Ab initio thermal expansion and thermoelastic properties of ringwoodite (\u3b3-Mg2SiO4) at mantle transition zone conditions

Thermal convection in the Earth\u2019s mantle is driven by lateral variations in temperature and density which are substantially controlled by the local volume thermal expansion of the constituent mineral phases. Ringwoodite is a major component of the lower mantle transition zone, but its thermal expansivity and thermoelastic properties are still affected by large uncertainties. Ambient thermal expansion coefficient (\u3b1_V0), for instance, can vary as much as 100% according to different experimental investigations available from the literature. In this work, we perform ab initio density functional theory calculations of vibrational properties of spinel-structured Mg2SiO4 ringwoodite in order to provide reliable thermophysical data up to mantle transition zone conditions. Temperature- and pressure-dependent thermal expansivity has been obtained by phonon dispersion calculations in the framework of quasi-harmonic approximation (QHA) up to 25 GPa and 2000 K. Theoretical analysis of vibrational spectra reveals that accurate prediction of IR and silent modes, along with their relative mode Gr\ufcneisen parameters, is crucial to define thermal expansivity. A six-parameter analytical function is able to reproduce ab initio values fairly well in the whole investigated P-T range, i.e. \u3b1_V (P,T) = (1.6033\ub710-5 + 8.839\ub710-9 T + 11.586\ub710-3 T-1 \u2013 6.055 T-2 + 804.31 T-3)\ub7exp-(\u20132.52\ub710-2 P), with temperature in Kelvin and pressure in Gigapascal. Ab initio static and isothermal bulk moduli have been derived for ringwoodite along with their P, T and cross derivatives, i.e. K_0 = 184.3 GPa, K_(T,300K) = 176.6 GPa; K_0^' = 4.13, K_(T,300K)^' = 4.16; (\u3016 02K\u3017_T/ 02T)_P = -0.0233 GPa/K and (\u3016 02^2 K\u3017_T/ 02P 02T)_0= 1.0\ub710-4 K-1. Computed thermal expansivity and thermoelastic properties supports the evidence that QHA performs remarkably well for Mg2SiO4 ringwoodite up to mantle transition zone temperatures. Since volume thermal expansion of ringwoodite is strongly pressure-dependent and its pressure dependence becomes more marked with the increasing temperature, internally-consistent assessments and empirical extrapolation of thermoelastic data to deep mantle conditions should be taken with care to avoid inaccurate or spurious predictions in phase equilibrium and mantle convection numerical modelling

Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data

OBJECTIVE: We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy. METHODS: A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered. RESULTS: The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively. CONCLUSIONS: This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV

L'Italia come modello per l'Europa e per il mondo nelle politiche sanitarie per il trattamento dell'epatite cronica da HCV

The World Health Organization foresees the elimination of HCV infection by 2030. In light of this and the curre nt, nearly worldwide, restriction in direct-acting agents (DAA) accessibility due to their high price, we aimed to evaluate the cost-effectiveness of two alternative DAA treatment policies: Policy 1 (universal): treat all patients, regardless of the fibrosis stage; Policy 2 (prioritized): treat only priori tized patients and delay treatment of the remaining patients until reaching stage F3. T he model was based on patient’s data from the PITER cohort. We demonstrated that extending HC V treatment of patients in any fibrosis stage improves health outcomes and is cost-effective

An Unexpected Thoracic Finding in a Patient With COVID-19

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Endoscopic stenting for colorectal cancer obstruction as a bridge-to-surgery strategy

