickening (BWT) at intestinal ultrasound (IUS) and blood inflammatory indexes (BII), alone or in combination, as diagnostic tools for inflammatory bowel disease (IBD) in pediatric patients. Methods: Retrospective data were collected on consecutive children (age 2–18 years) referred to our pediatric gastroenterology clinic, for recurrent abdominal pain and/or altered bowel habit from 2007 to 2013. Subjects who had diagnostic workup: laboratory tests (FC, BII, white blood cell (WBC), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) and IUS as initial assessment were eligible. Subjects with known gastrointestinal (GI) diseases, or signs or symptoms highly suggestive for organic diseases necessitating prompt endoscopy (e.g., perianal disease or rectal bleeding), or who had recently performed endoscopy were excluded. The accuracy of noninvasive tests for detecting IBD was assessed using endoscopic and/or radiological investigations, performed in subsequent clinical follow up, as reference gold standard. Results: Seventy-seven patients (mean age 11.3, 44 males) were included, 23 (29.9%) with a final diagnosis of IBD. As single tests, FC gave the highest sensitivity (96%) but lower specificity (72%) and IUS highest specificity (96%) with lower sensitivity (70%). The combination of FC + IUS showed excellent accuracy for detecting children with IBD with positive predictive value: 100%; negative predictive value: 88.5%. The probability of IBD in children with normal FC, BII and IUS was 0.09%. Conclusions: FC and increased BWT at IUS are accurate to guide reassurance or proceeding with further invasive procedures for detecting IBD in children with mild GI symptoms.

To assess the outcome of malignant pleural mesothelioma patients treated with extra-pleural pneumonectomy (EPP) and adjuvant radiotherapy (RT), using the most advanced radiotherapeutic techniques, namely image-guided intensity-modulated RT (IG-IMRT). Fifty-four patients were analyzed. Minimum radiation dose was 50 Gy (2 Gy/fr). Planning target volume encompassed the entire hemithorax, including the ipsilateral mediastinum if interested by disease, the pericardium and diaphragm, and any drain sites. The study endpoints included loco-regional control (LRC), distant metastases free survival (DMFS), and overall survival (OS), as well as radiation-related toxicity. Major patients and treatment characteristics were the following: median age 62 years, epithelioid histology in 51 (94%) cases, locally advanced disease in 41 (90%) cases, and metastatic mediastinal lymph nodes in 27 patients (50%). Only 7 patients (13%) had gross residual disease after surgery. Chemotherapy was administered in 38 patients (70%). Median follow-up was 16 months (range 0–73 months). Median and 2-year OS were 21 months and was 43.8%, respectively. The predominant pattern of failure was distant: 34 patients (62.9%) developed some component of distant failure, and only 5 patients (9.2%) developed an isolated loco-regional recurrence. The estimates of LRC and DMFS at 2 years were 63.4% and 43.4%, respectively. Three fatal pneumonitis were documented. Other major toxicities included: Grade 2 and 3 pneumonitis in 1 and 2 cases, respectively, 1 case of bronchial fistula, pleural empyema, and Grade 3 esophagitis, respectively. Although executed in the era of high-technology radiotherapy (IG-IMRT), EPP should not be routinely performed.

Students' school burnout has been extensively investigated in relation to interpersonal factors such as peer relations and social adjustment. However, few studies have examined the role of individual traits such as empathic skills. Our aim in this study was to test, within a single comprehensive model, how students' empathic skills affect their levels of school burnout, both directly and indirectly via satisfaction with school relationships. A sample of 998 high school students (aged 14 to 19 years) took part in this cross-sectional study. Participants completed quantitative self-report measures of school burnout, empathic skills (both cognitive and affective), and satisfaction with school relationships (peers and teachers). Using structural equation modeling, we tested a conceptual model in which emphatic skills were hierarchically associated with satisfaction about school relationships and school burnout, while also controlling for age. The structural equation model offered an excellent fit for the empirical data. Analysis of the total, direct, and indirect effects showed that empathic skills were associated with both satisfaction about school relationships and school burnout. Satisfaction with school relationships appeared to mediate the relationship between empathy and school burnout. Students' age was also found to have statistically significant effects. The negative effect of high school students' empathic skills on their risk of school burnout may be prevented or at least reduced by helping them to develop positive and satisfying relationships with both teachers and peers.

The main aim of the current study was to investigate the role of trait emotional intelligence (TEI) in preventing students&rsquo, school burnout directly and indirectly via anxiety and academic resilience. The data were derived from a sample of 1235 high school students (962 females and 273 males), ranging in age between 13 and 17 years (mean = 15.46, stand deviation = 1.22). Structural equation modelling revealed a strong indirect effect of TEI on school burnout, mediated via anxiety and resilience. Overall, students with high TEI were less likely to experience school anxiety and more likely to exhibit resilience which, in turn, reduced school burnout risk. Findings are discussed with reference to the wider role of TEI in educational contexts and highlight the need and potential for scientifically driven interventions to enhance emotional adjustment at school and in life, more generally.

