Linear, weakly nonlinear and fully nonlinear models for soft tissues: which ones provide the most reliable estimations of the stiffness?

Benign and malignant lesions in tissues or organs can be detected by elastographic investigations in which pathological regions are spotted from local alterations of the stiffness. As is known, the shear modulus provides a measure of the stiffness of an elastic material. Based on the classical theory of linear elasticity, an elastogram yields estimations of the linear shear modulus from measurements of the speed of small-amplitude transverse waves propagating in the medium tested. In this paper, we show that the estimation of the shear modulus can be improved significantly by employing the fourth-order weakly nonlinear theory of elasticity (FOE), and indicate how the stiffness can be assessed more precisely with the use of FOE. We discuss also why FOE provides more reliable results than the fully nonlinear theory of elasticity. This article is part of the theme issue 'The Ogden model of rubber mechanics: Fifty years of impact on nonlinear elasticity'.

Understanding the role of threading dislocations on 4H-SiC MOSFET breakdown under high temperature reverse bias stress.

The origin of dielectric breakdown was studied on 4H-SiC MOSFETs that failed after three months of high temperature reverse bias stress. A local inspection of the failed devices demonstrated the presence of a threading dislocation (TD) at the breakdown location. The nanoscale origin of the dielectric breakdown was highlighted with advanced high-spatial-resolution scanning probe microscopy (SPM) techniques. In particular, SPM revealed the conductive nature of the TD and a local increase of the minority carrier concentration close to the defect. Numerical simulations estimated a hole concentration 13 orders of magnitude larger than in the ideal 4H-SiC crystal. The hole injection in specific regions of the device explained the failure of the gate oxide under stress. In this way, the key role of the TD in the dielectric breakdown of 4H-SiC MOSFET was unambiguously demonstrated.

Potential role of the heat shock protein 90 (hsp90) in buffering mutations to favour cyclical parthenogenesis in the peach potato aphid Myzus persicae (Aphididae, Hemiptera).

Heat-shock proteins 90 (hsp90s) are a class of molecules able to stabilize a network of 'client' proteins that are involved in several processes. Furthermore, recent studies indicated that mutations in the hsp90-encoding gene induce a wide range of phenotypic abnormalities, which have been interpreted as an increased sensitivity of different developmental pathways to hidden/cryptic mutations. In order to verify the role of hsp90 in aphids, we amplified and sequenced the hsp90 gene in 17 lineages of the peach potato aphid Myzus persicae (Sulzer, 1776) looking for the presence of mutations. In particular, we compared lineages with different reproductive modes (obligate vs. cyclical parthenogenesis), propensity to develop winged females and karyotype stability. Differently from the cyclical parthenogenetic lineages that possessed functional hsp90 genes, the seven analysed asexual lineages showed severe mutations (including frameshift and non-sense mutations). In vivo functional assays with the hsp90-inhibitor geldanamycin showed that some lineages with cyclical parthenogenesis may lose their ability to induce sexuales in the absence of active hsp90 revealing the presence of cryptic mutations in their genomes. As a whole, our data suggest that hsp90 could play in aphids a role in buffering hidden/cryptic mutations that disrupt cyclical parthenogenesis.

Recognition and management of delirium among doctors, nurses, physiotherapists, and psychologists: an Italian survey.

