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Purpose: According to preclinical evidence, GLP-1 receptor may be an actionable target in neurodegenerative disorders, including Alzheimer’s disease (AD). Previous clinical trials of GLP-1 receptor agonists were conducted in patients with early AD, yielding mixed results. The aim was to assess in a proof-of-concept study whether slow-release exenatide, a long-acting GLP-1 agonist, can benefit the cognitive performance of people with mild cognitive impairment (MCI). Methods: Thirty-two (16 females) patients were randomized to either slow-release exenatide (n= 17; 2 mg s.c. once a week) or no treatment (n= 15) for 32 weeks. The primary endpoint was the change in ADAS-Cog11 cognitive test score at 32 weeks vs baseline. Secondary endpoints herein reported included additional cognitive tests and plasma readouts of GLP-1 receptor engagement. Statistical analysis was conducted by intention to treat. Results: No significant between-group effects of exenatide on ADAS-Cog11 score (p= 0.17) were detected. A gender interaction with treatment was observed (p= 0.04), due to worsening of the ADAS-Cog11 score in women randomized to exenatide (p= 0.018), after correction for age, scholar level, dysglycemia, and ADAS-Cog score baseline value. Fasting plasma glucose (p= 0.02) and body weight (p= 0.03) decreased in patients randomized to exenatide. Conclusion: In patients with MCI, a 32-week trial with slow-release exenatide had no beneficial effect on cognitive performance. Trial registration number: NCT03881371, registered on 21 July, 2016.

The current study evaluates six years of experience with laparoscopic Heller myotomy and Dor fundoplication for achalasia in a single-centre and single-surgeon series.From 2004 to 2010, 40 patients underwent Heller myotomy followed by Dor fundoplication. Before and after surgery, clinical evaluation and instrumental examinations were performed; clinical evaluation involved a modified De-Meester symptom score system, while instrumental examinations included upper gastrointestinal barium meal, oesophageal manometry, upper endoscopy, and pH monitoring. Changes in clinical and instrumental data before and after surgery were assessed by the evaluation of the differences in DeMeester scores and the investigation of both the oesophageal diameter and resting LES (lower oesophageal sphincter) pressure during patient follow-up, respectively.Heller-Dor treatment significantly improved both dysphagia and regurgitation symptoms (p-values <0.001). Specifically, the DeMeester mean score for dysphagia changed from 2.88 ± 0.34 to 0.81 ±0.54 points, showing a significant estimated adjusted mean reduction of 2.08 points; the DeMeester mean score for regurgitation fell from 2.09 ± 0.53 to 0.16 ± 0.37 points, showing a significant estimated adjusted mean reduction of 2.00 points. Furthermore, our findings suggested that preoperative resting LES pressure was a statistical significant predictor of dysphagia symptom improvement: the greater the baseline preoperative resting LES pressure, the more the improvement in dysphagia symptoms (p<0.001). No statistical associations with symptom improvement were found as regards the baseline oesophagus diameter. Moreover, significant estimated reductions of both oesophageal LES pressure (p-value for linear trend <0.001) and oesophagus diameter (p-value for linear trend=0.005), at baseline and after 5,10,15,30 months post surgery were also observed.Laparoscopic Heller myotomy with a Dor fundoplication is an excellent approach for achalasia, and preoperative resting LES pressure could be a relevant predictor of dysphagia symptom improvement.

Aim:We investigated inpatients with and without Type 2 diabetes mellitus, aged over 60 yr, to compare their vitamin D status and calcium homeostatic parameters. Materials and methods:We studied 140 patients consecutively admitted to our Internal Medicine Unit during the year 2010 (61 from November to April, 79 from May to October). The sample encompassed 70 patients with and 70 without diabetes. At admission we measured serum calcium (Ca), phosphate (P), sodium (Na), potassium (K), creatinine (Cr), alkaline phosphatase total activity (AP), albumin adjusted serum calcium (Caalb adj), 25 hydroxy-vitamin D (25OHD), PTH, and 24-h urinary Na/Cr (uNa/Cr), K/Cr (uK/Cr), Ca/Cr (uCa/Cr), P/Cr (uP/Cr) ratios, and calcium excretion (Ca ex). Results:25OHD levels of patients with and without diabetes did not significantly differ. In patients without diabetes recruited from November to April, 25OHD levels were significantly lower than those from May to October, whilst patients with diabetes did not show a significant seasonal variation. PTH had opposite non-significant seasonal variations, and negatively correlated with 25OHD in both groups of patients. This correlation was lost after adjusting for age and body mass index in patients with diabetes. These inpatients had higher serum P and lower uP/Cr, according to lower PTH. Their serum glucose negatively correlated with uCa/Cr and Ca ex, contrary to inpatients with other diseases. Instead, uCa/Cr and Ca ex correlated with uNa/Cr only in patients without diabetes. Conclusions:Inpatients with diabetes did differ from those with other disorders for vitamin D status and calcium-phosphate homeostatic mechanism.

