Real-time dry matter content of corn silage by a microwave sensor

Daily dry matter (DM) intake in dairy cow is a central point to meet nutritional requirements and optimal performance, reducing the incidence of metabolic diseases. DM content of some forages, such as silages, can undergo huge variations during storing, affecting the total daily DM consumed. Reference laboratory method is time consuming and cannot be applied to daily changes in diet composition. Currently, new promising real-time technologies are available to monitor the DM content of feeds. The aim of the study was to test and calibrate a portable microwave sensor (MS) for DM content in corn silage samples. Twenty-two samples were collected from a corn silage front; sampling procedure was optimized to collect as much as DM content variability as possible within the samples. MS readings were performed with 3 different methods for each samples: 1) directly on the silage front, 2) with the MS over the collected sample and 3) with MS placed under the sample. After the first MS reading, a correspondent silage sample was obtained by a silage corer for readings 2 and 3 and the laboratory DM content assay. A simple regression analysis was performed (JMP, SAS Institute, Cary, NC, 2015) over obtained data. Results evidences as the best MS reading method is represented by the probe burdening on the sample (R2=0.75) with respect to the other methods. The obtained results outlined as, with a correct reading method, MS can be valuable tool to determine DM content of corn silage directly at farm level

Psychological variables in medically assisted reproduction: a systematic review

Introduction: The paths of medically assisted reproduction represent the most important scientific progress to cope with the inability to achieve spontaneous conception (SC) and to reach desired parenthood. Couples undergoing assisted reproductive technology (ART) and couples not facing ovulation induction and artificial fertilization show sufficient levels of well-being and psychological adjustment. However, in some cases couples undergoing ART show lower perceived quality of life than couples with SC. Our aim is to investigate the main psychological variables involved in the special risk condition of medically assisted reproduction and how they could direct specific guidelines to enhance mental wellbeing in dealing with infertility. Material and methods: In this regard, we performed a systematic review following the PRISMA guidelines. From all the studies included, the considered outcome measures were psychological, social, and relational vari- ables and are presented in a systematic approach. Results: A total of 14 studies were included in this article, according to our strict inclusion criteria. Conclusions: Conflicting results have been proven by this systematic review. Even though all underlined the importance of taking charge of the psychological variables in infertility, few studies monitored and evaluated the effectiveness of these interventions. Moreover, none of the selected studies monitored the evolutionary implications of parental competence on the development of children born from ART

The PON “Reti e mobilità” and the objectives of Sustainability: the role of the Environmental Monitoring Plan.

