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Background and Aims. The composition of grapes (Vitis vinifera L.) at harvest is a key factor that determines the future quality of wine. The work aimed to evaluate and compare the environmental impact of the most evaluated technological parameters using three approaches: the wet-chem method, the optical method using benchtop devices, and the optical method using a prototype smart and cost-effective device (Technology Readiness Level: 5). Methods and Results. The life cycle assessment (LCA) methodology was used to identify the most environmentally sustainable solution in a “from-cradle-to-grave” approach. The functional unit was identified by the execution of the analyses necessary to measure the three technological parameters: TSS, pH, and TA. The findings show that the optical analysis carried out with the prototype is the most suitable and green solution (i.e., with the lowest environmental impact in all the impact categories analysed); in fact, the same technology has proved to be 3.2 times more sustainable than the wet-chem method for the best average environmental performance. Conclusions. The research demonstrated the environmental impact advantages of the optical analyses for assessment of grape composition. Significance of the Study. Innovations in agriculture and the development of smart solutions represent advantages for managing and monitoring the composition of agri-food products that are a green solution for the industry.

Although support for violent and non-violent radicalization can co-occur, only a few adolescents who support non-violent radicalization also support or engage in violent acts. Yet, little is known about what factors are associated with adolescents' paths towards or away from violent and/or non-violent radicalization. Within a socio-ecological and positive youth development framework, this study investigates profiles of support for violent and non-violent radicalization among adolescents attending high schools in Quebec (Canada) and whether such profiles are differently associated with experiences of social adversity, school-, family- and peer-related factors and psychological distress. Adolescents (N = 1911; M age  = 15.7; SD age  = 0.98; 48.7% girls) completed an online survey during school hours. A Latent Profile Analysis on scores of support for violent and non-violent radicalization was conducted. A multinomial logistic regression was used to explore the associations between profiles and variables of interest. We identified six profiles of adolescents. The heterogeneity of profiles suggested multiple and complex combinations of support for violent and non-violent radicalization as well as their co-existence in some but not all profiles. Adolescents who reported less discrimination, more positive school experiences and more family support were less likely to belong to profiles that supported violence. Primary prevention efforts in the field of support for violent radicalization must adopt a socio-ecological and social justice approach and consider the diversity of adolescents' profiles, attitudes and experiences., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Nowadays, when discussing agri-food products, it is important to talk about sustainable production methods. Environmental sustainability has become a production issue, especially when it comes to the design of a product, service, or process. Using frozen fresh cauliflower gnocchi marketed in different packaging and in different global areas as a case study, we aim to highlight the importance of the impact of product eco-design on the entire life cycle., Results: The environmental impact of cauliflower gnocchi was assessed based on the life cycle assessment methodology. With the cradle-to-gate approach, the most influential factors are the cultivation, distribution, and packaging phases. Considering the cradle-to-grave approach, home storage has proven to be the most influential factor for a quarter of the entire life cycle of cauliflower gnocchi. The eco-design of packaging has demonstrated how, by analysing only the packaging, it is possible to achieve significant reductions in impact (-47%), but when compared with the entire life cycle these actions have no significant responsibility (approximately 10%). If, however, the field of action is broadened and eco-design solutions are sought to reduce the impact deriving from the conservation phase, the consumer has the ability, through their decisions, to reduce the impact relating to conservation as much as possible or to double the impact of the product life cycle., Conclusion: Overall, to promote prosperity while protecting the environment, according to Agenda 2030, the agri-food system must analyse the supply chains without neglecting any step involved in the life cycle of the product. The eco-design must go beyond the usual factors analysed and shall include downstream activities to aim for more sustainable products, including consumer behaviours, following the cradle-to-grave approach. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Background: This study assessed the role of culture in the measurement of the Self-Curiosity Attitude-Interest scale (SCAI-M), a measure of attitude and interest in increasing one's knowledge of self, adopting both a person-centered and variable-centered approach. Methods: The study was conducted on a Mexican sample composed of 484 adult participants who completed both the SCAI-M and a series of instruments that measure cultural dimensions through Qualtrix. Data were collected between November 9, to December 18, 2020, and respondents were contacted using advertisements on social media platforms (Facebook and WhatsApp). Analyses included multigroup confirmatory factor analysis and latent profile analysis. Results: A latent profile analysis allowed for the generation of three groups featuring distinct cultural orientations that were similar to previously found cultural profiles (Consensus-oriented Egalitarians, Flexible Individualists, and Rules-based Competitors). Multigroup Confirmative Factor Analysis showed partial metric and scalar invariance for the SCAI-M between groups; moreover, we found proofs of convergent validity with other cultural dimensions besides the ones linked with the Hofstede model. Our results indicate that cultural profiles and cultural variables are associated with both the level and meaning of self-curiosity among Mexican citizens. Conclusions: Finally, the discussion includes considerations on self-curiosity divergence among minority cultures and relevant clinical applications; a field for which we propose future research., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Aschieri F et al.)

