An innovative approach for the evaluation of prolonged disorders of consciousness using NF-L and GFAP biomarkers: a pivotal study.

Behavioral assessments during the clinical evaluation in prolonged disorders of consciousness patients could be not sufficient for a correct diagnosis and prognostication. To this aim, we used an innovative approach, involving the ultra-sensitive determination of biological markers, correlating them with imaging parameters to investigate the prolonged disorders of consciousness (pDoC).We assessed the serum concentration of neurofilament light chain(NF-L) and glial fibrillary acidic protein (GFAP) in pDoC (n = 16), and healthy controls (HC, n = 6) as well as several clinical imaging parameters such as Fractional Anisotropy (FA), Whole Brain SUV, and White Matter Hyperintensities volumes (WMH) using PET-MRI acquisition. As for differential diagnosis task, only the imaging WMH volume was able to discriminate between vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS) patients (p-value < 0.01), while all selected markers (both imaging and in vitro) were able to differentiate between pDoC patients and HC. At subject level, serum NF-L concentrations significantly differ according to clinical progression and consciousness recovery (p-value < 0.01), highlighting a potential play for the longitudinal management of these patients.

Experimental and theoretical evaluations on Oleuropein as a natural origin corrosion inhibitor for copper in acidic environment.

Copper corrosion in acidic cleaning solutions is a major worry for heat exchangers. Corrosion inhibitors derived from natural sources might be a viable option. The isolation of Oleuropein compound from olive leaf and investigation of its anticorrosion potential for copper in 1.0 M H2SO4 solution are reported here. All experimental results from LC-MS, FT-IR, 1H and 13C-NMR characterizations support the molecular structure of Oleuropein. Electrochemical and gravimetric tests were used to evaluate the corrosion inhibition capabilities of Oleuropein. According to polarization investigation, Oleuropein is a mixed-type inhibitor. Oleuropein's inhibitory efficacy increases with concentration, attaining an optimum value (98.92%) at 100 mg L-1. At high temperatures, Oleuropein can be considered an efficient inhibitor. Thermodynamic variables for the activation operation and copper dissolution were computed and addressed as well. Scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) examinations revealed that Oleuropein produced an outer layer on the copper surface, shielding it from severe acid damage. Quantum chemical simulations were employed to propose molecular explanations for Oleuropein's inhibitory actions.

Optimal integration of vacuum UV with granular biofiltration for advanced wastewater treatment: Impact of process sequence on CECs removal and microbial ecology.

This study explored process synergies attainable by integrating a vacuum ultraviolet-based advanced oxidation process with biofiltration. A comparison using granular activated carbon or granular zeolite as filtration media were examined in context of advanced wastewater treatment for potable reuse. Six biofiltration columns, three with granular activated carbon and three with granular zeolite, were operated in parallel and batch-fed daily with nitrified secondary effluent. After achieving a pseudo-steady state through the filter columns, vacuum ultraviolet treatment was applied as pre-treatment or as post-treatment, at two different applied energies (i.e., VUV-E1=1 kWh/m3 and VUV-E10=10 kWh/m3). Once granular activated carbon had transitioned to biologically activated carbon, as determined based on soluble chemical oxygen demand removal, adsorption was still observed as the main mechanism for contaminants of emerging concern and nitrate removal. Vacuum ultraviolet pre-treatment markedly improved contaminants of emerging concern removal through the integrated system, achieving 40% at VUV-E1 and 90% at VUV-E10. When applied as post-treatment to zeolite column effluents, VUV-E1 and VUV-E10 further increased contaminants of emerging concern removal by 20% and 90%, respectively. In the zeolite system, vacuum ultraviolet pre-treatment also increased soluble chemical oxygen demand removal efficiency, indicating that higher energy vacuum ultraviolet increased biodegradability. Total prokaryotes were two-fold more abundant in biologically activated carbon than in zeolite, with vacuum ultraviolet pretreatment markedly affecting microbial diversity, both in terms of richness and composition. Media type only marginally affected microbial richness in the biofilters but showed a marked impact on structural composition. No clear relationship between compositional structure and depth was observed.

