Development of innovative materials for high efficiency polymer solar cells

This PhD thesis was focused on the implementation of suitable strategies for the fabrication of polymer solar cells (PSCs) to improve the device performances. To this aim, several materials having specific chemical and physical properties were used, and new strategies for fabrication of solar cells were implemented using simple techniques of practical interest, in a view to develop feasible scale up processes. For each approach the efficiency limiting factors were identified, providing useful scientific basis for future investigations. Moreover, this work confirmed that the use of spontaneous block copolymers (BCPs) self-assembly is a potential strategy to create tailored organic nanostructures able to precisely incorporate inorganic semiconductor nanoparticles (NPs) into specific domains for the realization of active layers in the hybrid PSCs

Cooperation and development for academic language skills in the university context

Abstract This paper analyses the learning process of students of a Master's course in Cooperation and Development (C&D) who attend classes in English for Academic Writing at the University of Calabria, and their awareness of competences achieved. The language objectives are to expand students' knowledge of the main elements of spoken and written discourse in English in academic contexts with focus on specialized language in the fields of C&D. The study evaluates the ability of students to improve their competences and assess their language development using the self-assessment grid of academic language competences included in the European Language Portfolio created at the Università della Calabria, Italy. Specifically, this version of the ELP focuses on academic language and contains descriptors aimed at evaluating learners' language competences in academic contexts. A group of 25 students participated in this didactic experience, in the second semester of the academic year 2018. Students' oral production, interaction and academic writing skills were monitored. For the written examination students were required to write a Research Proposal (RP) showing competence in text cohesion and content coherence, appropriate use of terminology and accurate use of language structures. Following on from the acceptance of the RP, students delivered an oral presentation on the topic presented, showing ability in answering questions and expressing opinions on issues presented by other students. The concepts of autonomous learning are crucial in order to monitor students' improvement and commitment. A contrastive analysis of data from students' first self-assessment to the final evaluation of competences achieved by the end of the academic year was conducted

Modulation of apoptosis by caprine herpesvirus 1 infection in a neuronal cell line

Caprine herpesvirus type 1 (CpHV-1), like other members of the alpha subfamily of herpesviruses, establishes latent infections in trigeminal ganglion neurons. Our groups previously demonstrated that CpHV-1 induces apoptosis in goat peripheral blood mononuclear cells and in an epithelial bovine cell line, but the ability of CpHV-1 to induce apoptosis in neuronal cells remains unexplored. In this report, the susceptibility of Neuro 2A cells to infection by CpHV-1 was examined. Following infection of cultured cells with CpHV-1, expression of cell death genes was evaluated using real-time PCR and Western blot assays. Analysis of virus-infected cells revealed activation of caspase-8, a marker for the extrinsic pathway of apoptosis, and caspase-9, a marker for the intrinsic pathway of apoptosis at 12 and 24 h post-infection. Significant increase in the levels of cleaved caspase-3 was also observed at the acme of cytopathic effect at 24 h post-infection. In particular, at 3 and 6 h post-infection, several proapototic genes were under-expressed. At 12 h post-infection several proapototic genes such as caspases, TNF, Cd70, and Traf1 were over expressed while Bcl2a1a, Fadd, and TNF genes were underexpressed. In conclusion, the simultaneous activation of caspase-8 and caspase-9 suggests that CpHV-1 can trigger the death-receptor pathway and the mitochondrial pathway separately and in parallel. Our findings are significant because this is the first published study showing the effect of CpHV-1 infection in neuronal cells in terms of gene expression and apoptosis modulation

Can Metformin Exert as an Active Drug on Endothelial Dysfunction in Diabetic Subjects?

Abstract: Cardiovascular mortality is a major cause of death among in type 2 diabetes (T2DM). Endothelial dysfunction (ED) is a well-known important risk factor for the development of diabetes cardiovascular complications. Therefore, the prevention of diabetic macroangiopathies by preserving endothelial function represents a major therapeutic concern for all National Health Systems. Several complex mechanisms support ED in diabetic patients, frequently cross-talking each other: uncoupling of eNOS with impaired endothelium-dependent vascular response, increased ROS production, mitochondrial dysfunction, activation of polyol pathway, generation of advanced glycation end-products (AGEs), activation of protein kinase C (PKC), endothelial inflammation, endothelial apoptosis and senescence, and dysregulation of microRNAs (miRNAs). Metformin is a milestone in T2DM treatment. To date, according to most recent EASD/ADA guidelines, it still represents the first-choice drug in these patients. Intriguingly, several extraglycemic effects of metformin have been recently observed, among which large preclinical and clinical evidence support metformin’s efficacy against ED in T2DM. Metformin seems effective thanks to its favorable action on all the aforementioned pathophysiological ED mechanisms. AMPK pharmacological activation plays a key role, with metformin inhibiting inflammation and improving ED. Therefore, aim of this review is to assess metformin’s beneficial effects on endothelial dysfunction in T2DM, which could preempt development of atherosclerosis

