Advanced portable micro-SORS prototype coupled with SERDS for heritage science.

We investigate the subsurface composition of turbid materials at the micro scale by means of a portable non-invasive technique, micro-spatially offset Raman spectroscopy (micro-SORS), combined with shifted excitation Raman difference spectroscopy (SERDS). This combination enables the microscale layer analysis and allows to deal effectively with highly fluorescing samples as well as ambient light, all in a form of an in-house portable prototype device optimised for applications in heritage science. The instrument comprises ability to simultaneously collect multiple spectra by means of an optical fibre bundle, thus reducing the dead time and simplifying the ease of deployment of the technique. The performance of the synergy between micro-SORS and 785 nm SERDS dual-wavelength diode laser is demonstrated on a stratified mock-up painting samples including highly fluorescing painted layers. This instrumental approach could be ground-breaking in heritage science, due to the largely unmet need of analysing the molecular composition of subsurface of artworks non-invasively and in situ, and in the presence of fluorescent background and ambient light. Moreover, many other fields are expected to benefit from this technological advancement such as solar energy, forensic and food analytical areas.

CARDIOCARE: An integrated platform for the management of elderly multimorbid patients with breast cancer therapy induced cardiac toxicity.

Breast cancer (BC) remains the most diagnosed cancer in women, accounting for 12% of new annual cancer cases in Europe and worldwide. Advances in surgery, radiotherapy and systemic treatment have resulted in improved clinical outcomes and increased survival rates in recent years. However, BC therapy-related cardiotoxicity, may severely impact short- and long-term quality of life and survival. This study presents the CARDIOCARE platform and its main components, which by integrating patient-specific data from different categories, data from patient-oriented eHealth applications and wearable devices, and by employing advanced data mining and machine learning approaches, provides the healthcare professionals with a valuable tool for effectively managing BC patients and preventing or alleviating treatment induced cardiotoxicity.Clinical Relevance- Through the adoption of CARDIOCARE platform healthcare professionals are able to stratify patients for their risk for cardiotoxicity and timely apply adequate interventions to prevent its onset.

The Community Engaged Digital Alzheimer's Research (CEDAR) Study: A Digital Intervention to Increase Research Participation of Black American Participants in the Brain Health Registry.

BACKGROUND: Although Black/African American older adults bear significant inequities in prevalence, incidence, and outcomes of Alzheimer's disease and related dementias, they are profoundly under-included in Alzheimer's Disease research. Community-Engaged Research (e.g., equitable community/science partnerships) is an evidence-based approach for improving engagement of underrepresented populations into Alzheimer's Disease research, but has lacked scalability to the national level. As internet use among older adults from underrepresented populations continues to grow, internet-based research shows promise as a feasible, valid approach to engagement and longitudinal assessment. The Community Engaged Digital Alzheimer's Research (CEDAR) study utilizes a community-engaged research approach to increase the engagement and research participation of Black/African American adults in the Brain Health Registry (BHR) and Alzheimer Disease clinical research. OBJECTIVES: To describe the methods and evaluate the feasibility of the CEDAR culturally-informed digital platform within BHR. DESIGN: All Black/African American participants in BHR were invited to enroll in CEDAR and to consider serving on a newly convened Community-Scientific Partnership Board to guide the study. The community board guided the development a culturally-informed cadre of engagement materials and strategies to increase research participation. Engagement strategies included incentives for study task completion, culturally-informed communications (e.g., landing page, emails and social media), resources about brain health, and video and written testimonials by CEDAR participants. SETTING: BHR, an Internet-based registry and cohort. PARTICIPANTS: BHR participants self-identifying as Black/African American were invited to enroll. All participants who signed an online informed consent document were enrolled. MEASUREMENTS: We report the number of participants invited, enrolled, completed tasks, and volunteered to join the community board. We compared the demographics, cognitive profile, and baseline BHR task completion rates between CEDAR participants and all those invited to join the study. RESULTS: Of 3738 invited, 349 (9.34%) enrolled in CEDAR. 134 (37% of CEDAR participants) volunteered to join the community board, of which 19 were selected for the community board. Compared to those invited, the CEDAR cohort had a higher percentage of female participants (84.5%) and a lower percentage of participants who identify as belonging to more than one ethnocultural group (21.8%). Compared to those did not enroll in CEDAR, those enrolled in CEDAR had a higher percentage of participants completing all BHR tasks (22%) and a higher percentage of participants completing at least one cognitive test (76%). Those enrolled in CEDAR also had a higher percentage of participants having an enrolled study partner (18%). CONCLUSIONS: A culturally-informed Community-Engaged Research approach, including a remotely-convened community board, to engagement of Black/African American participants in an online research registry is feasible. This approach can be adapted for use in various clinical studies and other settings. Future studies will evaluate the effectiveness of the engagement strategies.

Transient ischemic attack and minor stroke as "surgeons affairs": a narrative review.

OBJECTIVE: The scope of this paper is to review the subtypes of transient ischemic attack (TIA) and minor stroke (mS) in which a surgical treatment is needed, discussing the importance and the timing of a multidisciplinary approach, in order to achieve an optimized management and prevent major strokes or other critical complications. MATERIALS AND METHODS: The keywords "transient ischemic attack," "minor stroke," "surgical treatment," "vascular surgery," "heart surgery," "neurosurgery," and "multidisciplinary" were searched using MEDLINE, EMBASE, and Scopus. Relevant search results were discussed by the authors for references inclusion. RESULTS: Notwithstanding that best medical therapy is usually the first choice for the most part of cases, there are specific but recurrent etiologies that must be properly recognized because of a potential surgical approach, even in urgency. In fact, symptomatic carotid stenosis, or particular cases of hemodynamic cerebrovascular events, should be promptly referred to vascular surgeon, since increasing evidences highlighted a benefit from an early artery revascularization. In addition, beyond arrhythmic causes, cardioembolic events due to bacterial endocarditis and atrial myxoma should be quickly diagnosed, possibly in emergency department, because they are a presumptive urgency for heart surgery. In addition to the above-mentioned conditions, in patients suffering from vertebrobasilar TIA or mS, clinicians should keep in mind the Bow Hunter disease, because surgical artery decompression can represent the only suitable treatment in selected cases. CONCLUSIONS: TIA and mS require a multidisciplinary in order to discuss therapeutic options, comparing risks and benefits and determining the best timing for an optimized management.

Understanding Online Registry Facilitators and Barriers Experienced by Black Brain Health Registry Participants: The Community Engaged Digital Alzheimer's Research (CEDAR) Study.

BACKGROUND: Failure of Alzheimer's disease and related diseases (ADRD) research studies to include and engage Black participants is a major issue, which limits the impact and generalizability of research findings. Little is known about participation of Black adults in online ADRD-related research registries. OBJECTIVES: As part of the Community Engaged Digital Alzheimer's Research (CEDAR) Study, this study aims to increase our understanding of facilitators and barriers of Black adults to participating in ADRD-related online registries, as well as to understand their preferences for communication channels. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: We invited all Black participants enrolled in the Brain Health Registry (BHR) to complete a cross-sectional online survey. The survey consisted of rating scales and open-text questions asking about their attitudes towards brain health research, reasons for joining and continuing to participate in BHR, difficulties with participating, and preferences for modes of contact and website usage. RESULTS: Of all invited Black BHR participants (N=3,636), 198 (5.5%) completed the survey. The mean age was 58.4 (SD=11.3), mean years of education were 16.3 (SD=2.4), and 85.5% identified as female. Reported facilitators for joining and continuing to participate in BHR were personal interest (e.g., learning more about own brain health) and altruism (e.g., helping research). Among additional registry features which could encourage return, receiving feedback or scores about BHR tasks was rated the highest. Of those who found BHR participation difficult (21%), the most frequent reason was time burden. The most preferred way of receiving study information was via email. Participants reported that the websites that they used the most were YouTube and Facebook. DISCUSSION: The results of our study can inform the development of culturally-responsive registry features and engagement efforts to improve inclusion and participation of Black adults in online ADRD research. Providing participants with feedback about their registry performance and reducing the number of registry tasks are among the recommended strategies.

Cervical pessary for preterm birth prevention after an episode of arrested preterm labor: a retrospective cohort study with targeted maximum likelihood estimation of the average treatment effect.