Daratumumab plus bortezomib or daratumumab plus lenalidomide as salvage therapy for patients with myeloma: initial follow-up of an Italian multicentre retrospective clinical experience by 'Rete Ematologica Pugliese'.

We report herein a multicentre retrospective analysis of 192 consecutive patients with symptomatic refractory/relapsed multiple myeloma (RRMM) treated with daratumumab in combination with bortezomib or lenalidomide as salvage therapy at 9 haematological centres in Puglia. Choice of both regimens was based on previous treatment and/or physicians' preference. Considering the under-representation of older patients (very old patient ≥ 80 years) in clinical trials and the prognostic and predictive importance and value of frailty status, here, we further characterised the patient cohort by age. The overall response rate (ORR) was generally lower than what was previously reported in the CASTOR (ORR 72.6% vs 85%) and POLLUX (ORR 86.5% vs 93%) trials. The lower ORR in our analysis compared to the CASTOR and POLLUX trials could be related to a less selected population. Similarly, amongst very old patients, the ORR was encouraging: ORR to treatment with DVd (daratumumab + bortezomib + dexamethasone) was 66.7%, and ORR to treatment with DRd (daratumumab + lenalidomide + dexamethasone) was 92.3%. Median TTP (time to progression) was 10.8 months (1-year TTP: 44.7%; 2-year TTP: 25.3%) in the DVd group; median TTP was not reached in the DRd group (1-year TTP: 82.7%; 2-year TTP: 71.4%). Median OS (overall survival) was not reached either in the DRd group (1-year OS: 85.9%; 2-year OS: 73.7%) or the DVd group (1-year OS: 70.2%; 2-year OS: 58.9%).

Novel nanocomposites of Ni-Pc/polyaniline for the corrosion safety of the aluminum current collector in the Li-ion battery electrolyte.

In electrochemical energy storage systems, Li-ion batteries have drawn considerable interest. However, the corrosion of the aluminum current collector in the LiN(SO2CF3)2 electrolyte has a major effect on battery efficiency. To protect the current collector from the corrosive action of the LiN(SO2CF3)2 electrolyte, new nanocomposites based on Ni(II)tetrakis[4-(2,4-bis-(1,1-dimethyl-propyl)-phenoxy)]phthalocyanine (Ni-Pc) and polyaniline matrix (PANI) (i.e. PANI@Ni-Pc composites) are coated on the aluminum current. SEM, XRD, and EDS were used to characterize the PANI@Ni-Pc composite. This method represents a novel approach to the production of Li-ion batteries. Electrochemical tests show that the PANI@Ni-Pc composites can protect aluminum from corrosion in LiN(SO2CF3)2. The output of PANI@Ni-Pc composites is influenced by the Ni-Pc concentration. The composite PANI@Ni-Pc is a promising way forward to build high-stability Li-Ion batteries.

Electroencephalographic and Neuroimaging Asymmetry Correlation in Patients with Attention-Deficit Hyperactivity Disorder.

The present study explores the correlation between electroencephalographic and neuroimaging asymmetry index from EEG-MRI functional connectome and EEG power analysis in inattention, motion, and mixed profile subgroups of ADHD. Sixty-two subjects from Healthy Brain Network Biobank of the Child Mind Institute dataset were selected basing on the quotient score. From both MRI and EEG asymmetry index, Pearson's correlation, ANOVA, and partial least square analysis were performed matching left and right brain parcels and channels. The asymmetry index significantly correlated across subjects between fMRI and power-EEG in the inattention group in frontal and temporal areas for theta and alpha bands, an anticorrelation in the same areas for delta band was found. Significant patterns of hemispheric asymmetry index have been reported, involving EEG bands that underlie cognitive impairments in ADHD. Alpha and theta bands were altered in the inattention group of patients, reflecting widespread deficiency of basic attentional processing.

A broad-spectrum review on multimodal neuroimaging in bulimia nervosa and binge eating disorder.