The practice of modern medicine in cancer treatment is moving toward an increasingly tailored approach. Current therapeutic strategies require careful pretreatment stratification and timely and effective monitoring during and after therapy, in order to maximize patient benefit. Accordingly, there is an increasing need to non-invasively delineate individual patient characteristics, with particular attention to the tumor biology underlying cellular and extra-cellular mechanisms involved in the development and progression of the disease, as well as in treatment response. For this purpose, one of the major priorities in oncological research has been identified in developing increasingly sensitive and specific imaging biomarkers for noninvasive characterization of cancer-related features. Different imaging methods are currently being developed in experimental murine models of human diseases in order to identify and implement innovative biomarkers with the perspective of clinical translation.

Metastases with soft tissues invasion, impending fractures or spinal cord compression (complicated bone metastases) represent a common clinical problem in advanced cancers and frequently lead to deterioration of patients' quality of life (QoL). A phase I-II study was planned to define the maximum tolerated dose (MTD) of a short-course radiotherapy (RT) and its efficacy in palliation of complicated bone metastases. A phase I trial was designed with three dose-escalation steps: 16, 18, and 20Gy. Total dose at each level was delivered in 2 days, twice daily. Eligibility criteria were painful complicated bone metastases and ECOG performance status ≤ 3. The presence of acute toxicity ≥ Grade 3 (RTOG scale) was considered the dose limiting toxicity. The MTD was used to plan a phase II trial with pain response as the primary outcome. Pain was recorded using a Visual Analogic Scale (VAS), and QoL using CLAS scales. Forty-five patients were enrolled in this trial. In phase I no Grade ≥ 2 acute toxicities were recorded. Thus 20Gy was established as MTD. In phase II, with a median follow-up of 4 months, rates of complete symptom remission, partial response, no symptomatic change, and symptoms progression were 32.0%, 52.0%, 8.0%, and 8.0%, respectively. This RT protocol tested in our study is effective and tolerable with comparable results to traditional RT treatments delivered in 5-10 daily fractions.

The big data approach offers a powerful alternative to Evidence-based medicine. This approach could guide cancer management thanks to machine learning application to large-scale data. Aim of the Thyroid CoBRA (Consortium for Brachytherapy Data Analysis) project is to develop a standardized web data collection system, focused on thyroid cancer. The Metabolic Radiotherapy Working Group of Italian Association of Radiation Oncology (AIRO) endorsed the implementation of a consortium directed to thyroid cancer management and data collection. The agreement conditions, the ontology of the collected data and the related software services were defined by a multicentre ad hoc working-group (WG). Six Italian cancer centres were firstly started the project, defined and signed the Thyroid COBRA consortium agreement. Three data set tiers were identified: Registry, Procedures and Research. The COBRA-Storage System (C-SS) appeared to be not time-consuming and to be privacy respecting, as data can be extracted directly from the single centre's storage platforms through a secured connection that ensures reliable encryption of sensible data. Automatic data archiving could be directly performed from Image Hospital Storage System or the Radiotherapy Treatment Planning Systems. The C-SS architecture will allow "Cloud storage way" or "distributed learning" approaches for predictive model definition and further clinical decision support tools development. The development of the Thyroid COBRA data Storage System C-SS through a multicentre consortium approach appeared to be a feasible tool in the setup of complex and privacy saving data sharing system oriented to the management of thyroid cancer and in the near future every cancer type.

Radio-chemotherapy (RCT) is the primary treatment of anal cancer (AC). However, the role and the optimal total dose of a radiation boost is still unclear. No randomized controlled trials nor systematic reviews have been performed to analyze the efficacy of brachytherapy (BRT) as boost in AC. Therefore, we performed this systematic review based on PRISMA methodology to establish the role of BRT boost in AC. A systematic search of the bibliographic databases: PubMed, Scopus, and Cochrane library from the earliest possible date through January 31, 2018 was performed. At least one of the following outcomes: local control (LC), loco-regional control (LRC), overall survival (OS), disease-free survival (DFS), or colostomy-free survival (CFS) had to be present for inclusion in this systematic review in patients receiving a BRT boost. Data about toxicity and sphincter function were also included. Ten articles fulfilled the inclusion criteria. All the studies had retrospective study design. All studies were classified to provide a level of evidence graded as 3 according to SIGN classification. Median 5-year LC/LRC, CFS, DFS, and OS were: 78.6% (range, 70.7-92.0%), 76.1% (range, 61.4-86.4%), 75.8% (range, 65.9-85.7%), and 69.4% (63.4-82.0%), respectively. The reported toxicities were acceptable. RCT is the treatment cornerstone in AC. High-level evidences from studies on BRT boost in AC are lacking. Further studies should investigate: efficacy of BRT boost in comparison to no boost and to external beam boost, patients who can benefit from this treatment intensification, and optimal radiation dose.

