Characterisation of polycaprolactone scaffolds made by melt electrospinning writing for pelvic organ prolapse correction - a pilot study

Additive manufacturing and 3D printing technologies enable personalised treatments using custom-made prosthetics, implants and other medical devices. This research aimed to characterise novel biodegradable polycaprolactone (PCL) implants for pelvic organ prolapse repair, produced using melt electrospinning technology. PCL mesh filaments were printed in 5 configurations: 240 µm, 160 µm, three layers of 80 µm, two layers of 80 µm and one layer of 80 µm. Material sterilisation, degradation, mechanical behaviour, and geometric variation due to applied loads were studied. Polypropylene (PP) Restorelle mesh was used as a reference in this study and vaginal tissue as a baseline. Sterilisation by UV irradiation+ EtOH 70% did not affect the specimens. A significant weight loss was observed in 80 µm deposited fibers at 90 - and 180 - days of degradation, losing 10% of weight in neutral solution to 27% in acidic. All printed PCL deposited fibers had functional loss at 180 - day degradation in acidic solution (pH 4.2) (p < 0.05). PCL printed meshes were classified as ultra-lightweight, except lightweight 240 µm filament mesh. PCL meshes closely match the biomechanical properties of vaginal tissues, particularly in the comfort zone, unlike the Restorelle implant. The 3D printed mesh pores appeared to be stable compared to those of Restorelle meshes that had been used clinically until the FDA pulled its approval. Based on the pilot study results, improved implant designs will be studied, and in vitro experiments on the cell adhesion and growth response will be conducted

Assessing the effectiveness of primary angioplasty compared with thrombolysis and its relationship to time delay: a Bayesian evidence synthesis

Background: Meta-analyses of trials have shown greater benefits from angioplasty than thrombolysis after an acute myocardial infarction, but the time delay in initiating angioplasty needs to be considered. Objective: To extend earlier meta-analyses by considering 1- and 6-month outcome data for both forms of reperfusion. To use Bayesian statistical methods to quantify the uncertainty associated with the estimated relationships. Methods: A systematic review and meta-analysis published in 2003 was updated. Data on key clinical outcomes and the difference between time-to-balloon and time-to-needle were independently extracted by two researchers. Bayesian statistical methods were used to synthesise evidence despite differences between reported follow-up times and outcomes. Outcomes are presented as absolute probabilities of specific events and odds ratios (ORs; with 95% credible intervals (Crl)) as a function of the additional time delay associated with angioplasty. \ Results: 22 studies were included in the meta-analysis, with 3760 and 3758 patients randomised to primary angioplasty and thrombolysis, respectively. The mean ( SE) angioplasty-related time delay ( over and above time to thrombolysis) was 54.3 (2.2) minutes. For this delay, mean event probabilities were lower for primary angioplasty for all outcomes. Mortality within 1 month was 4.5% after angioplasty and 6.4% after thrombolysis ( OR = 0.68 ( 95% Crl 0.46 to 1.01)). For non-fatal reinfarction, OR = 0.32 ( 95% Crl 0.20 to 0.51); for non-fatal stroke OR = 0.24 ( 95% Crl 0.11 to 0.50). For all outcomes, the benefit of angioplasty decreased with longer delay from initiation. Conclusions: The benefit of primary angioplasty, over thrombolysis, depends on the former's additional time delay. For delays of 30-90 minutes, angioplasty is superior for 1- month fatal and non-fatal outcomes. For delays of around 90 minutes thrombolysis may be the preferred option as assessed by 6-month mortality; there is considerable uncertainty for longer time delays

A phytosociological investigation on the mixed hemycryptophitic and therophitic grasslands of the Cornicolani mountains (Lazio Region – central Italy)

Abstract In this paper a phytosociological study on the dry grasslands of the Cornicolani mountains is presented. The Cornicolani are a group of isolated limestone hills which emerge from the slightly ondulating grounds of the Rome countryside in the Tyrrhenian side of the central Italy. Eighty-nine relevés were performed using the Braun-Blanquet phytosociological approach. These were further subjected to hierarchical classification and to NMDS ordination. Five major types of grasslands were distinguished: short therophytic grasslands developed on shallow soils dominated, in turns, by Hypochaeris achyrophorus, Plantago lagopus and Plantago bellardii; sub-nitrophilous detriticolous perennial grasslands dominated by Dittrichia viscosa and Helichrysum italicum; Dasypyrum villosum and Vulpia ligustica lawn and fallow annual tall-grasslands; Ampelodesmos mauritanicus grasslands of the rocky S-facing slopes and sub-mesophilous Lolium perenne and Cynodon dactylon grasslands of the flat and pastured areas. From a syntaxonomical standpoint a new associations named Plantaginetum afrae-bellardii was proposed and included in the class Stipo-Trachynetea. In addition the association Helichryso italici-Inuletum viscosae Trinajstić 1965 (nom. inval.) was here validated

New opportunities in Haemophilia treatment: Efmoroctocog Alfa for patients with Haemophilia A

