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The most important features to assess the severity of an epidemic are its size and its timescale. We discuss these features in a systematic way in the context of SIR and SIR-type models. We investigate in detail how the size and timescale of the epidemic can be changed by acting on the parameters characterizing the model. Using these results and having as guideline the COVID-19 epidemic in Italy, we compare the efficiency of different containment strategies for contrasting an epidemic diffusion such as social distancing, lockdown, tracing, early detection and isolation.
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Different countries - and sometimes different regions within the same countries - have adopted different strategies in trying to contain the ongoing COVID-19 epidemic; these mix in variable parts social confinement, early detection and contact tracing. In this paper we discuss the different effects of these ingredients on the epidemic dynamics; the discussion is conducted with the help of two simple models, i.e. the classical SIR model and the recently introduced variant A-SIR (arXiv:2003.08720) which takes into account the presence of a large set of asymptomatic infectives.
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Octupolar order in three space dimensions is described by a real-valued, fully symmetric and traceless, third-rank tensor A. The real generalized eigenvalues of A are also the critical values of a real-valued potential [Formula: see text] defined on the unit sphere [Formula: see text] by A. Generalized eigenvalues of A and critical points of [Formula: see text] are equivalent means to describe octupolar order in a molecular assembly according to Buckingham's formula for the probability density distribution. Intuition suggests that [Formula: see text] would generically have four maxima, corresponding to the most probable molecular orientations, so that a (possibly distorted) tetrahedron would effectively describe A. This paper shows that another generic octupolar state flanks the expected one, featuring three maxima of [Formula: see text]. The two generic states are divided by a separatrix manifold, which may physically represent an intra-octupolar transition.
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In this study we investigate marginality in European rural areas to understand how EU policies for local development can stimulate novel approaches to social innovation and economic growth. The method applied is a Social Network Analysis (SNA) on the call tenders of an Italian Local Action Group managing the LEADER programme in the Piacentino and Parmense Apennine (Emilia-Romagna). The implementation of the Inner Area Strategy in a part of the LEADER territory (11 out of the 59 municipalities of the LEADER area) allows to verify complementarities, interrelations and overlays between the two development policies.
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Desenvolvimento Econômico , Políticas , Humanos , Avaliação de Programas e Projetos de SaúdeRESUMO
Recent studies highlight that economic expectations are a crucial determinant of citizens' satisfaction with democracy (SWD). This article relies on a cross-sectional analysis of European survey data collected in the aftermath of COVID-19 disease to investigate the relationship between citizens' expectations about future economic prospects and their SWD. Our findings support the idea that citizens' expectations about future economic prospects are correlated with SWD. Furthermore, they reveal that perceived conditions of material wellbeing moderate this relationship.
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Belantamab-mafodotin is an innovative and selective treatment for multi-refractory/relapsed multiple myeloma (MM) patients; however, available real-life experiences on efficacy and safety are limited. In this real-world multicentric retrospective study, we enrolled 28 MM patients treated in four Hematology units of Campania region, Italy, who received a median of six treatment lines prior to belantamab-mafodotin. The overall response rate (ORR) was 40% (complete remission, CR, 11%; very good partial remission, VGPR, 11%; and partial remission, PR, 18%), with a median progression-free survival (PFS) and overall survival (OS) of 3 and 8 months, respectively. One of the most frequent drug-related adverse events was keratopathy observed in nine (32%) patients, leading to therapy discontinuation in only three (11%) of them. Moreover, 22 out of 28 total patients who were treated with at least two administrations achieved an ORR of 50% (CR, 14%; VGPR, 14%; and PR, 22%) with a median PFS and OS of 5 and 11 months, respectively. In conclusion, our multicentric study confirmed efficacy and safety of belantamab-mafodotin in triple-refractory MM patients even in the real-life setting.
