The Rainbow Project: A Model to Fight Child Malnutrition in Zambia

Child malnutrition in Zambia is a public health priority that must be addressed by networking local authorities, communities and non-governmental organisations (NGOs), through interventions focused both on treatment and prevention. The Rainbow Project, under the Pope John 23rd Association, is a large-scale model of care for orphans and vulnerable children which has been operating since 1998 in Ndola District. It runs a community-based programme that operates through supplementary feeding programmes (SFPs), run by local partner organisations and coordinated by professional figures working in cooperation with district health management teams (DHMTs). The Rainbow Project organises capacity-building activities for people involved inmalnutrition projects at district and community level, radio programmes to sensitise civil society and avoidstigma, and urban agriculture horticulture programmes (container gardening). The networking community-based management is an effective and sustainable way to fight child malnutrition, a major killer for children under five in lower middle-income countries (LMICs)

Use of Pirfenidone in Idiopathic Pulmonary Fibrosis: A Case Study

Non disponibil

Uncovering the genomic heterogeneity of multifocal breast cancer.

Multifocal breast cancer (MFBC), defined as multiple synchronous unilateral lesions of invasive breast cancer, is relatively frequent and has been associated with more aggressive features than unifocal cancer. Here, we aimed to investigate the genomic heterogeneity between MFBC lesions sharing similar histopathological parameters. Characterization of different lesions from 36 patients with ductal MFBC involved the identification of non-silent coding mutations in 360 protein-coding genes (171 tumour and 36 matched normal samples). We selected only patients with lesions presenting the same grade, ER, and HER2 status. Mutations were classified as 'oncogenic' in the case of recurrent substitutions reported in COSMIC or truncating mutations affecting tumour suppressor genes. All mutations identified in a given patient were further interrogated in all samples from that patient through deep resequencing using an orthogonal platform. Whole-genome rearrangement screen was further conducted in 8/36 patients. Twenty-four patients (67%) had substitutions/indels shared by all their lesions, of which 11 carried the same mutations in all lesions, and 13 had lesions with both common and private mutations. Three-quarters of those 24 patients shared oncogenic variants. The remaining 12 patients (33%) did not share any substitution/indels, with inter-lesion heterogeneity observed for oncogenic mutation(s) in genes such as PIK3CA, TP53, GATA3, and PTEN. Genomically heterogeneous lesions tended to be further apart in the mammary gland than homogeneous lesions. Genome-wide analyses of a limited number of patients identified a common somatic background in all studied MFBCs, including those with no mutation in common between the lesions. To conclude, as the number of molecular targeted therapies increases and trials driven by genomic screening are ongoing, our findings highlight the presence of genomic inter-lesion heterogeneity in one-third, despite similar pathological features. This implies that deeper molecular characterization of all MFBC lesions is warranted for the adequate management of those cancers

Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma

Background: Prognostic assessment in patients with hepatocellular carcinoma (HCC) remains controversial. Using the Italian Liver Cancer (ITA.LI.CA) database as a training set, we sought to develop and validate a new prognostic system for patients with HCC. Methods and Findings: Prospective collected databases from Italy (training cohort, n = 3,628; internal validation cohort, n = 1,555) and Taiwan (external validation cohort, n = 2,651) were used to develop the ITA.LI.CA prognostic system. We first defined ITA.LI.CA stages (0, A, B1, B2, B3, C) using only tumor characteristics (largest tumor diameter, number of nodules, intra- and extrahepatic macroscopic vascular invasion, extrahepatic metastases). A parametric multivariable survival model was then used to calculate the relative prognostic value of ITA.LI.CA tumor stage, Eastern Cooperative Oncology Group (ECOG) performance status, Child–Pugh score (CPS), and alpha-fetoprotein (AFP) in predicting individual survival. Based on the model results, an ITA.LI.CA integrated prognostic score (from 0 to 13 points) was constructed, and its prognostic power compared with that of other integrated systems (BCLC, HKLC, MESIAH, CLIP, JIS). Median follow-up was 58 mo for Italian patients (interquartile range, 26–106 mo) and 39 mo for Taiwanese patients (interquartile range, 12–61 mo). The ITA.LI.CA integrated prognostic score showed optimal discrimination and calibration abilities in Italian patients. Observed median survival in the training and internal validation sets was 57 and 61 mo, respectively, in quartile 1 (ITA.LI.CA score ≤ 1), 43 and 38 mo in quartile 2 (ITA.LI.CA score 2–3), 23 and 23 mo in quartile 3 (ITA.LI.CA score 4–5), and 9 and 8 mo in quartile 4 (ITA.LI.CA score > 5). Observed and predicted median survival in the training and internal validation sets largely coincided. Although observed and predicted survival estimations were significantly lower (log-rank test, p < 0.001) in Italian than in Taiwanese patients, the ITA.LI.CA score maintained very high discrimination and calibration features also in the external validation cohort. The concordance index (C index) of the ITA.LI.CA score in the internal and external validation cohorts was 0.71 and 0.78, respectively. The ITA.LI.CA score’s prognostic ability was significantly better (p < 0.001) than that of BCLC stage (respective C indexes of 0.64 and 0.73), CLIP score (0.68 and 0.75), JIS stage (0.67 and 0.70), MESIAH score (0.69 and 0.77), and HKLC stage (0.68 and 0.75). The main limitations of this study are its retrospective nature and the intrinsically significant differences between the Taiwanese and Italian groups. Conclusions: The ITA.LI.CA prognostic system includes both a tumor staging—stratifying patients with HCC into six main stages (0, A, B1, B2, B3, and C)—and a prognostic score—integrating ITA.LI.CA tumor staging, CPS, ECOG performance status, and AFP. The ITA.LI.CA prognostic system shows a strong ability to predict individual survival in European and Asian populations

