Bilateral Tapia syndrome in teenager with post traumatic Hangman's fracture and carotid artery dissection.

Background: Tapia syndrome (TS) is a rare condition characterized by unilateral hypoglossal and recurrent laryngeal nerve palsy, leading to tongue deviation, swallowing difficulty and dysphonia. Case report: We describe a case of a 17-year-old boy who reported a bilateral TS following head and neck trauma with Hangman's fracture and right common carotid artery dissection. The confirmation occurred only after complete cognitive and motor recovery, verifying the inability to protrude the tongue and swallow, associated with complete paralysis of the vocal cords, diagnosed with fiber optic laryngoscopy.An initial recovery of tongue motility and phonation occurred after just over a month of rehabilitation. Conclusion: In addition to the lack of awareness due to the rarity of the syndrome, the diagnosis of TS may be delayed in patients who are unconscious or who have slow cognitive recovery following head trauma. The case we present may help to increase awareness and avoid unnecessary diagnostic investigations.

Bio-Composite Filaments Based on Poly(Lactic Acid) and Cocoa Bean Shell Waste for Fused Filament Fabrication (FFF): Production, Characterization and 3D Printing.

In this study, novel biocomposite filaments incorporating cocoa bean shell waste (CBSW) and poly(lactic acid) (PLA) were formulated for application in Fused Filament Fabrication (FFF) technology. CBSW, obtained from discarded chocolate processing remnants, was blended with PLA at concentrations of 5 and 10 wt.% to address the challenge of waste material disposal while offering eco-friendly composite biofilaments for FFF, thereby promoting resource conservation and supporting circular economy initiatives. A comprehensive analysis encompassing structural, morphological, thermal, and mechanical assessments of both raw materials and resultant products (filaments and 3D printed bars) was conducted. The findings reveal the presence of filler aggregates only in high concentrations of CBSW. However, no significant morphological or thermal changes were observed at either CBSW concentration (5 wt.% and 10 wt.%) and satisfactory printability was achieved. In addition, tensile tests on the 3D printed objects showed improved stiffness and load resistance in these samples at the highest CBSW concentrations. In addition, to demonstrate their practical application, several 3D prototypes (chocolate-shaped objects) were printed for presentation in the company's shop window as a chocolate alternative; while retaining the sensory properties of the original cocoa, the mechanical properties were improved compared to the base raw material. Future research will focus on evaluating indicators relevant to the preservation of the biocomposite's sensory properties and longevity.

Cytomegalovirus Pneumonia in a Patient with Down Syndrome.

Down syndrome (DS) is a chromosomal disorder due to the presence of an additional chromosome 21 that causes intellectual deficit and physical anomalies and predisposes patients to develop infections throughout their lives. Pneumonias are more serious in patients with DS, requiring hospitalization, and they represent an important cause of mortality in this population. Cytomegalovirus (CMV) causes widespread and serious infections in immunocompromised individuals, affecting the respiratory tract and, when causing interstitial pneumonia, associated with a high mortality rate. However, CMV-induced pneumonia is not reported in DS patients. The prevalence and severity of CMV respiratory infections in subjects with DS is unknown. This case describes a 50-year-old female patient with DS who developed extensive bilateral pneumonia with severe respiratory failure which required hospitalization in intensive care, intubation, and mechanical ventilation after approximately 10 days of empiric antibiotic and anitimycotic therapy for fever, cough, and dyspnea. The patient was diagnosed with CMV pneumonia and recovered after treatment with ganciclovir. To the best of our knowledge, this is the first reported case of CMV pneumonia in a patient with DS. This case aims to highlight that CMV pneumonia in individuals with DS can be a life-threatening condition. It also clarifies the importance of early diagnosis of infections from opportunistic pathogens such as CMV to ensure timely and efficient treatment.

Current practices for nutritional evaluation and care during the treatment of pediatric oncology patients: a survey among AIEOP centers.

