Clinical, Histological and Trichoscopic Correlations in Scalp Disorders

Trichoscopy is the term coined for the dermoscopic imaging of scalp and hair. This diagnostic technique, simple and noninvasive, can be used as a handy bedside tool for the diagnosis and follow-up of hair and scalp disorders. It allows the recognition of morphologic structures not visible by the naked eye and provides the clinician with a range of dermoscopic findings necessary for differential diagnosis. Trichoscopy observation can be broadly grouped as interfollicular patterns and follicular patterns. Recently, a third mixed class, called the follicular plus interfollicular pattern, has been introduced. Some of these features are specific to a certain scalp disease, while others can be found in many hair disorders. Although studies suggest that the use of trichoscopy can improve clinical accuracy, further investigation is needed. This review provides update information on the trichoscopic features of the most common scalp disorders, striving to show a histopathological and clinical correlation

Efficient District Heating in a Decarbonisation Perspective: A Case Study in Italy

The European and national regulations in the decarbonisation path towards 2050 promote district heating in achieving the goals of efficiency, energy sustainability, use of renewables, and reduction of fossil fuel use. Improved management and optimisation, use of RES, and waste heat/cold sources decrease the overall demand for primary energy, a condition that is further supported by building renovations and new construction of under (almost) zero energy buildings, with a foreseeable decrease in the temperature of domestic heating systems. Models for the simulation of efficient thermal networks were implemented and described in this paper, together with results from a real case study in Italy, i.e., University Campus of Parma. Activities include the creation and validation of calculation codes and specific models in the Modelica language (Dymola software), aimed at investigating stationary regimes and dynamic behaviour as well. An indirect heat exchange substation was coupled with a resistive-capacitive model, which describes the building behaviour and the thermal exchanges by the use of thermos-physical parameters. To optimise indoor comfort conditions and minimise consumption, dynamic simulations were carried out for different operating sets: modulating the supply temperature in the plant depending on external conditions (Scenario 4) decreases the supplied thermal energy (-2.34%) and heat losses (-8.91%), even if a lower temperature level results in higher electricity consumption for pumping (+12.96%), the total energy consumption is reduced by 1.41%. A simulation of the entire heating season was performed for the optimised scenario, combining benefits from turning off the supply in the case of no thermal demand (Scenario 3) and from the modulation of the supply temperature (Scenario 4), resulting in lower energy consumption (the thermal energy supplied by the power plant -3.54%, pumping +7.76%), operating costs (-2.40), and emissions (-3.02%). The energy balance ex-ante and ex-post deep renovation in a single user was then assessed, showing how lowering the network operating temperature at 55 degrees C decreases the supplied thermal energy (-22.38%) and heat losses (-22.11%) with a slightly higher pumping consumption (+3.28%), while maintaining good comfort conditions. These promising results are useful for evaluating the application of low-temperature operations to the existing district heating networks, especially for large interventions of building renovation, and confirm their potential contribution to the energy efficiency targets

Expressed Alu repeats as a novel, reliable tool for normalization of real-time quantitative RT-PCR data

Expressed Alu repeats are a reliable, accurate and universal reference for use in RT-qPCR normalization of human gene

Chronic cerebrospinal venous insufficiency in multiple sclerosis: a highly prevalent age-dependent phenomenon

BACKGROUND: This study aimed to investigate the prevalence and clinical relevance of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis (MS) patients and healthy controls using extra- and intracranial colour Doppler sonography. METHODS: We examined 146 MS patients, presenting with a clinically isolated syndrome, relapsing-remitting, secondary progressive, or primary progressive MS, and 38 healthy controls. Sonographic examination was performed according to Zamboni’s protocol and was performed by three independent sonographers. The results of sonographic examination were compared with clinical and demographic characteristics of the patients. RESULTS: CCSVI, defined as the presence of at least two positive Zamboni’s criteria, was found in 76% of MS patients and 16% of control subjects. B-mode anomalies of internal jugular veins, such as stenosis, malformed valves, annuli, and septa were the most common lesions detected in MS patients (80.8%) and controls (47.4%). We observed a positive correlation between sonographic diagnosis of CCSVI and the patients’ age (p = 0.003). However, such a correlation was not found in controls (p = 0.635). Notably, no significant correlations were found between sonographic signs of CCSVI and clinical characteristics of MS, except for absent flow in the jugular veins, which was found more often in primary (p<0.005) and secondary (p<0.05) progressive patients compared with non-progressive patients. Absent flow in jugular veins was significantly correlated with patients’ age (p < 0.0001). CONCLUSIONS: Sonographically defined CCSVI is common in MS patients. However, CCSVI appears to be primarily associated with the patient’s age, and poorly correlated with the clinical course of the disease

Digital twin reference model development to prevent operators' risk in process plants

In the literature, many applications of Digital Twin methodologies in the manufacturing, construction and oil and gas sectors have been proposed, but there is still no reference model specifically developed for risk control and prevention. In this context, this work develops a Digital Twin reference model in order to define conceptual guidelines to support the implementation of Digital Twin for risk prediction and prevention. The reference model proposed in this paper is made up of four main layers (Process industry physical space, Communication system, Digital Twin and User space), while the implementation steps of the reference model have been divided into five phases (Development of the risk assessment plan, Development of the communication and control system, Development of Digital Twin tools, Tools integration in a Digital Twin perspective and models and Platform validation). During the design and implementation phases of a Digital Twin, different criticalities must be taken into consideration concerning the need for deterministic transactions, a large number of pervasive devices, and standardization issues. Practical implications of the proposed reference model regard the possibility to detect, identify and develop corrective actions that can affect the safety of operators, the reduction of maintenance and operating costs, and more general improvements of the company business by intervening both in strictly technological and organizational terms

