SmartHeart CABG Edu

The paper reports on the SmartHeart CABG Edu Android app. The app was conceived to be an innovative and up-to-date tool for patient education, the first of its kind in the Italian context. In particular, the app was developed to provide educational material for patients about to undergo Coronary Artery Bypass Graft (CABG) surgery, a set of self-assessment tools concerning health status (i.e., BMI calculator, LDL cholesterol calculator and anxiety assessment tool) and usability questionnaires (i.e., SEQ and SUS). The paper initially describes the app, then reports on its evaluation, concerning both the app usability and the pre-operative anxiety, and ends by showing the improvements -- derived from the usability evaluation -- put into practice

Long Term Survival in Patients Suffering from Glio-blastoma Multiforme: A Single-Center Observational Cohort Study

Background: Glioblastomas (GBM) are generally burdened, to date, by a dismal prognosis, although long term survivors have a relatively significant incidence. Our specific aim was to determine the exact impact of many surgery-, patient- and tumor-related variables on survival parameters. Methods: The surgical, radiological and clinical outcomes of patients have been retrospectively reviewed for the present study. All the patients have been operated on in our institution and classified according their overall survival in long term survivors (LTS) and short term survivors (STS). A thorough review of our surgical series was conducted to compare the oncologic results of the patients in regard to: (1) surgical-(2) molecular and (3) treatment-related features. Results: A total of 177 patients were included in the final cohort. Extensive statistical analysis by means of univariate, multivariate and survival analyses disclosed a survival advantage for patients presenting a younger age, a smaller lesion and a better functional status at presentation. From the histochemical point of view, Ki67 (%) was the strongest predictor of better oncologic outcomes. A stepwise analysis of variance outlines the existence of eight prognostic subgroups according to the molecular patterns of Ki67 overexpression and epidermal growth factor receptor (EGFR), p53 and isocitrate dehydrogenase (IDH) mutations. Conclusions: On the grounds of our statistical analyses we can affirm that the following factors were significant predictors of survival advantage: Karnofsky performance status (KPS), age, volume of the lesion, motor disorder at presentation and/or a Ki67 overexpression. In our experience, LTS is associated with a gross total resection (GTR) of tumor correlated with EGFR and p53 mutations with regardless of localization, and poorly correlated to dimension. We suppose that performing a standard molecular analysis (IDH, EGFR, p53 and Ki67) is not sufficient to predict the behavior of a GBM in regards to overall survival (OS), nor to provide a deeper understanding of the meaning of the different genetic alterations in the DNA of cancer cells. A fine molecular profiling is feasible to precisely stratify the prognosis of GBM patients

Evaluation of biogenic amines in wine: Determination by an improved HPLC-PDA method.

An improved, simple and sensitive method to quantify the biogenic amines ethanolamine, methylamine, ethylamine, isoamylamine and the usually investigated b-phenylethylamine, putrescine, cadaverine, histamine, tyramine, spermidine, spermine has been developed and validated in red and white wines. The analyses were derivatised with dansyl chloride and separated by HPLC coupled with PDA detector. The calibration curves showed good linearity (r>0.9990) and biogenic amines recovery varied from 72 to 97%. The repeatability ranged from 1 to 8% for red wine and from 1 to 5% for white wine. The detection and quantification limits were from 0.02 to 0.10 mg/L and from 0.08 to 0.30 mg/L, respectively. The method was successfully applied to detect and quantify biogenic amines in Italian red and white wines from Abruzzo Region. The proposed method is suitable for simultaneous detection and for accurate and precise quantification of eleven biogenic amines in wines

coal mining and coal use the european perspective

n/

Effect of ewe diet on milk and muscle fatty acid composition of suckling lambs of the protected geographical origin abbacchio romano

Consumers increasingly pay more attention to the lipid profile of meat products and consume less meat to reduce cholesterol and heart disease. In Italy, sheep producers are increasingly feeding sheep fresh forage. We investigated whether the supplementation of dam diet with extruded linseed would be an alternative strategy to pasture for improving the intramuscular and subcutaneous FA compositions of their suckling lambs. The ewe diets were enriched with either extruded linseed (L), un-supplemented farm diet (F), or pasture (P). Milk saturated fatty acids (SFA) decreased in P and L compared with F, while the opposite pattern was observed for polyunsaturated FA (PUFA) and conjugated linoleic acids after seven days. The FA composition of lamb meat was similar to that of their dam\u2019s milk, showing higher PUFA in P and L compared to F, while SFA was higher in F. Regarding the lamb meat obtained from barn-held ewes, L had lower n-6/n-3 content compared to F, while an intermediate content was found in P. These results indicate a better n-3 FA profile in milk and lamb\u2019s meat from pasture and linseed-enriched diets. No changes in lamb performance were observed

