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Introduction: The purpose of this study was to evaluate and compare leveling of the curve of Spee (COS) achieved by traditional fixed appliances and Invisalign clear aligners (Align Technology, Santa Clara, Calif).Methods: This retrospective study involved 2 groups of subjects with an increased COS depth. Patients treated with the Invisalign system (I group) and patients treated with the standard edgewise full-fixed appliance (F group). The I group included 30 subjects (13 males, 17 females; mean age, 24 years 5 months ± 19 months). The F group included 32 subjects (12 males, 20 females; mean age, 22 years 4 months ± 21 months). The 2 groups were matched for sex, age, vertical pattern, and observation period. Pretreatment (T0) and posttreatment (T1) lateral cephalograms were analyzed. COS depth was measured on digital dental casts. The intragroup variation between T0 and T1 was analyzed with a paired t test. The intergroup variation was evaluated using an unpaired t test.Results: The leveling of COS was statistically significant, comparing T0 and T1 within the groups. The F group presented a statistically significant extrusion of posterior teeth, with a flaring of the mandibular incisors. The I group showed a statistically significant intrusion of the mandibular incisors, with excellent control in the proclination of incisors during the intrusion movement.Conclusions: Traditional continuous archwire treatment and the Invisalign system effectively level the COS. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic and associated lockdown measures have disrupted educational and nutrition services globally. Understanding the overall and differential impacts of disruption of nutritional (school feeding) services is critical for designing effective post-COVID-19 recovery policies.Objectives: The aim of this study was to examine the impact of COVID-19-induced disruption of school feeding services on household food security in Nigeria.Methods: We combined household-level, pre-COVID-19 in-person survey data with postpandemic phone survey data, along with local government area (LGA)-level information on access to school feeding services. We used a difference-in-difference approach and examined temporal trends in the food security of households with and without access to school feeding services. Of the sampled households, 83% live in LGAs with school feeding services.Results: Households experienced an increase in food insecurity in the post-COVID-19 survey round. The share of households skipping a meal increased by 47 percentage points (95% CI: 44-50 percentage points). COVID-19-induced disruptions of school feeding services increased households' experiences of food insecurity, increasing the probability of skipping a meal by 9 percentage points (95% CI: 3-17 percentage points) and the likelihood of going without eating for a whole day by 3 percentage points (95% CI: 2-11 percentage points). Disruption of school feeding services is associated with a 0.2 SD (95% CI: 0.04-0.41 SD) increase in the food insecurity index. Households residing in states experiencing strict lockdown measures reported further deterioration in food insecurity. Single mothers and poorer households experienced relatively larger deteriorations in food security due to disruption of school feeding services.Conclusions: Our findings show that COVID-19-induced disruptions in educational and nutritional services have exacerbated households' food insecurity in Nigeria. These findings can inform the designs of immediate and medium-term policy responses, including the designs of social protection policies and alternative programs to substitute nutritional services affected by the pandemic. [ABSTRACT FROM AUTHOR]

The paper presents a real-scale experimental study of Glass Fiber Reinforced Concrete (Glass-FRC) jointless slabs-on-grade in outdoor conditions before the application of service loads to evaluate deformations due to shrinkage phenomena and thermal effects. A square slab (20 ×20×0.18 m) and a unidimensional slab (2 ×20×0.18 m) reinforced with 10 kg/m3 of glass macro-fibers were cast and monitored for about six months through external and embedded sensors to detect in-plane and out-plane slab displacements. A double plastic sheet layer was used under the slab to reduce friction with the support while another plastic sheet was applied on the top slab for a curing-time of seven days to reduce risk of cracking. Among the complementary tests, the frictional behavior between the slab and the support was assessed through a large-scale interface shear test. Environmental temperature and relative humidity were continuously measured over the whole period as well as Glass-FRC main mechanical properties. No cracks were detected by visual inspection after approximately six months. [Display omitted] • A heavily instrumented 20×20×0.18 m jointless slab was monitored during more than 6 months. • 20 m Long unidimensional slab was monitored during the same period. • Useful experimental information about the interfacial friction between slab and subgrade. • Evaluation of the influence of glass macro-fibers on shrinkage and thermal phenomena. • Prediction with a simplified model adequate for unidimensional slab. [ABSTRACT FROM AUTHOR]

