Explore the vast range of titles available.

Gastric cancer patients undergoing total gastrectomy face nutrition-related complications and worsening quality of life after surgery. In this context, gastrectomized cancer patients are required to cope with new conditions. Little is known about their accommodating feeding to the new life condition as a negotiated process among stakeholders in real contexts. This study aimed to investigate the shaping of this process as influenced by the perspectives of patients, health-care professionals (HPs), and caregivers (CGs). A constructivist grounded theory study, through semi-structured interviews and interpretative coding, was designed to answer the following research question: \"what is the process of returning to eating and feeding after a gastrectomy?\" The final sample included 18 participants. \"Defining a balance by compromising with fear\" is the core category explaining returning to eating as a process negotiated by all actors involved, with patients trying to find a feeding balance through a multi-layer compromise: with the information received by HPs, the proprioception drastically altered by gastric resection, new dietary habits to accept, and complex and often minimized conviviality. This process involves 4 main conceptual phases: relying on the doctors' advice, perceptive realignment, rearranging food intake, and food-regulated social interaction. Those categories are also shaped by the fear of being unwell from eating and the constant fear of tumor relapse. Multiple actors can meet patients' and their CGs' nutritional, care, and psychosocial needs. A multidisciplinary approach involving nutritionists, psychologists, occupational therapists, social workers, and anthropologists can be key to effectively managing these patients' survivorship care. We suggest training all the professionals on the first level of nutritional counseling.

AimsIdentification of epidermal growth factor receptor (EGFR) mutations in lung adenocarcinomas is the single most important predictor of clinical response and outcome using EGFR tyrosine kinase inhibitors (TKIs). EGFR E746-A750del and L858R mutations are the most common gene alterations, also predicting the best clinical response to TKIs. We evaluated the accuracy of EGFR mutation-specific antibodies in a large cohort of lung adenocarcinomas, with different molecular settings and types of tissue samples.Methods300 lung adenocarcinomas diagnosed on cytology (48 cell blocks), biopsy (157 cases) and surgical resections (95 cases) were selected. All cases were investigated for EGFR by sequencing and two mutation-specific antibodies (clone 6B6 for E746-A750del; clone 43B2 for L858R) were tested using an automated immunostainer. Discordant results were investigated by next-generation sequencing (NGS).ResultsOverall sensitivity and specificity of mutant-specific antibodies were 58.6% and 98.0%, respectively, and they increased up to 84% and 100% if only tumours harbouring E746-A750del were considered. In 13 discordant cases, NGS confirmed immunohistochemistry results in eight samples.ConclusionsThe EGFR mutation-specific antibodies have a fair/good sensitivity and good/high specificity in identifying classic mutations, but they cannot replace molecular tests. The antibodies work equally well on biopsies and cell blocks, possibly permitting a rapid screening in cases with poor material.

Objectives Combination chemotherapy is very active in small cell lung cancer (SCLC), although no improvement in overall survival (OS) has been done in the last 25 years, with Cisplatin-Etoposide (PE) still considered the world-wide standard, with an average median survival of about 7–8 months in patients with extended disease (ED). In 1995, a randomized trial of the Hoosier Group in 171 ED patients showed a significant advantage in overall survival in patients treated with PEI (Cisplatin, Etoposide and Ifosfamide), compared to PE. Despite that, PEI regimen has not become a commonly used regimen in SCLC. Materials and methods Here we present a retrospective analysis of 46 consecutive patients (30 males and 16 females) with SCLC that were treated at our Institution with PEI regimen: Cisplatin 20 mg/m2, Etoposide 75 mg/m2 and Ifosfamide 1200 mg/m2, day 1 to 4, every 3 weeks. Patients received a total of 219 cycles of chemotherapy, with a mean of 4,7 cycles per patient. Median age was 63 (range 59–70); performance status (PS) was 0 in 29 patients (63%), 1 in 13 patients (28%) and 2 in 4 patients (9%). Results In 19 limited disease (LD) patients partial response (PR) rate was 74%, and complete response (CR) was 16%. In 27 ED patients we observed 63% of PR and 26% of CR. Median time to progression (TTP) was 15.2 months in LD and 7.1 months in ED with median overall survival (OS) of 28.2 and 11.8 months, respectively. Toxicity was manageable, with a high dose intensity. Conclusions PEI regimen, in our opinion, may be a possible therapeutic option, with high activity and an acceptable toxicity profile. Trial registration ClinicalTrials.gov Identifier: NCT02324296 . Institutional review board that approved the study Institutional review board of Reggio Emilia, Azienda Ospedaliera S.Maria Nuova/IRCCS.

