The connection between diverticulosis and colonic superficial neoplastic lesions in patients who underwent screening colonoscopy.

PURPOSE: If could be a potential pathophysiological connection between colonic diverticula and colonic superficial neoplastic lesions, beyond the shared risk factors, has been a subject of debate in the last years. This study tries to evaluate the association between diverticulosis and colonic neoplastic lesions. METHODS: This is a cross-sectional study including asymptomatic patients who underwent a screening colonoscopy (patients with a positive fecal occult blood test under the regional program of colorectal cancer (CRC) screening), surveillance after polypectomy resection, or familiarity (first-degree relatives) between 2020 and 2021 to evaluate the association between diverticula and colonic polyps. A multivariate analysis with multiple logistic regression and odds ratio (OR) to study the independent association between adenomas and adenocarcinomas was performed. RESULTS: One thousand five hundred one patients were included. A statistically significant association between adenomas or CRC alone and colonic diverticula was found (p = 0.045). On a multivariate analysis of demographic (age, gender) and clinical parameters (familiarity for diverticula and adenoma/CRC), only age was significantly associated with the development of colorectal adenomas or cancer (OR 1.05, 95% CI 1.03-1.07, p < 0.0001). CONCLUSIONS: This study showed a statistically significant association between diverticula and colonic adenomas. However, it is impossible to establish a cause-effect relationship due to the intrinsic characteristics of this study design. A study with a prospective design including both patients with diverticulosis and without colonic diverticula aimed at establishing the incidence of adenoma and CRC could help to answer this relevant clinical question, since a potential association could indicate the need for closer endoscopic surveillance.

Aspergillus fumigatus and aspergillosis: From basics to clinics.

The airborne fungus Aspergillus fumigatus poses a serious health threat to humans by causing numerous invasive infections and a notable mortality in humans, especially in immunocompromised patients. Mould-active azoles are the frontline therapeutics employed to treat aspergillosis. The global emergence of azole-resistant A. fumigatus isolates in clinic and environment, however, notoriously limits the therapeutic options of mould-active antifungals and potentially can be attributed to a mortality rate reaching up to 100 %. Although specific mutations in CYP 51A are the main cause of azole resistance, there is a new wave of azole-resistant isolates with wild-type CYP 51A genotype challenging the efficacy of the current diagnostic tools. Therefore, applications of whole-genome sequencing are increasingly gaining popularity to overcome such challenges. Prominent echinocandin tolerance, as well as liver and kidney toxicity posed by amphotericin B, necessitate a continuous quest for novel antifungal drugs to combat emerging azole-resistant A. fumigatus isolates. Animal models and the tools used for genetic engineering require further refinement to facilitate a better understanding about the resistance mechanisms, virulence, and immune reactions orchestrated against A. fumigatus. This review paper comprehensively discusses the current clinical challenges caused by A. fumigatus and provides insights on how to address them.

Is the inferior occlusal plane a reliable anatomic landmark for inferior alveolar nerve block? A study on dry mandibles of Brazilian adults.

PURPOSE: To investigate the relationship between the mandibular foramen (MF) and the inferior occlusal plane (IOP) of anatomic specimens, in order to guide clinicians in the inferior alveolar nerve block (IANB). METHOD: Eighty-two dry mandibles (totally or partially toothed) of Brazilian adults were selected, totalizing 66 left and 66 right antimeres. A flat plate of rigid PVC plastic was placed on the occlusal surfaces of posterior teeth and pressure was then manually applied to simulate the IOP. Following, the perpendicular distance from the IOP to the lowest point of the MF was measured by the use of a digital caliper, adopting negative values inferiorly and positive values superiorly. RESULTS: Regarding the antimeres, the majority of the lowest limits of the MF was below the IOP (right: 86.4%, left: 81.8%) with a mean of -4.2mm (±4.8) in the right and -4.1mm (±4.8) in the left ones, without any statistical significance. Considering both sexes, no statistically significant difference was obtained between them. CONCLUSION: The IOP seems not to be a good anatomical landmark to localize the MF and, its turn, to guide clinicians during the IANB for Brazilian adults, given the marked topographic variations.