Clinical hyperthyroidism in hydatidiform mole: case report

Introduction: Gestational trophoblastic disease (GTD) is a group of diseases responsible for producing high hCG titers, which may lead to possible complications such as hyperthyroidism and, in more severe situations, the thyrotoxic crisis. Hyperthyroidism is present in only 5% of cases of GTD, and its early diagnosis is important. Case Report: A 49-year-old female patient, G6L2A3, presented to the emergency room reporting irregular vaginal bleeding for four months, hyperemesis, irritability, tremors, palpitations, xerostomia, and a history of recurrent miscarriages. Gynecological examination revealed coffee-ground type bleeding through the cervix’s external orifice, and at the bimanual touch, there was a pelvic mass above the umbilical scar. TVUS showed a uterine volume of 1302 cc³ and images corresponding to GTD. TSH and FT4 of 0.015 mU/L (RV: 0.4 - 4.5 mU/L) and 2.34 ng/dL (RV: 0.7 - 1.8 ng/dL) respectively, and BhCG plasma dosage > 225,000 mIU/mL. The physical examination showed a slightly enlarged thyroid of parenchymal consistency and a slightly exalted Achilles reflex. There was no family history of thyroid disease and negative screening for anti-TPO, anti-TG, and TRAb antibodies. The patient underwent Manual Intrauterine Aspiration. Due to the maintenance of high BhCG levels, a new TVUS was requested, which suggested GTD. Due to the high risk of neoplasia, absence of metastatic focus, and constituted offspring, it was decided to perform a total abdominal hysterectomy, with bilateral salpingectomy and preservation of the ovaries bilaterally, as a form of treatment. TSH normalized at 0.5 mU/L after surgery. The histopathology showed an Invasive Mole. Conclusion: Diseases with elevated hCG may lead to secondary hyperthyroidism. Although this condition is present in only 5% of cases of GTD, the physician cannot ignore the importance of his or her investigation for an early diagnosis to avoid more severe complications such as the thyrotoxic crisis.Introdução: A doença trofoblástica gestacional (DTG) constitui um grupo de doenças responsável pela produção de elevados títulos de hCG, podendo levar a possíveis complicações como hipertireoidismo e, em situações mais graves, a crise tireotóxica. O hipertireoidismo está presente em apenas 5% dos casos de DTG, sendo importante seu diagnóstico precoce. Relato de Caso: Paciente feminina, 49 anos, G6PC2A3, apresentou-se no pronto socorro relatando sangramento vaginal irregular por 4 meses, hiperêmese, irritabilidade, tremores, palpitações, xerostomia e histórico de abortos de repetição. Ao exame ginecológico, notou-se sangramento em borra de café através do orifício externo do colo uterino, e ao toque bimanual, massa pélvica acima da cicatriz umbilical. USG/TV mostrou volume uterino de 1302 cc³ e imagens correspondentes à DTG. TSH e T4L de 0,015 mU/L (VR: 0,4 – 4,5 mU/L) e 2,34 ng/dL (VR: 0,7 – 1,8 ng/dL) respectivamente, e dosagem plasmática do BhCG > 225.000 mUI/mL. Ao exame físico, demonstrou tireoide discretamente aumentada de consistência parenquimatosa e reflexo aquileu pouco exaltado. Ausência de histórico familiar para tireoidopatias e rastreio dos anticorpos anti-TPO, anti-TG e TRAb negativo. A paciente foi submetida a Aspiração Manual Intrauterina (AMIU). Em razão da manutenção dos níveis elevados de BhCG, foi solicitado nova USG/TV cujo resultado sugeriu DTG. Devido ao alto risco de neoplasia, ausência de focos metastáticos e prole constituída, optou-se por realizar histerectomia total abdominal, com salpingectomia bilateral e preservação dos ovários bilateralmente, como forma de tratamento. O TSH normalizou em 0,5 mU/L após procedimento cirúrgico. O histopatológico evidenciou Mola Invasora. Conclusão: Doenças que cursam com elevação do hCG podem levar a um quadro de hipertireoidismo secundário. Apesar desta patologia estar presente em apenas 5% dos casos de DTG, o médico não pode ignorar a importância de sua investigação para um diagnóstico precoce, com vistas a evitar complicações mais severas como por exemplo, a crise tireotóxica

