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Background The derangement of CSF circulation impacts the functions of glymphatic-lymphatic system (G-Ls), which regulates solute trafficking and immune surveillance in the CNS. The imaging features of dilated perivascular spaces imply the substantial impairment of the G-Ls and can be easily estimated It has been proposed that multiple sclerosis can be viewed as a disease involving a failure component and therapeutically could be targeted as such.Case presentationWe report the case of a female patient diagnosed with primary progressive multiple sclerosis, also presenting perivascular spaces dilatation, who transiently improved after CSF shunt diversions. ConclusionsThe G-Ls failure leads to dysregulation of waste molecule clearance in the brain and an altered CNS immune response, potentially in many diseases. The clinical improvement observed in our patient may relate to an increased clearance of inflammatory mediators following the G-Ls reestablishment obtained by CSF flow enhancement.

Lay abstract miRNAs play important role in the regulation of gene expression and are involved in various physiological processes. Dysregulation of their function can lead to human diseases including cancer, cardiovascular and metabolic diseases, liver conditions and immune dysfunction. The aim of this work is to systematically analyze the current scientific literature to identify miRNAs linked to the mechanism, development and treatment of HIV. A total of 35 articles were included and the miRNAs that were found with significantly different levels in compared groups of subjects (e.g., subjects with HIV vs healthy persons, persons able to limit the disease progression without therapy vs those whose immune system is already compromised by HIV) were highlighted. The most frequently reported miRNAs were: the hsa-miR-29 family, hsa-miR-146b-5p and hsa-miR-150-5p. To our knowledge, this is the first attempt to systematically identify the miRNAs associated with HIV and could be a useful contribution to general knowledge in this field.

Cultivars specifically adapted to organic agriculture are lacking in most crops, and tomato is no exception. Evolutionary-participatory breeding (EPB) combines the adaptive ability of evolutionary populations with farmers’ selection, thus representing a cost-effective strategy for the development of novel organic heterogeneous material, as introduced by the European regulation on organic agriculture (EU) 2018/848. An F4 ox-heart tomato composite cross population (CCP), derived from a half-diallel cross of four local varieties chosen for their superior performance under organic conditions, was submitted to both natural and farmers’ selection on three organic farms and at one research station in Italy. During field days held at each location before harvest, farmers visually scored 400 plants, all of which were carried forward to develop the natural selection (NS) population, while the 20 best ranking plants were chosen to develop the farmers’ selection (FS). After two cycles of selection (2018 and 2019), one NS and one FS population were obtained at each location. After this two-year selection process, in 2020, the eight populations (four NS and four FS), were evaluated in a randomised complete block trial in the four locations of selection and evolution. Four local varieties chosen by farmers and two modern varieties (one open pollinated variety and one F1 hybrid) were added as controls. The ANOVA showed significant differences among entries for all traits. Entry-by-location interactions were larger than the genetic effect for the overall evaluation, yield at first harvest, total yield and percentage of marketable yield. This confirms the importance of decentralising selection when seeking to develop specifically adapted varieties and/or populations. Evidence was observed of the effectiveness of participatory selection for improving the yield at first harvest, with a slight trade-off effect for the total yield and plant vigour.

Rice is the fourth most important crop in Italy with a growing area under organic management. We conducted a participatory evaluation of 21 rice cultivars (10 old, 10 modern and a mixture) in four organic/biodynamic farms, for two cropping seasons, to assess the extent of varieties × farms and varieties × years within farm interactions and farmers’ preferences. There were significant differences between farms and varieties, as well as large interactions between varieties and farms, particularly in the case of plant height and reactions to Fusarium fujikuroi Nirenberg (bakanae) and Magnaporthe oryzae B Cooke (leaf and neck blast), but also for grain yield. There were also large interactions between varieties and years, which resulted in considerable differences in stability among varieties with one of the old, one modern and the mixture combining high grain yield and stability. Farmers, regardless of gender, were able to visually identify the highest yielding varieties in a consistent way across years, and although accustomed to seeing uniform varieties, they scored the mixture higher than the mean. The results are discussed in the context of a decentralized-participatory breeding program, to serve the target population of heterogenous environments represented by organic and biodynamic farms.

MicroRNAs (miRNAs) are single-stranded RNA that have key roles in the development of the immune system and are involved in the pathogenesis of various autoimmune diseases. We previously demonstrated that two members of the miR106b-25 cluster and the miR17-92 paralog cluster were upregulated in T regulatory cells from multiple sclerosis (MS) patients. The aim of the present work was to clarify the impact of miR106b-25 and miR17-92 clusters in MS pathogenesis. Here, we show that the mice lacking miR17-92 specifically in CD4+ T cells or both total miR106b-25 and miR17-92 in CD4+ T cells (double knockout) are protected from Experimental Autoimmune Encephalomyelitis (EAE) development while depletion of miR106b-25 only does not influence EAE susceptibility. We suggest that the absence of miR106b does not protect mice because of a mechanism of compensation of miR17-92 clusters. Moreover, the decrease of neuroinflammation was found to be associated with a significant downregulation of pro-inflammatory cytokines (GM-CSF, IFNγ, and IL-17) in the spinal cord of double knockout EAE mice and a reduction of Th17 inflammatory cells. These results elucidate the effect of miR106b-25 and miR17-92 deletion in MS pathogenesis and suggest that their targeted inhibition may have therapeutic effect on disease course.

