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This study explores the potential of graphene oxide (GO) as an additive in waterborne polyurethane (WPU) resins to create eco-friendly coatings with enhanced anticorrosive properties. Traditionally, WPU's hydrophilic nature has limited its use in corrosion-resistant coatings. We investigate the impact of incorporating various GO concentrations (0.01, 0.1, and 1.3 wt%) and functionalizing GO with ethylenediamine (EDA) on the development of anticorrosive coatings for carbon steel. It was observed, by potentiodynamic polarization analysis in a 3.5% NaCl solution, that the low GO content in the WPU matrix significantly improved anticorrosion properties, with the 0.01 wt% GO-EDA formulation showing exceptional performance, high E corr (-117.82 mV), low i corr (3.70 × 10 -9 A cm -2 ), and an inhibition corrosion efficiency (η) of 99.60%. Raman imaging mappings revealed that excessive GO content led to agglomeration, creating pathways for corrosive species. In UV/condensation tests, the 0.01 wt% GO-EDA coating exhibited the most promising results, with minimal corrosion products compared to pristine WPU. The large lateral dimensions of GO sheets and the cross-linking facilitated by EDA enhanced the interfacial properties and dispersion within the WPU matrix, resulting in superior barrier properties and anticorrosion performance. This advancement underscores the potential of GO-based coatings for environmentally friendly corrosion protection.

Background: Previous breast surgery does not represent an absolute contraindication for nipple-sparing mastectomy, although it may negatively interfere with surgical outcomes. The aim of the authors' study was to confirm the feasibility of nipple-sparing mastectomy after previous breast surgery, focusing on skin incisions and risk factors, complications, and oncologic outcomes., Methods: The authors retrospectively identified 368 patients who underwent 387 nipple-sparing mastectomies and reconstruction after previous surgery (quadrantectomy, breast resection, augmentation and reduction mammaplasty, mastopexy) at the European Institute of Oncology from January of 2003 to November of 2017. Patterns of skin incisions (i.e., radial, hemiperiareolar, periareolar, vertical pattern, inframammary fold, Wise-pattern, and round-block) for primary surgery and for mastectomy, type of reconstruction, and radiotherapy have been recorded. The authors collected data regarding early and late complications and further operations (implant change, fat grafting) performed within 2 years to improve cosmetic outcomes. Oncologic follow-up has been reported for in-breast recurrences., Results: Complete and partial nipple-areola complex necrosis occurred, respectively, in 2.8 percent and in 5.4 percent of cases. The authors recorded 5.4 percent failures resulting in implant removal. The analysis of risk factors for complications or for the need for further operations showed no significant association with skin incision for first surgery and mastectomy, use of the same skin incision, previous radiotherapy, or type of primary surgery. Five-year overall survival and disease-free survival were 99.1 and 93.8 percent, respectively. No nipple recurrence was recorded., Conclusions: The authors' results confirm that nipple-sparing mastectomy can be a safe surgical procedure after previous breast surgery. Surgical planning should be tailored to each patient., Clinical Question/level of Evidence: Therapeutic, III., (Copyright © 2021 by the American Society of Plastic Surgeons.)

Purpose: Increasing pressure pushes towards the objective competence assessment of clinical operators. Hand motion analysis (HMA) was introduced to measure surgical and clinical procedures; its recent application to FAST examinations leaves unsolved issues. This study aimed at determining optimal HMA parameters to discriminate between operators' skill levels, and which FAST tasks are experience-dependent., Methods: Ten experienced (EG) and 13 beginner (BG) sonographers performed a FAST examination on one female and one male model. A motion capture system returned the duration, working volume, number of movements (absolute and time normalized), and hand path length (absolute and time normalized) of each view., Results: BG took more time in completing specific views, with a higher working volume (p = 0.003) and longer hands path (p < 0.001). The number of movements was lower in the EG (p < 0.001) and differed between views (p = 0.014). No significant Group/Model differences were found for the normalized number of movements. The LUQ view required a higher number of movements (p < 0.001)., Conclusions: HMA identified kinematic parameters discriminating between proficiency level and critical subtasks in the FAST examination. These findings could be the base for a focused HMA-based evaluation of performances following a proctored training period. There is room to incorporate HMA into simulation metrics and evidence-based credentialing standards for clinical ultrasound applications.

Purpose of Review: To explore the current literature on the failure to rescue and rescue surgery concepts, to identify the key items for decreasing the failure to rescue rate and improve outcome, to verify if there is a rationale for centralization of patients suffering postoperative complications., Recent Findings: There is a growing awareness about the need to assess and measure the failure to rescue rate, on institutional, regional and national basis. Many factors affect failure to rescue, and all should be individually analyzed and considered. Rescue surgery is one of these factors. Rescue surgery assumes an acute care surgery background., Summary: Measurement of failure to rescue rate should become a standard for quality improvement programs. Implementation of all clinical and organizational items involved is the key for better outcomes. Preparedness for rescue surgery is a main pillar in this process. Centralization of management, audit, and communication are important as much as patient centralization., (Celsius.)

Aim: To report about an additional case of biliary ileus after bariatric surgery is reported and extensively reviewing the literature on this topic., Material of Study: We reviewed the literature and found three cases of gallstone ileus (GI) that occurred after bariatric surgery., Discussion: A 41 year old patient presented a GI eight years after a biliointestinal bypass (BIB) for morbid obesity. The patient complained of abdominal pain for two weeks. Computed tomography (CT) and abdominal ultrasound (US) allowed a preoperative diagnosis of GI and planning of surgical strategy. Surgical treatment was carried out through laparoscopic-assisted enterolithotomy alone procedure. This choice is supported discussing the related issues: morbidity, potential recurrence, eventual developing of gallbladder carcinoma., Conclusion: It is the first reported case of GI after BIB preoperatively diagnosed through CT scan and US, and treated with a laparoscopic assisted approach. Additional considerations concerning preoperative diagnosis, surgical strategy, technical details and follow-up can be usefully applied even in non post-bariatric biliary ileus., Key Words: Biliointestinal bypass, Gallstone ileus, Laparoscopy, Ultrasonography.