BACKGROUND: There are no studies that have identified the ability to recognize and manage delirium among Italian health providers caring for patients at risk. Therefore, the Italian Association of Psychogeriatrics (AIP) conducted a multicenter survey among doctors, nurses, psychologists and physiotherapists to assess their competence regarding the theme of delirium and its management in the everyday clinical practice. METHODS: The survey period was 1st June 2013 to 30th November 2013. The invitation to participate was sent via email, with publication on the AIP website. The survey included 14 questions and two case vignettes. RESULTS: A total of 648/1,500 responses were collected. Most responders were doctors (n = 322/800), followed by nurses (n = 225/500), psychologists (n = 51/100), and physiotherapists (n = 30/100). Generally, doctors and psychologists correctly defined delirium, while nurses and physiotherapists did not. The most frequently used diagnostic tools were the Confusion Assessment Method (CAM) and the Diagnostic and Statistical Manual of Mental Disorders-IV. Delirium intensity was rarely assessed. Hypoactive delirium was generally managed with non-pharmacological approaches, while hyperactive delirium with a combination of non-pharmacological and pharmacological approaches. However, possible causes of delirium were under-assessed by half of doctors and by the majority of other professionals. Nurses, psychologists and physiotherapists did not answer the case vignettes, while doctors identified the correct answer in most cases. CONCLUSIONS: This is the first Italian survey among health providers caring for patients at risk of delirium. This is also the first survey including doctors, nurses, psychologists and physiotherapists. The results emphasize the importance of training to improve knowledge of this relevant unmet medical need.

Insulin production and resistance in cystic fibrosis: effect of age, disease activity, and genotype.

AIM: To assess the major determinants of glucose tolerance between age, genotype, and clinical status in cystic fibrosis (CF) patients, and study if defects of insulin secretion and insulin sensitivity were associated with the onset of CF-related diabetes (CFRD). SUBJECTS AND METHODS: One hundred and nineteen patients, in stable clinical condition were studied. They were subdivided into 3 groups based on age, and 2 groups based on Schwachman-Kulczycki clinical score. All patients were genotyped, and subsequently divided into 3 groups. Ninety-four healthy normal-weight controls, comparable for sex and age were also studied. All subjects had baseline blood samples taken for glucose and insulin, C-peptide, and glycated hemoglobin. Homeostasis model assessment of insulin resistance (HOMA-IR), fasting glucose/insulin ratio (FGIR) were calculated as indices of IR and insulinogenic index as a marker of pancreatic ß-cell function. All patients underwent an oral glucose tolerance test, and 57 underwent an IVGTT for the calculation of first-phase (FPIR) and acute insulin responses (AIR). RESULTS: The F508del homozygous patients had an increased chance of developing impaired glucose tolerance (IGT) and significantly lower FPIR, decreased HOMA-IR, and insulinogenic index. Heterozygote F508del patients had an increased chance of having normal glucose tolerance. HOMA-IR, FGIR, and insulinogenic index did not change with age or clinical score. HOMAIR correlated with FPIR. FPIR correlated positively with insulinogenic index. AIR correlated negatively with FGIR, and positively with C-reactive protein. In multiple linear regression analyses, glucose tolerance was related to the agegroup, and to the HOMA-IR and insulinogenic indexes. CONCLUSIONS: IGT and CFRD were related mainly to genotype, although, as expected, the prevalence increased with age. The data suggested a possible combined contribution of insulin deficiency, ß-cell function, and reduced insulin sensitivity to the onset of CFRD; however, further studies are warranted to better elucidate this aspect.

Variation of genetic diversity over time in local Italian chicken breeds undergoing in situ conservation.

The aim of this study was to analyze the variation of different genetic diversity measures in 5 Italian local chicken breeds over a 4-yr period of conservation. The local breeds were Ermellinata di Rovigo, Padovana, Pépoi, Robusta Lionata, and Robusta Maculata. A total of 368 samples were chosen for the analysis among the birds hatched in the years 2002 and 2006. Genetic variation over 30 microsatellite loci was analyzed. All 30 microsatellites were polymorphic, with a total number of alleles equal to 251, a mean (±SD) of 8.367 ± 3.378 across populations and 3.233 ± 1.338 within population. After 4 yr of conservation, a loss of alleles occurred for all the microsatellites, with the exception of 4 loci. The total number of alleles and expected heterozygosity estimates significantly decreased during the 4 yr of conservation, whereas no significant differences were detected for the microsatellites polymorphism information content or for the observed heterozygosity estimates. A decrease of the inbreeding coefficient occurred for all the breeds, with the exception of Padovana and Robusta Lionata. All populations showed evidence of a persistent significant deviation from Hardy-Weinberg equilibrium caused by an excess of homozygotes, except Robusta Maculata, which reached the equilibrium in 2006. For Pépoi, Padovana, Ermellinata di Rovigo, and Robusta Maculata, molecular coancestry increased significantly (P < 0.001) after the 4 yr of conservation. No evident genetic structures were detectable within breed, both for 2002 and for 2006 individuals. However, a slight increase in the proportion of membership for each breed had occurred in the year 2006 compared with the data obtained in the year 2002. As consequence, within breed, individuals in 2006 appear more homogeneous, producing clearer, more distinctive and separated groups. Molecular markers analysis helped us monitor the genetic variability of local breeds involved in a conservation scheme, enabling the planning of new strategies for the improvement of in situ conservation schemes.

