Search

Synthetic or natural cationic polymers, such as polyacrylamide and chitosan, are exploited as coagulants due to their characteristics, such as a high positive surface charge. Due to variations in culture conditions, such as species and cell concentration, different interactions of coagulants with microalgae occur, affecting the efficiency of biomass recovery. Thus, in this study, the separation efficiency of biomass of the microalgae Scenedesmus obliquuswas evaluated by coagulation-flocculation with the synthetic polymer polyacrylamide and natural polymer chitosan to optimize the dose and pH by means of a rotational central composite design. Biomass removal efficiencies greater than 90% and greater than 70% were observed for the synthetic polymer and chitosan, respectively. Notably, the reduced optical density and biological nature of microalgae make the use of response surface methodology challenging. Optimal regions with doses of 12.8 mg of synthetic polymer and 5.0 mg of chitosan were obtained per liter of microalgae sample. An optimal pH of 6.5, falling within the natural range of culture conditions was indicated for both coagulants, minimizing reagent costs. The interaction with microalgae and the potential application of chitosan and other natural coagulants that are efficient and economically viable should be explored.

ABSTRACTAligned with research recommendations (e.g., Wadey & Everard, 2021), the purpose of this multi-method multi-study investigation was to construct a measure of athletes’ experiences of growth following sport injury. Study 1 systematically reviewed the literature on sport injury-related growth (SIRG) and extracted a pool of relevant and specific items organised in themes. In Study 2, a panel of experts (i.e., academics, sport psychologists, and previously injured athletes) was asked to quantitatively and qualitatively assess the items for relevance, clarity, and specificity. These two studies provided evidence for the content validity of the pool of items. Study 3 tested the psychometric properties of the instrument on a sample of previously injured athletes (N = 452), identifying satisfactory factor structure, concurrent validity, and reliability. Collectively, the multi-study supports the construct validity of a 24-item scale, named the Sport Injury-Related Growth Inventory-24 (SIRGI-24), measuring eight sub-dimensions of SIRG: sense of mastery, positive relations with others, responsibility for one’s health, self-awareness, emotional ability, purpose in life, purpose in sport, and body awareness. To conclude, the SIRGI-24 allows researchers and sport psychologists to assess the SIRG experienced by injured athletes.

Fabry disease is a rare X-linked disease characterized by deficient expression and activity of alpha-galactosidase A with consequent lysosomal accumulation of glycosphingolipids, particularly globotriaosylceramide in various organs. Currently, enzyme replacement therapy with recombinant human α-galactosidase is the cornerstone of the treatment of Fabry patients, although in the long term enzyme replacement therapy fails to halt disease progression, in particular in case of late diagnosis. This suggests that the adverse outcomes cannot be justified by the lysosomal accumulation of glycosphingolipids alone, and that additional therapies targeted at further pathophysiologic mechanisms might contribute to halting the progression of cardiac, cerebrovascular and kidney disease in Fabry patients. Recent evidence points toward the involvement of oxidative stress, oxidative stress signaling and inflammation in the pathophysiology of cardio cerebrovascular and kidney damage in Fabry patients. This review reports the current knowledge of the involvement of oxidative stress in Fabry disease, which clearly points toward the involvement of oxidative stress in the pathophysiology of the medium to long-term cardio-cerebrovascular-kidney damage of Fabry patients and summarizes the antioxidant therapeutic approaches currently available in the literature. This important role played by oxidative stress suggests potential novel additional therapeutic interventions by either pharmacologic or nutritional measures, on top of enzyme replacement therapy, aimed at improving/halting the progression of cardio-cerebrovascular disease and nephropathy that occur in Fabry patients.

Background The use of balloon microcatheters in interventional neuroradiology is well documented. However, their use is sometimes limited by the small diameter and excessive tortuosity of the vasculature. The Scepter Mini dual-lumen balloon microcatheter (SMBM) (Microvention, Aliso Viejo, CA) has been designed to address these challenges by decreasing the distal catheter profile, allowing distal access to the target vessel.Methods This is a single-centre retrospective analysis of the initial cases performed using the Scepter Mini balloon microcatheter. The targeted conditions were vascular malformations. Patient clinical data, angiographic features of the vascular abnormalities and operation reports were reviewed and the procedural parameters, radiation doses, occlusion rates and complications were assessed.Results A total of 15 SMBM were used in 11 cases. In all cases the procedure performed was balloon inflation and antegrade delivery of precipitating hydrophobic injectable liquid (PHIL) (Microvention, Aliso Viejo, CA) for embolisation of a targeted feeding vessel and cranial and spinal vascular malformations. Successful feeding vessel distal access and antegrade liquid embolisation was achieved in 100% of the cases. One of the 11 cases was an emergency procedure. One procedural target vessel rupture, likely due to overinflation, and three minor post-procedure complications were observed.Conclusion The SMBM represents a significant advance in the treatment of cerebrospinal vascular malformations, allowing balloon catheter access into tortuous and small calibre vessels.

Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary vascular resistance (PVR), imposing overload on the right ventricle (RV) and imbalance of the redox state. Our study investigated the influence of treatment with sulforaphane (SFN), found in cruciferous vegetables, on RV remodeling and redox homeostasis in monocrotaline (MCT)-induced PAH. Male Wistar rats were separated into 4 groups: control (CTR); CTR + SFN; MCT; and MCT + SFN. PAH induction was implemented by a single dose of MCT (60 mg/kg intraperitoneally). Treatment with SFN (2.5 mg/kg/day intraperitoneally) started on the seventh day after the MCT injection and persisted for 2 weeks. After 21 days of PAH induction, echocardiographic, hemodynamic, and oxidative stress evaluation was performed. The MCT group showed an increase in RV hypertrophy, RV systolic area, RV systolic, mean pulmonary artery pressure, and PVR and exhibited a decrease in the RV outflow tract acceleration time/ejection time ratio, RV fractional shortening, and tricuspid annular plane systolic excursion compared to CTR (P< 0.05). SFN-treated PAH attenuated detrimental changes in tricuspid annular plane systolic excursion, mean pulmonary artery pressure, and PVR parameters. Catalase levels and the glutathione/Glutathione disulfide (GSSG) ratio were diminished in the MCT group compared to CTR (P< 0.05). SFN increased catalase levels and normalized the glutathione/GSSG ratio to control levels (P< 0.05). Data express the benefit of SFN treatment on the cardiac function of rats with PAH associated with the cellular redox state.

