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In ER+ breast cancer, usually seen as the low immunogenic type, the main mechanisms favouring the immune response or tumour growth and immune evasion in the tumour microenvironment (TME) have been examined. The principal implications of targeting the oestrogen-mediated pathways were also considered. Recent experimental findings point out that anti-oestrogens contribute to the reversion of the immunosuppressive TME. Moreover, some preliminary clinical data with the hormone-immunotherapy association in a metastatic setting support the notion that the reversion of immune suppression in TME is likely favoured by the G0-G1 state induced by anti-oestrogens. Following immune stimulation, the reverted immune suppression allows the boosting of the effector cells of the innate and adaptive immune response. This suggests that ER+ breast cancer is a molecular subtype where a successful active immune manipulation can be attained. If this is confirmed by a prospective multicentre trial, which is expected in light of the provided evidence, the proposed hormone immunotherapy can also be tested in the adjuvant setting. Furthermore, the different rationale suggests a synergistic activity of our proposed immunotherapy with the currently recommended regimen consisting of antioestrogens combined with cyclin kinase inhibitors. Overall, this lays the foundation for a shift in clinical practice within this most prevalent molecular subtype of breast cancer.

In recent years, unmanned aerial vehicles (UAVs) have been increasingly used to monitor and assess air quality. The interest in the application of UAVs in monitoring air pollutants and greenhouse gases is evidenced by the recent emergence of sensors with the most diverse specifications designed for UAVs or even UAVs designed with integrated sensors. The objective of this study was to conduct a comprehensive review based on bibliometrics to identify dynamics and possible trends in scientific production on UAV-based sensors to monitor air quality. A bibliometric analysis was carried out in the VOSViewer software (version 1.6.17) from the Scopus and Web of Science reference databases in the period between 2012 and 2022. The main countries, journals, scientific organizations, researchers and co-citation networks with greater relevance for the study area were highlighted. The literature, in general, has grown rapidly and has attracted enormous attention in the last 5 years, as indicated by the increase in articles after 2017. It was possible to notice the rapid development of sensors, resulting in smaller and lighter devices, with greater sensitivity and capacity for remote work. Overall, this analysis summarizes the evolution of UAV-based sensors and their applications, providing valuable information to researchers and developers of UAV-based sensors to monitor air pollutants.

The use of sensor technologies to monitor cows’ behavior is becoming commonplace in the context of dairy production. This study aimed at validating a commercial collar-based sensor system, the AFICollar® (Afimilk, Kibbutz Afikim, Israel), designed to monitor dairy cattle feeding and ruminating behavior. Additionally, the performances of two versions of the software for behavior classification, the current software AFIfarm® 5.4 and the updated version AFIfarm® 5.5, were compared. The study involved twenty Holstein-Friesian cows fitted with the collars. To evaluate the sensor performance under different feeding scenarios, the animals were divided into four groups and fed three different types of feed (total mixed ration, long hay, animals allowed to graze). Recordings of hourly rumination and feeding time produced by the sensor were compared with visual observation by scan sampling at 1 minute intervals using Spearman correlation, concordance correlation coefficient (CCC), Bland–Altman plots and linear mixed models for assessing the precision and accuracy of the system. The analyses confirmed that the updated software version V5.5 produced better detection performance than the current V5.4. The updated software version produced high correlations between visual observations and data recorded by the sensor for both feeding (r = 0.85, CCC = 0.86) and rumination (r = 0.83, CCC = 0.86). However, the limits of agreement for both behaviors remained quite wide (feeding: −19.60 min/h, 17.46 min/h; rumination: −15.80 min/h, 15.00 min/h). Type of feed did not produce significant effects on the agreement between visual observations and sensor recordings. Overall, the results indicate that the system can provide farmers with adequately accurate data on feeding and rumination time, and can be used to support herd management decisions. Despite all this, the precision of the system remained relatively limited, and should be improved with further developments in the classification algorithm.

PurposeSpinal bone tumors include a heterogeneous broad of primary or metastatic lesions that may present as incidental findings or manifest with painful symptoms and pathological fractures. Optimal management of spine bone lesions is often difficult and treatment algorithms are usually solidly based on surgery. We aimed to evaluate the contribution of trans-arterial embolization in this field, with particular attention to the procedure efficacy, technical difficulties and complications.MethodsWe present a literature review on the role of trans-arterial embolization in the management of spinal bone tumors, both primary and metastatic, evaluating its contribution as preoperative treatment, palliative procedure and standalone curative strategy.ResultsTrans-arterial embolization provides an important contribution to reducing surgery hemorrhagic risks, offering a better visualization of the operating field, and possibly increasing tumor susceptibility to chemotherapy or radiation therapy. Nonetheless, it plays an important part in pain palliation, with the unquestionable advantage of being easily repeatable in case of necessity. Its curative role as a standalone therapy is still subject of debate, and at the present time, satisfactory results have been recorded only in the treatment of aneurysmal bone cysts.ConclusionPercutaneous trans-arterial embolization has established as a highly useful minimally invasive procedure in the management of spinal bone lesions, particularly as adjuvant preoperative therapy and palliative treatment.