Background/aim The primary endpoint of this phase I study was the maximum tolerated dose (MTD) of middle half body (MHB) accelerated radiotherapy (RT) in multiple bone metastatic (BM) prostate cancer (PCa) patients. Patients and methods Three step dose escalation [13 Gy (3.25 Gy/fraction), 14 Gy (3.5 Gy/fraction), and 15 Gy (3.75 Gy/fraction)] in three consecutive patient cohorts were planned. RT was delivered in two consecutive days and two daily fractions. Six patients were enrolled in the first two cohorts and 12 in the third cohort. Grade ≥3 toxicity was considered as a dose-limiting toxicity (DLT). Results Twenty-five patients (median age=71 years, median follow-up=7.4 months) were enrolled. Defined MTD dose was 15 Gy. Overall pain response rate was 76%: 9 patients (36%) showed complete and 10 patients (40%) reported partial response of pain. Conclusion MHB accelerated RT (total dose: 15 Gy) delivered in two consecutive days and two daily fractions is well tolerated.

Aim To define safety and efficacy of a palliative, short-course accelerated radiation therapy for symptomatic locally advanced primary pelvic cancer. Materials and methods A phase II trial was planned based on the minimax Simon's two-stage design. A total of 18 Gy in 4.5 Gy/fraction administered twice a day was delivered (SHARON). Pain and quality of life were recorded according to the Visual Analogue self-assessment and the cancer linear analog scales (CLAS), respectively. Results Twenty-five patients were enrolled in the study. The most frequent baseline symptoms were pain (48%), bleeding (40%), bleeding/pain (8%), and intestinal sub-occlusion (4%). The overall palliative response rate was 96.0%, with a median palliative duration of 6 months. An improvement of quality-of-life indices (well-being, fatigue, and ability to perform daily activities) was noted in 64.0%, 36.0%, and 48.0% of patients, respectively. Conclusion The SHARON regimen was well tolerated and effective in the palliative treatment of patients with locally advanced pelvic cancer. Based on these results, a multicentric prospective phase III trial is ongoing to compare this regimen with traditional 2-week radiotherapy treatment.

BACKGROUND Controversial results have shown a significant association with either low or high total testosterone (tT) levels and high risk prostate cancer (PCa). We tested the relationship between circulating tT and grade group 5 (G5) PCa at radical prostatectomy (RP) in patients with preoperative low- to intermediate-risk disease. METHODS Serum sex hormones were assessed the day before RP in a cohort of 846 patients with low- to intermediate-risk PCa. Patients were segregated using the new 5-tiered Gleason grade groups. Restricted cubic spline functions and logistic regression analyses tested the association between sex hormones and G5 PCa. Differences in potential predictive accuracy (PA) were assessed for tT and prostate-specific antigen (PSA) levels. RESULTS Overall, 27 men (3.2%) had G5 PCa at RP, and this group had higher PSA values than patients with G1-G4 PCa (P = 0.02). The groups did not differ in terms of preoperative mean hormonal values. Both low and high circulating tT values depicted a nonlinear U-shaped correlation with G5 PCa at RP. The lowest and highest (10th and 90th percentiles) tT values and biopsy PCa grade emerged as multivariable independent predictors of G5 PCa at RP (all P

Introduction Several definitions of erectile function (EF) recovery after bilateral nerve-sparing radical prostatectomy (BNSRP) have been proposed based on the results of the International Index of EF (IIEF). Aim We aimed at evaluating overall satisfaction (OS) after BNSRP according to the ability to achieve the pretreatment EF. Methods We evaluated data of 652 patients treated with BNSRP for clinically localized prostate cancer (PCa). Erectile dysfunction (ED) was classified according to the IIEF-EF domain score. Return to baseline EF was defined as patients who reached the same preoperative ED category during the 3-year follow-up. Cox regression analyses were fitted to predict return to baseline IIEF-EF and to predict OS defined according to the IIEF-OS in the overall population. Logistic regression analyses were performed to analyze OS in men who reached the back to baseline status. Main Outcome Measures The outcome of the study was to evaluate back to baseline EF status and to correlate it with postoperative OS. Results Preoperative satisfaction was reported by 218 (33.4%) patients. Postoperative satisfaction was achieved by 103 patients. Overall, 383 patients were able to achieve the preoperative IIEF-EF score. However, only 26.9% reported being satisfied. Age and preoperative IIEF-EF score were significantly associated with baseline IIEF-EF recovery (all P ≤ .02). Patients who were able to return to baseline IIEF-EF were more likely to be satisfied (P < .001). Time elapsed between surgery and achievement of baseline IIEF-EF was significantly associated with OS (P < .001). Among patients who were able to achieve the baseline IIEF-EF score, a preoperative IIEF-EF of 22–25 and 26–30 was significantly associated with postoperative satisfaction (all P < .001). Conclusion After BNSRP, reaching the baseline IIEF-EF score is not always sufficient to obtain patient satisfaction. Only patients with a preoperative IIEF-EF ≥22 who reached the baseline score after surgery considered themselves satisfied. This should be taken into account in preoperative patient counseling.

