Andrea Attanasio - Academia.edu (original) (raw)
Papers by Andrea Attanasio
The Journal of Clinical Endocrinology Metabolism, Jul 2, 2013
To determine the effects of long-term GH treatment on QoL, we evaluated QLS-H Zscores in 576 adul... more To determine the effects of long-term GH treatment on QoL, we evaluated QLS-H Zscores in 576 adult patients with GH deficiency (GHD) enrolled in HypoCCS, an international observational study, using data from five countries in which comparative QLS-H data from the general population were available.
The Journal of Clinical Endocrinology Metabolism, Jul 2, 2013
If GH therapy of children with GH deficiency (GHD) has been adequate, body composition should be ... more If GH therapy of children with GH deficiency (GHD) has been adequate, body composition should be comparable to that of patients who have undergone normal childhood development and become hypopituitary thereafter. To assess this, body composition was determined in 92 patients with childhood onset (CO) GHD, aged 18 -30 yr, who had been treated to final height with GH for 8.98 ؎ 4.30 yr and had stopped treatment 1.57 ؎ 1.20 yr previously, but who remained GHD (assessed by a GH stimulation test and IGF-I values). These were compared with 35 age-matched GH-naïve hypopituitary patients with adult onset (AO) GHD. Lean body mass, fat mass, and total bone mineral content were assessed by dual energy x-ray absorptiometry and corrected for actual height. CO patients were shorter (CO height, ؊1.18 ؎ 1.16 SD score; AO height, ؊0.38 ؎ 1.12 SD score; P < 0.001) and had lower body mass index (CO, 23.19 ؎ 5.76 kg/m 2 ; AO, 28.9 ؎ 6.27 kg/m 2 ; P < 0.001) than the AO group. Although there were gender differences, within genders CO patients had lower lean body mass, fat mass, and bone mineral content (P < 0.001 in all cases) compared with AO patients. Standard deviation scores for IGF-I (CO female, ؊9.2 ؎ 3.1; AO female, ؊5.2 ؎ 2.6; CO male, ؊6.4 ؎ 2.7; AO male, ؊3.5 ؎ 2.3; P < 0.001 within each gender) and IGFBP-3 (CO female, ؊3.5 ؎ 2.5; AO female, ؊1.7 ؎ 1.5; CO male, ؊2.8 ؎ 2.0; AO male, ؊1.1 ؎ 1.6; P < 0.001 within each gender) were significantly lower in the CO group. These results suggest that patients with CO GHD who were treated to final height suffer a significant maturational deficit despite GH replacement during childhood. (J Clin Endocrinol
Background: GH therapy in adult patients with GH deficiency (GHD) was approved over 10 yr ago, an... more Background: GH therapy in adult patients with GH deficiency (GHD) was approved over 10 yr ago, and the indication has subsequently gained broad acceptance. The HypoCCS surveillance database is a suitable means to examine the evolution of diagnostic patterns since 1996.
