Contemporaneous Portal-Arterial Reperfusion during Liver Transplantation: Preliminary Results

We prospectively compared sequential portal-arterial revascularization (SPAr, group 1 no. 19) versus contemporaneous portal-hepatic artery revascularization (CPAr, group 2 no. 21) in 40 consecutive liver transplantation (LT). There were no differences in the demographics characteristics, MELD score, indication to LT, and donor's parameters between the two groups. CPAr had longer warm ischemia 66 ± 8 versus 37 ± 7 min (P < .001), while SPAr had longer arterial ischemia 103 ± 42 min (P = .0004). One-year patient's and graft survival were, respectively, 89% and 95% versus 94% and 100% (P = .29). At median followup of 13 ± 6 versus 14 ± 7 months biliary complications were anastomotic stenosis in 15% versus 19% (P = .78), and intrahepatic nonanastomotic biliary strictures in 26% versus none (P = .01), respectively, in SPAr and CPAr. CPAr reduces the incidence of intrahepatic biliary strictures by decreasing the duration of arterial ischemia

Epidemiology of early onset dementia and its clinical presentations in the province of Modena, Italy

Introduction: Patients with early onset dementia (EOD), defined as dementia with symptom onset at age &lt;65, frequently present with atypical syndromes. However, the epidemiology of different EOD presentations, including variants of Alzheimer's disease (AD) and frontotemporal dementia (FTD), has never been investigated all together in a population-based study. Epidemiologic data of all-cause EOD are also scarce. Methods: We investigated EOD epidemiology by identifying patients with EOD seen in the extended network of dementia services of the Modena province, Northern Italy ( 48700,000 inhabitants) from 2006 to 2019. Results: In the population age 30 to 64, incidence was 13.2 per 100,000/year, based on 160 new cases from January 2016 to June 2019, and prevalence 74.3 per 100,000 on June 30, 2019. The most frequent phenotypes were the amnestic variant of AD and behavioral variant of FTD. Discussion: EOD affects a significant number of people. Amnestic AD is the most frequent clinical presentation in this understudied segment of the dementia population

Evaluating inhibition conditions in high-solids anaerobic digestion of organic fraction of municipal solid waste

High-solids anaerobic digestion (HSAD) processes, when applied to different types of organic fractions of municipal solid waste (OFMSW), may easily be subjected to inhibition due to organic overloading. In this study, a new approach for predicting these phenomena was proposed based on the estimation of the putrescibility (oxygen consumption in 20 h biodegradation, OD20) of the organic mixtures undergoing the HSAD process. Different wastes exhibiting different putrescibility were subjected to lab-scale batch-HSAD. Measuring the organic loading (OL) as volatile solids (VS) was found unsuitable for predicting overload inhibition, because similar VS contents corresponded to both inhibited and successful trials. Instead, the OL calculated as OD20 was a very good indicator of the inhibiting conditions (inhibition started for OD20 > 17\u201318 g O2 kg^(-1)). This new method of predicting inhibition in the HSAD process of diverse OFMSW may be useful for developing a correct approach to the technology in very different contexts

Postoperative trends and prognostic values of inflammatory and nutritional biomarkers after liver transplantation for hepatocellular carcinoma