Nutritional status plays a crucial role in the mortality rates of the pediatric oncology patients. However, there is a lack of systematic approaches for nutritional assessment in this population. This study aims to assess the current practice for nutritional assessment and care of pediatric cancer patients in Italy. A 25-items web-based, nation-wide questionnaire was circulated as of January 9, 2023 among physicians within the AIEOP network, composed of 49 national centers, out of which 21 routinely perform HCT. This survey examined the practices of 21 Italian pediatric oncology centers, revealing significant heterogeneity in nutritional practices. Only half of the centers routinely assessed all patients, utilizing different clinical and biochemical parameters. The use of neutropenic diets remained prevalent after chemotherapy or stem cell transplantation. CONCLUSION: This study underscores the pressing need for unified recommendations to improve nutritional care and potentially enhance outcomes for pediatric cancer patients. WHAT IS KNOWN: • The assessment and support of nutrition are gaining interest in the overall care of children with cancer. • The assessment and management of nutritional needs in pediatric cancer patients, including those undergoing hematopoietic cell transplantation, currently lack a systematic approach. WHAT IS NEW: • There is considerable variability in the nutritional assessment and support among Italian centers treating pediatric patients with cancer. • To enhance nutritional assessment and support for pediatric cancer patients, it is essential to establish shared national and international guidelines.

Poly-Lactic Acid-Bagasse Based Bio-Composite for Additive Manufacturing.

Beer bagasse is a residue waste produced in great amounts; nevertheless, it is still underestimated in the industry. The aim of this paper is to develop an innovative and efficient methodology to recycle the beer bagasse by producing Poly-lactic acid(PLA)-based bio-composites, in the forms of pellets and filaments, to be used in additive manufacturing processes. To assess the suitability of beer bagasse for extrusion-based 3D printing techniques, it was, firstly, physically and chemically characterized. Then, it was added in combination with different kinds of plasticizers to PLA to make bio-composites, analyzing their thermal and physical properties. The results prove the great potential of bagasse, evidencing its printability. Both composites' pellets and filaments were used in two different 3D printing machines and the mechanical properties of the 3D-printed models were evaluated as a function of the composition and the kind of technology used. All the used plasticizers improved processability and the polymer-bagasse interface. Compared to neat PLA, no changes in thermal properties were detected, but a lowering of the mechanical properties of the 3D-printed composites compared to the neat polymers was observed. Finally, a comparison between the efficiency of the two 3D printing techniques to be used with the bio-based composites was performed.

Fused Filament Fabrication and Computer Numerical Control Milling in Cultural Heritage Conservation.

This paper reports a comparison between the advantages and disadvantages of fused filament fabrication (FFF) and computer numerical control (CNC) milling, when applied to a specific case of conservation of cultural heritage: the reproduction of four missing columns of a 17th-century tabernacle. To make the replica prototypes, European pine wood (the original material) was used for CNC milling, while polyethylene terephthalate glycol (PETG) was used for FFF printing. Neat materials were chemically and structurally characterized (FTIR, XRD, DSC, contact angle measurement, colorimetry, and bending tests) before and after artificial aging, in order to study their durability. The comparison showed that although both materials are subject to a decrease in crystallinity (an increase in amorphous bands in XRD diffractograms) and mechanical performance with aging, these characteristics are less evident in PETG (E = 1.13 ± 0.01 GPa and σ = 60.20 ± 2.11 MPa after aging), which retains water repellent (ca = 95.96 ± 5.56°) and colorimetric (∆E = 2.6) properties. Furthermore, the increase in flexural strain (%) in pine wood, from 3.71 ± 0.03% to 4.11 ± 0.02%, makes it not suitable for purpose. Both techniques were then used to produce the same column, showing that for this specific application CNC milling is quicker than FFF, but, at the same time, it is also much more expensive and produces a huge amount of waste material compared to FFF printing. Based on these results, it was assessed that FFF is more suitable for the replication of the specific column. For this reason, only the 3D-printed PETG column was used for the subsequent conservative restoration.

From Virtual Reconstruction to Additive Manufacturing: Application of Advanced Technologies for the Integration of a 17th-Century Wooden Ciborium.