Liver transplant oncology (TO) represents an area of increasing clinical and scientific interest including a heterogeneous group of clinical–pathological settings. Immunosuppressive management after LT is a key factor relevantly impacting result. However, disease-related guidance is still lacking, and many open questions remain in the field. Based on such a substantial lack of solid evidences, the Italian Board of Experts in Liver Transplantation (I-BELT) (a working group including representatives of all national transplant centers), unprecedently promoted a methodologically sound consensus conference on the topic, based on the GRADE approach. The group final recommendations are herein presented and commented. The 18 PICOs and Statements and their levels of evidence and grades of recommendation are reported and grouped into seven areas: (1) risk stratification by histopathological and bio-molecular parameters and role of mTORi post-LT; (2) steroids and HCC recurrence; (3) management of immunosuppression when HCC recurs after LT; (4) mTORi monotherapy; (5) machine perfusion and HCC recurrence after LT; (6) physiopathology of tumor-infiltrating lymphocytes and immunosuppression, the role of inflammation; (7) immunotherapy in liver transplanted patients. The interest in mammalian targets of rapamycin inhibitors (mTORi), for steroid avoidance and the need for a reduction to CNI exposure emerged from the consensus process. A selected list of unmet needs prompting further investigations have also been developed. The so far heterogeneous and granular approach to immunosuppression in oncologic patients deserves greater efforts for a more standardized therapeutic response to the different clinical scenarios. This consensus process makes a first unprecedented step in this direction, to be developed on a larger scale.

Diffuse midline glioma, H3 K27-altered (DMG-H3 K27) is an aggressive group of diffuse gliomas that predominantly occurs in pediatric patients, involves midline structures, and displays loss of H3 p.K28me3 (K27me3) expression by immunohistochemistry and characteristic genetic/epigenetic profile. Rare examples of a diffuse glioma with an H3 p.K28M (K27M) mutation and without involvement of the midline structures, so-called “diffuse hemispheric glioma with H3 p.K28M (K27M) mutation” (DHG-H3 K27), have been reported. Herein, we describe 2 additional cases of radiologically confirmed DHG-H3 K27 and summarize previously reported cases. We performed histological, immunohistochemical, molecular, and DNA methylation analysis and provided clinical follow-up in both cases. Overall, DHG-H3 K27 is an unusual group of diffuse gliomas that shows similar clinical, histopathological, genomic, and epigenetic features to DMG-H3 K27 as well as enrichment for activating alterations in MAPK pathway genes. These findings suggest that DHG-H3 K27 is closely related to DMG-H3 K27 and may represent an unusual presentation of DMG-H3 K27 without apparent midline involvement and with frequent MAPK pathway activation. Detailed reports of additional cases with clinical follow-up will be important to expand our understanding of this unusual group of diffuse gliomas and to better define the clinical outcome and how to classify DHG-H3 K27.

BackgroundPhysician variablity in preoperative planning of endovascular implant deployment and associated inaccuracies have not been documented. This study aimed to quantify the variability in accuracy of physician flow diverter (FD) planning and directly compares it with PreSize Neurovascular (Oxford Heartbeat Ltd) software simulations.MethodsEight experienced neurointerventionalists (NIs), blinded to procedural details, were provided with preoperative 3D rotational angiography (3D-RA) volumetric data along with images annotated with the distal landing location of a deployed Surpass Evolve (Stryker Neurovascular) FD from 51 patient cases. NIs were asked to perform a planning routine reflecting their normal practice and estimate the stent’s proximal landing using volumetric data and the labeled dimensions of the FD used. Equivalent deployed length estimation was performed using PreSize software. NI- and software-estimated lengths were compared with postprocedural observed deployed stent length (control) using Bland–Altman plots. NI assessment agreement was assessed with the intraclass correlation coefficient (ICC).ResultsThe mean accuracy of NI-estimated deployed FD length was 81% (±15%) versus PreSize’s accuracy of 95% (±4%), demonstrating significantly higher accuracy for the software (p<0.001). The mean absolute error between estimated and control lengths was 4 mm (±3.5 mm, range 0.03–30.2 mm) for NIs and 1 mm (±0.9 mm, range 0.01–3.9 mm) for PreSize. No discernable trends in accuracy among NIs or across vasculature and aneurysm morphology (size, vessel diameter, tortuousity) were found.ConclusionsThe study quantified experienced physicians’ significant variablity in predicting an FD deployment with current planning approaches. In comparison, PreSize-simulated FD deployment was consistently more accurate and reliable, demonstrating its potential to improve standard of practice.

Here, in a multi-ancestry genome-wide association study meta-analysis of kidney cancer (29,020 cases and 835,670 controls), we identified 63 susceptibility regions (50 novel) containing 108 independent risk loci. In analyses stratified by subtype, 52 regions (78 loci) were associated with clear cell renal cell carcinoma (RCC) and 6 regions (7 loci) with papillary RCC. Notably, we report a variant common in African ancestry individuals (rs7629500) in the 3′ untranslated region of VHL, nearly tripling clear cell RCC risk (odds ratio 2.72, 95% confidence interval 2.23–3.30). In cis-expression quantitative trait locus analyses, 48 variants from 34 regions point toward 83 candidate genes. Enrichment of hypoxia-inducible factor-binding sites underscores the importance of hypoxia-related mechanisms in kidney cancer. Our results advance understanding of the genetic architecture of kidney cancer, provide clues for functional investigation and enable generation of a validated polygenic risk score with an estimated area under the curve of 0.65 (0.74 including risk factors) among European ancestry individuals.

Objectives: To evaluate lifestyle habits and dietary patterns among university students during the COVID-19 pandemic and their association with skin color. Methods: This cross-sectional study was conducted with 1315 undergraduate students from a public higher education institution. Sociodemographic characteristics, lifestyle habits, and food consumption were collected. Factor analysis was used to identify dietary patterns and multivariate logistic regression was conducted to estimate the associations between race/skin color and outcomes. Results: Black individuals were less likely to show behaviors associated with the use of cigarettes or tobacco products (OR = 0.61; 95% CI 0.42−0.89). However, black individuals with higher income (greater than, or equal to one minimum wage per person) were less likely to show behaviors associated with illicit drug use (OR = 0.54; 95% CI 0.31−0.96), use of cigarettes or tobacco products (OR = 0.46; 95% CI 0.24−0.87) and alcohol consumption (OR = 0.64; CI 95% 0.42−0.98). In addition, individuals of race/skin color black with lower income (less than one minimum wage per person) showed decreased consumption of vegetables (OR = 0.68; CI 95% 0.48−0.96). Conclusions: Black college students with higher income were less likely to show undesirable behaviors related to the use of psychoactive substances. In contrast, individuals with lower income had lower consumption of foods from the vegetable group, which can be considered an unfavorable health-related behavior.

