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AbstractThe article explores the discursive representations of Syrian and Ukrainian refugees in the European Parliament (EP). The theoretical framework draws on Critical Securitisation Theory, pointing out the implicit hierarchies that affect the European Union (EU) reception policies in terms of race and gender. The main hypothesis is that a stigmatisation process based on race and gender affects the representation of refugees in the EU. Against this backdrop, the manuscript delves into how speech acts can either cast refugees as urgent threats or even facilitate the de-construction of the refugee as a threat. These are investigated through Computational Text-Analysis tools, such as Word- and Bigram-Frequency Analysis, Term Frequency-Inverse Document Frequency test and Structural Topic Modelling. On the one hand, contrary to expectations of a securitisation of Syrian refugees primarily based on race, what emerges is also a process of de-personalisation that helps justify the anti-migration stand of some members of the EP (MEPs). On the other hand, the assumption that deconstruction of the refugee as a threat would mainly occur through an emphasis on cultural proximity between Ukrainian people and the EU is challenged. Instead, our analysis shows a gender-based victimisation of Ukrainian refugees, which contributes leading to protective measures being enacted by the EU.

The interaction of europium nitrate with triazine-based luminophores, namely 3-(pyridin-2-yl)triimidazo[1,2-a:1′,2′-c:1″,2′′-e][1,3,5]triazine (L1), 3-(pyridin-4-yl)triimidazo[1,2-a:1′,2′-c:1″,2′′-e][1,3,5]triazine (L2), and 3,7,11-tri(pyridin-4-yl)triimidazo[1,2-a:1′,2′-c:1″,2″-e][1,3,5]triazine (L3), resulted in three Eu(III) compounds with the compositions (L1H)[Eu(NO3)4(H2O)2] (1), (L2HL2)2[Eu(NO3)5(H2O)] (CH3CN)2(2), and [Eu(NO3)3(H2O)2(L3)] (3) whose structures were disclosed by single crystal X-ray diffraction analysis. In the organic–inorganic hybrid salts 1and 2, the direct Eu(III)–triazinic ligand coordination is lacking, while in the neutral complex 3the direct Eu(III)–L3coordination occurs through one of the luminophore’s N-pyridine binding sites. The solid-state photoluminescence behavior of 2and 3was studied. At room temperature, 2revealed predominantly the ligand-based photoluminescence in the cyan-blue region of the spectrum when excited at 337 nm; the orange-red Eu(III)-based emission dominated the spectrum when excited at 405 nm. On the other hand, irrespective of the excitation wavelength, compound 3displayed the characteristic emission of Eu(III), suggesting that the coordinated L3ligand effectively played an antenna effect toward the metal. The Eu(III)-based contribution in photoluminescence in 2and 3displayed an opposite thermochromic behavior when monitored in the 12–300 K range. Specifically, the emission intensity decreases for 2and increases for 3with an increase in the temperature. The unusual thermochromic effect for 3was hypothesized from a density of states (DOS) viewpoint.

Total knee arthroplasty (TKA) is widely used to manage severe knee osteoarthritis. However, conventional TKA (C-TKA) often leaves patients dissatisfied due to suboptimal alignment and soft-tissue balance. Robotic-assisted TKA (RA-TKA), particularly with imageless systems like the NAVIO Surgical System, promises enhanced accuracy and improved outcomes. This study aims to validate the accuracy of RA-TKA in achieving functional alignment (FA) and to explore the learning curve associated with this technique.

In the present report, homochiral hydrogen-bonded assemblies of heavily N-doped (C9H6N6) heterocyclic triimidazole (TT) molecules on an Ag(111) substrate were investigated using scanning tunneling microscopy (STM) and low energy electron diffraction (LEED) techniques. The planar and prochiral TT molecules, which exhibit a threefold rotation symmetry and lack mirror symmetry when assembled on the substrate, carry multiple hydrogen-bonding donor and acceptor functionalities, inevitably leading to the formation of hexameric two-dimensionally extended assemblies that can be either homo- (RR/SS) or heterochiral (RS). Experimental STM data showing well-ordered homochiral domains and experimental LEED data are consistent with simulations assuming the 21×21R19.1° overlayer on the Ag(111) lattice. Importantly, we report the unexpected coincidence of spontaneous resolution with the condensation of neighboring islands in adjacent “Janus pairs”. The islands are connected by a characteristic fault zone, an observation that we discuss in the context of the fairly symmetric molecule and its propensity to compromise and benefit from interisland bonding at the expense of lattice mismatches and strain in the defect zone. We relate this to the close to triangular shape and the substantial but weak bonding scheme beyond van der Waals (vdW) of the TT molecules, which is due to the three N-containing five-membered imidazole rings. Density functional theory (DFT) calculations show clear energetic differences between homochiral and heterochiral pairwise interactions, clearly supporting the experimental results.

Saber-toothed cats dominated the latest Pliocene to Early Pleistocene ecosystems in the Old World, potentially competing with early hominins for food resources. However, the Pleistocene fossil records of the medium-sized Megantereonare often fragmented and scarce, leading to contentious debates regarding its evolutionary history.

