Has the Removing of the Mesentery during Ileo-Colic Resection an Impact on Post-Operative Complications and Recurrence in Crohn's Disease? Results from the Resection of the Mesentery Study (Remedy).

Some evidence suggests a reduction in clinical and surgical recurrence after mesenteric resection in Crohn's Disease (CD). The aim of the REsection of the MEsentery StuDY (Remedy) was to assess whether mesenteric removal during surgery for ileocolic CD has an impact in terms of postoperative complications, endoscopic and ultrasonographic recurrences, and long-term surgical recurrence. Among the 326 patients undergoing primary resection between 2009 and 2019 in two referral centers, in 204 (62%) the mesentery was resected (Group A) and in 122 (38%) it was retained (Group B). Median follow-up was 4.7 ± 3 years. Groups were similar in the peri-operative course. Endoscopic and ultrasonographic recurrences were 44.6% and 40.4% in Group A, and 46.7% and 41.2% in Group B, respectively, without statistically significant differences. The five-year time-to-event estimates, compared with the Log-rank test, were 3% and 4% for normal or thickened mesentery (p = 0.6), 2.8% and 4% for resection or sparing of the mesentery (p = 0.6), and 1.7% and 5.4% in patients treated with biological or immunosuppressants versus other adjuvant therapy (p = 0.02). In Cox's model, perforating behavior was a risk factor, and biological or immunosuppressant adjuvant therapy protective for surgical recurrence. The resection of the mesentery does not seem to reduce endoscopic and ultrasonographic recurrences, and the five-year recurrence rate.

DOE analysis of the rheological data of shear-thickening fluids for puncture-resistant composite shells.

The dilatancy (Shear-thickening) is a time-independent rheological behaviour exhibited by some non-Newtonian fluids. These fluids manifest a surge in the apparent viscosity with an increase in the shear rate. If these fluids are encapsulated, they can be used to manufacture high-end stab resistance inserts (Cecchini et al., 2018) [1]. In the first part of this work, a comparison between the rheological performance of different shear-thickening fluids (STFs) based on nanosilica dispersed in glycols is presented. This analysis attempts to investigate the combinations of fillers and carriers with the highest energy-absorbing capabilities, among the various glycol-based colloidal STFs. In the second part, the influence of the composition of the STF on its rheological properties is analyzed statistically. The statistical analysis is performed by evaluating the interaction between the main design variables of the fluids (filler dimension, weight-to-weight ratio and molecular weight of the carrier). Finally, the puncture resistance of a composite system obtained by encapsulating the previously manufactured shear-thickening fluids in a polymeric shell is analyzed by means of a high-speed puncture test. This test is performed on the mockup of a tyre tread containing the best performing STF. The results showed that the use of the STF core increased the resistance to puncture by 20% as compared to the same volume of tyre tread material. Furthermore, the STF hermetically sealed the pierced sample, even when the tyre mockup was inflated at high internal pressures.

Eco-sustainable systems based on poly(lactic acid), diatomite and coffee grounds extract for food packaging.

In the food packaging sector many efforts have been (and are) devoted to the development of new materials in order to reply to an urgent market demand for green and eco-sustainable products. Particularly a lot of attention is currently devoted both to the use of compostable and biobased polymers as innovative and promising alternative to the currently used petrochemical derived polymers, and to the re-use of waste materials coming from agriculture and food industry. In this work, multifunctional eco-sustainable systems, based on poly(lactic acid) (PLA) as biopolymeric matrix, diatomaceous earth as reinforcing filler and spent coffee grounds extract as oxygen scavenger, were produced for the first time, in order to provide a simultaneous improvement of mechanical and gas barrier properties. The influence of the diatomite and the spent coffee grounds extract on the microstructural, mechanical and oxygen barrier properties of the produced films was deeply investigated by means of X-Ray diffraction (XRD), infrared spectroscopy (FT-IR, ATR), scanning electron microscopy (SEM), uniaxial tensile tests, O2 permeabilimetry measurements. An improvement of both mechanical and oxygen barrier properties was recorded for systems characterised by the co-presence of diatomite and coffee grounds extract, suggesting a possible synergic effect of the two additives.

Tibial Tuberosity Anteromedialization for Patellofemoral Chondral Disease: Prognostic Factors.

BACKGROUND: Tibial tuberosity anteromedialization (TTA) is a well-established treatment option for patellofemoral chondral disease that is resistant to nonoperative treatment. However, the prognostic factors of this procedure are unknown. PURPOSE: To analyze the prognostic factors correlated with the midterm outcomes of TTA for patellofemoral chondral disease and determine the survivorship. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Indications of TTA for chondral disease included skeletal maturity, age <65 years, 7 points (34.6% of knees) in the multiple regression model was associated with age >45 years (odds ratio [OR], 10.4; 95% CI, 2.0-55.0) and increased femoral anteversion (OR, 7.9; 95% CI, 1.4-44.1). A Kujala score of <80 points (61.5% of knees) was associated with age >45 years (OR, 12.0; 95% CI, 2.6-56.2) and foot pronation (OR, 5.1; 95% CI, 1.3-20.4). Patient satisfaction of <7 of 10 points (32.1% of knees) was associated with positive postoperative patellofemoral crepitus (OR, 3.6; 95% CI, 1.1-11.7). The Kaplan-Meier survivorship of TTA with dissatisfaction (<5/10 points) as an end point was 94% at 43 months, 88% at 77 months, and 77% at 108 months. CONCLUSION: Overall, good outcomes and survivorship (77% at 108 months) were obtained in this case series. However, 25.6% of the patients would not undergo the surgery again. Increased age, increased femoral anteversion, foot pronation, and postoperative patellofemoral crepitus were identified as negative prognostic factors.

Beneficial defects: exploiting the intrinsic polishing-induced wafer roughness for the catalyst-free growth of Ge in-plane nanowires.

We outline a metal-free fabrication route of in-plane Ge nanowires on Ge(001) substrates. By positively exploiting the polishing-induced defects of standard-quality commercial Ge(001) wafers, micrometer-length wires are grown by physical vapor deposition in ultra-high-vacuum environment. The shape of the wires can be tailored by the epitaxial strain induced by subsequent Si deposition, determining a progressive transformation of the wires in SiGe faceted quantum dots. This shape transition is described by finite element simulations of continuous elasticity and gives hints on the equilibrium shape of nanocrystals in the presence of tensile epitaxial strain. PACS: 81.07.Gf; 68.35.bg; 68.35.bj; 62.23.Eg.