Investigating the evolution of the technologies for collecting microplastics.

To stop the dispersion of microplastics in the ecosystem, many technologies for collecting them were designed, tested and developed in the last period. However, a complete and exhaustive comparison of these technologies to guide in the choice and/or in the development of the most suitable appropriate one is missing in the literature. This study investigates the presence of some known technological trends, deriving from the TRIZ (Russian acronym for "Theory of Inventive Problem Solving") in the behaviour (i.e. the operating principle) of these technologies. To do this, a systematic methodology was followed, which has a general value and consists in analysing the patents relating to these technologies through various bibliometric indexes (i.e. Innovation index, Emergence Score index, Independent Claims index and Technology Cycle Time index). In general, the obtained results did not reveal a clearly identifiable ranking of the behaviour which was unanimously confirmed by all the considered bibliometric indexes. In addition, the average of the scores of the different indexes associated with the different behaviours equalized their differences. However, these results are mainly due to the markedly different evaluations obtained by the Emergence Score index compared to those of the other indexes. From the comparison of the results with the evolutionary trends, it emerged that the operative zone reduction trend was the most confirmed, while the technical system dematerialization was the least confirmed by the bibliometric analysis of all the indexes. In particular, the ranking of the behaviours provided by the Innovation index best confirmed all the evolutionary trends, while that of the Emergence Score index was the worst. In conclusion, this study confirmed the adherence of the development that technologies for collecting microplastics are following to the evolutionary trends through bibliometric analysis: this sequence places magnetic technologies in first place, followed by chemical, fluid dynamics, dynamic mechanics and static mechanics. The analysis of the performances declared in the patents substantially confirms this result.

Bioptic intraprostatic chronic inflammation predicts adverse pathology at radical prostatectomy in patients with low-grade prostate cancer.

PURPOSE: To determine the potential role of bioptic inflammation (Irani score) in predicting adverse pathology (AP) at radical prostatectomy (RP) in patients with low-grade (ISUP Gleason Group [ISUP GG] 1 and 2) prostate cancer (CaP). METHODS: After institutional review board-approval, we identified patients who underwent prostate biopsy, had bioptic Irani score assessment, were diagnosed with low-grade CaP (ISUP GG 1-2, prostate-specific antigen [PSA] <20 ng/ml), and underwent RP. The impact of standard clinicopathological variables and bioptic Irani Score (G = grade and A = aggressiveness) on AP at RP, defined as stage ≥T3 and/or ISUP GG ≥3, was assessed by univariate and multivariate logistic regression analysis. RESULTS: A total of 282 patients were eligible for this study. AP at RP occurred in 37 of 214 (17.3%) patients with ISUP GG 1, and 26 of 68 (38.2%) with ISUP GG 2. At univariate analysis, serum PSA, PSA density, bioptic ISUP GG, number of positive cores, total percentage of core involvement and Irani G score emerged as significant risk factors of AP. At multivariate analysis, however, only PSA density, bioptic ISUP GG, total percentage of core, and Irani G score kept statistical significance. The area under the curve for the resulting model was 0.75. CONCLUSIONS: This is the first study demonstrating that low-grade inflammation is associated with a significantly increased risk of AP at RP. These findings would support the concept of prostatic inflammation being inversely correlated with presence and aggressiveness of CaP. Further studies are needed to externally validate the role of this readily available parameter in the decision-making process of patients with low-grade CaP.

Role of androgen receptor expression in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.

In order to evaluate the potential prognostic/predictive role of androgen receptor (AR) expression in non-muscle-invasive bladder cancer (NMIBC), and whether it may represent a therapeutic target, we conducted a systematic search of the literature using 'androgen receptor or AR', 'testosterone', 'bladder cancer' and 'non-muscle invasive bladder cancer or NMIBC' as keywords. Eleven studies met the inclusion/exclusion criteria. No significant association was found between AR status and patients' gender (p=0.232), tumor size (p=0.975), tumor stage (p=0.237), tumor grade (p=0.444), tumor multicentricity (p=0.397), concomitant CIS (p=0.316) and progression of disease (p=0.397). On the other hand, relative lack of AR expression was significantly correlated to recurrent disease (p=0.001). Evidence for a direct correlation between AR expression and recurrence-free survival of patients with NMIBC indicate ARs as potential markers of BC behavior; moreover, the finding of a role of androgen blockade therapy in improving survival highlights the potential clinical application of this pathway, which deserves to be further explored.