Background: Acute obstructive colorectal cancer requires prompt decompression commonly by emergency surgery (ES). However, self-expanding metal stents (SEMS) have been increasingly used as a bridge-to-surgery (BTS) strategy. Materials and methods: In an 8-year period, consecutive patients with acute left-sided colonic obstruction, due to locally advanced colorectal cancer, underwent ES or SEMS implantation. We evaluated technical/clinical success of SEMS, adverse events, and overall (OS) and disease-free survival (DFS) of the two therapeutic options. Results: Forty-five patients underwent ES (n = 23) or SEMS (n = 22). The two groups were comparable for sex, age, ASA score and cancer site/stage. Technical and clinical successes of SEMS were 100% and 72.7%, respectively. Clinical success correlated with neutrophil-lymphocyte ratio (NLR) at baseline (OR = 0.65, 95% CI 0.43-0.98, P =.04). SEMS allowed primary anastomosis in the 45.5% of cases (0% in ES). SEMS implantation allowed a higher rate of surgery carried out by a laparoscopic approach: 36.4% vs 13.0% in ES. Performance of a definitive stoma and complications were similar. Median OS (34 in SEMS; 45 in ES, P =.33) and DFS (36 in SEMS; 35 in ES, P =.35) did not differ between the two groups. At univariate analysis, DFS was positively associated with primary anastomosis (HR = 2.44, 95% CI 1.4-16.6, P =.04) and laparoscopic surgery (HR = 8.33, 95% CI 1.08-50, P =.04), and inversely associated with a NLR > 3.6 (HR = 0.59, 95% CI 0.16-0.92, P =.03). At multivariate analysis, no feature retained an independent predictive power. Conclusion: SEMS is an effective and safe procedure, equivalent to emergency surgery in terms of complications, OS and DFS, providing the chance of a primary anastomosis in the majority of patients

Interface Contractility between Differently Fated Cells Drives Cell Elimination and Cyst Formation

Although cellular tumor-suppression mechanisms are widely studied, little is known about mechanisms that act at the level of tissues to suppress the occurrence of aberrant cells in epithelia. We find that ectopic expression of transcription factors that specify cell fates causes abnormal epithelial cysts in Drosophila imaginal discs. Cysts do not form cell autonomously but result from the juxtaposition of two cell populations with divergent fates. Juxtaposition of wild-type and aberrantly specified cells induces enrichment of actomyosin at their entire shared interface, both at adherens junctions as well as along basolateral interfaces. Experimental validation of 3D vertex model simulations demonstrates that enhanced interface contractility is sufficient to explain many morphogenetic behaviors, which depend on cell cluster size. These range from cyst formation by intermediate-sized clusters to segregation of large cell populations by formation of smooth boundaries or apical constriction in small groups of cells. In addition, we find that single cells experiencing lateral interface contractility are eliminated from tissues by apoptosis. Cysts, which disrupt epithelial continuity, form when elimination of single, aberrantly specified cells fails and cells proliferate to intermediate cell cluster sizes. Thus, increased interface contractility functions as error correction mechanism eliminating single aberrant cells from tissues, but failure leads to the formation of large, potentially disease-promoting cysts. Our results provide a novel perspective on morphogenetic mechanisms, which arise from cell-fate heterogeneities within tissues and maintain or disrupt epithelial homeostasis

Minor perpetrators of sexual crimes: personality, coping style, and parental care - Twenty-three Italian cases