• Innovative upper bound limit analysis approach with homogenization. • Study of six non-periodic masonry patterns, ranging from rubble to quasi-periodic masonry. • Utilization of refined meshes with "pixel 2D" FEs having only linear velocities as variables. • Master-slave approach where blocks are assumed infinitely resistant. • Comparison on in-plane homogenized failure surfaces between rubble and quasi periodic masonry. This paper presents a novel and straightforward procedure for the derivation of homogenized failure surfaces for non-periodic masonry. The most innovative feature of this procedure is the automatic generation of a convenient finite element mesh directly from the sketch of the considered masonry panel, based on the so-called "pixel strategy" that converts each pixel into an element. An upper bound limit analysis problem coupled with homogenization is then solved by aptly formulating it as a linear programming problem. Another main feature is the implementation of a reduced formulation of such problem (called "master-slave approach") so that the number of unknown variables is reduced and, consequently, the computational times needed for the extraction of the homogenized failure surfaces are shortened as well. A simple procedure is also implemented for a quick identification of the statistical Representative Element of Volume (or REV) for a non-periodic masonry panel. The REV is the smallest portion of a composite material that includes all the physical and geometrical characteristics needed for its complete description. The reliability of the procedure is tested by investigating six case studies displaying different degrees of non-periodicity, extracting and critically commenting the results obtained in terms of homogenized failure surfaces and failure modes. [ABSTRACT FROM AUTHOR]

Highlights • Fictile tubules are hollow, cylindrical clay bricks (tubules, amphorae , caroselli). • Employed in many heritage buildings in and around Mediterranean area. • Caroselli 's compressive strength influenced by number of microorganisms' imprints. • Derivation of homogenised properties for composite material caroselli + mortar. • Satisfying fitting of homogenised properties against experimental data. Abstract The historical centres of many Italian cities are integral parts of the Country's cultural heritage, and guaranteeing their conservation over time is paramount. Many constructions are characterised by building techniques that are not well-known and still have to be studied. In particular, one technique involving the use of clay fictile tubules is here examined through historical studies, experimental characterisation and numerical investigations. This technique is typical of the Mediterranean area and Southern Italy, and dates back to Roman and early Christian times; three different types of elements were usually employed (tubules, amphorae and caroselli). Walls, domes and vaulted structures with different geometries were built with this technique, which allowed for the creation of modular construction elements in potteries. Relevant historical building issues are first addressed in detail, then a comprehensive experimental investigation on the constitutive materials (caroselli and mortar) is presented, provided with a series of numerical simulations aimed at validating the experimental results. Eventually, the composite material consisting of caroselli and mortar is investigated through a homogenisation approach, allowing its mechanical characterisation through the evaluation of equivalent homogenised material properties. They are derived through the investigation of an analytical elementary cell, subject to uniaxial tension and compression, which enables to derive homogenised constitutive laws. These are validated by comparing experimental data obtained from compressive tests performed on three real elementary cells with numerical results gathered from the use of such homogenised properties on an equivalent cell. [ABSTRACT FROM AUTHOR]

Highlights • We study the direct and the general equilibrium effects of scaling-up the South African Child Support Grant. • We use a recursive bottom-up/top-down CGE-microsimulation approach with three different financing scenarios. • The proposed reform brings small positive impacts at the macro level and a decrease in poverty. • Direct and indirect factors contribute to the poverty change but unlikely to be significant, with the direct being prevalent. • Important progressive heterogeneous are found, with the richest percentiles slightly deteriorating their welfare. Abstract Social grant schemes have become an important component of many developing countries’ inclusive growth strategies with governments increasingly investing in large-scale cash transfer programs. South Africa’s Child Support Grant (CSG) is one of the largest cash transfer systems in Africa. However, child poverty remains high in the country, leading to calls to expand the CSG. Government faces resource scarcity and therefore needs to create fiscal space to set up such a reform. This paper evaluates the economy-wide impact of the CSG on the economy using a recursive bottom-up/top-down CGE-micro simulation approach. This allows the estimation of the potential effects of a 20% increase in the grant on households’ welfare, the economy, as well as on the fiscal constraint. This reform is evaluated under three fiscal scenarios to take into account the fiscal stress the country is currently experiencing. We find that the reform brings some positive impacts at the macro level, and a decrease in poverty for the whole population as well as for children. The direct effect brought by the CSG increase represents the largest contribution to poverty reduction, but the indirect (general equilibrium) effects globally reduce the positive poverty effects engendered by the CSG. Some interesting heterogeneous effects are also found, with the proposed reform being progressive and the richest percentiles showing a (small) deterioration due to the decrease in wage revenues. However, the overall poverty and inequality effects are small and unlikely to be robust. The paper’s results can assist South Africa, and indeed other African countries, calling for increased coverage of grants as well as exploring universal coverage. Further, the use of the integrated macro-micro simulation methodology is a major contribution of this paper. [ABSTRACT FROM AUTHOR]