Waste to energy efficiency improvements: Integration with solar thermal energy.

Hybridisation of waste to energy with solar facility can take competing energy technologies and make them complementary. However, realising the benefits of solar integration requires careful consideration of the technical feasibility as well as the economic and environmental benefits of a proposed system. In this work, a solar-integrated waste-to-energy plant scheme is proposed and analysed from an energy, environmental and economic point of view. The new system integrates a traditional waste-to-energy plant with a concentrated solar power plant, by superheating the steam produced by the waste-to-energy flue gas boiler in the solar facility. The original waste-to-energy plant - that is, the base case before introducing the integration with concentrated solar power - has a thermal power input of 50 MW and operates with superheated steam at 40 bar and 400 °C; net power output is 10.7 MW, and the net energy efficiency is equal to 21.65%. By combining waste-to-energy plant with the solar facility, the power plant could provide higher net efficiency (from 1.4 to 3.7 p.p. higher), lower specific CO2 emissions (from 69 to 180 kg MWh-1 lower) and lower levellised cost of electricity (from 13.4 to 42.3 EUR MWh-1 lower) comparing with the standalone waste to energy case. The study shows that: (i) in the integrated case and for the increasing steam parameters energy, economic and ecological performances are improved; (ii) increasing the solar contribution could be an efficient way to improve the process and system performances. In general, we can conclude that concentrated solar-power technology holds significant promise for extending and developing the waste to energy systems.

Autosomal-dominant myopia associated to a novel P4HA2 missense variant and defective collagen hydroxylation.

We recently described a complex multisystem syndrome in which mild-moderate myopia segregated as an independent trait. A plethora of genes has been related to sporadic and familial myopia. More recently, in Chinese patients severe myopia (MYP25, OMIM:617238) has been linked to mutations in P4HA2 gene. Seven family members complaining of reduced distance vision especially at dusk underwent complete ophthalmological examination. Whole-exome sequencing was performed to identify the gene responsible for myopia in the pedigree. Moderate myopia was diagnosed in the family which was associated to the novel missense variant c.1147A > G p.(Lys383Glu) in the prolyl 4-hydroxylase,alpha-polypeptide 2 (P4HA2) gene, which catalyzes the formation of 4-hydroxyproline residues in the collagen strands. In vitro studies demonstrated P4HA2 mRNA and protein reduced expression level as well as decreased collagen hydroxylation and deposition in mutated fibroblast primary cultures compared to healthy cell lines. This study suggests that P4HA2 mutations may lead to myopic axial elongation of eyeball as a consequence of quantitative and structural alterations of collagen. This is the first confirmatory study which associates a novel dominant missense variant in P4HA2 with myopia in Caucasian patients. Further studies in larger cohorts are advisable to fully clarify genotype-phenotype correlations.

Polymicrobial antibiofilm activity of the membranotropic peptide gH625 and its analogue.

This work illustrates a new role for the membranotropic peptide gH625 and its derivative gH625-GCGKKK in impairing formation of polymicrobial biofilms. Mixed biofilms composed of Candida and bacterial species cause frequently infections and failure of medical silicone devices and also show a major drug resistance than single-species biofilms. Inhibition and eradication of biofilms were evaluated by complementary methods: XTT-reduction, and crystal violet staining (CV). Our results indicate that gH625-GCGKKKK, better than the native peptide, strongly inhibited formation of mixed biofilms of clinical isolates of C. tropicalis/S. marcescens and C. tropicalis/S. aureus and reduced the biofilm architecture, interfering with cell adhesion and polymeric matrix, as well as eradicated the long-term polymicrobial biofilms on silicone surface.

Tests of a novel imaging algorithm to localize hidden objects or cavities with muon radiography.

A novel algorithm developed within muon radiography to localize objects or cavities hidden inside large material volumes was recently proposed by some of the authors (Bonechi et al. 2015 J. Instrum. 10, P02003 (doi:10.1088/1748-0221/10/02/P02003)). The algorithm, based on muon back projection, helps to estimate the three-dimensional position and the transverse extension of detected objects without the need for measurements from different points of view, which would be required to make a triangulation. This algorithm can now be tested owing to the availability of real data collected both in laboratory tests and from real-world measurements. The methodology and some test results are presented in this paper.This article is part of the Theo Murphy meeting issue 'Cosmic-ray muography'.

