Pancreatic cystosis in cystic fibrosis. Sometimes a bike ride can help you decide

Pancreatic cystosis (PC) is an uncommon manifestation of pancreas involvement in cystic fibrosis (CF), characterized by the presence of multiple macrocysts partially or completely replacing pancreas. Only few reports are available from literature and management (surgery vs follow up) is commonly based on the presence of symptoms or complications due to local mass effect, although evidence-based recommendations are still not available. We here report the case of a young adult CF patient with PC, in which cardiopulmonary exercise testing (CPET) provided important information to be integrated to the radiological finding of inferior vena cava compression by the multicystic pancreas complex. Through the analysis of oxygen kinetic cardiodynamic phase pattern, CPET may be helpful to safely exclude significant mass effects on blood venous return and to improve the decision-making process on whether to consider surgery or not in patients with PC

Cardiac oxidative stress and inflammatory cytokines response after myocardial infarction

Oxidative stress in heart failure or during ischemia/reperfusion occurs as a result of the excessive generation or accumulation of free radicals or their oxidation products. Free radicals formed during oxidative stress can initiate lipid peroxidation, oxidize proteins to inactive states and cause DNA strand breaks. Oxidative stress is a condition in which oxidant metabolites exert toxic effects because of their increased production or an altered cellular mechanism of protection. In the early phase of acute heart ischemia cytokines have the feature to be functional pleiotropy and redundancy, moreover, several cytokines exert similar and overlapping actions on the same cell type and one cytokine shows a wide range of biological effects on various cell types. Activation of cytokine cascades in the infarcted myocardium was established in numerous studies. In experimental models of myocardial infarction, induction and release of the pro-inflammatory cytokines like TNF-&alpha (Tumor Necrosis Factor &alpha), IL-1&beta (Interleukin- 1&beta) and IL-6 (Interleukin-6) and chemokines are steadily described. The current review examines the role of oxidative stress and pro-inflammatory cytokines response following acute myocardial infarction and explores the inflammatory mechanisms of cardiac injur

Enacting Productive Dialogue: Addressing the Challenge that Non-Human Cognition Poses to Collaborations Between Enactivism and Heideggerian Phenomenology

This chapter uses one particular proposal for interdisciplinary collaboration – in this case, between early Heideggerian phenomenology and enactivist cognitive science – as an example of how such partnerships may confront and negotiate tensions between the perspectives they bring together. The discussion begins by summarising some of the intersections that render Heideggerian and enactivist thought promising interlocutors for each other. It then moves on to explore how Heideggerian enactivism could respond to the challenge of reconciling the significant differences in the ways that each discourse seeks to apply the structures it claims to uncover

UVES observations of QSO 0000-2620: oxygen and zinc abundances in the Damped Ly-alpha galaxy at z_abs=3.3901

Observations of the QSO 0000-2620 with UVES spectrograph at the 8.2m ESO KUEYEN telescope are used for abundance analysis of the damped Ly-alpha system at z_{abs}=3.3901. Several Oxygen lines are identified in the Ly_alpha forest and a measure for the oxygen abundance is obtained at [O/H]=-1.85 +/- 0.1 by means of the unsaturated OI 925 A and OI 950 A lines. This represents the most accurate O measurement in a damped Ly_alpha galaxy so far. We have also detected ZnII 2026 A and CrII 2056, 2062 A redshifted at about 8900 A and found abundances [Zn/H] = -2.07 +/- 0.1 and [Cr/H]=-1.99 +/- 0.1. Furthermore, previous measurements of Fe, Si, Ni and N have been refined yielding [Fe/H]=-2.04 +/- 0.1, [Si/H]=-1.90 +/- 0.1, [Ni/H]=-2.27 +/- 0.1, and [N/H]=-2.68 +/- 0.1. The abundance of the non-refractory element zinc is the lowest among the damped Ly-alpha systems showing that the associated intervening galaxy is indeed in the early stages of its chemical evolution. The fact that the Zn abundance is identical to that of the refractory elements Fe and Cr suggests that dust grains have not formed yet. In this Damped Ly-alpha system the observed [O,S,Si/Zn,Fe,Cr] ratios, in whatever combination are taken, are close to solar (i.e 0.1-0.2 dex) and do not show the [alpha-element/Fe] enhancement observed in Milky Way stars of comparable metallicity. The observed behavior supports a galaxy evolution model characterized by either episodic or low star formation rate rather than a Milky-Way-type evolutionary model.Comment: Accepted by Ap