Cholesterol-loaded nanoparticles ameliorate synaptic and cognitive function in Huntington's disease mice

Brain cholesterol biosynthesis and cholesterol levels are reduced in mouse models of Huntington's disease (HD), suggesting that locally synthesized, newly formed cholesterol is less available to neurons. This may be detrimental for neuronal function, especially given that locally synthesized cholesterol is implicated in synapse integrity and remodeling. Here, we used biodegradable and biocompatible polymeric nanoparticles (NPs) modified with glycopeptides (g7) and loaded with cholesterol (g7-NPs-Chol), which per se is not blood-brain barrier (BBB) permeable, to obtain high-rate cholesterol delivery into the brain after intraperitoneal injection in HD mice. We report that g7-NPs, in contrast to unmodified NPs, efficiently crossed the BBB and localized in glial and neuronal cells in different brain regions. We also found that repeated systemic delivery of g7-NPs-Chol rescued synaptic and cognitive dysfunction and partially improved global activity in HD mice. These results demonstrate that cholesterol supplementation to the HD brain reverses functional alterations associated with HD and highlight the potential of this new drug-administration route to the diseased brain

Nirmatrelvir treatment of SARS-CoV-2-infected mice blunts antiviral adaptive immune responses

Alongside vaccines, antiviral drugs are becoming an integral part of our response to the SARS-CoV-2 pandemic. Nirmatrelvir-an orally available inhibitor of the 3-chymotrypsin-like cysteine protease-has been shown to reduce the risk of progression to severe COVID-19. However, the impact of nirmatrelvir treatment on the development of SARS-CoV-2-specific adaptive immune responses is unknown. Here, by using mouse models of SARS-CoV-2 infection, we show that nirmatrelvir administration blunts the development of SARS-CoV-2-specific antibody and T cell responses. Accordingly, upon secondary challenge, nirmatrelvir-treated mice recruited significantly fewer memory T and B cells to the infected lungs and mediastinal lymph nodes, respectively. Together, the data highlight a potential negative impact of nirmatrelvir treatment with important implications for clinical management and might help explain the virological and/or symptomatic relapse after treatment completion reported in some individuals

Pattern of care for re-irradiation in locally recurrent rectal cancer: a national survey on behalf of the AIRO gastrointestinal tumors study group

PurposeRadical resection (R0) represents the best curative treatment for local recurrence (LR) rectal cancer. Re-irradiation (re-RT) can increase the rate of R0 resection. Currently, there is a lack of guidelines on Re-RT for LR rectal cancer. The Italian Association of Radiation and clinical oncology for gastrointestinal tumors (AIRO-GI) study group released a national survey to investigate the current clinical practice of external beam radiation therapy in these patients.Material and methodsIn February 2021, the survey was designed and distributed to members of the GI working group. The questionnaire consisted of 40 questions regarding center characteristics, clinical indications, doses, and treatment techniques of re-RT for LR rectal cancer.ResultsA total of 37 questionnaires were collected. Re-RT was reported as an option for neoadjuvant treatment in resectable and unresectable disease by 55% and 75% of respondents, respectively. Long-course treatment with 30-40 Gy (1.8-2 Gy/die, 1.2 Gy bid) and hypofractionated regimen of 30-35 Gy in 5 fractions were used in most centers. A total dose of 90-100 Gy as EqD2 dose (& alpha;/& beta; = 5 Gy) was delivered by 46% of the respondents considering the previous treatment. Modern conformal techniques and daily image-guided radiation therapy protocols were used in 94% of centers.ConclusionOur survey showed that re-RT treatment is performed with advanced technology that allow a good management of LR rectal cancer. Significant variations were observed in terms of dose and fractionation, highlighting the need for a consensus on a common treatment strategy that could be validated in prospective studies

Adalimumab and ABP 501 in the Treatment of a Large Cohort of Patients with Inflammatory Arthritis: A Real Life Retrospective Analysis

The recent introduction of ABP 501, an adalimumab biosimilar, in the treatment of rheumatic diseases was supported by a comprehensive comparability exercise with its originator. On the other hand, observational studies comparing adalimumab and ABP 501 in inflammatory arthritis are still lacking. The main aim of this study is to compare the clinical outcomes of the treatment with adalimumab, both the originator and ABP 501, in a large cohort of patients affected by autoimmune arthritis in a real life setting. We retrospectively analysed the baseline characteristics and the retention rate in a cohort of patients who received at least a course of adalimumab (originator or ABP 501) from January 2003 to December 2020. We stratified the study population according to adalimumab use: naive to original (oADA), naive to ABP 501 (bADA) and switched from original to ABP 501 (sADA). The oADA, bADA and sADA groups included, respectively, 724, 129 and 193 patients. In each group, the majority of patients had a diagnosis of rheumatoid arthritis. The total observation period was 9805.6 patient-months. The 18-month retentions rate in oADA, bADA and sADA was, respectively, 81.5%, 84.0% and 88.0% (p &gt; 0.05). The factors influencing the adalimumab retention rate were an axial spondylarthritis diagnosis (Hazard Ratio (HR) 0.70; p = 0.04), switch from oADA to ABP 501 (HR 0.53; p = 0.02) and year of prescription (HR 1.04; p = 0.04). In this retrospective study, patients naive to the adalimumab originator and its biosimilar ABP 501 showed the same retention rate. Patients switching from the originator to biosimilar had a higher retention rate, even though not statistically significant, when compared to naive