The Use of Six Sigma to Assess Two Prostheses for Immediate Breast Reconstruction

Breast reconstruction is fundamental and urgent for patients in order to avoid future psychological and physical issues. That’s why immediate breast reconstruction has been requested increasingly in the last years. In this study two prosthesis with different structures and properties were compared according the aesthetic appearance (BREAST-Q© was employed) and five complications (seroma, hematoma, infections, dehiscence and red breast syndrome). The overall population was composed by 56 patients: 24 received a Tutomesh prosthesis and 32 received a Surgimend prosthesis. The DMAIC (define, measure, analyse, improve and control) cycle was implemented as a problem-solving strategy of the Six Sigma to compare the prostheses. While statistically significant difference between the two groups wasn’t found according to the overall BREAST-Q© (p-value = 0.674), the number of complications of the two groups resulted statistically different (p-value of chi-square test less than 0.001). Although it is not possible to understand from this study the reasons of the differences between the complications, this research proved that Surgimend and Tutomesh prostheses can be both implanted safely for immediate breast reconstruction since the higher costs of Surgimend could be neutralized with its lower hospitalization compared to Tutomesh. © 2021, Springer Nature Switzerland AG

Development of doped-KMgF3 fluoro-perovskite nanoparticles with upconversion properties for potential biomedical application

Upconverting nanoparticles (UCNps) possess the ability to convert light from low to high energy. In particular, the absorption of radiation by these nanomaterials in the near-infrared region of the spectrum, and their subsequent emission in the visible region, is of great interest for biomedical applications. Conventional antitumor therapies often produce a high degree of side effects. Consequently, it is proposed to investigate the development of less invasive alternative therapies as photothermal therapy, using UCNps. The upconversion property could be achieved by incorporating dopants (rare earths and transition metals) in fluorine-based crystalline environments. On the other hand, it is important to control the size of the nanoparticles for their use in biomedical applications, for that reason we plan to obtain nanoparticles with an approximate size less than 50 nm. In the present work, the development of KMgF3 fluoroperovskite nanoparticles by solvothermal synthesis is presented, applying a factorial experimental design which consists of four factors (temperature, time and two limiting reagents) at two levels and choosing the average particle size as a variable response. The samples were characterized by powder X-ray diffraction and Transmission Electron Microscopy, in order to know the crystalline phase and particle size. As a result, KMgF3 nanoparticles with an average size between 13 and 31 nm were obtained. In addition, data obtained were statistically processed by Analysis of Variance, to determine the significant factors and their interactions, achieving the optimal synthesis conditions. From these results, a series of samples doped with Mn2+ and/or Nd3+ were obtained in order to find the optimal dopant concentrations for efficient upconversion properties. Our work is the starting point for the development of UCNps allowing them to be applied in future antitumor therapies.Agencia Nacional de investigación e InnovaciónPEDECIBAComisión Académica de Postgrad

Precision medicine and machine learning towards the prediction of the outcome of potential celiac disease

Potential Celiac Patients (PCD) bear the Celiac Disease (CD) genetic predisposition, a significant production of antihuman transglutaminase antibodies, but no morphological changes in the small bowel mucosa. A minority of patients (17%) showed clinical symptoms and need a gluten free diet at time of diagnosis, while the majority progress over several years (up to a decade) without any clinical problem neither a progression of the small intestine mucosal damage even when they continued to assume gluten in their diet. Recently we developed a traditional multivariate approach to predict the natural history, on the base of the information at enrolment (time 0) by a discriminant analysis model. Still, the traditional multivariate model requires stringent assumptions that may not be answered in the clinical setting. Starting from a follow-up dataset available for PCD, we propose the application of Machine Learning (ML) methodologies to extend the analysis on available clinical data and to detect most influent features predicting the outcome. These features, collected at time of diagnosis, should be capable to classify patients who will develop duodenal atrophy from those who will remain potential. Four ML methods were adopted to select features predictive of the outcome; the feature selection procedure was indeed capable to reduce the number of overall features from 85 to 19. ML methodologies (Random Forests, Extremely Randomized Trees, and Boosted Trees, Logistic Regression) were adopted, obtaining high values of accuracy: all report an accuracy above 75%. The specificity score was always more than 75% also, with two of the considered methods over 98%, while the best performance of sensitivity was 60%. The best model, optimized Boosted Trees, was able to classify PCD starting from the selected 19 features with an accuracy of 0.80, sensitivity of 0.58 and specificity of 0.84. Finally, with this work, we are able to categorize PCD patients that can more likely develop overt CD using ML. ML techniques appear to be an innovative approach to predict the outcome of PCD, since they provide a step forward in the direction of precision medicine aimed to customize healthcare, medical therapies, decisions, and practices tailoring the clinical management of PCD children

Fluoro-perovskite nanomaterials for photodynamic cancer treatment”

