Spontaneous gastric rupture in a 22-month-old boy: Case report and review of the literature: The diagnostic work up and management of a rare pediatric emergency

AbstractWe report the case of 22-month-old boy who sustained spontaneous gastric rupture. The patient had an episode of nausea and vomiting after a large meal the day before admission to our emergency ward. Abdominal ultrasonography revealed free and corpuscolate fluid in the abdomen. Abdominal X-ray showed free air in the abdominal cavity, leading to diagnosis of gastrointestinal perforation. Blood examination revealed metabolic acidosis. An emergency laparotomy detected a wide perforation of gastric wall involving fundus and greater curvature. A sleeve gastrectomy was performed with two layers closure of abdominal wall. Idiopathic gastric rupture, beyond neonatal period, is extremely rare in childhood. Early diagnosis and surgery are mandatory to avoid fatal complications

Alcune considerazioni sull’omicidio: una prospettiva darwiniana

Paleoanthropological remains and historical data show that human beings have a long history of violent aggression. However, killing in group is distinct from killing in a one-to-one interaction, as Darwin found out. Our ability to kill a member of our own species is something we share with many other social carnivorous species. Along with the growth of cooperation and altruism, it developed in small groups of individuals – the Homo Sapiens’ forefathers – characterised by a strong territorial instinct and still subject to predation, so that the attacks from the rival groups were one of the main threats to survival. This particular aggressive ability has kept itself over time in more and more complex human groups, who have shown it – along with such abilities as empathy and social reciprocity, which might be a specific expression of it – mostly towards the members of other groups (rivals). In this contribution we intend to advance an evolutionist hypothesis, the result of almost a decade of work in the field of Darwinian criminology, which sees the homicidal behaviour as a non-unitary phenomenon and as the product (mostly maladaptive) of the development of our ability to kill within a group, but essentially as different from killing (a foe) in a coalitional way. As a matter of fact, within the common phenomenon of murder we can detect only a few potentially adaptive behaviours: killing in selfdefence, infanticide – according to the criteria appropriately established by our penal code to define such a phenomenon - and killing on behalf of an organised (crime) group. We should always bear in mind that, even when behaviour may turn out to be adaptive, this does not mean that it has to be culturally accepted. Research on murder based on the evolutionist theories clearly shows how the homicidal phenomenon is strongly sensitive to factors linked to our peculiar sociality. Far from anchoring the phenomenon to ineluctable and unchangeable genetic characteristics, the evolutionist theories on murder show that much can be done to control the phenomenon mainly through a real understanding of human nature, which is, by definition, malleable and extremely sensitive to the social context.Stando ai reperti paleoantropologici e ai dati storici gli esseri umani hanno una lunga storia di aggressività violenta. L’uccidere in gruppo va però tenuto ben distinto dall’uccidere in una interazione uno ad uno, come già aveva individuato Darwin. La nostra capacità di uccidere un individuo della nostra stessa specie, che condividiamo con molte altre specie carnivore sociali, si è probabilmente evoluta, assieme allo svilupparsi della cooperazione e dell’altruismo, nei piccoli gruppi di individui predecessori dei sapiens caratterizzati da forte territorialità che erano ancora soggetti a forte predazione e per i quali gli attacchi di gruppi rivali potevano costituire una delle principali minacce alla sopravvivenza. Tale particolare capacità aggressiva si è quindi mantenuta nel corso del tempo all'interno dei gruppi umani sempre più complessi, esprimendosi assieme ed essendo probabilmente anche una specifica manifestazione di capacità quali l’empatia e la reciprocità sociale ed essendo principalmente rivolta verso individui appartenenti ad altri gruppi (rivali).In questo contributo vogliamo proporre un’ipotesi evoluzionista, frutto dell’ormai quasi decennale impegno nel campo della Criminologia darwiniana, che vede il comportamento omicidiario come un fenomeno non unitario, prodotto collaterale e il più delle volte maladattativo dell’evoluzione della nostra capacità di uccidere in gruppo, ma sostanzialmente differente dall’uccidere (un nemico) in modo coalizzato. All’interno del comune fenomeno omicidiario si possono infatti ritrovare solo alcuni comportamenti in vario modo potenzialmente adattivi: l’uccidere per legittima difesa, mettere in atto un infanticidio, con i limiti che opportunamente pone il nostro codice penale per definire questa specifica fattispecie, o, infine, l’uccidere per conto di un gruppo (criminale) organizzato, rammentando sempre che, anche se un comportamento può risultare adattivo, non significa che esso debba necessariamente essere accettato culturalmente.Le ricerche sull’omicidio, improntate alle teorie evoluzioniste, mostrano chiaramente quanto l’omicidio sia un fenomeno fortemente sensibile a fattori che hanno a che vedere con la nostra peculiare socialità. Le teorie evoluzioniste sull’omicidio, lungi dall’ancorare il fenomeno dell’omicidio a nostre ineluttabili e immodificabili caratteristiche genetiche, mostrano, al contrario, che molto si può fare per contenere il fenomeno proprio partendo dalla reale conoscenza della natura umana che è per definizione plastica ed estremamente sensibile al contesto sociale

