Currently, for the EU DEMO, two Breeding Blankets (BBs) have been selected as potential candidates for the integration in the reactor. They are the Water Cooled Lithium Lead and the Helium Cooled ...Pebble Bed BB concepts. The two BB variants together with the associated ancillary systems drive the design of the overall plant. Therefore, a holistic investigation of integration issues derived by the BB and the installation of its ancillary systems has been performed. The issues related to the water activation due to the 16N and 17N isotopes and the impact on the primary heat transfer systems have been investigated providing guidelines and dedicated solution for the integration of safety devices as isolation valves. The tritium retention and the permeation rates through the blanket and its ancillary systems have been also assessed taking into account different operating points both for the BB and ancillaries and comparing, when possible, the releases with the operating and safety limits. Moreover, the issues related to the tritium start-up inventory as well as the uncertainties on the Tritium Breeding Ratio (TBR) due to the integration of the auxiliary systems within the Vacuum Vessel have been also studied. Finally, the impact of the BB concepts on the safety systems like the Vacuum Vessel Pressure Suppression System is described with a particular focus on the different measures that should be implemented according to the considered concept. All these aspects are then taken into account to drive future developments during the Concept Design Phase.
Accurate assessment of polyphenol intakes is needed in epidemiologic research in order to study their health effects, and this can be particularly challenging in international study settings.
The ...purpose of this work is to describe the procedures to prepare a comprehensive polyphenol food-composition database that was used to calculate standardized polyphenol intakes from 24-h diet recalls (24HDRs) and dietary questionnaires (DQs) in the European Prospective Investigation into Cancer and Nutrition (EPIC).
With the use of the comparable food classification and facet-descriptor system of the computerized 24HDR program EPIC-Soft (renamed GloboDiet), foods reported in the 24HDR (n = 74,626) were first aggregated following a stepwise process. Multi-ingredient and generic foods were broken down into ingredients or more-specific foods with consideration of regional consumption habits before matching to foods in the Phenol-Explorer database. Food-composition data were adjusted by using selected retention factors curated in Phenol-Explorer. DQ foods (n = 13,946) were matched to a generated EPIC 24HDR polyphenol-composition database before calculation of daily intakes from the 24HDR and DQ.
Food matching yielded 2.0% and 2.7% of foods with missing polyphenol content in the 24HDR and DQ food data sets, respectively. Process-specific retention factors for 42 different polyphenol compounds were applied to adjust the polyphenol content in 35 prioritized Phenol-Explorer foods, thereby adjusting the polyphenol content in 70% of all of the prepared 24 food occurrences. A detailed food-composition database was finally generated for 437 polyphenols in 19,899 aggregated raw and prepared foods reported by 10 EPIC countries in the 24HDR.
An efficient procedure was developed to build the most-comprehensive food-composition database for polyphenols, thereby standardizing the calculations of dietary polyphenol intakes obtained from different dietary assessment methods and European populations. The whole database is accessible online. This procedure could equally be used for other food constituents and in other cohorts.
Introduction
On March 13th 2020, in execution of the Law Decree 14/2020 regarding the reorganization of National Health Care related to COVID-19 emergency, all non-urgent outpatient healthcare ...services were suspended in Italy. The present work describes remote support and online group psychotherapy set in motion during COVID-19 emergency for outpatients with Binge Eating Disorder.
Objectives
Aim of the present work is to describe and evaluate online support and group psychotherapy for outpatients with Binge Eating Disorder during lockdown due to COVID-19 emergency. Outcomes were evaluated by remote administration of questionnaires.
Methods
20 outpatients with Binge Eating Disorder, treated by psychotherapists of Hospital Psychology Unit in Psychiatry Day Hospital of an Italian General Hospital, received remote support by phone calls and online group psychotherapy from march to may 2020. During the first two weeks, patients were supported via phone calls. From the third week on, they took part to online group psychotherapy sessions, held every week at the same day and time. Pre-post remote administration of Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and the Questionnaire of Eating Behaviours (Scheda dei Comportamenti Alimentari, SCA) was used to evaluate outcomes. Data were analyzed by Student’s t-test.