The Journal of Clinical Endocrinology Metabolism, Jul 2, 2013
Lean body mass (LBM), fat mass (FM), and total bone mineral content are significantly reduced in ... more Lean body mass (LBM), fat mass (FM), and total bone mineral content are significantly reduced in adult GHD subjects who had received pediatric GH. To test the hypothesis that continued GH therapy after final height is necessary to attain adult body composition, we performed a prospective, multinational, randomized, controlled, 2-yr study in patients who completed pediatric GH treatment at final height. Patients were randomized to GH at 25.0 g/kg⅐d (pediatric dose; n ؍ 58) or 12.5 g/kg⅐d (adult dose; n ؍ 59) or no GH treatment (control; n ؍ 32). LBM and FM were measured by dual energy x-ray absorptiometry and were centrally evaluated. IGF-I, IGFbinding protein-3, and lipid concentrations were also measured centrally. During the 2 yr, GH-treated patients gained a significant amount of LBM compared with controls (P < 0.001), but the change with the higher pediatric dose (14.2 ؎ 11.7%) was not different from that seen with the lower adult dose (12.7 ؎ 9.4%; P ؍ 0.970). Similarly, the decrease in FM was significantly (P ؍ 0.029) influenced by treatment, but with no dose effect (adult dose, ؊7.1 ؎ 22.8%; pediatric dose, ؊6.0 ؎ 26.6%; P ؍ 0.950). When the GH treatment effect was analyzed by gender, males gained 15.6 ؎ 9.8% and 14.3 ؎ 11.7% LBM (P ؍ 0.711) and lost 12.4 ؎ 22.2% and 11.0 ؎ 27.1% FM (P ؍ 0.921) with the low and high doses, respectively. Females gained 8.3 ؎ 7.3% and 12.5 ؎ 12.8% LBM with the two doses (P ؍ 0.630), but increased their FM by 3.5 ؎ 16.2% with the lower dose and lost only 1.2 ؎ 23.2% FM with the higher dose (P ؍ 0.325). A similar pattern was seen in IGF-I SD score; the 2-yr GH dose response was significantly higher with the pediatric than with the adult dose in females (P ؍ 0.008), but not males (P ؍ 0.790). The divergent pattern of change in LBM and FM in males and females is consistent with normal developmental sexual dimorphism and indicates that GH-dependent progress to target body composition continues after the age at which GH treatment is usually terminated. Dose requirements may have to be adjusted by gender, with females requiring a higher dose than males. (J Clin Endocrinol Metab 89: [4857][4858][4859][4860][4861][4862] 2004)
Neuro endocrinology letters
Operations Research/Computer Science Interfaces Series, 2007
In this chapter we describe an innovative real-time fleet management system designed and implemen... more In this chapter we describe an innovative real-time fleet management system designed and implemented for eCourier Ltd (London, UK) for which patents are pending in the United States and elsewhere. This paper describes both the business challenges and benefits of the implementation of a real-time fleet management system (with reference to empirical metrics such as courier efficiency, service times, and
2009 IEEE International Workshop on Intelligent Data Acquisition and Advanced Computing Systems: Technology and Applications, 2009
Some optimization problems are too complex to be solved exactly, using specific software tools. F... more Some optimization problems are too complex to be solved exactly, using specific software tools. For this reason, in many cases it is more convenient to define and design a heuristic procedure even though the final solution is generally sub-optimal. One of the most promising approaches in the traditional computing environment is the Iterated Local Search method. It is based on an exploration of the neighbor of the current solution and its performance is estimated to be very high for a large number of problems. The main drawback of the approach could be the required computational time, in particular when the neighbor to be explored becomes too large. We propose a general distributed framework, based on Iterated Local Search, and we show a concrete application in logistics, related to the optimal assignment of products to storage locations in a warehouse.
Pediatric Research, 1987
The adrenocorticotropin (ACTH), cortisol, and dehydroepiandrosterone responses to synthetic human... more The adrenocorticotropin (ACTH), cortisol, and dehydroepiandrosterone responses to synthetic human corticotropin-releasing factor (CRF) were studied in 28 endocrinologically healthy children (age 1-16 yr) and in six adult volunteers (age 24-42 yr). CRF was given as an intravenous bolus (I pg/kg body weight) between 0900 and 1000 hr. Significant increments in ACTH and cortisol levels after CRF were observed in all subjects, with an ACTH peak value of 48.2 2 3.4 pg/ml at 10 min Cp < 0.001). The ACTH and cortisol response patterns after CRF did not change with age or pubertal maturation and did not differ in children and in adults. In contrast, the dehydroepiandrosterone response to CRF clearly was related to the stage of pubertal development. The peak value after CRF significantly increased from puberty stage 1 to puberty stage 5 (164 +. 18 versus 779 +. 86 ng/100 ml, p < 0.001). In adults, the mean dehydroepiandrosterone peak value after CRF did not differ from that of P5 children.
Pediatric Research, 1985
In the 32 cases classified as non-3 deficient all GH levels rose to more than 8 ng/ml (1. IRP) ab... more In the 32 cases classified as non-3 deficient all GH levels rose to more than 8 ng/ml (1. IRP) above basal with trends according to sex and age. In 19 cases GHD had been established by testing with insulln and arginine, and Sm measurements. In these patients GH increments were: <3 ng/ml in 10, 3-5 ng/ml in 6, and >9 ng/ml (14.6, 9.1, 35.8) in 3 cases. Thus, GRF(~-29) is suitable for GH testing. Easier synthesis rakes it also appear to be a favourable alternative for attempts to treat hypothalamic gravth hormone deficiency.