OBJECTIVE: To evaluate whether cervical pessary effectively reduces the preterm birth < 37 weeks rate in patients who have not delivered after an episode of arrested preterm labor. PATIENTS AND METHODS: Retrospective cohort study was conducted on singleton pregnant patients admitted to our institution between January 2016 and June 2021 for threatened preterm labor and who had a cervical length < 25 mm. Women in whom a cervical pessary was placed were considered as exposed, while women in whom expectant management was preferred were considered as unexposed. The primary outcome was the rate of preterm birth before 37 weeks. A targeted maximum likelihood estimation was used to estimate the average treatment effect of cervical pessary by adjusting for a-priori-defined confounders. RESULTS: A cervical pessary was placed in 152 (36.6%) patients (exposed), while the remaining 263 (63.4%) were managed expectantly (unexposed). The adjusted average treatment effect was -14% (-18 to -11%), -17% (-20 to -13%), and -16% (-20 to -12%) for preterm birth < 37 weeks, < 34 weeks, and < 32 weeks, respectively. The average treatment effect for adverse neonatal outcomes was -7% (-8 to -5%). No difference in gestational weeks at delivery between exposed and unexposed emerged when gestational age at first admission was > 30.1 gestational weeks. CONCLUSIONS: The positioning of a cervical pessary placement may be evaluated to reduce the risk of a subsequent preterm birth after an episode of arrested preterm labor in pregnant patients with onset of symptoms before 30 gestational weeks.

Droplet Lasers for Smart Photonic Labels.

Microscopic lasers represent a promising tool for the development of cutting-edge photonic devices thanks to their ability to enhance light-matter interaction at the microscale. In this work, we realize liquid microlasers with tunable emission by exploiting the self-formation of three-dimensional liquid droplets into a polymeric matrix driven by viscoelastic dewetting. We design a flexible device to be used as a smart photonic label which is detachable and reusable on various types of substrates such as paper or fabric. The innovative lasing emission mechanism proposed here is based on whispering gallery mode emission coupled to random lasing, the latter prompted by the inclusion of dielectric compounds into the active gain medium. The wide possibility of modulating the emission wavelength of the microlasers by acting on different parameters, such as the cavity size, type and volume fraction of the dielectrics, and gain medium, offers a multitude of spectroscopic encoding schemes for the realization of photonic barcodes and labels to be employed in anticounterfeiting applications and multiplexed bioassays.

Sepsis due to Yersinia enterocolitica in an aborted equine fetus: case report / Sepse por Yersinia enterocolitica em um feto equino abortado: relato de caso

Yersinia enterocolitica is a bacterium with zoonotic potential and there are no previous records of this bacteria being isolated from aborted foals. This report aims to describe a case of sepsis due to Y. enterocolitica in a seven month old aborted equine. The fequinoetus was submitted to necropsy and samples of all the organs were collected for the histological exam. Samples of liver, lung, placenta, and stomach contents were collected for bacterial culture. Macroscopically, the liver was enlarged with yellowish heterogeneous color, heart with pale myocardial areas; lungs not collapsed, heavy and shiny, thickened umbilical cord covered with fibrin and pus. Histopathologically, there was moderate multifocal necrosuppurative myocarditis and thrombosis, moderate diffuse suppurative bronchopneumonia, mild multifocal fibrinonecrotic hepatitis, and moderate diffuse necrosuppurative omphalitis with intralesional bacterial myriads and thrombosis. Mild multifocal suppurative placentitis, nephritis, myositis, cystitis, and dermatitis were also observed, in addition to mild diffuse lymphoid rarefaction. The microbiological evaluation identified Y. enterocolitica in the liver, lung, and stomach fluid. This is the first report of sepsis due to Y. enterocolitica causing an abortion in a horse. This bacterium has zoonotic importance; therefore, it should be investigated in abortion in this species, serving as a differential diagnosis in reproductive disorders.(AU)