This study evaluated the static, postural, dynamic, and clinical outcomes among five groups of patients: a bilateral CTEV (congenital talipes equinovarus) group treated with tenotomy (n= 14), bilateral CTEV group treated conservatively (n= 6), unilateral CTEV group treated with tenotomy (n= 7), unilateral CTEV group treated conservatively (n= 3), and control group (n= 20). Data were collected through baropodometric examinations and clinical evaluations using Pirani, clubfoot assessment protocol, foot and ankle disability index (FADI), and American Orthopedic Foot and Ankle Society scores. Bilateral CTEV patients treated with tenotomy showed no statistically significant differences compared to healthy controls. Significant differences were found in lateral-lateral variation in the bilateral postural group (P= 0.002) and in static peak pressure in unilateral tenotomy patients (P= 0.046). Dynamic comparisons revealed significant differences in mean pressure between unilateral groups (P= 0.002) and lateral-lateral variation in bilateral groups (P= 0.004). The Pirani score showed significant differences between tenotomy-treated and postural patients (P= 0.000). Statistically significant differences in FADI scores were found between bilateral groups (P= 0.0037), between tenotomy-treated groups (P= 0.0020), and between the bilateral tenotomy-treated group and the unilateral postural group (P= 0.021). Bilateral CTEV patients treated with tenotomy develop static and dynamic values comparable to healthy controls. Bilateral patients develop better dynamic values compared to patients with a unilateral variant.Level of evidence: III.

In Europe, the statistics related to hospital-acquired infections (HAIs) are startling. One out of 10 patients is affected by healthcare-related infections. There are an estimated 3 million cases of HAIs [...]

While the general economy may be struggling to regain its footing, the medical device industry continues to develop to meet the demand for innovative products that extend and enhance lives. [...]

First, proposed healthcare legislation could have significant ramifications for medical device manufacturers (MDMs). The U.S. Senate and House of Representatives are considering bills that would impose billions of dollars in [...]

The Study in Brief Mending the much-maligned North American Free Trade Agreement (NAFTA), which recently came under attack on the United States presidential campaign trail as a source of American [...]

Subcutaneous injections of interleukin-2 in addition to zidovudine and didanosine appear to be effective in the early stages of HIV infection. Interleukin-2 stimulates the production of CD4 and CD8 T cells and also stimulates the immune system in other ways. Researchers asked 12 patients in the early stages of HIV infection to inject themselves with interleukin-2 four times a month for six months. The patients also took zidovudine and didanosine regularly. At the end of six months, CD4 T cell counts had risen and remained high after interleukin-2 was discontinued. Viral counts were lower and remained so after interleukin-2 was discontinued.

Supplemental Digital Content is available in the text.The objectives of this study were to collect and analyze current diagnosis and treatment options of symptomatic flexible flatfoot (FFF), as well as to identify treatment expectations, among the members of the Italian Pediatric Orthopedics Society (SITOP). Diagnosis and treatment preferences were recorded according to a web-based survey. The survey was divided into six main sections: (1) general clinical parameters; (2) foot aspects; (3) X-ray angles (or lines); (4) expectations; (5) standard clinical assessment; (6) treatment options. One hundred and ten out of 248 SITOP members answered to the questionnaire. Age (85.5%), pain at the level of the plantar arch or fascia (61.8%), fatigue (59.1%) were the clinical parameters of crucial importance. Heel valgus (85.4%), flexibility (61.8%) and forefoot supination (47.3%) were identified as the most important foot aspects. Ninety-two responders (83.6%) identified the ‘improved ability to walk longer without symptoms or discomfort’ as the principal treatment expectation. Pain evaluated through the visual analog scale (VAS) was considered crucial in 31.8% of cases. All respondents confirmed they also treat patients with FFF surgically; in particular, 97.3% of SITOP affiliates declare to perform arthroereisis followed by lateral column lengthening (29.1%) and medializing calcaneal osteotomy (9.1%). Although in this survey heterogeneous findings for diagnosis and treatment of patients with symptomatic FFF within SITOP members were found, a large preference for age, heel valgus, flexibility as clinical aspects and parameters, as well as nonoperative treatment and arthroereisis, was reported.

Cyclic triimidazole (C9H6N6, L), with C3hmolecular symmetry and three nitrogen atoms available for coordination, is here successfully employed for the first time in the synthesis of coordination compounds. In particular, by varying the reaction conditions (e.g., solvent, temperature, template), seven Cu(I)-halide coordination polymers of different dimensionality are obtained: two 1D polymers, [CuIL]n(1) and {[CuIL]·(I2)0.5}n(2), three 2D nets, [CuXL]n(X = I, Br) (3–5), and two 3D networks, [CuClL]n(6) and {[Cu3L4]I3}n(7). Single crystal X-ray diffraction analysis reveals that the structural versatility of both the ligand and the CuX moiety allows isolating 1D double-stranded stairs in which Lis monodentate, 2D layers containing either Cu2(μ-X)2or Cu2(μ-X) moieties and bidentate Lligands, 3D frameworks built up by tridentate Llinkers and either monodentate or noncoordinating halogen atoms. The 3D frameworks show nets of srsand bortopologies. The SHG efficiency of powders of 7(the only noncentrosymmetric derivative of the series) is 10 times higher than that of sucrose. Phosphorescent emission of XLCT character is observed for 1and 6.

Customs compliance is a growing field for US firms. Qualifications for these specialists include a customs broker's license and customs compliance corporate experience. Greater qualifications are becoming necessary as greater legal and financial liability results from errors.

