Objective: To report the relationship between disease activity and health-related quality of life (HRQoL) in relapsing multiple sclerosis, and the impact of natalizumab. Methods: HRQoL data were available from 2,113 multiple sclerosis patients in natalizumab clinical studies. In the Natalizumab Safety and Efficacy in Relapsing Remitting Multiple Sclerosis (AFFIRM) study, patients received natalizumab 300mg (n = 627) or placebo (n = 315); in the Safety and Efficacy of Natalizumab in Combination with Interferon Beta-1a in Patients with Relapsing Remitting Multiple Sclerosis (SENTINEL) study, patients received interferon beta-la (IFN-β-1a) plus natalizumab 300mg (n = 589), or IFN-β-1a plus placebo (n = 582). The Short Form-36 (SF-36) and a subject global assessment visual analog scale were administered at baseline and weeks 24, 52, and 104. Prespecified analyses included changes from baseline to week 104 in SF-36 and visual analog scale scores. Odds ratios for clinically meaningful improvement or worsening on the SF-36 Physical Component Summary (PCS) and Mental Component Summary were calculated. Results: Mean baseline SF-36 scores were significantly less than the general US population and correlated with Expanded Disability Status Scale scores, sustained disability progression, relapse number, and increased volume of brain magnetic resonance imaging lesions. Natalizumab significantly improved SF-36 PCS and Mental Component Summary scores at week 104 in AFFIRM. PCS changes were significantly improved by week 24 and at all subsequent time points. Natalizumab-treated patients in both studies were more likely to experience clinically important improvement and less likely to experience clinically important deterioration on the SF-36 PCS. The visual analog scale also showed significantly improved HRQoL with natalizumab. Interpretation: HRQoL was impaired in relapsing multiple sclerosis patients, correlated with severity of disease as measured by neurological ratings or magnetic resonance imaging, and improved significantly with natalizumab. © 2007 American Neurological Association. Published by Wiley-Liss, Inc.
Health-related quality of life in multiple sclerosis: Effects of natalizumab
Rudick, R. A.; Miller, D.; Hass, S.; Hutchinson, M; Calabresi, P. A.; Confavreux, C.; Galetta, S. L.; Giovannoni, G.; Havrdova, E.; Kappos, L.; Lublin, F. D.; Miller, D. H.; O'Connor, P. W.; Phillips, J. T.; Polman, C. H.; Radue, Ew; Stuart, W. H.; Wajgt, A.; Weinstock Guttman, B.; Wynn, D. R.; Lynn, F.; Panzara, M. A.; Affirm; SENTINEL Investigators including: R. Macdonell; Hughes, A.; Taylor, I.; Lee, Y. C.; Ma, H.; King, J.; Kilpatrick, T.; Butzkueven, H.; Marriott, M.; Pollard, J.; Spring, P.; Spies, J.; Barnett, M.; Dehaene, I.; Vanopdenbosch, L.; D’Hooghe, M.; Van Zandijcke, M.; Derijck, O.; Seeldrayers, P.; Jacquy, J.; Piette, T.; De