Activation of the Erk8 Mitogen-activated Protein (MAP) Kinase by RET/PTC3, a Constitutively Active Form of the RET Proto-oncogene

Mitogen-activated protein (MAP) kinases have a central role in several biological functions, including cell adhesion and spreading, chemotaxis, cell cycle progression, differentiation, and apoptosis. Extracellular signal-regulated kinase 8 (Erk8) is a large MAP kinase whose activity is controlled by serum and the c-Src non-receptor tyrosine kinase. Here, we show that RET/PTC3, an activated form of the RET proto-oncogene, was able to activate Erk8, and we demon- strate that such MAP kinase participated in RET/PTC3-dependent stimulation of the c-jun promoter. By using RET/PTC3 molecules mutated in specific tyrosine autophosphorylation sites, we charac- terized Tyr981, a known binding site for c-Src, as a major determi- nant of RET/PTC3-induced Erk8 activation, although, surprisingly, the underlying mechanism did not strictly depend on the activity of Src. In contrast, we present evidence that RET/PTC3 acts on Erk8 through Tyr981-mediated activation of c-Abl. Furthermore, we localized the region responsible for the modulation of Erk8 activity by the RET/PTC3 and Abl oncogenes in the Erk8 C-terminal domain. Altogether, these results support a role for Erk8 as a novel effector of RET/PTC3 and, therefore, RET biological functions

A Meta-Analysis for an Interactive, Intersectional and Inclusive Exhibition Based on the SDGs

The main goal of the project is to create an interactive exhibition, innovative and technological in its approach, that aims to create awareness and promote the knowledge of the Sustainable Development Goals of the Agenda ONU 2030 – in particular, on the value of social and environmental sustainability. 178 Countries adopted a common agenda to preserve our planet for the first time in 1992, during the Rio de Janeiro Summit. From that moment, the concept of sustainability has changed forever and has been changing ever since. In this paper, after understanding the state of the art in the field of the interactive exhibition, it is going to be explained how the methodology is applied in order to evolve from a desk and field analysis to a concept definition. These key points will then help define the concept in the shape of an operative strategy with methodological guidelines and a structured solution. From this stage, a few considerations on the future of this proposal can be drawn

Axilla management in sentinel node positive breast cancer patients at Mater Dei Hospital : an audit and literature review

BACKGROUND: In breast cancer patients with a positive SLN, surgical axillary clearance and axillary radiation therapy (ART) provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS trial. ART has the advantage of causing less complications with significantly lower rates of lymphoedema. The aim of this audit is to review clinical practice of axillary management of breast cancer patients in Malta following identification of positive SLN and compare results with international criteria. The possibility of de-escalating therapy might improve the morbidity of our patients without compromising their outcomes.METHODS: A retrospective and quantitative analysis of 329 breast cancer patients who underwent an axillary SLN procedure at Mater Dei Hospital (MDH) between January 2019 and 2020 was performed. The inclusion criteria were patient demographics, pre-/post-operative staging, tumour size, and treatment given. Data was analysed and compared to International randomised trials. The San Matteo Criteria based on the AMAROS trial, were reviewed, and used as a standard and compared to local practice.RESULTS: 329 patients were analysed, of which 284 patients fulfilled the inclusion criteria. 70 patients had a positive SLN with 74% having one SLN positive, of which 40% underwent ALND, 6% had ART, 2% refused ART and 52% received no treatment. 26% had 2 positive SLNs of which 44% underwent ALND, none received ART and 56% received no treatment in those with two positive SLN. Patients with more than 2 positive SLNs were excluded.CONCLUSION: We have determined that ALND is the accepted management for breast cancer patients with positive SLN in MDH. ART should be considered as a more favourable treatment option in patients with positive SLN being treated as it provides comparable results with significantly lower morbidity than ALND.peer-reviewe

Evaluation of the biofilm-forming ability and molecular characterization of dairy Bacillus spp. isolates