Several strategies have been explored with the attempt of improving the safety and feasibility of umbilical cord blood transplantation (UCBT) in adults. The aim of this retrospective analysis was to examine the safety and efficacy of intrabone transplantation of a single unwashed cord blood unit in an antithymocyte globulin-free, sirolimus-based graft-versus-host disease prophylaxis platform. We collected data for all consecutive UCBTs infused intrabone (IB) and unwashed at San Raffaele Hospital in Milan between 2012 and 2021. Thirty-one consecutive UCBTs were identified. All but 3 UCB units had a high-resolution HLA typing on 8 loci at the time of selection. At the time of cryopreservation, the median CD34 + cell count was 1 × 10 5 /kg (range, .6 to 12.0 × 10 5 /kg) and the median total nucleated cell (TNC) count was 2.8 × 10 7 /kg (range, 1.48 to 5.6 × 10 7 /kg). Eighty-seven percent of patients received myeloablative conditioning, and 77% underwent transplantation for acute myeloid leukemia. The median duration of follow-up among survivors was 38.2 months (range, 10.4 to 123.6 months). No adverse events were related to the IB infusion at bedside under short-conscious periprocedural sedation or to the no wash technique. After thawing, median CD34 + cell and TNC counts were .8 × 10 5 /kg (range, .1 to 2.3 × 10 5 /kg) and 1.42 × 10 7 /kg (range, .69 to 3.2 × 10 7 /kg). The median time to engraftment was 27 days for neutrophils and 53 days for platelets. One patient experienced graft rejection and was subsequently rescued with a salvage transplantation. The median time to a CD3 + cell count >100/μL was 30 days. The 100-day cumulative incidence of grade III-IV acute graft-versus-host disease (GVHD) was 12.9% (95% confidence interval [CI], 4% to 27.3%), and the 2-year cumulative incidence of moderate-to-severe chronic GVHD (cGVHD) was 11.8% (95% CI, 2.7% to 28.3%). At 2 years, overall survival (OS) was 52.7% (95% CI, 33% to 69%), relapse incidence was 30.7% (95% CI, 13.7% to 49.6%), and transplantation-related mortality was 29% (95% CI, 14.3% to 45.6%). In univariate analysis, infused CD34 + cell count did not impact transplantation outcomes. In patients who underwent transplantation in first complete remission, relapse rate was 13%, with a 2-year OS >90%. In our cohort, IB infusion of a single cord blood unit was feasible, with no adverse reactions related to the no wash/IB infusion, low rates of cGVHD and disease relapse, and rapid immune reconstitution., (Copyright © 2023 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)

Cancer therapies use different compounds of synthetic and natural origin. However, despite some positive results, relapses are common, as standard chemotherapy regimens are not fully capable of completely eradicating cancer stem cells. While vinblastine is a common chemotherapeutic agent in the treatment of blood cancers, the development of vinblastine resistance is often observed. Here, we performed cell biology and metabolomics studies to investigate the mechanisms of vinblastine resistance in P3X63Ag8.653 murine myeloma cells. Treatment with low doses of vinblastine in cell media led to the selection of vinblastine-resistant cells and the acquisition of such resistance in previously untreated, murine myeloma cells in culture. To determine the mechanistic basis of this observation, we performed metabolomic analyses of resistant cells and resistant drug-induced cells in a steady state, or incubation with stable isotope-labeled tracers, namely, 13 C 15 N-amino acids. Taken together, these results indicate that altered amino acid uptake and metabolism could contribute to the acquisition of vinblastine resistance in blood cancer cells. These results will be useful for further research on human cell models.