Introduction: Patients with ischemic stroke (IS) and atrial fibrillation (AF) face a higher risk of recurrent vascular events. This study evaluates the impact of atherosclerotic vascular disease burden across different vascular territories on the risk of vascular events in patients with recent ischemic stroke and AF within 90 days. Patients and Methods: We included patients with IS and AF from the International RAF network in a prospective 90-day follow-up. Atherosclerotic vascular disease was identified by at least one of the following: Symptomatic ischemic heart disease, symptomatic peripheral artery disease, internal carotid stenosis ≥50%, or the presence of plaques in the aorta. The primary outcome was a composite of stroke, transient ischemic attack, systemic embolism, cerebral bleeding, and major extracranial bleeding within 90 days postacute stroke. Patients were categorized into 5 groups based on the number of affected atherosclerotic vascular territories, with those with no atherosclerotic vascular disease as the reference. Kaplan–Meier curves were generated and compared using the log-rank test to determine the predictive value of the number of diseased territories for the risk of events. Data analysis was performed with SPSS/PC Win Package 25.0. Results: Of the 2148 patients (mean age 77.59; 53.86% female), 744 (34.60%) had atherosclerosis. Multivariable analysis revealed that involvement of 3 (hazard ratio [HR] 2.80, 95% confidence interval [CI]: 1.20-6.53) or 4 (HR 6.81, 95% CI: 1.02-36.24) vascular territories was significantly associated with the risk of combined events. Conclusions: In patients with recent ischemic stroke and AF, atherosclerosis across multiple territories correlates with a higher risk of future vascular events.

Anticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). T he identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence. In consecutive patients with acute ischemic stroke and AF, TTE was performed within 7 days from hospital admission. Study outcomes were recurrent ischemic cerebrovascular events (stroke or TIA) and systemic embolism. 854 patients (mean age 76.3 ± 9.5 years) underwent a TTE evaluation; 63 patients (7.4 %) had at least a study outcome event. Left atrial thrombosis was present in 11 patients (1.3 %) among whom 1 had recurrent ischemic event. Left atrial enlargement was present in 548 patients (64.2 %) among whom 51 (9.3 %) had recurrent ischemic events. The recurrence rate in the 197 patients with severe left atrial enlargement was 11.7 %. On multivariate analysis, the presence of atrial enlargement (OR 2.13; 95 % CI 1.06–4.29, p  = 0.033) and CHA 2 DS 2 -VASc score (OR 1.22; 95 % CI 1.04–1.45, p  = 0.018, for each point increase) were correlated with ischemic recurrences. In patients with AF-associated acute stroke, left atrial enlargement is an independent marker of recurrent stroke and systemic embolism. The risk of recurrence is accounted for by severe atrial enlargement. TTE-detected left atrial thrombosis is relatively uncommon.

We study signatures of primordial non-Gaussianity (PNG) in the redshift-space halo field on non-linear scales, using a combination of three summary statistics, namely the halo mass function (HMF), power spectrum, and bispectrum. The choice of adding the HMF to our previous joint analysis of power spectrum and bispectrum is driven by a preliminary field-level analysis, in which we train graph neural networks on halo catalogues to infer the PNG \\(f_\\mathrm{NL}\\) parameter. The covariance matrix and the responses of our summaries to changes in model parameters are extracted from a suite of halo catalogues constructed from the Quijote-PNG N-body simulations. We consider the three main types of PNG: local, equilateral and orthogonal. Adding the HMF to our previous joint analysis of power spectrum and bispectrum produces two main effects. First, it reduces the equilateral \\(f_\\mathrm{NL}\\) predicted errors by roughly a factor \\(2\\), while also producing notable, although smaller, improvements for orthogonal PNG. Second, it helps break the degeneracy between the local PNG amplitude, \\(f_\\mathrm{NL}^\\mathrm{local}\\), and assembly bias, \\(b_{\\phi}\\), without relying on any external prior assumption. Our final forecasts for PNG parameters are \\(\\Delta f_\\mathrm{NL}^\\mathrm{local} = 40\\), \\(\\Delta f_\\mathrm{NL}^\\mathrm{equil} = 210\\), \\(\\Delta f_\\mathrm{NL}^\\mathrm{ortho} = 91\\), on a cubic volume of \\(1 \\left(h^{-1}{\\rm Gpc}\\right)^3\\), with a halo number density of \\(\\bar{n}\\sim 5.1 \\times 10^{-5}~h^3\\mathrm{Mpc}^{-3}\\), at \\(z = 1\\), and considering scales up to \\(k_\\mathrm{max} = 0.5~h\\,\\mathrm{Mpc}^{-1}\\).

Primordial non-Gaussianity of the local type induces a strong scale-dependent bias on the clustering of halos in the late-time Universe. This signature is particularly promising to provide constraints on the non-Gaussianity parameter \\(f_{\\rm NL}\\) from galaxy surveys, as the bias amplitude grows with scale and becomes important on large, linear scales. However, there is a well-known degeneracy between the real prize, the \\(f_{\\rm NL}\\) parameter, and the (non-Gaussian) assembly bias i.e., the halo formation history-dependent contribution to the amplitude of the signal, which could seriously compromise the ability of large-scale structure surveys to constrain \\(f_{\\rm NL}\\). We show how the assembly bias can be modeled and constrained, thus almost completely recovering the power of galaxy surveys to competitively constrain primordial non-Gaussianity. In particular, studying hydrodynamical simulations, we find that a proxy for the halo properties that determine assembly bias can be constructed from photometric properties of galaxies. Using a prior on the assembly bias guided by this proxy degrades the statistical errors on \\(f_{\\rm NL}\\) only mildly compared to an ideal case where the assembly bias is perfectly known. The systematic error on \\(f_{\\rm NL}\\) that the proxy induces can be safely kept under control.