3D modelling and 3D printing techniques have become increasingly popular in different fields, including cultural heritage. In this field, there are still many challenges to overcome, such as the difficulty of faithfully reproducing complex geometries or finding materials suitable for restoration, due to the limited scientific studies. This work proposes an example of the application of advanced technologies for the reproduction of four missing columns of a 17th century polychrome wooden ciborium. The difficulties of an automatic scan due to its reflective surface (water gilding and estofado decorations) were overcome by creating a 2D manual survey and a subsequent manual 3D redrawing. The CAD model was used to print the missing elements with fused filament fabrication (FFF) in polyethylene terephthalate glycol (PETG), using the following printing parameters: nozzle 0.4 mm, infill 20%, extrusion temperature of PLA 200 °C and of PETG 220 °C, plate temperature 50 °C, printing speed 60 mm/s, layer height 0.2 mm. The conservation and restoration of the ciborium is nearing completion. This study highlights the importance of collaboration between different professionals for the correct design of a restoration, as well as the need to promote scientific research into the development of new high-performance 3D printing materials suitable for conservation.

Sustainable Polymer Composites Manufacturing through 3D Printing Technologies by Using Recycled Polymer and Filler.

In the last years, the excessive use of plastic and other synthetic materials, that are generally difficult to dispose of, has caused growing ecological worries. These are contributing to redirecting the world's attention to sustainable materials and a circular economy (CE) approach using recycling routes. In this work, bio-filaments for the Fused Filament Fabrication (FFF) 3D printing technique were produced from recycled polylactic acid (PLA) and artisanal ceramic waste by an extrusion process and fully characterized from a physical, thermal, and mechanical point of view. The data showed different morphological, thermal, rheological, and mechanical properties of the two produced filaments. Furthermore, the 3D objects produced from the 100% recycled PLA filament showed lower mechanical performance. However, the results have demonstrated that all the produced filaments can be used in a low-cost FFF commercial printer that has been modified with simple hand-made operations in order to produce 3D-printed models. The main objective of this work is to propose an example of easy and low-cost application of 3D printing that involves operations such as the reprocessing and the recyclability of materials, that are also not perfectly mechanically performing but can still provide environmental and economic benefits.

Historically Accurate Reconstruction of the Materials and Conservation Technologies Used on the Facades of the Artistic Buildings in Lecce (Apulia, Italy).

The protection of the stone surfaces of the buildings of the city of Lecce (Apulia, Italy) represents an ancient practice, which has always allowed the conservation of the historical-artistic heritage of the city, which nowadays is an international touristic and cultural destination. The identification of ancient recipes, materials and methodologies for the protection of historical buildings plays an important role in establishing correct protocols in order to ensure the durability of stone surfaces over time. This work presents a historically accurate reconstruction of the materials and conservation technologies used on the facades of the artistic buildings in Lecce. Several historical buildings, both civil and religious, have been selected in order to investigate the treatments applied on their facades and to know the traditions spread in the past in the field of building conservation in the Salento territory. Thanks to non-invasive or micro-destructive techniques (optical microscopy, ATR-FTIR spectroscopy, pyrolysis-gas chromatography-mass spectrometry), the characteristic molecular markers of the materials and the products of degradation have been identified, deepening the knowledge of the mechanisms of deterioration and interaction between the stone material, the surface finish and the surrounding environment. The paper is a valuable tool for the knowledge of ancient traditions and the planning of proper restoration works.

A Review of Polymer-Based Materials for Fused Filament Fabrication (FFF): Focus on Sustainability and Recycled Materials.

Recently, Fused Filament Fabrication (FFF), one of the most encouraging additive manufacturing (AM) techniques, has fascinated great attention. Although FFF is growing into a manufacturing device with considerable technological and material innovations, there still is a challenge to convert FFF-printed prototypes into functional objects for industrial applications. Polymer components manufactured by FFF process possess, in fact, low and anisotropic mechanical properties, compared to the same parts, obtained by using traditional building methods. The poor mechanical properties of the FFF-printed objects could be attributed to the weak interlayer bond interface that develops during the layer deposition process and to the commercial thermoplastic materials used. In order to increase the final properties of the 3D printed models, several polymer-based composites and nanocomposites have been proposed for FFF process. However, even if the mechanical properties greatly increase, these materials are not all biodegradable. Consequently, their waste disposal represents an important issue that needs an urgent solution. Several scientific researchers have therefore moved towards the development of natural or recyclable materials for FFF techniques. This review details current progress on innovative green materials for FFF, referring to all kinds of possible industrial applications, and in particular to the field of Cultural Heritage.