Porta campione per misure SNOM in trasmissione

Recently, a large and growing body of literature has investigated the health potential of different wheat species. In particular, a considerable number of studies dealing with nutritional aspects has grown up around the theme of the recovery of ancient wheat varieties (species that have remained unchanged over the last hundred years). According to several studies, indeed, ancient varieties present a healthier nutritional profile than modern ones. In the framework of the European project “CERERE, CEreal REnaissance in Rural Europe: embedding diversity in organic and low-input food systems”, this paper aimed to review recent research on the issue of health and nutritional cereal systems by adopting an innovative and participatory multi-actor approach which involved practitioners along with researchers. The participatory approach is the main innovation and peculiarity of this literature review. Nevertheless, the review highlights the many positive effects derived from eating whole and ancient grains such as a significant reduction in the risk of chronic diseases such as cancer, cardiovascular disease, and also a more favorable long-term weight management and increase in satiety. This review may be considered as a fruitful starting point that integrates research results to foster current and future healthier and sustainable practices in cereal systems.

International audience; Organic and low-input food systems are emerging worldwide in answer to the sustainability crisis of the conventional agri-food sector. Alternative systems are based on local, decentralized approaches to production and processing, regarding quality and health, and short supply-chains for products with strong local identities. Diversity is deeply embedded in these food systems, from the agrobiodiversity grown in farmers' fields, which improves resilience and adaptation, to diverse approaches, contexts and actors in food manufacturing and marketing. Diversity thus becomes a cross-sectoral issue which acknowledges consumers' demand for healthy products. In the framework of the European project CERERE, CEreal REnaissance in Rural Europe: embedding diversity in organic and low-input food systems, the paper aims at reviewing recent research on alternative and sustainable food systems by adopting an innovative and participatory multi-actor approach; this has involved ten practitioners and twenty-two researchers from across Europe and a variety of technical backgrounds in the paper and analysis stages. The participatory approach is the main innovation and distinctive feature of this literature review. Partners selected indeed what they perceived as most relevant in order to facilitate a transition towards more sustainable and diversity based cereal systems and food chains. This includes issues related to alternative food networks, formal and informal institutional settings, grass root initiatives, consumer involvement and, finally, knowledge exchange and sustainability. The review provides an overview of recent research that is relevant to CERERE partners as well as to anyone interested in alternative and sustainable food systems. The main objective of this paper was indeed to present a narrative of studies, which can form the foundation for future applied research to promote alternative methods of cereal production in Europe.

Several studies suggest that surgical manipulation of the intestine and increased intra-abdominal pressure promotes bacterial translocation (BT). This prospective randomized study has investigated the effect of surgery on BT in patients undergoing elective colectomy for colon cancer by comparing the laparoscopic with the open approach.One hundred nineteen consecutive patients underwent colectomy for colon cancer: 59 cases underwent open resection and 60 cases underwent laparoscopic resection. For bacterial identification, tissue samples were taken from the liver, spleen, and mesenteric lymph nodes.The incidence of BT increased in laparoscopic and open group after bowel mobilization (prior to ligation of the vascular pedicle), compared with the before mobilization (P.05). There was not a statistically significant difference in BT value between the 2 groups.BT increase was observed during the open and laparoscopic resection for colon cancer, without significant statistical difference between the 2 groups.

Purpose: Eventration is a rare complication after laparotomy and its treatment is actually not standardized. We retrospectively analyzed 12 patients with early postoperative eventration; 8 of 12 were treated with use of biological mesh (non-cross-linked porcine derma). Materials and Methods: We observed, from January 2009 to January 2014, 12 patients with eventration. In 4/12 patients we performed a direct abdominal wall closure and these patients were excluded from the study; remaining 8 patients encountered inclusion criteria and were enrolled on study. Study population was composed by 8 patients (6 male, 2 female). Mean age was 53 years (range 35-70). Direct abdominal wall closure was not performed because of the risk of “abdominal compartment syndrome” (ACS). In six of eight patients early post-operative eventration occurred after urgent surgery Surgical technique: in 4 patients we performed direct wall closure with biological prosthesis (porcine derma) (one-step procedure). In 2 patients wall closure with similar technique was delayed after 9 and 12 days of intra-abdominal VAC (vacuum assisted closure) Therapy (two-step procedure). In 2 cases, because of large skin defect, we applied biological prosthesis and a surface VAC Therapy system on the prosthesis after intra-abdominal VAC Therapy (three-step procedure). Results: We observed immediate complications in four cases (seroma). No patients underwent re-eventration. One year after surgery one patient manifested laparocele. Conclusions: In our opinion, in these cases biological prosthesis can be used as valid device. However, our study is limited by number of patients and other studies are needed to draw definitive conclusions.