Parallel Computing, 2006
Computational grids are highly complex distributed systems (involving multiple organizations with... more Computational grids are highly complex distributed systems (involving multiple organizations with different goals and policies) which aim at providing computing services without the users need to know the location and features of the required resources. A key issue in managing and scheduling grid resources is the coordination among multiple administrative domains. In this paper, we present a preliminary study which aims at developing auction mechanisms for decentralized scheduling which exhibit minimal communication overhead and an efficient usage of resources.
Parallel Computing, 2004
In the Dial-a-Ride problem (DARP) users specify transportation requests between origins and desti... more In the Dial-a-Ride problem (DARP) users specify transportation requests between origins and destinations to be served by vehicles. In the dynamic DARP, requests are received throughout the day and the primary objective is to accept as many requests as possible while satisfying operational constraints. This article describes and compares a number of parallel implementations of a Tabu search heuristic previously developed for the static DARP, i.e., the variant of the problem where all requests are known in advance. Computational results show that the proposed algorithms are able to satisfy a high percentage of user requests.
Journal of Mathematical Modelling and Algorithms, 2007
In this paper we examine a consolidation and dispatching problem motivated by a multinational che... more In this paper we examine a consolidation and dispatching problem motivated by a multinational chemical company which has to decide routinely the best way of delivering a set of orders to its customers over a multi-day planning horizon. Every day the decision to be made includes order consolidation, vehicle dispatching as well as load packing into the vehicles. We develop a heuristic based on a cutting plane framework, in which a simplified Integer Linear Program (ILP) is solved to optimality. Since the ILP solution may correspond to a infeasible loading plan, a feasibility check is performed through a tailored heuristic for a threedimensional bin packing problem with side constraints. If this test fails, a cut able to remove the infeasible solution is generated and added to the simplified ILP. Then the procedure is iterated. Computational results show that our procedure allows achieving remarkable cost savings.
The Journal of Clinical Endocrinology Metabolism, Jul 2, 2013
To determine the effects of long-term GH treatment on QoL, we evaluated QLS-H Zscores in 576 adul... more To determine the effects of long-term GH treatment on QoL, we evaluated QLS-H Zscores in 576 adult patients with GH deficiency (GHD) enrolled in HypoCCS, an international observational study, using data from five countries in which comparative QLS-H data from the general population were available.
The Journal of Clinical Endocrinology Metabolism, Jul 2, 2013
If GH therapy of children with GH deficiency (GHD) has been adequate, body composition should be ... more If GH therapy of children with GH deficiency (GHD) has been adequate, body composition should be comparable to that of patients who have undergone normal childhood development and become hypopituitary thereafter. To assess this, body composition was determined in 92 patients with childhood onset (CO) GHD, aged 18 -30 yr, who had been treated to final height with GH for 8.98 ؎ 4.30 yr and had stopped treatment 1.57 ؎ 1.20 yr previously, but who remained GHD (assessed by a GH stimulation test and IGF-I values). These were compared with 35 age-matched GH-naïve hypopituitary patients with adult onset (AO) GHD. Lean body mass, fat mass, and total bone mineral content were assessed by dual energy x-ray absorptiometry and corrected for actual height. CO patients were shorter (CO height, ؊1.18 ؎ 1.16 SD score; AO height, ؊0.38 ؎ 1.12 SD score; P < 0.001) and had lower body mass index (CO, 23.19 ؎ 5.76 kg/m 2 ; AO, 28.9 ؎ 6.27 kg/m 2 ; P < 0.001) than the AO group. Although there were gender differences, within genders CO patients had lower lean body mass, fat mass, and bone mineral content (P < 0.001 in all cases) compared with AO patients. Standard deviation scores for IGF-I (CO female, ؊9.2 ؎ 3.1; AO female, ؊5.2 ؎ 2.6; CO male, ؊6.4 ؎ 2.7; AO male, ؊3.5 ؎ 2.3; P < 0.001 within each gender) and IGFBP-3 (CO female, ؊3.5 ؎ 2.5; AO female, ؊1.7 ؎ 1.5; CO male, ؊2.8 ؎ 2.0; AO male, ؊1.1 ؎ 1.6; P < 0.001 within each gender) were significantly lower in the CO group. These results suggest that patients with CO GHD who were treated to final height suffer a significant maturational deficit despite GH replacement during childhood. (J Clin Endocrinol
Background: GH therapy in adult patients with GH deficiency (GHD) was approved over 10 yr ago, an... more Background: GH therapy in adult patients with GH deficiency (GHD) was approved over 10 yr ago, and the indication has subsequently gained broad acceptance. The HypoCCS surveillance database is a suitable means to examine the evolution of diagnostic patterns since 1996.