Summary. Background:Acquired hemophilia A (AHA) is a rare autoimmune disease caused by autoantibodies against coagulation factor VIII and characterized by spontaneous hemorrhage in patients with no previous family or personal history of bleeding. Although data on several AHA cohorts have been collected, limited information is available on the optimal management of AHA.

Objective:Non-autoimmune hyperthyrotropinemia has been previously reported among children born prematurely. The aim of this study was to follow up their thyroid function, volume, and structure and to investigate the relationship with growth, IGF-I, lipid profile, and insulin sensitivity. Methods:Seventy-two children born prematurely (33.2±2.2 weeks), 26 appropriate (AGA) and 46 small for gestational age (SGA), were evaluated at the age of 7.6±2.3 yr (time 1) and at the age of 11.4±2.3 yr (time 2). We also measured TSH, free T3(fT3), free T4(fT4), thyroperoxidase antibodies (TPO-Ab), thyroglobulin antibodies (TG-Ab), thyroid ultrasound, auxological parameters, lipid profile, glucose, and insulin level. Results:In the AGA group TSH was similar in both times (2.7±1.0 vs3.0±0.9 mU/l) and above the upper normal limit in 4 (15.4%) subjects at time 1 and in 6 (23.7%) subjects at time 2 (ns). In the SGA group, TSH was similar in both times (2.8±1.2 vs2.5±1.0 mU/l) and above the upper normal limit in 11 (23.9%) subjects at time 1 and 5 (10.8%) subjects at time 2 (ns). fT4and fT3were always normal and TPO- and TG-Ab absent. Thyroid volume increased progressively, but significantly only in the AGA group (p=0.0005). The thyroid structure was always normal and there was no influence on the growth and the biochemical profile. Conclusions:Some ex-premature babies show a mild and variable thyroid dysfunction, which does not seem to evolve toward an overt thyroid dysfunction.

To assess pregnancy and fetal outcomes after in utero exposure to interferon- (IFN) in all pregnancies occurring in women with multiple sclerosis (MS) during the study period, with a specific focus on the risk of spontaneous abortion.

To establish the prognostic role of clinical and demographic factors in a hospital-based cohort of MS patients categorized by age at clinical onset and clinical course.

In this paper, after recalling the main features of the NA57 experiment, we describe its silicon pixel tracker.

The charged particle multiplicity distributions measured with the WA97 and the NA57 multiplicity detectors in Pb+Pb collisions at 158 A GeV/ c have been analyzed in the framework of the Wounded Nucleon Model (WNM). We obtain a good description of the data within the centrality range of our samples. This allows us to make use of the measured multiplicities to estimate the number of wounded nucleons of the collision.

