Powder plasma spheroidization treatment and the characterization of microstructure and mechanical properties of SS 316L powder and L-PBF builds.

A plasma spheroidization treatment was applied to stock stainless steel 316L powder for additive manufacturing. The normal and treated powders were compared both in the powder state as well as in the resulting laser powder bed fusion (L-PBF) builds. The plasma spheroidization process slightly increased treated powder aspect ratio and sphericity and shifted the size distribution to larger diameters relative to the normal powder. The normal powder was austenitic in nature whereas the plasma spheroidization process introduced a small fraction (∼3.5 vol %) of ferrite in the treated powder. Ferrite in the powder was not retained in the printed samples and was not shown to negatively affect the build quality. Porosity areal fraction was generally smaller in the treated powder builds. The normal powder builds had a 6% higher yield strength than treated, however the scatter was significantly larger in the 45° and horizontal orientations compared to the treated powder builds.

Prevalence of anti-sperm antibodies and relationship of degree of sperm auto-immunization to semen parameters and post-coital test outcome: a retrospective analysis of over 10 000 men.

STUDY QUESTION: What is the prevalence and the relationship of anti-sperm antibodies (ASA), screened by means of IgG-mixed anti-globulin reaction (MAR) test, to semen quality and post-coital test (PCT) outcome? SUMMARY ANSWER: A 100% positive IgG-MAR test, detected in 2% of the study population, was associated with lower sperm output and progressive motility, and was the sole determinant of higher prevalence of a negative PCT outcome. WHAT IS KNOWN ALREADY: Although ASA may affect sperm fertilizing ability and the IgG-MAR test is recommended by the World Health Organization (WHO) as an integral part of semen analysis for screening the occurrence of ASA, the prevalence and clinical relevance of positive MAR test results remain controversial. STUDY DESIGN, SIZE, DURATION: A retrospective analysis of 12 296 consecutive men who attended a university/hospital andrology clinic for the evaluation of fertility potential was carried out. PARTICIPANTS/MATERIALS, SETTING, METHODS: Immunological screening with the IgG-MAR test was performed on all ejaculates as an integral part of semen analysis. Positive samples (≥10%) were further tested for IgA-ASA. The prevalence of positive IgG-MAR tests results, along with the relationship of the degree of sperm auto-immunization to semen parameters and PCT outcome, were analyzed. MAIN RESULTS AND THE ROLE OF CHANCE: After excluding semen samples showing azoospermia or severe oligo-asthenozoospermia, the prevalence of a positive IgG-MAR test in the remaining 10 025 men was 4%, 3.4% and 2%, with 10%, 50% and 100% thresholds, respectively. The 100%-positive MAR tests exhibited significantly higher consistency over time, and were significantly associated with higher prevalence of a mixed pattern (i.e. when the majority of sperm exhibited beads attached on both the head and along the tail) of positivity as well as with the concomitant occurrence of IgA-ASA. Additionally, the 100%-positive MAR tests were significantly associated with a lower median value of the total number of spermatozoa and progressive motility, compared to samples with a lower degree of positivity or negative samples. In the PCT performed in 120 couples, where ASA were detected in the male partner, the 100%-positive MAR tests were significantly associated with a higher prevalence of negative PCT outcome, in comparison to the lower degree of positivity, independent of, and without any significant contribution from, other determinants (semen and cervical mucus quality). LIMITATIONS, REASONS FOR CAUTION: Only surrogate infertility-related end-points were analyzed in the present study. However, since the impairment of sperm penetration through the cervical mucus represents the primary mechanism of ASA-interference with fertility, PCT outcome may represent a suitable clinical end-point. WIDER IMPLICATIONS OF THE FINDINGS: The present study, being the largest reported to date, provides a reliable estimate of ASA prevalence. Moreover, it indicates that a 50%-positive MAR test, which is suggested by WHO as the clinically-relevant threshold, also includes patients with a degree of sperm auto-immunization that contributes to couple infertility only in the presence of other causal factors; conversely, the 100%-positive MAR test can represent the sole determinant of couple infertility, as it was the sole significant predictor of the highly prevalent negative PCT outcome. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by the University of L'Aquila, Italy. The authors declare no competing interests. TRIAL REGISTRATION NUMBER: N/A.