Cardiomegaly associated with clinical hypothyroidism

Introduction: Primary hypothyroidism corresponds to 95% of the total cases of hypothyroidism. Primary hypothyroidism is characterized as a clinical syndrome in which thyroid stimulating hormone (TSH) is above the reference values and free thyroxine (T4 L) below the limit of normality. These changes lead to a decrease in the basal metabolic rate that may affect the cardiovascular system. Severe cases can lead to a pericardial effusion and cardiomegaly. This case report describes an atypical manifestation hypothyroidism, the pericardial effusion, as an initial event of the disease, and aims to contribute to the medical literature, discussing a propaedeutic performed for diagnosis and describing a therapeutic response and clinical evolution. Case Report: A 44-year-old female patient; history of hypothyroidism undergoing irregular treatment. She was referred for elective computed tomography examination of the abdomen in nephrolithiasis investigation, but an important pericardial effusion was demonstrated without hemodynamic compromise. The chest X-ray showed an increase in the cardiac area and the echocardiogram showed a pericardial effusion (swinging heart aspect), paradoxical movement of the interventricular septum. The electrocardiogram showed no changes. During the investigation, T4 L was lower than 0.4 ng/dL, TSH: 319.9 uUI/mL, anti-hyroperoxidase: 142.3 IU/ml. Rheumatologic evaluation ruled out diseases. Faced with the hypothesis of pericardial effusion due to hypothyroidism, the patient then underwent levothyroxine treatment at a dose of 125mcg/day. Through 7 months of treatment there was a regression of cardiomegaly and pericardial effusion. The exams of January/2018 corroborate the hypothesis evidencing levels of T4 L: 1,2; TSH: 2.2 with normal imaging tests. Conclusion: In view of the rarity of the case, this work shows an oligosymptomatic patient, but with great repercussion in relation to the cardiological manifestation. The authors emphasize the importance of investigating thyroid function in patients with cardiac alterations.Introdução: O hipotireoidismo primário corresponde a 95% do total de casos de hipotireoidismo. Caracteriza-se como uma síndrome clínica onde o hormônio estimulante da tireoide (TSH) encontra-se acima dos valores de referência e a tiroxina livre (T4 L) abaixo do limite da normalidade. Essas alterações levam a uma diminuição da taxa metabólica basal o que pode acometer o aparelho cardiovascular. Casos severos podem levar a um derrame pericárdico e cardiomegalia. Este relato de caso descreve uma manifestação atípica do hipotireoidismo, o derrame pericárdio, como um evento inicial da doença, e visa contribuir para a literatura médica, discutindo a propedêutica realizada para diagnóstico e descrevendo a resposta terapêutica e evolução clínica. Relato de Caso: sexo feminino, 44 anos, parda, história de hipotireoidismo em tratamento irregular veio encaminhada para um exame eletivo de tomografia computadorizada do abdome em investigação de nefrolitíase, porém neste evidenciou-se um importante derrame pericárdico sem comprometimento hemodinâmico. À radiografia de tórax evidenciou aumento da área cardíaca e o ecocardiograma evidenciou uma efusão pericárdica (aspecto swinging heart), movimento paradoxal de septo interventricular. O eletrocardiograma não demonstrou alterações. Durante a investigação evidenciou T4 L inferior a 0,4 ng/dL, TSH: 319,9 uUI/mL, anticorpos anti-tireoperoxidase (anti-TPO):142,3UI/ml. Avaliação reumatológica descartou doenças. Diante da hipótese de derrame pericárdico devido ao hipotireoidismo realizou então o tratamento com levotiroxina chegando à dose de 125mcg/dia. Durante os 7 meses do tratamento houve uma regressão da cardiomegalia e do derrame pericárdico. Os exames de janeiro/2018 corroboram a hipótese evidenciando níveis de T4 L: 1,2; TSH: 2,2 com os exames de imagens normais. Conclusão: Diante da raridade do caso, este trabalho mostra uma paciente oligossintomática, mas com grande repercussão em relação à manifestação cardiológica. Com isso, os autores ressaltam a importância da investigação da função tireoidiana em pacientes com alteração cardíaca

A competência técnica em informática de alunos de enfermagem

Os enfermeiros na era da informação precisam desenvolver seus conhecimentos e habilidades para que se tornem competentes nessa área. O objetivo deste estudo foi verificar o conhecimento dos alunos matriculados no primeiro e no oitavo semestres do curso de graduação em enfermagem dos anos de 2008 e 2007, respectivamente, no que se refere à utilização de recursos da informática. Trata-se de uma pesquisa não experimental do tipo estudo survey descritivo exploratório usado para a coleta dos dados em um questionário baseado em um conjunto de competências em informática. Os resultados mostraram o baixo índice de conhecimentos em informática dos alunos que estão ingressando no curso de graduação. Contudo, na comparação dos aplicativos que os alunos têm maior dificuldade, entre os dois períodos avaliados, a maior porcentagem foi de alunos do oitavo semestre, demonstrando a necessidade da introdução do uso do computador na formação desses novos profissionais para sua posterior adaptação ao mercado de trabalho

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms