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La histamina es el mediador químico principal producido por el mastocito ante estímulos inmunológicos y no inmunológicos que interviene en la producción de síntomas de broncoespasmos, rinitis, urticaria y anafilaxia. Los antihistamínicos H1 son fármacos ampliamente indicados por pediatras y clínicos en su práctica médica desde hace más de 50 años. El desarrollo de anti-H1 de segunda generación y sus metabolitos han contribuido a su uso más eficaz y con alta seguridad terapéutica. Este artículo tiene el objetivo revisar la farmacología e indicaciones clínicas más relevantes a fin de contribuir a la indicación adecuada y racional de los antihistamínicos H1.

Aim of the present manuscript is to provide an overview of all possible methods and light source typologies used by the different research groups for obtaining the energetic nano-materials’ photo-ignition, showing the latest progress related to such phenomenon employing, also, alternative radiation sources to the common Xe lamp. In fact, the employment of a different source typology can open new usage prospects respect to those enabled by the Xe lamp, mainly due to its technological limitations. Therefore, several studies are faced to test light sources, such as lasers and LEDs, for igniting the nano-energetic materials (as CNTs mixed with metallic catalyzers, Al / CuO nano-particles, etc); these nano-materials are usefully employed for starting, in volumetric and controlled way, the combustion of air-fuel mixtures inside internal combustion engines, leading to significant benefits to the combustion process also in terms of efficiency, reliability, and emissions of pollutants. Several research works are presented in literature concerning the ignition of liquid / gaseous fuels, without nano-particles, employing laser sources (i.e laser-based plugs in place of the common spark plugs); therefore, an innovative solution is proposed that employs multi-point laser-plugs for inducing the ignition of nano-materials dispersed into the air-fuel mixture inside the cylinder, so further improving the combustion of the fuel in an internal combustion engine.

Asma es una enfermedad heterogénea que se manifiesta con diferentes fenotipos y endotipos de fisiopatología compleja. El asma grave resistente al tratamiento con altas dosis de esteroides inhalatorios es una entidad infrecuente pero que plantea un gran desafío para el médico. Los progresos en los conocimientos de la fisiopatogenia del asma han permitido el desarrollo de nuevas terapias con inmunobiológicos que permiten una terapia más individualizada en el contexto de la medicina de precisión. La mayoría de estas nuevas terapias han sido desarrolladas para el asma T2 alta, principalmente eosinofílica, pero son menos los desarrollos para el asma T2 baja, cuyos mecanismos no están completamente dilucidados. Esta revisión intenta recopilar las más recientes evidencias acerca del uso de medicamentos biológicos en el asma grave, con especial énfasis en sus mecanismos de acción, indicaciones, eficacia clínica y posibles efectos adversos.

Detection of leakages in pipelines is a matter of continuous research because of the basic importance for a waterworks system is finding the point of the pipeline where a leak is located and − in some cases − a nature of the leak. There are specific difficulties in finding leaks by using spectral analysis techniques like FFT (Fast Fourier Transform), STFT (Short Term Fourier Transform), etc. These difficulties arise especially in complicated pipeline configurations, e.g. a zigzag one. This research focuses on the results of a new algorithm based on FFT and comparing them with a developed STFT technique. Even if other techniques are used, they are costly and difficult to be managed. Moreover, a constraint in the leak detection is the pipeline diameter because it influences accuracy of the adopted algorithm. FFT and STFT are not fully adequate for complex configurations dealt with in this paper, since they produce ill-posed problems with an increasing uncertainty. Therefore, an improved Tikhonov technique has been implemented to reinforce FFT and STFT for complex configurations of pipelines. Hence, the proposed algorithm overcomes the aforementioned difficulties due to applying a linear algebraic approach.

The use of Virtual Reality (VR) in education is getting more and more common, especially when hands-on learning experiences have to be delivered. With VR it becomes possible, e.g., to simulate dangerous or costly procedures that could hardly be implemented in real settings. However, engaging large classes in immersive laboratory activities may be difficult, since VR kits are still rather expensive for quantity purchases and may require powerful PCs as well as proper spaces to work. A possible way to deal with these issues could be to combine VR with so-called asymmetric Collaborative Learning (CL). CL is a particularly interesting pedagogical approach, as it make learners work in team to achieve a common educational goal, promoting critical thinking and active learning. In asymmetric CL, in particular, learners use different technologies to interact. When combined with VR, asymmetric CL could be used, e.g., to let some learners get immersed in a virtual environment, while some others actively participate in the experience using a desktop interface. This configuration could allow, in principle, to involve more learners in the same amount of time and with the same number of VR kits, while also letting them benefit of the advantages of CL. Based on these considerations, this paper investigates the impact of CL on VR-based education by leveraging an immersive virtual environment designed to support a laboratory experience in a Chemistry course. A user study was conducted by involving 46 university students enrolled in the course. Objective and subjective metrics were used to compare two education methods, i.e. one in which the students experienced the VR environment in isolation, another one in which pairs of students collaborated with an asymmetric approach. Students' knowledge acquisition was assessed by means of theoretical quizzes, whereas practical performance was automatically measured during the VR experience. The experimental results showed that trading off VR-based, individual learning for CL may have positive effects on the acquisition of theoretical knowledge, but may be detrimental to the achievement of practical abilities if sufficient exposure to technology cannot be guaranteed.