Nuovo microscopio AFM a grande scansione

The role of supplemental oxygen therapy in the healing of esophagojejunal anastomosis is still very much in an experimental stage. The aim of the present prospective, randomized study was to assess the effect of administration of perioperative supplemental oxygen therapy on esophagojejunal anastomosis, where the risk of leakage is high. We enrolled 171 patients between January 2009 and April 2012 who underwent elective open esophagojejunal anastomosis for gastric cancer. Patients were assigned randomly to an oxygen/air mixture with a fraction of inspired oxygen (FiO2) of 30 % (n = 85) or 80 % (n = 86). Administration commenced after induction of anesthesia and was maintained for 6 h after surgery. The overall anastomotic leak rate was 14.6 % (25 of 171): 17 patients (20 %) had an anastomotic dehiscence in the 30 % FiO2 group and 8 (9.3 %) in the 80 % FiO2 group (P

The majority of ischemic strokes are due to atherothrombosis, cardioembolism, systemic hypoperfusion (general decrease in blood supply, e.g., in shock), or small vessel occlusive disease. However, many ischemic strokes occur without a well-defined etiology and are labeled as cryptogenic, and they constitute 30–40 % of all ischemic strokes. By the TOAST classification, which is the most commonly used in clinical practice, cryptogenic stroke (or stroke of undetermined origin in TOAST terminology) is defined as brain infarction that is not attributable to a source of definite cardioembolism, large artery atherosclerosis, or small artery disease despite extensive vascular, cardiac, and serologic evaluation. This means that in a large part of our patients we are unable to identify stroke etiology. In our report we described an unusual cause of stroke discovered by non-routinary investigations.

In 2008 a new series of Unit Value Indexes was officially released; after few months the series of Production Price Indexes on non-domestic markets became available for the first time. The new sets of indicators were favourably welcomed by economists and researchers but they also gave a boost to the well-known debate on the adequateness of the official measurement for the analysis of competitiveness and internationalisation. The aim of this paper is both to test the robustness of export UVI to different coverage option and to perform a sensitivity analysis with regard to imputation techniques; moreover a measure of relative accuracy of monthly estimates will be given with regard to year 2005-2009.

BACKGROUND: Recurrent laryngeal nerve palsy (RLNP) and hypoparathyroidism are complications of thyroid surgery. The convalescence can depend on several factors (ie, pain, fatigue, nausea, and vomiting). Supplemental oxygen improves inflammatory and immune function and decreases nausea and vomiting after surgical procedures. We have investigated whether supplemental perioperative oxygen administration could improve surgical outcomes in patients undergoing thyroid surgery. STUDY DESIGN: Three hundred and sixty patients were randomized to an oxygen/air mixture with a fraction of inspired oxygen (FiO2) of 30% (n 1⁄4 179) or 80% (n 1⁄4 181). Administration was commenced after induction of anesthesia and maintained for 6 hours after surgery. The primary end points were temporary or permanent RLNP and transient or definitive hypoparathyroidism. Pain and fatigue scores, nausea, and the number of vomiting episodes were also registered. Preoperatively and at several times during the first 24 postoperative hours, we measured C-reactive protein, interleukin (IL)-6, and IL1b levels. RESULTS: In the 80% FiO2 group, the rate of temporary RLNP (4.4%) was significantly lower compared with the 30% FiO2 group (9.4%) (p1⁄4 0.040). In addition, postoperative transient biochemical hypoparathyroidism occurred more frequently in the 30% FiO2 group (48.5%) than in the 80% FiO2 group (16.3%) (p1⁄4 0.046). Supplemental 80% FiO2 significantly reduced postoperative levels of C-reactive protein (p< 0.01), IL6 and IL1b (p< 0.05), fatigue (p< 0.01), and overall pain during the first 24 postoperative hours (p < 0.01). Supplemental 80% FiO2 also reduced nausea and vomiting on the day of operation (p 1⁄4 0.058). CONCLUSIONS: Supplemental 80% FiO2 reduced postoperative temporary RLNP and hypoparathyroidism rates and reduced pain, fatigue, nausea, and vomiting after thyroid surgery. (J Am Coll Surg 2015;220:921e933. 2015 by the American College of Surgeons)

The primary objective was to elucidate ovarian follicular dynamics and hormonal profiles in nulliparous heifer (HE; n = 11 ) and mixed-parity (MP; n=10 ) Mediterranean Italian water buffaloes (Bubalus bubalis) following an estrus synchronization protocol. Both groups received a progesterone releasing intravaginal device (PRID) implant for 10 days; a luteolytic dose of synthetic prostaglandin was given 7 days after PRID insertion. Daily ultrasound monitoring and collection of blood to determine plasma concentrations estradiol and progesterone started 1 day after PRID removal and lasted for 55 and 65 days in HE and MP buffaloes, respectively. Data analysis was restricted to the first 5 days after PRID removal and to one estrus cycle following induced ovulation. The HE buffaloes were not inseminated and only one ovulated within 5 days after PRID removal; the remainder ovulated between 8 and 48 days after PRID removal (except one in which ovulation was never detected). All HP buffaloes were inseminated 72, 96 and 120 h after PRID removal; seven buffaloes ovulated within 5 days after PRID removal and two were pregnant. Mean diameter of the largest follicle was significantly smaller in HE than MP buffaloes the first 4 days after PRID removal. There was a parity by time interaction ( P=0.0047 ) for plasma progesterone concentrations; progesterone was higher in HE than MP buffaloes 1 day after PRID removal, but the converse was true 2 days after PRID removal. After induced ovulation, HE buffaloes exhibited a one-wave ( n=5; length of cycle, 8-12 days), two-wave ( n=4; range: 20-26 days) or three-wave cycle ( n=1; 25 days). In contrast, all non-pregnant MP buffaloes ( n=8 ) had a two-wave cycle (range: 19-25 days). For buffaloes with two-wave cycles, the growth rate and diameter of the largest follicle was significantly smaller in HE than MP buffaloes for both the first follicular wave (1.3mm versus 1.7 mm per day and 10.5 mm versus 13.3 mm, respectively) and the second follicular wave (1.0 mm versus 1.3 mm per day and 11.0 mm versus 13.8 mm). In conclusion, there were many significant morphological and endocrine differences between HE and MP buffaloes.