Gamma radiation studies from the44Ca(d, pγ)45Ca reaction, observed at a deuteron bombarding energy of 5 MeV, have established that the 1.90 MeV and the 1.43 MeV states of45Ca have both angular momentumJπ=32−. The 1.90 MeV level is shown to de-excite with a relative intensity of 12% to the 1.43 MeV state, of 68% to the 0.176 MeV state and of 20% to the ground state. The 1.43 MeV level is shown to de-excite with a relative intensity of 70% to the 0.176 MeV state and of 30% to the ground state. In addition, for the transition to the 1.90 MeV of45Ca it has been measured the (p-γ) angular correlation, in the reaction plane, with the proton counter on the peak of the stripping curve at 25°. The observed gamma angular correlation and the corresponding axis of symmetry are in agreement with the predictions of D.W.B.A. theory. Finally, experimental values of the multipole-mixing parameterδwere deduced and the experimental branching ratios were compared with the predictions of the shell-model theory. Satisfactory agreement between experiment and theory is obtained assuming an effective neutron charge of 0.6e. Vengono riportate le misure ottenute nella reazione44Ca(d, pγ)45Ca ad una energia incidente di 5 MeV. I risultati sperimentali permettono di assegnare senza ambiguità spin e paritàJπ=32−ai livelli ad un’energia di eccitazione di 1.90 e 1.43 MeV. Le correlazioni angolari osservate sono in buon accordo con quanto previsto dalla teoria con onde distorte in approssimazione di Born (D.W.B.A.). I rapporti di decadimento osservati sono in soddisfacente accordo con le previsioni del modello a strati, adottando una carica effettiva del neutrone di 0.6 unità elettroniche. Исследование гамма-иэлучения иэ реакции44Ca((d, pγ)45Ca, наблюдаемое при бомбардировке дейтронами с знергией 5 MзB, покаэало, что оба состояния 1.90 MзB и 1.43 MзB45Ca имеют моментJπ=32−. Покаэывается, что уровень 1.90 MзB девоэбуждается с относительными интенсивностями 12% в состояние 1.43 MзB, 68% в состояние 0.176 MзB и 20% в основное состояние. Покаэывается, что уровень 1.43 MзB девоэбуждается с относительными интенсивностями 70% в состояние 0.176 MзB и 30% в основное состояние. Кроме того, для перехода в состояние 1.90 MзB45Ca была иэмерена (p-γ) угловая корреляция, в плоскости реакции, с протонным счетчиком в пике кривой стриппинга при 25°. Наблюдаемая гамма-угловая корреляция и соответствуюшая ось симметрии находятся в соответствии с предскаэаниями D.W.B.A. теории. В эаключение, определяются зкспериментальные величины параметра многополюсного смещивания δ, и зкспериментальные отнощения ветвей сравниваются с предскаэаниями оболочечной модели. Получается удовлетворительное согласие между зкспериментом и теорией, предполагая зффективный эаряд нейтрона 0.6e.

A multi-chip, large area hybrid silicon pixel detector has been integrated in a particle physics experiment for the first time. The plane had 72K 75 μm × 500 μm sensor elements, covering a total area of about 30 cm2. It was constructed and characterized in a collaboration between heavy-ion experiment WA97 and R&D project RD19. Several such planes will be incorporated in a hyperon telescope, in order to improve tracking in the high multiplicity environment of central lead-lead collisions at the SPS. Results on the characterization of this detector in a proton beam at the Omega spectrometer at CERN are presented and discussed.

The uniformity of discriminator threshold and the precision of internal delay have been studied on single `Omega3/LHC1' pixel readout chips and on arrays of 24 chips containing 48 768 active pixels. On single chips we measured a threshold variation of 400e−r.m.s. for a mean threshold setting of 4000e−. The internal delay distribution shows a standard deviation of 6ns on a single chip and 16ns on the large arrays, after applying a 3-bit delay adjustment. These results, obtained using an electrical stimulus, were confirmed by tests in a beam of high-energy particles.

The50Ti(d, α)48Sc reaction was investigated using deuterons with the energy of 12.9 MeV. Energy spectra and angular distributions of α-particles emitted in this reaction have been measured. Relatively large cross-sections were found for transitions leading to the 0.14, 1.06 and 2.03 MeV excited states of the residual48Sc nucleus. The spin and parity values suggested for the 0.14 MeV state and the previously unobserved 1.06 MeV state areJπ=5+andJπ=7+respectively. La reazione50Ti(d, α)48Sc, indotta da deutoni di 12.9 MeV, è stata studiata per ottenere informazioni spettroscopiche sulla struttura dei livelli dello48Sc. Sperimentalmente si è trovato che dai livelli a bassa energia di eccitazione dello48Sc solo tre vengono apprezzabilmente popolati, e questi si trovano rispettivamente ad una energia di eccitazione di 0.14, 1.06 e 2.03 MeV. Dall’analisi dei risultati si hanno prove sperimentali che lo stato a 0.14 MeV ha valore di spin e paritàJπ=5+, mentre il livello a 1.06 MeV ha valore di spin e paritàJπ=7+.

Energy levels in theN=29 isotones (51Ti,52V,53Cr,54Mn,55Fe) arising from the coupling of protons in the 1f7/2shell and the single neutron in the 2p3/2shell are calculated by the use of effective interactions. The required two-body residual interactions are deduced from the experimental spectra of50Ti and56Co. A comparison with available experimental data shows in general good correspondence. However, some low-lying states indicate the mixing of configurations in which the single neutron outside the48Ca core is in the 2p1/2and 1f5/2orbits. Sono stati calcolati per il gruppo degli isotoni51Ti,52V,53Cr,54Mn e55Fe i livelli energetici originati dall’accoppiamento del singolo neutrone nello strato 2p3/2con i protoni nello strato 1f7/2. L’effettiva residua interazione protone-protone e neutrone-protone è stata dedotta dagli spettri sperimentali dei nuclei50Ti e56Co. Il confronto dei livelli calcolati con quelli osservati sperimentalmente mostra in generale un soddisfacente accordo. Comunque, per alcuni livelli a basse energie di eccitazione risulta evidente l’interazione, oltre a quella considerata, di altre configurazioni in cui il neutrone al di fuori del core48Ca si trovi nelle orbite 2p1/2e 1f5/2.