Congenital abnormalities of the spine are not uncommon in the general population and can be asymptomatic. Transverse megapophysis is a congenital anomaly manifested as an enlargement of the transverse processes, typically common in the lumbar vertebrae. Here, we describe a 4-month-old infant female with episodes of shooting pain and torticollis. At the beginning of the third month, the parents noticed she held her neck inclined towards the left side in a changeable way, and movement caused discomfort and crying. Muscular tonus, laboratory investigations, ECG and heart and transfontanellar ultrasound were normal. A cervical CT and MRI displayed at the C7 level a megapophysis transverse involving both sides. Treatment with no steroidal anti-inflammatory drugs twice a day and, after a few days, symptoms solved. At 8 months follow-up, neck maintains its natural position and no unmotivated pain has been noticed. Transverse C7 megapophysis presenting with torticollis is an example of a cause of severe pain in infancy, and it should be considered in the differential diagnosis of infantile torticollis.

In this paper we report the synthesis, the photophysical, conductometric, and second-order nonlinear optical (NLO) characterization of an ensamble of four NLO active organic tails nanoorganized on a cyclotetrasiloxane ring, to produce various macrocyclic NLO chromophores. The second-order NLO response of the macrocyclic NLO chromophores measured by the EFISH technique as μβ1.91, where μ is the dipole moment and β1.91the projection along the dipole moment axis of the vectorial component of the quadratic hyperpolarizability working with an incident wavelength of 1.907 μm, increases, compared to the reference monomeric NLO chromophores, from 2.8 up to 3.5 times for nonionic macrocyclic NLO chromophores. The increase is mainly due to an increase of the dipole moment when compared to reference monomeric NLO chromophores while the β1.91values remain almost unchanged. These macrocyclic NLO chromophores can be also considered as a simple model of a monolayer of organic NLO chromophores on a chemically engineered silica surface. Since the factor controlling their second-order NLO response is the orientation toward the dipole moment axis of the single organic NLO active tails, this kind of model confirms that the second-order NLO response of a monolayer of organic NLO chromophores on a chemically engineered silica surface is controlled by the topology of the binding sites on the surface, as suggested by previous investigations on multilayers on chemically engineered silica surface. The macrocyclic NLO chromophore with a ionic organic NLO active tail shows a strong concentration dependence of its second-order NLO response to be ascribed to a larger increase of its ionic dissociation by dilution, when compared to that of the reference ionic monomeric NLO chromophore. This behavior is evidence of a cooperative effect due to the nanoorganization, to be ascribed to a more facile ionic dissociation of the single ionic organic tail originated by a local increase of the solvent polarity favored by the closeness of the positive charges of the four organic tails. Finally it was shown that the Si(OSiMe3)3group behaves in a classical organic push−pull NLO chromophore as a pull group as strong as the nitro group.

Congenital lymphangiectasia-lymphedema is a rare disorder that presents with edema of the lower half of the body, the face, hands, and scrotum, or with protein-losing enteropathy owing to structural anomalies in the endothelium of the lymphatic system. We describe a biopsy-proven case of severe lymphangiectasia-lymphedema in a 16-year-old boy who was born to consanguineous parents and who, in addition, had mild (20 to 40 dB), early onset, sensorineural deafness and skin abnormalities, consisting of angiokeratomas of the face, hands, and feet, and also a large, localized angiokeratoma of the scrotum and the penis (Fordyce type). Both of the proband's parents had profound (>80 dB), congenital, mixed conductivesensorineural, nonsyndromic deafness to low-mid frequencies. To the best of our knowledge, this constellation of lymphatic, skin, hearing, and systemic abnormalities seen in the proband has not been previously reported.

The aim of this study was to investigate the immunohistochemical expression of p53 and Ki67 in colorectal adenomas in order to clarify their significance as indicators of malignancy and development of new polyps. Seventy-eight polyps were removed from 51 patients and examined. Twenty-nine patients (56.9%) had adenomas with low-grade atypia (13 of them developed new polyps at 3-year follow-up) and 22 (43.1%) had adenomas with high-grade atypia (6 of them developed new polyps at 3-year follow-up). We tested the association between p53 and Ki67 expression and various clinicopathological variables, and regression analysis was performed to identify the risk factors for malignancy and development of new adenomas. A significant correlation between the grade of atypia and p53 immunoreactivity was observed. Ki67 expression was not related to atypia and no correlation was found between p53 and Ki67 immunoreactivity. Regression analysis showed that size (p=0.0002) and p53 staining (p=0.0111) were the selected factors related to malignant transformation, whereas the number of synchronous primary polyps emerged as the only predictive factor of development of new adenomas, although without statistical significance. The expression of biological markers may be in future added to the currently examined features of polyps; however, further studies are needed to better define their predictive value.

This paper deals with two, related topics: the acquisition and recovery of information 'trapped' in the geometry of an historical artifact; the employment of this form of 'intangible heritage' as an historical source on a par with more explicit sources such as ancient drawings, books, archaeological excavations, etc. This study relates to the construction of a virtual model of ancient Rome within the framework of the international project known as "Rome Reborn 1.0" (www.romereborn.virginia.edu). It exploits intangible information in order to make a plausible reconstruction of ancient Rome, currently one of the largest virtual models ever developed in the field of cultural heritage.