Importance Recurrent laryngeal nerve dysfunction and hypoparathyroidism are well-recognized, important complications of thyroid surgery. The duration of convalescence after noncomplicated thyroid operation may depend on several factors, of which pain and fatigue are the most important. Nausea and vomiting occur mainly on the day of operation. Glucocorticoids are well known for their analgesic, anti-inflammatory, immune-modulating and antiemetic effects. However, there is little information in the literature on the use of steroids in thyroid surgery, and the information that is available is conflicting. Objective To investigate whether preoperative dexamethasone could improve surgical outcome in patients undergoing thyroid surgery. Design A randomized double-blind placebo-controlled trial. A 30-day follow-up for morbidity was performed in all cases. Setting All patients were hospitalized in a public hospital. Participants From June 2008 through August 2011, 328 patients were randomized to receive either intravenous dexamethasone, 8 mg, administered 90 minutes before skin incision, or saline solution (placebo). Interventions Intravenous dexamethasone, 8 mg. Main Outcomes and Measures The primary end points were temporary or permanent recurrent laryngeal nerve palsy. Transient and definitive hypoparathyroidism, pain and fatigue scores, nausea, and the number of vomiting episodes were also registered. Preoperatively and at several times during the first 24 postoperative hours, we measured C-reactive protein, interleukin 6, and interleukin 1β levels. Results In the dexamethasone group, the rate of temporary recurrent laryngeal nerve palsy (4.9%) was significantly lower compared with the placebo group (8.4%) ( P = .04). Also, postoperative transient biochemical hypoparathyroidism occurred more frequently in the placebo group (37.0%) than in the dexamethasone group (12.8%). Dexamethasone use significantly reduced postoperative levels of C-reactive protein ( P = .01) and interleukin 6 and interleukin 1β ( P = .02), fatigue ( P = .01), and overall pain during the first 24 postoperative hours ( P = .04), as well as the total analgesic (ketorolac tromethamine) requirement ( P = .04). Dexamethasone use also reduced nausea and vomiting on the day of operation ( P = .045). Conclusions and Relevance Preoperative administration of dexamethasone, 8 mg, reduced postoperative temporary recurrent laryngeal nerve palsy and hypoparathyroidism rates and reduced pain, fatigue, nausea, and vomiting after thyroid surgery. However, these data require further analysis in randomized prospective studies. Trial Registration clinicaltrials.gov Identifier:NCT01690806

AIM: To evaluate acute cholecystitis, complicated by peritonitis, acute phase response and immunological status in patients treated by laparoscopic or open approach. METHODS: From January 2002 to May 2012, we conducted a prospective randomized study on 45 consecutive patients (27 women, 18 men; mean age 58 years). These subjects were taken from a total of 681 patients who were hospitalised presenting similar preoperative findings: acute upper abdominal pain with tenderness, involuntary guarding under the right hypochondrium and/or in the flank; fever higher than 38 °C, leukocytosis greater than 10 × 109/L or both, and ultrasonographic evidence of calculous cholecystitis possibly complicated by peritonitis. These patients had undergone cholecystectomy for acute calculous cholecystitis, complicated by bile peritonitis. Randomly, 23 patients were assigned to laparoscopic cholecystectomy (LC), and 22 patients to open cholecystectomy (OC). Blood samples were collected from all patients before operation and at days 1, 3 and 6 after surgery. Serum bacteraemia, endotoxaemia, white blood cells (WBCs), WBC subpopulations, human leukocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin-1 (IL-1) and IL-6, and C-reactive protein (CRP) were measured at 0, 30, 60, 90, 120 and 180 min, at 4, 6, 12, 24 h, and then daily (8 A.M.) until post-op day 6. RESULTS: The two groups were comparable in the severity of peritoneal contamination as indicated by the viable bacterial count (open group = 90% of positive cultures vs laparoscopic group = 87%) and endotoxin level (open group = 33.21 ± 6.32 pg/mL vs laparoscopic group = 35.02 ± 7.23 pg/mL). Four subjects in the OC group (18.1%) and 1 subject (4.3%) in the LC group (P < 0.05) developed intra-abdominal abscess. Severe leukocytosis (range 15.8-19.6/mL) was observed only after OC but not after LC, mostly due to an increase in neutrophils (days 1 and 3, P < 0.05). This value returned to the normal range within 3-4 d after LC and 5-7 d after OC. Other WBC types and lymphocyte subpopulations showed no significant variation. On the first day after surgery, a statistically significant difference was observed in HLA-DR expression between LC (13.0 ± 5.2) and OC (6.0 ± 4.2) (P < 0.05). A statistically significant change in plasma elastase concentration was recorded post-operatively at days 1, 3, and 6 in patients from the OC group when compared to the LC group (P < 0.05). In the OC group, the serum levels of IL-1 and IL-6 began to increase considerably from the first to the sixth hour after surgery. In the LC group, the increase of serum IL-1 and IL-6 levels was delayed and the peak values were notably lower than those in the OC group. Significant differences between the groups, for these two cytokines, were observed from the second to the twenty-fourth hour (P < 0.05) after surgery. The mean values of serum CRP in the LC group on post-operative days (1 and 3) were also lower than those in the OC group (P < 0.05). Systemic concentration of endotoxin was higher in the OC group at all intra-operative sampling times, but reached significance only when the gallbladder was removed (OC group = 36.81 ± 6.4 ρg/mL vs LC group = 16.74 ± 4.1 ρg/mL, P < 0.05). One hour after surgery, microbiological analysis of blood cultures detected 7 different bacterial species after laparotomy, and 4 species after laparoscopy (P < 0.05). CONCLUSION: OC increased the incidence of bacteraemia, endotoxaemia and systemic inflammation compared with LC and caused lower transient immunological defense, leading to enhanced sepsis in the patients examined.

