Changes in total choline concentration in the breast of healthy fertile young women in relation to menstrual cycle or use of oral contraceptives: a 3-T 1H-MRS study

BACKGROUND: To evaluate changes in total choline (tCho) absolute concentration ([tCho]) in the breast of healthy fertile women in relation to menstrual cycle (MC) or use of oral contraceptives (OC). METHODS: After institutional review board approval, we prospectively evaluated 40 healthy fertile volunteers: 20 with physiological MC, aged 28 ± 3 years (mean ± standard deviation; nOC group); 20 using OC, aged 26 ± 3 years (OC group). Hormonal assays and water-suppressed single-voxel 3-T proton magnetic resonance spectroscopy (1H-MRS) were performed on MC days 7, 14, and 21 in the nOC group and only on MC day 14 in the OC group. [tCho] was measured versus an external phantom. Mann-Whitney U test and Spearman coefficient were used; data are given as median and interquartile interval. RESULTS: All spectra had good quality. In the nOC group, [tCho] (mM) did not change significantly during MC: 0.8 (0.3-2.4) on day 7, 0.9 (0.4-1.2) on day 14, and 0.4 (0.2-0.8) on day 21 (p = 0.963). In the OC group, [tCho] was 0.7 (0.2-1.7) mM. The between-groups difference was not significant on all days (p ≥ 0.411). All hormones except prolactin changed during MC (p ≤ 0.024). In the OC group, [tCho] showed a borderline correlation with estradiol (r = 0.458, p = 0.056), but no correlation with other hormones (p ≥ 0.128). In the nOC group, [tCho] negatively correlated with prolactin (r = -0.587, p = 0.006) on day 7; positive correlation was found with estradiol on day 14 (r = 0.679, p = 0.001). CONCLUSIONS: A tCho peak can be detected in the normal mammary gland using 3-T 1H-MRS. The [tCho] in healthy volunteers was 0.4-0.9 mM, constant over the MC and independent of OC use

Environmental improvement and conservation of useful pastures for wild herbivores in a Regional Park on the Apennines mountains

In order to investigate some effects of the environmental management with faunistic purpose on pastures located on the Apennines mountains, in open areas subjected to bracken fern (Pteridium aqulinum) infestation, samples of vegetation were taken for three years on an open area in the Regional Park of "Laghi di Suviana e Brasimone" (BO). Experimental samples, taken before and after the agronomical works, showed the effects of the pasture improvement on botanical composition, richness and biodiversity. The agronomical pasture management produced a considerable decrease in bracken density and an increase on biodiversity, and the final average value of the Pastoral Value index was quadruplicate. These results confirmed the effectiveness of the actions carried out and the importance of maintaining a continuous programme of pasture management through annual clearing of vegetation

The next step in sustainable dining: the restaurant food waste map for the management of food waste

In recent years, out-of-home food waste is growing exponentially and therefore represents an important focus of attention, albeit little research has been done on this instance. A few researchers have developed frameworks to better explain wasteful behaviors away from home, however a comprehensive interpretation of the phenomenon giving indications for maps/guidelines for the foodservice managers has not been carried out. In this paper, as a result of a thematic literature review, the Restaurant Food Waste Map (RFWM) was designed to describe the phases in which the food waste phenomenon occurs, and to identify mitigation activities of food waste generation processes. The proposed map is aimed to describe three phases in which the food waste phenomenon occurs: (1) kitchen food preparation, (2) food service, and (3) clients' consumption. Moreover, the present map highlights the approaches that restaurants could take into consideration to better manage the food waste: (1) prevention, (2) reduction, and (3) reuse/redistribution of food waste. These approaches set out guidance on the preferred methods of dealing with food waste so as to minimize its impact on the environment and society. The present study provides literature knowledge about food waste management at the restaurant level, and highlights some practical implications. Further studies could explore and analyze out-of-home waste from both the client and business perspective according to the proposed RFWM, to target specific attitudes and behavioral changes, and to quantify the impacts of the suggested changes. Reducing food waste is a key sustainability challenge for the food service industry. Despite the significance of this issue, a comprehensive interpretation of the phenomenon giving indications for maps/guidelines for the foodservice managers has received limited attention in the literature. As a result of a thematic literature review, the RFWM was designed to describe the phases in which the food waste phenomenon occurs, and to identify mitigation activities of food waste generation processes with practice-driven initiatives an organized map has been developed. The proposed map is aimed to describe three phases in which the food waste phenomenon occurs: (1) kitchen food preparation, (2) food service, and (3) clients' consumption. Moreover, the present map highlights the approaches that restaurants could take into consideration to reduce food waste: (1) prevention, (2) reduction, and (3) reuse/redistribution of food waste. The present study provides literature knowledge about food waste management at the restaurant level, and highlights some practical implications. Further studies could explore and analyze out-of-home waste from both the client and business perspective according to the proposed RFWM, to target specific attitudes and behavioral changes, and to quantify the impacts of the suggested changes. The concepts discussed here could help practitioners to become more aware of the factors that drive the adoption of food waste management practices

Feeding evaluation of spontaneous species used by wild ungulates

Abandonment of traditional agricultural practices can produce remarkable effects on land use and on the vegetal composition of marginal areas. This is particularly true in the once grazed zones in the mountain environments, that are now affected by encroachment of shrubby vegetation. The conservation of these open areas and the preservation of a correct ratio pasture/wood are of extremely importance for wild animals. In this note we describe the effectiveness of agronomical intervention carried out to enhance pasture quality in a protected area of central Italy. Data collection concerned botanical composition, floristic richness and biodiversity of vegetation, before and after the intervention efforts. Moreover, data on utilization of single species were collected in order to evaluate the real consumption of each plant species by wild animals. Results confirmed the efficiency of the improvement of the studied area in terms of botanical composition and of pastoral value and they provided useful indications about the actual utilization of non forage plants by wild ungulates