Background We conducted a phase II trial to evaluate the efficacy and safety of liposomal formulation of doxorubicin in recurrent ovarian carcinoma patients.Methods Thirty patients were included in the study after having obtained an informed consent. Their main characteristics were: median age, 64 years (range, 45-80), ECOG performance status 0 in 17 patients (56%), 1 in 11 patients (36%) and 2 in 2 patients (6.6%). Eighteen patients had metastatic disease and 12 locally advanced disease. All patients were pretreated with a platinum-based chemotherapy: 3 were considered refractory to platinum (progression or stable disease), 2 were platinum resistant (relapse <12 months), and 7 were platinum sensitive (relapse ≥12 months). Treatment consisted of liposomal doxorubicin, 50 mg/m2every 4 weeks.Results The overall response rate was 26.6%, with 2 complete responses and 6 partial responses lasting 3.5 months. The incidence of grade 3-4 toxicity was 23.3% for neutropenia, 10% for mucositis and 10% for plantar-palmar erythrodysesthesia. Median survival was 12+ months (range, 2-26+).Conclusions Liposomal doxorubicin appears to be a moderately active drug in pretreated patients, and its activity seems to be similar to that reported for other active regimens in terms of response rate. The toxicological profile of liposomal doxorubicin suggests that it may be combined with other drugs in the treatment of patients with ovarian cancer.

Coordination to the “Os3(CO)11” cluster core of substituted styrylpyridines such as trans-4-(4‘-NMe2-styryl)pyridine (L1), trans-4-(4‘-t-Bu-styryl)pyridine (L2), trans-4-(4‘-CF3-styryl)pyridine (L3), or trans,trans-4-(4‘-NMe2-phenyl-1,3-butadienyl)pyridine (L4) produces an enhancement of their quadratic hyperpolarizability, βEFISH, measured by the solution-phase dc electric-field-induced second harmonic (EFISH) generation method. This effect is due either to a red-shift of the intraligand charge-transfer (ILCT) transition upon coordination (when the substituent in para position is a strong electron donor) or to a metal-to-ligand charge-transfer (MLCT) transition (when the substituent is a strong electron acceptor). In the latter case the quadratic hyperpolarizability has a negative sign, due to the negative value of Δμeg. Therefore the “Os3(CO)11” cluster core displays an ambivalent acceptor or donor role. Some of the complexes investigated in this study show significant values (between 500 × 10^-48 and 900 × 10^-48 esu) of the product μβ0.

Reaction of [Re2(CO)8(THF)2] with R2R‘SiOH (R = Et, Ph; R‘ = Et, Ph, OH, OSiPh2OH) gives the new molecular models [Re2(CO)8(μ-H)(μ-OSiR2R‘)], which mimic a surface [Re2(CO)8(μ-H)(μ-OSi&tbd1;)] species anchored to isolated, geminal, or vicinal silanols. The bridging structure has been confirmed by the X-ray structure of [Re2(CO)8(μ-H)(μ-OSiPh2OH)]. Thermal treatment (70 °C) of [Re2(CO)8(μ-H)(μ-OH)] with excess Et3SiOH is another way to form [Re2(CO)8(μ-H)(μ-OSiEt3)], which can be reconverted into the hydroxo complex by addition of excess water at the same temperature. Both [Re2(CO)8(μ-H)(μ-OSiEt3)] and [Re2(CO)8(μ-H)(μ-OH)] are readily transformed into [Re2(CO)10] under 1 atm of CO at 150 °C. These molecular models, which are the only neutral carbonyl rhenium complexes bearing silanolate ligands reported up to now, constitute a new tool to clarify the first step of the surface chemistry of the photochemical interaction of [Re2(CO)10] with a rather inert support such as silica. Although the free silanol OH of both [Re2(CO)8(μ-H)(μ-OSiPh2OSiPh2OH)] and [Re2(CO)8(μ-H)(μ-OSiPh2OH)] is much less reactive than the OH of the corresponding noncoordinated silanol, it reacts at 25 °C with excess [Re2(CO)8(THF)2] to give the first bimetallic models [Re2(CO)8(μ-H)(μ-OSiPh2OSiPh2O-μ)(μ-H)Re2(CO)8] and [Re2(CO)8(μ-H)(μ-OSiPh2O-μ)(μ-H)Re2(CO)8], respectively. The latter complex, less stable to hydrolysis, is of particular interest because it constitutes the first molecular model of two metal carbonyl fragments linked to geminal surface silanols, thus suggesting that this kind of bimetallic system may occur also on a surface. Remarkably, the reaction of the rather unreactive [Os3(CO)10(μ-H)(μ-OSiPh2OSiPh2OH)] cluster with the very reactive [Re2(CO)8(THF)2] affords [Re2(CO)8(μ-H)(μ-OSiPh2OSiPh2O-μ)(μ-H)Os3(CO)10], the first heterobimetallic molecular model whose structure has been determined by X-ray diffraction.

