Hepatitis C Epidemiology: Insights from a Comprehensive Cohort Study in ASST Melegnano and Martesana, Lombardia Region, Northern Italy.

Hepatitis C virus (HCV) infection is a significant public health problem affecting 58 million people worldwide, including 3.9 million in Europe. Many of these infections go undiagnosed because chronic infection is often asymptomatic. This observational cohort study presents a detailed examination of hepatitis C virus epidemiology in Lombardia (Italy) and was conducted within the ASST "Melegnano e della Martesana". The study involved comprehensive HCV screening of 3290 patients accessing the collection points and/or hospitalized in the facilities of the ASST from 20 May 2022 to 13 April 2023. Screening was conducted using serological assays. The prevalence of anti-HCV-positive patients (HCV-Ab) and then HCV-positive patients (RNA) was calculated. Chi-square tests examined the associations between continuous and categorical variables. Logistic regression was used to evaluate the influence of demographic and geographic variables as predictors of HCV positivity. The study revealed an overall HCV-Ab prevalence of 0.912% (CI (0.59-1.24%)) in the examined cohort, of whom 15.15% (two females and three males) were positive for HCV RNA. The prevalence of HCV RNA positivity was 0.152% (CI (0.05-0.35%)). Sex disparity was evident, with male patients exhibiting a higher prevalence compared to females, confirmed by logistic regression (0.0147 vs. 0.0061-OR = 2.44; CI (0.0059-0.0124)). Age stratification indicated an ascending trend in prevalence with age, peaking at 1.35% in individuals aged over 50. These findings underscore the critical need for targeted HCV screening, contributing valuable insights to the global epidemiology of HCV in the era of DAAs.

Beyond the Gut: A Systematic Review of Oral Manifestations in Celiac Disease.

BACKGROUND: Celiac disease (CD) is a chronic immune-mediated gluten-sensitive enteropathy, affecting about 1% of the population. The most common symptoms include diarrhea, abdominal pain, weight loss, and malabsorption. Extra-intestinal symptoms include oral manifestations. This systematic review aims to catalog and characterize oral manifestations in patients with CD. METHODS: a systematic literature review among different search engines using PICOS criteria has been performed. The studies included used the following criteria: tissues and anatomical structures of the oral cavity in humans, published in English and available in full text. Review articles and papers published before 1990 were excluded. RESULTS: 209 articles were identified in the initial search. In the end, 33 articles met the selection criteria. The information extracted from the articles was classified based on the type of oral manifestation. Recurrent aphthous stomatitis (34.6%), atrophic glossitis and geographic tongue (15.26%), enamel defects (42.47%), delayed dental eruption (47.34%), xerostomia (38.05%), glossodynia (14.38%), and other manifestations including cheilitis, fissured tongue, periodontal diseases, and oral lichen planus were found in the celiac subjects of the studies analyzed. The quality of articles on the topic should be improved; however, oral manifestations in CD patients are widely described in the literature and could help diagnose celiac disease.

Occupational COVID-19 risk to dental staff working in a public dental unit in the outbreak epicenter.

OBJECTIVE: The management of the COVID-19 outbreak occurred in Lombardy (Italy) implied that non-COVID-19 health care was remodeled, limiting adequate resources in non-hospital public dental healthcare settings. This situation offered the opportunity to investigate the occupational COVID-19 risk to dental staff in public non-hospital dental units. METHODS: An infection control protocol was designed for dental health care in the Territorial Health and Social Services Authority (ASST) "Melegnano and Martesana" (Milan). Since specific guidance from central authorities was lacking, information was gathered from international public health organizations. The probability to visit asymptomatic COVID-19-infected patients was estimated, and the occupational risk to dental staff was calculated. RESULTS: The probability to visit asymptomatic patients passed from 1.2% (95% confidence interval -95 CI, 0.6%-2.5%) in the first period (20 February-15 March 2020) to 11.1% (95 CI, 5.8%-23.6%) in the second period (16 March-30 April). Dentists and dental assistants did not develop COVID-19, while one nurse did, the nature of her occupational risk was unclear, as nurses provided prevalently non-dental health care. The probabilities of developing COVID-19 per worked hour per person excluding and including this uncertain situation were 0.0% (95 CI, 0.0%-3.2%) and 0.9% (95 CI, 0.1%-4.7%). CONCLUSION: Relatively simple infection control procedures were enough to control occupational COVID-19 risk during the outbreak.

Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals.

Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.

Choline Hydrogen Dicarboxylate Ionic Liquids by X-ray Scattering, Vibrational Spectroscopy and Molecular Dynamics: H-Fumarate and H-Maleate and Their Conformations.

We explore the structure of two ionic liquids based on the choline cation and the monoanion of the maleic acid. We consider two isomers of the anion (H-maleate, the cis-isomer and H-fumarate, the trans-isomer) having different physical chemical properties. H-maleate assumes a closed structure and forms a strong intramolecular hydrogen bond whereas H-fumarate has an open structure. X-ray diffraction, infrared and Raman spectroscopy and molecular dynamics have been used to provide a reliable picture of the interactions which characterize the structure of the fluids. All calculations indicate that the choline cation prefers to connect mainly to the carboxylate group through OH⋯O interactions in both the compounds and orient the charged head N(CH3)3+ toward the negative portion of the anion. However, the different structure of the two anions affects the distribution of the ionic components in the fluid. The trans conformation of H-fumarate allows further interactions between anions through COOH and CO2- groups whereas intramolecular hydrogen bonding in H-maleate prevents this association. Our theoretical findings have been validated by comparing them with experimental X-ray data and infrared and Raman spectra.

Exciton-phonon coupling and power dependent room temperature photoluminescence of sulphur vacancy doped MoS2via controlled thermal annealing.

Via experiments performed by varying the doping level of single-layer mechanically exfoliated MoS2via post exfoliation thermal annealing in the 200-300 °C temperature range, we study the power dependent room temperature (RT) photoluminescence (PL), which is dominated by A type excitons. The PL spectral yields of the as-exfoliated and annealed samples show sub-linear behaviour as a function of the excitation laser power. The PL signal of the 200 °C annealed sample is dominated by the charged exciton (trion) related peak, while the PL signal of the 300 °C annealed sample is dominated by the neutral exciton related peak, and the PL spectral weight of excitons is tunable in this temperature range. The PL signal increase due to annealing and the intensity ratio of the A type excitons are related, showing a hyperbolic tangent trend. We directly quantitatively demonstrate the one-to-one correlation of the RT resonant Raman (632.8 nm) integrated spectral intensity with the corresponding PL spectral yield, providing experimental evidence of the exciton-phonon coupling effect. The in-plane E2g1 Raman mode exhibits strong coupling with A excitons, while the out-of-plane A1g Raman mode does not. This is an indication of the in-plane spatial symmetry of the A excitons.

Model for Taking Care of Patients with Early Childhood Caries during the SARS-Cov-2 Pandemic.

Pending the availability of vaccines to contain the SARS-CoV-2 pandemic, the current solution is "social distancing" with a reduction of dental treatments to those assessed as urgent and emergency cases. These treatments also involve Early Childhood Caries (ECC) due to the fact that this disease affects preschool children (a vulnerable population) and, in addition, shows a propensity to evolve into more serious complications (dental pain, infections). A narrative review was carried out to support a protocol for treating ECC with efficacious and safe (in terms of SARS-CoV-2 transmission) procedures. Protocol involves criteria for patients' selection remotely (telemedicine), and well-detailed criteria/equipment and hygiene procedures to combat against SARS-CoV-2 transmission. Moreover, the protocol proposes innovative caries treatments, named Minimally Invasive Treatments (MITs), well known in pedodontics for their high level of children's acceptance during dental care. MITs allow for caries removal (particularly in primary teeth) without any high-speed rotating instrument cooled with nebulized air-water spray (with high risk of virus environmental diffusion), usually adopted during traditional treatments. For evaluating MITs effectiveness in caries management, only Systematic Review and Randomized Controlled Trials (RCTs) were included in our study, without any risk of bias assessment. The indications proposed in this protocol could support clinicians for the temporary management of ECC until the SARS-CoV-2 pandemic ends.