11noPreoperative inflammatory biomarkers such as the Platelet-to-Lymphocyte Ratio (PLR) and the Neutrophil-to-Lymphocyte Ratio (NLR) strongly predict the outcome in surgically treated patients with hepatocellular carcinoma (HCC), while nutritional biomarkers such as the Controlling Nutritional Status (CONUT) and the Prognostic Nutritional Index (PNI) show an analogue prognostic value in hepatic resection (HR) but not in liver transplant (LT) cases. Data on the impact of LT on the inflammatory and nutritional/metabolic function are heterogeneous. Therefore, we investigated the post-LT trend of these biomarkers up to postoperative month (POM) 12 in 324 HCC patients treated with LT. Inflammatory biomarkers peaked in the early post-LT period but at POM 3 leveled off at values similar (NLR) or higher (PLR) than pre-LT ones. CONUT and PNI worsened in the early post-LT period, but at POM 3 they stabilized at significantly better values than pre-LT. In LT recipients with an overall survival &gt;1 year and no evidence of early HCC recurrence, 1 year post-LT NLR and PNI independently predicted patient overall survival, while 1 year post-LT PLR independently predicted late tumor recurrence. In conclusion, at 1 year post-LT, the nutritional status of liver-transplanted HCC patients significantly improved while their inflammatory state tended to persist. Consequently, post-LT PLR and NLR maintained a prognostic value for LT outcome while post-LT CONUT and PNI acquired it.openopenopenPravisani R.; Mocchegiani F.; Isola M.; Lorenzin D.; Adani G.L.; Cherchi V.; De Martino M.; Risaliti A.; Lai Q.; Vivarelli M.; Baccarani U.Pravisani, R.; Mocchegiani, F.; Isola, M.; Lorenzin, D.; Adani, G. L.; Cherchi, V.; De Martino, M.; Risaliti, A.; Lai, Q.; Vivarelli, M.; Baccarani, U

Improvements to dairy farms for environmental sustainability in Grana Padano and Parmigiano Reggiano production systems

Grana Padano (GP) and Parmigiano Reggiano (PR) are the two most important Italian PDO cheeses. To improve the environmental sustainability of their production, a Life Cycle Assessment (LCA) was completed on 84 dairy farms located in the province of Mantova (Northern Italy). In particular, 33 farms delivered milk for GP production, whereas 51 farms to dairies for PR production. In GP farms, maize silage represented 33.7% of total farmland and alfalfa represented 28.1%. While in PR farms, alfalfa represented 63.6% of total farmland. Fat and Protein Corrected Milk (FPCM) and Dairy Efficiency (DE, calculated as kg of produced FPCM per kg of DM intake) were different in the two production system: FPCM was 30.2 +/- 4.32 kg/d in GP farms and 25.0 +/- 4.71 kg/d in PR farms; DE was 1.35 +/- 0.26 in GP farms, and 1.15 +/- 0.22 in PR farms. Mitigation strategies to improve both environmental and economic sustainability were suggested focussing on forage crop production, milk production, herd management and off-farm purchased feed. From the preliminary results, there is evidence that improvements are needed. Climate Change (kg CO2 eq/kg FPCM) and Land Use (kg Carbon deficit/kg FPCM) were similar (1.38 +/- 0.33 and 19.3 +/- 7.08 for GP system; 1.46 +/- 0.37 and 21.8 +/- 11.4 for PR system). The most efficient farms in terms of milk production and DE generally showed the best environmental and economic sustainability, while the others show worse outcomes, mainly due to poor DE, livestock-management issues, feed purchase and ration composition

Clinical Features and Prevalence of Spondyloarthritis in a Cohort of Italian Patients Presenting with Acute Nongranulomatous Anterior Uveitis

Purpose. To describe the clinical features of acute nongranulomatous anterior uveitis (NGAU) patients and to estimate the prevalence of concomitant spondyloarthritis (SpA). Methods. Retrospective study of consecutive patients affected by NGAU referred to the Ocular Immunology Unit of the AUSL-IRCCS di Reggio Emilia, Italy, between January 2016 and January 2019. All patients underwent ophthalmic evaluation and blood test with HLA-B27 typing and were referred to a rheumatologist to identify any undiagnosed SpA. SpA was classified according to the Assessment of SpondyloArthritis international Society (ASAS) criteria in axial or peripheral SpA. Patients were divided into two groups: NGAU with associated SpA (SpA+) and NGAU without SpA (SpA-). Clinical and demographic features of the two groups, including sex, HLA-B27, family history of rheumatic disease, uveitis laterality, course, and severity of ocular inflammation, complications, and treatment, were compared. Results. Ninety-nine patients with NGAU were enrolled, of whom 36 (36%) with a diagnosis of SpA: 14 with peripheral SpA and 22 with axial SpA. The prevalence of SpA was higher in HLA-B27-positive patients than in HLA-B27-negative patients (50% vs. 15%, p&lt;0.0001). The multivariate logistic regression (R2=0.28) for SpA diagnosis identified as significant predictive factors: age at diagnosis (odds ratio OR=0.95, 95% confidence interval [CI]: 0.91-0.99) and HLA-B27+ (OR=5.32, 95% CI: 1.80-15.70). Conclusions. Our results confirmed the high prevalence of undiagnosed SpA in patients with NGAU, suggesting that, regardless of HLA-B27 status, in the presence of IBP and/or peripheral arthritis, patients with NGAU must be referred to the rheumatologist to allow earlier diagnosis