Abstract The present paper deals with an experimental study on the post-cracking tensile behavior of Steel Fiber Reinforced Concrete (SFRC). In this regard, a broad experimental campaign based on Uniaxial Tensile Tests (UTTs) on notched cylinders as well as three point bending tests (3 PBTs) on notched beams was carried out. Based on the experimental results, the benefits offered by the addition of fiber in the post-cracking behavior was deeply studied: fibers increase the toughness of concrete and the ultimate crack width. The uniaxial post-cracking tensile laws of SFRCs were directly obtained by UTTs and indirectly retrieved by 3 PBTs by performing an inverse analysis procedure. In the latter case the fracture energy was generally higher. It was proven that there is a strongly dependency of the SFRC post-cracking performance with the fiber distribution and orientation that was measured by means of image-analysis technique. [ABSTRACT FROM AUTHOR]

As the Whale and dolphin Watching (WW) industry grows, so does the need for better industry management. The present study aims to both evaluate the current compliance of WW operators with local WW statutory tools, as well as gain a multi-perspective overview of WW activities in the Strait of Gibraltar. To this end, a total of 637 questionnaires were filled out by stakeholders including WW customers and operators, researchers, environmental NGOs, technicians, and policy makers in Tarifa and Gibraltar between 2017 and 2019. A direct assessment of WW activities was also carried out in 2019. Results suggest that (1) local operators only partially follow rules, (2) customers prefer, and give higher ratings to operators when cetaceans are indifferent to or approach vessels and (3) stakeholders recognise the educational, scientific, and recreational values of WW. Suggestions for the improvement of compliance include the land-based monitoring of WW activities, the analysis of Automatic Identification System data and an increase in patrolling and enforcement (e.g., revoking of licenses). Moreover, the introduction of structured educational programmes during WW activities the designation of Marine Protected Areas, and of a regional shipping plan, together with an integrated management approach, could benefit the WW industry and improve its sustainability in the Strait. [ABSTRACT FROM AUTHOR]

Background Necroptosis is an inflammatory form of programmed cell death requiring receptor-interacting protein kinase 3 (RIP3) and mixed lineage kinase domain-like protein (MLKL). Aims The aim of this study is to examine in depth in vitro and ex vivo the contribution of necroptosis to intestinal inflammation. Methods In vitro: we used an intestinal cell line, HCT116RIP3, produced in our laboratory and overexpressing RIP3. Ex vivo: intestinal mucosal biopsies were taken from patients with inflammatory bowel disease (IBD) (20 with Crohn’s disease; 20 with ulcerative colitis) and from 20 controls. Results RIP3-induced necroptosis triggers MLKL activation, increases cytokine/alarmin expression (IL-8, IL-1β, IL-33, HMGB1), NF-kBp65 translocation and NALP3 inflammasome assembly. It also affects membrane permeability by altering cell–cell junctional proteins (E-cadherin, Occludin, Zonulin-1). Targeting necroptosis through Necrostatin-1 significantly reduces intestinal inflammation in vitro and in cultured intestinal explants from IBD. Conclusion We show for the first time in vitro and ex vivo that RIP3-driven necroptosis seriously affects intestinal inflammation by increasing pMLKL, activating different cytokines and alarmins, and altering epithelial permeability. The inhibition of necroptosis causes a significant decrease of all these effects. These data strongly support the view that targeting necroptosis may represent a promising new option for the treatment of inflammatory enteropathies. [ABSTRACT FROM AUTHOR]