Background. In breast cancer (BC) patients, conservative surgery (CS) followed by irradiation or immediate breast reconstruction (IBR) after modified radical mastectomy (MRM) has been proposed in the attempt to avoid the negative impact of MRM on feminine body image. Regardless of the type of operation, BC patients may feel pain even without recurrent disease with poor adjustment in terms of quality of life (QL). Methods. We adopted a questionnaire comprising the short form of the McGill Pain questionnaire, and a previously validated questionnaire able to identify four subscales exploring physical well-being, physical autonomy, relational life and psychological well-being. The questionnaire was mailed in 1999 to a consecutive series of 757 (CS: 481 cases; MRM + IBR with skin expander: 93 cases; MRM: 183 cases) disease-free patients treated for BC between March 1995 and March 1998. Results. The final analysis assessed the data relating to 529 patients who underwent axillary dissection. Pain was reported by 39.7% of women with higher incidence in patients who underwent CS than in those who underwent MRM ± IBR, but this difference did not reach statistical significance (p= 0.07). The only statistically significant difference (p< 0.05) between the surgical groups was the pain appearance that occurred earlier in the CS patients and later in the MRM + IBR patients. No other differences were observed. The women with pain had significantly worse QL scores on all of the subscales than those without. Conclusion. Pain after surgery for BC distress almost one-third of patients, regardless of the type of treatment, and had a negative effect on patients' QL. The different surgical procedures may marginally influence the quantitative characteristics of pain.

The aim of this report was to evaluate the incidence of Type 1 diabetes mellitus (T1DM) in the district of Catania (eastern Sicily) in children under 15 yr of age over a ten-yr period (01/01/1989 — 31/12/1998) in relation to age, sex, monthly-seasonal variability, calendar yr and spatial clustering. The estimated completeness of our register was 99.2%. The overall incidence rate was 12.38 per 100,000 during the period of the study. Twenty-four percent of cases were 0–4 yr at diagnosis, 42% were 5–9 yr and 34% were 10–14 yr. More males (no. 148) than females (no. 125) were newly diagnosed with a male/female ratio similar to the base population ratio in the range 0–14 yr and within age groups. The study revealed a non-random spatial distribution of T1DM incidence in children not accounted for by known demographic factors. A significant seasonal pattern and temporal trend of incidence were also detected.

Coordination to a Zn(II) center of chelating π-delocalized nitrogen donor ligands such as 5-X-1,10-phenanthrolines (X = OMe, NMe2, trans-CH&dbd;CHC6H4-4‘-NMe2, trans,trans-(CH&dbd;CH)2C6H4-4‘-NMe2) produces a significant enhancement of their quadratic hyperpolarizability measured either by the EFISH technique (β1.34) or by absorption and emission solvatochromic investigations (βCT) working with an incident wavelength of 1.34 μm. However, the enhancement factor by metal coordination of the quadratic hyperpolarizability of planar 5-X-1,10-phenanthrolines is lower than that of the nonplanar and flexible ligand 4-(p-(dibutylamino)styryl)-4‘-methyl-2,2‘-bipyridine because this latter ligand becomes planar and rigid by coordination. Coordination of 5-(trans-CH&dbd;CHC6H4-4‘-NMe2)-1,10-phenanthroline to the softer Cd(CH3CO2)2 does not produce an enhancement of the quadratic hyperpolarizability. This is due to a significant decrease of Δμeg (difference of the dipole moment in the excited and ground states of the intraligand charge transfer (ILCT)) upon coordination to the Cd(II) center. Strangely enough, the second-order NLO response of Zn(II) and Pt(II) complexes carrying two 4-trans-NC5H4CH&dbd;CHC6H4-4‘-NMe2 stilbazole ligands in a tetrahedral or planar coordination indicates a significant increase, upon coordination, of the quadratic hyperpolarizability βCT, along the ILCT transition of the ligand, but an irrelevant increase of β1.34, which is the vectorial component of the tensor β along the molecular dipole moment axis, although in the free ligand both βCT and β1.34 are comparable. The lack of coincidence of the molecular dipole moment axis with the direction of the ILCT transition of the ligand, a major origin of the second-order NLO response, could explain why βCT and β1.34 values are not comparable. In fact, a detailed solvatochromic analysis shows that the increase of βCT upon coordination to Zn(II) or Pt(II) of the single stilbazole ligand is not significant, in agreement with EFISH measurements and the irrelevant red shift of the ILCT transition.

The reactivity (e.g., toward hydrolysis, alcoholysis, reduction by CO or H2) of various [Os3(CO)10(μ-H)(μ-OSiPh2R‘)] (R‘ = Ph, OH, OSiPh2OH) clusters and the thermal behavior of [Os3(CO)10(μ-H)(μ-OSiEt3)] have been studied with the aim of clarifying by a molecular approach some aspects of the surface chemistry of silica-anchored [Os3(CO)10(μ-H)(μ-OSi&tbd1;)]. Their easy and selective reduction to [Os3(CO)12] (under CO) and to [H4Os4(CO)12] (under H2) suggests that [Os3(CO)10(μ-H)(μ-OSi&tbd1;)] does not require, as a reactive intermediate, a previous hydrolysis to the more reactive molecular species [Os3(CO)10(μ-H)(μ-OH)] in order to generate different osmium carbonyl clusters in their silica-mediated synthesis starting from OsCl3 or [Os(CO)3Cl2]2. The thermal behavior of [Os3(CO)10(μ-H)(μ-OSiEt3)] dissolved in triethylsilanol (to mimic a silica surface with many available surface silanols) or triglyme (to mimic a highly dehydroxylated silica surface) gives an answer to the controversy on the nature of the products formed by thermal degradation on the silica surface of [Os3(CO)10(μ-H)(μ-OSi&tbd1;)]. In triethylsilanol, oxidation occurs to give a Os(II) hydrido carbonyl species which, on the basis of chemical and spectroscopic evidence, we suggest to be [Os(CO)3(μ-OSiEt3)2(OSiEt3)(H)Os(CO)2]n (n = probably 2), whereas in triglyme an aggregation to high-nuclearity clusters such as [H4Os10(CO)24]^2- and [H5Os10(CO)24]^- occurs. Therefore, it is shown for the first time that molecular models not only are a tool to define structural aspects but also may be a springboard to understand and clarify by a molecular approach aspects of the reactivity of organometallic species on the silica surface.