In the literature there is a lack of tools able to optimize contextually the design and operation of a multi-energy system in its entirety, meaning with this both i) the number, type and size of the energy conversion and storage plants supplying the end users of the system with the required energy, and ii) the geometry and capacity of the distribution networks delivering that energy to the users. Moreover, rarely the retrofit design problem is considered, meaning with “retrofit design” the addition of new capacity to components initially available in existing systems. Here, a general method is proposed to simultaneously optimize the retrofit design and operation of a multi-energy system and the associated energy networks. The goal consists in finding the additional capacity to be added to the already available components – energy conversion and storage plants, energy networks – and the new components to be installed, in order to comply with given reduction targets in carbon emissions, while keeping the life-cycle cost of the system at a minimum. A district composed of commercial and residential buildings operating in a microgrid is considered as case study. Heat can be provided to the end users via a district heating network, while electricity can be either generated on site or imported from the national power grid. Results of the retrofit design problem show a contextual reduction of 35% in CO2 emission and 20% in life cycle cost with respect to the original system configuration.

BackgroundSarcomas are a rare and diverse group of cancers occurring mainly in young individuals for which an underlying germline genetic cause remains unclear in most cases.MethodsGermline DNA from 177 children, adolescents and young adults with soft tissue or bone sarcomas was tested using multigene panels with 113 or 126 cancer predisposing genes (CPGs) to describe the prevalence of germline pathogenic/likely pathogenic variants (GPVs). Subsequent testing of a subset of tumours for loss of heterozygosity (LOH) evaluation was performed to investigate the clinical and molecular significance of these variants.ResultsGPVs were detected in 21.5% (38/177) of the patients (15.8% in children and 21.6% in adolescents and young adults), with dominant CPGs being altered in 15.2% overall. These variants were found in genes previously associated with the risk of developing sarcomas (TP53, RB1, NF1, EXT1/2) but also in genes where that risk is still emerging/limited (ERCC2, TSC2and BRCA2) or unknown (PALB2, RAD50, FANCMand others). The detection rates of GPVs varied from 0% to 33% across sarcoma subtypes and GPV carriers were more likely to present more than one primary tumour than non-carriers (21.1%×6.5%; p=0.012). Loss of the wild-type allele was detected in 48% of tumours from GPV carriers, mostly in genes definitively associated with sarcoma risk.ConclusionOur findings reveal that a high proportion of young patients with sarcomas presented a GPV in a CPG, underscoring the urgency of establishing appropriate genetic screening strategies for these individuals and their families.

Sodium–glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial.

The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population.

Robots are increasingly used in subsea environments because of their positive impact on human safety and operational capabilities in the deep ocean. However, achieving full autonomy remains challenging because of the extreme conditions they encounter. In this context, we propose an autonomous underwater architecture for long-term deep-ocean inspection that robustly plans activities and efficiently deliberates with no human help. It combines the innovative Saipem’s Hydrone-R subsea vehicle with an advanced planning architecture, resulting in a robot that autonomously perceives its surroundings, plans a mission, and adapts in real time to contingencies and opportunities. After describing the robot hardware, we present the technological advancements achieved in building its software, along with several compelling use cases. We explore scenarios where the robot conducts long-term underwater missions operating under resource constraints while remaining responsive to opportunities, such as new inspection points. Our solution gained significant reliability and acceptance within the oil and gas community as evidenced by its current deployment on a real field in Norway.

Abstract:Multiliteracies pedagogy, which focuses on the development of linguistic, visual and digital literacies, is closely tied to the concept of self-directed learning. This paper proposes that higher education institutions should provide students with opportunities to practise multiliteracies through self-directed learning projects. The University of Fribourg serves as a case study, with the analysis delving into the pedagogical framework and student acceptance. Evaluation data, including questionnaires and student reflections, are used to gauge the programme's effectiveness. The study finds that providing students with resources, support and training on effective resource utilisation is essential for successful integration of self-directed language learning projects. Furthermore, the paper discusses strategies for implementing such programmes in university settings and offers recommendations for enhancement. It emphasises the importance of language policies that advocate for the benefits of self-directed learning and individual support while encouraging its integration into group classes. This approach can help address potential resource constraints and foster a more comprehensive, learner-centred educational experience.Résumé:La pédagogie des littératies multiples, qui se concentre sur le développement des littératies linguistiques, visuelles et numériques, est étroitement liée au concept d'apprentissage autodirigé. Cet article propose que les établissements d'enseignement supérieur offrent aux étudiants des opportunités de pratiquer les multilittératies par le biais de projets d'apprentissage autodirigés. L'Université de Fribourg sert d'étude de cas, l'analyse approfondissant le cadre pédagogique et l'acceptation par les étudiants. Les données d'évaluation, y compris les questionnaires et les réflexions des étudiants, sont utilisées pour évaluer l'efficacité du programme. L'étude révèle que fournir aux étudiants des ressources, un soutien et une formation sur l'utilisation efficace des ressources est essentiel pour une intégration réussie des projets d'apprentissage des langues autodirigés. En outre, le document discute des stratégies pour mettre en œuvre de tels programmes dans les milieux universitaires et propose des recommandations d'amélioration. Il souligne l'importance des politiques linguistiques qui prônent les avantages de l'apprentissage autodirigé et du soutien individuel tout en encourageant son intégration dans les cours collectifs. Cette approche peut aider à résoudre les contraintes potentielles en matière de ressources et favoriser une expérience éducative plus complète et centrée sur l'apprenant.

Multiliteracies pedagogy, which focuses on the development of linguistic, visual and digital literacies, is closely tied to the concept of self-directed learning. This paper proposes that higher education institutions should provide students with opportunities to practise multiliteracies through self-directed learning projects. The University of Fribourg serves as a case study, with the analysis delving into the pedagogical framework and student acceptance. Evaluation data, including questionnaires and student reflections, are used to gauge the programme’s effectiveness. The study finds that providing students with resources, support and training on effective resource utilisation is essential for successful integration of self-directed language learning projects. Furthermore, the paper discusses strategies for implementing such programmes in university settings and offers recommendations for enhancement. It emphasises the importance of language policies that advocate for the benefits of self-directed learning and individual support while encouraging its integration into group classes. This approach can help address potential resource constraints and foster a more comprehensive, learner-centred educational experience.

•Retrospective study on 514 individuals with HIV: 229 were eligible for LAI CAB+RPV.•Eligible individuals are younger, in ART for less time and experienced less drugs.•The current NNRTI use was associated with higher probability of being eligible.•GRT is a crucial tool to screen individuals eligible for CAB+RPV regimen.