Use of biosurfactants from urban wastes compost in textile dyeing and soil remediation

A compost isolated humic acid-like (cHAL) material was pointed out in previous work for its potential as auxiliary in chemical technology. Its potential is based on its relatively low 0.4 g L-1 critical micellar concentration (cmc) in water, which enables cHAL to enhance the water solubility of hydrophobic substances, like phenanthrene, when used at higher concentrations than 0.4 g L-1. This material could be obtained from a 1:1 v/v mixture of municipal solid and lignocellulosic wastes composted for 15 days. The compost, containing 69.3% volatile solids, 39.6% total organic C and 21 C/N ratio, was extracted for 24 h at 65 °C under N2 with aqueous 0.1 mol L-1 NaOH and 0.1 mol L-1 Na4P2O7, and the solution was acidified to separate the precipitated cHAL in 12% yield from soluble carbohydrates and other humic and non-humic substances. In this work two typical applications of surfactants, i.e., textile dyeing (TD) and soil remediation by washing (SW), were chosen as grounds for testing the performance of the cHAL biosurfactant against the one of sodium dodecylsulfate (SDS), which is a well established commercial synthetic surfactant. The TD trials were carried out with nylon 6 microfiber and a water insoluble dye, while the SW tests were performed with two soils contaminated by polycyclic aromatic hydrocarbons (PAH) for several decades. Performances were rated in the TD experiments based on the fabric colour intensity (ΔE) and uniformity (σΔE), and in the SW experiments based on the total hydrocarbons concentration (CWPAH) and on the residual surfactant (Cre) concentrations in the washing solution equilibrated with the contaminated soils. The results show that both cHAL and SDS exhibit enhanced performance when applied above their cmc values. However, while in the TD case a significant performance effect was observed at the surfactants cmc value, in the SW case the required surfactants concentration values were equivalent to 25-125 × cmc for cHAL and to 4-22 × cmc for SDS. The vis-a-vis comparison of the two surfactants gave the following results: in the TD case the cHAL biosurfactant at 0.4 g L-1 yields good colour intensity and equal colour uniformity as SDS at 5 g L-1, in the SW case cHAL was found to enhance CWPAH by a factor of 2-4 relative to SDS with one soil, whereas with the other soil the two surfactants behaved similarly. The Cre data, however, showed that both soils absorbed by far more SDS (68-95%) than cHAL (12-54%). The results point out intriguing technological and environmental perspectives deriving from the use of compost isolated biosurfactants in the place of synthetic surfactants

Chemical Characterization and Nematicidal Activity of the Essential Oil of Nepeta nuda L. ssp. pubescens and Nepeta curviflora Boiss. from Lebanon

The chemical characterization and the nematicidal activity of the essential oils from Nepeta nuda L. ssp. pubescens and Nepeta curviflora Boiss. growing wild in Lebanon are reported. A comparative study was carried out as, to the best of our knowledge, no information is available on Nepeta nuda L. ssp. pubescens. In addition, both Nepeta species were collected in the same geographical area in order to rule out the environmental factors influencing essential oil composition and bioactivity. The most abundant (> 5 %) components of N. nuda ssp. pubescens essential oil were pinene (12.89 %), 1-ethyl-1H-pyrrole (12.67 %), 1-cycloethyl- 1-(2-methylenecyclohexyl) ethanol (10.37 %), 3-methyl-2-cyclohexen-1-one (9.17 %) and 2,3-dimethyl-3- hexanol (5.88 %). Among oxygenated monoterpenes, two nepetalactones were identified, i.e. (E, Z)nepetalactone (2.24 %) and (Z, E)-nepetalactone (0.31 %). The major constituents (> 5 %) of N. curviflora essential oil were 2-isopropyl-5-methyl-3-cyclohexen-1-one (12.51%), (-)-spathulenol (11.73%), cis-Z-alpha-bisabolene epoxide (8.07 %), widdrol (7.0 %), (E, Z)-5,7-dodecadiene (6.93 %), dihydronepetalactone (5.57 %) and 4-propyl-cyclohexene (5.43 %). The essential oil of N. curviflora was more active than the N. nuda ssp. pubescens one against the nematode Panagrolaimus rigidus. According to the motility assay, LD50 was 0.5 mg/mL and 2.5 mg/mL 24 h after treatment with N. curviflora and N. nuda ssp. pubescens essential oil, respectively