Il  PON Reti e mobilità 2007-2013 (PON) è stato approvato dalla Commissione Europea con decisione C(2007)6318 del 7 dicembre 2007.La strategia del Programma, rivolto alle Regioni “Obiettivo Convergenza” (Campania, Calabria, Sicilia, Puglia) si  concretizza con interventi tesi a sviluppare l’intermodalità, a migliorare la mobilità e l’accessibilità anche per controllare e attenuare i fenomeni di congestione e a garantire la riduzione degli impatti ambientali delle infrastrutture di trasporto, in particolare in termini di riduzione delle emissioni di sostanze inquinanti attraverso il miglioramento complessivo della qualità e dell’efficienza del sistema dei trasporti con specifico riferimento alle merci.Appare dunque evidente come il PON Reti e mobilità tenga fortemente in conto i principi di sostenibilità affermati a livello europeo, non ultimi, quelli sottesi nel Libro Bianco dei Trasporti pubblicato nel 2011 dalla Commissione Europea. A conferma di una strategia complessiva del Programma improntata sulla sostenibilità ambientale, il PON Reti e mobilità destina oltre il 70% delle risorse programmate (cfr. Decreto dell’Autorità di Gestione del 28 luglio 2011) alla realizzazione di interventi relativi a modalità di trasporto sostenibili così come individuate a livello europeo (ferrovie, porti, trasporti multimodali e sistemi di trasporto intelligente).Il PON Reti e mobilità è stato sottoposto a procedura di VAS in accordo a quanto previsto dalla Direttiva 2001/42/CE del 27 giugno 2001, recepita in Italia con D. Lgs 152/2006 “Norme in materia ambientale”, successivamente modificato con D. Lgs 4/2008 e D. Lgs 128/2010.Nel Rapporto Ambientale della VAS del PON grande attenzione è dedicata all’attività di monitoraggio, come dimostra la previsione di  “adeguate misure per il monitoraggio ambientale, anche al fine di apportare eventuali misure correttive nella fase di attuazione”. Un primo e rilevante passaggio in tal senso è rappresentato dall’elaborazione del Piano di Monitoraggio Ambientale (PMA), che costituisce il principale documento di riferimento per la successiva implementazione delle attività di monitoraggio.In questo articolo, a valle della presentazione del Programma e dell’indicazione degli obiettivi di sostenibilità ambientale che si intendono perseguire attraverso l’attuazione degli interventi finanziati, verrà dunque illustrato il PMA, adottato dal Ministero delle Infrastrutture e dei Trasporti (Autorità di Gestione del PON) nel  febbraio 2011 che si pone nel panorama italiano come esperienza pilota nel campo del monitoraggio soprattutto dal punto di vista metodologico.The National Operative Program (PON) “Reti e mobilità” has been approved by European Commission on the 7th of December 2007.The strategic  approach of the PON, exclusively devoted to the  so-called “convergence regions” of Italy (Campania, Calabria, Sicilia, Puglia), aims to:1.    improve the modal balance by an economic, social and environmental perspective;2.    develop the inter-modality in order to move towards the integration of convergence area into the network of the European transport system;3.    improve the mobility and the accessibility, also to reduce the traffic congestion;4.    increase the efficiency related to security standards, to management techniques and to the quality of transportation services in the sector of freight; 5.    guarantee the reduction of environmental impacts through a global improvement of the efficiency of the transport systems.In such a way it is clear that the PON “Reti e mobilità”  takes greatly into account the Sustainability principles recognized at European scale as attested by the budget, namely over the 70% of the entire fund, associated with low-impacts infrastructures (railways and harbors). The PON has been submitted to the SEA procedure, following what the 2001/42/CE Directive establishes.The Environmental Report of PON devotes  great attention to the monitoring activity as shown by the reported recommendation about the need for adequate measures for the environmental monitoring, also in order to apply corrective measures during the implementation of the program. By this point of view, a first and important step has been the elaboration of the “Environmental Monitoring Plan”  (EMP) that represents the main methodological  document for the following implementation of the monitoring activity.This paper, after a brief presentation of the program and of the objectives of Sustainability that the Programs aims to pursue through the realization of specific projects, is devoted to introduce the Environmental Monitoring Plan of the PON that has been approved by the Ministry of the Infrastructures and Transport -in charge as Management Authority of the PON- in February 2011. In detail, the PMA represents the tool through which, the Management Authority, that has specific responsibilities and functions in terms of monitoring and environmental assessment of the program, controls the significant impacts on the environment caused by the implementation of the PON and verify the level of achievement of the established objectives of environmental sustainability. The structure of EMP is based on three main aspects:1)  the adoption of the results of other interesting experiences carried out by experts institutions on the topic;2)  an approach favoring the creation of an “integrated” monitoring system with  the others Operative Programs activated at regional scale;3)  the implementation of a cooperation and shared process with all the directly-involved actors

Delisting of liver transplant candidates with chronic hepatitis C after viral eradication: A European study

International audienceBACKGROUND & AIMS:All oral direct acting antivirals (DAA) have been shown to improve the liver function of patients with decompensated cirrhosis but it is presently unknown whether this clinical improvement may lead to the delisting of some patients. The aim of this study was to assess if and which patients can be first inactivated due to clinically improvement and subsequently delisted in a real life setting.METHODS:103 consecutive listed patients without hepatocellular carcinoma were treated with different DAA combinations in 11 European centres between February 2014 and February 2015.RESULTS:The cumulative incidence of inactivated and delisted patients by competing risk analysis was 15.5% and 0% at 24weeks, 27.6% and 10.3% at 48weeks, 33.3% and 19.2% at 60weeks. The 34 patients who were inactivated showed a median improvement of 3.4 points for MELD (delta MELD, p20:HR=0.042; p<0.0001), delta MELD (HR=1.349; p<0.0001) and delta albumin (HR=0.307; p=0.0069) both assessed after 12weeks of DAA therapy.CONCLUSIONS:This study showed that all oral DAAs were able to reverse liver dysfunction and favoured the inactivation and delisting of about one patient out-of-three and one patient out-of-five in 60weeks, respectively. Patients with lower MELD scores had higher chances to be delisted. The longer term benefits of therapy need to be ascertained.LAY SUMMARY:The excellent efficacy and safety profile of the new drugs against Hepatitis C virus, "direct acting antivirals" or DAAs, have made antiviral therapy possible also for patients with advanced liver disease and for those on the waiting list for liver transplantation (LT). This study shows for the first time that the DAAs may lead to a remarkable clinical improvement allowing the delisting of one patient out of 5