New high yield routes to the high nuclearity hydrido carbonyl clusters [H5Os10(CO)24]-and [H4Os10(CO)24]2-, model systems for the chemisorption of CO and H2on metal surfaces, are reported. [H5Os10(CO)24]-is obtained in good yields by hydrogenation (1 atm) at 200°C of physisorbed [Os(CO)3(OH)2]nwhereas in refluxing ethylene glycol solution, that is less acidic than the silica surface, [H4Os10(CO)24]2-is obtained in high yield starting from [Os(CO)3(OH)2]nor, more conveniently, from α-[Os(CO)3Cl2]2in the presence of the stoichiometric amount of sodium carbonate. The quantitative equilibrium $$[{\text{H}}_{\text{4}} {\text{Os}}_{{\text{10}}} ({\text{CO}})_{24} ]^{2 - } \mathop {\underset { + {\text{H}}^{\text{ + }} } \leftrightarrows }\limits^{ + {\text{OH}}^ - } {\text{ }}[{\text{H}}_{\text{5}} {\text{Os}}_{{\text{10}}} ({\text{CO}})_{24} ]^ -$$ is confirmed.

Background:Cow’s milk allergy is a common disease of infancy and early childhood. If the baby is not breast-fed, a substitute for cow’s milk formula is necessary. Objective:The aim of this study was to investigate, in vitro and in vivo, the allergenicity of mare’s milk in a population of selected children with severe IgE-mediated cow’s milk allergy. Methods:Twenty-five children (17 male and 8 female) aged 19 to 72 months (median age 34 months) with IgE-mediated cow’s milk allergy were selected for this study. All the children underwent skin prick tests with cow’s milk and mare’s milk and double-blind placebo-controlled oral food challenge (DBPCOFC) with fresh cow’s milk, fresh mare’s milk, and, as placebo, a soy formula (Isomil, Abbott, Campoverde, Italy). We performed immunoblotting of cow’s and mare’s milk developed with IgE from allergic children. Results:All the children showed strong positive skin test responses to cow’s milk (4+); 2 children had positive skin test responses to mare’s milk (2+). All children had positive DBPCOFCs to cow’s milk; one child had a positive DBPCOFC to mare’s milk. No children reacted to the placebo (Isomil). In the cow’s milk, some proteins are able to strongly react with human IgE; when the sera are tested with mare’s milk, the bands corresponding to the same proteins are recognized by a lower percentage of sera. Conclusion:These data suggest that mare’s milk can be regarded as a good substitute of cow’s milk in most children with severe IgE-mediated cow’s milk allergy. It would be prudent, however, to confirm its tolerability by a supervised titrated oral challenge test. (J Allergy Clin Immunol 2000;105:1031-4.)

Background. Immediate breast reconstruction (IBR) by means of skin expander is currently one of the most widely used methods of breast reconstruction in mastectomized patients. However, given that many breast cancer patients usually receive adjuvant chemotherapy, the adoption of IBR raises new questions concerning possible cumulative toxicity. The present study reports our experience in the use of concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expander after mastectomy for breast cancer and the acute cumulative toxicity of the treatments. Methods. We evaluated a consecutive series of 52 breast cancer patients who have received IBR by skin expander after radical mastectomy and adjuvant chemotherapy concurrently during skin expansion between 1995 and 1998 (IBR/CT group). We identified two series of control patients treated during the same period: 51 consecutive patients undergoing radical mastectomy and IBR without adjuvant chemotherapy (IBR group) and 63 consecutive patients undergoing radical mastectomy and adjuvant chemotherapy without IBR (CT group). For each patient, we evaluated the incidence of surgical complications and chemotherapy's side effects and dose intensity. Results. The interval between surgery and the start of expander inflation was similar in IBR/CT (range 0–19, median 5 days) and IBR groups (range 0–40, median 5 days) and the timing of inflation was not influenced by chemotherapy. The overall incidence of surgical complications in patients undergoing IBR was low: seroma in eight cases, infection in one, skin necrosis in one, expander rupture in two and erythema in three. There were no statistically significant differences in the distribution of complications between the IBR/CT and IBR groups. The dose intensity of chemotherapy was similar between IBR/CT and CT groups, with a median dose intensity of 96% and 95% of the projected dose, respectively. The only statistically significant difference in terms of chemotherapy side effects (p=0.03) was that stomatitis was more frequent and intense in the CT than in the IBR/CT group. Conclusions. Concurrent treatment with IBR and adjuvant chemotherapy appears feasible and safe, it does not increase acute surgical complications or chemotherapy side effects, and does not require any changes in dose intensity or the timing of inflation.