Evolution of anthropometric data and quality of life in active bariatric individuals.

OBJECTIVE: Obesity is a disease characterized by the accumulation of abnormal or excessive fat that can damage health. Bariatric surgery, an effective and safe way to treat this disease, requires multidisciplinary monitoring with an educational nature to change lifestyle. Adherence to routine physical activity can be a part of adopting a healthier lifestyle and can assist in the treatment of this disease and its related comorbidities. Thus, the aim of this study was to analyze the correlation between the evolution of anthropometric variables and the domains of quality of life at different times, including at one year after bariatric surgery in very active and irregularly active individuals. METHODS: This was a longitudinal, observational, prospective, and analytical study. The collected data included anamnesis, level of physical activity (International Physical Activity Questionnaire Short Form), height, weight, body mass index (BMI), average waist circumference, percentage of fat, and the World Health Organization Quality of Life Assessment Bref. RESULTS: Seven female individuals were evaluated and divided into two groups: a very active group and an irregularly active group. In the very active individuals, significant results were found in the evolutionary variables: weight (p<0.001); body mass index (p<0.001); average waist circumference (p<0.001); percentage of fat (p<0.001); and quality of life general (p=0.001). In the irregularly active individuals, a significant result was found only in one evolutionary variable: body mass index (p<0.001). CONCLUSION: Thus, it is evident that the improvement and maintenance of good health is more effective in bariatric individuals who maintain a routine with regular physical activity.

Evolution of anthropometric data and quality of life in active bariatric individuals

SUMMARY Obesity is a disease characterized by the accumulation of abnormal or excessive fat that can damage health. Bariatric surgery, an effective and safe way to treat this disease, requires multidisciplinary monitoring with an educational nature to change lifestyle. Adherence to routine physical activity can be a part of adopting a healthier lifestyle and can assist in the treatment of this disease and its related comorbidities. OBJECTIVE: Thus, the aim of this study was to analyze the correlation between the evolution of anthropometric variables and the domains of quality of life at different times, including at one year after bariatric surgery in very active and irregularly active individuals. METHODS: This was a longitudinal, observational, prospective, and analytical study. The collected data included anamnesis, level of physical activity (International Physical Activity Questionnaire Short Form), height, weight, body mass index (BMI), average waist circumference, percentage of fat, and the World Health Organization Quality of Life Assessment Bref. RESULTS: Seven female individuals were evaluated and divided into two groups: a very active group and an irregularly active group. In the very active individuals, significant results were found in the evolutionary variables: weight (p<0.001); body mass index (p<0.001); average waist circumference (p<0.001); percentage of fat (p<0.001); and quality of life general (p=0.001). In the irregularly active individuals, a significant result was found only in one evolutionary variable: body mass index (p<0.001). CONCLUSION: Thus, it is evident that the improvement and maintenance of good health is more effective in bariatric individuals who maintain a routine with regular physical activity.

Infantile Brain Tumors: A Review of Literature and Future Perspectives.

Brain tumors in infants including those diagnosed in fetal age, newborns and under a year old represent less than 10% of pediatric nervous system tumors and present differently when compared with older children in terms of clinical traits, location and histology. The most frequent clinical finding is a macrocephaly but non-specific symptoms can also be associated. The prognosis is usually poor and depends on several factors. Surgery continues to be the main option in terms of therapeutic strategies whereas the role of chemotherapy is not yet well defined and radiotherapy is exceptionally undertaken. In view of this situation, a molecular characterization could assist in providing therapeutic options for these tumors. This review highlights the recent advances in the diagnosis and treatment of brain tumors in infants with a particular focus on the molecular landscape and future clinical applications.

Two new missense mutations in the protein interaction ASH domain of OCRL1 identified in patients with Lowe syndrome.