Advanced chemical stability diagrams to predict the formation of complex zinc compounds in a chloride environment.

A chemical stability map is advanced by incorporating ion complexation, solubility, and chemical trajectories to predict ZnO, Zn(OH)2, ZnCO3, ZnCl2, Zn5(CO3)2(OH)6, and Zn5(OH)8Cl2·H2O precipitation as a function of the total Zn content and pH of an NaCl solution. These calculations demonstrate equilibrium stability of solid Zn products often not considered while tracking the consumed and produced aqueous Zn ion species concentrations through chemical trajectories. The effect of Cl-based ligand formation is incorporated into these stability predictions, enabling enhanced appreciation for the local corrosion conditions experienced at the Zn surface in chloride-containing environments. Additionally, the complexation of Cl- with Zn2+ is demonstrated to compete with the formation of solid phases, making precipitation more difficult. The present work also extends the chemical stability diagram derivations by incorporating a Gibbs-Thompson curvature relation to predict the effect of nanoscale precipitate phase formation on species solubility. These thermodynamic predictions correlate well with experimental results for Zn corrosion in full and alternate NaCl immersion, and have far-reaching utility in a variety of fields requiring nanoscale, semiconductor, and/or structural materials.

[Medication adverse events: Impact of pharmaceutical consultations during the hospitalization of patients]. / Évènements iatrogènes médicamenteux : impact des consultations pharmaceutiques en cours d'hospitalisation.

The medication iatrogenic events are responsible for nearly one iatrogenic event in five. The main purpose of this prospective multicenter study is to determine the effect of pharmaceutical consultations on the occurrence of medication adverse events during hospitalization (MAE). The other objectives are to study the impact of age, of the number of medications and pharmaceutical consultations on the risk of MAE. The pharmaceutical consultation is associated to a complete reassessment done by both a physician and a pharmacist for the home medication, the hospital treatment (3days after admission), the treatment during chemotherapy, and/or, the treatment when the patient goes back home. All MAE are subject to an advice for the patient, additional clinical-biological monitoring and/or prescription changes. Among the 318 patients, 217 (68%) had 1 or more clinically important MAE (89% drug-drug interaction, 8% dosing error, 2% indication error, 1% risk behavior). The patients have had 1121 pharmaceutical consultations (3.2±1.4/patient). Thus, the pharmaceutical consultations divided by 2.34 the risk of MAE (unadjusted incidence ratio, P≤0.05). Each consultation decreased by 24% the risk of MAE. Moreover, adding one medication increases from 14 to 30% as a risk of MAE on the population. Pharmaceutical consultations during the hospital stay could reduce significantly the number of medication adverse effects.

Body size evolution in Titanosauriformes (Sauropoda, Macronaria).

Titanosauriformes is a conspicuous and diverse group of sauropod dinosaurs that inhabited almost all land masses during Cretaceous times. Besides the diversity of forms, the clade comprises one of the largest land animals found so far, Argentinosaurus, as well as some of the smallest sauropods known to date, Europasaurus and Magyarosaurus. They are therefore good candidates for studies on body size trends such as the Cope's rule, the tendency towards an increase in body size in an evolutionary lineage. We used statistical methods to assess body size changes under both phylogenetic and nonphylogenetic approaches to identify body size trends in Titanosauriformes. Femoral lengths were collected (or estimated from humeral length) from 46 titanosauriform species and used as a proxy for body size. Our findings show that there is no increase or decrease in titanosauriform body size with age along the Cretaceous and that negative changes in body size are more common than positive ones (although not statistically significant) for most of the titanosauriform subclades (e.g. Saltasaridae, Lithostrotia, Titanosauria and Somphospondyli). Therefore, Cope's rule is not supported in titanosauriform evolution. Finally, we also found a trend towards a decrease of titanosauriform mean body size coupled with an increase in body size standard deviation, both supporting an increase in body size variation towards the end of Cretaceous.