Telemedicine (TM) contributes to bridge the gap between healthcare facilities and patients’ homes with neuromuscular disease (NMD) because of mobility issues. However, its deployment is limited due to difficulties evaluating subtle neurological signs such as mild weakness or sensory deficits. The COVID-19 pandemic has disrupted healthcare delivery worldwide, necessitating rapid measures implementation by health care providers (HCPs) to protect patients from acquiring SARS-CoV-2 while maintaining the best care and treatment. Given the challenges faced by remote healthcare assistance of NMD patients, we aim to evaluate the use of TM in NMD during the COVID-19 pandemic. Based on the Model for Assessment-of-Telemedicine-Applications (MAST), we conducted a survey amongst clinicians of the ERN EURO NMD (European-Reference-Network-for-Rare-Neuromuscular-Diseases). Based on 42 responses over 76 expected ones, our results show that the COVID-19 pandemic significantly increased the number of HCPs using TM (from 60% to 100%). The TM types most used during the COVID-19 period are teleconsultation and consultation by phone, particularly in the context of symptoms worsening in NMD patients with COVID-19 infection. Most European HCPs were satisfied when using TM but as a complementary option to physical consultations. Many responses addressed the issue of technical aspects needing improvement, particularly for elderly patients who need caregivers’ assistance for accessing the TM platform. TM has been essential during COVID-19, but its use still presents some limitations for NMD patients with cognitive deficits or for first-time diagnosis. Thus, TM should be used as complement to, rather than substitute, for face-to-face consultations.

This article presents the NEFFIE (which stands for ‘Neuroaesthetic Photography’) project, a contemporary reinterpretation of Franco Vaccari’s iconic artwork, presented 50 years ago at the 1972 International Venice Art Biennale and entitled Exhibition in Real Time No. 4: Leave on the Walls a Photographic Trace of Your Fleeting Visit. Thanks to today’s technological innovation, NEFFIE develops Vaccari’s idea from a more contemporary perspective. Vaccari’s original photo booth becomes a technologically revisited booth that uses an algorithm and wearable sensors to reshape the subjective emotional-cognitive responses derived from viewing particular images, thus generating the ‘cognitive photograph’ or ‘COFFIE metapicture’. These metapictures are subsequently minted as NFTs (non-fungible tokens) objects and then displayed on a virtual wall, the ‘COFFIE wall’, generating what can be defined as a Virtual Exhibition in Real Time, a hypothetical contemporary re-actualization of Vaccari’s artistic proposition. The NEFFIE project could be considered a pervasive media art proposal capable of promoting social cohesion, by encouraging creative participation and co-creation. The project is being developed in Milan, thanks to a fruitful interdisciplinary collaboration between the Research Center in Advanced Technology in Health and Well-Being of San Raffaele Hospital, and ICONE, the European Research Center in History and Theory of the Image of Vita-Salute San Raffaele University. This multidisciplinary approach combines art-historical theoretical thinking with the world of technological innovation. In particular, the NEFFIE project integrates the visual and conceptual tools of photography with the methodologies and knowledge of biomedical engineering and computer science.

The accumulation of soluble oligomers of the amyloid-β peptide (AβOs) in the brain has been implicated in synapse failure and memory impairment in Alzheimer’s disease. Here, we initially show that treatment with NUsc1, a single-chain variable-fragment antibody (scFv) that selectively targets a subpopulation of AβOs and shows minimal reactivity to Aβ monomers and fibrils, prevents the inhibition of long-term potentiation in hippocampal slices and memory impairment induced by AβOs in mice. As a therapeutic approach for intracerebral antibody delivery, we developed an adeno-associated virus vector to drive neuronal expression of NUsc1 (AAV-NUsc1) within the brain. Transduction by AAV-NUsc1 induced NUsc1 expression and secretion in adult human brain slices and inhibited AβO binding to neurons and AβO-induced loss of dendritic spines in primary rat hippocampal cultures. Treatment of mice with AAV-NUsc1 prevented memory impairment induced by AβOs and, remarkably, reversed memory deficits in aged APPswe/PS1ΔE9 Alzheimer’s disease model mice. These results support the feasibility of immunotherapy using viral vector-mediated gene delivery of NUsc1 or other AβO-specific single-chain antibodies as a potential therapeutic approach in Alzheimer’s disease.

BackgroundThe radial artery approach has become popular as a ‘radial first’ strategy for arterial access in neuroangiography and neurointerventions. Recent studies have shown that transradial arterial access (TRA) for cerebral angiography has been associated with reduced access site complication rates and improved patient satisfaction compared with transfemoral access (TFA). The goal of this study was to evaluate the presence of abnormal MRI diffusion weighted imaging (DWI) foci following DSA and correlate their frequency with TRA or TFA.MethodsWe prospective analyzed 200 consecutive adult DSAs performed from January 2021 to January 2022, at a single tertiary center.ResultsOf the 200 consecutive diagnostic cerebral angiograms, 51% were performed via TRA and 49% were performed via TFA. Of the TRA cerebral angiograms, 17.5% demonstrated at least one hyperintense focus on MRI DWI. Of the TFA procedures, 5.2% were considered positive. One patient (0.5%) in the TRA group experienced a minor neurologic deficit postoperatively that had not completely resolved at 90 days after the procedure and no neurologic deficits occurred in the TFA group.ConclusionsDespite the proven benefit of TRA over TFA in neurointervention, the number of MRI DWI restriction foci were significantly more frequent during cerebral angiography when TRA was selected. Although the number of clinically symptomatic events were minimal, the widespread use of the technique may become clinically relevant. Further studies contrasting the TRA and TFA techniques will be beneficial for cerebral angiography.

Rituximab (RTX) is widely employed to treat Epstein-Barr virus reactivation in children undergoing Hematopoietic Cell Transplantation (HCT). The resulting loss of B cells may cause persistent hypogammaglobulinemia. This retrospective cross-sectional study aims to identify flow cytometry biomarkers associated with persistent hypogammaglobulinemia in patients receiving RTX after HCT. We analyzed 5 patients (cases group) requiring immunoglobulin substitution due to low level of IgG (IgG <5 g/L) detected after RTX treatment and 5 patients (controls group) not requiring long-term immunoglobulin (Ig) substitution. We investigated the B cell reconstitution, and in patients group we observed a significantly lower count in B total, IgD+CD27+ marginal B cells and IgD-CD27+ switched-memory B cells, after a median of 5 years from HCT, compared with the control group. Despite the importance limits of our study and the heterogeneity of our data (age of included patients, time of evaluation, interval between RTX dose and assessment) we conclude that RTX given early after HCT might cause a deranged B cell maturation, contributing to the delation in B cell recovery following HCT, and switched memory and marginal zone B cell counts could be a promising biomarker to identify patients requiring long-term Ig substitution.