Feasibility of the direct application of near-infrared reflectance spectroscopy on intact chicken breasts to predict meat color and physical traits.

Physical and color characteristics of chicken meat were investigated on 193 animals by directly applying a fiberoptic probe to the breast muscle and using the visible-near-infrared (NIR) spectral range from 350 to 1,800 nm. Data on pH was recorded 48 h postmortem (pH); lightness (L*), redness (a*), and yellowness (b*) 48 h postmortem; thawing and cooking losses and shear force after freezing. Partial least squares regressions were performed using untreated data, raw absorbance data (log(1/R)), and multiplicative scatter correction plus first or second derivative spectra. Models were validated using full cross-validation, and their predictive ability was determined by root mean square error of cross-validation (RMSE(CV)) and correlation coefficient of cross-validation (r(cv)). Means (±SD) of pH, L*, a*, b*, thawing loss, cooking loss, and shear force were 5.83 ± 0.13, 44.54 ± 2.42, -1.90 ± 0.62, 3.21 ± 3.28, 4.84 ± 2.44%, 19.39 ± 2.95%, and 16.08 ± 3.83 N, respectively. The best prediction models were developed using log(1/R) spectra for b* (r(cv) = 0.93; RMSE(CV) = 1.16) and a* (r(cv) = 0.88; RMSE(CV) = 0.29), while a medium predictive ability of NIR was obtained for pH, L*, and thawing and cooking losses (r(cv) from 0.69 to 0.76; RMSE(CV) from 0.01 to 1.73). Finally, predicted model for shear force (r(cv) = 0.41; RMSE(CV) = 3.18) was unsatisfactory. Results suggest that NIR is a feasible technique for the assessment of several quality traits of intact breast muscle.

Genetic characterization of local Italian breeds of chickens undergoing in situ conservation.

The objectives of this study were to determine genetic variation and to analyze population structure of 6 Italian local chicken breeds involved in a conservation program. Twenty microsatellite markers were investigated in 337 birds belonging to 6 breeds: Ermellinata di Rovigo, Robusta Maculata, Robusta Lionata, Pépoi, Padovana, and Polverara; a commercial layer cross was used as reference. One hundred twelve alleles were detected in the overall population, with a mean number of 5.6 +/- 2.1 alleles per locus. For the local breeds, the observed and expected heterozygosity ranged from a minimum of 0.240 to a maximum of 0.413 and from 0.243 to 0.463 for the Pépoi and Polverara breeds, respectively. Deviation from Hardy-Weinberg equilibrium was observed in 5 breeds and in the commercial cross. The overall population heterozygote deficiency was 0.427, the average inbreeding coefficient was 0.097, and the heterozygote deficiency due to breed subdivisions was 0.437. Reynolds' distances were used to draw an unrooted neighbor-joining tree, which topology gave information on the genetic origin of these breeds and confirmed their known history. The estimated molecular kinship within a breed ranged from 0.559 to 0.769, evidencing high coancestry. Structure analysis was performed to detect the presence of population substructures. Inferred clusters corresponded to the different breeds, without presence of admixture. The exception was the Polverara breed, for which a more complex genetic structure was found. The results supported the decision of safeguarding these breeds as an important reservoir of genetic diversity and confirmed the usefulness of microsatellite markers to characterize and to monitor genetic variability in local chicken breeds.

