Screening for significant chronic liver disease by using three simple ultrasound parameters

Objectives Chronic liver diseases remain asymptomatic for many years. Consequently, patients are diagnosed belatedly, when cirrhosis is unmasked by lifethreatening complications. We aimed to identify simple ultrasound parameters for the screening of patients with unknown significant chronic liver disease. Methods Three hundred and twenty seven patients with chronic liver disease, liver biopsy, and ultrasound examination were included in the derivation set. 283 consecutive patients referred for ultrasound examination were included in the validation set; those selected according to the ultrasound parameters identified in the derivation set were then referred for specialized consultation including non-invasive fibrosis tests and ultimately liver biopsy if liver fibrosis was suspected. Results In the derivation set, three ultrasound parameters were independent predictors of severe fibrosis: liver surface irregularity, spleen length (>110 mm), and demodulation of hepatic veins. The association of ≥2 of the three above parameters provided 49.1% sensitivity and 86.9% specificity. In the validation set, at ≥2 of the three parameters were present in 23 (8%) of the patients. Among these patients, 8 had liver fibrosis (F ≥ 1), 5 had significant fibrosis (F  ≥2) and two cirrhosis. Conclusion The generalized search of three simple ultrasound signs in patients referred for abdominal ultrasound examination may be an easy way to detect those with silent but significant chronic liver disease

Characterization of the biogenic volatile organic compounds (BVOCs) and analysis of the PR1 molecular marker in Vitis vinifera L. inoculated with the nematode Xiphinema index

Upon pathogen attack, plants very quickly undergo rather complex physico-chemical changes, such as the production of new chemicals or alterations in membrane and cell wall properties, to reduce disease damages. An underestimated threat is represented by root parasitic nematodes. In Vitis vinifera L., the nematode Xiphinema index is the unique vector of Grapevine fanleaf virus, responsible for fanleaf degeneration, one of the most widespread and economically damaging diseases worldwide. The aim of this study was to investigate changes in the emission of biogenic volatile organic compounds (BVOCs) in grapevines attacked by X. index. BVOCs play a role in plant defensive mechanisms and are synthetized in response to biotic damages. In our study, the BVOC profile was altered by the nematode feeding process. We found a decrease in \u3b2-ocimene and limonene monoterpene emissions, as well as an increase in \u3b1-farnesene and \u3b1-bergamotene sesquiterpene emissions in nematode-treated plants. Moreover, we evaluated the PR1 gene expression. The transcript level of PR1 gene was higher in the nematode-wounded roots, while in the leaf tissues it showed a lower expression compared to control grapevines

A farm-scale pilot plant for biohydrogen and biomethane production by two-stage fermentation

Hydrogen is considered one of the possible main energy carriers for the future, thanks to its unique environmental properties. Indeed, its energy content (120 MJ/kg) can be exploited virtually without emitting any exhaust in the atmosphere except for water. Renewable production of hydrogen can be obtained through common biological processes on which relies anaerobic digestion, a well-established technology in use at farm-scale for treating different biomass and residues. Despite two-stage hydrogen and methane producing fermentation is a simple variant of the traditional anaerobic digestion, it is a relatively new approach mainly studied at laboratory scale. It is based on biomass fermentation in two separate, seuqential stages, each maintaining conditions optimized to promote specific bacterial consortia: in the first acidophilic reactorhydrogen is produced production, while volatile fatty acids-rich effluent is sent to the second reactor where traditional methane rich biogas production is accomplished. A two-stage pilot-scale plant was designed, manufactured and installed at the experimental farm of the University of Milano and operated using a biomass mixture of livestock effluents mixed with sugar/starch-rich residues (rotten fruits and potatoes and expired fruit juices), afeedstock mixture based on waste biomasses directly available in the rural area where plant is installed. The hydrogenic and the methanogenic reactors, both CSTR type, had a total volume of 0.7m3 and 3.8 m3 respectively, and were operated in thermophilic conditions (55 2 °C) without any external pH control, and were fully automated. After a brief description of the requirements of the system, this contribution gives a detailed description of its components and of engineering solutions to the problems encountered during the plant realization and start-up. The paper also discusses the results obtained in a first experimental run which lead to production in the range of previous laboratory results, with a typical hydrogen and methane specific productivity of 2.2 and 0.5 Nm3/m3reactor per day, in the first and second stage of the plant respectively. At our best knowledge, this plant is one of the very first prototypes producing biohydrogen at farm scale, and it represents a distributed, small scale demonstration to obtain hydrogen from renewable waste-sources

Simple blood fibrosis tests reduce unnecessary referrals for specialized evaluations of liver fibrosis in NAFLD and ALD patients

