TOWARDS THE USE OF NEW TECHNOLOGIES FOR NUTRITIONAL SAFETY

In this thesis five experimental studies were reported with the objective to improve the knowledge and provide new solutions for different and important aspects of dairy cow nutrition. The first trial was performed to examine the relationships between blood concentrations of fatty acids (NEFA), \u3b2-hydroxybutyrate (BHB) and \u3b1-tocopherol during the periparturient period in dairy cows. For the study 131 cows from 4 different farms, 2 in Italy and 2 in Greece were used. We determined blood concentrations of NEFA, BHB, and \u3b1- tocopherol at dry-off, at calving, and 30d postpartum. We found a weak correlation between NEFA and BHB throughout the periparturient period. Negative correlations between NEFA and \u3b1-tocopherol were highly significant at 30d postpartum and approached the level of significance at dry-off. However, both correlations became nonsignificant following the adjustment of \u3b1-tocopherol with cholesterol, indicating that the correlations were a reflection of changes in lipid transport. We found significant negative correlations between BHB and \u3b1- tocopherol after adjustment with cholesterol. The aims of the second research presented was to understand the effects of lactic acid bacteria (LAB) inoculation on fermentation products and quality of alfalfa and ryegrass silage and the use of thermal camera and electronic nose to evaluate the silage quality. Wilted ryegrass and alfalfa silage were inoculated with a commercial product containing Lactobacillus Rhamnosus and Lactobacillus Farciminis and stored in triplicate micro fermenters for each treatment. The silos were opened after 2, 5, 30, 60, 90 and 120 days and silages were collected and analyzed. The results obtained showed better acidification of treated silages with pH value lower in both alfalfa and ryegrass silages (P 640.01). Alfalfa silage has had higher content of lactic acid (P 640.01) with unexpected higher values of NH4 (P 640.01). In ryegrass silage the LAB concentration was lower in treated compared to control silage (P 640.01). Instead no significant difference of LAB concentration was observed between control and treated alfalfa silages. Strong negative correlation between pH and lactic acid 97% (P 640.01) and positive correlation between pH and LAB concentration 93% (P 640.01) were observed in alfalfa silage. The LAB concentration was positive correlated with pH value 94% (P 640.01). Significant but not strong negative correlation was observed between pH and NH4 33% (P 640.05). Probably due to the good quality of both treated and control silages no differences of temperature were observed. Although, different results were obtained between ryegrass and silage analysis the electronic nose showed promising ability to evaluate the silage quality but further studies will be needed to understand his ability to evaluate the silage quality. In the third experimental trial the combined use of thermal camera and electronic nose was evaluated for rapid assessment of unfavorable fermentations that can occur in a corn silage mass. From April to September, five sampling times were performed to collect silage samples. The thermal camera was used to detect the temperature. For all samples chemical analysis were performed to evaluate the silage quality and was used electronic nose to perform the off-flavors analysis. The silage quality remained constant and no differences were observed throughout the trial. Significant statistical differences were observed between samples with normal temperature and that with higher temperature for pH value (P<0.01), lactic acid (P<0.05). The off-flavors analysis showed the ability of electronic nose to distinguish the strong wrong fermentation. The results obtained showed that the use thermal camera and electronic nose can provide an indication of silage quality in short time and with low cost. Further studies aimed to study the accuracy of both instruments are necessary. The aim of the fourth experimental study was to investigate the physical quality of a selected lot of twenty animal feed samples collected in Italy and Serbia. The samples belonged to different categories and analyzed to assess the flowability, particle size distribution, hardness and durability. Granulation of cattle and pig feed was finer in Italian than in Serbian samples. Flowability of samples from both countries in mash form were rated from fair to good (angle of repose >30\ub0) while granulated samples (pellets and extrudates) had improved flowability (angle of repose 10 kg) than pelleted products (<8 kg). Durability of most of the extruded and pelleted products was higher tha 95%. Most of the physical characteristics of the samples responded to recommendations, which showed that the similar practices are in use in both countries. The last research reported in this thesis had the aim to determine the influence of filling level, cutting and mixing time on homogeneity and particle size distribution of a dairy cow total mixed ration (TMR). The mixing wagon was loaded to 40%, 70% and 100% of maximum nominal load (21m3). The cutting time and mixing time were 4, 5 and 6 minutes. Samples of TMR were collected at the beginning, in the middle and at the end of the feeding alley and analysed to evaluate the dry matter (DM), ether extract (EE), crude protein (CP), neutral detergent fibre (NDF), and ash content. At the same time TMR particle size distribution was determined in triplicate for each sampling point by Penn State Particle Separator. The coefficient of variation (CV %) of DM, CP, NDF and EE was used to evaluate the multiple effect of filling level, cutting and mixing time on ration uniformity and differences between the theoretical ration formulated and that provided to dairy cattle. The filling level was the main factor affecting uniformity and differences from theoretical ration, the best results were obtained to 70%. The mixing time had less and different effects uniformity and ration composition. The cutting time showed no effects