Laser ablation is superior to TACE in large-sized hepatocellular carcinoma: A pilot case-control study

Background:Limited therapies are available for large ( 6540 mm) unresectable hepatocellular carcinoma (HCC). Currently, the standard treatment with transarterial chemoembolisation (TACE) is unsatisfactory with high recurrence rate and limited effect on survival. Laser Ablation (LA) has emerged as a relatively new technique characterized by high efficacy and good safety. This study is aimed to evaluate the efficacy of LA in comparison to TACE in patients with large HCC. Methods: Eighty-two patients with a single HCC nodule 6540 mm (BCLC stage A or B) were enrolled in this case-control study. Forty-one patients were treated with LA and 41 patients were treated with TACE. Response to therapy was evaluated according to the mRECIST criteria. Survival was calculated with Kaplan-Meier from the time of cancer diagnosis to death with values censored at the date of the last follow-up. Results: Twenty-six (63.4%) and 8 (19.5%) patients had a complete response after LA and TACE, respectively (p &lt; 0.001). Subsequently we stratified the HCCs in 3 categories according to the nodule size: 40-50 mm, 51-60 mm, and &gt; 60 mm. LA resulted superior to TACE especially in nodules ranging between 51 and 60 mm in diameter, with a complete response rate post-LA and post-TACE of 75% and 14.3%, respectively (p = 0.0133). The 36 months cumulative survival rate in patients treated with LA and TACE was 55.4% and 48.8%, respectively. The disease recurrence rates after LA and TACE were 19.5% and 75.0%, respectively. Conclusions: LA is a more effective therapeutic option than TACE in patients with solitary large HCC

Decomposition of hexamethylcyclotrisiloxane over solid oxides

The decomposition of hexamethylcyclotrisiloxane (HMCTS) has been studied at room temperature and in the range 473–673 K over the surface of basic (CaO, MgO) and acidic oxides (Al2O3, SiO2). Alumina allows the complete removal of HMCTS from synthetic biogases at 673 K. A reactive adsorption occurs with surface silication and release of methane. The adsorption capacity of our alumina adsorbent (180 m2 g1), until saturation, at 673 K, is 0.31 g (HMCTS) g(Al2O3) 1, which corresponds to one silicon atom per 9 Å2, i.e. the silication monolayer capacity. On the contrary, silica, which is an excellent adsorbent for siloxanes at room temperature, looses its adsorption ability at high temperature as it is typical of a molecular adsorption behavior. Basic oxides such as MgO and CaO have strong reactivity in decomposing siloxanes in the absence of CO2, but loose reactivity when in contact with carbon dioxide because of surface carbonation

Microbial Characterisation of a Two-Stage Anaerobic Digestion Process for Conversion of Agri-Based Feedstock in Biogas and Long-Chain Fatty Acids in a Circular Economy Framework

In addition to energy recovery, the anaerobic digestion of agro-industrial byproducts can also produce different high-value-added compounds. Two-stage and single-stage reactors were compared for microbial communities’ selection and long-chain fatty acid (LCFA) accumulation to investigate which microbial genera are most linked to the production of these compounds. The microbial communities present in the two reactors’ configuration in the steady state were characterised by 16S rRNA amplicon sequencing, while LCFAs were extracted and quantified from digestate samples by gas chromatography. The results showed the differentiation of the microbially dominant families in the two setups: Defluviitaleaceae and Clostridiaceae in the acidogenic and methanogenic reactor of the two-stage reaction respectively, while Dysgonomonadaceae in the single-stage set-up. LCFA accumulation was significantly detected only in the acidogenic reactor, with palmitic (2764 mg/kg), linoleic (1795 mg/kg) and stearic (1751 mg/kg) acids as the most abundant. The dominance of Defluviitaleaceae UCG 011, along with the low abundance of the LCFA oxidiser Syntrophomonas spp. in the acidogenic reactor, could be linked to the accumulation of such compounds. Therefore, the different microbial communities shaped by the two reactors’ configuration affected the accumulation of LCFAs, indicating that the two-stage anaerobic digestion of agro-industrial byproducts was more effective than single-stage digestion