Intramural hematoma of the colon is rare. It may be "spontaneous" in patients with anticoagulant therapy or blood dyscrasia or caused by blunt abdominal trauma. An uncertain origin is also reported, so we have also "idiopathic hematoma". The AA report a new case of uncertain origin and review the literature. The diagnosis is difficult. Symptoms and signs of intestinal obstruction or colic bleeding are often present. Rx plain abdomen and colonoscopy are not diriment. Angio-TC is useful for detailed diagnosis. Resection of colic segment with hematoma is the gold standard therapy, but evacuation of hematoma might be considered. The reported data show that also colic intramural hematoma should be taken into account in cases of colic obstruction or bleeding. This diagnosis should be considered specially in patients with anticoagulant therapy or referred blunt abdominal trauma.

Altered miRNA expression in T regulatory cells in course of multiple sclerosis. OBJECTIVES: Multiple sclerosis (MS) is a chronic inflammatory response against constituents of the central nervous system. It is known that regulatory T cells (Tregs) play a key role in the autoimmune balance and their improper function may facilitate the expansion of autoaggressive T cell clones. Recently, microRNAs (miRNAs) have been involved in autoimmune disorders and their loss-of-function in immune cells was shown to facilitate systemic autoimmune disorders. Here, we analyzed the miRNA expression profile in Tregs from MS-RR. METHODS: We assessed miRNA genome-wide expression profile by microarray analysis on CD4(+)CD25(+high) T cells from 12 MS relapsing-remitting patients in stable condition and 14 healthy controls. Since CD4(+)CD25(+high) T cells comprise both T regulatory cells (CD4(+)CD25(+high)CD127(dim/-)) and T effector cells (CD4(+)CD25(+high)CD127(+)), we performed a quantitative RT-PCR on CD4(+)CD25(+high)CD127(dim/-) and CD4(+)CD25(+high)CD127(+) cells isolated from the same blood sample. RESULTS: We found 23 human miRNAs differentially expressed between CD4(+)CD25(high)bona fide Treg cells from MS patients vs. healthy donors, but, conversely, among the deregulated miRNAs, members of the miR-106b-25 were found down-regulated in MS patients when compared to healthy donors in CD4(+)CD25(high)CD127(dim/-) T regulatory cells. More interesting, the ratio between Treg/Teff showed an enrichment of these microRNA in T regulatory cells derived from patients if compared to healthy controls. CONCLUSION: miR-106b and miR-25 were previously shown to modulate the TGF-β signaling pathway through their action on CDKN1A/p21 and BCL2L11/Bim. TGF-β is involved in T regulatory cells differentiation and maturation. Therefore, the deregulation of this miRNA cluster may alter Treg cells activity in course of MS, by altering TGF-β biological functions.

Serum active matrix metalloproteinase (MMP)-9 and -2 levels and their tissue inhibitors TIMP-1 and -2 were measured in 28 patients with spontaneous intracerebral hemorrhage (SICH) at 24 h, 48 h and 7 days after bleeding. Perihematomal edema volume was calculated on non-enhanced computed tomography scans by using the formula AxBxC/2 at the same time points. Mean levels of serum active MMP-9 and MMP-2, as well as perihematomal edema volume, were significantly different over time (p0.0001). In comparison to values observed at 24 h, serum active MMP-9 mean concentrations increased at 48 h and reached their peak at 7 days, serum active MMP-2 mean levels progressively declined at 48 h and at 7 days, whereas perihematomal edema volume increased at 48 h and at 7 days. Perihematomal edema volume was positively correlated with active MMP-9 and MMP-2 at 24 h (p0.02 and p0.05, respectively) and with active MMP-9 at 48 h (p0.05), but was inversely correlated with active MMP-2 at 7 days (p0.02). These findings suggest a different involvement of active MMP-9 and MMP-2 in perihematomal-associated inflammatory response occurring in the transition from acute to subacute phases after SICH.

Serum levels of sHLA-G (sHLA-G1/HLA-G5) antigens and their soluble isoforms, sHLA-G1 and HLA-G5, were measured by ELISA in 22 patients with spontaneous intracerebral hemorrhage (SICH) at 24 h, 48 h and 7 days after bleeding. The perihematomal edema volume was calculated on non-enhanced computed tomography scans using the formula AxBxC/2 at the same time points. The mean serum concentrations of sHLA-G1/HLA-G5 and sHLA-G1 as well as the perihematomal edema volume changed significantly over time (p0.0001, p0.001 and p0.0001, respectively), whereas no statistical differences were found in serum HLA-G5 concentrations over the course of the experiment. In comparison to the values found at 24 h, sHLA-G1/HLA-G5 and sHLA-G1 increased at 48 h and then decreased at 7 days, whereas the perihematomal edema volume was more elevated at 48 h and, to a lesser extent, at 7 days. A positive correlation was detected between mean serum sHLA-G1/HLA-G5 and sHLA-G1 levels and perihematomal edema volume at 24 h (p0.02) and at 48 h (p0.01). Our results may indicate a role for sHLA-G in inflammatory mechanisms related to SICH, where these proteins probably act as anti-inflammatory molecules and are predominantly produced as the sHLA-G1 isoform.