Yersinia enterocolitica é uma bactéria com potencial zoonótico, e não há informações desse agente como causa de abortamento em equinos. O objetivo deste relato é descrever um caso de sepse por Y. enterocolitica em um feto equino abortado aos sete meses. O feto foi submetido à necropsia, e amostras de todos os órgãos foram processadas para histopatologia. Para microbiologia, foram coletadas amostras de fígado, pulmão, placenta e conteúdo estomacal. Macroscopicamente, observou-se fígado aumentado com coloração amarelada heterogênea; coração com áreas pálidas no miocárdio; pulmões não colabados, pesados e brilhantes; e cordão umbilical espessado e recoberto por fibrina e pus. Na análise histopatológica, havia miocardite necrossupurativa multifocal moderada e trombose, broncopneumonia supurativa difusa moderada, hepatite fibrinonecrótica multifocal discreta e onfalite necrossupurativa difusa moderada com miríades bacterianas intralesionais e trombose. Observou-se também placentite, nefrite, miosite, cistite e dermatite supurativa multifocal discreta, além de rarefação linfoide difusa discreta. A avaliação microbiológica identificou Y. enterocolitica no fígado, no pulmão e no líquido estomacal. Este é o primeiro relato de sepse por Y. enterocolitica causando abortamento na espécie equina. Essa bactéria tem importância zoonótica, portanto deve ser investigada em casos de abortamento nessa espécie, servindo como diagnóstico diferencial em tal distúrbio reprodutivo.(AU)

Is Laparoscopic CME Right Hemicolectomy an Optimal Indication for NET of the Right Colon and Terminal Ileum?

PURPOSE: Since lymphadenectomy is crucial in midgut neuroendocrine tumor (NET) surgery, we adopted laparoscopic CME right hemicolectomy (LRH-CME) for the treatment of right colon and terminal ileum NETs. In this report, we present a series of nine cases of terminal midgut NETs (TM-NETs) treated by LRH-CME with a video demonstrating oncological principles and the surgical technique. METHODS: From September 2014 to November 2019, nine patients affected by TM-NETs underwent LRH-CME at the Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, ENETS Center of Excellence. Clinicopathological data, post-operative and oncological outcomes were prospectively collected and analyzed. RESULTS: Tumors were in ileocecal valve or terminal ileum (5 cases), right colon (3 cases), and appendix (one case). Surgery had a curative intent (R0 resection) in 7 cases. Surgical debulking was required in 2 metastatic cases. Mean surgical time was 212 + 41 min and blood loss 47 + 24 mL. No postoperative mortality was observed. Post-operative course was uneventful in all except one case (Clavien-Dindo III). Median number of harvested lymph nodes was 21 (range, 11-31) and eight out of 9 patients were node positive (median 3, range 0-6). At a median follow-up of 18 months (range, 6-50), none of the patients suffered from mesenteric locoregional recurrence and all R0 resected patients were disease-free. CONCLUSIONS: Terminal midgut NETs represent an optimal indication for LRH-CME which increases the chance of complete resection and allows optimal lymphadenectomy. In expert hands, laparoscopic approach should be favored in consideration of good short-term outcomes.

Non-invasive characterisation of molecular diffusion of agent into turbid matrix using micro-SORS.

This study proposes a non-invasive analytical method to study the molecular diffusion of a chemical agent into a turbid matrix with an emerging analytical technique, micro-Spatially Offset Raman Spectroscopy (micro-SORS). Here, the micro-SORS concept has been extended from the analysis of chemically distinct stratified layers to the studies and monitoring of the absorption and diffusion processes, addressing a key analytical need in a number of areas including polymer, pharmaceutical, forensic and biomedical sciences. In Cultural Heritage the knowledge of the penetration depth of a polymer used to consolidate or to protect an object, or the absorption depth of solvents used during a cleaning procedure is crucial for the performance evaluation of restoration methods and their safety towards the work of art. To date the most common protocol for obtaining this type of information comprises the application of stratigraphical analysis on cross-sections prepared after taking a small amount of sample from the work of art. This approach is destructive and may lack of statistical meaning, since the analytical information is limited to the micro area of sampling. To overcome these drawbacks, in this study micro-SORS was successfully used, for the first time, to non-invasively characterise the penetration of a polymer and of a viscous solvent into a gypsum substrate, permitting the reconstruction of the diffusion trends of the products into the matrix and the evaluation of their performances.

Impact of visceral obesity and sarcobesity on surgical outcomes and recovery after laparoscopic resection for colorectal cancer.

