Risks of combining immunosuppressive and biological treatments in inflammatory bowel disease - in reply

We thank Roblin and Phelip for their comment on a timely issue. The recent report of the rare hepatosplenic T-cell lymphoma (HSTCL) in young patients with CD treated with both infliximab and azathioprine or steroids has rightly unleashed a series of doubts regarding the optimal use of biological agents in this and other conditions. How these observations may directly relate to the design of our study\u2014as implied by Roblin and Phelip\u2014is unclear though. While azathioprine by itself has been linked to lymphoma development including HSTCL, recent studies have shown that neither infliximab nor methotrexate, which was used in our study, alone or in combination in CD or in rheumatoid arthritis, appear to be associated with an increased risk of developing lymphomas. In addition, methotrexate alone has never been associated thus far with HSTCL in CD

Annular elastolytic giant cell granuloma treated with topical pimecrolimus.

4openopenErrichetti E; Stinco G; Avellini C; Patrone P.Errichetti, E; Stinco, Giuseppe; Avellini, C; Patrone, Pasqual

Il progetto invisibile. Vicinanza come strumento: prove lungo il Tevere

La tesi esplora la relazione tra materialità e immaterialità dello spazio urbano, osservandola tanto nel progetto quanto nelle pratiche quotidiane degli individui. Nella pratica progettuale, infatti, questa relazione è stata perlopiù pensata come dicotomica, attraverso visioni funzionaliste per cui alterare la materialità dello spazio permette di determinarne gli usi possibili. Allo stesso tempo, gli studi urbanistici, antropologici e sociologici delle pratiche urbane hanno mostrato come i modi in cui le persone vivono uno spazio pensano aspetti materiali e immateriali dello spazio come un’unità inscindibile. L’obiettivo della ricerca è quindi quello di costruire uno strumento interpretativo che permetta di ricomprendere all’interno del progetto urbano un’analisi delle pratiche, capace di tenere conto degli sguardi multidisciplinari che si occupano della città. Per raggiungere questo obiettivo mi sono confrontata con il caso del tratto urbano del fiume Tevere, spazio in cui l’opposizione tra una fisicità difficile da alterare e il grande accumularsi di memorie e significati hanno nel tempo reso difficile pensare qualsiasi forma di intervento. Attraverso l’analisi delle stagioni progettuali che hanno ragionato sul Tevere e il confronto con una letteratura multidisciplinare riguardante il rapporto tra materialità e immaterialità, ho definito il concetto di “vicinanza”, termine polisemico che sta ad indicare una lente interpretativa con cui osservare la relazione tra spazio e individui per come viene mediata proprio dalle caratteristiche materiali e immateriali del luogo. Ho messo alla prova questo strumento all’interno di una ricerca sul campo basata sulla teoria attore-rete e su un approccio etnografico. Attraverso l’incontro con i frequentatori di piazza Tevere, lo strumento vicinanza mi ha permesso di individuare e rappresentare graficamente i termini in cui individui e luogo si relazionano e gli effetti di questa relazione. L’unione dell’osservazione sul campo delle pratiche e la conoscenza delle caratteristiche architettoniche di questo spazio permette infatti di individuare gli attanti che fungono da mediatori di queste relazioni, i nodi fondamentali su cui potenzialmente agire, mostrando come nelle pratiche dei frequentatori del Tevere le sue caratteristiche fisiche e immateriali vengano integrate al punto da non poter essere più distinguibili. Lo strumento vicinanza infine emerge per la possibilità che offre nella collaborazione multidisciplinare, facilitando la traducibilità di dati qualitativi all’interno di schemi rappresentativi più vicini e più facilmente utilizzabili in contesti progettuali, andando anzi a permetterci di rappresentare e implementare i progetti invisibili racchiusi nelle pratiche degli individui

E-learning e futuri studenti in mobilità internazionale. Riflessioni su aspetti e potenzialità di un corso di lingua italiana

The A1 online Italian course offered by the CLA (University Linguistic Centre) of the University of Perugia, is one of the results achieved during various research projects, which has contributed, on the one hand, to the internationalization of the Institution, on the other, to the enhancement of digital technologies providing future university mobility students with the opportunity to acquire linguistic-cultural knowledge, even before the beginning of their mobility exchange programme in Italy. The experience reported in this article reflects on an evolving work, describing its design phase – course structure, selection and creation of linguistic and didactic materials, tools available in the Moodle open-source learning platform – and its subsequent phases of course activation and verification. Throughout the entire project, we focused on two fundamental aspects: inspiring and maintaining student motivation in addition to constructing an assisted, and above all, interactive self-learning path

Colloidal CuFeS2 Nanocrystals: Intermediate Fe d-Band Leads to High Photothermal Conversion Efficiency

We describe the colloidal hot-injection synthesis of phase-pure nanocrystals (NCs) of a highly abundant mineral, chalcopyrite (CuFeS2). Absorption bands centered at around 480 and 950 nm, spanning almost the entire visible and near infrared regions, encompass their optical extinction characteristics. These peaks are ascribable to electronic transitions from the valence band (VB) to the empty intermediate band (IB), located in the fundamental gap and mainly composed of Fe 3d orbitals. Laser-irradiation (at 808 nm) of an aqueous suspension of CuFeS2 NCs exhibited significant heating, with a photothermal conversion efficiency of 49%. Such efficient heating is ascribable to the carrier relaxation within the broad IB band (owing to the indirect VB-IB gap), as corroborated by transient absorption measurements. The intense absorption and high photothermal transduction efficiency (PTE) of these NCs in the so-called biological window (650-900 nm) makes them suitable for photothermal therapy as demonstrated by tumor cell annihilation upon laser irradiation. The otherwise harmless nature of these NCs in dark conditions was confirmed by in vitro toxicity tests on two different cell lines. The presence of the deep Fe levels constituting the IB is the origin of such enhanced PTE, which can be used to design other high performing NC photothermal agents.Comment: 12 pages, Chemistry of Materials, 31-May-201