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We analyze traveling solitary wave solutions in the Barbi-Cocco-Peyrard twist-opening model of nonlinear DNA dynamics. We identify conditions, involving an interplay of physical parameters and asymptotic behavior, for such solutions to exist, and provide first-order ordinary differential equations whose solutions give the required solitary waves; these are not solvable in analytical terms, but are easily integrated numerically. The conditions for existence of solitary waves are not satisfied for trivial asymptotic behavior and physical values of the parameters, i.e., the Barbi-Cocco-Peyrard model admits only solitary wave solutions that entail a global modification of the molecule; this is compared with the situation met in another recently formulated class of DNA models with two degrees of freedom per site.
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DNA/química , Conformação de Ácido Nucleico , Biofísica/métodos , Modelos Biológicos , Modelos Estatísticos , Modelos Teóricos , Nucleotídeos/química , Polímeros/químicaRESUMO
OBJECTIVE: Families choice to institutionalize an Alzheimer's disease (AD)-affected relative is hard and possibly painful. Recent literature contributions have investigated the causes of the emergence of desire to institutionalize (DI) who is affected by AD. This paper contributes to the topic by providing an Italy-based empirical analysis of factors correlated with DI in primary informal caregivers of patients affected by AD. METHODS: Data were drawn from an original survey carried out over 2009. 171 primary informal caregivers of patients followed in two Italian outpatients AD Care Units, located in two of the major Italian cities, Naples (46.78%) and Rome (53.22%), were interviewed. The caregiver desire to institutionalize AD affected patients was observed and its heterogeneity was studied through logistic regression. RESULTS: DI was positively correlated with patient poor autonomy, to the housewife/househusband status of primary caregiver and to the presence of a formal caregiving. DI was also barely correlated with patient gender and with the hours of informal supervision (pâ¯<â¯0.10). The housewife status of the primary caregiver was also positively associated with DI, while the female gender of the patient was negatively associated to it. DISCUSSION: The institutionalization of an AD-affected relative is a painful decision which is discouraged by the scarcity of adapted facilities and the need of an economical contribution in case of institutionalization in private facilities not receiving public support.
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Doença de Alzheimer/epidemiologia , Cuidadores , Institucionalização/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Autonomia Pessoal , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
Introducion: Bacterial infections frequently complicate liver cirrhosis. The aim of this study was to identify risk factors and clinical impact of bacterial pneumonia in patients with cirrhosis. MATERIALS AND METHODS: Bacterial infection prevalence study: consecutive patients with cirrhosis were enroled over a six-month period in 13 Italian centres. Pneumonia and other infections were diagnosed by standard methods. Pneumonia study: cirrhotic patients with pneumonia were enroled for an additional six-month period and HIV-positive patients were included. RESULTS: Pneumonia was the fourth most frequent infection. In the two parts of the study, 79 cases of pneumonia were recorded and 441 patients with cirrhosis without infections served as controls. Seventy-eight patients had extra-pulmonary infections. There were no clinical differences between HIV-negative and -positive cases with pneumonia. Previous gastro-intestinal bleeding (p = .02) and long-term prophylactic antibiotic use (p < .0001) were associated with pneumonia. Hospital stay was longer and renal failure more frequent than in patients without infections. Pneumonia was hospital acquired (HAP) in 6 cases, healthcare associated (HCAP) in 24 and community acquired (CAP) in 28. A new category of antibiotic prophylaxis associated pneumonia (APAP) was proposed for 21 cases. Cultures were positive in 21/79 patients (26.6%) with Gram-positive isolates in 57%. Unfavourable outcomes were recorded in 11.4% of the cases (3.6% of CAP, 33% of HAP, 12.5% of HCAP and 14.3% of APAP). CONCLUSIONS: Receiving antibiotic prophylaxis was associated with pneumonia and the study identified a new sub-group of patients, who require broad spectrum initial antibiotic therapy.