Bulimia nervosa (BN) and binge eating disorder (BED) are psychiatric conditions marked by emotional disorders managed through the ingestion of great amount of food, with consequent vomiting for avoiding weight gain. Such behavioral habits are dysfunctional and severely impact both psychological and physical health, also compromising neurobiological processes. In the present review, we focus on recent neuroimaging findings (2010-2019) that provide insight into the neural bases of BN and BED. We describe the role of different neuroimaging techniques (magnetic resonance imaging, both structural and functional, positron emission tomography, single-photon emission computerized tomography, electroencephalography and magnetoencephalography) in the delineation of pathophysiological aspects of BN and BED. Results highlight the main involvement of the frontal system and its relationships with temporal areas for reward and self-regulatory processes modulation. The network that regulates food-stimuli control seems to be widespread across the brain, catching the insula, precentral gyrus, frontal cortex and extending until the visual cortex for processing of body image. These results demonstrate diffuse brain vulnerability associated with BN and BED and can confirm that symptomatology maintenance results from several neurostructural and neurofunctional alterations.

Stainless steel bipolar plate coated with polyaniline/Zn-Porphyrin composites coatings for proton exchange membrane fuel cell.

The proton exchange membrane fuel cells are the promising sustainable energy sources. The present study focuses on the enhancement the fuel cell performance and the protection of the stainless steel bipolar plate from the corrosion using polyaniline/Zn-Porphyrin composites coatings. The electrochemical properties (polarization and impedance) of the coated 303 stainless steel in 1.0 M H2SO4 solution have been evaluated. The coated 303 stainless steel by new composites exhibits the excellent anti-corrosion activity towards corrosive fuel cell electrolyte. The polyaniline/Zn-Porphyrin composite gives an excellent performance by adding 1.0% of Zn-Porphyrin. This composite improves the output power of the fuel cell.

Controlling micropollutants in tertiary municipal wastewater by O3/H2O2, granular biofiltration and UV254/H2O2 for potable reuse applications.

A comprehensive pilot study was carried out to experimentally assess the potential of newly developed treatment trains integrating two-stage AOPs and biofiltration to reach potable reuse water quality standards from municipal wastewater. The processes consisted of a two-stage AOPs with (carbon or limestone) biofiltration, the first AOP (O3/H2O2) serving as pre-treatment to biofiltration and the second AOP (UV254/H2O2) serving as post-biofiltration finishing step to ensure advanced disinfection. A comprehensive monitoring campaign was put in place resulting from the combination of targeted, non-targeted and suspect screening measurements. It was found that 13 organic micropollutants were detected from a list of 219 suspects although at ng/L level only. For the treatment conditions piloted in this study (O3 = 13 ±â€¯0.5 mg/L, H2O2 = 11 ±â€¯0.4 mg/L for the O3/H2O2 process, and UV = 410 ±â€¯63.5 mJ/cm2, H2O2 = 5 mg/l for the UV254/H2O2 process), it was possible to estimate the overall removal efficacy for each unit process, which was found to follow this order: RO (99%)  > BAC (87%) > O3-H2O2 (78%)  > BAL (67%)  > UV/H2O2 (43%)  > AOP contact chamber (19%)  > UF(0%), with the treatment train integrating two AOPs and granular biofiltration with activated carbon (O3/H2O2 + BAC + UV254/H2O2) showing superior performance with a 99% abatement in total micropollutants. No ecotoxicologically-positive response was generally observed for any of the effluent samples from the tested trains, even when pre-concentration factors up to 100-1000 times were employed to increase the sensitivity of the bioassay methods.

Exploring corrosion protection properties of alkyd@lanthanide bis-phthalocyanine nanocomposite coatings.

