V for vaccines and variants.

In the context of the Covid-19 pandemic, we evaluate the effects of vaccines and virus variants on epidemiological and macroeconomic outcomes by means of Monte Carlo simulations of a macroeconomic-epidemiological agent-based model calibrated using data from the Lombardy region of Italy. From simulations we infer that vaccination plays the role of a mitigating factor, reducing the frequency and the amplitude of contagion waves and significantly improving macroeconomic performance with respect to a scenario without vaccination. The emergence of a variant, on the other hand, plays the role of an accelerating factor, leading to a deterioration of both epidemiological and macroeconomic outcomes and partly negating the beneficial impacts of the vaccine. A new and improved vaccine in turn can redress the situation. Vaccinations and variants, therefore, can be conceived of as drivers of an intertwined cycle impacting both epidemiological and macroeconomic developments.

Hypofractionated radiation therapy versus chemotherapy with temozolomide in patients affected by RPA class V and VI glioblastoma: a randomized phase II trial.

INTRODUCTION: In RPA V-VI glioblastoma patients both hypofractionated radiotherapy and exclusive temozolomide can be used; the purpose of this trial is to compare these treatment regimens in terms of survival and quality of life. METHODS: Patients with histologic diagnosis of glioblastoma were randomized to hypofractionated radiotherapy (RT-30 Gy in 6 fractions) and exclusive chemotherapy (CHT-emozolomide 200 mg/m2/day 5 days every 28 days). Overall (OS) and progression free survival (PFS) were evaluated with Kaplan Maier curves and correlated with prognostic factors. Quality- adjusted survival (QaS) was evaluated according to the Murray model (Neurological Sign and Symptoms-NSS) RESULTS: From 2010 to 2015, 31 pts were enrolled (CHT: 17 pts; RT: 14pts). Four pts were excluded from the analysis. RPA VI (p = 0.048) and absence of MGMT methylation (p = 0.001) worsened OS significantly. Biopsy (p = 0.048), RPA class VI (p = 0.04) and chemotherapy (p = 0.007) worsened PFS. In the two arms the initial NSS scores were overlapping (CHT: 12.23 and RT: 12.30) and progressively decreased in both group and became significantly worse after 5 months in CHT arm (p = 0.05). Median QaS was 104 days and was significantly better in RT arm (p = 0.01). CONCLUSIONS: The data obtained are limited by the poor accrual. Both treatments were well tolerated. Patients in RT arm have a better PFS and QaS, without significant differences in OS. The deterioration of the NSS score would seem an important parameter and coincide with disease progression rather than with the toxicity of the treatment.

Exploiting Robot Hand Compliance and Environmental Constraints for Edge Grasps.

This paper presents a method to grasp objects that cannot be picked directly from a table, using a soft, underactuated hand. These grasps are achieved by dragging the object to the edge of a table, and grasping it from the protruding part, performing so-called slide-to-edge grasps. This type of approach, which uses the environment to facilitate the grasp, is named Environmental Constraint Exploitation (ECE), and has been shown to improve the robustness of grasps while reducing the planning effort. The paper proposes two strategies, namely Continuous Slide and Grasp and Pivot and Re-Grasp, that are designed to deal with different objects. In the first strategy, the hand is positioned over the object and assumed to stick to it during the sliding until the edge, where the fingers wrap around the object and pick it up. In the second strategy, instead, the sliding motion is performed using pivoting, and thus the object is allowed to rotate with respect to the hand that drags it toward the edge. Then, as soon as the object reaches the desired position, the hand detaches from the object and moves to grasp the object from the side. In both strategies, the hand positioning for grasping the object is implemented using a recently proposed functional model for soft hands, the closure signature, whereas the sliding motion on the table is executed by using a hybrid force-velocity controller. We conducted 320 grasping trials with 16 different objects using a soft hand attached to a collaborative robot arm. Experiments showed that the Continuous Slide and Grasp is more suitable for small objects (e.g., a credit card), whereas the Pivot and Re-Grasp performs better with larger objects (e.g., a big book). The gathered data were used to train a classifier that selects the most suitable strategy to use, according to the object size and weight. Implementing ECE strategies with soft hands is a first step toward their use in real-world scenarios, where the environment should be seen more as a help than as a hindrance.

Radiosurgery Using Tomotherapy for Patients with Brain Oligo-metastasis: A Retrospective Analysis on Feasibility and Tolerance.

AIM: Aim of the study was to evaluate feasibility and toxicities of exclusive radiosurgery using tomotherapy in patients with brain oligo-metastases. PATIENTS AND METHODS: Between 2008 and 2013 68 patients underwent stereotactic radiosurgery (SRS). Mean patient age was 63 years. Brain was the only site involved in 32 patients, while 36 had extracranial disease. Pre-SRS MRI 56 patients had sovratentorial lesions, 10 subtentorial and 2 patients had both. Fifty-two patients had 1 brain lesion, 11 had 2, and 5 patients had three. All patients underwent SRS using Tomotherapy. The median delivered dose was 18 Gy. RESULTS: After a mean follow-up of 13 months, 14 patients were alive, while 54 patients had died. Two patients had complete response, 32 had partial response, 21 stable disease and 13 disease progression. Overall response rate was 80.9%. One- and two-year overall survival were 41,2% and 24,7%, while local control 61.5% and 37.7%. Toxicity was acceptable. CONCLUSION: SRS using tomotherapy has been proven feasible as non-invasive exclusive treatment for oligometastatic patients with good prognostic score.