The first implementation of the AGATA spectrometer consisting of five triple germanium detector clusters has been installed at Laboratori Nazionali di Legnaro, INFN. This setup has two major goals, ...the first one is to validate the
γ
-
tracking
concept and the second is to perform an experimental physics program using the stable beams delivered by the Tandem–PIAVE-ALPI accelerator complex. A large variety of physics topics will be addressed during this campaign, aiming to investigate both neutron and proton-rich nuclei. The setup has been designed to be coupled with the large-acceptance magnetic-spectrometer PRISMA. Therefore, the in-beam prompt
γ
rays detected with AGATA will be measured in coincidence with the products of multinucleon-transfer and deep-inelastic reactions measured by PRISMA. Moreover, the setup is versatile enough to host ancillary detectors, including the heavy-ion detector DANTE, the
γ
-
ray
detector array HELENA, the Cologne plunger for lifetime measurements and the Si-pad telescope TRACE. In this paper the design, characteristics and performance figures of the setup will be described.
Purpose
Randomized trials show that liraglutide 1.8 mg is more effective than 1.2 mg in reducing HbA1c, but dose escalation is neither routinely considered nor recommended by some guidelines. We ...report real world data on the effects of dose-escalating liraglutide from 1.2 to 1.8 mg.
Methods
In a pseudo-prospective, case–control study, patients who underwent liraglutide dose escalation to 1.8 mg for not having met individualized targets while on the 1.2 mg dose (
n
= 52) were compared to matched patients who remained on 1.2 mg (
n
= 52) for having shown good response, as defined by the patient’s own diabetologist. HbA1c was recorded at ≤6-month intervals until the end of observation.
Results
The two groups were matched for all clinical characteristics, including baseline HbA1c (8.5 %). During a 12-month follow-up, patients who remained on liraglutide 1.2 mg showed a maximal HbA1c reduction of 1.29 ± 0.15 %. Patients who escalated to 1.8 mg showed a lower HbA1c reduction during therapy with 1.2 mg than controls (0.58 ± 0.16 %;
p
= 0.0017). Escalation to 1.8 mg resulted in a further HbA1c reduction of 0.62 ± 0.17 %. During a total 18-month follow-up, patients who escalated to 1.8 mg showed a total maximal HbA1c reduction of 0.84 ± 0.22 %. At the end of the observation, HbA1c was 7.54 ± 0.17 % in patients who remained on 1.2 mg and 7.92 ± 0.21 in patients who escalated to 1.8 mg (
p
= 0.13). Escalation to 1.8 mg also helped further body weight reduction.
Conclusions
Escalating liraglutide dose to 1.8 mg in patients who responded less than expected to 1.2 mg helps in reducing HbA1c and reaching therapeutic targets.
Aim
To compare effectiveness of dapagliflozin versus DPP-4 inhibitors on individualized HbA1c targets and extra-glycaemic endpoints among elderly patients with type 2 diabetes (T2D).
Methods
This was ...a multicentre retrospective study on patients aged 70–80 years with HbA1c above individualized target and starting dapagliflozin or DPP-4 inhibitors in 2015–2017. The primary outcome was the proportion reaching individualized HbA1c targets. Confounding by indication was addressed by inverse probability of treatment weighting (IPTW), multivariable adjustment (MVA), or propensity score matching (PSM).
Results
Patients initiating dapagliflozin (
n
= 445) differed from those initiating DPP-4i (
n
= 977) and balance between groups was achieved with IPTW or PSM. The median follow-up was 7.5 months and baseline HbA1c was 8.3%. A smaller proportion of patients initiating dapagliflozin attained individualized HbA1c target as compared to those initiating DPP-4 inhibitors (RR 0.73,
p
< 0.0001). IPTW, MVA, and PSM yielded similar results. Between-group difference in the primary outcome was observed among patients with lower eGFR or longer disease duration. Dapagliflozin allowed greater reductions in body weight and blood pressure than DPP-4 inhibitors.
Conclusions
Elderly patients with T2D initiating dapagliflozin had a lower probability of achieving individualized HbA1c targets than those initiating DPP-4 inhibitors but displayed better improvements in extra-glycaemic endpoints.