Short versus mid-long-term outcome of transanal irrigation in children with spina bifida and anorectal malformations.

PURPOSE: We assessed short- and mid-long-term clinical efficacy of transanal irrigation (TAI) and its effect on the quality of life of children with spina bifida (SB) and anorectal malformations (ARM). METHODS: Seventy-four pediatric patients (age 6-17 years) with SB and ARM with neurogenic bowel dysfunction were enrolled for a prospective and multicentric study. Patients were evaluated before the beginning of TAI (T0), after 3 months (T1) and after at least 2 years (range 24-32 months) (T2) using a questionnaire assessing bowel function, the Bristol scale, and two validated questionnaires on quality of life: the CHQ-PF50 questionnaire for the parents of patients aged 6-11 years and the SF36 questionnaires for patients aged between 12 and 18 years. RESULTS: Seventy-two patients completed TAI program in T1, and 67 continued into T2. Bowel outcomes (constipation and fecal incontinence) improved in both the SB and the ARM groups in the short and mid-long term. In both groups at T1 and T2, parents and children reported an improvement in quality of life and there was a significant increase of stool form types 4 and 5 as described by the Bristol scale. Common adverse effects during the study were similar at T1 and T2 without serious complications. CONCLUSIONS: We observed a sustained improvement in bowel management and quality of life in SB and ARM children during the study, more significant in the short term than in mid-long term. To maintain success rates in the mid-long term and to reduce the dropout rate, we propose patient training and careful follow-ups.

Peristeen(®) transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study.

AIM: In paediatric and adult patients with neurogenic bowel, transanal irrigation (TAI) of the colon has gained popularity due to the introduction of a specifically designed device. The aim of this pilot study was to present the results of TAI using the Peristeen(®) TAI system in a group of paediatric patients with anorectal malformation (ARM) and congenital or acquired spinal cord lesions (SCLs). METHOD: Eight Italian paediatric surgery and spina bifida centres participated in the study. The inclusion criteria were age between 6 and 17 years, weight above 20 kg and unsatisfactory bowel management. Patients with chronic inflammatory bowel disease, mental disability and surgery within the previous 3 months were excluded. At the beginning of treatment (T0) and after 3 months (T1) the Bristol scale, a questionnaire assessing bowel function, and two questionnaires on quality of life (QoL) for patients aged 6-11 years (CHQ-pf50) and 12-17 years (SF36) were administered. RESULTS: Eighty-three patients were enrolled, and seventy-eight completed the study (41 ARMs, 37 SCLs). At T1, constipation was reduced in ARMs from 69% to 25.6% and in SCLs from 92.7% to 41.5%, faecal incontinence in ARMs from 50% to 18.6% and in SCLs from 39% to 9.8% and flatus incontinence in ARMs from 20.9% to 9.8% and in SCLs from 31.7% to 10%. At T0, the Bristol Stool Scale types were 1-2 in 45% of ARMs and 77.5% of SCL patients, whereas at T1 types 1-2 were recorded in only 2.5% of SCL patients. QoL improved in both groups. In the younger group, a significant improvement in QoL was recorded in ARM patients for eight of nine variables and in SCL patients for seven of nine variables. CONCLUSION: This study showed that Peristeen TAI resulted in a significant time reduction in colonic cleansing, increased independence from the carer and improved QoL in paediatric patients with ARMs and SCLs.

Splenic marginal zone lymphoma in a HIV-1 infected patient: evidence favouring a pathogenetic role of HIV-1 itself in the lymphomagenesis.

A rare case of splenic marginal zone lymphoma (SMZL) in a human immunodeficiency virus (HIV)-1 infected patient is described. As an association between SMZL and viral infections has been reported, the presence of the hepatitis C virus and HIV-1 genomes was evaluated. Only HIV-1 DNA levels were detected in enriched splenic B lymphocytes, suggesting a HIV-1 involvement in lymphomagenesis.

Nitrous oxide and hypnotherapy in paediatric dentistry.

