This paper describes the achievements of the H2020 project INDIGO-DataCloud. The project has provided e-infrastructures with tools, applications and cloud framework enhancements to manage the ...demanding requirements of scientific communities, either locally or through enhanced interfaces. The middleware developed allows to federate hybrid resources, to easily write, port and run scientific applications to the cloud. In particular, we have extended existing PaaS (Platform as a Service) solutions, allowing public and private e-infrastructures, including those provided by EGI, EUDAT, and Helix Nebula, to integrate their existing services and make them available through AAI services compliant with GEANT interfederation policies, thus guaranteeing transparency and trust in the provisioning of such services. Our middleware facilitates the execution of applications using containers on Cloud and Grid based infrastructures, as well as on HPC clusters. Our developments are freely downloadable as open source components, and are already being integrated into many scientific applications.
This study evaluated the accuracy of home care nurses' ratings of the Outcome and Assessment Information Set (OASIS) depression items. The accuracy of home care nurses' depression assessments was ...studied by comparing nurse ratings of OASIS depression items with a research diagnostic assessment based on the Structured Clinical Interview for Axis I Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). The setting for this study was a nonprofit, Medicare‐certified, voluntary home healthcare agency. Sixty‐four home care nurses assessed 220 patients aged 65 and older with the OASIS upon admission. Of the 220 patients, using standard SCID criteria, 35 cases of major or minor depression were identified. The home care nurses accurately documented the presence of depression in 13 of 35 cases (sensitivity=37.1%; positive predictive value=0.56). Of the 220 patients, 185 had no SCID‐identified major or minor depression. The nurses agreed on the absence of depression in 175 of 185 cases (specificity=94.6%; negative predictive value=88.8%). This study indicates that home care nurses often do not accurately rate OASIS depression items for older adult patients.
Proton beams obtained by hydrogenated Al targets Velardi, L.; Turco, V.; Caricato, A.P. ...
Nuclear instruments & methods in physics research. Section B, Beam interactions with materials and atoms,
11/2019, Volume:
459
Journal Article
Peer reviewed
Nowadays, the transport and acceleration of particle beams is performed by conventional accelerators, but in the last decade the scientific community is focused on the study of laser-driven ion ...acceleration, which can offer a potentially more compact and cost-effective mean of delivering ions/protons. To this purpose, the choice of the target plays a fundamental role in the quality and intensity of the ion beam. The starting point to obtain protons is the use of materials rich in hydrogen (adsorbed through contaminants and H2O) or hydrogenated chemical compounds (hydrates, polymers and so on). In this paper, we show a method to enhance the proton yield via ablation process, from aluminium targets. The method consists in the hydrogen enrichment of the targets with laser treatment in H2 atmosphere. Ablation measurements performed on treated Al targets (500 μm thick) showed a very high increase of proton yield (above 100%) with respect to those not enriched in hydrogen.
Alzheimer's disease (AD) pathology precedes symptoms and its detection can identify at-risk individuals who may benefit from early treatment. Since the retinal nerve fiber layer (RNFL) is depleted in ...established AD, we tested whether its thickness can predict whether cognitively healthy (CH) individuals have a normal or pathological cerebrospinal fluid (CSF) Aß42 (A) and tau (T) ratio.
As part of an ongoing longitudinal study, we enrolled CH individuals, excluding those with cognitive impairment and significant ocular pathology. We classified the CH group into two sub-groups, normal (CH-NAT, n = 16) or pathological (CH-PAT, n = 27), using a logistic regression model from the CSF AT ratio that identified >85% of patients with a clinically probable AD diagnosis. Spectral-domain optical coherence tomography (OCT) was acquired for RNFL, ganglion cell-inner plexiform layer (GC-IPL), and macular thickness. Group differences were tested using mixed model repeated measures and a classification model derived using multiple logistic regression.
Mean age (± standard deviation) in the CH-PAT group (n = 27; 75.2 ± 8.4 years) was similar (p = 0.50) to the CH-NAT group (n = 16; 74.1 ± 7.9 years). Mean RNFL (standard error) was thinner in the CH-PAT group by 9.8 (2.7) μm; p < 0.001. RNFL thickness classified CH-NAT vs. CH-PAT with 87% sensitivity and 56.3% specificity.
Our retinal data predict which individuals have CSF biomarkers of AD pathology before cognitive deficits are detectable with 87% sensitivity. Such results from easy-to-acquire, objective and non-invasive measurements of the RNFL merit further study of OCT technology to monitor or screen for early AD pathology.
To evaluate the dose sparing efficacy of intraoral customized stents in combination with IGRT/VMAT in Head & Neck cancer patients.
Despite advances in high-dose conformal radiotherapy (RT) ...techniques, adverse effects (such as oral mucositis) during and after RT often require temporary suspension of treatment and affect the quality of life in survivors. Intraoral customized stents can decrease radiation doses in healthy tissues and minimize damage from radiations. At the best of our knowledge the clinical impact of such devices in combination with VMAT (volumetric modulated arc therapy) is not reported in the literature.
Three Head & Neck cancer patients were submitted to image guided (IG) RT/VMAT in their treatment protocol. Dose distribution with and without the use of an intraoral stent was compared in each patient. Mean radiation doses proved to be lower in all patients, especially in the subsite: oral cavity.
There are several reports on the efficacy of IS during RT for Head & Neck cancer. Despite technological advances, the combination between high conformal RT and intraoral stents could still play a role in the management of this kind of patients. This strengthens the usefulness of the individualization of treatments and multidisciplinary approach.
Information on individual mental healthcare costs and utilization patterns in Italy is scant. We analysed the use and the annual costs of community mental health services (MHS) in an Italian local ...health authority (LHA). Our aims are to compare the characteristics of patients in the top decile of costs with those of the remaining 90%, and to investigate the demographic and clinical determinants of costs.
This retrospective study is based on administrative data of adult patients with at least one contact with MHS in 2013. Costs of services were estimated using a microcosting method. We defined as high cost (HC) those patients whose community mental health services costs place them in the top decile of the cost distribution. The predictors of costs were investigated using multiple linear regression.
The overall costs borne for 7601 patients were 17 million €, with HC accounting for 87% of costs and 73% of services. Compared with the rest of the patients, HC were younger, more likely to be male, to have a diagnosis of psychosis, and longer and more intensive MHS utilization. In multiple linear regression, younger age, longer duration of contact with MHS, psychosis, bipolar disorder, personality disorder, depression, dementia and Italian citizenship accounted for 20.7% of cost variance.
Direct mental health costs are concentrated among a small fraction of patients who receive intensive socio-rehabilitation in community services. One limitation includes the unavailability of hospital costs. Our methodology is replicable and useful for national and cross-national benchmarking.
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