Diagnostic and prognostic roles of CK20 in the pathology of urothelial lesions. A systematic review.

Cytokeratin 20 (CK20) is one of the most common immunohistochemical markers in the routine practice of a pathology lab, as biopsies from the urinary tract encompass a wide spectrum of lesions which may pose issues in their detection and classification. In this review, we aim to outline the diagnostic accuracy and prognostic value of CK20 in flat urothelial lesions, papillary non-invasive and invasive urothelial carcinoma, molecular subgroups and variant histology, and we briefly discuss its limitations and potential pitfalls.

Prognostic and therapeutic role of HER2 expression in micropapillary carcinoma of the bladder.

Micropapillary carcinoma of the bladder (MPBC) is a variant type of infiltrating urothelial carcinoma, which portends a poor biological behavior in terms of disease stage at first diagnosis and clinical outcome; its peculiar morphology raises issues concerning the ability of tumor detection by imaging techniques and proper biopsy procedure, and the appropriate treatment for non-muscle infiltrating and muscle-infiltrating MPBC remains a matter of debate. On the basis of its established prognostic and therapeutic role in breast and gastro-esophageal cancer in the first instance, the human epidermal growth factor receptor-2 (HER2) has been investigated in selected case series of MPBC over the last 10 years. The aim of the present review was to summarize the existing evidence on HER2 status in MPBC, and to discuss its present and future utility in risk assessment and treatment choice of this uncommon, yet aggressive, disease.

Morphological and Immunohistochemical Biomarkers in Distinguishing Prostate Carcinoma and Urothelial Carcinoma: A Comprehensive Review.

The differential diagnosis between high-grade prostate carcinoma and infiltrating urothelial carcinoma (UC) in transurethral resection prostate specimens as well as cystoprostatectomy specimens may often be challenging due to morphologic and clinical overlap of the 2 entities. Such distinction has critical therapeutic and staging consequences, yet it is hampered by both issues in morphology and by the low accuracy rates of single immunohistochemical markers, as reported in literature. This review aims to provide a comprehensive analysis of the available morphological and immunohistochemical parameters, which may allow to discriminate between prostate carcinoma and urothelial carcinoma in the proper clinical context and to discuss their diagnostic applications in daily practice.

Human Epidermal Growth Factor Receptor 2 in Non-Muscle Invasive Bladder Cancer: Issues in Assessment Methods and Its Role as Prognostic/Predictive Marker and Putative Therapeutic Target: A Comprehensive Review.

Although human epidermal growth factor receptor 2 (HER2) plays a prognostic and predictive role in breast and gastric cancer, its function in bladder cancer (BC) is still controversial. A comprehensive review of the literature has been carried out. An electronic search of databases from PubMed, Scopus, Google Scholar was implemented. The search terms were: "BC," "bladder carcinoma," "bladder neoplasm," "human epidermal growth factor 2," "HER2," "HER-2," "c-erbB-2," "c-erbB2," "erbB-2," "erbB2," "neu," "marker," "biomarker," and "prognosis". Results of the review consented to (a) summarize the available data on HER2 a predictor of recurrence and/or progression free survival on univariate and multivariate analysis, (b) explore the related issues in assessing HER2 status on these tumor samples, since they may severely impair its predictive function, and (c) report the state-of-the art of HER2 as a putative therapeutic target in BC and especially non-muscle invasive BC. HER2 stands out for being a prognostic factor as well as a therapeutic target in various cancers. Data from the literature concerning its use in BC provide conflicting results, probably due to the inherent complexity of BC biology. Efforts should be made to establish a suitable tumor-specific scoring system, and to assess single drugs' efficacy in well-designed clinical trials.

Evaluation of the effectiveness and efficiency of the triage emergency department nursing protocol for the management of pain.