AIM: Patient compliance is of paramount importance for proper dental treatment, which can be difficult to achieve in children due to anxiety and fear, hindering the therapeutic procedure. In addition to well-known sedation methods (pharmacological and nitrous oxide), further methods of approach are being tested, such as hypnotherapy. MATERIALS: The sample consisted of 150 children (90 males, 60 females). Paper questionnaires, frequency meter, nitrous oxide dispenser in association with the use of the television were exploited. At the end of treatment, subjective pain was assessed using the VAS scale, while objective pain was assessed using the FLACC scale and heart rate. This made it possible to compare two experimental groups, one treated with nitrous oxide, and the other with hypnotherapy. The control group was treated with classic behavioural approach techniques. The results obtained were analysed by SPSS Software (Statistical Package for Social Science, version 27) and the inferences between the results were calculated for confirmation. CONCLUSION: Hypnotherapy can be a valid substitute for nitrous oxide in paediatric dentistry.

Dim artificial light at night alters gene expression rhythms and growth in a key seagrass species (Posidonia oceanica).

Artificial light at night (ALAN) is a globally spreading anthropogenic stressor, affecting more than 20% of coastal habitats. The alteration of the natural light/darkness cycle is expected to impact the physiology of organisms by acting on the complex circuits termed as circadian rhythms. Our understanding of the impact of ALAN on marine organisms is lagging behind that of terrestrial ones, and effects on marine primary producers are almost unexplored. Here, we investigated the molecular and physiological response of the Mediterranean seagrass, Posidonia oceanica (L.) Delile, as model to evaluate the effect of ALAN on seagrass populations established in shallow waters, by taking advantage of a decreasing gradient of dim nocturnal light intensity (from < 0.01 to 4 lx) along the NW Mediterranean coastline. We first monitored the fluctuations of putative circadian-clock genes over a period of 24 h along the ALAN gradient. We then investigated whether key physiological processes, known to be synchronized with day length by the circadian rhythm, were also affected by ALAN. ALAN influenced the light signalling at dusk/night in P. oceanica, including that of shorter blue wavelengths, through the ELF3-LUX1-ZTL regulatory network, and suggested that the daily perturbation of internal clock orthologs in seagrass might have caused the recruitment of PoSEND33 and PoPSBS genes to mitigate the repercussions of a nocturnal stress on photosynthesis during the day. A long-lasting impairment of gene fluctuations in sites characterised by ALAN could explain the reduced growth of the seagrass leaves when these were transferred into controlled conditions and without lighting during the night. Our results highlight the potential contribution of ALAN to the global loss of seagrass meadows, posing questions about key interactions with a variety of other human-related stressors in urban areas, in order to develop more efficient strategies to globally preserve these coastal foundation species.

Detection of possible factors favouring the evolution of migraine without aura into chronic migraine.

In a minority of cases, the natural history of migraine without aura (MO) is characterised over time by its evolution into a form of chronic migraine (CM). In order to detect the possible factors predicting this negative evolution of MO, we searched in our Headache Centre files for all clinical records that met the following criteria: (a) first visit between 1976 and 1998; (b) diagnosis of MO or of common migraine at the first observation, with or without association with other primary headache types; (c) <15 days per month of migraine at the first observation; and (d) at least one follow-up visit at least 10 years after the first visit. The patients thus identified were then divided into two groups based on a favourable/steady evolution (Group A: n = 243, 195 women and 48 men) or an unfavourable evolution (Group B: n = 72, 62 women and 10 men) of their migraine over time. In the two groups, we compared various clinical parameters that were present at the first observation or emerged at the subsequent follow-up visits. The parameters that were statistically significantly more frequent in Group B--and can therefore be considered possible negative prognostic factors--were: (a) ≥ 10 days per month of migraine at the first observation; (b) presence of depression at the first visit in males; and (c) onset of depression or arterial hypertension after the first observation but before transformation to CM in females. Based on these findings, in MO patients the high frequency of migraine attacks, comorbidity with depression, and the tendency to develop arterial hypertension should require particular attention and careful management to prevent evolution into CM.

Environmental Life Cycle Assessment of Hydrothermal Carbonization of Sewage Sludge and Its Products Valorization Pathways.