AbstractObjective:Epidemiological studies have shown associations between polyphenol consumption and reduced risk of cardiovascular diseases. This study aimed to assess the association between polyphenol intake and the prevalence of hypertension.Methods:This cross-sectional study was performed on data from the Cohort of Universities of Minas Gerais (CUME) project. Participants completed an online food frequency questionnaire, and polyphenol intake was assessed using the Phenol-Explorer databaseand articles. Hypertension was determined by a medical diagnosis, having a blood pressure ≥ 130 mmHg/80 mmHg, or using antihypertensive drugs. Adjusted logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the prevalence of hypertension.Results:The prevalence of hypertension was 39.57%, and the average intake of total polyphenols was 860.79 mg/day. The highest (5thquintile) intake of flavonoids (mean: 368.46mg/day; OR: 0.83; 95%CI 0.70; 0.97), hydroxybenzoic acids (mean: 379.38mg/day; OR: 0.77; 95%CI: 0.66;0.91), and flavonols (mean: 44.13mg/day; OR: 0.79; 95%CI: 0.67; 0.93) was inversely associated with hypertension prevalence, compared to the lowest intake (1stquintile).Conclusions:Our findings demonstrate that the intake of flavonoids, hydroxybenzoic acids, and flavonols is associated with a lower prevalence of hypertension.

Objectives(1) To develop reference values for health-related fitness in European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries.MethodsThis study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test–retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method.ResultsA total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu).ConclusionThis study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

To control persimmon anthracnose, fungicides are applied from flowering until fruit harvest. Systemic fungicides registered for this crop are mainly from the group of quinone outside inhibitors (QoIs) and demethylation inhibitors (DMIs), both presenting risks for resistance development. For this reason, sensitivity studies and fungicide efficacy tests are important to determine the levels of sensitivity of isolates from different Colletotrichumspp. from persimmon to fungicides. The objectives of this work were: (i) to investigate the sensitivity of Colletotrichumisolates obtained from persimmon twigs and flowers to registered and non-registered active ingredients; (ii) to evaluate the cross-resistance of Colletotrichumspp. among tested fungicide groups; and (iii) to test the efficacy of fungicides in controlling anthracnose on immature and mature detached fruit. There were differences between Colletotrichumspp. in levels of sensitivity to the active ingredients evaluated, with C. horiiisolates being more sensitive to site-specific fungicides than C. chrysophilum, C. nymphaeaeand C. melonis. There was a high risk of cross-resistance for the active ingredients of the QoIs, medium risk for the DMIs and multisite compounds, and low risk for the succinate dehydrogenase inhibitors (SDHIs). Negative cross-resistance correlation was observed for anilopyrimidines (APs). Anthracnose control in immature and mature fruit ex vivo varied between products. In general, isolates recovered from both twigs and flowers were sensitive to the fungicides tested. The SDHI fungicides were efficient in controlling Colletotrichumin the in vitroassay, appearing as an alternative to be tested in the control of the disease. Difenoconazole-based fungicides and mixed formulations of QoI and DMI were the most effective for controlling persimmon anthracnose both for immature and mature fruit.

Introduction: The use of oral nonsteroidal anti-inflammatory drugs (NSAIDs) for acute musculoskeletal pain should be at the lowest effective dosage and for the shortest duration to minimize potential adverse effects. This study evaluated treatment satisfaction, effectiveness, and tolerability of a low-dose diclofenac epolamine 12.5-mg soft capsule formulation (DHEP 12.5-mg capsules) using patient-reported outcome measures in a real-life setting over a short period (3 days) in subjects with mild-to-moderate acute musculoskeletal pain. Methods: A prospective, open-label, phase IV clinical study in adult outpatients at hospital clinic departments/general practitioner’s clinics at eight sites in Italy. The primary efficacy variable was the degree of satisfaction with treatment at 72 ± 7 h after initiation of treatment, assessed using the Overall Satisfaction Question of the Pain Treatment Satisfaction Scale (PTSS) and described by classic descriptive statistics. Secondary objectives were to evaluate the analgesic effect after the first administration and over time; the time to and satisfaction with the onset of pain relief, amount of and duration of pain relief; pain intensity differences over time; and safety and tolerability. The investigator’s satisfaction with the treatment was also assessed. Subjects initially took 1–2 capsules of the study treatment and then one or two soft capsules every 4–6 h according to their needs. Not more than six soft capsules were to be taken in any 24-h period. Results: A total of 182 subjects (mean age, 56.2 years; 54.4% female) took ≥ 1 dose of DHEP capsule and were included in the full analysis set. The most common musculoskeletal conditions were arthralgia (39.0%) and low back pain (23.1%). All subjects completed the study, and 165/182 (90.7%, 95% CI 0.86, 0.95) were satisfied or very satisfied with the treatment at 72 ± 7 h after the first dose (primary efficacy variable). Similar percentages were recorded for treatment satisfaction concerning other efficacy parameters. The onset of the analgesic effect was rapid, with complete pain relief reached after a mean of 49.45 min. Investigators rated their overall treatment satisfaction as 92.9%. Treatment was well tolerated. Conclusions: The low-dose (12.5 or 25 mg) oral diclofenac epolamine soft capsules formulation exerted rapid, effective, and safe analgesic activity in patients with mild-to-moderate musculoskeletal pain, with subjects’ overall satisfaction with treatment more than 90%. Trial registration: EudraCT Number: 2018-004886-15 (Study 18I-Fsg08). Registered 04/09/2018.

Extrusion-based Additive Manufacturing (AM) processes have recently gained increasing attention in the scientific and industrial communities because of the wide range of processible materials (from thermoplastics to composite and biomaterials), printable volumes, and industrial applications. As for many other AM processes, the actual problems with process stability and repeatability are still limiting the industrial process adoption, as these problems can significantly impact on the final part quality. In this framework, a latest research trend aims at developing in-situ monitoring solutions for inline defect detection, in a zero-waste production perspective. Among the existing in-situ sensing techniques, many studies showed that in-situ thermography represents a viable solution to describe the temperature dynamic and validate the thermal models but very few approaches have been proposed to quantitively study the temperature evolution to quickly detect process instabilities.

Fabry disease (FD) is rare genetic syndrome which determines a lysosomal storage disorder caused by pathogenic variants in the alpha–galactosidase A (GLA) gene that lead to alpha–galactosidase A (AGAL– A) enzyme activity disfunction.The fenotipic effect is a left ventricular hypertrophy (LVH) that is frequently misdiagnosed as hypertrophic cardiomyopathy (HCM).This disease in still unfamiliar for the most part of cardiologists cause of the fenotipic familiarities with other more common and wellknown diseases and according to recent data the prevalence of FD among unexplained LVH is 0.93%.These characteristics drive to a heavy under diagnosis of a disease with many therapy chances. The prompt initiation of these treatments, subsequently an early diagnosis, is actually considered the best strategy to improve the natural course of the disease.The critical evaluation of the clinical history and basic cardiomiopaty assessments could drive the cardiologist to the diagnosis.Precisely, we present an example of three family pedigree discovered in a couple of months subsequently the unmasking of proband male patients with decennary misdiagnosis of HCM. The ambulatory suspect of non sarcomeric disease in LVH drove us to critically reexaminate EKGs and previous CMR scans finding respectively PR shortage associated with right bundle block and basal inferolateral late gadolinium enhancement (figure 1). In a proband it is not possible to perform MRI with gadolinium due to the presence of renal failure and the diagnostic suspicion arose by analyzing the T1 mapping signal (figure 2).The score ID FABRY–HCM were applied resulting suggestive too.Having thus corroborated the suspicion, blood spot tests were performed finally detecting a very low AGAL–A activity. The following GLA genetic tests identified the tipical mutation of late onset Fabry’s disease (p.N215Ser). Fulfilling the consensus criteria for the therapy initiation, the patients were treated with enzyme replacement therapy. We completed families predigree identifying other six famale gene mutation carriers with almost preserved AGAL–A activity. The diagnosis of FD allowed us to perform the specific therapy in affected patients hopefully effecting their quality of life and their prognosis and to bring out healthy carriers.The initial suspect questioning a previous diagnosis starting to simple clinical and routine strumental elements were crucial.