Cock, C.; Medaer, R.; Soors, P.; Vanroose, E.; Vanderhoven, L.; D’Hooghe, M.; Nagels, G.; Dubois, B.; Deville, M. C.; D’Haene, R.; Jacques, F.; Hallé, D.; Gagnon, S.; Likavcan, E.; Murray, T. J.; Bhan, V.; Mackelvey, R.; Maxner, C. E.; Christie, S.; Giaccone, R.; Guzman, D. A.; Melanson, M.; Esfahani, F.; Gomori, A. J.; Nagaria, M. H.; Grand’Maison, F.; Berger, L.; Nasreddine, Z.; Duplessis, M.; Brunet, D.; Melanson, M.; Jackson, A.; Pari, G.; O’Connor, P.; Gray, T.; Hohol, M.; Marchetti, P.; Lee, L.; Murray, B.; Sahlas, J.; Perry, J.; Devonshire, V.; Hooge, J.; Hashimoto, S.; Oger, J.; Smyth, P.; Rice, G.; Kremenchutzky, M.; Stourac, P.; Kadanka, Z.; Benesova, Y.; Niedermayerova, I.; Meluzinova, E.; Marusic, P.; M,; Bojar,; Zarubova, K.; Houzvicková, E.; Piková, J.; Talab, R.; Faculty, Hospital Olomouc; Olomouc, B. Muchova; Urbánek, K; Kettnerova, Z.; Mares, J.; Otruba, P.; Zapletalová, O.; Hradilek, P.; Ddolezil, D. Dolezil; Woznicova, I.; Höfer, R.; Ambler J. Fiedler, Z. Ambler J. Fiedler; Sucha, J.; Matousek, V.; Rektor, I.; Dufek, M.; Mikulik, R.; Mastik, J.; Tyrlikova, I.; General, Teaching Hospital; Prague, E. Havrdová; Horakova, D.; Kalistová, H.; Týblová, M.; Ehler, E.; Novotná, A.; Geier, P.; Soelberg Sorensen, P.; Ravnborg, M.; Petersen, B.; Blinkenberg, M.; Färkkilä, M.; Harno, H.; Kallela, M.; Häppölä, O.; Elovaara, I.; Kuusisto, H.; Ukkonen, M.; Peltola, J.; Palmio, J.; Pelletier, J.; Feuillet, L.; Suchet, L.; Dalecky, A.; Tammam, D.; Edan, G.; Le Page, E.; Mérienne, M.; Yaouanq, J.; Clanet, M.; Mekies, C.; Azais Vuillemin, C.; Senard, A.; Lau, G.; Steinmetz, G.; Warter V. Wolff, J. Warter V. Wolff; Fleury, M.; Tranchant, C.; Stark, E.; Buckpesch Heberer, U.; Henn, K. H.; Skoberne, T.; Schimrigk, S.; Hellwig, K.; Brune, N.; Weiller, C.; Gbadamosi, J.; Röther, J.; Heesen, C.; Buhmann, C.; Karageorgiou, C.; Korakaki, D.; Giannoulis, D.r.; Tsiara, S.; Thomaides, T.; Thomopoulos, I.; Papageorgiou, H.; Armakola, F.; Komoly, S.; Rózsa, C.; Matolcsi, J.; Szabó, G.y.; Molnár, B.; Lovas, G.; Dioszeghy, P.; Szulics, P.; Magyar, Z.; Incze, J.; Farkas, J.; Clemens, B.; Kánya, J.; Valicskó, Z.s.; Bense, E.; Nagy, Z.s.; Geréby, G.; Perényi, J.; Simon, Z.s.; Szapper, M.; Gedeon, L.; Csanyi, A.; Rum, G.; Lipóth, S.; Szegedi, A.; Jávor, L.; Nagy, I.; Adám, I.; Szirmai, I.; Simó, M.; Ertsey, C.; I,; Amrein,; Kamondi, A.; Harcos, P.; Dobos, E.; Szabó, B.; Balas, V.; Guseo, A.; Fodor, E.; Jófejü, E.; Eizler, K.; Csiba, L.; Csépány, T.; Pallagi, E.; Bereczki, D.; Jakab, G.; Juhász, M.; Bszabó, B. Szabó I. Mayer; Katona, G.; Hutchinson, M.; O’Dwyer, J.; O’Rourke, K.; Sanders, E. A. C. M.; Rijk van Andel, J. F.; Bomhof, M. A. M.; van Erven, P.; Hintzen I. Hoppenbrouwers, R. Q. Hintzen I. Hoppenbrouwers; Neuteboom, R. F.; Zemel, D.; van Doorn, P. A.; Jacobs, B. C.; Munster, E. T.h. L. Van; ter Bruggen, J. P.; Bernsen, R.; Jongen, P. J. H.; de