BACKGROUND: Liver fibrosis evaluation is mandatory in non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) to decide the patient management. Patients with these diseases are usually under the care of non-liver specialists who refer them to specialized centers where the most accurate fibrosis tests are available. We aimed to evaluate whether simple blood fibrosis tests available to all physicians help to reduce the rate of unnecessary referral of NAFLD and ALD patients without advanced fibrosis. METHODS: NAFLD and/or ALD patients newly referred to our center for a non-invasive evaluation of liver fibrosis were retrospectively included. The FibroMeter (FM, combination of blood markers and Fibroscan results) was defined as the reference test for specialized evaluation of liver fibrosis. A FM result <0.384 indicated the absence of advanced fibrosis and thus an "unnecessary referral". RESULTS: 558 patients were included (NAFLD: 283, ALD: 156, mixed NAFLD+ALD: 119). FM was <0.384 (unnecessary referral) in 58.8% of patients. FIB4 was <1.30 in 45.2% and eLIFT <8 in 47.7% of the patients. 84.9% of patients with FIB4 <1.30 and 85.3% of patients with eLIFT <8 had also FM <0.384. Therefore, using FIB4 or eLIFT as first-line evaluation of liver fibrosis decreased by three-fold the rate of unnecessary referral. The negative predictive value of FIB4 and eLIFT was >80% whatever the underlying cause of chronic liver disease. CONCLUSION: The use of eLIFT by non-liver specialists for NAFLD and ALD patients can improve the relevance of referrals for specialized evaluation of liver fibrosis

Chlorhexidine delivery system from titanium/polybenzyl acrylate coating: evaluation of cytotoxicity and early bacterial adhesion

Objectives: The formation of biofilms on titanium dental implants is one of the main causes of failure of these devices. Streptococci are considered early colonizers that alter local environment favouring growing conditions for other colonizers. Chlorhexidine (CHX) is so far the most effective antimicrobial treatment against a wide variety of Gram-positive and Gram-negative organisms as well as fungi. This study was designed to develop a CHX delivery system appropriate for healing caps and abutments, with suitable drug release rate, effective as antimicrobial agent, and free of cytotoxic effects. Methods: Polybenzyl acrylate (PBA) coatings with and without CHX (Ti/PBA and Ti/PBA-CHX, respectively) and different drug loads (0.35, 0.70, and 1.40%, w/w) were assayed. The cytotoxic effect of CHX released from the different substrates on UMR106 cells was tested by alkaline phosphatase specific activity (ALP), and microscopic evaluation of the cells. Noncytotoxic drug load (0.35%, w/w) was selected to evaluate the antimicrobial effectiveness of the system using a microbial consortium of Streptococcus species. Results: The kinetic profile of CHX delivered by Ti/PBA-CHX showed an initial fast release rate followed by a monotonic increase of delivered mass over 48 h. The number of attached bacteria decreased in the following order: Ti > Ti/PBA > Ti/PBA-0.35. Conclusions: PBA-0.35 coating is effective to inhibit the adhesion of early colonizers on Ti without any cytotoxic effect on UMR-106 cells

Chlorhexidine delivery system from titanium/polybenzyl acrylate coating: Evaluation of cytotoxicity and early bacterial adhesion

Objectives: The formation of biofilms on titanium dental implants is one of the main causes of failure of these devices. Streptococci are considered early colonizers that alter local environment favouring growing conditions for other colonizers. Chlorhexidine (CHX) is so far the most effective antimicrobial treatment against a wide variety of Gram-positive and Gram-negative organisms as well as fungi. This study was designed to develop a CHX delivery system appropriate for healing caps and abutments, with suitable drug release rate, effective as antimicrobial agent, and free of cytotoxic effects. Methods: Polybenzyl acrylate (PBA) coatings with and without CHX (Ti/PBA and Ti/PBA-CHX, respectively) and different drug loads (0.35, 0.70, and 1.40%, w/w) were assayed. The cytotoxic effect of CHX released from the different substrates on UMR106 cells was tested by alkaline phosphatase specific activity (ALP), and microscopic evaluation of the cells. Noncytotoxic drug load (0.35%, w/w) was selected to evaluate the antimicrobial effectiveness of the system using a microbial consortium of Streptococcus species. Results: The kinetic profile of CHX delivered by Ti/PBA-CHX showed an initial fast release rate followed by a monotonic increase of delivered mass over 48 h. The number of attached bacteria decreased in the following order: Ti > Ti/PBA > Ti/PBA-0.35. Conclusions: PBA-0.35 coating is effective to inhibit the adhesion of early colonizers on Ti without any cytotoxic effect on UMR-106 cells.Facultad de Ciencias Exacta

Controllo fuzzy di digestori a doppio stadio: sperimentazione a scala di laboratorio per la produzione di bioidrogeno e biometano