A chart review on the feasibility and safety of the Vincristine Irinotecan Pazopanib (VIPaz) association in children and adolescents with resistant or relapsed sarcomas

Background: Pediatric patients with relapsed or refractory sarcomas have poor outcome and need novel therapies that provide disease control while maintaining an acceptable quality of life. The safety of vincristine, irinotecan, and pazopanib (VIPaz) association has not yet been published in this population. Methods: A chart review was conducted in children and adolescents with relapsed or refractory bone and soft tissue sarcomas who received VIPaz in our institution. Results: One hundred sixty-six patients with a diagnosis of soft or bone sarcoma were admitted to our hospital in the period between March 2015 and August 2018, 30 were relapsed or resistant. Seventeen out of 30 resistant or relapsed patients (median age, 14 years) received 114 VIPaz cycles (median six cycles per patient, range 1–17). Sixteen courses (15%) resulted in gastrointestinal toxicity with Grade two diarrhea; 35 courses (30%) resulted in Grade ≥3 neutropenia. One patient presented Grade two hypothyroidism after nine courses, and another one had Grade two hyperbilirubinemia after 12 courses. Two and five patients required a 25% dose reduction of irinotecan (because of diarrhea) and pazopanib (because of neutropenia four and hyperbilirubinemia 1), respectively. No patient experienced heart failure, hypertension, nor posterior reversible encephalopathy syndrome. Pneumothorax was not reported in any case even in lung metastatic patients. After two and four VIPaz cycles, we observed one complete response (CR), five partial responses (PRs), seven stable diseases (SDs), and four progressive diseases (PDs). With a median follow-up of 15 months (range 3–32), five out of 17 (29%) patients were alive, and four patients were in continuous CR after 12 VIPaz cycles. Conclusions: The VIPaz regimen might be a safe option in children and adolescents with relapsed or refractory sarcomas otherwise unable to be enrolled in other clinical trials; on the other hand, the efficacy of pazopanib observed cannot be sustained from the current study

A theoretical timeline for myocardial infarction: immunohistochemical evaluation and western blot quantification for Interleukin-15 and Monocyte chemotactic protein-1 as very early markers

Background: Experimental and human studies have demonstrated that innate immune mechanisms and consequent inflammatory reaction play a critical role in cardiac response to ischemic injury. Thus, the detection of immuno-inflammatory and cellular phenomena accompanying cardiac alterations during the early inflammatory phase of myocardial infarction (MI) may be an excellent diagnostic tool. Current knowledge of the chronology of the responses of myocardial tissue following the occurrence of ischemic insult, as well as the existence of numerous studies aiming to identify reliable markers in dating MI, induced us to investigate the myocardial specimens of MI fatal cases in order to better define the age of MI. Methods: We performed an immunohistochemical study and a Western blot analysis to evaluate detectable morphological changes in myocardial specimens of fatal MI cases and to quantify the effects of cardiac expression of inflammatory mediators (CD15, IL-1 β, IL-6, TNF-α, IL-15, IL-8, MCP-1, ICAM-1, CD18, tryptase) and structural and functional cardiac proteins. Results: We observed a biphasic course of MCP-1: it was strongly expressed in the very early phase (0-4 hrs), to diminish in the early period (after 6-8 hrs). Again, our choice of IL-15 is explained by the synergism with neutrophilic granulocytes (CD15) and our study shows the potential for striking cytokine synergy in promoting fast, local neutrophil response in damaged tissues. A progressively stronger immunoreaction for the CD15 antibody was visible in the areas where the margination of circulating inflammatory cells was detectable, up to very strong expression in the oldest ones (>12 hours). Further, the induction of CD15, IL-15, MCP-1 expression levels was quantified by Western blot analysis. The resultswereasfollows:IL-15/β-actin 0.80, CD15/ β-actin 0.30, and MCP-1/β-actin 0.60, matching perfectly with the results of immunohistochemistry. Control hearts from traumatic death cases did not show any immunoreactivity to the pro-inflammatory markers, neither were there any reactions in Western blot analysis. Conclusions: Essential markers (i.e. IL-15, MCP-1) are suitable indicators of myocardial response to ischemic insult involving very early phase reaction (inflammatory response and cytokine release). In the very near future, proteomics may help clinicians and pathologists to better understand mechanisms relating to cardiac repair and remodeling and provide targets for future therapies