Role of cardiolipin in mitochondrial diseases and apoptosis.

Apoptosis is a highly programmed cell death strictly connected to the pathogenesis of many human diseases, including neoplastic, neurodegenerative or cardiovascular diseases. Mitochondria play a key role in the apoptotic process; their damage activates a series of events which provoke the release of cytochrome c and other pro-apoptotic factors from the mitochondrial intermembrane space, and culminate in cell death. This review provides an overview of the key role played by mitochondria in the activation of the apoptotic process. In particular, the interest is focused on the role played by cardiolipin, a phospholipid deeply involved in the first steps of the process culminating in cell apoptosis. Mitochondrial phospholipids are involved in several cellular functions, such as cell respiration, apoptosis, and autophagy. Therefore, any alteration in the production of phospholipids or in their structural properties causes deep effects on the cell behavior and induces the arising of different pathologies. The present review summarizes the most recent advances in the study of the role that CL, a phospholipid possessing a unique structure, plays in mitochondrial activity, in apoptosis, and in the onset of human diseases.

Ileovesicostomy: update.

Currently, we have different technical options for treating clinically complex scenarios such as neurogenic bladder, difficult to manage lower urinary tract obstruction and many disasters sometimes seen after prostate cancer treatment. During the seventies, clean intermittent bladder catheterization was established as the best treatment option for these patients. As a method, suprapubic urinary diversion has undergone a major evolution over the past fifty years trying to solve the most refractory and poor prognosis cases. Continent ileovesicostomy is an easy emptying and low-pressure non-catheterizable urinary conduit that enables safe and durable urine elimination. In this article a detailed and updated knowledge of this technique is provided.

Surgical treatment of post-traumatic distraction posterior urethral strictures.

Approximately 4-14% pelvic fractures cause a posterior urethral injury. Pelvic fractures associated with straddle injuries or large trauma accidents are more frequently involved with this kind of lesions. Primary open repair of the urethral injury is discouraged in the acute setting. 3-6 months after urinary diversion a formal open reconstruction can be safely attempted. This gives time for scar maturation, reabsorption of pelvic hematomas, and relative restoration of anatomical fascial layers. The complexity of such interventions can be minimized following proper diagnostic and surgical protocols. Anastomotic urethroplasty under the precepts of the progressive perineal approach provides an excellent treatment option for these patients. The aim of this paper is the detailed description of the procedure for the treatment of such injuries.

Tratamiento quirúrgico de la estenosis uretral membranosa post-traumática / Surgical treatment of post-traumatic distraction posterior urethral strictures

Aproximadamente entre el 4 y el 14% de las fracturas de pelvis producen una lesión uretral posterior. Las fracturas producidas en el contexto de una caída a horcajadas o un gran traumatismo se asocian más frecuentemente a este tipo de lesiones. La reparación abierta como primera intención no constituye una opción de tratamiento en el momento agudo. A los 3-6 meses de haber emplazado un catéter de derivación suprapúbica puede realizarse un intento de reparación programado por segunda intención. Este tiempo, permite la maduración de la cicatriz, la reabsorción del hematoma pélvico y la reestructuración relativa de los planos y fascias. La complejidad de este tipo de intervenciones puede minimizarse siguiendo un correcto protocolo tanto diagnóstico como quirúrgico. La uretroplastia anastomótica bajo los preceptos del abordaje perineal progresivo constituye una magnífica opción de tratamiento para estos pacientes.El objetivo de este trabajo es la descripción detallada de la técnica realizada en nuestro centro para el tratamiento de este tipo de lesiones(AU)