Recently new opportunities are emerging for improving the way patients with Haemophilia A are treated. Among these opportunities, efmoroctocog alfa is a first-in-class recombinant factor VIII-Fc fusion protein (rFVIIIFc) produced by recombinant DNA technology with an extended half-life compared with conventional FVIII preparations. The available evidence coming from an Italian HTA report indicates that efmoroctocog alfa provides an effective alternative to conventional FVIII preparations (including standard rFVIIIs) for the management of Haemophilia A. Moreover, by reducing the frequency of injections required, it has the potential to reduce treatment burden, and hence improve adherence to prophylaxis and patient Quality-of-Life.&nbsp

New Molecular Aspects of Cardiac Arrest; Promoting Cardiopulmonary Resuscitation Approaches

Introduction: Cardiopulmonary resuscitation (CPR) is a method to improve survival of patients with cardiac arrest. This study aimed to identify the key genes affected five minutes after cardiac arrest, hoping to elevate the efficacy of CPR.Methods: In this bioinformatics study differentially expressed genes of six pigs were downloaded from GEO and screened. The significant and characterized genes were analyzed via calculating fold change and protein-protein interaction (PPI) networks. The crucial nodes were determined based on centrality parameters and their related biological processes were investigated via ClueGO.Results: 17 significant up-regulated (LogFC ≥ 2) and 22 down-regulated (LogFC &lt; -0.5) genes were detected. Transthyretin (TTR logFC = 4.59) and Gonadotropin-releasing hormone receptor (GNRHR logFC = 3.84) had higher logFC among up-regulated and down-regulated genes, respectively. The critical genes including four up-regulated and five down-regulated genes were detected from network analysis. GNRHR and Prolactin precursor (PRL) were among the most important down res 5 minutes after cardiac arrest and Beta-2 adrenergic receptor and Cadherin-1 were among the most important up regulated gens. Conclusion: The introduced potential biomarkers could reveal a new molecular aspect for CPR performance and pituitary gland protection was highlighted in this respect.  

Comparison among single-phase test, automated screening method and GC/MS for the traceability of ketamine in urine

BACKGROUND The use of ketamine, for non-medical purpose, results widespread also in Italy. This drug is not searched by institutional centers, charged of the responsibility to realize the execution of toxicological analysis based on the article 187 of The New Italian Highway Code. We evaluated the reliability of the single-phase test comparing it with an automated screening method and a gas chromatography-mass spectrometry to search the presence of ketamine on casualty patients involved in car accidents in Rome.METHODS The screening analysis were performed by a single-phase test (with a cut-off settled at 1000 ng/ml), and an automated immunoenzymatic assay (cut-off settled at 330 ng/ml). The confirmation tests have been realized by gas chromatography-mass spectrometry.RESULTSThe single-phase test highlighted ten positive samples out of 294. The automated instrument confirmed only six out of ten previous positive samples, meanwhile the instrument found further four positive samples, considered negative by the single-phase test. The presence of ketamine is confirmed by gas chromatography-mass spectrometry only in seven samples out of fourteen resulted positives from both screening analysis. Three samples out of seven confirmed by gas chromatography-mass spectrometry were positive only to ketamine.CONCLUSION Following the law indications, ketamine is not searched: this limit does not make the authorities able to apply the penalties expected for road laws violations. The automation is essential to guarantee the reliability of toxicological screening tests, especially to medico-legal significance. This results highlight the absolutely necessity of the execution of the confirmation test, successively to screening analysis

Contribution to the salinization risk assessment, under drought conditions, in the Alqueva irrigation area (South Portugal)

In Mediterranean regions, climate changes have enlarged water limitation for crops, leading to an increased demand for irrigation water. During the hydrological years of 2016 and 2017, Portugal experienced a drought season that has extended throughout almost the entire mainland territory reaching a severe drought level. Under water scarcity conditions and high atmosphere evaporative demand, the risk of land salinization is one of the major threats to the sustainability of irrigated agriculture. Therefore, it is very important to assess the quality of irrigation water and the risks of salinity for crop production, in order to adopt appropriate management practices in irrigated areas. This study is focused on the salinity risks for the production of the most representative crops grown in the Alqueva irrigation area. This is a large irrigation scheme with a total area of 120 000 ha centered in the Alqueva reservoir. For the purpose of the study, a chemical assessment of some major inorganic ions (Na+, Ca2+, Mg2+, K+, SO4 2- and Cl-), pH and electric conductivity (ECW), was conducted throughout 2017, on water samples collected on four platforms sited in the reservoir. Water quality for irrigation was evaluated considering both the Portuguese regulations and the FAO guidelines. Sodium adsorption ratio (SAR) and soil salinity (ECe) were estimated, in order to assess potential sodium-related soil permeability and crusting problems, as well as, potential yield reductions in the most significant crops of the Alqueva perimeter. Higher ion concentrations and water salinity were quantified with the increase of atmosphere evaporative demand. Sodium hazard assessment showed slight to moderate risk of reduced infiltration rates, a result that should be taken into account when surface or sprinkler irrigation systems are used. Furthermore, relative yield reductions may be mainly found in horticultural crops, classified as moderately sensitive to sensitive in the salt tolerance scale.This work was co-funded by the European Union through the European Regional Development Fund, framed in COMPETE 2020 (Operational Programme Competitiveness and Internationalization), through the ICT project (UID/GEO/04683/2013) with reference POCI-01-0145-FEDER-007690 and the ALOP project (ALT20-03-0145-FEDER-000004