Smet, E. A. A.; Tacken, H. F. H.; Polman, C.; Zwemmer, J.; Nielsen, J.; Kalkers, N.; Kragt, J.; Jasperse, B.; Willoughby, E.; Anderson, N. E.; Barber, A.; Anderson, T.; Parkin, P. J.; Fink, J.; Avery, S.; Mason, D.; Kwiecinski, H.; Zakrzewska Pniewska, B.; Kaminska, A.; Podlecka, A.; Nojszewska, M.; Czlonkowska, A.; Zaborski, J.; Wicha, W.; Kruszewska Ozimowska, J.; Darda Ledzion, L.; Selmaj, K.; Mochecka Thoelke, A.; Pentela Nowicka, J.; Walczak, A.; Stasiolek, M.; Stelmasiak, Z.; Bartosik Psujek, H.; Mitosek Szewczyk, K.; Belniak, E.; Chyrchel, U.; Wajgt, A.; Maciejowski, M.; Strzyzewska Lubos, L.; Lubos, L.; Matusik, E.; Maciejek, Z.; Niezgodzinska Maciejek, A.; Sobczynska, D.; Slotala, T.; Wawrzyniak, S.; Kochanowicz K. Kuczynski, J. Kochanowicz K. Kuczynski; Zimnoch, R.; Pryszmont, M.; Drozdowski, W.; Baniukiewicz, E.; Kulakowska, A.; Borowik, H.; Lewonowska, M.; Szczudlik, A.; Róg, T.; Gryz Kurek, E.; Pankiewicz, J.; Furgal, J.; Kimkowicz, A.; Fryze, W.; Wierbicki, T.; Michalak, L.; Kowalewska, J.; Swiatkiewicz, J.; Hillert, J.; Åkesson, E; Fredrikson, S.; Diener, P; Olsson, T.; Wallström, E.; Fpiehl, F. Piehl L. Hopia; Brundin, L.; Marta, M.; Andersson, M.; Lycke, J.; Runmarker, B.; Malmeström, C.; Vaghfeldt, P.; Skoog, B.; Schluep, M.; Bogousslavskyr, J.; Du Pasquier, R.; Kappos, L.; Achtnichts, L.; Kuhle, J.; Buitrago Telez, C.; Schläger, R.; Naegelin, Y.; Eraksoy, M.; Bebek, N.; Akman Demir, G.; Topcuoglu, B.; Kurtuncu, M.; Istanbul, University; Istanbul:, A. Siva; Saip, S.; Altintas, A.; Kiyat, A.; Sharief, M.; Kasti, M.; Giovannoni, G.; Lim, E. T.; Rashid, W.; Silber, E.; Saldanha, G.; Hawkins, C.; Mamutse, G.; Woolmore, J.; Hawkes, C.; Findley, L.; Dasilva, R.; Gunasekara, H.; Palace, J.; Cader, Z.; Littleton, E.; Burke, G.; Sharrack O. Suliman, B. Sharrack O. Suliman; Klaffke, S.; Swash, M.; Dhillon, H.; Bates, D.; Westwood, M.; Nichol, P.; Barnes, D.; Wren, D.; Stoy, N.; Robertson, N.; Pickersgill, T.; Pearson, O.; Lawthom, C.; Young, C.; Mills, R.; Lecky, B.; Ford, C.; Katzman, J.; Rosenberg, G.; Cooper, J.; Wrubel, B.; Richardson, B.; Lynch, S.; Ridings, L.; Mcvey, A.; Nowack, W.; Rae Grant, A.; Mackin, G. A.; Castaldo, J. E.; Spikol, L. J.; Carter, J.; Wingerchuk, D.; Caselli, R.; Dodick, D.; Scarberry, S.; Bailly, R.; Garnaas, K.; Haake, B.; Rossman, H.; Belkin, M.; Boudouris, W. D.; Pierce, R. P.; Mass, M.; Yadav, V.; Bourdette, D.; Whitham, R. H.; Phillips, J. T.; Heitzman, D.; Martin, A.; Greenfield, C. F.; Agius, M.; Richman, D. P.; Vijayan, N.; Wheelock, V. L.; Reder, A.; Arnason, B.; Noronha, A.; Balabanov, R.; Ray, A.; Sheremata, W.; Delgado, S.; Shebert, B.; Maldonado, J.; Bowen, J.; Garden, G. A.; Distad, B. J.; Carrithers, M.; Rizzo, M.; Vollmer, T.; Reiningerova, J.; Guarnaccia, J.; Lo, A.; Richardson, G. B.; Fazekas, F.; Enzinger, C.; Seifert, T.; Storch, M.; Strasser