INTRODUCTION: Pain is a common symptom presented in the emergency department (ED) although it is often underestimated, poorly evaluated and treated. The application of a protocol for timely pain management ensured by the nurse can avoid the delays in the analgesic treatment and improve the patient's quality of waiting. AIMS: To check the effectiveness and efficiency of the protocol aimed at early pain management in triage, active in our ED. In particular, the response to analgesic treatment was evaluated 60 minutes after the administration and at discharge. Patient satisfaction was also evaluated using two anonymous questionnaires both at discharge and 48 hours later via telephone. METHODS: A single-center, observational study was conducted on a prospective cohort of patients (aged ≥4 years) with a pain symptom at admission in ED with no surgical picture. RESULTS: In the observation period (June 2015-May 2016), 382 patients were enrolled, and of these, 312 (84.8%) accepted pain therapy during triage stage in the ED. In 97.4% of the cases, orosoluble paracetamol 1000 mg was administered. In the re-evaluation done 60 minutes later, 65.9% of the patients showed a reduction of at least 2 points on Numeric Rating Scale (NRS), equal to a mean reduction of 2.24 points (95% CI: 2.03-2.45). The mean time of analgesia intake was equal to 5.9 minutes (95% CI: 3.8-8.1). In the re-evaluation done at discharge, 33.2% of the patients showed a reduction of NRS score >50%, leading to a mean reduction of 39% (95% CI: 35.3%-41.9%). The level of patient satisfaction was high with a mean value >9 points (maximum satisfaction =10). CONCLUSION: This protocol shows that optimal pain management was achieved by patients rapidly receiving an effective painkiller therapy at triage, leading to substantial patient satisfaction. In moderate pain, orosoluble paracetamol 1000 mg provided a reduction of NRS score by 2 points in 67.6% of the patients, confirming to be the analgesic of choice in ED.

¿Cuál es el nivel óptimo de presión espiratoria positiva (PEP) capaz de mejorar la tolerancia a la deambulación de los pacientes con enfermedad pulmonar obstructiva cronica (EPOC) grave? / Is there an optimal level of positive expiratory pressure (PEP) to improve walking tolerance in patients with severe COPD?

Introducción: La aplicación de dispositivos de presión espiratoria positiva (PEP) durante el ejercicio se había propuesto con el objetivo de contrarrestar la hiperinflación pulmonar, reducir la disnea y mejorar así la tolerancia al ejercicio de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) grave. En este ensayo controlado, aleatorizado y cruzado se investigó el efecto de dos niveles de PEP (1 cm de H2O y 10 cm de H2O) sobre la distancia recorrida por pacientes con EPOC grave durante la prueba de marcha de 6 min (PM6M). Los criterios de valoración secundarios fueron los efectos de la PEP sobre variables fisiológicas y de la función pulmonar. Métodos: Se reclutaron setenta y dos pacientes con EPOC grave, hospitalizados o ambulatorios, derivados a nuestros hospitales. El primer día de este estudio aleatorizado y cruzado se efectuó la PM6M sin ningún dispositivo, y posteriormente se repitió con una PEP de 1 cm de H2O (PEP1) y de 10 cm de H2O (PEP10). Antes y después de cada PM6M se practicaron espirometrías lentas y forzadas, que incluyeron la medición de la capacidad inspiratoria. Resultados: Cincuenta pacientes (edad media 69,92 años, FEV1 medio 41,42% del previsto) finalizaron el ensayo. La PM6M mejoró significativamente con los dos niveles de PEP, en comparación con la situación inicial (323,8 m al inicio vs. 337,8 con la PEP1 y 341,8 con la PEP10; p < 0,002 y p < 0,018, respectivamente). La diferencia entre la PEP10 y la PEP1 no fue significativa. No se observaron mejorías en la función pulmonar, los síntomas ni las variables fisiológicas posteriores a la prueba PM6 M. Conclusiones: En pacientes con EPOC grave, la aplicación de una PEP de 1 cm de H2O parece mejorar la tolerancia al ejercicio, al igual que lo hace la aplicación de 10 cm H2O y con un grado similar de disnea. Deben realizarse otros estudios para investigar los efectos de los niveles bajos de PEP en los programas de entrenamiento aeróbico