When talking about environmental and sustainability topics, the wine sector plays a fundamental role ensuring that wine remains not only economically but also environmentally sustainable, hence the importance of conducting analyses to measure the impact of food production through Life Cycle Assessment tool. This paper aims to propose a systematic review of the LCA studies related to the grape and wine production chain providing both a qualitative and a quantitative analysis of methodologies used, and results proposed, as well as focusing the attention on carbon and water environmental indicators that can be evaluated using the LCA tool. Both the qualitative and the quantitative analysis showed a strong variability among the studies starting from the selection of the functional unit till the way the impact assessment is carried out. The results indicated the lack of homogeneity on the application of the LCA, emphasizing the need for deeper research on the wine sector. Based on the interpretation of the results, it was possible to identify the main drivers and barriers of the environmental impact assessment, allowing the contribution towards providing insights both for LCA practitioners and stakeholders of the wine sector. To this end, the main novelty of this work was to give an all-around view of the application of LCA tool in the wine sector providing a first step in the creation of a standardized procedure that harmonize the way a LCA study must be done. This opportunity would be a huge advantage for the scientific community, allowing the possibility to compare different wine production realities by using a globally recognized procedure without bias. Future research will have to focus on understanding and developing this scheme for enhancing the added value of the wine product., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background/aim: Supra hemodiafiltration with reinfusion of the endogenous ultrafiltrate (Supra-HFR) is a dialysis technique used to improve uremic toxin removal in the range of the middle molecular weight molecules. Supra-HFR does not require the preparation and online infusion of high-purity dialysis water because it allows the production of an endogenous ultrafiltrate that undergoes detoxification through an adsorbing resin., Patients and Methods: We investigated the ability of Supra-HFR to remove fibroblast growth factor 23 (FGF23), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), interleukin 8 (IL-8), and transforming growth factor alpha (TGF-alpha) after a single session dialysis in nine patients affected by end stage renal disease (ESRD). The same patients underwent a single session of online hemodiafiltration (OL-HDF) to evaluate possible differences in FGF23 and IL-6 levels., Results: A significant reduction in FGF23 was observed with both Supra-HFR (p=0.001) and OL-HDF. As for TNF-alpha and TGF-alpha, which were measured using Supra-HFR only, their percentage values were significantly lower at the end of dialysis than at the start (p=0.0028 and p=0.03, respectively). This did not change with post-dialysis rebound. Supra-HFR was found to have no effect on IL-6 and IL-8. Interestingly, the removal rate for FGF23 and IL-6 was similar to that observed with OL-HDF., Conclusion: Supra-HFR was not superior to OL-HDF, with suboptimal convective volume in the removal of the molecules tested, especially FGF23, which is considered a large middle molecular weight uremic toxin., (Copyright © 2022, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Several methods are available to answer questions regarding similarity and accuracy, each of which has specific properties and limitations. This study focuses on the Latent Congruence Model (LCM; Cheung, 2009), because of its capacity to deal with cross-informant measurement invariance issues. Until now, no cross-national applications of LCM are present in the literature, perhaps because of the difficulty to deal with both cross-national and cross-informant measurement issues implied by those models. This study presents a step-by-step procedure to apply LCM to dyadic cross-national research designs controlling for both cross-national and cross-informant measurement invariance. An illustrative example on parent-child support exchanges in Italy and Germany is provided. Findings help to show the different possible scenarios of partial invariance, and a discussion related to how to deal with those scenarios is provided. Future perspectives in the study of parent-child similarity and accuracy in cross-national research will be discussed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Tagliabue, Zambelli, Sorgente, Sommer, Hoellger, Buhl and Lanz.)