For close to 2 years, we have witnessed the impacts of the SARS-CoV-2 pandemic on research at several different levels. Among the list, limited access to laboratory-based training for undergraduate students prevented this cohort from gaining exposure to the realities of a research laboratory at a critical time in training when they may have found motivation in this area as a career. COVID exposed a weakness in our training pipeline; an extreme dependency on face-to-face training that threatened to create a void in the research talent needed to replenish the scientific community every year. In the classroom, we witnessed a revolution of e-learning based approaches that could be rapidly implemented based on existing footprints. Out of necessity, our laboratory developed and implemented an e-learning model of an undergraduate peer mentor network that provides a knowledge and experience exchange platform between students with different levels of research experience. Implementation of the platform was to aid students with gaining knowledge in multiple aspects of scientific research and hands-on work in a research laboratory. The collaboration between the students of the network was aimed at not only advancing the theoretical and practical research experience, but also at developing feedback implementation and practicing "soft skills" critical for teamwork and leadership. Herein, we present an overview of the model along with survey responses of the students participating in the peer mentor network. We have found that peer delivery of practical benchwork both via scientific presentations and visualized experiments, reduced the time of training and the amount of staff assistance needed when students returned to the bench. Furthermore, this model accelerated student independence in laboratory work and increased research interest overall. In summary, the model of a peer mentor network has the potential to serve as a training platform and as a customized tool, supplementing research laboratory training at the undergraduate level beyond the pandemic.

Sergio Parco, Fulvia Vascotto, Roberto Simeone, Patrizia Visconti Department of Health Technology Assessment, Institute for Maternal and Child Health, Trieste, Italy Background: Working in health care carries the risk of transmission of infected blood to patients by hospital workers and to other health personnel in the form of occupational infections. Conscientious application of the standard precautions is the main method used to avoid needle stick injuries, contamination of skin and mucous membranes, cuts with sharp tools, and inadequate disposal and recapping of needles. The aim of this work was to investigate in Friuli Venezia Giulia, a region in north-east Italy, the enhancement carried out to prevent situations of biologic risk for health care workers, and to verify the related laboratory analyses. Methods: Biological accidents occurring during the years 2012–2013 in the departments of oncology and pediatric-obstetric surgery, and in the intensive care unit at Burlo Garofolo Children's Hospital in Trieste (a large town in Friuli Venezia Giulia) were reviewed, and a new panel of tests was introduced for patients and health care workers, to also detect human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), and aspartate transaminase and immunoglobulin G. All tests were submitted for external quality assessment. Results: In total, 230 nosocomial events were reported by health care workers in the above-mentioned hospital departments in 2012–2013. There were 158 accidents in 2012, including 55 accidental needle stick injuries (34.81%), 59 blood splashes (37.34%), and 44 cuts with infected instruments (27.84%). The risk of sustaining a cut was related to movement error during surgery when the appropriate procedure was not followed or when devices were being assembled and passed between doctors and nurses. Most accidents happened among physicians compared to nurses; the high percentage of needle stick injuries (34.81%) versus nurses (25.94%) were due to incorrect recapping of needles after use. No cases of health care workers being infected with HCV, HBV, or HIV were identified. In 2013, the number of biological accidents decreased to 61, comprising two needle stick injuries (3.27%), 35 blood splashes (57.37%), and 25 cuts with contaminated instruments (40.98%). The number of subcutaneous abscesses with scarring resulting from cuts with sharp instruments decreased from three in 2012 (one of which was the subject of medicolegal proceedings) to none in 2013. Although our study population was relatively small, we did detect a statistically significant decrease in the number of needle stick injuries (P

Sergio Parco, Patrizia Visconti, Fulvia Vascotto Institute for Maternal and Child Health, Trieste, Italy Abstract: Involvement of health personnel in a medical audit can reduce the number of errors in laboratory medicine. The checked control of point of care testing (POCT) could be an answer to developing a better medical service in the emergency department and decreasing the time taken to report tests. The performance of sanitary personnel from different disciplines was studied over an 18-month period in a children's hospital. Clinical errors in the emergency and laboratory departments were monitored by: nursing instruction using specific courses, POCT, and external quality control; improvement of test results and procedural accuracy; and reduction of hemolyzed and nonprotocol-conforming samples sent to the laboratory department. In January 2012, point of care testing (POCT) was instituted in three medical units (neonatology, resuscitation, delivery room) at the Children's Hospital in Trieste, northeast Italy, for analysis of hematochemical samples. In the same period, during the months of January 2012 and June 2013, 1,600 samples sent to central laboratory and their related preanalytical errors were examined for accuracy. External quality control for POCT was also monitored in the emergency department; three meetings were held with physicians, nurses, and laboratory technicians to highlight problems, ie, preanalytical errors and analytical methodologies associated with POCT. During the study, there was an improvement in external quality control for POCT from -3 or -2 standard deviations or more to one standard deviation for all parameters. Of 800 samples examined in the laboratory in January 2012, we identified 64 preanalytical errors (8.0%); in June 2013, there were 17 preanalytical errors (2.1%), representing a significant decrease (P

Journal manuscripts are peer reviewed with the hopes that the peer review will facilitate an editor's decision regarding the disposition of the article and that the feedback will be helpful to the authors in improving their manuscript. However peer reviews may not achieve these goals if they lack sufficient analysis and feedback. This article presents a domains of language for peer review (DoLPR) framework to improve depth and quality of peer reviews conducted on journal manuscripts. The framework was developed in hopes of improving the quality of peer reviews.

