Gestational diabetes: An overview with attention for developing countries

AbstractGestational diabetes mellitus (GDM) is defined as a glucose intolerance that occurs for the first time or it is first identified during pregnancy. The GDM etiology is multifactorial. It has not completely been established yet and several known risk factors may contribute to its onset. To date, there are no shared guidelines on the management and follow-up, especially regarding the low-income countries. In this paper, we describe the state of art about epidemiology, physiopathology, diagnosis, and management of GDM. Moreover, we focus on the current state in low income countries trying to outline basis for further research

Estimation of churches frequencies based on simplified geometry parameters

Nowadays, the modal properties of structures can be obtained by experimental methods that are still expensive for professionals who have to deal with the seismic assessment. Additionally, for heritage buildings, due to their complexity, the identification of the modal properties can be challenging and requires of experience on the field. This paper aims to develop a methodology to predict the frequency response of churches based on simplified geometrical parameters. In this context, an extensive literature review was carried out to collect data, aiming to define the principal typologies of churches. Afterwards, a parametric analysis with numerical simulations of the eigenvalue problem was performed to identify which are the main geometrical parameters that influence the dynamic behavior of the churches. The correlations between the natural frequencies and relevant geometrical parameters are illustrated and discussed in order to develop a proposal for the estimation of the natural frequencies of the churches. Churches with single nave and three naves were defined as the two principal types of churches, and six equations were proposed, aiming to estimate the first three natural frequencies for each type of church. Finally, the methodology was validated on real case studies found in literature, in which experimental identification of frequencies was performed. This comparison allowed to evaluate the accuracy of the method to estimate the natural frequencies.- (undefined

Handover checklist: testing a standardization process in an Italian hospital

Objectives: This study aimed to standardize and rationalize the handover, a critical and essential moment in common health care practices, through the realization of an efficient and standardized checklist, which could be used daily to ensure complete, thorough and effective handover. The principal purpose of the implementation of the handover is to reduce errors due to superficial and insufficient communication. Methods: The "operative group" defined the phases to the realization of the delineated aims: at first, the direct observation and the consequent realization of a handover checklist model and then, the experimental phases (trials). The handover checklist model was used for a month and it was daily and duly completed by the doctors who took part in the trial. To prove the success of the study, three questionnaires were distributed on different occasions. Results: Analyzing the answers to the questionnaires, the importance of the handover has come to light and that for the most part, the doctors consider it an essential and irreplaceable moment in daily health care work. Moreover, it became obvious that the use of the handover checklist guaranteed a considerable improvement in the traditional handover in terms of security, completeness, care continuity and clarity. The handover checklist was completely appreciated by the majority of the participant doctors who agree with the definitive introduction of it in their unit. Conclusions: Our study indicated the consistency of the handover checklist as an instrument to implement the handover and, indirectly, to improve the quality of the care

NGN2 mmRNA-Based Transcriptional Programming in Microfluidic Guides hiPSCs Toward Neural Fate With Multiple Identities

Recent advancements in cell engineering have succeeded in manipulating cell identity with the targeted overexpression of specific cell fate determining transcription factors in a process named transcriptional programming. Neurogenin2 (NGN2) is sufficient to instruct pluripotent stem cells (PSCs) to acquire a neuronal identity when delivered with an integrating system, which arises some safety concerns for clinical applications. A non-integrating system based on modified messenger RNA (mmRNA) delivery method, represents a valuable alternative to lentiviral-based approaches. The ability of NGN2 mmRNA to instruct PSC fate change has not been thoroughly investigated yet. Here we aimed at understanding whether the use of an NGN2 mmRNA-based approach combined with a miniaturized system, which allows a higher transfection efficiency in a cost-effective system, is able to drive human induced PSCs (hiPSCs) toward the neuronal lineage. We show that NGN2 mRNA alone is able to induce cell fate conversion. Surprisingly, the outcome cell population accounts for multiple phenotypes along the neural development trajectory. We found that this mixed population is mainly constituted by neural stem cells (45% \ub1 18 PAX6 positive cells) and neurons (38% \ub1 8 \u3b2IIITUBULIN positive cells) only when NGN2 is delivered as mmRNA. On the other hand, when the delivery system is lentiviral-based, both providing a constant expression of NGN2 or only a transient pulse, the outcome differentiated population is formed by a clear majority of neurons (88% \ub1 1 \u3b2IIITUBULIN positive cells). Altogether, our data confirm the ability of NGN2 to induce neuralization in hiPSCs and opens a new point of view in respect to the delivery system method when it comes to transcriptional programming applications

A development cooperation Erasmus Mundus partnership for capacity building in earthquake mitigation science and higher education

Successful practices have shown that a community’s capacity to manage and reduce its seismic risk relies on capitalization on policies, on technology and research results. An important role is played by education, than contribute to strengthening technical curricula of future practitioners and researchers through university and higher education programs. EUNICE is a European Commission funded higher education partnership for international development cooperation with the objective to build capacity of individuals who will operate at institutions located in seismic prone Asian Countries. The project involves five European Universities, eight Asian universities and four associations and NGOs active in advanced research on seismic mitigation, disaster risk management and international development. The project consists of a comprehensive mobility scheme open to nationals from Afghanistan, Bangladesh, China, Nepal, Pakistan, Thailand, Bhutan, India, Indonesia, Malaysia, Maldives, North Korea, Philippines, and Sri Lanka who plan to enroll in school or conduct research at one of five European partner universities in Italy, Greece and Portugal. During the 2010-14 time span a total number of 104 mobilities are being involved in scientific activities at the undergraduate, masters, PhD, postdoctoral and academic-staff exchange levels. Researchers, future policymakers and practitioners build up their curricula over a range of disciplines in the fields of earthquake engineering, seismology, disaster risk management and urban planning