Surgical bleeding after pre-operative unfractionated heparin and low molecular weight heparin for coronary bypass surgery

Background and Objectives Since the impairment of platelet function may cause excess peri-operative bleeding, pre-operative discontinuation of aspirin and heparin bridging are common for cardiac surgery. We evaluated the impact of pre-operative administration of enoxaparin and unfractionated heparin (UFH) on coagulation parameters and peri-operative bleeding in patients undergoing elective coronary artery bypass grafting (CABG) surgery after discontinuation of aspirin. Design and Methods Forty-three patients with three-vessel coronary artery disease undergoing elective CABG surgery discontinued aspirin and were randomized to receive either UFH 180 UI/Kg × 2/day s.c. or enoxaparin 100 UI/Kg × 2/day s.c. until 12 h before surgery (median pre-operative treatment 8 days, range 6–12 days). Surgery was performed as usual with UFH. Neither UFH nor any low molecular weight heparin was given in the immediate post-operative period. The effects of UFH and enoxaparin were monitored by the activated partial thromboplastin time (aPTT) and the Enox-test (sensitive to factor Xa inhibition) using a Rapidpoint® Coagulation Analyzer. aPTT and factor Xa activity were also measured by standard methods. Peri-operative bleeding and the nadirs of hemoglobin concentration, hematocrit and platelet count were monitored post-operatively. Results Patients in the two groups were similar for number of bypasses, on-pump time, total surgery time, and time from the last heparin administration. Coagulation parameters increased significantly and similarly at 30 min and 6 h with both treatments, but returned within the normal range at 12 h. Hemoglobin, hematocrit and platelet counts significantly decreased to the same extent after CABG and re-normalized at the same time. Transfusional requirements of blood and plasma units were similar in the two groups. Interpretation and Conclusions From the kinetics of coagulation parameters and the evaluation of bleeding, enoxaparin is a safe alternative to UFH as a bridging therapy to CABG after discontinuation of aspirin

Perinatal Mood and Anxiety Disorders in Women Undergoing Medically Assisted Reproduction

Background: Women taking advantage of medically assisted reproduction (MAR) techniques may differ from spontaneously conceiving women (nonMAR) in risk of depression and/or anxiety. We aimed to investigate possible differences between MAR and nonMAR through the use of the Edinburgh Postnatal Depression Scale in a sample of Italian-speaking women at their third trimester of pregnancy. Methods: We administered the Edinburgh Postnatal Depression Scale (EPDS) to two groups of pregnant women, MAR and nonMAR, at the third trimester of pregnancy (T0), one month after delivery (T1), and three months after delivery (T2) from February 2013 to December 2019. EPDS total scores cutoffs were ≥9 for risk of depression, 9–11 mild depression, ≥12 major depression, and the EPDS-3A cluster ≥4 was a proxy for anxiety. Results: Included were 1303 nonMAR women and 92 MAR, an expected disproportion. NonMAR and MAR women did not differ on depression or anxiety at any assessment timepoint. MAR women were older than nonMAR, consumed more alcohol and medical drugs, and displayed more complications during pregnancy. Scoring over the threshold on depression risk was associated with foreign nationality, unemployment, psychiatric history of the patient, family or partner, psychiatric problems in past pregnancies, hyperemesis, premenstrual syndrome (PMS), and stressful life events in the last year at baseline, and, for some of them, at other timepoints. In contrast, MAR past or current was associated with having suprathreshold depression at the first-month postpartum follow-up. Conclusions: Taken together, our data show that women opting for MAR do not differ from spontaneously conceiving women regarding psychiatric outcomes but do differ on some sociodemographic and clinical variables

Klebsiella pneumoniae infections in COVID-19 patients: a two-month retrospective analysis in an Italian hospital

