University of Siena

About: University of Siena is a education organization based out in Siena, Italy. It is known for research contribution in the topics: Population & Cancer. The organization has 12179 authors who have published 33334 publications receiving 1008287 citations. The organization is also known as: Università degli studi di Siena & Universita degli studi di Siena.

Colistin resistance superimposed to endemic carbapenem-resistant Klebsiella pneumoniae: a rapidly evolving problem in Italy, November 2013 to April 2014.

Abstract: Consecutive non-replicate clinical isolates (n=191) of carbapenem non-susceptible Enterobacteriaceae were collected from 21 hospital laboratories across Italy from November 2013 to April 2014 as part of the European Survey on Carbapenemase-producing Enterobacteriaceae (EuSCAPE) project. Klebsiella pneumonia carbapenemase-producing K. pneumoniae (KPC-KP) represented 178 (93%) isolates with 76 (43%) respectively resistant to colistin, a key drug for treating carbapenamase-producing Enterobacteriaceae. KPC-KP colistin-resistant isolates were detected in all participating laboratories. This underscores a concerning evolution of colistin resistance in a setting of high KPC-KP endemicity.

Phenotypic and Genotypic Characteristics of Cryopyrin-Associated Periodic Syndrome: A Series of 136 Patients From the Eurofever Registry

Abstract: Objective To evaluate genetic, demographic and clinical features in patients with cryopyrin-associated periodic syndrome (CAPS) from the Eurofever Registry, with a focus on genotype-phenotype correlations and predictive disease severity markers. Methods A web-based registry retrospectively collected data on patients with CAPS. Experts in the disease independently validated all cases. Patients carrying NLRP3 variants and germline-mutation-negative patients were included. Results 136 patients were analysed. The median age at disease onset was 9 months, and the median duration of follow-up was 15 years. Skin rash, musculoskeletal involvement and fever were the most prevalent features. Neurological involvement (including severe complications) was noted in 40% and 12% of the patients, respectively, with ophthalmological involvement in 71%, and neurosensory hearing loss in 42%. 133 patients carried a heterozygous, germline mutation, and 3 patients were mutation-negative (despite complete NLRP3 gene screening). Thirty-one different NLRP3 mutations were recorded; 7 accounted for 78% of the patients, whereas 24 rare variants were found in 27 cases. The latter were significantly associated with early disease onset, neurological complications (including severe complications) and severe musculoskeletal involvement. The T348M variant was associated with early disease onset, chronic course and hearing loss. Neurological involvement was less strongly associated with V198M, E311 K and A439 V alleles. Early onset was predictive of severe neurological complications and hearing loss. Conclusions Patients carrying rare NLRP3 variants are at risk of severe CAPS; onset before the age of 6 months is associated with more severe neurological involvement and hearing loss. These findings may have an impact on treatment decisions.

Post-surgical use of radioiodine ( 131 I) in patients with papillary and follicular thyroid cancer and the issue of remnant ablation: a consensus report

Abstract: Objective: To determine, based on published literature and expert clinical experience, current indications for the post-surgical administration of a large radioiodine activity in patients with differentiated thyroid cancer. Design and methods: A literature review was performed and was then analyzed and discussed by a panel of experts from 13 European countries. Results: There is general agreement that patients with unifocal microcarcinomas ¼ 1 cm in diameter and no node or distant metastases have a , 2% recurrence rate after surgery alone, and that postsurgical radioiodine confers recurrence and cause-specific survival benefits in patients, strongly suspected of having persistent disease or known to have tumor in the neck or distant sites. In other patients, there is limited evidence that after complete thyroidectomy and adequate lymph node dissection performed by an expert surgeon, post-surgical radioiodine provides clear benefit. When there is any uncertainty about the completeness of surgery, evidence suggests that radioiodine can reduce recurrences and possibly mortality. Conclusion: This survey confirms that post-surgical radioiodine should be used selectively. The modality is definitely indicated in patients with distant metastases, incomplete tumor resection, or complete tumor resection but high risk of recurrence and mortality. Probable indications include patients with tumors . 1 cm and with suboptimal surgery (less than total thyroidectomy or no lymph node dissection), with age , 16 years, or with unfavorable histology.

CNN-Based Adversarial Embedding for Image Steganography

Abstract: Steganographic schemes are commonly designed in a way to preserve image statistics or steganalytic features. Since most of the state-of-the-art steganalytic methods employ a machine learning (ML)-based classifier, it is reasonable to consider countering steganalysis by trying to fool the ML classifiers. However, simply applying perturbations on stego images as adversarial examples may lead to the failure of data extraction and introduce unexpected artifacts detectable by other classifiers. In this paper, we present a steganographic scheme with a novel operation called adversarial embedding (ADV-EMB), which achieves the goal of hiding a stego message while at the same time fooling a convolutional neural network (CNN)-based steganalyzer. The proposed method works under the conventional framework of distortion minimization. In particular, ADV-EMB adjusts the costs of image elements modifications according to the gradients back propagated from the target CNN steganalyzer. Therefore, modification direction has a higher probability to be the same as the inverse sign of the gradient. In this way, the so-called adversarial stego images are generated. Experiments demonstrate that the proposed steganographic scheme achieves better security performance against the target adversary-unaware steganalyzer by increasing its missed detection rate. In addition, it deteriorates the performance of other adversary-aware steganalyzers, opening the way to a new class of modern steganographic schemes capable of overcoming powerful CNN-based steganalysis.