Food processing lines represents a suitable environment for bacterial biofilm formation. One of the most common biofilm-forming genera in dairy processing plants is Bacillus, which includes species that may have a negative impact on safety and/or quality of dairy products. In the current study, we evaluated the biofilm forming ability and molecular characteristics of dairy Bacillus spp. isolates (B. cereus and B. subtilis). Reference strains (B. cereus ATCC 14579 and B. subtilis NCTC 3610) were also included in the experiment. All isolates were screened by micro-titer plate (96 wells) to assess their ability to form biofilm. Then, they were tested on two common food contact surfaces (polystyrene and stainless steel) by using 6-well plates and AISI 316 stainless steel coupons. Biofilm formation, expressed as biofilm production index (BPI), was higher on polystyrene than stainless steel (except for B. cereus ATCC 14579). These observations were further confirmed by scanning electron microscopy, which allowed the microscopy observation of biofilm structure. Moreover, a possible correlation among total viable cell counts (CFU) and BPI was examined, as well as a connection among biofilm formation and bacterial cell hydrophobicity. Finally, whole genome sequencing was performed highlighting a genetic similarity among the strains belonging to the same species. The presence of selected genes involved in biofilm formation was also examined showing that strains with a greater presence of these genes were able to produce more biofilm in the tested materials. Additionally, for B. cereus strains enterotoxin genes were detected

Changes Induced by Exposure of the Human Lung to Glass Fiber–Reinforced Plastic

The inhalation of glass dusts mixed in resin, generally known as glass fiber–reinforced plastic (GRP), represents a little-studied occupational hazard. The few studies performed have highlighted nonspecific lung disorders in animals and in humans. In the present study we evaluated the alteration of the respiratory system and the pathogenic mechanisms causing the changes in a group of working men employed in different GRP processing operations and exposed to production dusts. The study was conducted on a sample of 29 male subjects whose mean age was 37 years and mean length of service 11 years. All of the subjects were submitted to a clinical check-up, basic tests, and bronchoalveolar lavage (BAL); microscopic studies and biochemical analysis were performed on the BAL fluid. Tests of respiratory function showed a large number of obstructive syndromes; scanning electron microscopy highlighted qualitative and quantitative alterations of the alveolar macrophages; and transmission electron microscopy revealed the presence of electron-dense cytoplasmatic inclusions indicating intense and active phlogosis (external inflammation). Biochemical analyses highlighted an increase in protein content associated with alterations of the lung oxidant/antioxidant homeostasis. Inhalation of GRP, independent of environmental concentration, causes alterations of the cellular and humoral components of pulmonary interstitium; these alterations are identified microscopically as acute alveolitis

Advancing nursing in Italy through the development and evaluation of an innovative postgraduate programme in Family and Community Nursing - A pilot study

Introduction Due to the impact on the public health systems of the ageing and the increasing frailty of the population, the European Union and the World Health Organisation have emphasised how family and community nurses (FCNs) could play an important in supporting the ageing process through prevention, promotion, and protection in the territory. Methods This study describes the first experience in Italy of a one-year postgraduate course divided into 5 modules for FCNs piloted as part of the EuropeaN curriculum for fAmily aNd Community nursE (ENhANCE) 2018-2020 project, funded by the European Commission. Participants included a total of 45 students and 23 lecturers and a team of clinical tutors. Results The Italian pilot course for the FCNs proved to be a successful example of innovative teaching methods using blended didactic methods, which enabled participants to achieve high-standard learning outcomes and competencies in the field of family and community nursing. Conclusions The pilot course described in this paper is well suited to preparing highly skilled family and community nurses to meet the growing healthcare needs of the population. Therefore, we have planned to replicate this course to increase the workforce of family and community nurses, who through their healthcare services aimed at prevention, promotion and protection, will be able to ensure high quality services to the public and consequently relieve the burden on acute hospitals

Direct routes to functional RAFT agents from substituted N-alkyl maleimides

N-substituted maleimides have become an indispensable tool for the synthesis of bioconjugates and functional materials. Herein, we present three strategies for the incorporation of N-alkyl substituted maleimides into RAFT agents and show that these maleimide-derived CTAs can be used to easily introduce a range of chemical functionality at the β-position of polymer chains, resulting in α,β,ω-functional RAFT polymers. With both functional maleimides and RAFT agents that are increasingly available on the market, the approach presented in this study could facilitate the synthesis of end-functional macromolecules and will complement well the range of existing synthetic routes, including those utilising N-substituted maleimides, to functional polymeric materials