Fuchs, S.; Berger, T.; Dilitz, E.; Egg, R.; Deisenhammer, F.; Decoo, : D; Lampaert, J.; Bartholome, E.; Bier, J.; Stenager, : E.; Rasmussen, M.; Binzer, M.; Shorsh, K.; Christensen, M.; Ravnborg, M.; Soelberg Sørensen, P.; Blinkenberg, M.; Petersen, B.; Hansen, H. J.; Bech, E.; Petersen, T.; Kirkegaard, M.; Eralinna, : J.; Ruutiainen, J.; Soilu Hänninen, M.; Säkö, E.; Laaksonen, M.; Reunanen, M.; Remes, A.; Keskinarkaus, I.; Moreau, : T.; Noblet, M.; Rouaud, O.; Couvreur, G.; Edan, G.; Lepage, E.; Drapier, S.; De Burghgraeve, V.; Yaouanq, J.; Merienne, M.; Cahagne, V.; Gout, O.; Deschamps, R.; Le Canuet, P.; Moulignier, A.; Vermersch, P.; De Seze, J.; Stojkovic, T.; Griffié, G.; Engles,; Ferriby, D.; Debouverie, M.; Pittion Vouyouvitch, S.; Lacour, J. C.; Pelletier, J.; Feuillet, L.; Suchet, L.; Dalecky, A.; Tammam, D.; Lubetzki, C.; Youssov, K.; Mrejen, S.; Charles, P.; Yaici, S.; Clavelou, P.; Aufauvre, D.; Renouil Guy, N.; Cesaro, P.; Degos, F.; Benisty, S.; Rumbach, L.; Decavel, P.; Confavreux, C.; Blanc, S.; Aubertin, P.; Riche, G.; Brochet, B.; Ouallet, J. C.; Anne, O.; Menck, : S.; Grupe, A.; Gutmann, E.; Lensch, E.; Fucik, E.; Heitmann, S.; Hartung, H. P.; Schröter, M.; Kurz, F. M. W.; Heidenreich, F.; Trebst, C.; Pul, R.; Hohlfeld, R.; Krumbholz, M.; Pellkofer, H.; Haas, J.; Segert, A.; Meyer, R.; Anagnostou, P.; Kabus, C.; Poehlau, D.; Schneider, K.; Hoffmann, V.; Zettl, U.; Steinhagen, V.; Adler, S.; Steinbrecher E. Rothenfusser Körber, A. Steinbrecher E. Rothenfusser Körber; Zellner, R.; Baum, K.; Günther, A.; Bläsing, H.; Stoll, G.; Gold, R.; Bayas, A.; Kleinschnitz, C.; Limmroth, V.; Katsarava, Z.; Kastrup, O.; Haller, P.; Stoeve, S.; Höbel, D.; Oschmann, P.; Voigt, K.; Burger, C. V.; Abramsky, : O.; Karusiss, D.; Achiron, A.; Kishner, I.; Stern, Y.; Sarove Pinhas, I.; Dolev, M.; Magalashvili, D.; Pozzili, : C.; Lenzi, D.; Scontrini, A.; Millefiorini, E.; Buttinelli, C.; Gallo, P.; Ranzato, F.; Tiberio, M.; Perini, P.; LARONI, ALICE ;Marrosu, M.; Cocco P. Marchi, E. Cocco P. Marchi; Spinicci, G.; Massole, S.; Mascia, M.; Floris, G.; Trojano, M.; Bellacosa, A.; Paolicelli, D.; Bosco Zimatore, G.; Simone, I. L.; Giorelli, M.; Di Monte, E.; MANCARDI, GIOVANNI LUIGI ;Pizzorno, M.; Murialdo, A.; Narciso, E.; Capello, A.; Comi, G.; Martinelli, V.; Rodegher, M.; Esposito, F.; Colombo, B.; Rossi, P.; Polman, : C. H.; Jasperse, M. M. S.; Zwemmer, J. N. P.; Nielsen, J.; Kragt, J. J.; Jongen, P. J. H.; De Smet, E.; Tacken, H.; Frequin, S. T. F. M.; Siegers, H. P.; Mauser, H. W.; Fernandez