Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Static and dynamic characterization of biomedical polyethylene laser welding using biocompatible nano-particles

In this research, polymeric joints of Ultra High Molecular Weight Polyethylene (UHMWPE) sheets were realized and welded by a diode laser operating at 970 nm wavelength. One of the polymer sheet was doped, at different concentrations, with nano filler (carbon, titanium and silver nano-particles) in order to enhance the absorption coefficient at the laser wavelength. Laser operated in repetition rate with a maximum pulse energy 100 mJ, for times of the order of 1-60 s transporting the light trough a fiber with 300 μm diameter. The laser light has been transmitted by the transparent first polymer and absorbed on the face of the second doped polymer. At the interface of the two polymer foils, 0.5 mm thickness each, the released energy induces melting, assisted by pressure, producing a fast and resistant welding. Single lap and double lap geometries have been performed and studied by means of mechanical static (shear stress) and dynamical analysis. Effect of the different particles nature on the mechanical features of the joints has been evaluated. Morphological observation of the jointed areas are presented and discussed. Joints could be useful in biomedical field for their special features

Static and dynamic characterization of biomedical polyethylene laser welding using biocompatible nano-particles

In this research, polymeric joints of Ultra High Molecular Weight Polyethylene (UHMWPE) sheets were realized and welded by a diode laser operating at 970 nm wavelength. One of the polymer sheet was doped, at different concentrations, with nano filler (carbon, titanium and silver nano-particles) in order to enhance the absorption coefficient at the laser wavelength. Laser operated in repetition rate with a maximum pulse energy 100 mJ, for times of the order of 1-60 s transporting the light trough a fiber with 300 μm diameter. The laser light has been transmitted by the transparent first polymer and absorbed on the face of the second doped polymer. At the interface of the two polymer foils, 0.5 mm thickness each, the released energy induces melting, assisted by pressure, producing a fast and resistant welding. Single lap and double lap geometries have been performed and studied by means of mechanical static (shear stress) and dynamical analysis. Effect of the different particles nature on the mechanical features of the joints has been evaluated. Morphological observation of the jointed areas are presented and discussed. Joints could be useful in biomedical field for their special features

Downregulation of HNF-4α and defective zonation in livers expressing mutant Z α1-antitrypsin

α1 -antitrypsin (AAT) deficiency is one of the most common genetic disorders and the liver disease due to the Z mutant of α1 -antitrypsin (ATZ) is a prototype of conformational disorder due to misfolding of protein with consequent aberrant intermolecular protein aggregation. In the present study, we found that livers of PiZ transgenic mice expressing the human ATZ have altered expression of a network of hepatocyte transcriptional factors including HNF4-α, that is early downregulated and induces a transcriptional repression of ATZ expression. Reduced HNF-4α was associated with activation of β-catenin that regulates liver zonation. Livers of PiZ mice and human patients with AAT deficiency were both found to have a severe perturbation of liver zonation. Functionally, PiZ mice showed a severe defect of ureagenesis, as shown by increased baseline ammonia, and reduced urea production and survival after an ammonia challenge. Downregulation of HNF-4α expression and defective zonation in livers have not been yet recognized as features of the liver disease caused by ATZ and are likely responsible for metabolic disturbances and for the increased risks of hepatocellular carcinoma in patients with AAT deficiency. In conclusion, these findings are consistent with the concept that abnormal AAT protein conformation and intrahepatic accumulation have broad effect on metabolic liver functions. This article is protected by copyright. All rights reserved

Rhes Is Involved in Striatal Function

The development and the function of central nervous system depend on thyroid hormones. In humans, the lack of thyroid hormones causes cretinism, a syndrome of severe mental deficiency. It is assumed that thyroid hormones affect the normal development and function of the brain by activating or suppressing target gene expression because several genes expressed in the brain have been shown to be under thyroid hormone control. Among these, the Rhes gene, encoding a small GTP-binding protein, is predominantly expressed in the striatal region of the brain. To clarify the role of Rhes in vivo, we disrupted the Rhes gene by homologous recombination in embryonic stem cells and generated mice homozygous for the Rhes null mutation (Rhes(−/−)). Rhes(−/−) mice were viable but weighed less than wild-type mice. Furthermore, they showed behavioral abnormalities, displaying a gender-dependent increase in anxiety levels and a clear motor coordination deficit but no learning or memory impairment. These results suggest that Rhes disruption affects selected behavioral competencies

Lifestyle and physical fitness in adolescents with type 1 diabetes and obesity

Background: The association between Type 1 Diabetes Mellitus (T1DM) and obesity (Ob) is no longer unexpected due to unhealthy lifestyle mostly in adolescents. We compared clinicalbiochemical characteristics, adherence to the Mediterranean Diet (MD), lifestyle habits and physical fitness across different weight categories of T1DM adolescents from Campania Region. As second aim, we assessed the relationship among lifestyle and physical fitness in these patients. Methods: 74 adolescents (35M; 39F; 13–18 y), with T1DM diagnosed at least 6 mo before the study, were enrolled at the Regional Center for Pediatric Diabetology of Vanvitelli University of Naples. Height, weight, Body Mass Index (BMI), BMI z-score, and Clinical Biochemical health related parameters were determined. MD adherence, physical activity (PA) amount and sedentary habits were assessed by questionnaires. Handgrip strength, 2-Min Step test (2-MST) cardiorespiratory endurance and Timed up and go test (TUG) for agility and balance were used for physical fitness evaluation. Results: Our sample included 22 normal weight (NW), 37 overweight (OW) and 15 with Obese (Ob) adolescents. Across the three groups, adolescents showed similar Clinical-Biochemical parameters, MD adherence, PA amount, mostly walking (9.3 h/w), daily video exposure (8.5 h/d) and similar handgrip or 2-MST performance. Better performance was observed in NW compared to OW or Ob for TUG (7 vs 8 vs 9 s; p < 0.05). A positive correlation was found between TUG test and BMI, while no correlation was found between HbA1c (glycated haemoglobin) and BMI z score or 2-MST