Mesenchymal stromal cells (MSC) have emerged as a promising therapy to minimize the immunosuppressive regimen or induce tolerance in solid organ transplantation. In this randomized open-label phase Ib/IIa clinical trial, 20 liver transplant patients were randomly allocated (1:1) to receive a single pretransplant intravenous infusion of third-party bone marrow-derived MSC or standard of care alone. The primary endpoint was the safety profile of MSC administration during the 1-year follow-up. In all, 19 patients completed the study, and none of those who received MSC experienced infusion-related complications. The incidence of serious and non-serious adverse events was similar in the two groups. Circulating Treg/memory Treg and tolerant NK subset of CD56 bright NK cells increased slightly over baseline, albeit not to a statistically significant extent, in MSC-treated patients but not in the control group. Graft function and survival, as well as histologic parameters and intragraft expression of tolerance-associated transcripts in 1-year protocol biopsies were similar in the two groups. In conclusion, pretransplant MSC infusion in liver transplant recipients was safe and induced mild positive changes in immunoregulatory T and NK cells in the peripheral blood. This study opens the way for a trial on possible tolerogenic efficacy of MSC in liver transplantation. ClinicalTrials.gov identifier: NCT02260375., (© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)

Hematopoietic stem and progenitor cell (HSPC)-based gene therapy (GT) requires the collection of a large number of cells. While bone marrow (BM) is the most common source of HSPCs in pediatric donors, the collection of autologous peripheral blood stem cells (PBSCs) is an attractive alternative for GT. We present safety and efficacy data of a 10-year cohort of 45 pediatric patients who underwent PBSC collection for backup and/or purification of CD34 + cells for ex vivo gene transfer. Median age was 3.7 years and median weight 15.8 kg. After mobilization with lenograstim/plerixafor (n = 41) or lenograstim alone (n = 4) and 1-3 cycles of leukapheresis, median collection was 37 × 10 6 CD34 + cells/kg. The procedures were well tolerated. Patients who collected ≥7 and ≥13 × 10 6 CD34 + cells/kg in the first cycle had pre-apheresis circulating counts of at ≥42 and ≥86 CD34 + cells/μL, respectively. Weight-adjusted CD34 + cell yield was positively correlated with peripheral CD34 + cell counts and influenced by female gender, disease, and drug dosage. All patients received a GT product above the minimum target, ranging from 4 to 30.9 × 10 6 CD34 + cells/kg. Pediatric PBSC collection compares well to BM harvest in terms of CD34 + cell yields for the purpose of GT, with a favorable safety profile., Competing Interests: SR-TIGET is a joint venture between Fondazione Telethon and OSR. Gene therapies for ADA-SCID, WAS, MLD, β-thalassemia, and MPSIH developed at SR-TIGET were licensed to Orchard Therapeutics (OTL) in 2018 and 2019. A.A. is the principal investigator (PI) of the above clinical trials. M.E.B. is the current PI of the MPSIH clinical trial., (© 2021.)