BACKGROUND & AIMS: Studies analyzing the impact of visceral fat excess on surgical outcomes after resection for colorectal cancer (CRC) have yielded conflicting results. Visceral obesity (VO) and sarcobesity (SO) have been recently addressed as risk factors for poor short-term results while no data are available for recovery goals after surgery. No data are available on the protective effect of ERAS in VO and SO patients. The aim of this study was to assess clinical implications of computed tomography (CT) assessed VO and SO on surgical and recovery outcomes after minimally invasive resection for CRC before and after ERAS protocol implementation. METHODS: Visceral adipose tissue (VAT) and skeletal muscle area (SMA) were retrospectively assessed using pre-operative CT studies of 261 patients who underwent laparoscopic resection for CRC between January 2012 and April 2019; ERAS protocol was adopted in 160 patients operated on after March 2014. Patients' surgical and recovery outcomes were compared according to BMI categories, VO and SO which was defined using the VAT/SMA ratio (Sarcobesity Index). Predictive factors for poor surgical and recovery outcomes were evaluated by univariate and multivariate analyses. RESULTS: Of the 261 patients, 12.6% were BMI obese while 68.6% presented visceral obesity. BMI was not associated to any of the outcomes considered. No differences in intra-operative results were found except for a lower number of retrieved lymph nodes both in VO and SO patients. While VO showed no impact on post-operative course, SO resulted an independent risk factor for cardiac complications and prolonged post-operative ileus (PPOI) at logistic regression analysis. Furthermore, sarcobese patients showed delayed recovery after surgery. Patients enrolled in the ERAS protocol showed improved recovery outcomes for both VO and SO groups, although ERAS did not result to be a protective factor for cardiac complications and PPOI. CONCLUSIONS: A high Sarcobesity Index is a risk factor for developing cardiac complications and PPOI after laparoscopic resection for CRC. A reduced number of lymph nodes retrieved is associated to VO and SO. These conditions should then be considered in clinical practice for the risk of down staging the N stage. Effect of VO and SO on recovery items after surgery should be further investigated. ERAS protocol application should be implemented to improve recovery outcomes in VO and SO patients undergoing laparoscopic colorectal resection.

Nonlinear optical memory effect.

Light propagating through random media produces characteristic speckle patterns, directly related to the large multitude of scattering events. These complex dynamics remarkably display robustness to perturbation of the incoming light parameters, maintaining correlation in the scattered wavefront. This behavior is known as the optical memory effect. Here we unveil the properties of the nonlinear optical memory effect, which occurs when an optothermal nonlinearity perturbs the random material. The effect is characterized through a series of pump and probe experiments in silica aerogel, in the visible range. This additional degree of freedom further generalizes the memory effect, opening the road to applications based on the nonlinear response of random media.

Large-Scale Photonic Ising Machine by Spatial Light Modulation.

Quantum and classical physics can be used for mathematical computations that are hard to tackle by conventional electronics. Very recently, optical Ising machines have been demonstrated for computing the minima of spin Hamiltonians, paving the way to new ultrafast hardware for machine learning. However, the proposed systems are either tricky to scale or involve a limited number of spins. We design and experimentally demonstrate a large-scale optical Ising machine based on a simple setup with a spatial light modulator. By encoding the spin variables in a binary phase modulation of the field, we show that light propagation can be tailored to minimize an Ising Hamiltonian with spin couplings set by input amplitude modulation and a feedback scheme. We realize configurations with thousands of spins that settle in the ground state in a low-temperature ferromagneticlike phase with all-to-all and tunable pairwise interactions. Our results open the route to classical and quantum photonic Ising machines that exploit light spatial degrees of freedom for parallel processing of a vast number of spins with programmable couplings.

A follow-up study of the long-term satisfaction, reproductive experiences, and self-reported health status of oocyte donors in Spain.

Purpose: The aim of this study is to evaluate the health of oocyte donors and explain how they regard their experience in the long-term. Materials and methods: This is a cross-sectional study in a single fertility centre that consists of a telephone interview guided by a semi-structured questionnaire covering several aspects of reproductive health and personal experience. Results: At the time of interview, 84 out of 121 women (69%) had children while 64 (53%) were already mothers at the time of their donation. Of the 38 women achieving a pregnancy after donation, five reported six pregnancy complications. Two out of 121 (2%) women reported being in menopause (aged 41 and 45). Twenty-three women (19%) reported gynaecological issues and eight (7%) reported fertility problems, although only four consulted a specialist. Most of women highlighted positive feelings about their donation (113, 93%) and 155 (97%) would recommend donating. Less than half (53, 44%) mentioned some negative aspects, mainly related to physical discomfort: injections (20,17%), pain (17, 14%), and side effects of ovarian stimulation (10, 8%). Conclusion: The impact of donation on women's life was mostly favourable, with the majority of participants reporting positive aspects and recommending donation, although some negative feelings as physical discomfort also arose. Therefore, more comfortable stimulation protocols could be developed.