Italy has experienced one of the harshest and earliest COVID-19 epidemics, with the number of patients infected that followed, from the end of February up to the end of March, an exponential trend [1]. Between the 6 March and the 2 May, 394 patients were confirmed positive for SARS-CoV-2 at the University Hospital of Rome Policlinico Umberto I (PUI) [2]. At the PUI, 5 COVID-19 devoted wards were organized, including two brand new ICUs, counting 32 dedicated to COVID-19 patients: the first was the old general ICU converted into a dedicated COVID-19 ICU, while the second was created in the spaces of four operating rooms (new ICU). In the period of this study, a total of 80 COVID-19-affected patients were hospitalized in the two ICUs at PUI. Among them, 65 patients were screened for carbapenemase producing Enterobacterales (CPE) colonization (Brilliance™ CRE medium plates, Oxoid LTD, Basingstoke, UK): 41 out of 47 SARS-CoV-2 patients hospitalised in the old ICU and 24 out of 33 in the new one. Carbapenemase-producing K. pneumoniae were detected in 14/41 patients (34%) only in the old ICU. No CPE were detected from rectal swabs tested in patients hospitalized in the new ICU. In the same period, 11 CPEs were identified from the 39 rectal swabs out of 48 SARS-CoV-2-negative patients (28%) hospitalized in the non-COVID-ICU of the same hospital. Seven COVID-19 patients developed CPE co-infection (5 bronchoalveolar lavages and 2 blood cultures tested positives for carbapenemase-producing K. pneumoniae), while in the non-COVID-19 ICU 7 bloodstream infections (BSIs) also occurred (Table 1). Symptomatic patients were successfully treated with ceftazidime-avibactam

Is oropharyngoesophageal scintigraphy the method of choice for assessing dysphagia in systemic sclerosis? A single center experience

Objectives: To evaluate the performance of oropharyngoesophageal scintigraphy (OPES) in the assessment of dysphagia in patients with systemic sclerosis (SSc), and to compare OPES results with those of barium esophagogram. Methods: Adult SSc patients who underwent OPES for the assessment of dysphagia were enrolled. OPES was performed with both liquid and semisolid boluses and provided information regarding oropharyngeal transit time, esophageal transit time (ETT), oropharyngeal retention index (OPRI), esophageal retention index (ERI), and site of bolus retention. Barium esophagogram results were also collected. Results: Fifty-seven SSc patients (87.7% female, mean age 57.7 years) with dysphagia were enrolled. OPES identified at least one alteration in each patient and findings were generally worse for the semisolid bolus. Esophageal motility was widely impaired with 89.5% of patients with an increased semisolid ERI, and middle-lower esophagus was the most frequent site of bolus retention. However, oropharyngeal impairment was highlighted by widespread increased OPRI, especially in anti-topoisomerase I positivity. Older patients and with longer disease duration presented slower semisolid ETT (p = 0.029 and p = 0.002, respectively). Eleven patients with dysphagia had a negative barium esophagogram: all of them presented some alterations in OPES parameters. Conclusion: OPES revealed a marked SSc esophageal impairment, in terms of both slowed transit time and increased bolus retention, but also shed light on oropharyngeal swallowing alterations. OPES showed high sensitivity, being able to detect swallowing alterations in dysphagic patients with negative barium esophagogram. Therefore, the use of OPES for the assessment of SSc-related dysphagia in clinical practice should be promoted

A concept mission for the Stellar Population and Evolution with Cubesats (SPEC)

Binary or multiple stellar systems, constituting almost a third of the content of the Milky Way, represent a high priority astronomical target due to their repercussions on the stellar dynamical and evolutionary parameters. Moreover the spectral study of such class of stars allows to better constrain the evolutionary theories of the Galactic stellar populations. By resolving the members of stellar systems through photometric observations we are able to perform more detailed measurements to infer their mass. In this paper we investigate the feasibility of a cubesat based mission including an optical payload to directly optically discriminate the members of a selected sample of binary systems. The scientific targets, consisting 11 M class dwarf stars binary systems, have been extracted from the already studied Riaz catalogue. These subset has been selected considering the star distance, the members angular separation, and the distance from the Galactic plane (due to limit the background and foreground contamination). The satellite concept is based on a 6 unit Cubesat embedding some commercial off the shelf components and an ad hoc designed optical payload occupying almost 4 units. The optical configuration has been chosen in order to fit the angular resolution requirements, as derived from the target characteristics. Moreover, according to the optical analysis and the computed field of view some requirements on the attitude control system have been inferred and fulfilled by the component selection. The paper is organized as in the following: a brief scientific introduction is made; consequently the project is described with particular attention to the optical design and the standard sub-systems; finally the conclusions are drawn and the future perspectives are investigated