In the field of psycho forensics, any sexual behavior that occurs without consent, without, equality, or as a result of coercion is considered to be abusive (AACAP, 1999; Shaw, 2002). In order for sexual behavior to be considered consensual, certain criteria are necessary: comprehension of the nature of the proposal; an understanding of societal standards regarding sexuality; awareness of the potential consequences and alternatives; the presumption that agreement or disagreement will be respected in the same manner; the decision to engage is a voluntary one; and that those involved are mentally competent (AACAP, 1999). Equal relationship refers to situations in which the two people involved possess equal power within the relationship, and neither of the two is controlled or coerced by the other. Coercion refers to situations where one party abuses authority, offers bribes, makes threats, or uses intimidation tactics in order to win the cooperation or obedience of the other. Sexual conduct during adolescence must not be considered deviant if it involves non-coercive interaction between two peers. It is not always easy to demonstrate coercion, though expert testimony evaluations often focus on this critical aspect. At times it is also challenging to determine what age appropriate sexual behavior is, and if the two people involved are, in fact, developmental and/or chronological peers. Studies on the topic hypothesize the inability of the adolescent to recognize the other as different from him or herself, and the difficulties associated with entering into a sexual relationship with another person, where dysfunctional coping strategies are often employed. One pilot study from 2002 revealed that the parents of adolescent sexual offenders most often employ an overprotective-affectionless parenting style (Craissati J, McClurg G, Browne K). “Affectionless control” parenting style is a risk factor for the development of deviant behavior. Comorbidity rates in adolescent sexual offenders are high and involve behavioral disorders, personality disorders, and emotional-affective disorders. One recent study revealed that about two thirds of sexual offenders meet the criteria for personality disorder. Impulsivity is one of the characteristics typical of people who exhibit aberrant and violent behavior (Baltieri D.A., Andrade A.G., 2008). The aim of this study is to evaluate the relationship between personality, parental care, and coping style in adolescent sex offenders. Instruments: Clinical interviews; psychodiagnostic testing (MMPI, Minnesota for Adolescents, A/2; PBI-Parental Bonding Instrument; CISS-Coping Inventory for Stressful Situations; Questionnaire I-R, frustration-aggression by Caprara et al.; and healthcare, psychological, and judicial documentation. The sample studied thus far is comprised of 23 unmarried male adolescents between the ages of 15 and 20 years at the time of the interview. The average age was 17 years ± 1.6 (standard deviation), and almost all subjects were Italian (1 Albanian), and Catholic (1 atheist, and 1 agnostic). All were investigated for perpetrating sexual violence on other minors. The sample was taken from Judicial Juvenile Social Services, which intervenes following the commission of a crime by a minor. Preliminary results have revealed no particular pathologies on the part of the adolescent sexual offenders who were examined by the authors. The type of parenting style they received appears to have been intrusive-overprotective, which did not allow the adolescent to face typical life challenges, thus impeding his ability to develop coping skills. This type of parenting style includes intrusiveness, enmeshment, encouragement of dependence, and cutting the minor off from the outside world

Juvenile Sex Offenders: personality profile, coping styles and parental care

Il periodo tra i 14 e i 18 anni rappresenta una fase importante nella vita di un giovane, perché segna il passaggio dall’infanzia all’età adulta. In questo periodo, o anche più precocemente, generalmente i minori vivono i loro primi rapporti di coppia e le loro prime esperienze sessuali. Come per gli adulti, ma con modalità, forme espressive, comportamenti, differenti, anche nel periodo adolescenziale, l’esercizio dell’affettività della sessualità, può divenire reato. Se è più semplice immaginare ciò per gli adulti, una maggiore complessità e difficile decifrabilità del fenomeno “abuso sessuale”, attiene l’esperienza dei comportamenti sessualmente violenti in adolescenza. I juvenile sex offenders, rappresentano una popolazione eterogenea che va dall’insufficiente mentale che reperisce un oggetto sessuale più vulnerabile di lui, al ragazzo apparentemente adeguato che però si lascia coinvolgere e partecipa ad una violenza o stupro di gruppo, a situazioni che sembrano avere inizio come “un gioco adolescenziale” e poi assumono i profili del comportamento penalmente rilevante, alle situazione in cui franca ed evidente appare la psicopatologia degli autori e a volte anche delle vittime. La comunicazione che presentiamo vuole essere una occasione per presentare i primi dati di una complessa ricerca che ha visto coinvolti ricercatori di tre sezioni universitarie della Facoltà Scuola di Medicina della Università di Bari (Criminologia e Psicopatologia Forense, Psichiatria e Neuropsichiatria Infantile), in stretta collaborazione e sinergia con il Centro di Giustizia Minorile della Regione Puglia che ha fornito un contributo notevole ed indispensabile per il reclutamento dei soggetti da esaminare. La ricerca è stata anche una occasione concreta di confronto tra studiosi, ricercatori, operatori esperti di tale complesso fenomeno e tra operatori del mondo della Criminologia e della Psichiatria Forense, della Clinica e della Giustizia Minorile, impegnati non solo nell’aspetto valutativo ma anche in quello rieducativo-trattamentale, nonchè delle decisioni giudiziarie da adottare nei confronti dei minori che si rendono responsabili di questo particolare e oltremodo complesso tipo di reato