The influence of a new clinical motion for endodontic instruments on the incidence of postoperative pain

Previous studies showed that motor motions play an important role in determining apical extrusion of debris. Therefore a new clinical motion (MIMERACI) has been proposed. The basic idea is to progress slowly (1mm advancement), and after each 1mm, to remove the instrument from the canal, clean flutes and irrigate. The aim of the study was to prove whether the clinical use of MIMERACI technique would influence or not postoperative pain.MATERIALS AND METHODS: 100 teeth requesting endodontic treatment were selected for the study and divided into two similar groups based on anatomy, pre-operative symptoms and vitality, presence or absence of periapical lesion. All teeth were shaped, cleaned and obturated by the same operator, using the same NiTi instruments. The only difference between the two groups was the instrumentation technique: tradional (group A) vs MIMERACI (group B). Assessment of postoperative pain was performed 3 days after treatment. Presence, absence and degree of pain were recorded with a visual analogue scale (VAS), validated in previous studies. Collected data statistically analyzed using one-way ANOVA post hoc Tukey test. RESULTS: For VAS pain scores MIMERACI technique showed significantly better results than group A (p=0,031). Overall, both incidence and intensity of symptoms were significantly lower. Flare ups occurred in 3 patients, but none treated with the MIMERACI Technique. CONCLUSIONS: Since extruded debris can elicit more postoperative pain, results obtained by using MIMERACI technique are probably due to many factors: better mechanical removal and less production of debris and more efficient irrigation during instrumentation

Designing a Regulatory and Supervisory Framework for Integrated Financial Markets

The financial crisis that started in 2007 casts doubt about the ability of national laws and competent authorities to manage the stability of the financial system and to protect investors. This is due to the relevant evolving features of financial intermediation, like the cross-border strategies in banking, with many M&A undertaken, especially in Europe, and more in general the globalization of finance, also through the many recent operations among exchanges. The associated regulatory and supervisory challenges have proved to be difficult to tackle. An international perspective is needed on single banking regulatory instruments, even if it is impossible at this stage to imagine unique rules and single international authorities managing capital ratios, deposit insurance, reserve requirements and lending of last resort, as well as other tools for providing financial markets stability. However, some common principles on regulation and the structure of supervision may be stated both in US and in Europe: we suggest a “four peak” approach to the matter.The financial crisis that started in 2007 casts doubt about the ability of national laws and competent authorities to manage the stability of the financial system and to protect investors. This is due to the relevant evolving features of financial intermediation, like the cross-border strategies in banking, with many M&A undertaken, especially in Europe, and more in general the globalization of finance, also through the many recent operations among exchanges. The associated regulatory and supervisory challenges have proved to be difficult to tackle. An international perspective is needed on single banking regulatory instruments, even if it is impossible at this stage to imagine unique rules and single international authorities managing capital ratios, deposit insurance, reserve requirements and lending of last resort, as well as other tools for providing financial markets stability. However, some common principles on regulation and the structure of supervision may be stated both in US and in Europe: we suggest a “four peak” approach to the matter.Refereed Working Papers / of international relevanc

Oral health knowledge in pre-school children: a survey among parents in central Italy

Background: The aim of this survey was to evaluate the knowledge and awareness of parents about potential oral health risk factors and correct management of oral hygiene of their preschool children. Material and Methods: The participation to the survey was proposed to all parents of 3-5 year aged children attending a kindergarten in Campobasso. A self-administered questionnaire was completed to obtain information regarding demographic and education variables, knowledge about caries and its transmission, infant feeding practice, maternal oral health during pregnancy, parents and children’s oral hygiene habits and risk behaviors (e.g., sharing cutlery, tasting of baby food, nightly using of baby bottles or pacifier), oral health prevention and role of school. Results: Overall, the parents of 101 children consented to fill the questionnaire. Data analysis showed that only 24% of respondents was aware of the potential vertical transmissibility of cariogenic bacteria through contaminated saliva. It is still a common trend from61% of parents tasting food of their child. On 101 children, 30% used pacifier and 17% used baby bottle with milk during night and among these children 41% for more than 2 years. Parents reported no toothbrushing for 57% of the children in their first 3 years of life. Conclusions: From this survey, independently on parents education, it emerges as still nowadays parents are not fully trained and informed about the management of their child’s oral hygiene and as it’s necessary a parental oral health promoting program to control children oral health risk status, starting from school

Hereditary and sporadic beta-amyloidoses.