Organic coatings have been widely used to protect carbon steel pipelines from external corrosion; however, they often suffer from permeability and weak adhesion. Here we show that synthetic lanthanide bis-phthalocyanine complexes, LnPc2 (Ln = lanthanide metal, Pc = C32H16N8 denotes the phthalocyanine ligand) can be used to form new nanocomposite coatings to provide corrosion protection to the underlying carbon steel pipelines. Electrochemical studies (EIS and potentiodynamic polarization) showed that the incorporation of LnPc2 compound (PrPc2, SmPc2 and HoPc2) additives with alkyd coating, leads to a significant increase in the corrosion resistance of carbon steel in 0.5 M HCl solution. The alkyd@LnPc2 nanocomposite coatings absorb very low water volumes, when compared to the neat alkyd coating. LnPc2 compounds allowed enhancing the pull-off adhesion of coatings performance from 3.34 MPa to 19.94 MPa. The efficiency of alkyd@HoPc2 coating appears higher than that of alkyd@PrPc2 and alkyd@SmPc2 coatings. The protective properties of alkyd@LnPc2 coatings were confirmed by SEM, TGA, scratch hardness, impact resistance, bend test and contact angle analysis.

Novel hydroxyapatite nanorods improve anti-caries efficacy of enamel infiltrants.

OBJECTIVES: Enamel resin infiltrants are biomaterials able to treat enamel caries at early stages. Nevertheless, they cannot prevent further demineralization of mineral-depleted enamel. Therefore, the aim of this work was to synthesize and incorporate specific hydroxyapatite nanoparticles (HAps) into the resin infiltrant to overcome this issue. METHODS: HAps were prepared using a hydrothermal method (0h, 2h and 5h). The crystallinity, crystallite size and morphology of the nanoparticles were characterized through XRD, FT-IR and TEM. HAps were then incorporated (10wt%) into a light-curing co-monomer resin blend (control) to create different resin-based enamel infiltrants (HAp-0h, HAp-2h and HAp-5h), whose degree of conversion (DC) was assessed by FT-IR. Enamel caries lesions were first artificially created in extracted human molars and infiltrated using the tested resin infiltrants. Specimens were submitted to pH-cycling to simulate recurrent caries. Knoop microhardness of resin-infiltrated underlying and surrounding enamel was analyzed before and after pH challenge. RESULTS: Whilst HAp-0h resulted amorphous, HAp-2h and HAp-5h presented nanorod morphology and higher crystallinity. Resin infiltration doped with HAp-2h and HAp-5h caused higher enamel resistance against demineralization compared to control HAp-free and HAp-0h infiltration. The inclusion of more crystalline HAp nanorods (HAp-2h and HAp-5h) increased significantly (p<0.05) the DC. SIGNIFICANCE: Incorporation of more crystalline HAp nanorods into enamel resin infiltrants may be a feasible method to improve the overall performance in the prevention of recurrent demineralization (e.g. caries lesion) in resin-infiltrated enamel.

Gut barrier in health and disease: focus on childhood.

The gut barrier is a functional unit, organized as a multi-layer system, made up of two main components: a physical barrier surface, which prevents bacterial adhesion and regulates paracellular diffusion to the host tissues, and a deep functional barrier, that is able to discriminate between pathogens and commensal microorganisms, organizing the immune tolerance and the immune response to pathogens. Other mechanisms, such as gastric juice and pancreatic enzymes (which both have antibacterial properties) participate in the luminal integrity of the gut barrier. From the outer layer to the inner layer, the physical barrier is composed of gut microbiota (that competes with pathogens to gain space and energy resources, processes the molecules necessary to mucosal integrity and modulates the immunological activity of deep barrier), mucus (which separates the intraluminal content from more internal layers and contains antimicrobial products and secretory IgA), epithelial cells (which form a physical and immunological barrier) and the innate and adaptive immune cells forming the gut-associated lymphoid tissue (which is responsible for antigen sampling and immune responses). Disruption of the gut barrier has been associated with many gastrointestinal diseases, but also with extra-intestinal pathological condition, such as type 1 diabetes mellitus, allergic diseases or autism spectrum disorders. The maintenance of a healthy intestinal barrier is therefore of paramount importance in children, for both health and economic reasons. Many drugs or compounds used in the treatment of gastrointestinal disorders act through the restoration of a normal intestinal permeability. Several studies have highlighted the role of probiotics in the modulation and reduction of intestinal permeability, considering the strong influence of gut microbiota in the modulation of the function and structure of gut barrier, but also on the immune response of the host. To date, available weapons for the maintenance and repair of gut barrier are however few, even if promising. Considerable efforts, including both a better understanding of the gut barrier features and mechanisms in health and disease, and the development of new pharmacological approaches for the modulation of gut barrier components, are needed for the prevention and treatment of gastrointestinal and extraintestinal diseases associated with gut barrier impairment.

