Courage and representations of death in patients who are waiting for a liver transplantation

Context: In the last decade, a wide literature has highlighted the importance of religiosity as support of severe illnesses, especially the oncological ones, and in the end of life. In the field of the liver transplant there is a lack of similar research. This article aims to bridge this gap and presents an exploratory study on the relationships between fear of death, courage and religiosity among patients who wait for liver transplant. Method: Sixty-two participants awaiting a liver transplant were interviewed with regard to their quality of life, religiosity, ontological representations and fear of death, courage and fear of intervention, donor-related thoughts. The following instruments were utilized: a specific interview; the Short Form Health Survey (SF-36); the Testoni Death Representation Scale (TDRS) and the Courage Measure. Results: Patients reporting higher levels of fear for intervention showed less courage and were more likely to avoid the surgery. They also tended to be non-believers, to have a lower quality of life, and to represent death as an absolute annihilation. Conclusions: The less death was represented as a passage, the stronger the avoidance behaviour and the fear of transplant were. Since it is possible to develop a positive thought about death, the study underlined how the spiritual support could be useful to manage fear of transplantation

Use of a Zwitterionic Surfactant to Improve the Biofunctional Properties of Wool Dyed with an Onion (Allium cepa L.) Skin Extract

To improve the loadability and antioxidant properties of wool impregnated with onion skin extract, the introduction of SB3-14 surfactant in the dyeing process was evaluated. A preliminary investigation on the surfactant–quercetin interaction indicated that the optimal conditions for dye solubility, stability, and surfactant affinity require double-distilled water (pH = 5.5) as a medium and SB3-14 in a concentration above the c.m.c. (2.5 × 10−3 M). The absorption profile of textiles showed the flavonoid absorption band (390 nm) and a bathochromic feature (510 nm), suggesting flavonoid aggregates. The higher absorbance for the sample dyed with SB3-14 indicated greater dye uptake, which was further confirmed by HPLC analysis. The Folin–Ciocalteu method was applied to evaluate the total phenol content (TPC) released from the treated wool, while the assays FRAP, DPPH, ABTS, and ORAC were applied to evaluate the corresponding total antioxidant activity (TAC). Higher TPCs (about 20%) and TACs (5–55%) were measured with SB3-14, highlighting textiles with improved biofunctional properties. Spectrophotometric analyses were also performed with an artificial sweat. The potential cytotoxic effect of SB3-14 in both monomeric and aggregated forms, cell viability, and induction of apoptosis were evaluated in RAW 264.7 cells. These analyses revealed that SB3-14 is safe at concentrations below the c.m.c

Identification of cork characters for phenotypic selection

Global change effects can determine major changes in species distribution and productivity. In the Mediterranean region of the severity of hot and dry periods is growing and an increased frequency of extreme events and a major vulnerability of natural ecosystems is evident. Cork oak (Quercus suber L.) is widely spread in the West Mediterranean region and its economic and social is important

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Discourse Intonation and Systemic Functional Phonology

This paper is a reflection on praxis which addresses the phonological stratum as an integral part of the language system. As EFL teachertrainers, we often find that students isolate the different meaning-creating components of language as a natural result of the way courses areorganized at university level. It is in the spirit of helping students integrate the various aspects of language and context that we have set outto compare David Brazil, Malcolm Coulthard and Catherine Johns’s Discourse Intonation model –which we have been working with for morethan ten years– with the intonation approach in Systemic Functional Linguistics, by M.A.K. Halliday and William Greaves. We observe thetheoretical similarities between the two approaches in order to see how they may supplement one another. Then, we analyse a conversationtaken from a film following both theoretical approaches, and draw conclusions in the light of the comparison. Our preliminary results show thatthe two approaches explain the meanings conveyed with reference to different meaning-making resources. Brazil et al. explain the meaningsat risk in the interaction according to the phonological systems they describe (prominence, tone, key and termination). Halliday and Greavesdo so by referring to the phonological and lexico-grammatical strata in combination

Discourse Intonation and Systemic Functional Phonology

This paper is a reflection on praxis which addresses the phonological stratum as an integral part of the language system. As EFL teachertrainers, we often find that students isolate the different meaning-creating components of language as a natural result of the way courses areorganized at university level. It is in the spirit of helping students integrate the various aspects of language and context that we have set outto compare David Brazil, Malcolm Coulthard and Catherine Johns’s Discourse Intonation model –which we have been working with for morethan ten years– with the intonation approach in Systemic Functional Linguistics, by M.A.K. Halliday and William Greaves. We observe thetheoretical similarities between the two approaches in order to see how they may supplement one another. Then, we analyse a conversationtaken from a film following both theoretical approaches, and draw conclusions in the light of the comparison. Our preliminary results show thatthe two approaches explain the meanings conveyed with reference to different meaning-making resources. Brazil et al. explain the meaningsat risk in the interaction according to the phonological systems they describe (prominence, tone, key and termination). Halliday and Greavesdo so by referring to the phonological and lexico-grammatical strata in combination

Convenient Esterification of Carboxylic Acids by SN2 Reaction Promoted by a Protic Ionic-Liquid System Formed in Situ in Solvent-Free Conditions

The reaction of esterification of benzoic acid with benzyl chloride was chosen as a model reaction to study the esterification by SN2 promoted by tertiary amine as deprotonating agent. The use of ionic liquid (IL) 1,3-dimethylimidazolium methanesulfonate [MMIm][OMs] as reaction medium has proven to give quantitative yield of the ester, but interestingly the reaction does occur even in solvent-free conditions, where the acid + the amine form a liquid system (a protic IL) in situ. This last methodology was extended to several carboxylic acids in conditions of atom economy (i.e., without excess of any reagent), giving moderately good yields of esters (54–78%) recovered by weight in pure form