Carcase characteristics and qualitative meat traits of three Italian local chicken breeds.

1. An experiment involving 60 male chickens reared in an organic production system was carried out in order to investigate carcase characteristics and qualitative meat traits of three slow-growing Italian local breeds of chicken (Ermellinata, Padovana and Pepoi). 2. Chicks were randomly selected at hatch, raised together under the same conditions, slaughtered at 190 d of age, dissected for carcase traits, and meat (breast and thigh) stored for subsequent analysis of quality parameters. 3. Ermellinata (EA) chickens were significantly different from Padovana (PA) and Pepoi (PI) chickens for live, carcase and thigh weights. Breeds were also different for breast muscle protein content (EA > PI and PA), shear force (PA < EA and PI) and cooking loss (PI > PA and EA) values. 4. The CIE system values of lightness (L*), redness (a*), and yellowness (b*) evidenced a distinctive darker meat and lighter skin colour of PA breast meat. 5. Polyunsaturated fatty acids composition of breast meat was similar among the analysed breeds. EA had significantly higher saturated but significantly lower monounsaturated fatty acid contents than the other two breeds.

Severe acute colitis related to levodopa treatment.

The first case of severe drug-induced gastrointestinal injury related to levodopa is described. The 86-year-old patient experienced acute colitis temporally related to the intake of the drug with complete resolution of symptoms on levodopa withdrawal. Awareness of the possibility of a levodopa-related damage on colon biopsies performed for acute colitis is of paramount importance for pathologists. However, in order to exclude or confirm a drug-related damage an effective communications between clinicians and pathologists is always required.

Pathologist's assistant (PathA) and his/her role in the surgical pathology department: a systematic review and a narrative synthesis.

In recent decades, various highly qualified individuals have increasingly performed tasks that have historically been handled by physicians with the aim of reducing their workload. Over time, however, these "physician assistants" or "physician extenders" have gained more and more responsibilities, showing that specific tasks can be performed equally skilfully by specialised health care professionals. The pathologist's assistant (PathA) is a highly qualified technician who works alongside the pathologist and is responsible for the grossing and autopsies. This profession was developed in the USA, with formal training programmes starting in 1970 when Dr. Kinney, director of the Department of Pathology of Duke University, Durham, NC, started the first dedicated course. Most institutes in the USA and Canada currently employ these technical personnel for grossing, and numerous papers published over the years demonstrate the quality of the assistance provided by the PathA, which is equal to or sometimes even better than the performance of pathologists. The PathA can be employed to carry out a wide range of tasks to assist the pathologist, such as grossing (the description and reduction of surgical specimens), judicial autopsies and administrative and supervisory practices within the laboratory or assistance in research, although the diagnosis is always the pathologist's responsibility. Since this role has already been consolidated in North America, part of the relevant literature is altogether out of date. However, the situation is different in Europe, where there is an increasing interest in PathA, mainly because of the benefits of their inclusion in anatomic pathology laboratories. In the UK, biomedical scientists (BMS, the British equivalent of PathA) are involved in many tasks both in surgical pathology and in cytopathology, which are generally performed by medically trained staff. Several papers have been recently published to highlight the role of BMS with the broader public. This report aimed to conduct a systematic review of all the articles published about the PathA/BMS and to perform a narrative synthesis. The results may contribute to the evidence for including the PAthA/BMS within a surgical pathology laboratory organisation.

[Prevalence of hepatitis virus A, B, and C markers according to the geographic origin of medical students]. / Prevalenza dei marcatori dell'epatite (A, B e C) in relazione alla provenienza geografica degli studenti dei corsi di laurea in medicina.