The use of fiber reinforced concrete in tunnel linings, with or without conventional rebars, has increased in the two last decades, especially with regard to precast tunnel segmental linings. In addition, there is a general growing interest in the scientific community on macro-synthetic fibers for use in underground structures. Within this framework, the present study investigates the possibility of using polypropylene (PP) fiber reinforcement in hydraulic precast tunnel segments by means of an experimental program on six full-scale segments of Monte Lirio hydraulic tunnel (Panama). Three different reinforcement solutions were studied both under flexure and point load test: typical conventional reinforcement generally adopted in practice (reference samples, RC); PP fibers only (PFRC specimens); combination of PP fibers and conventional reinforcement (hybrid solution, RC + PFRC segments). Based on the loading configurations considered, experimental results showed that PP fibers (with or without reinforcing bars, depending on loading conditions) represent an efficient reinforcement for hydraulic precast tunnel segments. PP fibers can be used as flexural, splitting and minimum shear reinforcement, while concerning the spalling reinforcement, only PP fiber reinforcement could be used even if the combination with conventional reinforcement (hybrid solution) guarantees a better control of spalling cracks for high load levels. [ABSTRACT FROM AUTHOR]

The metabolic state represents a major hurdle for an effective adoptive T cell therapy (ACT). Indeed, specific lipids can harm CD8+ T cell (CTL) mitochondrial integrity, leading to defective antitumor responses. However, the extent to which lipids can affect the CTL functions and fate remains unexplored. Here, we show that linoleic acid (LA) is a major positive regulator of CTL activity by improving metabolic fitness, preventing exhaustion, and stimulating a memory-like phenotype with superior effector functions. We report that LA treatment enhances the formation of ER-mitochondria contacts (MERC), which in turn promotes calcium (Ca2+) signaling, mitochondrial energetics, and CTL effector functions. As a direct consequence, the antitumor potency of LA-instructed CD8 T cells is superior in vitro and in vivo. We thus propose LA treatment as an ACT potentiator in tumor therapy. [Display omitted] • Linoleic acid (LA) improves "quality" and "quantity" of CTL mitochondria • LA redirects CTL away from exhaustion and toward a memory-like phenotype • LA fosters MERC formation and harnesses CTL with superior effector functions • LA potentiates antitumor CTL response and improves ACT efficacy Nava-Lauson et al. report that linoleic acid potentiates antitumor function of CD8+ T cells by operating a profound metabolic reprogramming that protects from exhaustion and pushes toward a memory phenotype with superior cytotoxic functions. LA-redirected CD8+ T cells are empowered with an improved metabolic and functional fitness within the TME, thereby improving efficacy of ACT-based therapy. [ABSTRACT FROM AUTHOR]

The local splitting behaviour in Fibre Reinforced Concrete (FRC) elements under a high concentrated load is gaining a growing interest, especially with reference to precast tunnel segments. In fact, during the lining construction process, high concentrated thrust jack forces are introduced in the segments leading to both high compressive stresses under the thrust shoes that can provoke a concrete crushing and tensile transversal stresses that can cause cracks and, eventually, a splitting failure. In order to investigate the main involved mechanisms during either splitting or crushing failure, a simplified analytical study is firstly presented on the two load configurations generally adopted in practice, namely the Line Load (LL) and the Point Load (PL). Based on this analytical study, experimental tests on Steel Fibre Reinforced Concrete (SFRC) specimens subjected to a LL configuration have been carried out. Two different steel fibre types have been studied. Experimental results indicate that the use of a low amount of fibres significantly enhances both the splitting bearing capacity and the ductility. Fibres allow a stable propagation of the splitting crack both in terms of crack opening and development, as a result of a transverse stress redistribution that continuously provide equilibrium with the external applied load. [ABSTRACT FROM AUTHOR]