Prevalenza ed impatto sociale delle demenze ad esordio precoce (Early onset dementia-EOD) nella provincia di Modena

Introduzione. Le demenze in cui l’esordio dei sintomi si verifica prima dei 65 anni (Early Onset Dementia-EOD), hanno caratteristiche cliniche ed impatto socio-sanitario diversi rispetto alle demenze ad esordio tardivo. I dati epidemiologici disponibili sono scarsi, con stime di prevalenza variabili tra 15 e 150/100.000 soggetti appartenenti alla fascia di età 45-64 anni. Non sono attualmente disponibili dati di prevalenza in Italia. Metodi. Abbiamo ricercato i casi di EOD in pazienti residenti in Provincia di Modena, esaminando i pazienti valutati presso i Centri per i Disturbi Cognitive e Demenze (CDCD) della provincia (2 neurologici, 8 geriatrici dislocati in tutto il territorio provinciale) tra il 1/1/2006 e il 31/12/2018. I casi con esordio antecedente al 1/1/2017 sono stati identificati retrospettivamente, mentre i casi con esordio successivo sono stati accertati prospetticamente, mediante invio da parte dei Medici di Medicina Generale e dai Geriatri ai due CDCD neurologici della provincia. La diagnosi di EOD è stata posta da un Neurologo esperto in disturbi cognitivi. Abbiamo incluso nello studio i pazienti con diagnosi di EOD al 31/12/2018. Abbiamo esaminato diagnosi, età di insorgenza, età e gravità dei disturbi cognitivi alla diagnosi. Per un sottogruppo di pazienti abbiamo inoltre raccolto variabili socio-demografiche quali la composizione del nucleo familiare e la condizione occupazionale del paziente e del caregiver principale. Risultati. Abbiamo identificato 248 pazienti con EOD al 31/12/2018, con una prevalenza di 116,5/100.000 soggetti a rischio nella fascia di età 45-64 anni e 71,8/100.000 nella fascia di età 30-64 anni. Il 41% dei pazienti ha ricevuto una diagnosi di malattia di Alzheimer (31% non amnesici), il 26% di demenza fronto-temporale, il 10% di demenza vascolare, il 7% demenza in parkinsonismo. L’età media all’esordio è stata di 58,9 anni (range 39-64), l’età media alla diagnosi è stata di 61,9 (range 40-72) con un significativo ritardo diagnostico. Il MMSE medio alla diagnosi è risultato pari a 22,2/30 (range 10-28). Il 22% dei pazienti svolgeva attività lavorativa alla diagnosi, mentre il 24% è stato costretto a lasciare il lavoro a causa della malattia. Il 3,4% dei pazienti aveva figli minori al momento della diagnosi. I caregivers, aventi età media di 59 anni, per il 70% svolgevano attività lavorativa, sperimentando una perdita media di 2 giornate lavorative al mese a causa della malattia del familiare. Il 7,4% e 20,5% dei pazienti ha usufruito rispettivamente di un centro diurno o struttura protetta, che tuttavia in nessun caso era specificamente dedicata a pazienti con EOD. Conclusioni. I dati raccolti permettono per la prima volta di valutare il numero e le caratteristiche dei pazienti con EOD nella Provincia di Modena. I risultati ottenuti saranno essenziali per organizzare servizi appropriati, dal punto di vista sanitario e socioassistenziale, per pazienti con EOD ed i loro familiari