Background: The application of positive expiratory pressure (PEP) devices during exercise had been proposed in order to counteract the pulmonary hyperinflation, reduce the dyspnea and thus increase the exercise tolerance in patients with severe chronic obstructive pulmonary disease (COPD). This randomized controlled crossover trial investigated the effect of two different levels of PEP (1 cmH2O and 10 cmH2O) on distance covered at 6minute walk test (6MWT) in patients with severe COPD. Secondary outcomes were the evaluation of PEP effects on physiological and pulmonary function variables. Methods: Seventy-two severe COPD patients, referred to our hospitals as in and out patients, were recruited. A basal 6MWT without devices was performed on the first day, and then repeated with PEP 1 cmH2O (PEP1) and 10 cmH2O (PEP10), with a randomized crossover design. Slow and forced spirometries, including the inspiratory capacity measure, were repeated before and after each 6MWT. Results: 50 patients (average age 69,92 year, mean FEV1 41,42% of predicted) concluded the trial. The 6 MWT improved significantly among both PEP levels and baseline (323,8 mt at baseline vs. 337,8 PEP1 and 341,8 PEP10; p < .002 and p<.018, respectively). The difference between PEP10 and PEP1 did not reach the significance. No improvements were found in pulmonary function, symptoms and physiological variables after the 6MWT. Conclusions: In patients with severe COPD, the application of 1 cmH2O of PEP seems to improve the exercise tolerance as 10 cmH2O, with similar dyspnea. Further studies should investigate the effects of low levels of PEP on aerobic training programs

Is there an optimal level of positive expiratory pressure (PEP) to improve walking tolerance in patients with severe COPD? / ¿Cuál es el nivel óptimo de presión espiratoria positiva (PEP) capaz de mejorar la tolerancia a la deambulación de los pacientes con enfermedad pulmonar obstructiva cronica (EPOC) grave?

BACKGROUND: The application of positive expiratory pressure (PEP) devices during exercise had been proposed in order to counteract the pulmonary hyperinflation, reduce the dyspnea and thus increase the exercise tolerance in patients with severe chronic obstructive pulmonary disease (COPD). This randomized controlled crossover trial investigated the effect of two different levels of PEP (1 cmH2O and 10 cmH2O) on distance covered at 6minute walk test (6MWT) in patients with severe COPD. Secondary outcomes were the evaluation of PEP effects on physiological and pulmonary function variables. METHODS: Seventy-two severe COPD patients, referred to our hospitals as in and out patients, were recruited. A basal 6MWT without devices was performed on the first day, and then repeated with PEP 1 cmH2O (PEP1) and 10 cmH2O (PEP10), with a randomized crossover design. Slow and forced spirometries, including the inspiratory capacity measure, were repeated before and after each 6MWT. RESULTS: 50 patients (average age 69,92 year, mean FEV1 41,42% of predicted) concluded the trial. The 6MWT improved significantly among both PEP levels and baseline (323,8 mt at baseline vs. 337,8 PEP1 and 341,8 PEP10; p<.002 and p<.018, respectively). The difference between PEP10 and PEP1 did not reach the significance. No improvements were found in pulmonary function, symptoms and physiological variables after the 6MWT. CONCLUSIONS: In patients with severe COPD, the application of 1 cmH2O of PEP seems to improve the exercise tolerance as 10 cmH2O, with similar dyspnea. Further studies should investigate the effects of low levels of PEP on aerobic training programs.

A new patent-based approach for technology mapping in the pharmaceutical domain.

The key factor in decision-making is the quality of information collected and processed in the problem analysis. In most cases, patents represent a very important source of information. The main problem is how to extract such information from the huge corpus of documents with a high recall and precision, and in a short time. This article demonstrates a patent search and classification method, called Knowledge Organizing Module, which consists of creating, almost automatically, a pool of patents based on polysemy expansion and homonymy disambiguation. Since the pool is done, an automatic patent technology landscaping is provided for fixing the state of the art of our product, and exploring competing alternative treatments and/or possible technological opportunities. An exemplary case study is provided, it deals with a patent analysis in the field of verruca treatments.