Upconverting nanoparticles (UCNps) possess the ability to convert light from low to high energy. In particular, the absorption of radiation by these nanomaterials in the near-infrared region of the spectrum, and their subsequent emission in the visible region, is of great interest for biomedical applications. Conventional antitumor therapies often produce a high degree of side effects. Consequently, it is proposed to investigate the development of less invasive alternative therapies as photothermal therapy, using UCNps. The upconversion property could be achieved by incorporating dopants (rare earths and transition metals) in fluorine-based crystalline environments. On the other hand, it is important to control the size of the nanoparticles for their use in biomedical applications, for that reason we plan to obtain nanoparticles with an approximate size less than 50 nm. In the present work, the development of KMgF3 fluoroperovskite nanoparticles by solvothermal synthesis is presented, applying a factorial experimental design which consists of four factors (temperature, time and two limiting reagents) at two levels and choosing the average particle size as a variable response. The samples were characterized by powder X-ray diffraction and Transmission Electron Microscopy, in order to know the crystalline phase and particle size. As a result, KMgF3 nanoparticles with an average size between 13 and 31 nm were obtained. In addition, data obtained were statistically processed by Analysis of Variance, to determine the significant factors and their interactions, achieving the optimal synthesis conditions. From these results, a series of samples doped with Mn2+ and/or Nd3+ were obtained in order to find the optimal dopant concentrations for efficient upconversion properties. Our work is the starting point for the development of UCNps allowing them to be applied in future antitumor therapies.Agencia Nacional de investigación e InnovaciónPrograma de Desarrollo de las Ciencias BásicasComisión Académica de Postgrad

Molecular phylogeny of Nassauvia (Asteraceae, Mutisieae) based on nrDNA ITS sequences

The phylogeny of the genus Nassauvia and closely related genera was reconstructed using sequences from the internal transcribed spacer regions (ITS) of nuclear ribosomal DNA. The genus Triptilion is nested within Nassauvia, making the latter genus paraphyletic. Neither of the two subgenera Nassauvia and Strongyloma is resolved as monophyletic, and none of the sections of subgenus Nassauvia is recovered as monophyletic. The evolution of the compound secondary inflorescences has been complex in Nassauvia, with the highly aggregated forms representing the original condition in the genus. However, the ancestral condition is equivocal in several clades, and there are alternative reconstructions for the gains?losses of the variously aggregated conditions. There has been at least one gain of solitary capitula in Nassauvia. The evolution of flavonoid chemistry has been complex in Nassauvia, and flavonoids are of limited phylogenetictaxonomic utility in the genus. Gains?losses of flavonols occur only on terminals whereas changes in flavones and C-glycosyl flavones occur at various levels in the tree. Gains?losses of methylation of flavones and flavonols occur only on terminals.Nassauvia and closely related genera was reconstructed using sequences from the internal transcribed spacer regions (ITS) of nuclear ribosomal DNA. The genus Triptilion is nested within Nassauvia, making the latter genus paraphyletic. Neither of the two subgenera Nassauvia and Strongyloma is resolved as monophyletic, and none of the sections of subgenus Nassauvia is recovered as monophyletic. The evolution of the compound secondary inflorescences has been complex in Nassauvia, with the highly aggregated forms representing the original condition in the genus. However, the ancestral condition is equivocal in several clades, and there are alternative reconstructions for the gains?losses of the variously aggregated conditions. There has been at least one gain of solitary capitula in Nassauvia. The evolution of flavonoid chemistry has been complex in Nassauvia, and flavonoids are of limited phylogenetictaxonomic utility in the genus. Gains?losses of flavonols occur only on terminals whereas changes in flavones and C-glycosyl flavones occur at various levels in the tree. Gains?losses of methylation of flavones and flavonols occur only on terminals.Fil: Maraner, Fabrizio. Universidad de Viena; AustriaFil: Samuel, Rosabelle. Universidad de Viena; AustriaFil: Stuessy, Tod F.. Universidad de Viena; AustriaFil: Crawford, Daniel J.. University of Kansas; Estados UnidosFil: Crisci, Jorge Victor. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División de Plantas Vasculares; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Pandey, A.. University Of Delhi; IndiaFil: Mort, Mark E.. University of Kansas; Estados Unido

Post-exposure prophylaxis with sotrovimab for Omicron (B.1.1.529) SARS-CoV-2 variant during the aplastic phase of autologous stem cell transplantation

Background To date, there is no information on the safety and efficacy of the novel anti-sarbecoviruses monoclonal antibody sotrovimab administered, as a post-exposure prophylactic measure, during the aplastic phase of autologous stem cell transplantation (ASCT). Methods We describe the outcomes of a Multiple Myeloma (MM) patient, who was threateningly exposed to the Omicron (B.1.1.529) SARS-CoV-2 variant, two days after having received a myeloablative regimen of high-dose melphalan. The patient fulfilled all CDC criteria for prolonged close contacts with an index patient who tested positive for a molecular nasopharyngeal swab (Omicron; B.1.1.529) soon after admission to the ward. Given the high risks of morbidity and mortality in the case of COVID-19 developing during the aplastic phase of transplantation, we adopted a post-exposure prophylaxis intervention based on intravenous (i.v.) sotrovimab