Abstract: This study is aimed at evaluating through Life Cycle Assessment (LCA) the environmental performances of an integrated system of an existing Water Resources Recovery Facility (WRRF) and a hypothetical hydrothermal carbonization (HTC) plant applied to the generated sewage sludge (SS). Beside the valorisation of the solid product (hydrochar, HC) as a fuel substituting lignite, the possibility to valorize also the liquid fraction (process water, PW) derived by the HTC, by anaerobic digestion to produce biogas, is here proposed and analysed. Additionally, phosphorus recovery from HC, prior its use, by acid leaching with nitric acid is also suggested and evaluated. Thus, four integrated scenarios, based on SS carbonization, are proposed and compared with the current SS treatment, based on composting outside of the WRRF (Benchmark scenario). The proposed scenarios, based on HTC, show improved performances with respect to the benchmark one, for thirteen of sixteen considered impact indicators. For the Climate Change (CC) indicator, the two HTC scenarios are able to reduce the impacts up to - 98%, with respect to the Benchmark. Further, the introduction of anaerobic digestion of PW proves to reduce impacts more than other configurations in eleven on sixteen impact categories. On the contrary, the introduction of phosphorus recovery process negatively affects the values for most of indicators. Thus, possible solutions to improve the integration of this process are outlined (e.g., the use of sulfuric acid instead of nitric one, or the application of a different ratio between solid and acidified solution during acid leaching of HC to recover phosphorus). Supplementary Information: The online version contains supplementary material available at 10.1007/s12649-022-01821-x.

Hydrothermal carbonization of the wet fraction from mixed municipal solid waste: Hydrochar characteristics and energy balance.

Mixed municipal solid waste (MSW) may be pre-treated in a mechanical-biological treatment (MBT) plant to produce an exiting stream with improved combustible characteristics. The process also produces a second waste stream, which is generally separated on a size basis by industrial sieving equipment. It contains fractions with a high moisture content such as residual food waste, soiled paper and cardboard, and small fragments of other materials. Samples of this stream, collected at an existing plant, were characterized and processed by hydrothermal carbonization (HTC) at laboratory scale, at various temperatures (180, 200 and 220 °C), reaction times (1, 4 and 8 h) and solid to water ratios (0.15 and 0.07). The primary energy balance, on a hypothetical industrial scale, was performed. In brief, the results confirmed that the produced hydrochar was a brittle, hydrophobic, solid carbonaceous product which gave a better combustion performance as the residence time of the HTC process was increased. Moreover, the dewaterability of the carbonized waste was greatly improved when compared to raw, wet samples. The results of the primary energy balance confirmed that the energy contained in the produced hydrochar was higher than the energy consumption for the process itself, under all the HTC working conditions. The energy consumed in the process was in the range of 40-70 % of the energy content of the produced hydrochar.

Clowntherapy in paediatric dentistry: The psychological approach to the paediatric patient.

AIM: Anxiety towards dental treatments and visits in children are often cause for the avoidance and/or failure of the treatment itself, as well as a reason for stress in both the patient and the orthodontist. The aim of the research is to understand if the use of clown therapy in dental waiting rooms is efficient in bringing down the level of preoperative anxiety in paediatric dental patients. METHODS: Two psychometric tests were used: CFSS-DS (Dental Subscale of the Children's Fear Survey Schedule) and FIS (Facial Image Scale), after the translation of the original versions, to both the patients and their parents. The CFSS-DS is the most used instrument in order to assess dental fear in children, it is composed by 15 questions that outline situations which children and adolescents will have to face while on the dental chair. The FIS is a visual analogical scale that uses faces as indicators of anxiety. CONCLUSION: Clowntherapy proves to be an efficient non-pharmacological method to reduce anxiety and dental fear in paediatric patients, offeringa valid and practical support for paediatric dentists.

Distinct mechanisms for aerenchyma formation in leaf sheaths of rice genotypes displaying a quiescence or escape strategy for flooding tolerance.