The oculocerebrorenal syndrome of Lowe is a rare X-linked disease characterized by congenital cataracts, proximal renal tubulopathy, muscular hypotonia and mental impairment. This disease is caused by mutations in the OCRL gene encoding membrane bound inositol polyphosphate 5-phosphatase OCRL1. Here, we examined the OCRL gene of two Lowe syndrome patients and report two new missense mutations that affect the ASH domain involved in protein-protein interactions. Genomic DNA was extracted from peripheral blood of two non-related patients and their relatives. Exons and flanking intronic regions of OCRL were analyzed by direct sequencing. Several bioinformatics tools were used to assess the pathogenicity of the variants. The three-dimensional structure of wild-type and mutant ASH domains was modeled using the online server SWISS-MODEL. Clinical features suggesting the diagnosis of Lowe syndrome were observed in both patients. Genetic analysis revealed two novel missense variants, c.1907T>A (p.V636E) and c.1979A>C (p.H660P) in exon 18 of the OCRL gene confirming the clinical diagnosis in both cases. Variant c.1907T>A (p.V636E) was inherited from the patient's mother, while variant c.1979A>C (p.H660P) seems to have originated de novo. Analysis with bioinformatics tools indicated that both variants are pathogenic. Both amino acid changes affect the structure of the OCRL1 ASH domain. In conclusion, the identification of two novel missense mutations located in the OCRL1 ASH domain may shed more light on the functional importance of this domain. We suggest that p.V636E and p.H660P cause Lowe syndrome by disrupting the interaction of OCRL1 with other proteins or by impairing protein stability.

An Innovative Method for the Recycling of Waste Carbohydrate-Based Flours.

This work represents an innovative study that, for the first time, explores the possibility to use waste flours to produce thermoplastic polymeric bio-films. To the best of our knowledge, this is the first time that waste flours, derived from bakeries, pizzerias or pasta factories, have been proposed for the production of bio-polymers, as a replacement of neat starch. To this aim, durum waste flour derived from a pasta factory, soft waste flour derived from pizzerias and neat maize starch used as control material were firstly analyzed from dimensional, morphological and chemical points of view. Afterwards, waste flour films were produced by the addition of a nature-based plasticizer, glycerol. Mechanical characterization of the plasticized thermoplastic films, produced by compression molding, evidenced low performances, even in the case of the neat maize starch. In order to improve the mechanical properties, the possibility to include polylactic acid and cardanol-based plasticizer was also investigated. Mass transport properties of all the produced bio-films were investigated by measuring their water vapor permeability and hygroscopic absorption. The durability properties of the bio-films were assessed by accelerated ageing tests, while the bio-degradability of the waste-based films was evaluated by measuring the solubility and the degradation in water. The physicochemical analyses of the novel bio-films evidenced good mechanical properties; specifically, the waste-based films showed a lower hygroscopic absorption and water solubility than those of the blends containing neat starch.

Characterization of two Pantoea strains isolated from extra-virgin olive oil.

The olive oil is an unfavorable substrate for microbial survival and growth. Only few microorganisms use olive oil fatty acids as carbon and energy sources, and survive in the presence of olive oil anti-microbial components. In this study, we have evaluated the occurrence of microorganisms in 1-year-stored extra-virgin olive oil samples. We detected the presence of bacterial and yeast species with a recurrence of the bacterium Stenotrophomonas rhizophila and yeast Sporobolomyces roseus. We then assayed the ability of all isolates to grow in a mineral medium supplemented with a commercial extra-virgin olive oil as a sole carbon and energy source, and analyzed the utilization of olive oil fatty acids during their growth. We finally focused on two bacterial isolates belonging to the species Pantoea septica. Both these isolates produce carotenoids, and one of them synthesizes bioemulsifiers enabling the bacteria to better survive/growth in this unfavorable substrate. Analyses point to a mixture of glycolipids with glucose, galactose and xylose as carbohydrate moieties whereas the lipid domain was constituted by C6-C10 ß-hydroxy carboxylic acids.

Pirin: A novel redox-sensitive modulator of primary and secondary metabolism in Streptomyces.