Sergio Parco, Fulvia Vascotto, Patrizia Visconti Institute for Maternal and Child Health, Trieste, Italy Background: In northeastern Italy, according to Italian legislation, authorized public facilities can accept the donation and preservation of cord blood stem cells (CB-SC). Attitudes and knowledge in pregnant women differs between the local and immigrant (non-European Union [EU]) population. In this study we assessed the choices that pregnant women have with respect to the public and private harvesting system and the main reasons driving their decisions. We examined the ethnic origin of the families and compared tests for syphilis screening and leukocyte (WBC) counts in the CB-SC bags that are required for validation of the collection. Methods: Out of a population of 3450 pregnant patients at the Institute for Maternal and Child Health of Trieste, northeast Italy, 772 women agreed to cord blood harvesting and the associated lab tests. Of these, 221 women (28.6%) were from immigrant families of non-EU countries. Their ethnic affiliation was recorded, and tests were performed for syphilis screening and for nucleated red blood cell (NRBC) interference with the WBC count in CB-SC bags to assess cellularity and to determine if storage was appropriate. Results: Of the 772 pregnant women, 648 (84.0%) accessed the public collection system, which is free of charge, and 124 (15.0%) accessed the private fee-based system. One woman from the non-EU group opted for the private fee-based system. Of the 3450 pregnant women screened for syphilis at the Institute for Maternal and Child Health, the Treponema pallidum hemagglutination (TPHA) and Venereal Disease Research Laboratory (VDRL) tests were the main tests performed (66.0% of total cases) because many gynecologists in the public harvesting system apply the Italian regulations of the 1988 Decree, while the private system requires tests on syphilis and leaves the option to the lab physicians to select the best determination method. We found that the chemiluminescence method was more specific (97.0%) than the TPHA (83.0%) and nontreponemal rapid plasma reagin VDRL (75.0%) tests (P < 0.05, χ2 test). The specificity link between the two automatic methods versus microscopes for WBC dosing and NRBC interference was r2 = 0.08 (ADVIA 120) and r2 = 0.94 (XE-2100). The public system does not include human T-cell lymphotropic virus testing; this is reserved for the population from endemic zones. Conclusion: In northeastern Italy current legislation prevents the establishment of private fee-based banks for storage of CB-SC. The cryopreservation, for future autologous personal or family use, is possible only by sending to foreign private banks, with a further fee of €300. These regulations confirm that Italian legislation tries to increase the anonymous allogenic donations and the number of CB-CS bags stored in the free-cost public system, that are available to anyone with therapeutic needs. Private banking is used almost exclusively by the wealthier local population. In the public system, many physicians continue to use older Italian laws regarding syphilis diagnosis, and NRBC interference on WBC count may have an impact on cord blood harvesting. Our findings suggest that in the EU there is no consensus policy on donor management. The value of storage for potential use within the family is useful only with collaboration between the public and the private systems. Keywords: cord blood collection, public system, private system, pregnant women's choice

Summary:. Genital lymphedema is a challenging condition often refractory to conservative treatments. This case report presents a novel surgical approach combining a lymphatic system transfer based on a pedicled superficial circumflex iliac perforator flap with nanofibrillar collagen scaffolds to address genital lymphedema secondary to hidradenitis suppurativa. A 47-year-old man with hidradenitis suppurativa–related genital lymphedema, unresponsive to conservative measures, underwent the procedure. Indocyanine green lymphography and ultrahigh-frequency ultrasound were used for preoperative flap planning, including lymphatic vessels in the skin paddle. Nanofibrillar collagen scaffolds were placed to enhance lymphangiogenesis in distal genital areas. The patient experienced significant improvement, with a reduction in lymphedema severity from 5 of 9 to 1 of 9 on the Genital Lymphedema Score and substantial relief of symptoms. Single-photon emission computed tomography demonstrated uptake of 18F-fluorodeoxyglucose at the right inguinal lymph nodes, ipsilateral to the lymphatic flap. This case demonstrates the potential of this combined approach in managing complex genital lymphedema.

This article introduces this timely special issue on "Beyond Cultural Competence: Addressing racism, equity and inclusion," and provides information on how this issue was conceptualized. The editors reflect on the critical importance of equity and inclusion work in speech-language pathology and audiology in order to address structural racism and inequities for diverse students and professionals. It concludes by offering insights about the emerging levels of evidence as well as a call to action for continued engagement and expanded scholarship of teaching and learning research on these topics.