Il processo a doppio stadio \ue8 una semplice variante della tradizionale digestione anaerobica di biomasse che avviene in due distinti reattori in serie, che permette rese complessive migliori, oltre alla produzione di una significativa quantit\ue0 di idrogeno a fianco del classico biogas ricco in metano. A tali benefici corrispondono per\uf2 incrementi nei costi impiantistici e nella complessit\ue0 di gestione di processo che deve bilanciare le diverse esigenze dei due stadi alimentati sequenzialmente. Lo studio esplora l\u2019uso di un controllo a logica fuzzy per ottimizzare in modo dinamico il carico organico dell\u2019alimentazione, adeguandolo all\u2019andamento del processo sulla base dei valori delle principali variabili misurati online da sensori online. Nell\u2019ambito di una sperimentazione di lunga durata \ue8 stato monitorato il funzionamento di due identici impianti a doppio stadio a scala di laboratorio, confrontando il comportamento di un impianto alimentato dal sistema a controllo fuzzy con uno alimentato a carico costante. Grazie alla capacit\ue0 di adattare dinamicamente il carico organico in funzione dello stato di processo, il sistema fuzzy ha dimostrato sia capacit\ue0 di produrre significativamente pi\uf9 energia, sia di recuperare instabilit\ue0 di processo determinate da sovralimentazioni. Infine, il carattere interdisciplinare della ricerca viene poi discusso alla luce dell\u2019interessante tema del Convegno, ricavandone alcuni aspetti attuali della figura del Meccanico Agrario

Chlorhexidine delivery system from titanium/polybenzyl acrylate coating: Evaluation of cytotoxicity and early bacterial adhesion

Objectives: The formation of biofilms on titanium dental implants is one of the main causes of failure of these devices. Streptococci are considered early colonizers that alter local environment favouring growing conditions for other colonizers. Chlorhexidine (CHX) is so far the most effective antimicrobial treatment against a wide variety of Gram-positive and Gram-negative organisms as well as fungi. This study was designed to develop a CHX delivery system appropriate for healing caps and abutments, with suitable drug release rate, effective as antimicrobial agent, and free of cytotoxic effects. Methods: Polybenzyl acrylate (PBA) coatings with and without CHX (Ti/PBA and Ti/PBA-CHX, respectively) and different drug loads (0.35, 0.70, and 1.40%, w/w) were assayed. The cytotoxic effect of CHX released from the different substrates on UMR106 cells was tested by alkaline phosphatase specific activity (ALP), and microscopic evaluation of the cells. Noncytotoxic drug load (0.35%, w/w) was selected to evaluate the antimicrobial effectiveness of the system using a microbial consortium of Streptococcus species. Results: The kinetic profile of CHX delivered by Ti/PBA-CHX showed an initial fast release rate followed by a monotonic increase of delivered mass over 48 h. The number of attached bacteria decreased in the following order: Ti > Ti/PBA > Ti/PBA-0.35. Conclusions: PBA-0.35 coating is effective to inhibit the adhesion of early colonizers on Ti without any cytotoxic effect on UMR-106 cells.Facultad de Ciencias Exacta

Acoustic radiation force impulse: a new ultrasonographic technology for the widespread noninvasive diagnosis of liver fibrosis:

Background/aims: As a module of a standard ultrasound imaging device, acoustic radiation force impulse (ARFI) is a new technology for liver stiffness evaluation (LSE). We aimed to evaluate accuracy, feasibility, reproducibility, and training effect of ARFI for liver fibrosis evaluation.Methods: One hundred and one patients with chronic liver disease had LSE by Fibroscan and ARFI. LSE by ARFI was performed in the two liver lobes by two operators: an expert and a novice. Correlation and agreement were evaluated by the Pearson (Rp) and intraclass (Ric) correlation coefficients. The independent reference for liver fibrosis was fibrosis blood tests. Results: ARFI results, ranging from 0.7 to 4.6 m/s, were well correlated with Fibroscan results (Rp=0.76). Fibroscan had a significantly higher area under the receiver operating characteristic curve (AUROC) than ARFI for the perprotocol diagnosis of significant fibrosis: 0.890±0.034 versus 0.795±0.047 (P=0.04). However, LSE failure occurred in zero patients using ARFI versus six patients using Fibroscan (P=0.03). Thus, on an intention-to-diagnose basis, Fibroscan and ARFI AUROCs for the diagnosis of significant fibrosis were not different: 0.791±0.049 versus 0.793±0.046 (P=0.98). Interobserver agreement was very good (Ric=0.84) and excellent for ARFI interquartile range (IQR)≤0.30 (Ric=0.91). Indeed, agreement was independently predicted only by ARFI IQR, but not by LSE result as earlier observed for Fibroscan. ARFI AUROC was 0.876±0.057 in patients with ARFI IQR ratio≤0.30, and Fibroscan AUROC was 0.912±0.034 in patients with Fibroscan IQR ratio less than 0.21 (P=0.59). Intersite ARFI agreement between the two liver lobes was fair (Ric=0.60). There was no training effect for LSE by ARFI. Conclusion: ARFI is highly feasible and reproducible, and provides diagnostic accuracy similar to Fibroscan. This new device seems noteworthy for the widespread noninvasive diagnosis of liver fibrosis