Treatment conditions and biochemical processes influencing seed priming effectiveness

A review of the scientific literature indicates osmotic priming (osmopriming) as the principal method of seed priming and polyethylene glycol (PEG) as the principal osmotic agent. An analysis of the available data across experiments carried out with different species under varying conditions showed an average 11% increase in percent germination and 36% shorter mean germination time (MGT) in primed vs. unprimed seeds. Moreover, in primed seeds MGT was less dependent on temperature, which is consistent with the effects expected from the treatment. Priming effects are mainly influenced by osmotic potential, temperature and time; major biochemical processes (repair of damaged DNA and RNA, preparation for cell division and increased antioxidant activity) are involved in treatment effects to an extent which is not fully ascertained in literature. A reduction of seed storage life is the major disadvantage of priming and the principal constraint to its diffusion, since dehydration to the initial moisture (drying-back) is needed to allow seed storage. Seed behaviour during drying-back, the role of the raffinose family oligosaccharides in cell membrane integrity and the expression of antioxidant enzymes in germinating seeds need to be further elucidated in a sufficient number of species, to promote a more reliable use of this technique

Assessing the mechanical weakness of vertebrae affected by primary tumors : a feasibility study

Patients spend months between the primary spinal tumor diagnosis and the surgical treatment, due to the need for performing chemotherapy and/or radiotherapy. During this period, they are exposed to an unknown risk of fracture. The aim of this study was to assess if it is possible to measure the mechanical strain in vertebrae affected by primary tumors, so as to open the way to an evidence-based scoring or prediction tool. We performed biomechanical tests on three vertebrae with bone tumor removed from patients. The tests were designed so as not to compromise the standard surgical and diagnostic procedures. Non-destructive mechanical tests in combination with state-of-the-art digital image correlation allowed to measure the distribution of strain on the surface of the vertebra. Our study has shown that the strains in the tumor region is circa 3 times higher than in the healthy bones, with principal strain peaks of 40,000/−20,000 microstrain, indicating a stress concentration potentially triggering vertebral fracture. This study has proven it is possible to analyze the mechanical behavior of primary tumor vertebrae as part of the clinical treatment protocol. This will allow building a tool for quantifying the risk of fracture and improving decision making in spine tumors

Description of the relationship between NOHL classification in drug-induced sleep endoscopy and initial AHI in patients with moderate to severe OSAS, and evaluation of the results obtained with oral appliance therapy

Descrizione della relazione tra Classificazione NOHL definita durante la Drug-Induced Sleep Endoscopy e AHI iniziale in pazienti con OSAS da moderato a grave, e valutazione dei risultati ottenuti con dispositivi orali

Management Zones Delineation through Clustering Techniques Based on Soils Traits, NDVI Data, and Multiple Year Crop Yields

Availability of georeferenced yield data involving different crops over years, and their use in future crop management, are a subject of growing debate. In a 9 hectare field in Northern Italy, seven years of yield data, including wheat (3 years), maize for biomass (2 years), sunflower, and sorghum, and comprising remote (Landsat) normalized difference vegetation index (NDVI) data during central crop stages, and soil analysis (grid sampling), were subjected to geostatistical analysis (semi-variogram fitting), spatial mapping (simple kriging), and Pearson’s correlation of interpolated data at the same resolution (30 m) as actual NDVI values. Management Zone Analyst software indicated two management zones as the optimum zone number in multiple (7 year) standardized yield data. Three soil traits (clay content, total limestone, total nitrogen) and five dates within the NDVI dataset (acquired in different years) were shown to be best correlated with multiple-and single-year yield data, respectively. These eight parameters were normalized and combined into a two-zone multiple soil and NDVI map to be compared with the two-zone multiple yield map. This resulted in 83% pixel agreement in the high and low zone (89 and 10 respective pixels in the soil and NDVI map; 73 and 26 respective pixels in the yield map) between the two maps. The good agreement, which is due to data buffering across different years and crop types, is a good premise for differential management of the soil-and NDVI-based two zones in future cropping seasons

Epidemiology and outcome of Clostridium difficile infections in patients hospitalized in Internal Medicine: findings from the nationwide FADOI-PRACTICE study.