In this paper, a numerical insight on the historical masonry Castle of Finale Emilia, symbol of the consequences occurred after the seismic sequence of 20–29th May 2012 in Emilia Romagna, Italy, is presented. Some different numerical models are critically compared, in order to both have an insight into the causes at the base of the partial collapse of the structure and propose valuable rehabilitation interventions with seismic upgrading to prevent future damage under seismic loads. Two different meshes are utilized, the one very refined and constituted by tetrahedron elements, the other much coarser and mainly constituted by hexahedrons, along with different hypotheses presented for the masonry material (linear and elasto-plastic with damage and softening). The analyses performed include standard modal, nonlinear static (pushover) and nonlinear dynamic analyses, under different hypotheses concerning the material properties of the single walls. Three different configurations are compared, the first is the real one stricken by the earthquake (where only one of the walls had been consolidated), the second is a hypothetical castle without any consolidated wall, the last is the situation that should be encountered after full rehabilitation. At this aim, full three-dimensional (3D) detailed finite element models (FEM) are adopted, starting from the available documentation at disposal (photos and existing drawings). From numerical results, it is found that the insufficient resistance of the constituent materials is mostly responsible for the damages observed and that the partial rehabilitation implemented by the municipality on one wall helped in limiting the damaging effect of the seismic sequence. In all cases, the numerical analyses provide a valuable picture of active damage mechanisms, giving useful hints for the reconstruction and indicating that a limited upgrading of masonry mechanical properties could limit considerably the global seismic vulnerability of the structure, in light of a reconstruction of the collapsed parts of the Castle. [ABSTRACT FROM AUTHOR]

The use of Steel Fiber Reinforced Concrete (SFRC) was experimentally evaluated with the aim of verifying its effectiveness in reducing the damage and improving the ductility as well as the energy dissipation of seismic resistant columns with special emphasis to the base regions where plastic hinges develop. Sixteen full-scale cantilever columns were tested under reversing cyclic lateral loading and constant axial load. Both unidirectional (uniaxial) and bidirectional (biaxial) lateral displacements were imposed in order to better simulate the actual response of a column during an earthquake. A volume fraction of 1.0% of steel fibers was adopted together with different percentages of transverse reinforcement; the latter was adopted with two steel grades having different ductility performance in order to evaluate their influences on the column behavior. The results of the experimental campaign confirmed that SFRC may reliably reduce the columns damage by preventing the concrete cover to spall out at earlier stages and increase their initial stiffness and energy dissipation, especially for uniaxial loads that resulted less severe than the biaxial ones. [ABSTRACT FROM AUTHOR]

The present paper aims to investigate the influence of steel fibers on the behavior of high strength precast concrete columns in steel socket foundation under cyclic loading. The experimental program was mainly defined to study the effects of the volume fraction and the type of fibers on the behavior of full-scale precast columns subjected to reversed cyclic horizontal loading under constant axial load. Experimental parameters under investigation were: the transverse reinforcement ratio, the axial load, the fiber type and content as well as the effect of steel-to-concrete bond of rebars in the critical region. The latter was investigated since it could considerably govern the local ductility in terms of curvature and of global displacement of the precast column, especially in presence of fibrous reinforcement. Experimental results highlight the importance of the stirrup spacing in the critical region as well as the positive effect of fibers on the crack development, by preventing the concrete cover to spall-out at earlier stages. Steel Fiber Reinforced Concrete (SFRC) tends to enhance the structural stiffness, the strength and the dissipated energy. [ABSTRACT FROM AUTHOR]

The design process of segmental concrete linings in ground conditions generally refers to standard load cases of de-molding, storage, embedded ground condition and grouting process. Nevertheless, the application of the Tunnel Boring Machine (TBM) thrust jack forces is a crucial temporary loading condition during construction, which may govern the design procedure as well as the other stages. Tunnel segments were traditionally reinforced with conventional rebars in order to resist the tensile stresses at both Serviceability (SLS) and Ultimate Limit States (ULS). In the two last decades, Fiber Reinforced Concrete (FRC) has been also used in several precast tunnel segments with or without conventional rebars. For structural purposes, steel fibers are generally used, even though some types of structural macro-synthetic fibers, which are able to impart significant toughness and ductility to concrete, have been recently introduced in the market. For these reasons, an experimental program aimed to investigate the local splitting behavior in the segment regions under the TBM hydraulic jacks was carried out at the University of Brescia. Tests on concrete prisms (with or without fibrous reinforcement) under Line Load (LL) or Point Load (PL) configurations were carried out in order to evaluate the beneficial effects of polypropylene (PP) fibers in controlling typical splitting cracks occurring under the jack loads, which represent one of the most severe loading conditions for tunnel segments. Experimental results show the feasibility of using polypropylene fibers in tunnel segments, since they significantly enhance both the splitting bearing capacity and the ductility. Fibers lead to a stable development of the splitting crack, which allows a redistribution of stresses after cracking. However, the effectiveness of fibers is influenced by the casting direction, which leads to a different fiber orientation. When the latter is favorable (fibers expected to be mainly transversal to the splitting crack) the bearing capacity is higher than in case of an unfavorable casting direction (fibers expected to be mainly parallel to the splitting crack). [ABSTRACT FROM AUTHOR]