Connectivity for the frisbee architecture

In this paper we investigate the kconnectivity threshold of distributed dense ad hoc heterogeneous wireless sensor network architecture. We consider the situation when sensors are deployed in the surveillance area according to a uniform distribution perturbed by a Gaussian noise. We derive analytically the minimum detection range which guarantees an emerging structure in the network, namely the connectivity, which becomes larger and larger as the number of sensors in the network increase. This allows the target track to be propagated almost surely throughout the network using the minimum possible amount ofprime energy. We report the results of some simulation experiments which further support the theoretical results

Algorithms for the selection of the active sensors in distributed tracking: Comparison between Frisbee and GNS methods

This paper compares two different approaches for sensor selection for distributed tracking: 1) The Frisbee method, and 2) Global Node Selection (GNS). The Frisbee method is based on the proximity of the nodes to the predicted location of the target; GNS is based on minimizing the unbiased Cramer Rao lower bound (CRLB). Both theoretical and experimental results indicate that the Frisbee method is as effective as GNS. Furthermore, the Frisbee method is attractive due to its very light computational load

Seizure characteristics and the use of anti-epileptic drugs in children and young people with brain tumours and epileptic seizures: analysis of regional paediatric cancer service population

PURPOSE: Epileptic seizures complicate the management of childhood brain tumours. There are no published standards for clinical practice concerning risk factors, treatment selection or strategies to withdraw treatment with antiepileptic drugs (AED). METHOD: We undertook a case note review of 120 patients with newly diagnosed brain tumours, referred to a regional paediatric cancer service. RESULTS: Data was available on 117/120 (98%) children <18 years: median age at tumour presentation was 8.1 years (IQR 25°-75°: 3.6-12.7), median follow up was 33 months (IQR 25°-75°: 24-56), and 35/117 (29%) experienced seizures. A cortical tumour location was associated with the highest risk of seizures (OR: 7.1; CI 95% 2.9-17.3). At a median follow up of 24 months (IQR25°-75°: 15-48), 22/35 (63%) with seizures, had a single seizure episode, 15/35 (43%) were seizure free (SF) on AEDs, 13/35 (37%) were SF off AEDs, and 7/35 (20%) experienced continuing epileptic seizures. Overall 34/35 (97%) were treated with AEDs after a seizure, of whom 12/35 (35%) withdrew from AED medication, and although 4/35 (12%) had seizure relapse, all were after further acute events. The median duration of AED before withdrawal was 11 months (IQR25°-75° 5-14 months), and the median follow up after withdrawal was 15 months (IQR25°-75° 5-34 months). CONCLUSIONS: Seizures affect about 1/3rd of children and young people presenting with and being treated for brain tumours particularly when the tumour is in the cerebral cortex. The low risk of recurrent seizures after AED treatment justifies consideration of early withdrawal of AED after seizure control

Mid-term outcome comparing temporary K-wire fixation versus PDS augmentation of Rockwood grade III acromioclavicular joint separations

Backround The treatment of acute acromioclavicular (AC) joint injuries depends mainly on the type of the dislocation and patient demands. This study compares the mid term outcome of two frequently performed surgical concepts of Rockwood grade III AC joint separations: The temporary articular fixation with K-wires (TKW) and the refixation with an absorbable polydioxansulfate (PDS) sling. Findings Retrospective observational study of 86 patients with a mean age of 37 years underwent either TKW (n = 70) or PDS treatment (n = 16) of Rockwood grade III AC joint injuries. Mid term outcome with a mean follow up of 3 years was measured using a standardized functional patient questionnaire including Constant score, ASES rating scale, SPADI, XSMFA-D and a pain score. K-wire therapy resulted in significantly better functional results expressed by Constant score (88 ± 10 vs. 73 ± 18), ASES rating scale (29 ± 3 vs. 25 ± 5), SPADI (3 ± 9 vs. 9 ± 13), XSMFA-D function (13 ± 2 vs. 14 ± 3), XSMFA-D impairment (4 ± 1 vs. 6 ± 2) and pain score (1 ± 1 vs. 2 ± 2). Conclusion Either temporary K-wire fixation and PDS sling enable good or satisfying functional results in the treatment of Rockwood grade III AC separations. However functional outcome parameters indicate a significant advantage for the K-wire technique