Surgical Treatment Strategies and Prognosis of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC is the fifth most common cause of mortality worldwide and the third cancer related cause and is responsible for about 1 million deaths yearly [1]. The ageadjusted worldwide incidence is 5.5-14.9 per 100.000 population. In some areas of the world, such as sub-Saharan Africa and Southeast Asia, HCC represents the first cause of cancer death with an incidence of 52 per 100.000. Furthermore, in Europe and USA, HCC incidence has progressively raised in the past decade representing a burden problem. HCC is one of the few cancers for which a number of risk factors are known in great detail [2, 3]. HCC is almost always (80%) associated with cirrhosis, at least in developed countries, and chronic hepatitis C and B infection, alcoholic cirrhosis and haemocromatosis are some of the established risk factors [4]. The metabolic syndrome related to hypertension, central obesity, diabetes and obesity has been identified as a new risk factor. As a result, screening programs have developed, with the use of ultrasound and \u3b1-fetoprotein (AFP), with a hope to increase the chances of diagnosing small HCC and unltimately increase the rate of curability. Definitive diagnosis relies on the demonstration of a typical vascular pattern per liver imaging techniques (triple-phase CT-scan or MRI) of tumors larger than 2 cm with arterial hypervascularity and venous wash- out. Nodules, smaller than 2 cm, should be rechecked every six months or, if highly suspect, subjected to needle biopsy. It\u2019s likely that the study of tumor-specific tissue markers with prognostic value could introduce a systematic use of needle biopsy. Over the past 20 years, surgical treatment of hepatocellular carcinoma has seen an immense boost and improvement, with good survival outcomes and reduced morbidity and mortality.Liver resection (LR) and orthotopic liver transplantation (OLT) and ablative therapies are now considered the only potentially curative treatments for this cancer. LR has achieved improvement in survival within the past decade as a result of advances in diagnosis, surgical management of HCC and perioperative care. However, the long-term prognosis remains poor, and the 5-year overall survival rate ranges between 33% and 44%, with a 5-year cumulative recurrence rate of 80% to 100%. OLT could be viewed as the optimal treatment for HCC that is accompanied by advanced cirrhosis because of the widest possible resection margins for tumour and for a definitive cure of cirrhosis and its related complications. OLT for HCC performed within well-defined oncologic criteria (Milan criteria \u201creference\u201d) has shown long-term results comparable with those of transplantation for non-HCC patients. However, the critical shortage of available donated organs, together with the increasing number of patients awaiting transplantation, makes this therapeutic option available to only a small percentage of patients. Owing to the limited organ supply, many liver transplant centers usually make a selection to resect patients with compensated liver cirrhosis, defined as Child\u2013Pugh A chronic liver disease and resectable tumor and to reserve transplantation for those with impaired liver function (Child-Pugh class B-C) and small oligonodular HCC considered within the currently accepted criteria for transplantation. Radiofrequency and microwave ablation are relatively new percutaneous techniques in clinical use for HCC, that can produce tumour necrosis. Complete response rates are high in large series if tumour is less that 3 cm in diameter. This chapter will consider the main surgical techniques for the treatment of HCC in the light of the major guidelines currently available and of personal experience. Also, we will review HCC prognostic factors, and the particular situation of \u201clarge\u201d HCC and the strategy for liver tumours located at the hepato-caval confluence

A Review of Dietary Zinc Recommendations

Background. Large discrepancies exist among the dietary zinc recommendations set by expert groups. Objective. To understand the basis for the differences in the dietary zinc recommendations set by the World Health Organization, the U.S. Institute of Medicine, the International Zinc Nutrition Consultative Group, and the European Food Safety Agency. Methods. We compared the sources of the data, the concepts, and methods used by the four expert groups to set the physiological requirements for absorbed zinc, the dietary zinc requirements (termed estimated and/or average requirements), recommended dietary allowances (or recommended nutrient intakes or population reference intakes), and tolerable upper intake levels for selected age, sex, and life-stage groups. Results. All four expert groups used the factorial approach to estimate the physiological requirements for zinc. These are based on the estimates of absorbed zinc required to offset all obligatory zinc losses plus any additional requirements for absorbed zinc for growth, pregnancy, or lactation. However, discrepancies exist in the reference body weights used, studies selected, approaches to estimate endogenous zinc losses, the adjustments applied to derive dietary zinc requirements that take into account zinc bioavailability in the habitual diets, number of dietary zinc recommendations set, and the nomenclature used to describe them. Conclusions. Estimates for the physiological and dietary requirements varied across the four expert groups. The European Food Safety Agency was the only expert group that set dietary zinc recommendations at four different levels of dietary phytate for adults (but not for children) and as yet no tolerable upper intake level for any life-stage group

An Efficient Method for the Surface Functionalization of Luminescent Quantum Dots with Lipoic Acid Based Ligands

We describe herein an operationally advantageous general methodology for efficiently activating lipoic acid based compounds, a family of popular surface ligands for semiconductor nanocrystals, through the use of a borohydride exchange resin, and the use of the activated species to replace the native surface ligands of quantum dots. The procedure enabled phase transfer of the nanocrystals between polar and aqueous media and, if unsubstituted lipoic acid was used, a facile adjustment of their solubility in a wide range of solvents with varying polarity (from hexane to water). We show that the protocol is applicable to different types of nanocrystals and a variety of lipoic acid based ligands, and that the resulting quantum dots maintain their optical properties, in particular, an intense luminescence, and long-term colloidal stability