The easy replacement of the hydroxy ligand in [Os3(CO)10(μ-H)(μ-OH)] by siloxy ligands affords a high-yield procedure to model compounds of the type [Os3(CO)10(μ-H)(μ-OSiR2R‘)] (R = Et, Ph; R‘ = Et, Ph, OH, OSiPh2OH), a springboard to better understand the reactivity of osmium carbonyl species on the silica surface. The new clusters [Os3(CO)10(μ-H)(μ-OSiPh2OH)] and [Os3(CO)10(μ-H)(μ-OSiPh2OSiPh2OH)], characterized by X-ray crystallography, represent the first molecular models of silica-anchored [Os3(CO)10(μ-H)(μ-OSi&tbd1;)] having a ligand that mimics surface geminal and vicinal silanols, respectively.

Background:Cow’s milk allergy (CMA) is a common disease of infancy and childhood. An appropriate cow’s milk (CM) substitute is necessary for feeding babies with CMA. CM substitutes are soy formulas and casein- or whey-based extensively hydrolyzed formulas. In several countries, including Italy, goat’s milk (GM) formulas are available, and some physicians recommend them for feeding babies with CMA. Objective:We sought to investigate, in vitro and in vivo, the allergenicity of GM in 26 children with proven IgE-mediated CMA. Methods:All the children underwent skin tests with CM and GM; detection of specific serum IgE to CM and GM; and double-blind, placebo-controlled, oral food challenges (DBPCOFCs) with fresh CM, GM, and, as placebo, a soy formula (Isomil, Abbott, Italy). CAP inhibition and immunoblotting inhibition assays were also carried out in 1 of 26 and 4 of 26 children with positive RAST results to both CM and GM, respectively. Results:All the children had positive skin test responses and CAP results to both CM and GM, all had positive DBPCOFC results to CM, and 24 of 26 had positive DBPCOFCs to GM. In CAP inhibition tests, preincubation of serum with CM or GM strongly inhibited IgE either to CM or to GM. In immunoblotting inhibition assays, preincubation with CM completely extinguished reactivity to GM, whereas GM partially inhibited reactivity to CM. Conclusions:These data strongly indicate that GM is not an appropriate CM substitute for children with IgE-mediated CMA. A warning on the lack of safety of GM for children with CMA should be on the label of GM formulas to prevent severe allergic reactions in babies with CMA. (J Allergy Clin Immunol 1999;103:1191-4.)

The authors describe a case of hepatobiliary cystadenoma and its pathogenetic, histopathologic, and clinical aspects and point out its association with multiple hemangiomas.The authors describe a case of hepatobiliary cystadenoma and its pathogenetic, histopathologic, and clinical aspects and point out its association with multiple hemangiomas.

Abstract: Several studies have stressed the role of food intolerance as one of the major factors in the pathogenesis of irritable bowel syndrome (IBS). The purpose of this study was to determine the proportion of patients with IBS that can respond well to an exclusion diet with/without oral disodium cromoglycate and to document the effects of this combination. We selected 120 ambulatory patients with diarrhoeic type IBS; 66 of them (55%) had a concomitant food intolerance (assessed by skin prick test), showing a positive reaction to one (32%) or more foods (68%). Sixty-three (52.5%) tested by cytotoxic test showed more positive reactions. The results were evaluated by means of semiquantitative subjective and objective scores. Thirty patients were randomly treated with a strict exclusion diet, while the other 36 were treated with both exclusion diet and oral disodium cromoglycate (250 mg four times daily) for four months. We observed an improvement of symptoms in 18 (60%) of the 30 patients that had received the only exclusion diet, whereas thirty-two of 36 patients (89%) who had undergone both dietary and cromoglycate treatments showed an improvement that was clinically and statistically significant (p = 0.01). Thus it is concluded that dietary exclusion in association with disodium cromoglycate is most effective in carefully selected patients with diarrhoeic type IBS, with a very high probability of prolonged symptomatic benefit in those subjects that do respond.

Activation of [Os3(CO)12] by the silica surface via reaction with surface silanol groups provides a new convenient general approach to the selective, high-yield synthesis of various osmium carbonyl clusters such as [H4Os4(CO)12] and [HOs3(CO)10Y] (Y = a three-electron donor such as OH, OR, Cl, Br, I, O2CR, and SCN). These silica-mediated syntheses compare favorably with the more conventional syntheses in solution because (i) differently from other related intermediates used in solution, silica-anchored [HOs3(CO)10(OSi&tbd1;)] is easily obtained in quantitative yield starting from [Os3(CO)12] in one step and (ii) the conversion of [HOs3(CO)10(OSi&tbd1;)] occurs in one pot usually in high yields and under mild reaction conditions. In addition, the related species [HOs3(CO)10(OH)], which can be obtained almost quantitatively by hydrolysis of [HOs3(CO)10(OSi&tbd1;)], is even more reactive than its precursor and allows a three-step synthesis of various osmium clusters characterized by excellent total yields from [Os3(CO)12].