Pirins are evolutionarily conserved iron-containing proteins that are found in all kingdoms of life, and have been implicated in diverse molecular processes, mostly associated with cellular stress. In the present study, we started from the evidence that the insertional inactivation of pirin-like gene SAM23877_RS18305 (pirA) by ΦC31 Att/Int system-based vectors in spiramycin-producing strain Streptomyces ambofaciens ATCC 23877 resulted in marked effects on central carbon and energy metabolism gene expression, high sensitivity to oxidative injury and repression of polyketide antibiotic production. By using integrated transcriptomic, proteomic and metabolite profiling, together with genetic complementation, we here show that most of these effects could be traced to the inability of the pirA-defective strain to modulate beta-oxidation pathway, leading to an unbalanced supply of precursor monomers for polyketide biosynthesis. Indeed, in silico protein-protein interaction modeling and in vitro experimental validation allowed us to demonstrate that PirA is a novel redox-sensitive negative modulator of very long-chain acyl-CoA dehydrogenase, which catalyzes the first committed step of the beta-oxidation pathway.

Acute chemotherapy-induced nausea and vomiting in children with cancer: Still waiting for a common consensus on treatment.

Chemotherapy-induced nausea and vomiting (CINV) is one of the most common treatment side-effects, and remains a significant concern, in children undergoing chemotherapy. Although adult patients receive chemotherapy regimens combined with appropriate standardized antiemetic treatment, children can receive markedly varying antiemetic treatments. A narrative review of CINV was performed regarding CINV definition, scoring system, prevention and treatment, specifically focussing on studies conducted with paediatric oncology patients. The review highlighted a lack of rigorously developed CINV scoring systems and standardized CINV pharmacological treatment for paediatric oncology patients. Different scoring systems were found to identify potential risk factors for CINV associated with the use of several different antiemetic drugs, however, few studies have been performed in children undergoing chemotherapy. Thus, CINV remains a distressing and partially controlled side-effect in the paediatric patient population. To reduce emesis and improve quality of life in paediatric oncology patients, standardized antiemetic treatment may be preferred, using a unique CINV scoring system that accounts for the emetogenic level of the chemotherapy regimen adopted and the children's clinical characteristics.

Renal toxicity and chemotherapy in children with cancer.

The clinical use of antineoplastic drugs can be limited by different drug-induced toxicities. Of these, renal dysfunction may be one of the most troublesome in that it can be cumulative and in general is only partially reversible with the discontinuation of the treatment. Renal toxicity may be manifested as a reduction of the glomerular filtration rate, electrolyte imbalances, or acute renal failure. Careful assessment of renal function has to be performed taking into account that the impairment of renal function is initially silent and only later may be clinically dramatic. When clinically indicated, the reduction or, in cases of severe nephrotoxicity, the suspension of chemotherapy should be considered to avoid the progressive deterioration of the compromised glomerular and/or tubular function.

Rechallenge to Carboplatin in Children with Low Grade Glioma and Carboplatin Hypersensitivity Reactions.

Background: Carboplatin based regimens have demonstrated activity in pediatric patients with low grade gliomas (LGG). However, carboplatin hypersensitivity reactions (CHRs) may be a major problem leading to premature cessation of an effective therapy. The objectives of this study were to describe the prevalence, characteristics and management of CHR. Methods: We performed a retrospective review of children with LGG treated between January 1994 and July 2015 with carboplatin and vincristine who had a documented CHR. We identified two groups: the first was treated following the schema proposed by Packer et al., and re-exposed to carboplatin using a desensitization protocol; the second was treated according to protocol SIOP LGG 2004 and re-exposed with the infusion time prolonged. Results: CHRs were observed in 16 patients (34%) out of 47. Hypersensitivity reactions occurred in 6 patients (20.7%) of the first, and 10 patients (55.5%) of the second group, respectively. The grade 2 reactions were the most common. The median number of carboplatin doses administered at the first episode of CHR was 7 (range, 3-9) for the first group, and 8.5 (range, 5-11) for the second, respectively. Six patients were re-exposed to carboplatin using a desensitization protocol; 10 with a prolonged infusion time. Overall success rate for re-exposition was 43.75% (100% and 10%, respectively) (P = 0.001). Conclusions: Our results show that re-exposure is a safe alternative to abandoning carboplatin. Desensitization showed greater effectiveness compared to a prolonged infusion time, which allowed the patients to receive effective treatment without adverse reactions.