The addition of fibers in concrete determines a cracking phenomenon characterized by narrower and more closely spaced cracks, with respect to similar members without fibers. Fiber Reinforced Concrete (FRC) may significantly improve the tension stiffening into the undamaged portions of concrete among cracks, and, in addition, may provide noticeable residual stresses at a crack due to the bridging effect provided by its enhanced toughness. This paper aims at further investigating the ability of fibers in controlling cracks by discussing more than ninety tension tests on Reinforced Concrete (RC) prisms, carried out at the University of Brescia, having different sizes, reinforcement ratios, amount of fibers and concrete strengths. In particular the influence of FRC in reducing the crack spacing and the crack width is evaluated as a function of the FRC toughness. Finally, the most recent available models for predicting the crack spacing of FRC composites are evaluated and critically discussed. [ABSTRACT FROM AUTHOR]

Background The “multiple-biopsy” approach both in duodenum and bulb is the best strategy to confirm the diagnosis of celiac disease; however, this increases the invasiveness of the procedure itself and is time-consuming. Aim To evaluate the diagnostic yield of a single biopsy guided by narrow-band imaging combined with water immersion technique in paediatric patients. Methods Prospective assessment of the diagnostic accuracy of narrow-band imaging/water immersion technique-driven biopsy approach versus standard protocol in suspected celiac disease. Results The experimental approach correctly diagnosed 35/40 children with celiac disease, with an overall diagnostic sensitivity of 87.5% (95% CI: 77.3–97.7). An altered pattern of narrow-band imaging/water immersion technique endoscopic visualization was significantly associated with villous atrophy at guided biopsy (Spearman Rho 0.637, p < 0.001). Concordance of narrow-band imaging/water immersion technique endoscopic assessments was high between two operators ( K : 0.884). The experimental protocol was highly timesaving compared to the standard protocol. Conclusions An altered narrow-band imaging/water immersion technique pattern coupled with high anti-transglutaminase antibodies could allow a single guided biopsy to diagnose celiac disease. When no altered mucosal pattern is visible even by narrow-band imaging/water immersion technique, multiple bulbar and duodenal biopsies should be obtained. [ABSTRACT FROM AUTHOR]

Abstract: Tunnel linings are generally reinforced with conventional rebars that are placed to resist tensile stresses. As far as the service conditions are concerned, in recent years durability issues have became of paramount importance, especially for underground infrastructures. Durability design generally requires rebar protection against corrosion that can be achieved by reducing concrete porosity and crack width. The former can be obtained by using a matrix with a low water/cement ratio while the latter can be achieved by using a diffused reinforcement; to this aim, discrete fibrous reinforcement may represent an optimal solution. In fact, the addition of fibers into concrete may provide noticeable residual tensile strength at a crack, linking the two adjacent faces of any crack due to the bridging effect provided by its enhanced toughness. The latter also provides a significant resisting contribution against diffused tensile stresses acting in the structural element. However, when localized stresses (due to bending actions) occur, they are more efficiently resisted by localized reinforcement (rebars). Within this framework, this paper aims at investigating the behavior of FRC final tunnel linings, excavated with conventional method. Numerical non-linear analyses were carried out by considering different load conditions in order to achieve a reinforcement optimization based on the combination of conventional (rebars) and fiber reinforcement (FRC). The procedure is applied to a real case of a road tunnel. [Copyright &y& Elsevier]

Abstract: Tension stiffening is still a matter of discussion into the scientific community; the study of this phenomenon is even more relevant in structural members where the total reinforcement consists of a proper combination of traditional rebars and steel fibers. In fact, fiber reinforced concrete is now a worldwide-used material characterized by an enhanced behavior at ultimate limit states as well as at serviceability limit states, thanks to its ability in providing a better crack control. This paper aims at investigating tension stiffening by discussing pure-tension tests on reinforced concrete prisms having different sizes, reinforcement ratios, amount of steel fibers and concrete strength. The latter two parameters are deeply studied in order to determine the influence of fibers on crack patterns as well as the significant effect of the concrete strength; both parameters determine narrower cracks characterized by a smaller crack width. [Copyright &y& Elsevier]