Background The purpose of the present study was to investigate the therapeutic effectiveness of interleukin-2 (IL-2) and interferon (IFN), either alone or in combination, in comparable groups of patients affected by advanced renal cell carcinoma (RCC).Patients and methods In order to limit selection biases, treatment was allocated on a random basis. Patients randomized to IL-2 alone were scheduled to receive eight rIL-2 24-hour i.v. infusion cycles, days 1 to 4, at a daily dose of 18 x 106IU/m2for a total of 25 weeks. Patients randomized to IFN alone were scheduled to receive rIFN-α at a daily dose of 6 x 106IU/m2, days 1, 3 and 5, every week for a total of 52 weeks. Patients randomized to the combination of IFN and IL-2 were given the same drugs at the same daily doses for a total of 24 weeks. Drug dose was modified according to toxicity.Results Twenty-three percent (95% CI: ± 17.5) of patients treated with IL-2 alone showed an objective response to treatment (9% CR). The corresponding figures in patients treated with IFN alone or IFN plus IL-2 were 9% (95% CI: ± 11.9) and 9% (95% CI: ± 11.9), respectively. Complete responses were observed only in patients treated with IL-2. The median duration of response in the IL-2 arm was 18 months (range, 9.5-24). The duration of the two responses achieved by IFN alone was seven and nine, months, respectively. The corresponding figures in the two patients responding to the combination of IFN with IL-2 were 19 and 27 months, respectively. Total IL-2 dose appeared to be a major predictor of response. Only a minority of patients experienced grade 3-4 toxicity, the incidence being higher in those treated with IL-2 or IL-2 plus IFN.Conclusions Neither IFN nor IL-2 or the combination of the two appear to be very active in patients with advanced RCC, even when trial entry was restricted to patients with relatively indolent disease. This stresses the need for the development of new approaches.

[Ru3(CO)10Cl2], [Ru3(CO)12], [H4Ru4(CO)12], [H3Ru4(CO)12]^-, [HRu6(CO)18]^-, and [Ru6C(CO)16]^2- have been synthesized in good or high yields by one-step or two-step (with the surface species [Ru(CO)3Cl2(HOSi&tbd1;)] as intermediate) one-pot controlled reduction of RuCl3 supported on silica in the presence of alkali carbonates. The selectivity of the reaction is controlled by the (i) nature and quantity of the alkali carbonate (Na2CO3 or K2CO3), (ii) manner by which the alkali carbonate is deposited on the silica surface, (iii) gas-phase composition (CO, CO + H2, or CO + H2O), (iv) temperature, and (v) reaction time. The unusual selectivity can be explained by the initial formation of [Ru(CO)x(OH)2]n (x = 2, 3) which, under CO, aggregates first to [Ru3(CO)12], key intermediate for the synthesis in situ of various ruthenium carbonyl clusters on the silica surface.

The interplay of different Zn(II) and Cd(II) salts with two luminescent triimidazole ligands, triimidazo[1,2-a:1′,2′-c:1″,2″-e][1,3,5]triazine (L1) and its positional isomer triimidazo[1,2-a:1′,2′-c:1″,5″-e][1,3,5]triazine (L2), in solvothermal synthetic conditions resulted in mono-, bi-, and polynuclear Zn(II) and Cd(II) coordination compounds with diverse metal/luminophore(L1,L2)/anion/water ratios, [Zn(H2O)6](NO3)2(L1)2(1), [Zn(H2O)4(L1)2](NO3)2(H2O)2(2), [Cd(H2O)4(L1)2](NO3)2(H2O)2(3), [Zn(L1)(NO3)(H2O)3](NO3) (4), [Cd(L1)2(NO3)2(H2O)2] (5, 6), [Cd2(bdc)(L1)2(NO3)2(H2O)4]·2H2O (7), [Zn(H2O)4(L2)2](NO3)2(8), [Cd(L2)2(NO3)2(H2O)] (9), [Zn(L2)2(CH3COO)2] (10), [Cd(L2)2(CH3COO)2(Im)0.75(H2O)0.25]·0.5(H2O) (11), [Zn(Cl)2(L1)(H2O)] (12), {[Zn(Cl)2(L1)]·1/6(L1·H2O)}n(13), and [Cd(L2)6]2[Cd(H2O)6](ClO4)6·7(H2O) (14). Herein, for the first time, the Zn and Cd coordination compounds with L1and L2luminophores as inner-sphere ligands have been obtained and structurally characterized. The structural landscape includes inclusion compound 1, supramolecular isomers 1–3, isomorphs 2and 3, polymorphs 5and 6, and one-dimensional coordination polymer 13. In discrete complexes, both luminophores coordinate to the metals in monodentate mode; in 13, L1acts as a bidentate bridging ligand giving rise to the structure extension. Since the crystal packing and stacking patterns of the luminophore molecules are important factors underlying the aggregation induced emission, the finite and infinite stacking motifs registered in the crystal structures 1–14are reported. All compounds reveal an emissive response upon irradiation under the UV–vis lamp. The best performing compounds in the series, namely, 4, 5, and 10, have been fully spectroscopically characterized.

We report a rare case of congenital glioblastoma multiforme in a 13-day-old male neonate born at term who died from cardiocirculatory failure. The cerebral tumor was diagnosed in vivo by magnetic resonance imaging and confirmed histologically after autopsy. The histological and immunohistochemical features of this case were similar to those reported in the adult.

A high-yield procedure is described for the preparation, from [M(CO)3Cl2]2 (M = Ru, Os) and aqueous NaOH, of the new water-soluble and air-stable species [Ru(CO)2Cl(OH)]n, [Ru(CO)2(OH)2]n, [Os(CO)3Cl(OH)]2, and [Os(CO)3(OH)2]x (x = 2 or n).