BACKGROUND: Clostridium difficile (CD) is a leading cause of diarrhoea among hospitalized patients. The objective of this study was to evaluate the rate, the optimal diagnostic work-up, and outcome of CD infections (CDI) in Internal Medicine (IM) wards in Italy. METHODS: PRACTICE is an observational prospective study, involving 40 IM Units and evaluating all consecutive patients hospitalized during a 4-month period. CDI were defined in case of diarrhoea when both enzyme immunoassay for GDH, and test for A/B toxin were positive. Patients with CDI were followed-up for recurrences for 4 weeks after the end of therapy. RESULTS: Among the 10,780 patients observed, 103 (0.96 %) showed CDI, at admission or during hospitalization. A positive history for CD, antibiotics in the previous 4 weeks, recent hospitalization, female gender and age were significantly associated with CDI (multivariable analysis). In-hospital mortality was 16.5 % in CD group vs 6.7 % in No-CD group (p\u2009<\u20090.001), whereas median length of hospital stay was 16 (IQR\u2009=\u200913) vs 8 (IQR\u2009=\u20098) days (p\u2009<\u20090.001) among patients with or without CDI, respectively. Rate of CD recurrences was 14.6 %. As a post-hoc evaluation, 23 out of 34 GDH+/Tox- samples were toxin positive, when analysed by molecular method (a real-time PCR assay). The overall CD incidence rate was 5.3/10,000 patient-days. CONCLUSIONS: Our results confirm the severity of CDI in medical wards, showing high in-hospital mortality, prolonged hospitalization and frequent short-term recurrences. Further, our survey supports a 2-3 step algorithm for CD diagnosis: EIA for detecting GDH, A and B toxin, followed by a molecular method in case of toxin-negative samples

A novel, comprehensive tool for predicting 30-day mortality after surgical aortic valve replacement

OBJECTIVES: We sought to develop and validate a novel risk assessment tool for the prediction of 30-day mortality after surgical aortic valve replacement incorporating a patient's frailty. METHODS: Overall, 4718 patients from the multicentre study OBSERVANT was divided into derivation (n=3539) and validation (n=1179) cohorts. A stepwise logistic regression procedure and a criterion based on Akaike information criteria index were used to select variables associated with 30-day mortality. The performance of the regression model was compared with that of European System for Cardiac Operative Risk Evaluation (EuroSCORE) II. RESULTS: At 30 days, 90 (2.54%) and 35 (2.97%) patients died in the development and validation data sets, respectively. Age, chronic obstructive pulmonary disease, concomitant coronary revascularization, frailty stratified according to the Geriatric Status Scale, urgent procedure and estimated glomerular filtration rate were independent predictors of 30-day mortality. The estimated OBS AVR score showed higher discrimination (area under curve 0.76 vs 0.70, P CONCLUSIONS: The OBS AVR risk score showed high discrimination and calibration abilities in predicting 30-day mortality after surgical aortic valve replacement. The addition of a simplified frailty assessment into the model seems to contribute to an improved predictive ability over the EuroSCORE II. The OBS AVR risk score showed a significant association with long-term mortality.Peer reviewe

Practical and clinical utility of non-invasive vagus nerve stimulation (nVNS) for the acute treatment of migraine. A post hoc analysis of the randomized, sham-controlled, double-blind PRESTO trial

Background: The PRESTO study of non-invasive vagus nerve stimulation (nVNS; gammaCore®) featured key primary and secondary end points recommended by the International Headache Society to provide Class I evidence that for patients with an episodic migraine, nVNS significantly increases the probability of having mild pain or being pain-free 2 h post stimulation. Here, we examined additional data from PRESTO to provide further insights into the practical utility of nVNS by evaluating its ability to consistently deliver clinically meaningful improvements in pain intensity while reducing the need for rescue medication. Methods: Patients recorded pain intensity for treated migraine attacks on a 4-point scale. Data were examined to compare nVNS and sham with regard to the percentage of patients who benefited by at least 1 point in pain intensity. We also assessed the percentage of attacks that required rescue medication and pain-free rates stratified by pain intensity at treatment initiation. Results: A significantly higher percentage of patients who used acute nVNS treatment (n = 120) vs sham (n = 123) reported a ≥ 1-point decrease in pain intensity at 30 min (nVNS, 32.2%; sham, 18.5%; P = 0.020), 60 min (nVNS, 38.8%; sham, 24.0%; P = 0.017), and 120 min (nVNS, 46.8%; sham, 26.2%; P = 0.002) after the first attack. Similar significant results were seen when assessing the benefit in all attacks. The proportion of patients who did not require rescue medication was significantly higher with nVNS than with sham for the first attack (nVNS, 59.3%; sham, 41.9%; P = 0.013) and all attacks (nVNS, 52.3%; sham, 37.3%; P = 0.008). When initial pain intensity was mild, the percentage of patients with no pain after treatment was significantly higher with nVNS than with sham at 60 min (all attacks: nVNS, 37.0%; sham, 21.2%; P = 0.025) and 120 min (first attack: nVNS, 50.0%; sham, 25.0%; P = 0.018; all attacks: nVNS, 46.7%; sham, 30.1%; P = 0.037). Conclusions: This post hoc analysis demonstrated that acute nVNS treatment quickly and consistently reduced pain intensity while decreasing rescue medication use. These clinical benefits provide guidance in the optimal use of nVNS in everyday practice, which can potentially reduce use of acute pharmacologic medications and their associated adverse events. Trial registration: ClinicalTrials.gov identifier: NCT02686034

Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

Abstract Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist's effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications. Graphic abstract These slides can be retrieved under Electronic Supplementary Material

Reducing the Risk of Intraoperative Neurological Complications during Carotid Endarterectomy with Early Distal Control of the Internal Carotid Artery

n/