Results
No significant difference was found, thus indicating stability of symptomatology.
Conclusions
Lockdown was a highly stressful period, in which many people lost control on eating behaviours and those with Binge Eating Disorder were expected to have an exacerbation of symptoms. Remote support and online group psychotherapy proved effective in protecting patients from a possible aggravation of their condition.
The aim of our study is to correlate the CT adipose tissue distribution and recurrence risk of Prostatic Cancer (PCa) after Radical Prostatectomy (RP). Furthermore, we evaluated the association of ...adipose tissue and PCa aggressiveness.
We identified two groups of patients based on presence (group A) and absence (group B or control group) of Bio-chemical Recurrence (BCR) after RP. A semi-automatic function able to recognize the typical attenuation values of adipose tissue was used for sub-cutaneous (SCAT), visceral (VAT), total (TAT) and periprostatic (PPAT) adipose tissues. For both groups of patients, a descriptive analysis of continuous variables and categorical variables was performed.
After comparing between groups, a statistically significant difference was found for VAT (p<0.001) and for VAT/TAT ratio (p=0.013). No statistically significant correlation was found for PPAT and SCAT, even if higher values were found in patients with high grade tumors.
This study confirms visceral adipose tissue as a quantitative imaging parameter related to oncological risk of PCa recurrence development, and the role of abdominal fat distribution measured with CT before RP as an important tool to predict the PCa recurrence risk, particularly in patients with high grade tumors.
El objetivo de nuestro estudio es correlacionar la distribución del tejido adiposo en la TC y el riesgo de recurrencia del cáncer de próstata (CaP) después de la prostatectomía radical (PR). Además, evaluamos la asociación del tejido adiposo y la agresividad del CaP.
Identificamos dos grupos de pacientes en función de la presencia (grupo A) y la ausencia (grupo B o grupo de control) de recidiva bioquímica (RBQ) tras la PR. Se utilizó una función semiautomática capaz de reconocer los valores de atenuación típicos del tejido adiposo para el tejido adiposo subcutáneo (TAS), visceral (TAV), total (TAT) y periprostático (TAP). Para ambos grupos de pacientes se realizó un análisis descriptivo de las variables continuas y categóricas.
Al comparar los dos grupos, hubo una diferencia estadísticamente significativa para el TAV (p<0,001) y para la proporción TAV/TAT (p=0,013). No se encontró una correlación estadísticamente significativa para el TAP y el TAS, aunque se encontraron valores más altos en los pacientes con tumores de grado alto.
Este estudio confirma que el tejido adiposo visceral es un parámetro de imagen cuantitativo relacionado con el riesgo oncológico de desarrollo de recidiva del CaP, y el papel de la distribución de la grasa abdominal en la TC antes de la PR como una herramienta importante en la predicción del riesgo de recidiva del CaP, particularmente en pacientes con tumores de alto grado.
Assess multiparametric-MRI (mp-MRI) diagnostic accuracy in the detection of local recurrence of Prostate Cancer (PCa) after Radical Prostatectomy (PR) and before Radiation Therapy (RT).
A total of ...188 patients underwent 1.5-T mp-MRI after RP before RT. Patients were divided into two groups: with biochemical recurrence (group A) and without but with high risk of local recurrence (group B). Continuous variables were compared between two groups using T-Student; categoric variables were analyzed using Pearson chi-square. ROC analysis was performed considering PSA before RT, ISUP, pT and pN as grouping variables.
PCa recurrence (reduction of PSA levels after RT) was 89.8% in the group A and 80.3% in the group B. Comparing patients with and without PCa recurrence, there was a significant difference in PSA values before RT for group A and for PSA values before RT and after RT for group B. In group A, there was a significant correlation between PSA before RT and diameter of recurrence and between PSA before RT and time spent before recurrence. The mp-MRI diagnostic accuracy in detecting PCa local recurrence after RP is of 62.2% in group A and 38% in group B. DWI is the most specific MRI-sequence and DCE the most sensitive. For PSA = 0.5 ng/ml, the AUC decreases while sensitivity and accuracy increase for each MRI-sequence. For PSA = 0.9 ng/ml, DCE-AUC increases significantly.
mp-MRI should always be performed before RT when a recurrence is suspected. New scenarios can be opened considering the role of DWI for PSA ≤ 0.5 ng/ml.