Laurus nobilis , Salvia officinalis and Salvia sclarea essential oils (EOs) and hydrolates (HYs) were investigated to define their chemical compositions and biological properties. Gas-chromatography/Mass-spectrometry (GC/MS) and Headspace-GC/MS (HS-GC/MS) techniques were used to characterize the liquid and vapor phase chemical composition of EOs and HYs. 1,8-Cineole (42.2%, 33.5%) and α-pinene (16.7%, 39.0%) were the main compounds of L. nobilis EO; 1,8-cineole (30.3%, 48.4%) and camphor (17.1%, 8.7%) were for S. officinalis EO; linalyl acetate (62.6%, 30.1%) and linalool (11.1%, 28.9%) were for S. sclarea EO for the liquid and vapor phase, respectively. Chemical profile of HYs was characterized by 1,8-cineole (65.1%, 61.4%) as a main constituent of L. nobilis and S. officinalis HYs, while linalool (89.5%) was the main constituent of S. sclarea HY. The antioxidant activity of EOs and HYs was carried out by DPPH and ABTS assays and antimicrobial properties were also investigated by microdilution and the disc diffusion method for liquid and vapor phase against five different bacterial strains such as Escherichia coli ATCC 25922, Pseudomonas fluorescens ATCC 13525 and Acinetobacter bohemicus DSM 102855 among Gram-negative and Bacillus cereus ATCC 10876 and Kocuria marina DSM 16420 among Gram-positive. L. nobilis and S. officinalis EOs demonstrated considerable antibacterial activity, while S. sclarea EO proved to be less effective. Agar diffusion method and vapor phase test showed the EOs activity with the biggest halo inhibition diameters against A. bohemicus and B. cereus . A remarkably high antioxidant activity was determined for L. nobilis showing low EC 50 values and also for S. sclarea; good EO results were obtained in both of the used assays. S. officinalis EC 50 values were slightly higher to which corresponds to a lower antioxidant activity. Concerning the HYs, the EC 50 values for L. nobilis , S. officinalis and S. sclarea were remarkably high corresponding to an extremely low antioxidant activity, as also obtained by expressing the values in Trolox equivalent antioxidant capacity (TEAC).

Background and Aims: Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking., Methods: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis., Results: Between March 1 and June 27, 2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39 of 204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five percent of patients requiring hospitalization for COVID-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose., (Copyright © 2021 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Collection of an adequate amount of autologous haematopoietic stem progenitor cells (HSPC) is required for ex vivo manipulation and successful engraftment for certain inherited disorders. Fifty-seven paediatric patients (age 0.5-11.4 years) underwent a bone marrow harvest for the purpose of HSPC gene therapy (GT), including adenosine deaminase-severe combined immunodeficiency (ADA-SCID), Wiskott-Aldrich syndrome (WAS) and metachromatic leukodystrophy (MLD) patients. Total nucleated cells and the percentage and absolute counts of CD34+ cells were calculated at defined steps of the procedure (harvest, CD34+ cell purification, transduction with the gene transfer vector and infusion of the medicinal product). A minimum CD34+ cell dose for infusion was 2 × 10 6 /kg, with an optimal target at 5-10 × 10 6 /kg. Median volume of bone marrow harvested was 34.2 ml/kg (range 14.2-56.6). The number of CD34+ cells collected correlated inversely with weight and age in all patients and particularly in the MLD children group. All patients reached the minimum target dose for infusion: median dose of CD34+ cells/kg infused was 10.3 × 10 6 /kg (3.7-25.9), with no difference among the three groups. Bone marrow harvest of volumes > 30 ml/kg in infants and children with ADA-SCID, WAS and MLD is well tolerated and allows obtaining an adequate dose of a medicinal product for HSPC-GT.

Background: Chestnuts are gluten-free, low-fat, cholesterol-free products. Postharvest decay reduces chestnut shelf life and can cause severe economic losses. In this study we investigated the effect of ozone (O 3 ) gaseous treatment on chestnut rot caused by Gnomoniopsis castanea and the quality parameters of chestnuts., Results: The results showed that ozone treatment (150 ppb during the day, and 300 ppb during the night) reduced the decay of chestnuts and had a fungistatic effect on isolates of G. castanea. The exposure of chestnuts to ozone did not alter weight losses, sugar content and titratable acidity. The concentration of total phenolics decreased during the storage period, both for treated and untreated nuts. However, after 150 days of treatment the polyphenol content of the chestnuts exposed to ozone was significantly higher than in control nuts., Conclusions: Our results suggested that ozone is an appropriate and economical tool to maximize the quality of chestnut shelf life, enabling it to be stored for long periods. © 2019 Society of Chemical Industry., (© 2019 Society of Chemical Industry.)