Cerebral amyloidoses are chronic, progressive neurodegenerative diseases that are caused by the aggregation and deposition of misfolded proteins in the central nervous system, and lead to cognitive deficits, stroke, and focal neurological dysfunction including cerebellar and extrapyramidal signs. Among them, beta-amyloidoses are a heterogenous set of conditions characterised by the deposition of beta-amyloid protein in brain parenchyma and/or vessel walls that lead to the development of two main clinico-pathological entities: Alzheimer's disease and cerebral amyloid angiopathy, which may be sporadic or familial, and may also co-exist in the same patient. The aim of this review is to describe the most important differences in the pathways leading to parenchymal and cerebrovascular beta-amyloidoses, and the main clinical, neuropathological and biochemical characteristics of the two conditions. It also discusses the phenotypes associated with a series of familial and sporadic beta-amyloidoses in more detail in order to highlight the clinical and neuropathological features that may help to distinguish the different forms of disease

The interplay between mothers\u2019 and children behavioral and psychological factors during COVID-19: an Italian study

Italy has been the first nation outside of Asia to face the COVID-19 outbreak. To limit viral transmission of infection, by March 10th, 2020, the Italian Government has ordered a national lockdown, which established home confinement, home (smart) working, and temporary closure of non-essential businesses and schools. The present study investigated how these restrictive measures impacted mothers and their pre-school children\u2019s behavioral habits (i.e., sleep timing and quality, subjective time experience) and psychological well-being (i.e., emotion regulation, self-regulation capacity). An online survey was administered to 245 mothers with pre-school children (from 2 to 5\ua0years). Mothers were asked to fill the survey thinking both on their habits, behaviors, and emotions and on those of their children during the quarantine, and retrospectively, before the national lockdown (i.e., in late February). A general worsening of sleep quality and distortion of time experience in both mothers and children, as well as increasing emotional symptoms and self-regulation difficulties in children, was observed. Moreover, even when the interplay between the behavioral and psychological factors was investigated, the factor that seems to mostly impact both mothers' and children's psychological well-being was their sleep quality. Overall, central institutions urgently need to implementing special programs for families, including not only psychological support to sustain families with working parents and ameliorating children's management

What is a Gene? A Two Sided View

The need to account for all currently available experimental observations concerning the gene nature, has reshaped the concept of gene turning it from the essentially mechanistic unit, predominant during the '70s, into a quite abstract open and generalized entity, whose contour appears less defined as compared to the past. Here we propose the essence of the gene to be considered double faced. In this respect genotypic and phenotypic entities of a gene would coexist and mix reciprocally. This harmonizes present knowledge with current definitions and predisposes for remodelling of our thinking as a consequence of future discoveries. A two sided view of the gene also allows to combine the genetic and epigenetic aspects in a unique solution, being structural and functional at the same time and simultaneously able to include the different levels in an overlapping unicum

Effect of C/N shock variation on the performances of a moving bed membrane bioreactor

The effect of a sharp variation of C/N ratio in a moving bed membrane bioreactor (MB-MBR) pilot plant treating high strength wastewater has been investigated. The experimental campaign was divided into two periods, each characterized by a different C/N ratio (namely, 2.5 and 15, Period 1 and Period 2, respectively). The MB-MBR system was analyzed in terms of organic carbon removal, nitrification efficiency, biokinetic activity and fouling behavior. The results showed that the nitrification process was severely affected by lower C/N value and by high concentration of ammonia. It was noticed an extensive stress effect on the autotrophic bacteria. Furthermore, it was observed an increase of the resistance related to particle deposition into membrane pores, likely due to a worsening of the cake layer features, with a reduction of the "pre-filter" effect, also related to the increase of the total Extracellular Polymeric Substances production with the C/N ratio

Assessment of a Hydrogen-Fueled Heavy-Duty Yard Truck for Roll-On and Roll-Off Port Operations