CareToy system is an innovative tele-rehabilitative tool, useful in providing intensive, individualized, home-based, family-centred Early Intervention (EI) in infants. Our aim was to evaluate, through a Randomized Clinical Trial (RCT) study, the effects of CareToy intervention on early motor and visual development in preterm infants. 41 preterm infants (range age: 3.0-5.9 months of corrected age) were enrolled and randomized into two groups, CareToy and Standard Care. 19 infants randomized in CareToy group performed a 4-week CareToy program, while 22 allocated to control group completed 4 weeks of Standard Care. Infant Motor Profile (IMP) was primary outcome measure, Alberta Infant Motor Scale (AIMS) and Teller Acuity Cards were secondary ones. Assessments were carried out at baseline (T0) and at the end of CareToy training or Standard Care period (T1). T1 was the primary endpoint. After RCT phase, 17 infants from control group carried out a 4-week CareToy program, while 18 infants from the CareToy group continued with Standard Care. At the end of this phase, infants were re-assessed at T2. In RCT phase, delta IMP total score and variation and performance sub-domains were significantly higher (P<0.050) in CareToy group if compared to Standard Care group. Similar results were found for Teller Acuity Cards, while no differences between groups were found for AIMS. No differences were found in any outcome measure results (T2-T0), between infants who started CareToy training before or after one month of standard care. This RCT study confirms the results of a previous pilot study, indicating that CareToy system can provide effective home-based EI. This trial has been registered at www.clinicaltrials.gov (Identifier NCT01990183).

Background Current guidelines suggest specific criteria for oral or long-acting injectable antipsychotic drugs (LAIs). This review aims to describe the demographic and clinical characteristics of the ideal profile of the patient with schizophrenia treated with LAIs, through the analysis of nonrandomized studies. Methods A systematic review of nonrandomized studies in English was performed attempting to analyze the factors related to the choice and use of LAIs in daily practice. The contents were outlined using the Cochrane methods for nonrandomized studies and the variables included demographic as well as clinical characteristics. The available literature did not allow any statistical analysis that could be used to identify the ideal profile of patients with schizophrenia to be treated with LAIs. Results Eighty publications were selected and reviewed. Prevalence of LAI use ranged from 4.8% to 66%. The only demographic characteristics that were consistently assessed through retrieved studies were age (38.5 years in the 1970’s, 35.8 years in the 1980’s, 39.3 years in the 1990’s, to 39.5 years in the 2000’s) and gender (male > female). Efficacy was assessed through the use of various symptom scales and other indirect measurements; safety was assessed through extrapyramidal symptoms and the use of anticholinergic drugs, but these data were inconsistent and impossible to pool. Efficacy and safety results reported in the different studies yielded a good therapeutic profile with a maximum of 74% decrease in hospital admissions and the prevalence of extrapyramidal symptoms with LAIs consistently increased at 6, 12, 18, and 24 months (35.4%, 37.1%, 36.9%, and 41.3%, respectively). Conclusions This analysis of the available literature strongly suggests that further observational studies on patients with schizophrenia treated with LAIs are needed to systematically assess their demographic and clinical characteristics and the relationships between them and patient outcome. Besides the good efficacy and safety profile of LAIs, health care staff must also take into account the importance of establishing a therapeutic alliance with the patient and his/her relatives when selecting the most appropriate treatment. LAIs seem to be a good choice not only because of their good safety and efficacy profile, but also because they improve compliance, a key factor to improving adherence and to establishing a therapeutic alliance between patients with schizophrenia, their relatives, and their health care providers.