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Antibacterianos/uso terapêutico , Antibioticoprofilaxia/efeitos adversos , Coinfecção/complicações , Farmacorresistência Bacteriana Múltipla , Infecções por HIV/complicações , Cirrose Hepática/complicações , Pneumonia Bacteriana/complicações , Adulto , Idoso , Antibioticoprofilaxia/normas , Antibioticoprofilaxia/estatística & dados numéricos , Coinfecção/epidemiologia , Coinfecção/prevenção & controle , Infecções Comunitárias Adquiridas/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Cirrose Hepática/mortalidade , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/microbiologia , Pneumonia Bacteriana/mortalidade , Prevalência , Fatores de Risco , Adulto JovemRESUMO
Weierstrass's theory is a standard qualitative tool for single degree of freedom equations, used in classical mechanics and in many textbooks. In this Brief Report we show how a simple generalization of this tool makes it possible to identify some differential equations for which compact and even semicompact traveling solitary waves exist. In the framework of continuum mechanics, these differential equations correspond to bulk shear waves for a special class of constitutive laws.
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DNA torsion dynamics is essential in the transcription process; a simple model for it, in reasonable agreement with experimental observations, has been proposed by Yakushevich (Y) and developed by several authors; in this, the nucleotides (the DNA subunits made of a sugar-phosphate group and the attached nitrogen base) are described by a single degree of freedom. In this paper we propose and investigate, both analytically and numerically, a "composite" version of the Y model, in which the sugar-phosphate group and the base are described by separate degrees of freedom. The model proposed here contains as a particular case the Y model and shares with it many features and results, but represents an improvement from both the conceptual and the phenomenological point of view. It provides a more realistic description of DNA and possibly a justification for the use of models which consider the DNA chain as uniform. It shows that the existence of solitons is a generic feature of the underlying nonlinear dynamics and is to a large extent independent of the detailed modeling of DNA. The model we consider supports solitonic solutions, qualitatively and quantitatively very similar to the Y solitons, in a fully realistic range of all the physical parameters characterizing the DNA.
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DNA/química , DNA/ultraestrutura , Modelos Químicos , Modelos Moleculares , Simulação por Computador , Cinética , Movimento (Física) , Conformação de Ácido NucleicoRESUMO
The Yakushevich model of DNA torsion dynamics supports soliton solutions, which are supposed to be of special interest for DNA transcription. In the discussion of the model, one usually adopts the approximation l0 --> 0, where l0 is a parameter related to the equilibrium distance between bases in a Watson-Crick pair. Here we analyze the Yakushevich model without l0 --> 0. The model still supports soliton solutions indexed by two winding numbers (n,m); we discuss in detail the fundamental solitons, corresponding to winding numbers (1,0) and (0,1) respectively.
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DNA/química , DNA/ultraestrutura , Modelos Químicos , Modelos Moleculares , Simulação por Computador , Movimento (Física) , Dinâmica não Linear , Conformação de Ácido NucleicoRESUMO
BACKGROUND/OBJECTIVE: Alzheimer's disease (AD) is a very costly pathology. Total costs of AD result from the sum of direct and indirect costs. Intangible costs represent an additional burden that is difficult to quantify. This paper has reviewed the evaluation of the costs of AD and the methodologies to estimate them, and proposes the use of some tools which may be useful in establishing the financial weight of the disease. METHOD: A systematic literature search was conducted using the Pubmed and Medline databases as a source of published papers. RESULTS: In AD, direct and indirect costs and their sum (total costs) are very high and tend to increase parallel with the evolution of the pathology. The evolution of AD is characterized by the loss of functional autonomy, the onset of behavioral and sleep disorders, and the development of delusions and hallucinations. This requires more frequent medical examinations and hospitalizations resulting in higher direct costs, which become the relevant weight. None of the papers reviewed investigated intangible cost. CONCLUSION: The calculation of costs of AD is frequently based on cognitive decline and the degree of dependence of patients. The evaluation of intangible costs (psychological pain of the patient and of the unpaid caregivers' and their impaired quality of life) is a missing aspect in all reviewed studies. Due to the complexity of AD, it will be necessary to adopt cost evaluation systems including the different dimensions of the problem and its various aspects.