Approximately 4-14% pelvic fractures cause a posterior urethral injury. Pelvic fractures associa-ted with straddle injuries or large trauma accidents are more frequently involved with this kind of lesions. Primary open repair of the urethral injury is discouraged in the acute setting. 3-6 months after urinary diversion a formal open reconstruction can be safely attempted. This gives time for scar maturation, reabsorption of pelvic hematomas, and relative restoration of anatomical fascial layers. The complexity of such interventions can be mini-mized following proper diagnostic and surgical protocols. Anastomotic urethroplasty under the precepts of the progressive perineal approach provides an excellent treatment option for these patients.The aim of this paper is the detailed description of the procedure for the treatment of such injuries(AU)

Delayed elimination of methotrexate associated with co-administration of proton pump inhibitors.

AIM: We conducted a retrospective non-interventional cohort study to analyze the impact of proton pump inhibitors co-administration on methotrexate elimination in cancer patients receiving treatment protocol with the antifolate at high dose (>1 g/m(2) intravenously). PATIENTS AND METHODS: Between 2005 and 2008, 79 patients (mean age: 48.8 years; range: 16-76 years) were treated by high dose methotrexate for 197 cycles. RESULTS: Delayed methotrexate elimination (i.e., plasma concentration >15 µmol/l at 24 h, >1.5 µmol/l at 48 h and/or >0.15 µmol/l at 72 h) occurred in 16% (32/197) of the cycles. The co-prescription of a proton pump inhibitor (pantoprazole, lansoprazole, omeprazole, esomeprazole) was found in 53% (17/32) of the courses with delayed elimination and in 15% (24/165) of the cycles without delayed elimination. We identified co-administration of proton pump inhibitors as a major risk factor for delayed elimination (odds ratio 6.66, 95% confidence interval 3.13, 14.17). CONCLUSION: Proton pump inhibitors should not be administered during methotrexate treatment.

[Mechanisms of pharmacokinetic drug-drug interactions]. / Mécanismes des interactions médicamenteuses d'origine pharmacocinétique.

Pharmacokinetic drug-drug interactions occur when a drug alters the disposition (absorption, distribution, elimination) of a coadministered agent. Pharmacokinetic interactions may result in the increase or the decrease of plasma drug concentrations. These modifications are variable in intensity but can lead to contraindications of the association. The mechanisms of pharmacokinetic interactions involve drug metabolizing enzymes, drug transporters and orphan nuclear receptors that regulate at the transcriptional level the expression of enzymes and transporters. The increase of drug plasma concentrations is generally related to the inhibition of enzymes and/or drug transport. The decrease of drug concentrations reflects the activation of orphan nuclear receptors by inducers that lead to the increase of the expression of enzymes and drug transporters. Inhibition of drug metabolism or transport is quite immediate (24-48h) while induction is a slower process (7-10 days). Complex situations may be observed with drugs that are both inducers and inhibitors (rifampin, ritonavir). They can cause the decrease and the increase of the exposure of the combined agent depending on the duration of the association.

[Determination of the detergent efficiency of the detergents disinfecting for surfaces]. / Mesure de l'efficacité détersive des détergents désinfectants pour surfaces.