Allergenius, an expert system for the interpretation of allergen microarray results

BACKGROUND: An in vitro procedure based on a microarray containing many different allergen components has recently been introduced for use in allergy diagnosis. Recombinant and highly purified allergens belonging to different allergenic sources (inhalants, food, latex and hymenoptera) are present in the array. These components can either be genuine or cross-reactive, resistant or susceptible to heat and low pH, and innocuous or potentially dangerous. A large number of complex and heterogeneous relationships among these components has emerged, such that sometimes these interactions cannot be effectively managed by the allergist. In the 1960s, specialized languages and environments were developed to support the replacement of human experts with dedicated decision-making information systems. Currently, expert systems (ES) are advanced informatics tools that are widely used in medicine, engineering, finance and trading. METHODS: We developed an ES, named Allergenius ®, to support the interpretation of allergy tests based on microarray technology (ImmunoCAP ISAC ®). The ES was implemented using Flex, a LPA Win-Prolog shell. Rules representing the knowledge base (KB) were derived from the literature and specialized databases. The input data included the patient’s ID and disease(s), the results of either a skin prick test or specific IgE assays and ISAC results. The output was a medical report. RESULTS: The ES was first validated using artificial and real life cases and passed all in silico validations. Then, the opinions of allergists with experience in molecular diagnostics were compared with the ES reports. The Allergenius reports included all of the allergists’ opinions and considerations, as well as any additional information. CONCLUSIONS: Allergenius is a trustable ES dedicated to molecular tests for allergy. In the present version, it provides a powerful method to understand ISAC results and to obtain a comprehensive interpretation of the patient’s IgE profiling

Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study

To report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/non-referral and other covariates in driving surgical outcomes. The MIPA observational study enrolled women aged 18–80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis

Use of the ultrasound-based total malignancy score in the management of thyroid nodules

Purpose The purpose of this study was to validate the role of the total malignancy score (TMS) in identifying thyroid nodules suspicious for malignancy through the sum of their ultrasound features. Methods The local ethical committee approved this prospective observational study. We examined 231 nodules in 231 consecutive patients (164 females and 67 males; age range, 20 to 87 years; median age, 59 years; interquartile range, 48 to 70 years) who underwent ultrasound followed by fine-needle aspiration cytology (FNAC). The nodules were further classified using the TMS, which considers ultrasound features (number, echogenicity, structure, halo, margins, Doppler signal, calcifications, and growth), and the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), which considers cytological features. Patients with non-negative nodules (TBSRTC categories III to VI) underwent histological analysis, repeated FNAC, or 2 years of regular ultrasound follow-up. The associations between the final diagnosis, each of the ultrasound features, and the TMS were estimated using the chi-square test, the Mann-Whitney U test, and multivariate logistic regression. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of the TMS. Results On ultrasound, 47% of the nodules (108 of 231) had a TMS 3. The FNAC results of 85% of the nodules (196 of 231) were benign, while 15% (35 of 231) had non-negative results. Hypoechogenicity, solid structure, the presence of microcalcifications, and the number of nodules were independent predictors of the final diagnosis, and the diagnostic accuracy of the TMS was good (area under the ROC curve, 0.82). Conclusion The TMS system is simple to use, reliable, easily reproducible, and closely reflects malignancy risk. Based on our results, FNAC could be limited to nodules with a TMS ≥3 without missing any cases of carcinoma

Cost per care of the first year of direct antiviral agents in the liguria region: A multicenter analysis

Aims: Despite the remarkable efficacy shown in clinical practice, concerns have been raised about the costs associated with direct antiviral agent (DAA) therapy. This article presents the real-life costs for DAA treatment sustained by the Italian National Health Service in the Liguria Region (Northern Italy). Methods: A retrospective analysis of the cost per care sustained for DAA treatment, relating to the period from January 1 to December 31, 2015 in five centers in Liguria was performed. All patients undergoing DAA-based treatments for hepatitis C virus (HCV) infection were enrolled. On-treatment costs included: HCV treatment, laboratory test, outpatient services, attended visits, drugs used for the management of adverse events (erythropoietin, albumin or red blood cell packs) and inpatient service admissions. Results: In total, 327 patients were enrolled. No difference in terms of sustained virologic response (SVR) rate among different treatments was reported. The majority (85.0%) of patients did not report any side effects and only 15 (4.6%) required hospital admission. Forty-two patients (12.8%) required high-cost drugs for the management of adverse events. The overall cost sustained was \u20ac14,744,433. DAA\ub1ribavirin (RBV) accounted for the wide majority of this cost (98.9%; \u20ac14,585,123). Genotype (GT) 1, the most commonly treated GT, was associated with an average cost of \u20ac43,445 per patient. Detailed analysis of the costs for GT 1 showed the treatment based on ritonavir boosted paritaprevir/ombitasvir + dasabuvir\ub1RBV with an average cost of \u20ac24,978 (RBV+) and \u20ac25,448 (RBV 12) per patient was the most cost-effective. The average cost per SVR was \u20ac48,184. Once again, the ritonavir boosted paritaprevir/ ombitasvir + dasabuvir regimen was associated with the lowest cost/SVR (\u20ac25,448/SVR [GT 1b] and similar results for other GTs). Conclusion: Antiviral regimen is the major contributor to costs in the treatment of HCV infection. Appropriate regimen selection could result in a major cost saving, which can be reinvested to allow more patients to be treated