Evaluar la precisión diagnóstica de la resonancia magnética multiparamétrica (RMmp) en la detección de la recidiva local del cáncer de próstata (CaP) después de la prostatectomía radical (PR) y antes de la radioterapia (RT).
Un total de 188 pacientes se sometieron a una RMmp de 1,5 T después de la PR y antes de la RT. Los pacientes se dividieron en dos grupos: con recidiva bioquímica (grupo A), y sin recidiva bioquímica, pero con alto riesgo de recidiva local (grupo B). Las variables continuas se compararon entre los dos grupos mediante la prueba T-Student; las variables categóricas se analizaron mediante Chi-Cuadrado de Pearson. El análisis ROC se realizó considerando como variables de agrupación el PSA antes de la RT, el grado ISUP, el pT y el pN.
La recidiva del CaP (reducción de los niveles de PSA después de la RT) fue del 89,8% en el grupo A y del 80,3% en el grupo B. Al comparar los pacientes con y sin recidiva del CaP, hubo una diferencia significativa en los valores de PSA antes de la RT para el grupo A, y en los valores de PSA antes y después de la RT para el grupo B. En el grupo A hubo una correlación significativa entre el PSA antes de la RT y el diámetro de la recidiva, y entre el PSA antes de la RT y el tiempo transcurrido hasta la recidiva. La precisión diagnóstica de la RMmp en la detección de la recidiva local del CaP tras la RT es del 62,2% en el grupo A y del 38% en el grupo B. La imagen potenciada en difusión (DWI por Diffusion Weighted Imaging) es la secuencia de RM más específica y la perfusión dinámica con contraste (DCE por Dynamic Contrast Enhanced) la más sensible. Para el PSA = 0,5 ng/ml, el AUC disminuye, mientras que la sensibilidad y la precisión aumentan para cada secuencia de RM. Para el PSA = 0,9 ng/ml, el AUC de la DCE aumenta significativamente.
La RMmp debe realizarse siempre antes de la RT cuando se sospeche una recidiva. Se pueden abrir nuevos escenarios al considerar el papel de la DWI ante un PSA ≤ 0.5 ng/ml.
Electrode potential–pH (Pourbaix) diagrams provide a phase map of the most stable compounds of a metal, its corrosion products, and associated ions in solution. The utility of these phase diagrams is ...that they enable the assessment of electrochemical stabilities, for example, of Ni metal and its derived oxides, hydroxides, and oxyhydroxides, against corrosion in aqueous environments. Remarkably, the Ni Pourbaix diagrams reported over the last 50 years are largely inconsistent with various electrochemical observations, which may be attributed to inaccurate experimental free energies of formation (Δf G) for the complex Ni-based compounds used in producing the available diagrams. Here we show that state-of-the-art density-functional theory (DFT) can be used to obtain accurate Δf G values, which lead to Ni Pourbaix diagrams that are more consistent with direct electrochemical experiments: Electrochemical impedance spectroscopy and surface-enhanced Raman spectroscopy are used to characterize the electrochemical stabilities of NiO and Ni(OH)2 formed on Ni, demonstrating the reliability in correction-free first-principles based Pourbaix diagrams. Our results show the importance in applying modern density functionals in combination with experimental advances in aqueous environment compound identification for assessing electrochemical phase stability of materials, which will be useful for the design, synthesis, and selection of corrosion-resistant metals, photoabsorbers, and photocatalytic materials.