"Real world" outcome of lenalidomide plus dexamethasone in the setting of recurrent and refractory multiple myeloma: extended follow-up of a retrospective multicenter study by the "rete ematologica pugliese".

This current retrospective multicenter analysis represents, to our knowledge, the first Italian study evaluating the efficacy and toxicity profile of "lenalidomide plus dexamethasone" as salvage therapy in patients with recurrent-refractory MM in the real life contest. Our study included patients who are usually excluded from clinical trials because of unfavorable baseline characteristics. Median OS was significantly longer in patients receiving "lenalidomide plus dexamethasone" for more than 12 months compared with those who had received "lenalidomide plus dexamethasone" for a shorter interval (P<0.0001). Median OS was not affected by best response achieved (P 0.4) and age (P 0.3). Quality of response did not correlate with number of previous lines of therapy (P 0.77) and age. Higher ORRs were recorded in the patients group with relapsed MM compared to those with refractory disease, but this difference was not statistically significant (P 0.38).

Uterine leiomyosarcoma: report of three cases and review of the literature.

This is the report of three cases of unsuspected uterine leiomyosarcoma diagnosed by pathologist after hysteroscopic resection. The literature on this issue has been reviewed. Mesenchymal uterine tumors are rare malignancies, occurring in only 17 per one million women annually. The three most common variants of uterine sarcoma are endometrial stromal sarcoma, leiomyosarcoma, and malignant mixed Müllerian tumour. Less than one percent of women believed to have a leiomyoma actually have a sarcoma at hysterectomy. According to the authors' experience and the available literature reviewed, the removal of the whole myomatosus lesion, even if its appearance suggests a typical submucosal myoma, represents the only method to definitively rule out the presence of sarcomatous tissue.

Non-destructive evaluation of chlorophyll content in quinoa and amaranth leaves by simple and multiple regression analysis of RGB image components.

Leaf chlorophyll content provides valuable information about physiological status of plants; it is directly linked to photosynthetic potential and primary production. In vitro assessment by wet chemical extraction is the standard method for leaf chlorophyll determination. This measurement is expensive, laborious, and time consuming. Over the years alternative methods, rapid and non-destructive, have been explored. The aim of this work was to evaluate the applicability of a fast and non-invasive field method for estimation of chlorophyll content in quinoa and amaranth leaves based on RGB components analysis of digital images acquired with a standard SLR camera. Digital images of leaves from different genotypes of quinoa and amaranth were acquired directly in the field. Mean values of each RGB component were evaluated via image analysis software and correlated to leaf chlorophyll provided by standard laboratory procedure. Single and multiple regression models using RGB color components as independent variables have been tested and validated. The performance of the proposed method was compared to that of the widely used non-destructive SPAD method. Sensitivity of the best regression models for different genotypes of quinoa and amaranth was also checked. Color data acquisition of the leaves in the field with a digital camera was quick, more effective, and lower cost than SPAD. The proposed RGB models provided better correlation (highest R (2)) and prediction (lowest RMSEP) of the true value of foliar chlorophyll content and had a lower amount of noise in the whole range of chlorophyll studied compared with SPAD and other leaf image processing based models when applied to quinoa and amaranth.

[5 days Cefaclor vs. 10 days amoxicillin/clavulanate in the treatment of childhood streptococcal pharyngitis. Data from a randomized clinical trial]. / Efficacia di Cefaclor 5 giorni vs. amoxicillina-acido clavulanico 10 giorni, nella terapia della faringotonsillite streptococcia del bambino. Risultati di uno studio clinico randomizzato.