Spatially embedded random networks

Many real-world networks analyzed in modern network theory have a natural spatial element; e.g., the Internet, social networks, neural networks, etc. Yet, aside from a comparatively small number of somewhat specialized and domain-specific studies, the spatial element is mostly ignored and, in particular, its relation to network structure disregarded. In this paper we introduce a model framework to analyze the mediation of network structure by spatial embedding; specifically, we model connectivity as dependent on the distance between network nodes. Our spatially embedded random networks construction is not primarily intended as an accurate model of any specific class of real-world networks, but rather to gain intuition for the effects of spatial embedding on network structure; nevertheless we are able to demonstrate, in a quite general setting, some constraints of spatial embedding on connectivity such as the effects of spatial symmetry, conditions for scale free degree distributions and the existence of small-world spatial networks. We also derive some standard structural statistics for spatially embedded networks and illustrate the application of our model framework with concrete examples

Digital, memory and mixed-signal test engineering education: five centres of competence in Europe

The launching of the EuNICE-Test project was announced two years ago at the first DELTA Conference. This project is now completed and the present paper describes the project actions and outcomes. The original idea was to build a long-lasting European Network for test engineering education using both test resource mutualisation and remote experiments. This objective is fully fulfilled and we have now, in Europe, five centres of competence able to deliver high-level and high-specialized training courses in the field of test engineering using a high-performing industrial ATE. All the centres propose training courses on digital testing, three of them propose mixed-signal trainings and three of them propose memory trainings. Taking into account the demand in test engineering, the network is planned to continue in a stand alone mode after project end. Nevertheless a new European proposal with several new partners and new test lessons is under construction

Outpatient prescriptions practice and writing quality in a paediatric university hospital.

BACKGROUND: The writing of prescriptions is an important aspect of medical practice. This activity presents some specific problems given a danger of misinterpretation and dispensing errors in community pharmacies. The objective of this study was to determine the evolution of the prescription practice and writing quality in the outpatient clinics of our paediatric university hospital.¦METHODS: Copies of prescriptions written by physicians were collected from community pharmacies in the region of our hospital for a two-month period in 2005 and 2010. They were analysed according to standard criteria, including both formal and pharmaceutical aspects.¦RESULTS: A total of 597 handwritten prescriptions were reviewed in 2005 and 633 in 2010. They contained 1,456 drug prescriptions in 2005 and 1,348 in 2010. Fifteen drugs accounted for 80% of all prescriptions and the most common drugs were paracetamol and ibuprofen. A higher proportion of drugs were prescribed as International Nonproprietary Names (INN) or generics in 2010 (24.7%) compared with 2005 (20.9%). Of the drug prescriptions examined, 55.5% were incomplete in 2005 and 69.2% in 2010. Moreover in 2005, 3.2% were legible only with difficulty, 22.9% were ambiguous, and 3.0% contained an error. These proportions rose respectively to 5.2%, 27.8%, and 6.8% in 2010.¦CONCLUSION: This study showed that fifteen different drugs represented the majority of prescriptions, and a quarter of them were prescribed as INN or generics in 2010; and that handwritten prescriptions contained numerous omissions and preventable errors. In our hospital computerised prescribing coupled with advanced decision support is eagerly awaited

Role of post mortem CT (PMCT) in high energy traumatic deaths

Background. Post Mortem Computed Tomography (PMCT) is being increasingly implemented in forensic field and could be an adjuvant to classic autopsies. In this study we evaluated the feasibility of complementation of conventional autopsy in trauma victims with PMCT. Materials and methods. A total of 21 subjects, who had sustained various types of blunt high-energy trauma, were selected from the casuistry of the Section of Legal Medicine at University of Pisa: before autopsy, a PMCT examination (Toshiba Aquilion 16 CT scanner) was performed, and after the acquisition of the raw images, MPR and VR reconstructions were performed with dedicated software. Results. PMCT is more sensitive than conventional autopsy in detecting skeletal injuries, whilst autopsy constitutes the method of choice for the detection of thoracic and abdominal visceral injuries. Conclusion. PMCT should be considered a useful tool in addition to conventional autopsy in evaluating trauma victims: it detects further bone fractures in body parts difficult to investigate during autopsy (i.e. posterior regions), facilitating the pathologist in the reconstruction of events and in determining the cause of death