In this paper, we present a novel framework for finding the kinematic structure correspondences between two articulated objects in videos via hypergraph matching. In contrast to appearance and graph alignment based matching methods, which have been applied among two similar static images, the proposed method finds correspondences between two dynamic kinematic structures of heterogeneous objects in videos. Thus our method allows matching the structure of objects which have similar topologies or motions, or a combination of the two. Our main contributions can be summarised as follows: (i) casting the kinematic structure correspondence problem into a hypergraph matching problem by incorporating multi-order similarities with normalising weights, (ii) introducing a structural topology similarity measure by aggregating topology constrained subgraph isomorphisms, (iii) measuring kinematic correlations between pairwise nodes, and (iv) proposing a combinatorial local motion similarity measure using geodesic distance on the Riemannian manifold. We demonstrate the robustness and accuracy of our method through a number of experiments on synthetic and real data, outperforming various other state of the art methods. Our method is not limited to a specific application nor sensor, and can be used as building block in applications such as action recognition, human motion retargeting to robots, and articulated object manipulation amongst others.

Introduction: Autologous conditioned serum (ACS) is a novel blood product developed for intra-articular injection as a novel therapy for Osteoarthritis (OA). This study is a retrospective evaluation of 28 cases (25 Knee-OA and 3 hip-OA) treated with ACS between November 2013 and February 2016., Materials and Methods: ACS was prepared according to standards in an accredited Cell Manipulation Lab, and applied by an expert clinician (2 ml injection once weekly over 4 weeks). At any injection visit (Timepoints 1-4), and after a follow-up of 1 (Timepoint 5) and 6 months (Timepoint 6), patients were asked to describe the intensity of their pain with the VAS (visual analog scale) psychometric scale, and the objective parameter ROM (Range Of Motion) was recorded in case of injection in the knee., Results: Pain (VAS) reduced in all cases since the first injection up to Timepoint 5. A significant improvement was observed in VAS between Timepoint 1 and 6 (primary objective), with a median VAS decrease of 60 mm (range 20-100, p < 0.01). A significant difference was also recorded in ROM between Timepoint 1 and 6 (secondary objective), with a median increase of 25° (range 5-40, p < 0.01). Ten out of 14 patients (71%) who were undergoing a chronic therapy to relieve pain were able to interrupt it. No serious adverse events were recorded., Conclusions: Treatment with ACS produced a rapid decline in pain, accompanied by a large improvement in ROM. These results suggest that ACS is a valid option for the treatment of OA., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Context: Liver transplantation (LT) is considered the ideal therapy for patients with hepatocellular carcinoma (HCC) having cirrhosis but the shortage of liver donors and the risk of dropout from the wait list due to tumor progression severely limit transplantation. A new prognostic score, the HCC-model for end-stage liver disease (HCC-MELD), was developed by combining α-fetoprotein (AFP), MELD, and tumor size, to improve risk stratification of dropout in patients with HCC., Objectives: In this study, we investigated the ability of the HCC-MELD score in predicting the posttransplant for patients fulfilling Milan criteria (MC)., Design: Two hundred patients with stage II tumor were retrospectively reviewed from a total of 1290 transplants performed at our institution from October 1997 through April 2015. Cox regression analysis was performed to identify the prognostic factors impacting the posttransplant survival., Results: Overall survival at 1, 5, and 10 years was 89.3%, 71.1%, and 67.2%, whereas disease-free survival was 86.4%, 66.5%, and 52.4%, respectively. Multivariate analysis showed HCC-MELD score (hazard ratio [HR] 39.6, P < .001) and microvascular invasion (HR 2.41, P = .002) to be independent risk factors for recurrence, whereas HCC diameter (HR 1.15, P = .041), HCC-MELD (HR 15.611, P = .006), and grading (HR 2.17, P = .03) proved to be predictive factors of poor overall survival., Conclusion: Our study showed the validity of the HCC-MELD equation in the evaluation of patients undergoing LT for HCC. This score offers a reliable method to assess the risk of waiting list dropout and predict posttransplantation outcomes.