We investigated the Phase Change Memory (PCM) capabilities of In-doped Sb nanowires (NWs) with diameters of (20-40) nm, which were self-assembled by Metalorganic Chemical Vapor Deposition (MOCVD) via ...the vapor-liquid-solid (VLS) mechanism. The PCM behavior of the NWs was proved, and it was shown to have relatively low reset power consumption (~ 400 μW) and fast switching capabilities with respect to standard Ge-Sb-Te based devices. In particular, reversible set and reset switches by voltage pulses as short as 25 ns were demonstrated. The obtained results are useful for understanding the effects of downscaling in PCM devices and for the exploration of innovative PCM architectures and materials. Keywords: Phase change memories, Nanowires, MOCVD, In-Sb, TEM, XRD
Abstract Background Patients with diabetes are at increased cardiovascular risk. Simultaneous pancreas–kidney transplantation (SPKT) is the treatment of choice in patients with type 1 diabetes ...mellitus and diabetic nephropathy. We assessed coronary flow reserve (CFR) by transthoracic echocardiography as a marker of major adverse cardiac events (MACE) in SPKT patients. Methods We studied 48 consecutive SPKT patients (28 male, age at SPKT 54 ± 8 years). Time from transplantation was 8.5 ± 3 years. Follow-up was 4.6 ± 1.8 years. Coronary flow velocity in the left anterior descending coronary artery was detected by Doppler echocardiography at rest and during adenosine infusion. CFR was the ratio of hyperemic diastolic flow velocity (DFV) to resting DFV. A CFR ≤ 2 was considered abnormal and a sign of coronary microvascular dysfunction. MACE were cardiac death, myocardial infarction, and heart failure. Results CFR was 2.55 ± 0.8. CFR was ≤2 in 13 (27%) patients. CFR was lower in SPKT patients with MACE (2.1 ± 0.7 vs 2.7 ± 0.8, P = .03) and patients with MACE had a higher incidence of CFR ≤ 2 ( P = .03). Time from transplantation was shorter in patients with MACE ( P < .0001). Patients with CFR ≤ 2 had a lower MACE-free survival ( P = .03). CFR ≤ 2 predicted the risk of MACE ( P = .007) independently from coronary artery disease and metabolic control. However, this predicted role is lost when adjusted for the time from transplantation, which plays a protective role ( P = .001). Conclusions In SPKT, CFR ≤ 2 may be a reliable marker for MACE, independent of coronary artery disease diagnosis. However, this role seems to be reduced over time. This finding suggests a gradual reduction of cardiovascular risk in SPKT patients.
A new Radioactive Ion Beam (RIB) facility (SPES) is presently under construction at the Legnaro National Laboratories of INFN. The SPES facility is based on the ISOL method using an UCx Direct Target ...able to sustain a power of 8 kW. The primary proton beam is provided by a high current Cyclotron accelerator with energy of 35-70 MeV and a beam current of 0.2-0.7 mA. Neutron-rich radioactive ions are produced by proton induced fission on an Uranium target at an expected fission rate of the order of 1013 fissions per second. After ionization and selection the exotic isotopes are re-accelerated by the ALPI superconducting LINAC at energies of 10A MeV for masses in the region A=130 amu. The expected secondary beam rates are of the order of 107 - 109 pps. Aim of the SPES facility is to deliver high intensity radioactive ion beams of neutron rich nuclei for nuclear physics research as well as to be an interdisciplinary research centre for radio-isotopes production for medicine and for neutron beams.
This paper describes the entrance detector of the magnetic spectrometer PRISMA recently installed at Legnaro. The detector is based on rectangular (
80
×
100
mm
2
) Micro-Channel Plates (MCP). It ...provides a fast time signal and its position-sensitive anode allows to extract the
X
and
Y
information. It exploits an electrostatic field for the acceleration of secondary electrons from a thin Carbon foil (
≃
20
μ
g
/
cm
2
) onto the MCP assembly. The electrons are guided by a parallel magnetic field. Good performances were obtained in the laboratory tests. The detector is presently installed at the entrance of PRISMA and gives resolutions
⩽
400
ps
in time, and 1
mm in both
X
and
Y
-axes, with efficiency
≃
100
%
, in typical experiments with heavy-ion beams.
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