Fernandez, : O.; León, A.; Romero, F.; Alonso, A.; Tamayo, J.; Montalban, X.; Nos, C.; Pelayo, R.; Tellez, N.; Rio, J.; Tintore, M.; Arbizu, T.; Romero, L.; Moral, E.; Martinez, S.; Kappos, : L.; Achtnichts, L.; Wilmes, S.; Karabudak, : R.; Kurne, A.; Erdem, S.; Siva, A.; Saip, S.; Altintas, A.; Atamer, A.; Eraksoy, M.; Bilgili, F.; Topcular, B.; Giovannoni, : G.; Lim, E. T.; Lava, : N.; Murnane, M.; Dentinger, M.; Zimmerman, E.; Reiss, M.; Gupta, V.; Scott, T.; Brillman, J.; Kunschner, L.; Wright, D.; Perel, A.; Babu, A.; Rivera, V.; Killian, J.; Hutton, G.; Lai, E.; Picone, M.; Cadivid, D.; Kamin, S.; Shanawani, M.; Gauthier, S.; Morgan, A.; Buckle, G.; Margolin, D.; Weinstock Guttman, B.; Kwen, P. L.; Garg, N.; Munschauer, F.; Khatri, B.; Rassouli, M.; Saxena, V.; Ahmed, A.; Turner, A.; Fox, E.; Couch, C.; Tyler, R.; Horvit, A.; Fodor, P.; Humphries, S.; Wynn, D.; Nagar, C.; O’Brien, D.; Allen, N.; Turel, A.; Friedenberg, S.; Carlson, J.; Hosey, J.; Crayton, H.; Richert, J.; Tornatore, C.; Sirdofsky, M.; Greenstein, J.; Shpigel, Y.; Mandel, S.; Adbelhak, T.; Schmerler, M.; Zadikoff, C.; Rorick, M.; Reed, R.; Elias, S.; Feit, H.; Angus, E.; Sripathi, N.; Herbert, J.; Kiprovski, K.; Qu, X.; Del Bene, M.; Mattson, D.; Hingtgen, C.; Fleck, J.; Horak, H.; Javerbaum, J.; Elmore, R.; Garcia, E.; Tasch, E.; Gruener, G.; Celesia, G.; Chawla, J.; Miller, A.; Drexler, E.; Keilson, M.; Wolintz, R.; Drasby, E.; Muscat, P.; Belden, J.; Sullivan, R.; Cohen, J.; Stone, L.; Marrie, R. A.; Fox, R.; Hughes, B.; Babikian, P.; Jacoby, M.; Doro, J.; Puricelli, M.; Rossman, H.; Boudoris, W.; Belkin, M.; Pierce, R.; Eggenberger, E.; Birbeck, G.; Martin, J.; Kaufman, D.; Stuart, W.; English, J. B.; Stuart, D. S.; Gilbert, R. W.; Kaufman, M.; Putman, S.; Diedrich, A.; Follmer, R.; Pelletier, D.; Waubant, E.; Cree, B.; Genain, C.; Goodin, D.; Guarnaccia, J.; Patwa, H.; Rizo, M.; Kitaj, M.; Blevins, J.; Smith, T.; Mcgee, F.; Honeycutt, W.; Brown, M.; Isa, A.; Nieves Quinones, D.; Krupp, L.; Smiroldo, J.; Zarif, M.; Perkins, C.; Sumner, A.; Fisher, A.; Gutierrez, A.; Jacoby, R.; Svoboda, S.; Dorn, D.; Groeschel, A.; Steingo, B.; Kishner, R.; Cohen, B.; Melen, O.; Simuni, T.; Zee, P.; Cohan, S.; Yerby, M.; Hendin, B.; Levine, T.; Tamm, H.; Travis, L. H.; Freedman, S. M.; Tim, R.; Ferrell, W.; Stefoski, D.; Stevens, S.; Katsamakis, G.; Topel, J.; Ko, M.; Gelber, D.; Fortin, C.; Green, B.; Logan, W.; Carpenter, D.; Temple, L.; Sadiq, S.; Sylvester, A.; Sim, G.; Mihai, C.; Vertino, M.; Jubelt, B.; Mejico, L.; Phillips, J. T.; Martin, A.; Heitzman, D.; Greenfield, C. F.; Riskind, P.; Cabo, A.; Paskavitz, J.; Moonis, M.; Bashir J. Brockington, K. Bashir J. Brockington; Nicholas, A.; Slaughter, R.; Archer S. Harik, R. Archer S. Harik; Haddad, N.; Pippenger, M. A.; Van den