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

BACKGROUND: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. METHODS: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. RESULTS: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0.0001), AILD (p < 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. CONCLUSIONS: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

Background: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection.Methods: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected.Results: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p &lt; 0.0001), AILD (p &lt; 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-alpha levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level.Conclusions: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level

Performance of the model for end-stage liver disease score for mortality prediction and the potential role of etiology

Bakground &amp; aims Although discrimination of the model for end stage liver disease (MELD) is generally considered acceptable, its calibration is still unclear. In a validation study, we assessed the discrimination and calibration performance of 3 versions of the model: original MELD-TIPS, used to predict survival after transjugular intra-hepatic portosystemic shunt (TIPS); classic MELD-Mayo; MELD-UNOS, used by United Network for Organ Sharing (UNOS). Recalibration and model updating were also explored. Methods 776 patients submitted to elective TIPS (TIPS cohort), and 445 unselected patients (non-TIPS cohort) were included. Three, 6 and 12-month mortality predictions were calculated by the 3 MELD versions: discrimination was assessed by c-statistics and calibration by comparing deciles of predicted and observed risks. Cox and Fine and Grey models were used for recalibration and prognostic analyses. Results Major patient characteristics in TIPS/non-TIPS cohorts were: viral etiology 402/188, alcoholic 185/130, NASH 65/33; mean follow-up± SD 25±9/19±21months; 3-6-12 month mortality were respectively, 57-102-142/31-47-99. C-statistics ranged from 0.66 to 0.72 in TIPS and 0.66 to 0.76 in non-TIPS cohorts across prediction times and scores. A post-hoc analysis revealed worse c-statistics in non-viral cirrhosis with more pronounced and significant worsening in non-TIPS cohort. Calibration was acceptable with MELD-TIPS but largely unsatisfactory with MELD-Mayo and -UNOS whose performance improved much after recalibration. A prognostic analysis showed that age, albumin, and TIPS indication might be used for a MELD updating. Conclusions In this validation study the MELD performance was largely unsatisfactory, particularly in non-viral cirrhosis. MELD recalibration and candidate variables for a MELD updating are proposed. Lay summary While discrimination performance of the Model for End Stage Liver Disease (MELD) is credited to be fair to good, its calibration, the correspondence of observed to predicted mortality, is still unsettled. We found that application of 3 different versions of the MELD in two independent cirrhosis cohorts yielded largely imprecise mortality predictions particularly in non-viral cirrhosis and propose a validated model recalibration. Candidate variables for a MELD updating are proposed

Improving the Early Assessment of Child Neglect Signs—A New Technique for Professionals

This paper grants some considerations on a critical phenomenon for child health: child neglect. It is an omission-type form of childhood maltreatment, which is widespread but very hard to intercept. For the assessment of child neglect, the Italian Society of Pediatric Psychology (S.I.P.Ped.) has developed and validated a specific assessment technique (the C.N.A. technique). It is supposed to be for parents of children between 3 and 9 years old. It is based on a paradigm that identifies the dysregulation of parental competence as the cause of neglect. It can occur in hypo- or hyperactivation of three fundamental factors (recognition, stimulation, and care). The child neglect assessment technique (C.N.A.) differs from the retrospective tools available in the literature since it allows for interception of the “signs” of possible child neglect when negligence occurs

Gastrointestinal lesions associated with spondyloarthropathies

Subclinical gut inflammation has been described in up to two-thirds of patients with spondyloarthropathies (SpA). Arthritis represents an extra-intestinal manifestation of several gastrointestinal diseases, including inflammatory bowel disease (IBD), Whipple’s disease, Behcet’s disease, celiac disease, intestinal bypass surgery, parasitic infections of the gut and pseudomembranous colitis. Moreover about two-thirds of nonsteroidal anti-inflammatory drug users demonstrate intestinal inflammation. Arthritis may manifest as a peripheral or axial arthritis. The spondyloarthropathy family consists of the following entities: ankylosing spondylitis, undifferentiated spondyloarthritis, reactive arthritis, psoriatic arthritis, spondyloarthritis associated with IBD, juvenile onset spondyloarthritis. This topic reviews the major gastrointestinal manifestations that can occur in patients with SpA and in nonsteroidal anti-inflammatory drugs users