Up to 40% of elderly patients with untreated diffuse large B-cell lymphoma (DLBCL) given a regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone every 21 days (R-CHOP21) relapse or develop refractory disease. Lenalidomide has high activity in relapsed or refractory aggressive B-cell lymphomas. In phase 2 of the REAL07 trial, we aimed to establish the safety and efficacy of the combination of lenalidomide and R-CHOP21 in elderly patients with untreated DLBCL. REAL07 was an open-label, multicentre trial that was done in 13 centres in Italy and one in Germany. Eligible patients were aged 60–80 years; had newly diagnosed, untreated, CD20-positive, Ann Arbor stage II–IV DLBCL or grade 3b follicular lymphoma; had an Eastern Cooperative Oncology Group performance status of 0–2; had an International Prognostic Index (IPI) risk of low-intermediate, intermediate-high, or high; and were fit according to comprehensive geriatric assessment. Participants were to receive 15 mg oral lenalidomide on days 1–14 of six 21-day cycles, and standard doses of R-CHOP21 chemotherapy (375 mg/m2 intravenous rituximab, 750 mg/m2 intravenous cyclophosphamide, 50 mg/m2 intravenous doxorubicin, and 1·4 mg/m2 intravenous vincristine on day 1, and 40 mg/m2 oral prednisone on days 1–5). The primary endpoint was frequency of overall response (complete response [CR] and partial response [PR]), which was assessed by 18F-fluorodeoxyglucose (18F-FDG) PET at the end of the treatment. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00907348. 49 patients were included in phase 2: nine had been enrolled into phase 1 between Oct 23, 2008, and June 4, 2009, and had received the maximum tolerated dose of 15 mg lenalidomide; and 40 were enrolled into phase 2 between April 28, 2010, and June 3, 2011. 45 patients (92%, 95% CI 81–97) achieved a response (42 [86%] CR; three [6%] PR). Three patients (6%) did not respond and one (2%) died for reasons unrelated to treatment or disease. 277 (94%) of 294 planned cycles of lenalidomide and R-CHOP21 were completed. Grade 3–4 neutropenia was reported in 87 cycles (31%), grade 3–4 leukopenia in 77 (28%), and grade 3–4 thrombocytopenia in 35 (13%). No grade 4 non-haematological adverse events were reported. No patients died during the study as a result of toxic effects. Lenalidomide with R-CHOP21 is effective and safe in elderly patients with untreated DLBCL. Fondazione Italiana Linfomi and Celgene.

This study characterizes a compost-bedded pack barn of a dairy cattle farm in terms of CO2 emissions approximately 20 min after tilling under stable atmospheric conditions. Emission fluxes were calculated with the bLS model WindTrax, assessing modeled CO2 concentrations at two altitudes (5.0 m and 10.0 m ABGL) by comparing them with those measured by a UAV-based system at the same two altitudes. The UAV-based system was equipped with a low-cost self-engineered MSP (multi-sensor platform) containing an NDIR sensor for measuring concentrations and detecting environmental conditions, which were measured both by MSPs and commercial sensors. The input data were provided by the same sensors positioned on the ground (1.5 m ABGL), upwind and downwind with respect to the emission source. A sensitivity analysis of atmospheric stability in the bLS model yielded differences between median calculated emission fluxes for stable and unstable conditions from −0.020 to 0.034 g ∙ m−2 ∙ s−1. Mean percentage errors gave overestimates of 8–39% and 13–21% 5.0 m and 10.0 m ABGL. The RMSE also indicated overestimates ranging from 44 to 275 ppm. This is the first study to validate concentrations calculated by a bLS model at two altitudes by using a UAV-based system on a compost-bedded pack barn.

The objective of this study was to evaluate the potential of the practical application of unmanned aerial vehicles and RGB vegetation indices (VIs) in the monitoring of a coffee crop. The study was conducted in an experimental coffee field over a 12-month period. An RGB digital camera coupled to a UAV was used. Nine VIs were evaluated in this study. These VIs were subjected to a Pearson correlation analysis with the leaf area index (LAI), and subsequently, the VIs with higher R2 values were selected. The LAI was estimated by plant height and crown diameter values obtained by imaging, which were correlated with these values measured in the field. Among the VIs evaluated, MPRI (0.31) and GLI (0.41) presented greater correlation with LAI; however, the correlation was weak. Thematic maps of VIs in the evaluated period showed variability present in the crop. The evolution of weeds in the planting rows was noticeable with both VIs, which can help managers to make the decision to start crop management, thus saving resources. The results show that the use of low-cost UAVs and RGB cameras has potential for monitoring the coffee production cycle, providing producers with information in a more accurate, quick and simple way.

Intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) represent efficacious medical treatments for osteoarthritis (OA), although no comparative study on long-term efficacy in hip OA exists. The goals of the current study were to compare the clinical efficacy of PRP vs HA at 12 months of follow-up in patients with hip OA and evaluate the influence of the type of infiltration and patient age, sex, body mass index, and degree of OA on temporal clinical evolution. One hundred patients with chronic unilateral symptomatic hip OA were consecutively enrolled and randomly assigned to 1 of 2 groups: group A received PRP and group B received HA administered via intra-articular ultrasound-guided injections. Patients were evaluated at baseline and after 1, 3, 6, and 12 months using the Harris Hip Score (HHS) and visual analog scale (VAS). An overall improvement was detected in both groups between 1- and 3-month follow-up. Despite a slightly progressive worsening between 6- and 12-month follow-up, the final clinical scores remained higher compared with baseline ( P <.0005), with no significant differences between PRP and HA. Regarding clinical temporal evolution, multivariate analysis showed that HHS was not influenced by the type of infiltration, patient age, sex, body mass index, or degree of OA, whereas a significant association was detected between OA grade IV and VAS evolution ( P <.0005). Intra-articular injections of PRP are efficacious in terms of functional improvement and pain reduction but are not superior to HA in patients with symptomatic hip OA at 12-month follow-up.