We report follow-up results from the randomized, placebo-controlled, phase 3 HELIOS trial of ibrutinib+bendamustine and rituximab (BR) for previously treated chronic lymphocytic leukemia (CLL)/small ...lymphocytic lymphoma (SLL) without deletion 17p. Overall, 578 patients were randomized 1:1 to either ibrutinib (420 mg daily) or placebo, in combination with 6 cycles of BR, followed by ibrutinib or placebo alone. Median follow-up was 34.8 months (range: 0.1-45.8). Investigator-assessed median progression-free survival (PFS) was not reached for ibrutinib+BR, versus 14.3 months for placebo+BR (hazard ratio HR 95% CI, 0.206 0.159-0.265; P < 0.0001); 36-month PFS rates were 68.0% versus 13.9%, respectively. The results are consistent with the primary analysis findings (HR = 0.203, as assessed by independent review committee, with 17-month median follow-up). Median overall survival was not reached in either arm; HR (95% CI) for ibrutinib+BR versus placebo: 0.652 (0.454-0.935; P = 0.019). Minimal residual disease (MRD)-negative response rates were 26.3% for ibrutinib+BR and 6.2% for placebo+BR (P < 0.0001). Incidence of treatment-emergent adverse events (including grades 3-4) were generally consistent with the initial HELIOS report. These long-term data support improved survival outcomes and deepening responses with ibrutinib+BR compared with BR in relapsed CLL/SLL.
Reaching and grasping in primates depend on the coordination of neural activity in large frontoparietal ensembles. Here we demonstrate that primates can learn to reach and grasp virtual objects by ...controlling a robot arm through a closed-loop brain-machine interface (BMIc) that uses multiple mathematical models to extract several motor parameters (i.e., hand position, velocity, gripping force, and the EMGs of multiple arm muscles) from the electrical activity of frontoparietal neuronal ensembles. As single neurons typically contribute to the encoding of several motor parameters, we observed that high BMIc accuracy required recording from large neuronal ensembles. Continuous BMIc operation by monkeys led to significant improvements in both model predictions and behavioral performance. Using visual feedback, monkeys succeeded in producing robot reach-and-grasp movements even when their arms did not move. Learning to operate the BMIc was paralleled by functional reorganization in multiple cortical areas, suggesting that the dynamic properties of the BMIc were incorporated into motor and sensory cortical representations.
The first in this series of five papers concerns the evaluation and management of renal injuries. The authors of this paper come from four continents and seven countries, and they reviewed all papers ...on renal injury published between 1966 and April 2002. The results of the authors’ deliberations are present here as a consensus document.
OBJECTIVE
To determine the optimal evaluation and management of renal injuries by review of the world's English‐language literature on the subject.
METHODS
A consensus conference convened by the World Health Organization and the Societé Internationale d’Urologie met to critically review reports of the diagnosis and treatment of renal trauma. The English‐language literature about renal trauma was identified using Medline, and additional cited works not detected in the initial search obtained. Evidence‐based recommendations for the diagnosis and management of renal trauma were made with reference to a five‐point scale.
RESULTS
There were many Level 3 and 4 citations, few Level 2, and one Level 1 which supported clinical practice patterns. Findings of nearly 200 reviewed citations are summarized.
CONCLUSIONS
Published reports on renal trauma still rely heavily on expert opinion and single‐institution retrospective case series. Prospective trials of the most significant issues, when possible, might improve the quality of evidence that dictates the behaviour of practitioners.
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare disease of controversial origin recently recognized as a neoplasm deriving from plasmacytoid dendritic cells (pDCs). Nevertheless, it ...remains an orphan tumor with obscure biology and dismal prognosis. To better understand the pathobiology of BPDCN and discover new targets for effective therapies, the gene expression profile (GEP) of 25 BPDCN samples was analyzed and compared with that of pDCs, their postulated normal counterpart. Validation was performed by immunohistochemistry (IHC), whereas functional experiments were carried out ex vivo. For the first time at the molecular level, we definitely recognized the cellular derivation of BPDCN that proved to originate from the myeloid lineage and in particular, from resting pDCs. Furthermore, thanks to an integrated bioinformatic approach we discovered aberrant activation of the NF-kB pathway and suggested it as a novel therapeutic target. We tested the efficacy of anti-NF-kB-treatment on the BPDCN cell line CAL-1, and successfully demonstrated by GEP and IHC the molecular shutoff of the NF-kB pathway. In conclusion, we identified a molecular signature representative of the transcriptional abnormalities of BPDCN and developed a cellular model proposing a novel therapeutic approach in the setting of this otherwise incurable disease.
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