Intraoperative transfusions seem associated with patient death and graft failure after PLTx. A retrospective analysis of recipients' and donors' characteristics and transplantation data in a cohort of patients undergoing PLTx from 2002 to 2009 at the Bergamo General Hospital was performed. A two-stage hierarchical Cox proportional hazard regression with forward stepwise selection was used to identify the main risk factors for major complications. In addition, propensity score analysis was used to adjust risk estimates for possible selection biases in the use of blood products. Over the 12-year period, 232 pediatric cirrhotic patients underwent PLTx. One-year patient and graft survival rates were 92.3% and 83.7%, respectively. The Kaplan-Meier shows that the main decrease in both graft and patient survival occurs during the first months post-transplantation. At the same time, it appears that most of the complications occur during the first month post-transplantation. One-month and 1-year patient complication-free survival rates were 24.8% and 12.1%, respectively. Our study shows that intraoperative red blood cells and platelet transfusions are independent risk factors for developing one or more major complications in the first year after PLTx. Decreasing major complications will improve the health status and overall long-term patient survival after pediatric PLTx., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Liver transplantation (LT) is considered the best treatment option for HCC patients with cirrhosis. However, the scarce availability of liver donors and the risk of dropout from the waiting list due to the tumor progression severely limit LT for HCC. In this study, we evaluate the survival and recurrence in a cohort of patients undergoing LT for HCC fulfilling "Milan Criteria" (MC) pre-LT. In this study, we propose the development of a new prognostic score which could improve the accuracy in predicting recurrence post-LT., Methods: Between 1997 and 2011, out of 1010 LT performed in our unit, 131 patients had T2 staged HCC (inside MC). The prognostic model predicting HCC recurrence post-LT was derived from Cox regression analysis. The performance of this model was validated in an external cohort of 198 HCC patients transplanted at another center., Results: Overall survival at 1-3-5 years was 87%, 74.4%, 68.2%, whereas recurrence-free survival was 94.1%, 81.4%, 77.6%, respectively. Predictive factors for recurrence-free survival included high tumor grading (HR 5.01; p = 0.006) and tumor diameter (HR 1.46; p = 0.045). According to this model, the estimated relative risk of HCC recurrence after LT is given by this formula: 0.382 × (Tumor size [cm]) + 1.613 × (if Grading 3-4). The ROC curve was 0.878 (p < 0.001) in predicting HCC recurrence., Conclusion: In conclusion, our study showed that the use of this new prognostic score, taking into account maximal tumor diameter and tumor differentiation, improves the accuracy of Milan criteria in predicting HCC recurrence., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Bone and soft tissue remodeling after tooth extraction may have dramatic effects. The socket preservation technique has demonstrated to be effective in maintaining volume before implant placement. The Pink Esthetic Score (PES) is an easy and complete evaluation of esthetic parameters. The aim of this study was to compare the PES index of anterior teeth needing to be replaced and the correspondent implant-supported prostheses after the socket preservation technique with 1 year of follow-up. Twenty-four patients were enrolled in this study. Eighteen maxillary central incisors and 6 maxillary lateral incisors were extracted, and then, every alveolar site was treated with the socket preservation technique and filled with Bio-Oss, mixed with fibrin glue, and covered with a collagen sponge. After 6 months of undisturbed healing, implants were placed and left healing for 4 months. After they were regularly loaded and at 1 year of follow-up, peri-implant PESs were recorded. All implants integrated successfully. No dropouts were recorded. Comparing PES results before extraction (mean, 12.25) and after implant loading (mean, 12.35), those around implants are similar if not better, and there are no statistically significant differences as analyzed with the t-test. The socket preservation technique combined with delayed implant placement and a standard healing time before implant loading has demonstrated to be effective in maintaining volumes and also esthetic values around implants compared with PES values before tooth extraction.

Neonatal haemochromatosis is a rare alloimmune gestational disease with a high mortality. The hallmark of neonatal haemochromatosis is severe neonatal liver failure associated with extrahepatic siderosis. Thus far, no pituitary dysfunction has been reported to result from the tissue damage associated with extrahepatic siderosis. The present report describes a neonate with neonatal haemochromatosis and secondary hypothyroidism associated with pituitary iron deposition. Both the conditions were successfully treated by ABO-incompatible liver transplantation. Pituitary gland dysfunction is another possible extrahepatic manifestation of neonatal haemochromatosis, and it is reversible after liver transplantation., (© 2014 Steunstichting ESOT.)