When the United Nations Universal Periodic Review was established in 2007, it was stressed that it should complement the work of the United Nations treaty bodies. At the same time, fears were expressed that similarities between the two procedures might lead to potentially problematic duplications or contradictions among them. To shed light on whether this is the case, this article devises a framework to assess the degree to which human rights bodies provide duplicating or contradicting recommendations to States. Focusing on the case of torture, it creates an original database of recommendations delivered to 14 countries in the years 2012–2016. Results show that duplications are frequent and provide opportunities to States to use the Universal Periodic Review to contest the implementation of treaty bodies’ recommendations. Contradictions are limited, although when they occur, they create room for States to selectively choose which recommendations to implement.

Meloidogyne javanicaand M. incognitaare the most common nematode species belonging to the genus Meloidogynethat cause extensive losses in crop yield. One of the main management strategies is the use of resistant cultivars. However, limited data are available regarding the reaction of the genotypes to these nematodes. Hence, this work intended to evaluate the host reaction of wheat genotypes to M. javanicaand M. incognita. For M. javanica, 26 treatments (genotypes) were evaluated, in which 24 included the wheat genotypes and two the susceptibility controls. Four trials were conducted adopting the completely randomized experimental design with five (Experiments I and II) and six (Experiments III and IV) replicates. For M. incognita, 12 treatments were evaluated, 11 of them were the wheat genotypes, and one was the susceptibility control. Two trials were conducted adopting a completely randomized design with five replicates (Experiments V and VI). The experimental units included 945-mL capacity styrofoam pots, with three plants per pot. The suspensions (Pi) containing the inocula of each nematode species were inoculated into each pot 15 days post seed germination. For M. javanica, the Pi used was 1000 eggs and J2 per plant. For M. incognita, 2000 eggs and J2 were inoculated per plant. All genotypes evaluated were classified as susceptible to M. javanica, except TBIO Sossego, which exhibited a resistant reaction to this nematode. For M. incognita, all genotypes were classified as susceptible. The cultivation of wheat should not be recommended in areas infested with root-knot nematodes.

Melanomas that arise in sun-protected sites, including acral and oral mucosal melanomas, are likely under the control of unique, specific mechanisms that lead to mutagenesis through various pathways. In this study, we examined somatic mutations in tumors by targeted sequencing using a custom Ion Ampliseq Panel, comprising hotspots of 14 genes that are frequently mutated in solid tumors. Tumor DNA was extracted from 9 formalin fixation, paraffin-embedded sun-protected melanomas (4 primary oral mucosal melanomas and 5 acral lentiginous melanomas), and we identified mutations in the NRAS, PIK3CA, EGFR, HRAS, ERBB2, and ROS1genes. This study reveals new actionable mutations that are potential targets in the treatment of photo-protected melanomas. Additional studies on more of these melanoma subtypes could confirm our findings and identify new mutations.

The rising tide of non-alcoholic fatty liver disease (NAFLD) associated with the obesity epidemic is a major health concern worldwide. NAFLD — specifically its more advanced form, non-alcoholic steatohepatitis (NASH)-related cirrhosis — is now the fastest growing indication for liver transplantation in the USA and Europe. Although the short-term and mid-term overall survival rates of patients who receive a liver transplant for NASH-related cirrhosis are essentially similar to those of patients who receive a transplant for other liver indications, recipients with NASH-related cirrhosis have an increased risk of waiting-list mortality and of developing recurrent liver disease and cardiometabolic complications in the longer term after liver transplantation. This Review provides a brief overview of the epidemiology of NAFLD and NASH and the occurrence of NAFLD or NASH in patients after liver transplantation for NASH and other liver indications. It also discusses the putative metabolic mechanisms underlying the emergence of NAFLD or NASH after liver transplantation as well as optimal therapeutic approaches for recipients of liver transplants, including the management of cardiometabolic comorbidities, tailored immunosuppression, lifestyle changes and pharmacotherapy for NAFLD.

Purpose: Administration of questionnaires to assess the diffusion of disordered eating behaviours via the web is becoming common today. The aim of this study is to assess whether two different approaches of administering a test to assess traits of eating disorders (EDs), orthorexia nervosa (ON) and muscle dysmorphia (MD) by email recruitment and online completion (web-based survey—WBS) and by in person recruitment and paper-and-pencil completion (paper-based survey—PBS), gives different results. Methods: During 2 consecutive academic years, a self-reported questionnaire consisting of questions about personal characteristics and three tests for the evaluation of ON (ORTO-15), MD (MDDI-ITA), and EDs (EAT-26) were administered to two groups of undergraduates, respectively, as a WBS and a PBS. Results: The WBS response rate was 6.7% (N= 137), and the PBS response rate was 86.5% (N= 372). The WBS group showed a statistically significant higher prevalence of students with eating disordered behaviours (21.2% vs 5.4%) and registered a higher mean score on the EAT-26 test (13.5 ± 11.1 vs 6.0 ± 8.0); no differences between the two groups emerged for ON and MD prevalence and test scores. Moreover, in the WBS group, the number of students with one or more tests with test scores above the cut-off values was significantly higher (46.0% vs 32.3%). Conclusion: The choice of the approach to administer a questionnaire to assess the diffusion of EDs and related issues must take into account all the factors that can result in selection bias and that can affect the reliability of the results. Level of evidence: Level V, descriptive cross-sectional survey.