The Journal of Clinical Endocrinology Metabolism, Jul 2, 2013
Lean body mass (LBM), fat mass (FM), and total bone mineral content are significantly reduced in ... more Lean body mass (LBM), fat mass (FM), and total bone mineral content are significantly reduced in adult GHD subjects who had received pediatric GH. To test the hypothesis that continued GH therapy after final height is necessary to attain adult body composition, we performed a prospective, multinational, randomized, controlled, 2-yr study in patients who completed pediatric GH treatment at final height. Patients were randomized to GH at 25.0 g/kg⅐d (pediatric dose; n ؍ 58) or 12.5 g/kg⅐d (adult dose; n ؍ 59) or no GH treatment (control; n ؍ 32). LBM and FM were measured by dual energy x-ray absorptiometry and were centrally evaluated. IGF-I, IGFbinding protein-3, and lipid concentrations were also measured centrally. During the 2 yr, GH-treated patients gained a significant amount of LBM compared with controls (P < 0.001), but the change with the higher pediatric dose (14.2 ؎ 11.7%) was not different from that seen with the lower adult dose (12.7 ؎ 9.4%; P ؍ 0.970). Similarly, the decrease in FM was significantly (P ؍ 0.029) influenced by treatment, but with no dose effect (adult dose, ؊7.1 ؎ 22.8%; pediatric dose, ؊6.0 ؎ 26.6%; P ؍ 0.950). When the GH treatment effect was analyzed by gender, males gained 15.6 ؎ 9.8% and 14.3 ؎ 11.7% LBM (P ؍ 0.711) and lost 12.4 ؎ 22.2% and 11.0 ؎ 27.1% FM (P ؍ 0.921) with the low and high doses, respectively. Females gained 8.3 ؎ 7.3% and 12.5 ؎ 12.8% LBM with the two doses (P ؍ 0.630), but increased their FM by 3.5 ؎ 16.2% with the lower dose and lost only 1.2 ؎ 23.2% FM with the higher dose (P ؍ 0.325). A similar pattern was seen in IGF-I SD score; the 2-yr GH dose response was significantly higher with the pediatric than with the adult dose in females (P ؍ 0.008), but not males (P ؍ 0.790). The divergent pattern of change in LBM and FM in males and females is consistent with normal developmental sexual dimorphism and indicates that GH-dependent progress to target body composition continues after the age at which GH treatment is usually terminated. Dose requirements may have to be adjusted by gender, with females requiring a higher dose than males. (J Clin Endocrinol Metab 89: [4857][4858][4859][4860][4861][4862] 2004)
Neuro endocrinology letters
Operations Research/Computer Science Interfaces Series, 2007
In this chapter we describe an innovative real-time fleet management system designed and implemen... more In this chapter we describe an innovative real-time fleet management system designed and implemented for eCourier Ltd (London, UK) for which patents are pending in the United States and elsewhere. This paper describes both the business challenges and benefits of the implementation of a real-time fleet management system (with reference to empirical metrics such as courier efficiency, service times, and
2009 IEEE International Workshop on Intelligent Data Acquisition and Advanced Computing Systems: Technology and Applications, 2009
Some optimization problems are too complex to be solved exactly, using specific software tools. F... more Some optimization problems are too complex to be solved exactly, using specific software tools. For this reason, in many cases it is more convenient to define and design a heuristic procedure even though the final solution is generally sub-optimal. One of the most promising approaches in the traditional computing environment is the Iterated Local Search method. It is based on an exploration of the neighbor of the current solution and its performance is estimated to be very high for a large number of problems. The main drawback of the approach could be the required computational time, in particular when the neighbor to be explored becomes too large. We propose a general distributed framework, based on Iterated Local Search, and we show a concrete application in logistics, related to the optimal assignment of products to storage locations in a warehouse.