AIM: The duration of therapy represents a fundamental aspect in the compliance to the therapy of child pathologies, such as pharyngotonsillitis, treated with oral therapy. Although penicillin and amoxicillin are the first choice antibiotics in the case of a child suffering from pharyngotonsillitis with the proven presence of Group A ß-hemolytic Streptococcus (GAS), the number of orally administered doses and 10 days of therapy, considerably lower the compliance. METHODS: An open phase IV randomized multicenter clinical trial was conducted in parallel groups, involving 49 family pediatrician (FP), distributed over the entire national territory, enrolling 435 children suffering from GAS-FT. 210 children received Cefaclor, 50 mg/kg/day, administered twice daily for five days, whilst 213 children received amoxicillin/clavulanate 40 mg/kg/day administered twice daily for 10 days. RESULTS: The results showed percentages of eradication of 88.4% for the Cefaclor group and 94.3% for the amoxicillin/clavulanate group, and a positive clinical judgement of 92.3% for the Cefaclor group and 96.6% for the amoxicillin/clavulanate group. The two arms of the study did not have any significant statistical differences, neither for the eradication, nor for the clinical judgement nor for the reduction of the Milano Score between the beginning and the end of treatment, with a P=0.042 for amoxicillin/clavulanate for eradication. CONCLUSION: This study confirms that the administration of Cefaclor for five days during GAS-FT has the same efficacy as a 10-day therapy with amoxicillin/clavulanate, with a clearly different compliance.

Atopic dermatitis (AD) management in an Italian pediatric clinic.

AIM: Atopic dermatitis (AD) is a common, chronic relapsing inflammatory skin disease characterized by dry skin and variable pruritus sometimes associated with allergic disease in other organs as asthma and rhinoconjunctivitis. AD affects deeply the Quality of Life, thus can be extremely disabling and may cause psychological problems for both affected children and their families. METHODS: In order to investigate the estimated prevalence of the disease and the beliefs of the Italian pediatricians, a group of 437 Italian family pediatricians covering a population of almost 380000 children participated in a study based on a questionnaire of 38 items. RESULTS: According to answers of the participants, the incidence of AD has been estimated around 10% of the population and food allergy is believed to be the trigger of the acute phase of the disease in infants. As a second opinion, dermatologists are consulted more frequently than allergologists. CONCLUSION: The use of emollients is advised in general whilst topical corticosteroids treatment is prescribed only in selected cases; more than 50% of pediatricians do not prescribe topical calcineurin inhibitors.

The association between time to disposition plan in the emergency department and in-hospital mortality of general medical patients.

BACKGROUND: A perceived risk of time-limited emergency department (ED) assessment of patients is inadequate workup leading to inappropriate disposition. The aim of this study was to examine the association of time to disposition plan (TDP) on ED length of stay (LOS) and correlate this to mortality. METHODS: A retrospective review of data collected from ED information systems at three hospitals was conducted between June 2008 and October 2009. Included patients were admitted to a general medical unit. Patients were excluded if admitted to intensive care, coronary care, a cardiac monitored bed or required surgery in first 24 h or had an expected LOS of <48 h. Multivariate regression analysis was used to identify independent associations with mortality. RESULTS: A total of 10,107 patient episodes was analysed, of which 6768 patients (67.0%) had an ED LOS of ≥8 h. There was significant effect modification by ED LOS in the association of TDP and mortality. In the setting of longer ED LOS, a TDP of <4 h was associated with significantly higher mortality (OR 1.57, 95% CI: 1.28-1.92, P < 0.001), corrected for age, gender and triage category. This association was not significant when ED LOS was <8 h (OR 0.88, 95% CI: 0.60-1.27, P = 0.49). CONCLUSIONS: In the setting of prolonged ED LOS, completing ED assessment and management within 4 h of presentation was associated with significantly higher mortality. Further prospective studies are required to understand the relationship between rapid decision making in the ED and patient safety.