EU-NICE, Eurasian University Network for International Cooperation in Earthquakes

Despite the remarkable scientific advancements of earthquake engineering and seismology in many countries, seismic risk is still growing at a high rate in the world’s most vulnerable communities. Successful practices have shown that a community’s capacity to manage and reduce its seismic risk relies on capitalization on policies, on technology and research results. An important role is played by education, than contribute to strengthening technical curricula of future practitioners and researchers through university and higher education programmes. In recent years an increasing number of initiatives have been launched in this field at the international and global cooperation level. Cooperative international academic research and training is key to reducing the gap between advanced and more vulnerable regions. EU-NICE is a European Commission funded higher education partnership for international development cooperation with the objective to build capacity of individuals who will operate at institutions located in seismic prone Asian Countries. The project involves five European Universities, eight Asian universities and four associations and NGOs active in advanced research on seismic mitigation, disaster risk management and international development. The project consists of a comprehensive mobility scheme open to nationals from Afghanistan, Bangladesh, China, Nepal, Pakistan, Thailand, Bhutan, India, Indonesia, Malaysia, Maldives, North Korea, Philippines, and Sri Lanka who plan to enrol in school or conduct research at one of five European partner universities in Italy, Greece and Portugal. During the 2010-14 time span a total number of 104 mobilities are being involved in scientific activities at the undergraduate, masters, PhD, postdoctoral and academic-staff exchange levels. This high number of mobilities and activities is selected and designed so as to produce an overall increase of knowledge that can result in an impact on earthquake mitigation. Researchers, future policymakers and practitioners build up their curricula over a range of disciplines in the fields of engineering, seismology, disaster risk management and urban planning. Specific educational and research activities focus on earthquake risk mitigation related topics such as: anti-seismic structural design, structural engineering, advanced computer structural collapse analysis, seismology, experimental laboratory studies, international and development issues in disaster risk management, social-economical impact studies, international relations and conflict resolution

NAB-paclitaxel and gemcitabine in metastatic pancreatic ductal adenocarcinoma (PDAC): From clinical trials to clinical practice

Background: Pancreatic adenocarcinoma is an aggressive disease with poor prognosis. In a randomized phase III trial, combination of Nab-paclitaxel (Nab-P) plus gemcitabine showed superior activity and efficacy in first-line treatment compared with gemcitabine alone. Methods: Nab-P is not dispensed in Italy; however, we obtained this drug from our Ethics Committee for compassionate use. The aim of this study was to evaluate the efficacy and safety profile of this Nab-P and gemcitabine combination in a cohort of patients treated outside clinical trials. From January 2012 to May 2014, we included 41 patients with advanced pancreatic adenocarcinoma receiving combination of 125 mg/m2 Nab-P and 1 g/m2 gemcitabine on days 1, 8 and 15 of a 28-day cycle, as first-line treatment. Median age of patients was 67 (range 41-77) years, and 11 patients were aged ≥70 years. Results: Eastern Co-operative Oncology Group performance status was 0 or 1 in 32 patients (78 %) and 2 in nine patients (22 %). Primary tumor was located in the pancreatic head or body/tail in 24 (58.5 %) and 17 (41.5 %) patients, respectively, and nine patients had received biliary stent implantation before starting chemotherapy. Median carbohydrate antigen 19-9 level was 469 U/l (range 17.4-61546 U/l) and 29 patients (70.7 %) had referred pain at the time of diagnosis. Patients received a median six cycles (range 1-14) of treatment. Overall response rate was 36.6 %; median progression-free survival was 6.7 months [(95 % confidence interval (CI) 5.966-8.034), and median overall survival was 10 months (95 % CI 7.864-12.136). Treatment was well tolerated. No grade 4 toxicity was reported. Grade 3 toxicity included neutropenia in 10 patients (24.3 %), thrombocytopenia in five (12 %), anemia in three (7.3 %), diarrhea in four (9.7 %), nausea and vomiting in two (4.9 %), and fatigue in six (14.6 %). Finally, pain control was achieved in 24 of 29 patients (82.3 %) with a performance status improvement of 10 % according to the Karnofsky scale. Conclusions: Our results confirm that combination of gemcitabine plus Nab-P is effective both in terms of overall response rate, progression-free survival and overall survival, with a good safety profile

Long-term survival of a woman with well differentiated papillary mesothelioma of the peritoneum: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is a rare subtype of epitheloid mesothelioma, which is usually seen in young women. WDPMP is generally considered of low malignant potential, however the long-term nature of the tumor remains poorly defined.</p> <p>Case presentation</p> <p>We describe the long-term follow-up of a 60-year-old woman of West African descent who has survived 24 years with WDPMP after receiving extensive local and systemic adjuvant chemotherapy. Her clinical course has included three exploratory laparotomies with intraperitoneal and intravenous chemotherapy over two decades. Her course was complicated by anthracycline-induced cardiomyopathy, for which she underwent an orthotopic heart transplant. Our patient is alive with stable radiological evidence of peritoneal disease, and continues to suffer from chronic abdominal pain.</p> <p>Conclusion</p> <p>No consensus exists regarding optimal treatment strategies for WDPMP. However, given the low malignant potential of the tumor, careful consideration should be made before proceeding with aggressive interventions. Further, long-term follow-up reports are required to fully characterize this tumor.</p