The existence of mild forms of celiac disease (CD) can make the histology-based diagnosis difficult to reach. Since anti-endomysium (EMA) and anti-tissue transglutaminase (anti-tTG) are detectable in culture supernatants of duodenal biopsies from CD patients, our aim was to assess if this system can support the histology in the diagnostic work-up. A total of 559 suspected CD patients underwent serum EMA/anti-tTG detection, upper endoscopy with duodenal biopsy sampling, histologic analysis, and organ culture to detect EMA/anti-tTG in supernatants. A subgroup of 30 patients with organ culture positive results were put on a gluten-free diet (GFD). Their gluten-dependency was evaluated by the psychological general well-being and beck depression inventory indexes. Statistical analysis was performed by Cohen k inter-test, Friedman test, and Dunn multiple comparison. Two hundred forty-one out of 559 (43.1%) patients showed intestinal villous atrophy, whereas serum and organ culture EMA/anti-tTG were positive in 293/559 (52.4%) and 334/559 (59.7%) patients, respectively. The strength of agreement resulted good for serology vs histology (k = 0.730), good for organ culture vs histology (k = 0.662), and very good for serology vs organ culture (k = 0.852). After 12 months of GFD, psychological general well-being index significantly increased, and beck depression inventory index significantly decreased (P < 0.001 for each one). Data highlight the organ culture system as a useful tool to assist the histology in diagnosing CD, mainly in cases without villous atrophy or in seronegative patients. The marked improvement in quality of life after a GFD further supports the reliability of this system in diagnosing CD. [ABSTRACT FROM AUTHOR]

Objective: To report the long-term therapeutic results for patients with conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma who were treated with intralesional injections of interferon-α (IFN-α). Design: Prospective, nonrandomized, interventional case series. Participants: Twenty eyes of 16 patients with histologically proven conjunctival MALT lymphoma in the absence of systemic disease. Methods: Patients were given 1 500 000 international units (IU) of IFN-α (Roferon-A; Roche s.p.a., Milano, Italy) subconjunctivally inside the lesion 3 times weekly for 4 weeks. If there was even a minimal response, a further cycle of 1 000 000 IU 3 times weekly for 4 weeks was administered. Main Outcome Measures: Patients were followed up clinically using slit-lamp examination to determine evidence of tumor disappearance or recurrence. In 10 eyes, an incisional biopsy was performed 6 months after therapy to verify the histologic absence of the lesion. Results: A complete response was obtained in 15 eyes (75%) at the end of first cycle treatment, and in 5 eyes (25%) after further cycles. Seventeen eyes (85%) showed no local recurrence after a median follow-up of 65 months (range, 15–136 months). Three eyes (15%) demonstrated recurrence at variable points after treatment. One patient with stage IIA lymphoma exhibited systemic lymphoma progression. Conclusions: Local immunotherapy with IFN-α seems to be an effective and lasting treatment method and provides an alternative to radiotherapy for conjunctival MALT lymphomas. Very few transient side effects were detected. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the long-term efficacy of verteporfin photodynamic therapy (PDT) as the primary treatment for symptomatic circumscribed choroidal hemangioma (CCH). Design: Prospective consecutive, 2-centered, noncomparative, interventional case series. Participants: Twenty-five subjects with symptomatic CCH. All patients had recent onset of visual symptoms and evidence of exudative macular changes on fluorescein angiography (FA) and optical coherence tomography (OCT). Methods: Verteporfin 6 mg/m2 body surface area was administered intravenously over a 10-minute interval. Five minutes after infusion, a 689 nm laser was applied with a light dose of 50 J/cm2 for the first 3 patients and a light dose of 100 J/cm2 for all the other patients. Retreatments were performed in case of persistent exudation found on OCT. Evaluation of best-corrected visual acuity (BCVA) using Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria, FA, indocyanine green angiography (ICGA), OCT, and ultrasound were performed before PDT and on follow-up examinations. All patients were followed for at least 5 years. Main Outcome Measures: Primary outcome measures were changes in BCVA and foveal center thickness (FCT) between baseline and month 60. Secondary measures were tumor thickness decrease, absence of leakage on FA, and adverse events. Results: Twenty-two patients received 1 PDT session at 100 J/cm2, and no recurrences were detected. Three eyes, treated with 50 J/cm2, received a second PDT session at 100 J/cm2 1 month after the first session. After a follow-up of 60 months, BCVA improved an average of 18.5 ETDRS letters (P<0.001); BCVA improved by ≥2 lines in 19 eyes (76%). The FCT decreased from a mean of 386.20 μm to 179.2 μm, and OCT showed the complete resolution of macular exudation in all cases. All tumors responded with a reduction in size. No treatment-related adverse events or complications were identified. Conclusions: The 5-year results of PDT in treating symptomatic CCH support treatment with a light dose of 100 J/cm2 after slow intravenous infusion of verteporfin to stabilize or improve visual acuity and resolution of macular exudation. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Epidemiological evidence supports the concept that diets rich in fruits and vegetables promote health and attenuate or delay the onset of cardiovascular disease (CVD). Although a variety of factors contribute to the beneficial effects of plant foods, much attention has been addressed to plant polyphenols. In this regard, in the daily Western diet, both black and green teas contribute to a relevant proportion of total phenol intake. The more abundant class of flavonoids that is present in teas is represented by flavanols, i.e., catechin, epicatechin, epigallocatechin, epicatechin gallate, and epigallocatechin gallate. Studies using animal models of atherosclerosis indicate that dietary flavonoid consumption delays atherosclerotic plaque development. Accordingly, an inverse association between tea intake and CVD has been demonstrated. Further, flavonoids can reduce endothelial dysfunction, i.e., the key step in the development of atherosclerosis. Concordantly, human data suggest that tea may reduce blood pressure levels. Despite this, although they often show that tea may have cardiovascular protective effects, results from epidemiological studies exploring the association between tea and health are controversial. Conflicting results may be caused by disparate study designs and flavonoid contents in different kinds of tea. Thus, because tea is a popular beverage worldwide, and several studies have shown that it is protective against CVD, further studies are needed to determine the role of tea in primary and secondary cardiovascular prevention. [ABSTRACT FROM AUTHOR]