Serum levels of sHLA-G (sHLA-G1/HLA-G5) antigens and their soluble isoforms, sHLA-G1 and HLA-G5, were measured by ELISA in 22 patients with spontaneous intracerebral hemorrhage (SICH) at 24 h, 48 h and 7 days after bleeding. The perihematomal edema volume was calculated on non-enhanced computed tomography scans using the formula A×B×C/2 at the same time points. The mean serum concentrations of sHLA-G1/HLA-G5 and sHLA-G1 as well as the perihematomal edema volume changed significantly over time (p < 0.0001, p < 0.001 and p < 0.0001, respectively), whereas no statistical differences were found in serum HLA-G5 concentrations over the course of the experiment. In comparison to the values found at 24 h, sHLA-G1/HLA-G5 and sHLA-G1 increased at 48 h and then decreased at 7 days, whereas the perihematomal edema volume was more elevated at 48 h and, to a lesser extent, at 7 days. A positive correlation was detected between mean serum sHLA-G1/HLA-G5 and sHLA-G1 levels and perihematomal edema volume at 24 h (p < 0.02) and at 48 h (p < 0.01). Our results may indicate a role for sHLA-G in inflammatory mechanisms related to SICH, where these proteins probably act as anti-inflammatory molecules and are predominantly produced as the sHLA-G1 isoform.

Serum active matrix metalloproteinase (MMP)-9 and -2 levels and their tissue inhibitors TIMP-1 and -2 were measured in 28 patients with spontaneous intracerebral hemorrhage (SICH) at 24 h, 48 h and 7 days after bleeding. Perihematomal edema volume was calculated on non-enhanced computed tomography scans by using the formula AxBxC/2 at the same time points. Mean levels of serum active MMP-9 and MMP-2, as well as perihematomal edema volume, were significantly different over time (p < 0.0001). In comparison to values observed at 24 h, serum active MMP-9 mean concentrations increased at 48 h and reached their peak at 7 days, serum active MMP-2 mean levels progressively declined at 48 h and at 7 days, whereas perihematomal edema volume increased at 48 h and at 7 days. Perihematomal edema volume was positively correlated with active MMP-9 and MMP-2 at 24 h (p < 0.02 and p < 0.05, respectively) and with active MMP-9 at 48 h (p < 0.05), but was inversely correlated with active MMP-2 at 7 days (p < 0.02). These findings suggest a different involvement of active MMP-9 and MMP-2 in perihematomal-associated inflammatory response occurring in the transition from acute to subacute phases after SICH.

Neuromyelitis optica is associated with antibodies to aquaporin-4 channels and has been classically defined as the occurrence of bilateral optic neuritis and transverse myelitis with no other neurological involvement. We describe here a 63-year-old woman who presented to our local hospital with an acute, bilateral visual loss followed by progressive paraparesis. Medical evaluations revealed a lung tumor and spinal MRI showed multiple cervical-dorsal hyperintense T(2) lesions with mild mass effect. Testing for NMO-Ig resulted positive. Patient's diagnosis was thus consistent with a possible paraneoplastic neuromyelitis optica associated with non-small cell lung cancer and evidence of NMO-Ig.

Summary: Fournier’s gangrene is a rapidly progressing necrotizing fasciitis, involving perineal, perianal, or genital regions, and it constitutes a true surgical emergency. Surgical excision of all necrotic tissue is required, and multiple debridements may be necessary to remove all nonviable tissue. After surgical intervention for debridement, reconstruction may be necessary. We present our experience in the treatment of tissue loss after Fournier’s gangrene of genital and perianal regions with the use of biological mesh (derma porcine mesh) in association with vacuum-assisted closure therapy.

The objective of this study was to monitor ovarian function in postpartum primiparous and pluriparous Mediterranean Italian buffaloes (Bubalus bubalis) during months of increasing daylength. Ovarian ultrasound monitoring was carried out for a total of 60 days from calving in 10 primiparous and 10 pluriparous buffaloes. Progesterone was determined from calving until a week after first postpartum ovulation. The study was undertaken during months of increasing day length. Time required for complete postpartum uterine involution was 31 +/- 1.0 and 33 +/- 1.3 days in primiparous and pluriparous buffaloes respectively (P = 0.1). The first postpartum ovulation was recorded on 4 primiparous and 8 pluriparous buffaloes (P = 0.16). Time for first postpartum ovulation to occur was 25.5 +/- 6.9 and 15.5 +/- 1.3 days in primiparous and pluriparous buffaloes, respectively (P = 0.07). Overall, 8 of the 12 first postpartum ovulations (66.6%) occurred in the ovary contra-lateral to the one bearing the gravidic CL, one out of 4 in primiparous and 3 out of 8 in pluriparous buffaloes (P = 1.0). Following a first postpartum ovulation, 3 primiparous and 4 pluriparous buffaloes displayed a complete wave of follicular development leading to a new ovulation. Ovulation following parturition was not recorded in 6 primiparous and two pluriparous buffaloes for the 60 days of ultrasound monitoring. Growth rate (mm/d) and largest size (mm) of first postpartum ovulating follicle was 0.95 +/- 0.18 and 1.07 +/- 0.07 (P = 0.4), and 13.5 +/- 0.8 and 14.1 +/- 0.4 (P = 0.4) in primiparous and pluriparous buffaloes, respectively. Following calving, the total number of available antral follicles (or =2 mm) declined gradually towards the end of the study period. Follicles greater or equal to 3 mm in diameter on the contrary showed a prominent increase in the first 2 weeks from calving. The number of follicles greater or equal to 3 mm in diameter was significantly higher in the ovary contra-lateral to the one bearing the gravidic CL. A balance in the number of such follicles was reached toward the end of the first month. In conclusion, although some follicular activity was recorded in the ovaries of all buffaloes, true postpartum resumption of cyclicity in the months of increasing daylight hours was delayed in the majority of animals.