Since the disinfecting activity of disinfectants is evaluated by standards, the intrinsic detergent activity is not easily quantifiable and no standard have been suggested yet. Beyond the physicochemical parameters like wettability or foaming presented by the manufacturers, it appears necessary to us to objectively measure the real effect of the detergent agent. The objective of our work is to propose a simple, fast and reproducible method to evaluate detersive activity of the disinfecting detergents. We measured three factors (total amount of extracted bacteria, extraction efficiency and slope of extracting curve) by using Rodac prints technique on two different supports (PVC, stainless steel) that have been contaminated by either E. coli or S. aureus. An increasing mark from 1 to 6 is given to each of these factors in case of statistically differences. The three factors allowed us to calculate a "Specific Index of detersion" (SI) for each germ/support couple (3 to 18). Addition of the marks given to each couple for each disinfecting detergent allowed to calculate a "Globally Index of detersion" (GI) (9 to 72). We tested 4 commercialised disinfecting detergents: Surfanios, Aniosurf, Major C100 and Ecodiol. All detergents may be classified according to their effectiveness on a bacterium/support couple (value of the SI). This enlights a specific spectrum for each disinfecting detergents. As a result, Ecodiol seems to be the most effective deterging agent on 3 of the 4 germ/support couples (S. aureus/PVC, E. coli/PVC and E. coli/stainless steel), whereas Aniosurf is most effective on the S. aureus/stainless steel couple. The GI is very useful to choose the best compromise between activities for all situations. GI rankings of the tested agents were as follows: water < Aniosurf < Surfanios < neutralizing < Major C100 < Ecodiol. This experimental model will be used to test and compare the intrinsic detergent activities of other commercialised products which are usually used for the biocleaning of the medical devices (i.e. endoscopes or reusable dialysis device).

Beta-chemokine receptor CCR5 in human spermatozoa and its relationship with seminal parameters.

BACKGROUND: Chemokine receptor CCR5, the main HIV-1 coreceptor, is present in the human spermatozoa. This study aimed to investigate (i) whether the percentage of CCR5-positive spermatozoa varies under conditions associated with changes in the membrane architecture, such as capacitation and fixation/permeabilization procedures; (ii) whether there is any relationship between individual variability in sperm CCR5 expression and semen parameters. METHODS AND RESULTS: In cytometric analysis, the percentage of CCR5-positive unfixed spermatozoa varied from approximately 10 to approximately 60%, and it significantly decreased after 5 h capacitation. The percentage of CCR5-positive spermatozoa was increased to more than 90% following fixation and permeabilization, suggesting the existence of large intracellular pools of the receptor. Immunocytochemistry showed positive staining in the anterior region of the sperm head. In ejaculates from male partner of 102 infertile couples, the CCR5 expression rate significantly correlated with sperm count, total sperm number and forward motility, but not with sperm morphology. In stepwise analysis, only forward motility entered into the model; however, this explained only approximately 8% of the variability in CCR5 expression. Interquartile analysis showed significant differences between the first and fourth quartiles of CCR5 expression for all semen parameters, except morphology. CONCLUSIONS: The percentage of CCR5-positive spermatozoa may vary under conditions associated with changes in membrane architecture and spermatozoa showed large intracellular pools of CCR5. A lower expression of CCR5 in asthenozoospermia seems to be suggested; however, it would only partially contribute to the inter-individual variability in the CCR5 expression. A genetic basis can be hypothesized to explain the variability.

Apoptosis and human diseases: mitochondrion damage and lethal role of released cytochrome C as proapoptotic protein.

Apoptosis is strictly connected to the pathogenesis of many human diseases, including neoplastic, neurodegenerative or cardiovascular diseases. It is a highly programmed cell death which can be activated by various factors. Mitochondria play a key role in the apoptotic process; their damage, which involves permeabilization of the outer mitochondrial membrane, activates a series of events that lead to cell death. Of the two proposed signaling pathways of apoptosis, i.e. the 'extrinsic' and the 'intrinsic' pathway, the latter is assumed to initiate in mitochondria. Its activation involves release of cytochrome c and other pro-apoptotic factors from the mitochondrial intermembrane space. In the cytosol, cytochrome c exerts its pro-apoptotic action. It binds to the apoptosis protease activation factor (APAf-1) and forms a complex indicated as 'apoptosome'. The complex-induced activation of pro-caspase 9 initiates an enzymatic reaction cascade leading to the execution of apoptosis in cells. This review provides an overview of the key role played by mitochondria and cytochrome c in the activation of the apoptotic process.