Abstract: The deep structures of the Central–Southern Apennines are analysed on the basis of the regional component of gravity anomalies, obtained applying a stripping technique. This procedure allows the accurate removal of the gravimetric effect of the three-dimensional shallow (within the first 10km) geological bodies from the observed Bouguer anomaly. The resulting anomaly map differs quite significantly from the Bouguer anomaly map, providing new constraints on the nature of the deeper part of the crust and on the upper mantle. The stripping reveals that the regional gravity lows are shifted westward in comparison with Bouguer anomaly lows. Moreover, the gravimetric pattern indicates a lack of cylindrism for the deep structures of the Apennine Chain, which in the study area can be roughly divided into three main segments. The observed differences between the gravity anomalies pattern of the Central Apennines and that of the Southern Apennines are marked. The integration of gravimetric results with other geophysical data suggests that: (i) a ramp-dominated style for the buried Apulia (Adria) units and part of the underlying basement is compatible with gravimetric data and (ii) most of the regional gravity anomalies in the Central Apennines seem to originate within the lower crust. [Copyright &y& Elsevier]

We report on the conduct of a systematic review to assess the efficacy and the safety of hepatitis A vaccines in adults and children. We identified, retrieved, and assessed all trials evaluating the effects of hepatitis A vaccines on prevention of cases of hepatitis A, death from hepatitis A, and assessing nature and frequency of adverse events. We included eight randomised trials, four containing efficacy outcomes, three containing only safety outcomes and a single study containing efficacy and adverse events outcomes. Combined inactivated vaccine effectiveness was 86% (95% CI: 63–95%). Combined attenuated vaccine effectiveness was 95% (95% CI: 81–99%). Inactivated vaccine effectiveness in the prevention of HAV secondary cases, compared to non-intervention was 82% (95% CI: 23–96%). Safety profile of vaccines was similar to that of their comparators. Despite poor design and reporting of trials, we found convincing evidence of the effectiveness and safety of inactivated HAV vaccines. [Copyright &y& Elsevier]