Pediatric Research, 1987
The adrenocorticotropin (ACTH), cortisol, and dehydroepiandrosterone responses to synthetic human... more The adrenocorticotropin (ACTH), cortisol, and dehydroepiandrosterone responses to synthetic human corticotropin-releasing factor (CRF) were studied in 28 endocrinologically healthy children (age 1-16 yr) and in six adult volunteers (age 24-42 yr). CRF was given as an intravenous bolus (I pg/kg body weight) between 0900 and 1000 hr. Significant increments in ACTH and cortisol levels after CRF were observed in all subjects, with an ACTH peak value of 48.2 2 3.4 pg/ml at 10 min Cp < 0.001). The ACTH and cortisol response patterns after CRF did not change with age or pubertal maturation and did not differ in children and in adults. In contrast, the dehydroepiandrosterone response to CRF clearly was related to the stage of pubertal development. The peak value after CRF significantly increased from puberty stage 1 to puberty stage 5 (164 +. 18 versus 779 +. 86 ng/100 ml, p < 0.001). In adults, the mean dehydroepiandrosterone peak value after CRF did not differ from that of P5 children.
Pediatric Research, 1985
In the 32 cases classified as non-3 deficient all GH levels rose to more than 8 ng/ml (1. IRP) ab... more In the 32 cases classified as non-3 deficient all GH levels rose to more than 8 ng/ml (1. IRP) above basal with trends according to sex and age. In 19 cases GHD had been established by testing with insulln and arginine, and Sm measurements. In these patients GH increments were: <3 ng/ml in 10, 3-5 ng/ml in 6, and >9 ng/ml (14.6, 9.1, 35.8) in 3 cases. Thus, GRF(~-29) is suitable for GH testing. Easier synthesis rakes it also appear to be a favourable alternative for attempts to treat hypothalamic gravth hormone deficiency.
Parallel Computing, 2006
Computational grids are highly complex distributed systems (involving multiple organizations with... more Computational grids are highly complex distributed systems (involving multiple organizations with different goals and policies) which aim at providing computing services without the users need to know the location and features of the required resources. A key issue in managing and scheduling grid resources is the coordination among multiple administrative domains. In this paper, we present a preliminary study which aims at developing auction mechanisms for decentralized scheduling which exhibit minimal communication overhead and an efficient usage of resources.
Parallel Computing, 2004
In the Dial-a-Ride problem (DARP) users specify transportation requests between origins and desti... more In the Dial-a-Ride problem (DARP) users specify transportation requests between origins and destinations to be served by vehicles. In the dynamic DARP, requests are received throughout the day and the primary objective is to accept as many requests as possible while satisfying operational constraints. This article describes and compares a number of parallel implementations of a Tabu search heuristic previously developed for the static DARP, i.e., the variant of the problem where all requests are known in advance. Computational results show that the proposed algorithms are able to satisfy a high percentage of user requests.
Journal of Mathematical Modelling and Algorithms, 2007
In this paper we examine a consolidation and dispatching problem motivated by a multinational che... more In this paper we examine a consolidation and dispatching problem motivated by a multinational chemical company which has to decide routinely the best way of delivering a set of orders to its customers over a multi-day planning horizon. Every day the decision to be made includes order consolidation, vehicle dispatching as well as load packing into the vehicles. We develop a heuristic based on a cutting plane framework, in which a simplified Integer Linear Program (ILP) is solved to optimality. Since the ILP solution may correspond to a infeasible loading plan, a feasibility check is performed through a tailored heuristic for a threedimensional bin packing problem with side constraints. If this test fails, a cut able to remove the infeasible solution is generated and added to the simplified ILP. Then the procedure is iterated. Computational results show that our procedure allows achieving remarkable cost savings.