The ongoing COVID-19 pandemic has been having a devastating impact on society not only from a health and economic perspective but also due to its direct and indirect effects on the human rights of citizens. In particular, the pandemic has had several negative effects on citizens’ right to integrity. For example, lockdown measures adopted by governments to manage the pandemic frequently resulted in increased levels of violence against women and girls; so much so that the UN body working on gender equality (UN Women) coined a new term—‘shadow pandemic’—to refer to the severe intensification of all forms of violence against women and girls that occurred during the pandemic, particularly domestic violence. In addition, in some cases, police officials have employed disproportionate force to ensure strict adherence to public health measures. Finally, hate crimes against individuals of Asian origin or descent have increased substantially in Western countries. However, and perhaps more surprisingly, there have been situations in which the pandemic, directly or indirectly, has seemingly led to a decrease in specific forms of violence. Researchers have, for instance, observed that at the height of the pandemic, there has been a decrease in reported cases of street violence against women, because of fewer people leaving their homes.

A 82–year–old previously healthy male was referred to the emergency department complaining sudden onset dyspnea and witnessed syncope complicated by head trauma. Recurrent dizziness occurred previously. No history or drug consumption noted. On admission: heart rate 90 beats/min, blood pressure 110/60 mmHg, respiratory rate 25 breaths/min, oxygen saturation 87% in room air, normal body temperature. No lower extremities tenderness or swelling reported. Consistent with peripheral blood oxygen saturation levels, arterial blood gas analysis showed hypoxemia and respiratory alkalosis. Laboratory exams were significant for thrombocytopenia (89.000 cells/L), elevated cardiac troponin T levels (222 ng/L) and natriuretic peptide (NT pro–BNP 3944 pg/mL). Head CT excluded acute cerebral hemorrhage. At the electrocardiogram, signs of RV strain were present (biphasic T–waves in V1–V3 leads, S1–Q3–T3). Transthoracic echocardiography (TTE) showed dilated RV with hypokinetic free wall, “D–shaped” LV, “60/60” sign and a mobile filiform mass crossing the tricuspid valve plan in the right atrium (fig. 1). The patient did not present structural valvular abnormalities or endocarditis–related risk factors. CT pulmonary angiography detected a “saddle” PE and extensive thrombosis in inferior vena cava. After unfractioned heparin (UFH) bolus, the patient was transferred to our intensive care unit and balancing risks and benefits the chosen treatment option consisted in half dose systemic thrombolysis (50 mg rtPA in 60’’; 10 mg as loading dose in 2’). Because of potential harmful effects in thrombocytopenia and recent head trauma, UFH was temporarily withheld and started again after 1 hour. The day after, a beside TTE showed complete tricuspid thrombus resolution, a significant decrease in RV/LV ratio and systolic pulmonary artery pressure (fig. 2). Apart from small hematomas, no bleedings were reported. The patient was shifted to the ward on the next day and following course was uneventful. On day 4 a direct oral anticoagulant (Dabigatran 110 mg) was started. Abdominal and inferior limb–deep–venous ultrasound were both negative for pathological reports. A total body CT was scheduled to exclude silent malignancies at discharge. Take home message: in intermediate–high risk PE, half dose systemic fibrinolysis strategy is controversial since its potential benefit is counterbalanced by concerns about major bleedings, but increasing data suggest its efficacy with low risk profile.

Ruxolitinib (RUX) is extensively used in myelofibrosis (MF). Despite its early efficacy, most patients lose response over time and, after discontinuation, have a worse overall survival (OS). Currently, response criteria able to predict OS in RUX-treated patients are lacking, leading to uncertainty regarding the switch to second-line treatments. In this study, we investigated predictors of survival collected after 6 months of RUX in 209 MF patients participating in the real-world ambispective observational RUXOREL-MF study (NCT03959371). Multivariable analysis identified the following risk factors: (1) RUX dose <20 mg twice daily at baseline, months 3 and 6 (hazard ratio [HR], 1.79; 95% confidence interval [CI], 1.07-3.00; P = .03), (2) palpable spleen length reduction from baseline ≤30% at months 3 and 6 (HR, 2.26; 95% CI, 1.40-3.65; P = .0009), (3) red blood cell (RBC) transfusion need at months 3 and/or 6 (HR, 1.66; 95% CI, 0.95-2.88; P = .07), and (4) RBC transfusion need at all time points (ie, baseline and months 3 and 6; HR, 2.32; 95% CI, 1.19-4.54; P = .02). Hence, we developed a prognostic model, named Response to Ruxolitinib After 6 Months (RR6), dissecting 3 risk categories: low (median OS, not reached), intermediate (median OS, 61 months; 95% CI, 43-80), and high (median OS, 33 months; 95% CI, 21-50). The RR6 model was validated and confirmed in an external cohort comprised of 40 MF patients. In conclusion, the RR6 prognostic model allows for the early identification of RUX-treated MF patients with impaired survival who might benefit from a prompt treatment shift.

Ruxolitinib (RUX) is extensively used in myelofibrosis (MF). Despite its early efficacy, most patients lose response over time and, after discontinuation, have a worse overall survival (OS). Currently, response criteria able to predict OS in RUX-treated patients are lacking, leading to uncertainty regarding the switch to second-line treatments. In this study, we investigated predictors of survival collected after 6 months of RUX in 209 MF patients participating in the real-world ambispective observational RUXOREL-MF study (NCT03959371). Multivariable analysis identified the following risk factors: (1) RUX dose <20 mg twice daily at baseline, months 3 and 6 (hazard ratio [HR], 1.79; 95% confidence interval [CI], 1.07-3.00; P= .03), (2) palpable spleen length reduction from baseline ≤30% at months 3 and 6 (HR, 2.26; 95% CI, 1.40-3.65; P= .0009), (3) red blood cell (RBC) transfusion need at months 3 and/or 6 (HR, 1.66; 95% CI, 0.95-2.88; P= .07), and (4) RBC transfusion need at all time points (ie, baseline and months 3 and 6; HR, 2.32; 95% CI, 1.19-4.54; P= .02). Hence, we developed a prognostic model, named Response to Ruxolitinib After 6 Months (RR6), dissecting 3 risk categories: low (median OS, not reached), intermediate (median OS, 61 months; 95% CI, 43-80), and high (median OS, 33 months; 95% CI, 21-50). The RR6 model was validated and confirmed in an external cohort comprised of 40 MF patients. In conclusion, the RR6 prognostic model allows for the early identification of RUX-treated MF patients with impaired survival who might benefit from a prompt treatment shift.