The energy spectra of alpha particles from bombardment of C12, O16and Mg24with 15 MeV deuterons have been measured at many angles between 10° and 90° (laboratory system) by means of an ionization chamber with a resolution in energy of about 1.2%. The alpha groups leading to the 1.74 MeV, T= 1, 0+level of B10and to the 2.31 MeV, T= 1,0+level of N14were not observed. The 2.22 MeV level of Na22was slightly excited for angles of observation less than 40° (laboratory system) but for higher angles it appeared with an intensity comparable with the intensity of other T= 0 levels of Na22. Angular distributions and absolute cross sections corresponding to the ground, 0.72, 2.15 and 3.58 MeV states of B10to the ground state of N14and to the ground 0.58, 0.89, 1.53 and 2.58 MeV states of Na22are reported. The general shape of these angular distributions indicates that the (d, α) reactions, leading to the low lying states of the residual nuclei, proceed by a direct surface interaction.

Angular distributions of α-particles from the25Mg(3He, α)24Mg and26Mg(3He, α)25Mg reactions, leading to the ground and the low excited states of24Mg and25Mg, were measured at a bombarding energy of 5.50 MeV. Relative total cross-sections were obtained from the experimental results for transitions to the ground, 1.37, 4.12, 4.23, 5.22 and 6 MeV states of24Mg and for transitions to the ground, 0.58,0.98, 1.61 and 1.96 MeV states of25Mg. The ratios of the total cross-sections were compared with the predictions of the theory of Hauser and Feshbach and a satisfactory agreement has been found. In addition, the transition to the ground state of25Mg in the26Mg(3He, α)25Mg reaction seems predominantly due to a direct interaction mechanism.

Relatively unselective methods were available before 1947 for the reduction of carboxylic acids and related compounds. With the advent of complex metal hydrides some selectivity was achieved yet the immediate applications were concerned with monocarboxylic acids and derivatives. Consequently, a very challenging area of research still exists in the development of preparative methods leading to aromatic dialdehydes in which the aldehyde groups are vicinal, e.g. phthalaldehyde (I). We describe here three reductive procedures leading to I in good yields.

We present a case of disseminated histiocytosis X with hepatic involvement characterized by sinusoidal dilation. This histological feature regressed in connection with the clinical remission of the disease. The present report suggests that sinusoidal dilation might represent a feature of hepatic involvement in the course of histiocytosis X.

We present a case of disseminated histiocytosis X with hepatic involvement characterized by sinusoidal dilation. This histological feature regressed in connection with the clinical remission of the disease. The present report suggests that sinusoidal dilation might represent a feature of hepatic involvement in the course of histiocytosis X.

Background. Type 2 diabetes (T2D) might occur within metabolic syndrome (MbS). One of the complications of T2D is an impaired (imp) cardiovascular autonomic function (CAF). Aims. In subjects with T2D and age ≤ 55 years, the prevalence of impCAF and its relationship with BMI, waist, HbA1c values, MbS, hypertension, and family history of T2D and/or hypertension were analysed. Methods. 180 subjects consecutively undergoing a day hospital for T2D were studied. The IDF criteria were used to diagnose MbS. To detect impCAF, 5 tests for the evaluation of CAF were performed with Cardionomic (Meteda, Italy). Univariate and multivariate analyses were performed. Results. The prevalence of impCAF and MbS were 33.9% and 67.8%, respectively. Among diabetics with impCAF, 86.9% had MbS. ImpCAF was significantly associated with MbS, overweight, and HbA1c>7%. Both logistic (P=0.0009) and Poisson (P=0.0113) models showed a positive association between impCAF and MbS. The degree of ImpCAF showed a positive linear correlation with BMI and HbA1c values. Conclusions. The study demonstrates that glycaemic control and overweight influence CAF and that T2D + MbS is more strongly associated with impCAF than isolated T2D. We suggest that MbS not only increases the cardiovascular risk of relatively young subjects with T2D but is also associated with impCAF.