Antibodies against viral hepatitis A, B and C were evaluated in 221 students of graduate courses of the Medical School of Padua University born in countries different from Italy. Data were compared with those measured in 362 students born in Veneto Region and 87 students born in Centre-Southern Italy. The results showed a high, significant prevalence of positive antibodies against hepatitis A in students from Africa (94.7%), Asia (60.9%), Centre-Southern America (60.9%) and East Europe (52.7%); in Italy, the prevalence was significant in student from Centre-Southern Italy (19.5%). A high prevalence of hepatitis B antibodies was observed in 33.3% of Africa students (two subjects HBsAg positive), in 22.6% of students from East Europe (five subjects HBsAg positive) and in 12.5% of Asian and Centre-Southern American students (one HBeAg positive). Finally, infection with hepatitis C is sporadic and without a significant geographic distribution (three subjects only).

[Prevalence of virus hepatitis B markers among medical students]. / Prevalenza dei marcatori dell'epatite B negli studenti dei corsi di laurea in medicina.

Healthcare workers are a category of subjects at risk of infections higher than general population, though the introduction of vaccination against hepatitis B generally reduced this risk. In the present research, 2137 students of graduate course for health professions were subdivide in two age classes: 25 years old or younger and older than 25 years old according to the vaccination strategy defined by the law 165/91. A high number of students (82.3%) appeared immune against hepatitis B virus, whereas 16.7% were negative. About 30% of negative subjects declared vaccination. Females and subjects 25 years old or younger showed a significantly higher prevalence of anti-HBsAg antibodies (p < 0.001) than males and older subjects respectively. The obtained results show the need to evaluate the immunity status of the healthcare workers in training with the aim to reduce the number of susceptible subjects.

Development and validation of a novel SNP panel for the genetic characterization of Italian chicken breeds by next-generation sequencing discovery and array genotyping.

The aim of this study was to compare the intra and inter genetic variability and population structure of 7 indigenous chicken breeds of the Veneto region, through a novel panel of 64 SNP, each located in an exonic region and mostly on different chromosomes. A total of 753 blood samples from 7 local chicken breeds (Ermellinata di Rovigo, Millefiori di Lonigo, Polverara, Pepòi, Robusta Lionata, Robusta Maculata, and Padovana) was collected and analyzed. Two strains of Polverara (Nera and Bianca) and Padovana (Dorata and Camosciata) were included in the study. The observed heterozygosity ranged from 0.124 (Pèpoi) to 0.244 (Ermellinata di Rovigo), and the expected heterozygosity varied from 0.132 (Millefiori di Lonigo) to 0.300 (Ermellinata di Rovigo). Global FIS results (0.114) indicated a low-medium inbreeding effect, with values ranging from 0.008 (Millefiori di Lonigo) to 0.223 (Ermellinata di Rovigo). Pairwise FST values (0.167) for all populations ranged from 0.020 (Polverara Nera and Polverara Bianca) to 0.193 (Robusta Lionata and Polverara Nera), indicating that the studied breeds were genetically highly differentiated. The software STRUCTURE was used to detect the presence of population substructures, and the most probable number of clusters (K) of the 10 chicken populations was at K = 8. The affiliation was successful in all Veneto chicken breeds. The present SNP marker results, compared with previous data obtained using microsatellites, provided a reliable estimate of genetic diversity within and between the studied breeds, and demonstrated the utility of the proposed panel as a rapid, efficient, and cost-effective tool for periodical monitoring of the genetic variability among poultry populations. In addition, the present SNP panel could represent a resource for a systematic approach with relevant impact on breeding program decisions and could turn out to be a reliable tool for genetic traceability of indigenous chicken meat. Adoption of a periodical monitoring system of genetic diversity is a fundamental tool in conservation actions and should increase the value of typical and niche products.

Radiograph-based femur morphing method.

Many applications in orthopaedic surgery require the creation of personalised design models that can serve as the basis for navigation in computer aided surgery systems or be used to create a personalised model to perform structural analysis during pre-operative planning or post-operative follow-up. The paper introduces a method for developing a three-dimensional (3D) patient-specific model of a femur bone from an antero-posterior radiograph. A generic femur was employed and was altered on the basis of bone boundaries visible on radiographs. Morphological errors were evaluated against 3D models obtained from computed tomography (CT) scans. When only the antero-posterior radiograph was used, the average radius estimation error was 4.8 mm, the average percentage area estimation error was 14%, and the average percentage estimation error for inertial moments was 15%. If both the medial-lateral and the anterior-posterior radiographs were used, these errors were 2.0 mm, 5% and 7%, respectively. The procedure described can be profitably employed whenever CT scans are not available, such as during a retrospective analysis, or when CT scans cannot be justified because of X-ray exposure and cost considerations.