Patient-derived xenografts (PDX) have emerged as one of the most promising model systems to study cancer biology and to develop new antineoplastic drugs. Renal cell carcinoma (RCC) represents up to 90% of all kidney tumors, exhibits aggressive behavior, and has a propensity for metastasis. At diagnosis, 30% of patients with RCC have metastases, while up to 50% of those with localized disease treated with curative protocols experience recurrence. This study aimed to establish an RCC PDX platform to identify novel clinical and molecular biomarkers of recurrence risk in order to facilitate precision medicine. Tumor samples were obtained from surgical specimens of 87 RCC patients; fragments were implanted in immunodeficient NOD/SCID/gamma (NSG) mice. 17 Fragments were implanted subcutaneously in an initial group while a second group of 70 samples were implanted orthotopically in the subcapsular space. A total of 19 PDX developed only after orthotopic implantation, and included 15 cases of clear cell RCC subtype, 3 cases of papillary subtype, and 1 unclassifiable tumor. 1 PDX of clear cell RCC recapitulated the phenotype of vena caval tumor thrombus extension that had been diagnosed in the source patient. PDX characterization by immunohistochemistry and targeted sequencing indicated that all PDXs preserved RCC identity and major molecular alterations. Moreover, the capacity of tumor engraftment was a strong prognostic indicator for patients with locally advanced disease. Taken together, these results suggest that the orthotopic xenograft model of RCC represents a suitable tool to study RCC biology, identify biomarkers, and to test therapeutic candidates.

Purpose: To provide an operational guide for corneal transplantation during the COVID-19 pandemic aimed to maintain surgery and avoid spreading of SARS-CoV-2.Methods: Prospective observational case series study in patients requiring corneal graft manage toward separate free and restricted pathways for those COVID-19 negative or positive, respectively.Results: During the national lockdown, 30 consecutive patients underwent endothelial (n= 16), penetrating (n= 9), and anterior lamellar keratoplasty (n= 5). Two patients followed the COVID-19 restricted pathway, as they were considered positive while waiting for test results. Nine patients were hospitalized one night in the hospital. On admission to the hospital before surgery, at surgery, the day after surgery and at 7 and 30 days all patients and health-care personnel showed no symptoms and resulted negative at risks factors/exposure to the SARS-CoV-2 infection and occurrence of COVID-19. Nucleic acid testing resulted not detectable in all patients and SARS-CoV-2 antibodies quantification showed IgG and IgM below the positive predicted value in 29 patients. One patient showed IgM above the cut-off of significance (1.21 and 1.03 preoperative and 1-month postoperative, respectively) that were considered irrelevant because of the absence of symptoms and exposure risks.Conclusions: The concept of donor emergency (i.e. short-term availability of transplant tissues), makes corneal transplantation an always-urgent activity because it is related to the availability of the corneal tissue from a donor. Modest adjustments to ophthalmic clinic and eye surgery organization are required to maintain surgery and care of eye patients in a safe environment.

Purpose: While SARS-CoV-2 infection appears not to be clinically evident in the testes, indirect inflammatory effects and fever may impair testicular function. To date, few long-term data of semen parameters impairment after recovery and comprehensive andrological evaluation of recovered patients has been published. The purpose of this study was to investigate whether SARS-CoV-2 infection affect male reproductive health. Methods: Eighty patients were recruited three months after COVID-19 recovery. They performed physical examination, testicular ultrasound, semen analysis, sperm DNA integrity evaluation (TUNEL), anti-sperm antibodies (ASA) testing, sex hormone profile evaluation (Total testosterone, LH, FSH). In addition, all patients were administered International Index of Erectile Function questionnaire (IIEF-15). Sperm parameters were compared with two age-matched healthy pre-COVID-19 control groups of normozoospermic (CTR1) and primary infertile (CTR2) subjects. Results: Median values of semen parametersfrom recovered SARS-CoV-2 subjects were within WHO 2010 fifth percentile. Mean percentage of sperm DNA fragmentation(%SDF) was 14.1 ± 7.0%. Gelatin Agglutination Test (GAT) was positive in 3.9% of blood serum samples, but no positive semen plasma sample was found. Only five subjects (6.2%) had total testosterone levelsbelow the laboratory reference range. Mean bilateral testicular volumewas 31.5 ± 9.6 ml. Erectile dysfunctionwas detected in 30% of subjects. Conclusion: Our data remark that COVID-19 does not seem to cause direct damage to the testicular function, while indirect damage appears to be transient. It is possible to counsel infertile couples to postpone the research of parenthood or ART procedures around three months after recovery from the infection.

Wet coffee processing produces large amounts of liquid effluent, known as coffee processing wastewater (CPW). CPW is considered a pollutant due to its low pH and high concentrations of organic matter, salts, and nutrients. Because of these characteristics, it is essential to treat this effluent before discharging it into the environment. One promising option, which is still little studied or employed, is coagulation-flocculation followed by dissolved air flotation (C/DAF). Coagulation-flocculation is a simple and efficient method, while dissolved air flotation can allow the same volume of pollutants to be removed from the sediment in a shorter period of time. Conventionally, metallic salts are used in coagulation-flocculation; however, these products can be harmful to the environment and to human health. One possible option for study is replacing the metallic salts by natural coagulants, such as the seeds of Moringa oleiferasp. and cladodes of Hylocereus polyrhisussp. (red pitaya). The aim of this research, therefore, was to evaluate C/DAF using the seeds of Moringa oleiferasp. and a cladode from Hylocereus polyrhisussp. in a saline calcium chloride solution in the treatment of CPW, optimizing the doses of coagulants and salt using a central rotational composite design (CCRD). From the results, it was found that using Moringa oleiferasp., about 80% of turbidity were removed, and that using the H. polyrhisussp. cladode, turbidity removal was about 63%. For the water under study the optimal values for dose and salinity using Moringa oleiferasp. are up to 1.2 g·L−1and 2.5 to 4 g·L−1, respectively. When using Hylocereus polyrhisussp., the optimal values for dose and salinity are between 1.1 and 5 g·L−1, and 2.3 and 3.5 g·L−1, respectively. It can be seen that dissolving natural coagulants in saline solution is an interesting alternative in the treatment of CPW, as it allows a reasonably efficient removal of contaminants without employing other products such as metallic salts or alkalizing products.

Introduction: Central venous accesses devices (CVADs) have a fundamental importance for diagnostic and therapeutic purposes in pediatric onco-hematological patients. The treatment of pediatric onco-hematological diseases is complex and requires the use of integrated multimodal therapies. Long-lasting and safe central venous access is therefore a cornerstone for any successful treatment.Methods: The aim of this work is to define pediatric guidelines about the management of CVADs in onco-hematology. A panel of experts belonging to the working groups on Infections and Supportive Therapy, Surgery and Nursing of the Italian Pediatric Hematology Oncology Association (AIEOP) revised the scientific literature systematically, scored the level of evidence and prepared these guidelines. The content of the following guidelines was approved by the Scientific Board of AIEOP.Results and Conclusions: Important innovations have been developed recently in the field of CVADs, leading to new insertion methods, new materials and new strategy in the overall management of the device, especially in the adult population. These guidelines recommend how to apply these innovations in the pediatric population, and are directed to all physicians, nurses and health personnel active in the daily management of CVADs. Their aim is to update the knowledge on CVAD and improve the standard of care in pediatric patients with malignancies.