The aim of this study was the investigation of hormonal and ovarian follicular dynamics in prepuberal buffaloes (Bubalus bubalis) bred in Italy. Eleven 5-9-month old buffalo calves ranging in weight from 122 to 270kg, maintained under controlled nutritional and environmental conditions, underwent 50 days of ultrasonographic ovarian follicular monitoring in the months of October-December. Blood sampling for E(2) and FSH determination and ultrasonographic monitoring using a 7.5MHz linear probe and an ALOKA SSD-500 monitor were performed daily. No differences in any of the parameters under study were highlighted when calves were divided into two weight categories (200 and200kg) and thus data were pooled. In this study, values are reported as mean+/-S.D. A range of two-six regular follicular waves was reported among calves with an average of 4+/-1.1. Overall interval (days) between wave emergence was 9.9+/-2.8 and largest diameters (mm) of dominant and first subordinate follicles were 8.4+/-1.2 and 4.8+/-0.6, respectively (P0.05). With the exception of one calf, some minor follicular waves (short waves or SWs; 1.6+/-1), lasting10 days (6.1+/-1.2) were reported. They were monitored contemporaneously on the ovary contralateral (n=7) or ipsilateral (n=3) to the main follicular wave. Growth rate (mm per day) of dominant follicles (DF) was significantly faster than for corresponding subordinate follicles (SF) and follicles of SWs (1.08+/-0.2 versus 0.79+/-0.1 and 0.83+/-0.1, respectively, P0.05). The static phase (days) lasted longer in DF compared to SF and SW (5.4+/-1.8 versus 2.4+/-1.2 and 2.6+/-1, respectively, P0.05). The regressing phase (mm per day) was similar among DF, SF and SW (0.86+/-0.2, 0.94+/-0.2 and 0.84+/-0.1, respectively, P=0.09). Episodic spikes of E(2) and FSH were reported, corresponding to wave development throughout the course of investigation. In conclusion, the majority of buffalo calves displayed a typical pattern of regular follicular development in conjunction with a dynamic trend of ovarian and hypophyseal hormones. Some minor follicle turnover was reported with parallel main follicular waves.

The objective of this study was to determine the best combined hormonal treatment to utilize in order to obtain a high number of good quality in vivo and in vitro matured oocytes from prepuberal Mediterranean Italian buffalo calves (Bubalus bubalis). Transvaginal ultrasound follicular aspiration was employed to recover oocytes from antral follicles. Fifteen barn housed buffalo calves, between 5 and 9 months of age were used in this study and randomly divided into control (Group A) and treated groups. A commercially available preparation of 2000 IU eCG was administered to animals in the treatment groups, followed by 2000 IU of hCG given either 12 h (Group B), or 24 h (Group C) before ovum pick up (OPU). From the time of administration of eCG treatments, the best timing for hCG administration before OPU was determined and integrated with the administration of 500 IU of FSH-LH in a decreasing dosage protocol over 4 days (Group D). Expanded cumulus oocyte complexes (COCs) recovered from all groups were immediately fixed for later aceto-orcein staining. All other COCs were processed for in vitro maturation using standard procedures and then fixed and stained for assessment of nuclear maturation. Collectively, hormonal stimulation did not increase the number of ovarian antral follicles available compared to the control group (P > 0.05), but did result in higher output of medium (Group B: 9.8 +/- 7.1; Group C: 3.4 +/- 6.7; Group D: 15.6 +/- 4.9 versus Group A: 1.6 +/- 2.2) and large follicles (Group B: 44.8 +/- 22.9; Group C: 8.7 +/- 6.1; Group D: 70.2 +/- 10 versus Group A: 6.1 +/- 6.3). Administration of hCG 12 h before follicle aspiration proved to be the best strategy to obtain high numbers of immature and mature oocytes from antral follicles (P < 0.05; Group B: 70.8 +/- 12 and Group D: 82 +/- 12.6 versus Group A: 43.6 +/- 13.9 and Group C: 27.2 +/- 13.9). A significantly higher number of expanded COCs was obtained from hormonally stimulated groups compared to the control group (P < 0.05; Group B: 28.7 +/- 16.8, Group C: 16.3 +/- 5.9 and Group D: 27.1 +/- 16.9 versus Group A: 6.2 +/- 6). A higher oocyte maturational competence (P < 0.05) was found in Groups A, B and D (80.8 +/- 7.9, 87.5 +/- 8.2, and 86.5 +/- 4.3, respectively) compared to Group C (60 +/- 26.2). In conclusion, in prepuberal buffalo calves combined gonadotrophin stimulation protocols yielded higher numbers of medium to large size follicles compared to a control group. A high number of good quality oocytes were recovered by transvaginal ultrasound follicle aspiration, and a high rate of metaphase II progression was reached after in vivo and in vitro maturation.

