Fracture energy of sustainable geopolymer composites with and without the addition of slaughterhouse by-products as fibre-reinforcement: An experimental investigation

This work focuses on the development and on the mechanical characterization of geopolymer composites to be used as sustainable plasters or mortars. The starting point of the work is the synthesis of a geopolymer binder, which is subsequently used for the production of two different mortars: the first one is obtained by simply adding fine aggregates (control mortar), while in the second case, also slaughterhouse wastes (SHW) are included in the admixture. Nowadays, slaughtering industry produces a large amount of biological wastes, that are usually discarded via incineration or landfills. Among SHW, horns and hooves, which are rich in keratin, can be potentially used as additives in the manufacturing process of mortars, both in the form of fibre-reinforcement, as well as fine aggregates and fillers. In the second mortar considered in this work, 2% of SHW fibres and 2% of SHW filler are added in the admixture. The mechanical properties of the three products are experimentally investigated and compared to each other. Apart for compressive strength, close attention is paid to the flexural behaviour and to the determination of fracture energy. To evaluate the effect of SHW addition on crack propagation and width, digital image correlation technique is also adopted

Assessment of the different types of failure on anterior cantilever resin-bonded fixed dental prostheses fabricated with three different materials: An in vitro study

background: resin-bonded fixed dental prosthesis (RBFDP) represents a highly aesthetic and conservative treatment option to replace a single tooth in a younger patient. The purpose of this in vitro study was to compare the fracture strength and the different types of failure on anterior cantilever RBFDPs fabricated using zirconia (ZR), lithium disilicate (LD), and PMMA-based material with ceramic fillers (PM) by the same standard tessellation language (STL) file. Methods: sixty extracted bovine mandibular incisives were embedded resin block; scanned to design one master model of RBFDP with a cantilevered single-retainer. Twenty cantilevered single-retainer RBFDPs were fabricated using ZR; LD; and PM. Static loading was performed using a universal testing machine. Results: the mean fracture strength for the RBFDPs was: 292.5 Newton (Standard Deviation (SD) 36.6) for ZR; 210 N (SD 37.6) for LD; and 133 N (SD 16.3) for PM. All the failures of RBFDPs in ZR were a fracture of the abutment tooth; instead; the 80% of failures of RBFDPs in LD and PM were a fracture of the connector. Conclusion: within the limitations of this in vitro study, we can conclude that the zirconia RBFDPs presented load resistance higher than the maximum anterior bite force reported in literature (270 N) and failure type analysis showed some trends among the groups

Impact of use of oral anticancer drugs on activity of Italian oncology practices: results of a survey conducted by the Italian Society of Medical Oncology (AIOM)

AIMS AND BACKGROUND: In recent years, the number of oral anticancer drugs used in clinical practice has rapidly increased. The Italian Society of Medical Oncology (AIOM) conducted a survey to describe the impact of the use of oral anticancer drugs on the daily activity of Italian oncology practices. METHODS AND STUDY DESIGN: A survey questionnaire was distributed to the coordinators of the regional sections of AIOM. A 6-month period was considered, from January 1, 2010 to June 30, 2010. The survey addressed (1) quantitative aspects of the use of oral anticancer drugs; (2) practical aspects in the management of patients treated with these drugs; (3) issues related to treatment costs and reimbursement procedures. RESULTS: Thirty-six questionnaires were received from institutions distributed throughout the Italian territory. Oral anticancer drugs (both chemotherapy and molecularly targeted agents) accounted for a significant proportion (17%) of prescribed treatments. Among the responding institutions, there were different dispensation procedures of oral drugs to patients: drugs were dispensed by the pharmacist (57%) or directly by the medical oncologist (23%) or nurse (20%). The medical oncologist played a major role in the communication with patients (73% alone and a further 24% in cooperation with other professional figures) and was the point of reference in the event of side effects in 97% of cases. In most cases, the reimbursement of drug costs was separated ("File F" procedure) from the flat fare received by the hospital for outpatient visits or day-hospital access. CONCLUSIONS: Optimal organization of oral anticancer treatment warrants the cooperation and integration of multiple professional figures. At least three figures are involved in patient management in the hospital: the medical oncologist, the nurse, and the hospital pharmacist. Oral anticancer treatments are associated with specific reimbursement issues: in the majority of cases, the cost of the drug is reimbursed separately from the cost of patient access

Breast cancer "tailored follow-up" in Italian oncology units: a web-based survey

urpose: Breast cancer follow-up procedures after primary treatment are still a controversial issue. Aim of this study was to investigate, through a web-based survey, surveillance methodologies selected by Italian oncologists in everyday clinical practice. Methods: Referents of Italian medical oncology units were invited to participate to the study via e-mail through the SurveyMonkey website. Participants were asked how, in their institution, exams of disease staging and follow-up are planned in asymptomatic women and if surveillance continues beyond the 5th year. Results: Between February and May 2013, 125 out of 233 (53.6%) invited referents of Italian medical oncology units agreed to participate in the survey. Ninety-seven (77.6%) referents state that modalities of breast cancer follow-up are planned according to the risk of disease progression at diagnosis and only 12 (9.6%) oncology units apply the minimal follow-up procedures according to international guidelines. Minimal follow-up is never applied in high risk asymptomatic women. Ninety-eight (78.4%) oncology units continue follow-up in all patients beyond 5 years. Conclusions: Our survey shows that 90.4% of participating Italian oncology units declare they do not apply the minimal breast cancer follow-up procedures after primary treatment in asymptomatic women, as suggested by national and international guidelines. Interestingly, about 80.0% of interviewed referents performs the so called "tailored follow-up", high intensity for high risk, low intensity for low risk patients. There is an urgent need of randomized clinical trials able to determine the effectiveness of risk-based follow-up modalities, their ideal frequency and persistence in time

Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): a double-blind, randomised controlled trial

Background Third-generation aromatase inhibitors are more effective than tamoxifen for preventing recurrence in postmenopausal women with hormone-receptor-positive invasive breast cancer. However, it is not known whether anastrozole is more effective than tamoxifen for women with hormone-receptor-positive ductal carcinoma in situ (DCIS). Here, we compare the efficacy of anastrozole with that of tamoxifen in postmenopausal women with hormone-receptor-positive DCIS. Methods In a double-blind, multicentre, randomised placebo-controlled trial, we recruited women who had been diagnosed with locally excised, hormone-receptor-positive DCIS. Eligible women were randomly assigned in a 1:1 ratio by central computer allocation to receive 1 mg oral anastrozole or 20 mg oral tamoxifen every day for 5 years. Randomisation was stratified by major centre or hub and was done in blocks (six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation and only the trial statistician had access to treatment allocation. The primary endpoint was all recurrence, including recurrent DCIS and new contralateral tumours. All analyses were done on a modified intention-to-treat basis (in all women who were randomised and did not revoke consent for their data to be included) and proportional hazard models were used to compute hazard ratios and corresponding confidence intervals. This trial is registered at the ISRCTN registry, number ISRCTN37546358. Results Between March 3, 2003, and Feb 8, 2012, we enrolled 2980 postmenopausal women from 236 centres in 14 countries and randomly assigned them to receive anastrozole (1449 analysed) or tamoxifen (1489 analysed). Median follow-up was 7·2 years (IQR 5·6–8·9), and 144 breast cancer recurrences were recorded. We noted no statistically significant difference in overall recurrence (67 recurrences for anastrozole vs 77 for tamoxifen; HR 0·89 [95% CI 0·64–1·23]). The non-inferiority of anastrozole was established (upper 95% CI <1·25), but its superiority to tamoxifen was not (p=0·49). A total of 69 deaths were recorded (33 for anastrozole vs 36 for tamoxifen; HR 0·93 [95% CI 0·58–1·50], p=0·78), and no specific cause was more common in one group than the other. The number of women reporting any adverse event was similar between anastrozole (1323 women, 91%) and tamoxifen (1379 women, 93%); the side-effect profiles of the two drugs differed, with more fractures, musculoskeletal events, hypercholesterolaemia, and strokes with anastrozole and more muscle spasm, gynaecological cancers and symptoms, vasomotor symptoms, and deep vein thromboses with tamoxifen. Conclusions No clear efficacy differences were seen between the two treatments. Anastrozole offers another treatment option for postmenopausal women with hormone-receptor-positive DCIS, which may be be more appropriate for some women with contraindications for tamoxifen. Longer follow-up will be necessary to fully evaluate treatment differences

A Reinterpretation of the Imidazolate Au(I) Cyclic Trinuclear Compounds Reactivity with Iodine and Methyl Iodide with the Perspective of the Inverted Ligand Field Theory

Coinage metal cyclic trinuclear compounds (CTCs) are an emerging class of metal coordination compounds that are valuable for many fine optoelectronic applications, even though the reactivity dependence by the different bridging ligands remains somewhat unclear. In this work, to furnish some hints to unravel the effect of substituents on the chemistry of Au(I) CTCs made of a specific class of bridging ligand, we have considered two imidazolate Au(I) CTCs and the effect of different substituents on the pyrrolic N atoms relative to classic metal oxidations with I2 or by probing electrophilic additions. Experimental suggestions depict a thin borderline between the addition of MeI to the N-methyl or N-benzyl imidazolyl CTCs, which afford the oxidized CTC in the former and the ring opening of the CTC and the formation of carbene species in the latter. Moreover, the reactions with iodine yield to the oxidation of the metal centers for the former and just of a metal center in the latter, even in molar excess of iodine. The analysis of the bond distances in the X-ray crystal structures of the oxidized highlights that Au(III)-C and Au(III)-N bonds are longer than observed for Au(I)-C and Au(I)-N bonds, as formally not expected for Au(III) centers. Computational studies converge on the attribution of these discrepancies to an additional case of inverted ligand field (ILF), which solves the question with a new interpretation of the Au(I)-ligand bonding in the oxidized CTCs, which furnishes a new interpretation of the Au(I)-ligand bonding in the oxidized CTCs, opening a discussion about addition/oxidation reactions. Finally, the theoretical studies outputs depict energy profiles that are compatible with the experimental results obtained in the reaction of the two CTCs toward the addition of I2, MeI, and HCl

Digital vs conventional workflow for screw-retained single-implant crowns: A comparison of key considerations

Purpose: To evaluate patient perception and operating time of digital (DW) and conventional (CW) workflows for the rehabilitation of a screw-retained, single-implant crown. Materials and Methods: A convenience sample of 10 patients with single implants in posterior sites was recruited for treatment with screw-retained single crowns, fabricated with either a DW or a CW protocol. Operating time and clinical adjusting time were recorded with a stopwatch, and patient preference and self-perception of the esthetic outcome were evaluated with a visual analog scale. Results: The mean operating time for the DW crowns was 16:21 minutes and for the CW crowns was 28:28 minutes. The mean total adjustment times were 118.1 seconds for the DW protocol and 181.5 seconds for the CW protocol. The mean score regarding self-perception of the esthetic outcome was 73 for DW crowns and 69 for CW crowns; for discomfort, the mean score was 15.5 for DW and 62 for CW. Conclusion: The DW approach resulted in a time reduction for both the impression phase and operative time