Development and Validation of a New Questionnaire for the Evaluation of Upper Gastrointestinal Symptoms in the Elderly Population: A Multicenter Study

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Multidimensional prognostic index and mortality in intermediate care facilities: A retrospective study

Multidimensional prognostic index (MPI) is a frailty assessment tool used for stratifying prognosis in older hospitalized people, but data regarding older people admitted to intermediate care facilities (ICFs) are missing. The aim of this study is to evaluate whether MPI can predict mortality in older patients admitted to the ICFs. MPI was calculated using different domains explored by a standard comprehensive geriatric assessment and categorized into tertiles (MPI-1 ≤ 0.20, MPI 2 0.20–0.34, MPI 3 &gt; 0.34). A Cox’s regression analysis, taking mortality as the outcome, was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). In total, 653 older patients were enrolled (mean age: 82 years, 59.1% females). Patients in MPI-2 (HR = 3.66; 95%CI: 2.45–5.47) and MPI-3 (HR = 6.22; 95%CI: 4.22–9.16) experienced a higher risk of mortality, compared to MPI-1. The accuracy of MPI in predicting mortality was good (area under the curve (AUC) = 0.74, 95%CI: 0.70–0.78). In conclusion, our study showed that prognostic stratification, as assessed by the MPI, was associated with a significantly different risk of mortality in older patients admitted to the ICFs, indicating the necessity of using a CGA-based tool for better managing older people in this setting as well. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Association between the multidimensional prognostic index and mortality during 15 Years of Follow-up in the InCHIANTI Study

Background: Multidimensional Prognostic Index (MPI) is recognized as a prognostic tool in hospitalized patients, but data on the value of MPI in community-dwelling older persons are limited. Using data from a representative cohort of community-dwelling persons, we tested the hypothesis that MPI explains mortality during 15 years of follow-up. Methods: A standardized comprehensive geriatric assessment was used to calculate the MPI and to categorize participants in low-, moderate-, and high-risk classes. The results were reported as hazard ratios (HRs) and the accuracy was evaluated with the area under the curve (AUC), with 95% confidence intervals (CIs) and the C-index. We also reported the median survival time by standard age groups. Results: All 1453 participants (mean age 68.9 years, women = 55.8%) enrolled in the InCHIANTI study at baseline were included. Compared to low-risk group, participants in moderate (HR = 2.10; 95% CI: 1.73-2.55) and high-risk MPI group (HR = 4.94; 95% CI: 3.91-6.24) had significantly higher mortality risk. The C-index of the model containing age, sex, and MPI was 82.1, indicating a very good accuracy of this model in explaining mortality. Additionally, the time-dependent AUC indicated that the accuracy of the model incorporating MPI to age and sex was excellent (&gt;85.0) during the whole follow-up period. Compared to participants in the low-risk MPI group across different age groups, those in moderate- and high-risk groups survived 2.9-7.0 years less and 4.3-8.9 years less, respectively. Conclusions: In community-dwelling individuals, higher MPI values are associated with higher risk of all-cause mortality with a dose-response effect. © 2020 The Author(s) 2020

PSS21 The Cost-Effectiveness of Intravitreal Aflibercept (IVT-AFL) in Treating Neovascular Age-Related Macular Degeneration in an Italian Setting

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Diencephalic syndrome in child with NF-1 and hypothalamic tumour

We describe a 20 month old boy with neuro-fibromatosis type 1 (NF-1) who presented with diencephalic syndrome due to a large hypothalamic tumour and developed massive necrosis after chemotherapy associated with severe encephalopathy. We report this case because of rapid progression of presenting symptoms, the rare association with diencephalic syndrome in NF-1, chemotherapy induction of “tumour lysis” associated with encephalopathy, reduced toxicity and sustained improvement with vinblastine, the therapeutic benefit of tumour drainage signs of resolution of diencephalic syndrome and then restoration of visual movements and function associated with developmental recovery. The presentation of tumour in this case highlights the importance for parents and doctor to known and recognize the precocious symptoms, and justifies sharing these features as an indicator with parents and GP’s to justify early / urgent specialist review, particularly in the first two years of life. Early recognition could offer a reduced risk of brain injury