Pyroelectric energy harvesting has the ability to transform wasted heat into useful energy and as such has a potential to create “green” energy from freely available sources such as ambient temperature changes, and contribute to the fight against climate change. Current pyroelectrics applications are limited to low-power electronics, portable systems or tasks needing only very low range of power (μW–mW). Developing further this highly promising technology should ultimately lead to the creation of more powerful, autonomous and self-powered electronic devices that could one day use to recycle currently “lost” thermal energy to power electronic devices in both domestic and industrial settings. To the best of our knowledge, hexagonal phase ZnS (wurtzite ZnS) has not been studied as a possible energy harvesting pyroelectric material despite w-ZnS being isostructural to the well-exploited and widely praised hexagonal ZnO [1]. In addition, the Tc temperature (1020 ˚C for bulk material) is high enough for ZnS that it has the ability to operate at higher temperature that are good match with the working temperature of power plants and automobiles, and hence w-ZnS ceramics should have a potential to be used in pyroelectric harvesters of waste heat coming from those activities [2]. Here we report on the pyroelectric output registered for a wurtzite phase ZnS ceramic fabricated as part of our project. To probe the pyroelectric output for a w-ZnS ceramic a simple device (a “pyro-cell”) was created by evaporating gold electrods on both sides of a ceramic sample, which was mounted on a Cu-metalized rectangular insulating base (vetronite) using silver paint. This device is stable from room temperature up to approximately 180°C. Two different heating and cooling testing set-ups were established: Set-up n°1 used an industrial scale laser, providing a source with fast temperature change, and Set-up n°2 had a standard lab hot plate heating element, providing a much slower temperature change. The characterization required an accurate measurement of the currents of the order of 10-9 A. In addition, using the Pyroelectric Test System (PK‐SPIV17T, State College, PA, USA) with a Keithley 6517 B Picoammeter, we were able to measure the pyroelectric coefficient and monitor its change at different frequencies as afunction of temperature from 20 °C up to 150° C, with a heating rate of between 2 and 10 °C/min. Figure 1: Pyroelectric current measurements on an ZnS ceramic sample, using testing set-up n°1. The horizontal axis shows the time (seconds). References [1] Y. Yang, W. Guo, K.C. Pradel, G. Zhu, Y. Zhou, Y. Zhang, Y. Hu, L. Lin, Z. Lin Wang, “Pyroelectric Nanogenerators for Harvesting Thermoelectric Energy”, Nano Lett, 12 (6), 2012, 2833–2838 [2] L.A. Chavez, F.O. Zayas Jimenez, B.R. Wilburn, L.C. Delfin, H. Kim, N. Love, Y. Lin, “Characterization of Thermal Energy Harvesting Using Pyroelectric Ceramics at Elevated Temperatures”, Energy Harvesting and Systems, 5(1-2), 2018, 3–10 &nbsp

We focus on the diagnostic and therapeutic problems of duodenal adenocarcinoma, reporting a case and reviewing the literature. A 65-year old man with adenocarcinoma in the third duodenal portion was successfully treated with a segmental resection of the third part of the duodenum, avoiding a duodeno-cephalo-pancreatectomy. This tumor is very rare and frequently affects the III and IV duodenal portion. A precocious diagnosis and the exact localization of this neoplasia are crucial factors in order to decide the surgical strategy. Given a non-specificity of symptoms, endoscopy with biopsy is the diagnostic gold standard. Duodeno-cephalo-pancreatectomy (DCP) and segmental resection of the duodenum (SRD) are the two surgical options, with overlapping morbidity (27% vs 18%) and post operative mortality (3% vs 1%). The average incidence of postoperative long-term survival is 100%, 73.3% and 31.6% of cases after 1, 3 and 5 years from surgery, respectively. Long-term survival is made worse by two factors: the presence of metastatic lymph nodes and tumor localization in the proximal duodenum. The two surgical options are radical: DCP should be used only for proximal localizations while SRD should be chosen for distal localizations.

At a time of climate emergency and the scarcity of fossil fuels, pyroelectric energy harvesting could be the right methodology to rescue some of the enormous quantities of energy wasted as heat. This technology is able to convert thermal fluctuation into electrical energy by using a pyroelectric device that generates voltage when cyclically heated or cooled down [1]. Here we report on the pyroelectric output registered for a wurtzite phase ZnS ceramic. We created a simple device (a “pyro-cell”): the ceramic sample which has evaporated Au electrodes on both sides is mounted on a Cu-metalized rectangular insulating base (vetronite) using either silver paint or conductive epoxy glue; the electrical connection is provided by tiny Cu wires that are welded to the sample and the vetronite base using tin alloy. This device is stable from room temperature up to approximately 180°C. Two different heating and cooling testing set-ups were used to heat and cool the ZnS sample: Set-up n°1 used an industrial scale laser, providing a fast temperature change, and Set-up n°2 had a standard lab hot plate heating element, providing a much slower temperature change. Acknowledgements: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 797951. &nbsp