Background: The University of Chile, backed by its extensive experience in Objective Structured Clinical Examinations (OSCEs), performs the practical exam to graduates of foreign medical school in this format. This test format would give more guarantees of validity and fairness as compared with the previous oral examination that was required for title revalidation., Aim: To compare the performance of graduates of foreign medical schools and last year medical students of the University of Chile in the same internal medicine OSCE., Material and Methods: Seventy-seven last year medical students and thirty-three graduates of foreign medical schools participated in the same Internal Medicine OSCE, but in different moments. At the end of the examination, graduates of foreign medical schools answered a questionnaire about their prior experience with OSCEs and about their perception about this type of examination., Results: The performance of graduates of foreign medical schools was lower than those of our last year medical students in four of the eight stations of the examination. Graduates of foreign medical schools considered the examination objective, fair, and that it assessed skills adequately and that the degree difficulty was homogeneous for all examinees., Conclusions: The possibility of obtaining comparable results in a transparent process makes the OSCE the assessment tool of choice for title revalidation of physicians migrating from foreign countries.

In the last few years, several monitoring programs were established as an effect of the EU Directives which included requirements for monitoring the quality of water resources (drinking water, groundwater and surface water). Plant Protection Products (PPPs) are an obvious target for monitoring activities, since they are directly released into the environment. In Italy, the National Environmental Protection Agency (ISPRA) has recently published several reports containing the results of the National Plans for Control of Environmental Effects of PPPs. These documents contain the collection of monitoring data related to the presence of PPP residues in surface and groundwater systems. In this paper, these results (monitoring campaigns from 2005 to 2009) were analysed. Particularly, the attention was focused on the concentration levels of terbuthylazine (TBZ) and its metabolite desethyl-terbuthylazine (DTZ) detected in the groundwater systems of the Lombardia Region (Northern Italy). The analysis allowed us to identify the spatial and temporal trends of contamination of both substances. Furthermore the DTZ/TBZ ratio was calculated in order to recognize point and non-point sources of contamination.

There is a 10 years teaching experience for fourth year medical students and interns in a Chilean private hospital. The students attend an eight weeks practical course. The interns rotate during 16 weeks by specialties and make shifts. The hospital structure with Clinical Services and Medical-Surgical departments facilitates the teaching process. There are approximately 30,000 admissions per year with a mean stay of 3.7 days, that allow the students to be in touch with patients with different diseases that are managed with updated technology. We emphasize the ethical and clinical management of concrete problems of patients, learning and communication skills. The students evaluate their stay answering surveys and with semi structured interviews. Teaching is assessed by tutors and heads of departments, in clinical rounds, sometimes prepared by the students, by a thorough revision of problem oriented medical records and with practical and theoretical tests. The results of the program have been quite satisfactory for participants.

Piezoelectric transparent thin films are of great interest for use in tunable filters. We present experimental results on Ta2O5 single layers coated on fused-silica substrates with an electron-beam deposition process. Above 450 degrees C, coatings change from an amorphous to a polycrystallized structure. When this structure shows a preferred orientation matching the piezoelectric tensor of the Ta2O5 crystal and the external electric field, variation in the piezoelectric layer thickness is expected. We detail experimental results in terms of optical (spectrophotometric and scattering measurements) and nonoptical characterizations (x-ray diffraction and scanning electron microscopy). Then the resultant thickness variation under oscillating applied voltage is measured with an extrinsic Fabry-Perot interferometer setup.

To answer the question whether the level of p53 expression also reflects the status of a cell, with reference to transformation and genome stability, we have examined, by immunocytochemistry, the presence of p53 protein in a number of cell types including human diploid cells, Chinese hamster embryonal cells at different passages and gene amplified and/or transformed Chinese hamster cell lines. Primary human fibroblasts at early passage (LEO) and an established, non transformed, Chinese hamster cell line at early passage (CHEF/18) did not show any detectable p53 expression, either nuclear or cytoplasmic. All transformed human (Raji) and Chinese hamster cell lines (CHO, V79, V79/B7) showed a nuclear expression of p53, although at different intensities. Two cell lines selected from V79/B7 for their resistance to phosphonacetyl-L-aspartate or methotrexate and previously shown to bear gene amplification, showed p53 expression. In PALA L cells p53 expression was nuclear as in other positive cell lines tested, while in MTX M cells it was cytoplasmic. CHEF/18 cells at late passage in culture showed the typical behaviour of transformed cells and p53 was detected in several cells. Moreover, when transformed CHO cells were treated with compounds known to induce reverse transformation, both the disappearance of hallmarks of transformed phenotype and p53 reduction were observed. These results indicate a strong association within the same cell type between p53 expression and transformed status.

Prolonged recordings at different levels of the small intestine have become necessary in motility studies. This has increased the number of motor events that are registered. The direct measurement of the numerous contractions is time-consuming, monotonous and rutinary. The use of computer analysis of this activity has been small. It is our objective to report our experience with this technique. Simultaneous recordings of small intestine motility were obtained on a polygraph and in a computer with an analogue digital converse system. The following parameters were compared: frequency, amplitude, motility index, and area under the curve. Excellent correlation of results obtained by both methods was observed. Computer analysis reduced the relation recording time/analysis time from 1/1.2 to 1/0.08. In our experience, the study of intestinal motility with analogue digital technique is very efficient and exact.