Noort, S.; Thai, G.; Olek, M.; Demetriou, M.; Shin, R.; Calabresi, P.; Rus, H.; Bever, C.; Johnson, K.; Sheremata, W.; Delgado, S.; Sherbert, R.; Herndon, R.; Uschmann, H.; Chandler, A.; Markowitz, C.; Jacobs, D.; Balcer, L.; Mitchell, G.; Chakravorty, S.; Heyman, R.; Stauber, Z.; Goodman, A.; Segal, B.; Schwid, S.; Samkoff, L.; Levin, M.; Jacewicz, M.; Menkes, D.; Pulsinelli, W.; Frohman, E.; Racke, M.; Hawker, K.; Ulrich, R.; Panitch, H.; Hamill, R.; Tandon, R.; Dulaney, E.; Simnad, V.; Miller, J.; Wooten, G. F.; Harrison, M.; Bowen, J.; Doherty, M.; Wundes, A.; Garden, G. A.; Distad, J.; Kachuck, N.; Berkovich, R.; Burnett, M.; Sahai, S.; Bandari, D.; Weiner, L.; Storey, J. R.; Beesley, B.; Hart, D.; Moses, H.; Sriram, S.; Fang, J.; O’Duffy, A.; Kita, M.; Taylor, L.; Elliott, M.; Roberts, J.; Jeffery, D.; Maxwell, S.; Lefkowitz, D.; Kumar, S.; Sinclair, M.; Radue, E. W.; de Vera, A.; Bacelar, O.; Kuster, P.; Kappos, L.
2007-01-01
Abstract
Objective: To report the relationship between disease activity and health-related quality of life (HRQoL) in relapsing multiple sclerosis, and the impact of natalizumab. Methods: HRQoL data were available from 2,113 multiple sclerosis patients in natalizumab clinical studies. In the Natalizumab Safety and Efficacy in Relapsing Remitting Multiple Sclerosis (AFFIRM) study, patients received natalizumab 300mg (n = 627) or placebo (n = 315); in the Safety and Efficacy of Natalizumab in Combination with Interferon Beta-1a in Patients with Relapsing Remitting Multiple Sclerosis (SENTINEL) study, patients received interferon beta-la (IFN-β-1a) plus natalizumab 300mg (n = 589), or IFN-β-1a plus placebo (n = 582). The Short Form-36 (SF-36) and a subject global assessment visual analog scale were administered at baseline and weeks 24, 52, and 104. Prespecified analyses included changes from baseline to week 104 in SF-36 and visual analog scale scores. Odds ratios for clinically meaningful improvement or worsening on the SF-36 Physical Component Summary (PCS) and Mental Component Summary were calculated. Results: Mean baseline SF-36 scores were significantly less than the general US population and correlated with Expanded Disability Status Scale scores, sustained disability progression, relapse number, and increased volume of brain magnetic resonance imaging lesions. Natalizumab significantly improved SF-36 PCS and Mental Component Summary scores at week 104 in AFFIRM. PCS changes were significantly improved by week 24 and at all subsequent time points. Natalizumab-treated patients in both studies were more likely to experience clinically important improvement and less likely to experience clinically important deterioration on the SF-36 PCS. The visual analog scale also showed significantly improved HRQoL with natalizumab. Interpretation: HRQoL was impaired in relapsing multiple sclerosis patients, correlated with severity of disease as measured by neurological ratings or magnetic resonance imaging, and improved significantly with natalizumab. © 2007 American Neurological Association. Published by Wiley-Liss, Inc.
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Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande. La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.