BACKGROUND AND AIMS: Rice is one of the few crops able to withstand periods of partial or even complete submergence. One of the adaptive traits of rice is the constitutive presence and further development of aerenchyma which enables oxygen to be transported to submerged organs. The development of lysigenous aerenchyma is promoted by ethylene accumulating within the submerged plant tissues, although other signalling mechanisms may also co-exist. In this study, aerenchyma development was analysed in two rice (Oryza sativa) varieties, 'FR13A' and 'Arborio Precoce', which show opposite traits in flooding response in terms of internode elongation and survival. METHODS: The growth and survival of rice varieties under submergence was investigated in the leaf sheath of 'FR13A' and 'Arborio Precoce'. The possible involvement of ethylene and reactive oxygen species (ROS) was evaluated in relation to aerenchyma formation. Cell viability and DNA fragmentation were determined by FDA/FM4-64 staining and TUNEL assay, respectively. Ethylene production was monitored by gas chromatography and by analysing ACO gene expression. ROS production was measured by using Amplex Red assay kit and the fluorescent dye DCFH(2)-DA. The expression of APX1 was also evaluated. AVG and DPI solutions were used to test the effect of inhibiting ethylene biosynthesis and ROS production, respectively. KEY RESULTS: Both the varieties displayed constitutive lysigenous aerenchyma formation, which was further enhanced when submerged. 'Arborio Precoce', which is characterized by fast elongation when submerged, showed active ethylene biosynthetic machinery associated with increased aerenchymatous areas. 'FR13A', which harbours the Sub1A gene that limits growth during oxygen deprivation, did not show any increase in ethylene production after submersion but still displayed increased aerenchyma. Hydrogen peroxide levels increased in 'FR13A' but not in 'Arborio Precoce'. CONCLUSIONS: While ethylene controls aerenchyma formation in the fast-elongating 'Arborio Precoce' variety, in 'FR13A' ROS accumulation plays an important role.

The Hannes hand prosthesis replicates the key biological properties of the human hand.

Replacing the human hand with artificial devices of equal capability and effectiveness is a long-standing challenge. Even the most advanced hand prostheses, which have several active degrees of freedom controlled by the electrical signals of the stump's residual muscles, do not achieve the complexity, dexterity, and adaptability of the human hand. Thus, prosthesis abandonment rate remains high due to poor embodiment. Here, we report a prosthetic hand called Hannes that incorporates key biomimetic properties that make this prosthesis uniquely similar to a human hand. By means of an holistic design approach and through extensive codevelopment work involving researchers, patients, orthopaedists, and industrial designers, our proposed device simultaneously achieves accurate anthropomorphism, biomimetic performance, and human-like grasping behavior that outperform what is required in the execution of activities of daily living (ADLs). To evaluate the effectiveness and usability of Hannes, pilot trials on amputees were performed. Tests and questionnaires were used before and after a period of about 2 weeks, in which amputees could autonomously use Hannes domestically to perform ADLs. Last, experiments were conducted to validate Hannes's high performance and the human likeness of its grasping behavior. Although Hannes's speed is still lower than that achieved by the human hand, our experiments showed improved performance compared with existing research or commercial devices.

Down-regulation of LFA-1 adhesion receptors by C-myc oncogene in human B lymphoblastoid cells.

The function of the c-myc gene and its role in tumorigenesis are poorly understood. In order to elucidate the role of c-myc oncogene activation in B cell malignancy, the phenotypic changes caused by the expression of c-myc oncogenes in human B lymphoblastoid cells immortalized by Epstein-Barr virus were analyzed. C-myc oncogenes caused the down-regulation of lymphocyte function-associated antigen-1 (LFA-1) adhesion molecules (alpha L/beta 2 integrin) and loss of homotypic B cell adhesion in vitro. Down-regulation of LFA-1 occurred by (i) posttranscriptional modulation of LFA-1 alpha L-chain RNA soon after acute c-myc induction, and (ii) transcriptional modulation in cells that chronically express c-myc oncogenes. Analogous reductions in LFA-1 expression were detectable in Burkitt lymphoma cells carrying activated c-myc oncogenes. Since LFA-1 is involved in B cell adhesion to cytotoxic T cells, natural killer cells, and vascular endothelium, these results imply functions for c-myc in normal B cell development and lymphomagenesis.