Primordial non-Gaussianity (PNG) is one of the most powerful probes of the early Universe and measurements of the large scale structure of the Universe have the potential to transform our understanding of this area. However relating measurements of the late time Universe to the primordial perturbations is challenging due to the non-linear processes that govern the evolution of the Universe. To help address this issue we release a large suite of N-body simulations containing four types of PNG: \\textsc{quijote-png}. These simulations were designed to augment the \\textsc{quijote} suite of simulations that explored the impact of various cosmological parameters on large scale structure observables. Using these simulations we investigate how much information on PNG can be extracted by extending power spectrum and bispectrum measurements beyond the perturbative regime at \\(z=0.0\\). This is the first joint analysis of the PNG and cosmological information content accessible with power spectrum and bispectrum measurements of the non-linear scales. We find that the constraining power improves significantly up to \\(k_\\mathrm{max}\\approx 0.3 h/{\\rm Mpc}\\), with diminishing returns beyond as the statistical probes signal-to-noise ratios saturate. This saturation emphasizes the importance of accurately modelling all the contributions to the covariance matrix. Further we find that combining the two probes is a powerful method of breaking the degeneracies with the \\(\\Lambda\\)CDM parameters.

We study primordial non-Gaussian signatures in the redshift-space halo field on non-linear scales, using a quasi-maximum likelihood estimator based on optimally compressed power spectrum and modal bispectrum statistics. We train and validate the estimator on a suite of halo catalogues constructed from the Quijote-PNG N-body simulations, which we release to accompany this paper. We verify its unbiasedness and near optimality, for the three main types of primordial non-Gaussianity (PNG): local, equilateral, and orthogonal. We compare the modal bispectrum expansion with a \\(k\\)-binning approach, showing that the former allows for faster convergence of numerical derivatives in the computation of the score-function, thus leading to better final constraints. We find, in agreement with previous studies, that the local PNG signal in the halo-field is dominated by the scale-dependent bias signature on large scales and saturates at \\(k \\sim 0.2~h\\,\\mathrm{Mpc}^{-1}\\), whereas the small-scale bispectrum is the main source of information for equilateral and orthogonal PNG. Combining power spectrum and bispectrum on non-linear scales plays an important role in breaking degeneracies between cosmological and PNG parameters; such degeneracies remain however strong for equilateral PNG. We forecast that PNG parameters can be constrained with \\(\\Delta f_\\mathrm{NL}^\\mathrm{local} = 45\\), \\(\\Delta f_\\mathrm{NL}^\\mathrm{equil} = 570\\), \\(\\Delta f_\\mathrm{NL}^\\mathrm{ortho} = 110\\), on a cubic volume of \\(1 \\left({ {\\rm Gpc}/{ {\\rm h}}} \\right)^3\\), at \\(z = 1\\), considering scales up to \\(k_\\mathrm{max} = 0.5~h\\,\\mathrm{Mpc}^{-1}\\).

We investigate how much can be learnt about four types of primordial non-Gaussianity (PNG) from small-scale measurements of the halo field. Using the QUIJOTE-PNG simulations, we quantify the information content accessible with measurements of the halo power spectrum monopole and quadrupole, the matter power spectrum, the halo-matter cross spectrum and the halo bispectrum monopole. This analysis is the first to include small, non-linear scales, up to \\(k_\\mathrm{max}=0.5 \\mathrm{h/Mpc}\\), and to explore whether these scales can break degeneracies with cosmological and nuisance parameters making use of thousands of N-body simulations. We perform all the halo measurements in redshift space with a single sample comprised of all halos with mass \\(>3.2 \\times 10^{13}~h^{-1}M_\\odot\\). For local PNG, measurements of the scale dependent bias effect from the power spectrum using sample variance cancellation provide significantly tighter constraints than measurements of the halo bispectrum. In this case measurements of the small scales add minimal additional constraining power. In contrast, the information on equilateral and orthogonal PNG is primarily accessible through the bispectrum. For these shapes, small scale measurements increase the constraining power of the halo bispectrum by up to \\(\\times4\\), though the addition of scales beyond \\(k\\approx 0.3 \\mathrm{h/Mpc}\\) improves constraints largely through reducing degeneracies between PNG and the other parameters. These degeneracies are even more powerfully mitigated through combining power spectrum and bispectrum measurements. However even with combined measurements and small scale information, equilateral non-Gaussianity remains highly degenerate with \\(\\sigma_8\\) and our bias model.