Objectives: The intravenous injection of bisphosphonates, currently used as treatment for osteoporosis, bone Paget's disease, multiple myeloma, or bone metastases, can cause jaw bone necrosis especially in consequence of trauma. The present research aimed to clarify the mechanisms underlying bone necrosis, exploring involvement of the oral mucosa "in vivo.", Patients and Methods: Specimens of oral mucosa were removed from bisphosphonate-treated patients with or without jaw bone necrosis. In mucosa specimens, expression was evaluated of: cytokines involved in the inflammatory process, factors involved in osteoclast activity, i.e., receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin, a factor involved in cell proliferation, namely hydroxymethylglutaryl coenzyme A reductase, and a factor involved in angiogenesis, namely vascular endothelial growth factor (VEGF)., Results: Interleukin (IL)-6 and the RANK/osteoprotegerin ratio were significantly elevated in mucosa from patients with versus without jaw necrosis, whereas hydroxymethylglutaryl coenzyme A reductase and VEGF were significantly decreased., Conclusions: Our results suggest that mucosa, stimulated by bisphosphonate released from the bone, can contribute to the development of jaw necrosis, reducing VEGF, and producing IL-6 in consequence of hydroxymethylglutaryl coenzyme A reductase reduction. In turn, IL-6 stimulates osteoclast activity, as shown by the increased RANKL/osteoprotegerin ratio., Clinical Relevance: The results of this study suggest the importance of evaluating during bisphosphonate treatment the production of IL-6, RANKL, osteoprotegerin, and VEGF, in order to monitor the jaw osteonecrosis onset. To avoid repeated mucosa excisions, the determination of these factors could be carried out in crevicular fluid.

Unlabelled: In spite of more recent techniques for breast reduction, the inferior pedicle technique has proven to be enduring and still a very popular option in the plastic surgeon's armamentarium despite certain shortcomings. This technique is especially important for treating large breasts with a long sternal notch-to-nipple distance. The modifications we describe in this article overcome some of the main drawbacks of the standard inferior pedicle technique and make the procedure particularly effective when used on appropriately selected patients. This is achieved principally by the creation of a strong, durable, and internalized "dermal cage" that remains fixed to the chest wall in the upper part, as well as on both sides, to support the majority of the remaining breast tissue. This serves several purposes, including narrowing the breast thereby giving good projection and reduction of the N-IMF length of the inferior pedicle. Through suspension and fixation of the inferior pedicle to the chest wall, one can mitigate the effects of gravity on the inferior pedicle. The benefits of this include reduced tension on the T junction, thereby reducing the incidence of wound dehiscence in the immediate postoperative period, while reduction of tension on the nipple-areola complex reduces "bottoming" out over the long term. This process has been the main shortcoming of the inferior pedicle technique to date. The technique was used on 26 patients over a 7-year period with a mean long-term follow-up of 41 months. The results demonstrate the short- and long-term effectiveness of our own particular combination of modifications to previously described techniques and modifications of the inferior pedicle breast reduction., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Full-right-full-left split liver transplantation divides a donor liver into two grafts to be transplanted in adult-size patients. Major technical and organizational difficulties have limited its application to few single center series. We retrospectively analyzed the long-term results of the first multicenter series of this procedure with graft sharing. Between November 1998 and January 2005, 43 transplants were performed by five centers from 23 full-right-full-left in situ split liver procedures; 65% of the grafts were shared. A total of 31 (72%) patients had complications above grade II; 3 (6.9%) were retransplanted. Hospital mortality was 23% with sepsis as the main cause. Six patients died in the long term, two of them for a road accident. A total of 27 patients are alive after a median follow-up of 3200 days (2035-4256). Actuarial survival at 1 and 10 years were 72.1%, 62.6% and 65.1%, 57.9%, respectively for patients and grafts. These figures are similar to those reported for adult living donor liver transplantation by the European Registry over a similar period. Multicenter collaboration in sharing of these grafts is feasible and can help facing the organizational limits, thus increasing diffusion of full-right-full-left split liver transplantation., (© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.)