Resistive Micromegas, originally developed for the upgrade of the muon system of the ATLAS experiment at LHC, are nowadays used in numerous applications and considered for future experiments as well as upgrades of existing ones. It is then of paramount importance to assess their ageing properties and the behavior under high irradiation. Two resistive Micromegas detectors have been installed in the Gamma Irradiation Facility (GIF++) at CERN in 2015 and continuously operated with a Ar:CO 2 93:7 gas mixture. The detectors have accumulated 0.3 C/cm2, corresponding to a charge equivalent to about 15 years of operations at the highest particle rate expected in Muon systems at High Luminosity LHC runs. The detector current has been constantly monitored over the three years of irradiation. The efficiency for muon detection has been measured before and after the irradiation. Finally, the detector performance, in particular resolution and gain, has been measured as a function of photon background rate with a muon beam combined with a photon background. Based on these results we conclude that the resistive Micromegas under study have a rate capability well beyond 50 kHz/cm2 and did not show any significant performance degradation due to ageing.

The purpose of the present study was to propose an optimized 2D technique (2D-conformal) for radiotherapy (RT) of pancreatic cancer (CaP). This technique is based on double simulation which resolves the problems of radiographic image distortion. Five patients with locally advanced CaP were identified and enrolled. Treatment planning was simulated in 3 different ways: Two dimensional-standard (2D-SRT), 2D-conformal (2D-CRT), and three dimensional-conformal (3D-CRT) techniques for 10 MV LINAC. Simulation for a cobalt machine was also performed using only the 2D techniques. 2D-SRT technique was planned with fields definition based on anatomical landmarks (bone and duodenum). 3D-CRT was planned with standard virtual simulation technique, and 3D dose evaluation and optimization. 2D-CRT technique was based on manual information transfer from a diagnostic CT-scan to simulation radiograms. To eliminate the X-ray image distortion, a double simulation was employed and the profile of the GTV was delineated on radiographs bearing the simulator isocenter into the target center. Concerning target irradiation of either LINAC (10 MV) or cobalt source, the PTV constraints (ICRU 62) were met in all patients (Dmin >95%, Dmax

Aim To determine the maximum tolerated dose (MTD) of a short-course accelerated radiotherapy and its feasibility for symptomatic palliation of advanced head and neck cancer or head and neck metastases from any primary site. Patients and methods A phase I trial in four dose-escalation steps was planned: total dose ranged between 14 and 20 Gy in a total of four fractions administered twice a day. The dose-limiting toxicity (DLT) was determined as grade 3 or more toxicity occurring during treatment. The MTD obtained was used to plan a phase II trial. Results A total of 48 patients were treated. In the phase I trial, the 20 Gy dose level was determined to be the MTD. In the phase II trial, the palliative response rate was 82.7%, with a median duration of palliation of 3 months. Conclusion Short-course accelerated radiotherapy was well tolerated and effective for palliation. These findings may help design future prospective randomized studies.

This study investigated the utilitarian and emotion-related components of morality, both as a function of gender and age and in relation to hostile vs. pro-social behaviors in bullying. We presented 45 primary and 62 middle school students with different types of moral and control dilemmas to assess their acceptance of utilitarian behaviors that did or did not violate moral norms (with high or low emotional involvement) in relation to their propensity to assume hostile and/or pro-social roles. We found greater acceptance of utilitarian solutions to dilemmas in boys, older children and those inclined to take on hostile roles. An inverse association was found between utilitarian styles and pro-social roles, particularly when utilitarian thinking violated a moral norm with high emotional involvement. We discuss these results in terms of different functioning styles in typically developing children.

Resistive strip Micromegas detectors have already proved to be suitable for precision tracking in dense particle rate environment up to few kHz/cm2. In order to achieve higher rate capability, with low occupancy, fine-segmented strips could be replaced by few mm2 pads. A first prototype, with readout and resistive pads connected by resistors embedded in an insulating layer, has been constructed at CERN and first performance studies are presented.