Sustainable Liquid-Phase Exfoliation of Layered Materials with Nontoxic Polarclean Solvent.

Liquid-phase exfoliation is the most suitable platform for large-scale production of two-dimensional materials. One of the main open challenges is related to the quest of green and bioderived solvents to replace state-of-the-art dispersion media, which suffer several toxicity issues. Here, we demonstrate the suitability of methyl-5-(dimethylamino)-2-methyl-5-oxopentanoate (Rhodiasolv Polarclean) for sonication-assisted liquid-phase exfoliation of layered materials for the case-study examples of WS2, MoS2, and graphene. We performed a direct comparison, in the same processing conditions, with liquid-phase exfoliation using N-methyl-2-pyrrolidone (NMP) solvent. The amount of few-layer flakes (with thickness <5 nm) obtained with Polarclean is increased by ∼350% with respect to the case of liquid-phase exfoliation using NMP, maintaining comparable values of the average lateral size, which even reaches ∼10 µm for the case of graphene produced by exfoliation in Polarclean, and of the yield (∼40%). Correspondingly, the density of defects is reduced by 1 order of magnitude by Polarclean-assisted exfoliation, as evidenced by the I(D)/I(G) ratio in Raman spectra of graphene as low as 0.07 ± 0.01. Considering the various advantages of Polarclean over state-of-the-art solvents, including the absence of toxicity and its biodegradability, the validation of superior performances of Polarclean in liquid-phase exfoliation paves the way for sustainable large-scale production of nanosheets of layered materials and for extending their use in application fields to date inhibited by toxicity of solvents (e.g., agri-food industry and desalination), with a subsequent superb impact on the commercial potential of their technological applications.

Italian guidelines for the prevention and management of dental trauma in children.

Dental trauma is a frequent occurrence in children and adolescent and a correct diagnosis and treatment are essential for a favourable long-term prognosis. The present Guidelines aim to formulate evidence-based recommendations to assist dentists, paediatricians, surgeons, teachers, school and sport staff, parents in the prevention and first aid of dental trauma in children and to provide a careful assessment of the medico-legal implications, reviewing the first draft of the guidelines published in 2012. A multidisciplinary panel on the behalf of the Italian Ministry of Health and in collaboration with the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan, developed this document. The following four queries were postulated: 1) Which kind of precautions the health personnel, parents, sports and educational personnel must activate in order to prevent the dental trauma damage? 2) How an orofacial trauma in paediatric patients should be managed either in the Emergency Care Unit and/or in private dental office? 3) What criteria should be adopted by a dentist private practitioner to fill in a certificate in cases of dental and/or tempomandibular joint trauma occurring in children and adolescents? 4) What are the elements that should lead clinicians to suspect a non-accidental dental trauma? A systematic review and analysis of the scientific literature published in English, Italian and French from 2007 to 2017 regarding dental trauma in children and adolescents aged 0-18 years was performed, and about 100 papers were analysed and included. The following four domains were analysed and discussed: Dental Trauma Prevention Strategies and Health Education, First aid in orofacial and dental trauma, Certificate of the dental trauma, Oral and dental signs of child abuse and neglect. Twenty-eight recommendations were draw up and codified by the panel according to the Methodological handbook, produced by the Istituto Superiore di Sanità, in order to guide physicians in the prevention and first aid of dental trauma in children and adolescents. In addition, a careful assessment of the medico-legal implications is reported in this document.

Bias Tunable Photocurrent in Metal-Insulator-Semiconductor Heterostructures with Photoresponse Enhanced by Carbon Nanotubes.