Prognostic value of thrombocytosis in patients undergoing surgery for colorectal cancer with synchronous liver metastases.

PURPOSE: The purpose of this study was to evaluate the prognostic role of thrombocytosis in patients with synchronous colorectal liver metastases (CRLM). METHODS: Retrospective analysis of patients who underwent surgery for colorectal cancer with synchronous CRLM at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust between 2005 and 2016. RESULTS: One hundred and ninety-six patients met the inclusion criteria. High platelet count (H-PC) was found in 32%, and it was associated with a higher rate of palliative surgery (p < 0.001), extra-hepatic metastases (p < 0.001), bilobar liver disease (p = 0.007), presence of more than three metastases (p = 0.005), biggest metastasis larger than 5 cm (p < 0.001), and CEA level higher than 200 ng/mL (p = 0.035). H-PC was significantly associated with poorer 5-year overall survival (14.3% vs. 34.3%; p = 0.001). At the multivariate analysis on R0-1 cases, platelet count resulted the only independent predictor of survival (HR 2.07, p = 0.036). CONCLUSION: H-PC correlates with the main negative clinical-pathological factors in patients with synchronous CRLM, as well as with overall survival. Moreover, it was the only independent prognostic factor in those who underwent curative surgery.

Fibroblast activation and abnormal extracellular matrix remodelling as common hallmarks in three cancer-prone genodermatoses.

BACKGROUND: Recessive dystrophic epidermolysis bullosa (RDEB), Kindler syndrome (KS) and xeroderma pigmentosum complementation group C (XPC) are three cancer-prone genodermatoses whose causal genetic mutations cannot fully explain, on their own, the array of associated phenotypic manifestations. Recent evidence highlights the role of the stromal microenvironment in the pathology of these disorders. OBJECTIVES: To investigate, by means of comparative gene expression analysis, the role played by dermal fibroblasts in the pathogenesis of RDEB, KS and XPC. METHODS: We conducted RNA-Seq analysis, which included a thorough examination of the differentially expressed genes, a functional enrichment analysis and a description of affected signalling circuits. Transcriptomic data were validated at the protein level in cell cultures, serum samples and skin biopsies. RESULTS: Interdisease comparisons against control fibroblasts revealed a unifying signature of 186 differentially expressed genes and four signalling pathways in the three genodermatoses. Remarkably, some of the uncovered expression changes suggest a synthetic fibroblast phenotype characterized by the aberrant expression of extracellular matrix (ECM) proteins. Western blot and immunofluorescence in situ analyses validated the RNA-Seq data. In addition, enzyme-linked immunosorbent assay revealed increased circulating levels of periostin in patients with RDEB. CONCLUSIONS: Our results suggest that the different causal genetic defects converge into common changes in gene expression, possibly due to injury-sensitive events. These, in turn, trigger a cascade of reactions involving abnormal ECM deposition and underexpression of antioxidant enzymes. The elucidated expression signature provides new potential biomarkers and common therapeutic targets in RDEB, XPC and KS. What's already known about this topic? Recessive dystrophic epidermolysis bullosa (RDEB), Kindler syndrome (KS) and xeroderma pigmentosum complementation group C (XPC) are three genodermatoses with high predisposition to cancer development. Although their causal genetic mutations mainly affect epithelia, the dermal microenvironment likely contributes to the physiopathology of these disorders. What does this study add? We disclose a large overlapping transcription profile between XPC, KS and RDEB fibroblasts that points towards an activated phenotype with high matrix-synthetic capacity. This common signature seems to be independent of the primary causal deficiency, but reflects an underlying derangement of the extracellular matrix via transforming growth factor-ß signalling activation and oxidative state imbalance. What is the translational message? This study broadens the current knowledge about the pathology of these diseases and highlights new targets and biomarkers for effective therapeutic intervention. It is suggested that high levels of circulating periostin could represent a potential biomarker in RDEB.

Does the purinergic system affect extracellular matrix functions in the central nervous system?

