The Gastropack Access System as a Model to Access Gastroenterology Services for Gastroscopy Appropriateness in Patients with Upper Gastrointestinal Symptoms: A Comparison with the Open Access System.

Esophagogastroduodenoscopy (EGD) appropriateness in Open-Access System (OAS) is a relevant issue. The Gastropack Access System (GAS) is a new system to access gastroenterological services, based on the partnership between Gastroenterologists and GPs. This study aims to evaluate if GAS is superior to OAS in terms of EGDS appropriateness. Secondarily, we evaluated the diagnostic yield of EGDS according to ASGE guidelines. The GAS was developed in an area of Bologna where General Practitioners (GPs) could decide to directly prescribe EGDS through OAS or referring to GAS, where EGDS can be scheduled after contact between GPs and specialists sharing a patient's clinical information. Between 2016 and 2019, 2179 cases (M:F = 861:1318, median age 61, IQR 47.72) were referred to GAS and 1467 patients (65%) had a prescription for EGDS; conversely, 874 EGDS were prescribed through OAS (M:F = 383:491; median age 58 yrs, IQR 45.68). Indication was appropriate in 92% in GAS (1312/1424) versus 71% in OAS (618/874), p < 0.001. The rate of clinically significant endoscopic findings (CSEF) was significantly higher in GAS (49% vs. 34.8%, p < 0.001). Adherence to ASGE guidelines was not related to CSEF; however, surveillance for pre-malignant conditions was independently related to CSEF. All neoplasm were observed in appropriate EGD. GAS is an innovative method showing extremely high rates of appropriateness. ASGE guidelines confirmed their validity for cancer detection, but their performance for the detection of other conditions needs to be refined.

Shedding light on the aqueous synthesis of silicon nanoparticles by reduction of silanes with citrates.

The synthesis of silicon nanoparticles in water has recently attracted a lot of attention. However, many scientists have expressed concerns on the nanomaterials obtained. We decided to explore two different routes to obtain silicon nanoparticles starting from a silane precursor. We report our findings regarding the preparation of nanomaterials under microwave irradiation and hydrothermal conditions starting from aqueous mixtures of (3-aminopropyl) triethoxysilane and sodium citrate. The microwave process, in particular, has been reported to yield silicon quantum dots bearing a surface layer of 3-aminopropyl moieties, allowing for the preparation of luminescent substrates amenable to biological-friendly amide chemistry. However, rigorous experimental design and thorough characterization of the products definitely rules out the formation of silicon nanoparticles. By highlighting the main issues linked to the proper characterization of these materials, we prove that the nanoparticles produced under both microwave and hydrothermal conditions, are a mixture of silica and carbon quantum dots.

Mechanical chiral resolution.

Mechanical interactions of chiral objects with their environment are well-established at the macroscale, like a propeller on a plane or a rudder on a boat. At the colloidal scale and smaller, however, such interactions are often not considered or deemed irrelevant due to Brownian motion. As we will show in this tutorial review, mechanical interactions do have significant effects on chiral objects at all scales, and can be induced using shearing surfaces, collisions with walls or repetitive microstructures, fluid flows, or by applying electrical or optical forces. Achieving chiral resolution by mechanical means is very promising in the field of soft matter and to industry, but has not received much attention so far.

Oscillations, travelling fronts and patterns in a supramolecular system.

Supramolecular polymers, such as microtubules, operate under non-equilibrium conditions to drive crucial functions in cells, such as motility, division and organelle transport1. In vivo and in vitro size oscillations of individual microtubules2,3 (dynamic instabilities) and collective oscillations4 have been observed. In addition, dynamic spatial structures, like waves and polygons, can form in non-stirred systems5. Here we describe an artificial supramolecular polymer made of a perylene diimide derivative that displays oscillations, travelling fronts and centimetre-scale self-organized patterns when pushed far from equilibrium by chemical fuels. Oscillations arise from a positive feedback due to nucleation-elongation-fragmentation, and a negative feedback due to size-dependent depolymerization. Travelling fronts and patterns form due to self-assembly induced density differences that cause system-wide convection. In our system, the species responsible for the nonlinear dynamics and those that self-assemble are one and the same. In contrast, other reported oscillating assemblies formed by vesicles6, micelles7 or particles8 rely on the combination of a known chemical oscillator and a stimuli-responsive system, either by communication through the solvent (for example, by changing pH7-9), or by anchoring one of the species covalently (for example, a Belousov-Zhabotinsky catalyst6,10). The design of self-oscillating supramolecular polymers and large-scale dissipative structures brings us closer to the creation of more life-like materials11 that respond to external stimuli similarly to living cells, or to creating artificial autonomous chemical robots12.

[Water supply and public health]. / Approvvigionamento idrico e salute.

EU legislative framework on water for human consumption has recently been deeply modified. As from 25 December 2003, the Directive 80/778/EEC has been abrogated by the Directive 98/83/EC, transposed into the Italian legislation with the law 31/2001, which establishes as an inspiring principle the observance of laws common to all Member States while leaving them the discretion to introduce secondary parametric values. The directive provides that the parametric values should be respected until water distribution, by making the final user fall into the sphere of responsibility as a responsible of either a public commercial concern or a privately-run concern. This piece of legislation lays the foundation for an actual cultural revolution and the involvement of all the institutional, political and technical components of the territory, the aim being to safeguard a property that "belongs to future generations" and, thus, to be protected.

[Quality assurance of cooked food in conventional hospital food service]. / Il controllo di qualità della filiera del legame caldo nella ristorazione nosocomiale convenzionale.

The aim of this study was to evaluate the effectiveness of the hospital food service of the Azienda in preserving microbiological quality and temperature of cooked foods during the distribution to the different wards of the hospital. During three years, microbiological parameters and temperatures were monitored in the central kitchen before distribution (T0), in the first (T1) and in the last ward (T2) of the distribution route during a three-year period for a total of 337 analytical determinations. Temperature values before distribution improved during the study period, whereas the capacity of keeping adequate temperature values during the distribution decreased over time, in spite of the introduction of a new technology after the first year of the study. No significant deteriorations of the microbiological quality of the cooked foods were detected. The results of the study clearly indicate that an integrated approach involving new technology, work organization and personnel training is needed in preserving food quality in hospitals.