Metal-insulator-semiconductor-insulator-metal (MISIM) heterostructures, with rectifying current-voltage characteristics and photosensitivity in the visible and near-infrared spectra, are fabricated and studied. It is shown that the photocurrent can be enhanced by adding a multi-walled carbon nanotube film in the contact region to achieve a responsivity higher than 100   mA   W - 1 under incandescent light of 0.1   mW   cm - 2 . The optoelectrical characteristics of the MISIM heterostructures are investigated at lower and higher biases and are explained by a band model based on two asymmetric back-to-back Schottky barriers. The forward current of the heterojunctions is due to majority-carrier injection over the lower barrier, while the reverse current exhibits two different conduction regimes corresponding to the diffusion of thermal/photo generated carriers and majority-carrier tunneling through the higher Schottky barrier. The two conduction regimes in reverse bias generate two plateaus, over which the photocurrent increases linearly with the light intensity that endows the detector with bias-controlled photocurrent.

Two-Step Exfoliation of WS2 for NO2, H2 and Humidity Sensing Applications.

WS2 exfoliated by a combined ball milling and sonication technique to produce few-layer WS2 is characterized and assembled as chemo-resistive NO2, H2 and humidity sensors. Microstructural analyses reveal flakes with average dimensions of 110 nm, "aspect ratio" of lateral dimension to the thickness of 27. Due to spontaneous oxidation of exfoliated WS2 to amorphous WO3, films have been pre-annealed at 180 °C to stabilize WO3 content at ≈58%, as determined by X-ray Photoelectron Spectroscopy (XPS), Raman and grazing incidence X-ray Diffraction (XRD) techniques. Microstructural analysis repeated after one-year conditioning highlighted that amorphous WO3 concentration is stable, attesting the validity of the pre-annealing procedure. WS2 films were NO2, H2 and humidity tested at 150 °C operating Temperature (OT), exhibiting experimental detection limits of 200 ppb and 5 ppm to NO2 and H2 in dry air, respectively. Long-term stability of the electrical response recorded over one year of sustained conditions at 150 °C OT and different gases demonstrated good reproducibility of the electrical signal. The role played by WO3 and WS2 upon gas response has been addressed and a likely reaction gas-mechanism presented. Controlling the microstructure and surface oxidation of exfoliated Transition Metal Dichalcogenides (TMDs) represents a stepping-stone to assess the reproducibility and long-term response of TMDs monolayers in gas sensing applications.

Damping of vibrational excitations in glasses at terahertz frequency: The case of 3-methylpentane.

We report a compared analysis of inelastic X ray scattering (IXS) and of low frequency Raman data of glassy 3-methylpentane. The IXS spectra have been analysed allowing for the existence of two distinct excitations at each scattering wavevector obtaining a consistent interpretation of the spectra. In particular, this procedure allows us to interpret the linewidth of the modes in terms of a simple model which relates them to the width of the first sharp diffraction peak in the static structure factor. In this model, the width of the modes arises from the blurring of the dispersion curves which increases approaching the boundary of the first pseudo-Brillouin zone. The position of the boson peak contribution to the density of vibrational states derived from the Raman scattering measurements is in agreement with the interpretation of the two excitations in terms of a longitudinal mode and a transverse mode, the latter being a result of the mixed character of the transverse modes away from the center of the pseudo-Brillouin zone.

Vibrations of bioionic liquids by ab initio molecular dynamics and vibrational spectroscopy.

Density functional theory and vibrational spectroscopy are used to investigate a class of bioionic liquids consisting of a choline cation and carboxylate anions. Through quantum mechanical studies of motionless ion pairs and molecular dynamics of small portions of the liquid, we have characterized important structural features of the ionic liquid. Hydrogen bonding produces stable ion pairs in the liquid and induces vibrational features of the carboxylate groups comparable with experimental results. Infrared and Raman spectra of liquids have been measured, and main bands have been assigned on the basis of theoretical spectra.