The port-logistic industry has a significant impact on the urban environment nearby ports and on the surrounding coastal areas. This is due to the use of large auxiliary power systems on ships operating during port stays, as well as to the employment of a number of fossil fuel powered road vehicles required for port operations. The environmental impact related to the use of these vehicles is twofold: on one hand, they contribute directly to port emissions by fuel consumption; on the other hand, they require some of the ship auxiliary systems to operate intensively, such as the ventilation system, which must operate to remove the pollutants produced by the vehicle engines inside the ship. The pathway to achieve decarbonization and mitigation of energy use in ports involves therefore the adoption of alternative and cleaner technology solutions for the propulsion systems of such port vehicles. This paper presents the performance analysis of a hydrogen powered cargo-handling vehicle for roll-on and roll-off port operations in a real case scenario. The fuel cell/battery hybrid powertrain of the vehicle has been previously designed by the authors. On the base of real data acquired during an on-field measurement campaign, and by means of a validated numerical model of the vehicle dynamics, different mission profiles are defined, in terms of driving and duty cycles, in order to represent typical port operations. A rule-based energy management strategy is then used to estimate the energy and hydrogen consumptions required by the vehicle and to assess its suitability to accomplish the defined target port operations. Outputs from this study show the potential of the proposed solution to take the place, in a foreseeable future, of conventional Diesel-engine vehicles, today commonly used in port logistics, towards a zero-emission scenario

Ambulatory surgery for perianal Crohn’s disease. Study of feasibility

Background. One-third of Crohn’s disease (CD) patients present perianal fistula. The gold standard in the diagnosis and treatment of symptomatic perianal disease (PAD) in CD is the exploration of the anal canal and distal rectum under anesthesia (EUA). This procedure is mainly conducted as a day case surgery. Unfortunately, it is not always possible to proceed within the ideal timing and any delay may well represent a relevant clinical issue. The aim of this study was to evaluate the feasibility of outpatient treatment of symptomatic perianal fistulas in CD patients. Methods. All CD patients under regular follow-up at our inflammatory bowel disease referral center, presenting with symptomatic perianal fistulas, were offered surgical consultation. The data of patients were prospectively collected for three years (February 2014 to February 2017) for the purpose of the study. All clinical information, including previous EUA and/or records from MRI and endoscopic ultrasound, was included. Outpatient anal canal and distal rectum exploration and treatment (OE) were undertaken during the specialist surgical consultation. Fistulas were classified according to Parks’s classification; the type of outpatient treatment and compliance of patients were recorded. Pain was assessed by VAS at the time of the procedure and during the first control. Patients were followed up in the surgical clinic in relation to the study. Results. Ninety-two CD patients with symptomatic perianal fistulas had surgical consultation during the study period. OE was offered to all but 18 patients who fulfilled the exclusion criteria or had an extremely severe disease; six patients refused the OE (8.11%). Of the 68 patients undergoing OE, eleven (16.18%) had previous surgery for perianal disease. The OE was accomplished in sixty-one patients (89.71%), while in 7 patients, it was abandoned for scarce compliance. Nine patients (14.75%) underwent drainage of perianal abscess; in 3 of them, it was possible to probe the fistula tract, find the internal orifice, and pass a loose seton. Overall, setonage was performed in 50 patients (81.97%). Rectovaginal setons were placed in 3 patients and more than one seton (up to 3) in 6 cases. Fistulotomy was performed in 4 simple subcutaneous fistulous tracts. Concordance with the preoperative findings was found in 54 out of 61 patients. EUA was scheduled at the time of OE for the 7 patients who did not complete the procedure. All sixty-one patients who had the OE were followed up for a minimum of 12 months. Conclusions. This preliminary study indicates that OE in CD patients with symptomatic perianal fistulas is safe and feasible in a high-volume referral center. It might provide several benefits, including patients’ logistics, reduce or remove patients’ symptoms and discomfort, allow for a timely start of medical therapy, and avoid further complications

An Approach to the Simulation of a Batch-respirometer

Dynamic models in activated sludge processes have demonstrated to be a reliable and useful instrument in design and management of wastewater treatment plants. The biochemical nature of the processes involved the models which need a specific calibration to local conditions. A common method to determine kinetic and stoichiometric parameters of the biomass or wastewater/sludge fractionations is respirometry. Theoretically, nearly all biomass parameters and fractions can be estimated by respirometry, but a lot of difficulties rise when some parameters, such as saturation and hydrolysis rate constants, have to be drawn from experimental data. The aim of our work is the setting up of a simple method to calibrate Activated Sludge Model No. 1 applying traditional batch respirometric tests together with dynamic simulations of the respirometer itself