Bladder tissue biomechanical behavior: Experimental tests and constitutive formulation.

A procedure for the constitutive analysis of bladder tissues mechanical behavior is provided, by using a coupled experimental and computational approach. The first step pertains to the design and development of mechanical tests on specimens from porcine bladders. The bladders have been harvested, and the specimens have been subjected to uniaxial cyclic tests at different strain rates along preferential directions, considering the distribution of tissue fibrous components. Experimental results showed the anisotropic, non-linear and time-dependent stress-strain behavior, due to tissue conformation with fibers distributed along preferential directions and their interaction phenomena with ground substance. In detail, experimental data showed a greater tissue stiffness along transversal direction. Viscous behavior was assessed by strain rate dependence of stress-strain curves and hysteretic phenomena. The second step pertains the development of a specific fiber-reinforced visco-hyperelastic constitutive model, in the light of bladder tissues structural conformation and experimental results. Constitutive parameters have been identified by minimizing the discrepancy between model and experimental data. The agreement between experimental and model results represent a term for evaluating the reliability of the constitutive models by means of the proposed operational procedure.

Glutamate receptors of the AMPA type modulate neurotransmitter release and peristalsis in the guinea-pig isolated colon.

To assess the role of AMPA and kainate receptors in modulating neurotransmitter release from the myenteric plexus, the effect of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and kainic acid on endogenous acetylcholine (ACh) and noradrenaline (NA) overflow from the guinea-pig isolated colon was studied. AMPA inhibited spontaneous ACh overflow and increased electrically-evoked NA overflow. Kainic acid did not influence both ACh and NA overflow. AMPA-mediated effects on ACh and NA overflow were significantly reduced by the AMPA/kainate antagonist, 6-cyano-7-nitroquinoxaline-2,3-dione, CNQX. The inhibitory effect of AMPA on ACh overflow could be due, at least in part, to the AMPA-induced NA overflow as it was greatly reduced after adrenoceptor blockade and virtually abolished in sympathetically-denervated animals. The possible functional significance of these findings was studied by measuring the efficiency of the peristaltic reflex in the presence of the different agonists. The efficiency of peristalsis was enhanced by AMPA, whereas it was not modified by kainic acid. In conclusion, AMPA receptors, but not kainate receptors, may play a role in the modulation of ACh and NA release and of peristalsis in the guinea-pig colon.

Classification and radiographic features of uterine malformations: hysterosalpingographic study.

A series of 13470 hysterosalpingographic investigations demonstrated congenital uterine malformations in 1160 cases (8.6%). Uterus arcuatus and uterine hypoplasia, the latter ranking as a malformation on embryological grounds, together accounted for two-thirds of the cases, uterus unicornis unicollis and uterus bicornis unicollis together for over a quarter and the others, uterine didelphys, uterus bicornis bicollis and uterus septus/subseptus, for much smaller percentages. Each malformation is described and illustrated by typical hysterosalpingograms. In addition to its decisive importance in diagnosis, hysterosalpingography it also valuable in planning surgical correction in many cases.

Radiograph processing for quantitative assessment of bone remodelling.

Video-densitometric analysis has proved useful in the study of bone remodelling, however, for more efficient results, an investigation procedure that enables the comparison of X-rays is needed. In the present research an automated method has been developed which considerably speeds up the entire procedure through the implementation of specially designed C++ software. At present, a sequence of six X-rays can be analyzed in about 1 h irrespective of the number of areas to be investigated, which can be arbitrarily increased (200 or more). Analysis is fast as well as more reliable and accurate. In clinical practice, the results offer an effective support to observation on the biomechanical behaviour of bone implant systems.