Exracellular matrix (ECM) consists of a plethora of proteins and polysaccharides, which aggregate into an organized network connected to the surface of the producing cells. It is structurally and functionally present in all components of tissues and organs and represents the substrate on which cells adhere, migrate, proliferate and differentiate, influencing their survival, shape and function. In response to acute (trauma) or chronic (degenerative) insults, brain ECM modifies its composition and function, actively contributing to "scar forming" gliosis or tissue degeneration/remodelling. Moreover, morphological changes in dendritic spines associated with extracellular matrix remodeling play key roles in rewiring synaptic circuitry pertinent to memory formation. In the present report, we collected the main acquisitions on the functional interplay between ECM alterations and the adenine-/guaninebased purine system with particular regard on how purine compounds and their respective receptors may affect and be affected by changes of the cerebral ECM.

New concepts in neuroinflammation: mast cells pro-inflammatory and anti-inflammatory cytokine mediators.

The activation of brain nociceptors and neurons may lead to neurogenic inflammation, an event that involves immune cells including mast cells (MCs). Microglia are similar to macrophages and secrete pro-inflammatory IL-1 family members and TNF. TNF is rapidly released (first 10 minutes from MC granules) and is subsequently secreted along with other pro-inflammatory cytokines with a new synthesis after several hours. MC-derived TNF is a very powerful pro-inflammatory cytokine which mediates sensitization of the meningeal nociceptors. Here, we report the involvement of MCs in neuroinflammation, the role of inflammatory cytokine IL-1 family members, and of TNF, as well as the potential inhibition of IL-37.

Promotion of hand hygiene: the experience of the orthopaedic hospital Gaetano Pini-CTO, Milan, Italy.

BACKGROUND: Hand hygiene is the primary preventive measure against health care-associated infections in terms of cost-effectiveness. In 2005, the WHO proposed the "Global Patient Safety Challenge" campaign, with the aim of reducing the overall incidence of such infections, through multimodal programs and strategies, interactive training tools and standardised methods for monitoring compliance. STUDY DESIGN: On the basis of project "Rimani", sponsored by the Health and Social Care Authority of Emilia-Romagna, the Istituto Ortopedico Gaetano Pini has implemented a project which seeks to increase healthcare staff's compliance with hand hygiene. METHODS: A multidisciplinary working group was created to prepare the project documents. Starting from 5th April 2015, twenty operational units were asked to produce information and training material. On 5th May, during a conference, a committee selected the three best works. The material was distributed on a monthly basis to the various departments. In addition to the training, the specifically trained operators of the Medical Monitoring Department carried out direct hand washing tests, filling out appropriate checklists. Non-compliance relating to the technique recorded in 2014 and 2015 was compared and a statistical analysis was conducted using Student's t-test for paired data. RESULTS: Three tests were carried out in 2014. Ninety-nine cases were monitored and 5 non-compliance cases were reported, concerning the execution of the procedural steps, the running time and closing the tap with one's hands at the end of the wash. In 2015 two tests, involving 30 operational units, were carried out. 60 observations were performed, and no non-conformities emerged concerning the technique. Statistical analysis showed a significant reduction of non-compliances between the 2014 and 2015 P = 0.000). CONCLUSION: The results obtained agree with the main findings in literature. The comparison between the 2014 and 2015 tests shows a trend of improvement in the wash technique. This confirms the effectiveness of a multidisciplinary approach and recognises the active and participatory involvement suggested by the WHO.

Curcumin-loaded graphene oxide flakes as an effective antibacterial system against methicillin-resistant Staphylococcus aureus.

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for serious hospital infections worldwide and represents a global public health problem. Curcumin, the major constituent of turmeric, is effective against MRSA but only at cytotoxic concentrations or in combination with antibiotics. The major issue in curcumin-based therapies is the poor solubility of this hydrophobic compound and the cytotoxicity at high doses. In this paper, we describe the efficacy of a composite nanoparticle made of curcumin (CU) and graphene oxide (GO), hereafter GOCU, in MRSA infection treatment. GO is a nanomaterial with a large surface area and high drug-loading capacity. GO has also antibacterial properties due mainly to a mechanical cutting of the bacterial membranes. For this physical mechanism of action, microorganisms are unlikely to develop resistance against this nanomaterial. In this work, we report the capacity of GO to support and stabilize curcumin molecules in a water environment and we demonstrate the efficacy of GOCU against MRSA at a concentration below 2 µg ml-1. Further, GOCU displays low toxicity on fibroblasts cells and avoids haemolysis of red blood cells. Our results indicate that GOCU is a promising nanomaterial against antibiotic-resistant MRSA.