P12.14: 4D/3D ultrasound‐guided embryo transfer

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A proposal for an EU (SPISE) database of the licensed sprayers inspectors and inspection centres

In order to guarantee at European level the easy identification of sprayers inspected and to allow mutual recognition of inspections as recommended by the European Directive on Sustainable Use of Pesticides (128/2009/EC) it would be necessary to create a SPISE database enabling to collect the list of the technicians authorized to make inspections of sprayers in use and of the licensed inspection centers. This database should be managed at SPISE level and should be linked to the national databases for getting regular updates.Actually in Italy there is a public national online database (www.centriprovairroratrici.unito.it) that was realized by the ENAMA working group. Only the sprayers inspected by the test stations listed in this database are recognized all over the country.This national database contains also the results of all the inspections made in the different Italian Regions and therefore provides a support for monitoring the inspection activity at national level. Independently of the software used at local level for managing data of sprayer inspections, some key information have to be necessarily provided in order to identify the sprayer inspected.They are the coordinates of the test station, the name of the technician who inspected the sprayer, the name of the owner of the sprayer, the data of the machine inspected, the date of the inspection and its response

The necessity of a harmonized procedure for sprayers inspectors training: the Italian activity

European Directive on Sustainable Use of Pesticides requires that the people making inspections of sprayers in use have an official license, recognized at national level, released by the competent Authority. In Italy, Authorities responsible of training and upgrading of sprayers inspectors are Regional and Provincial administrations. They make this job in collaboration with research institutes that provide qualified teachers.With the aim to homogenize in the whole country the activity of training and licensing of sprayers inspectors the rules for training courses and the criteria for releasing licenses have been defined by ENAMA. Training courses shall have a duration of at least 40 hours subdivided between theory (60% of total time) and practical (40% of total time).Topics treated during courses are: criteria to apply pesticides, main sprayer types used in agriculture and relative components, test methods and equipment used to carry out the inspections of sprayers in use and to adjust them. The exam to get the inspector license shall consist in: a) filling of a questionnaire with multiple answers (at least 80% of answers have to be correct); the questions are selected among a database approved by ENAMA Working Group; b) oral test; c) practical exam consisting in the complete inspection of one sprayer.In order to guarantee the same quality level of sprayers inspections in the different European countries and to guarantee the mutual recognition of inspections made it is considered necessary to reach in short terms an agreement to harmonize the activity of training, licensing and upgrading of sprayers inspectors across Europe

Minimally invasive (flapless) crown lengthening by erbium: YAG laser in aesthetic zone

Crown lengthening is a surgical procedure aimed at exposure of a larger tooth surface by gingivectomy alone or with cortical bone remodelling for aesthetic purposes in the anterior zone of the maxilla or for reconstruction of teeth affected by subgingival caries. We report two cases of crown lengthening in the anterior maxilla for aesthetic purposes by gingival and bone re-contouring performed by erbium-doped yttrium aluminium garnet (erbium:YAG) laser. As highlighted in this report, the erbium:YAG laser-assisted crown lengthening is less invasive and also leads to faster clinical outcomes in contrast to the conventional surgical technique by scalpel incision, flap elevation and osteoplastic

A minimally invasive technique for short spiral implant insertion with contextual crestal sinus lifting in the atrophic maxilla: A preliminary report

The most recently reported techniques for the rehabilitation of the atrophic posterior maxilla are increasingly less invasive, as they are generally oriented to avoid sinus floor elevation with lateral access. The authors describe a mini-invasive surgical technique for short spiral implant insertion for the prosthetic rehabilitation of the atrophic posterior maxilla, which could be considered a combination of several previously described techniques based on the under-preparation of the implant site to improve fixture primary stability and crestal approach to the sinus floor elevation without heterologous bone graft. Eighty short spiral implants were inserted in the molar area of the maxilla in patients with 4.5–6 mm of alveolar bone, measured on pre-operative computed tomography. The surgical technique involved careful drilling for the preparation of implant sites at differentiated depths, allowing bone dislocation in the apical direction, traumatic crestal sinus membrane elevation, and insertion of an implant (with spiral morphology) longer than pre-operative measurements. Prostheses were all single crowns. In all cases, a spiral implant 2–4 mm longer than the residual bone was placed. Only two implants were lost due to peri-implantitis but subsequently replaced and followed-up. Bone loss values around the implants after three months (at the re-opening) ranged from 0 to 0.6 mm, (median value: 0.1 mm), while after two years, the same values ranged from 0.4 to 1.3 mm (median value: 0.7 mm). Clinical post-operative complications did not occur. After ten years, no implant has been lost. Overall, the described protocol seems to show good results in terms of predictability and patient compliance

Sampling protein motion and solvent effect during ligand binding.

An exhaustive description of the molecular recognition mechanism between a ligand and its biological target is of great value because it provides the opportunity for an exogenous control of the related process. Very often this aim can be pursued using high resolution structures of the complex in combination with inexpensive computational protocols such as docking algorithms. Unfortunately, in many other cases a number of factors, like protein flexibility or solvent effects, increase the degree of complexity of ligand/protein interaction and these standard techniques are no longer sufficient to describe the binding event. We have experienced and tested these limits in the present study in which we have developed and revealed the mechanism of binding of a new series of potent inhibitors of Adenosine Deaminase. We have first performed a large number of docking calculations, which unfortunately failed to yield reliable results due to the dynamical character of the enzyme and the complex role of the solvent. Thus, we have stepped up the computational strategy using a protocol based on metadynamics. Our approach has allowed dealing with protein motion and solvation during ligand binding and finally identifying the lowest energy binding modes of the most potent compound of the series, 4-decyl-pyrazolo[1,5-a]pyrimidin-7-one

Vibration issues in timber structures: A state-of-the-art review

The increasing use of timber structures worldwide has brought attention to the challenges posed by their lightweight nature, making them more prone to vibrations than more massive structures. Consequently, significant research efforts have been dedicated to understanding and mitigating vibrations in timber structures, while scientific committees strive to establish suitable design regulations. This study aims to classify and identify the main research themes related to timber structure vibrations and highlight future research needs and directions. A bibliometricbased selection process briefly introduces each research topic, presenting the latest findings and proposals for vibration design in timber structures. The paper emphasizes the key outcomes and significant contributions to understanding and addressing vibration issues in timber structures. These findings serve as valuable guidance for researchers, designers, and regulatory bodies involved in designing and assessing timber structures subjected to vibrations

Clinical and genetic characterization of patients with hypertrophic cardiomyopathy and right atrial enlargement

AIMS: Prevalence and clinical significance of right atrial enlargement (RAE) has been poorly characterized in hypertrophic cardiomyopathy. METHODS: One hundred and sixty consecutive patients with hypertrophic cardiomyopathy (35.5 ± 20 years; 64% men) were studied. They underwent clinical examination, standard ECG, M-mode, 2D and Doppler echocardiography, stress test and ECG Holter monitoring. Major adverse cardiac events were considered: cardiac death (sudden death, heart failure death); cardiac transplant; resuscitated cardiac arrest or appropriate implantable cardioverter defibrillator discharge. Genetic analysis of eight sarcomeric genes was performed using Sanger sequencing. RESULTS: RAE was observed in 22 patients (14%), associated with left atrial enlargement in all cases. Patients with RAE were likely to have restrictive mitral pattern (P < 0.001) and had higher New York Heart Association (P < 0.001), N-terminal prohormone of brain natriuretic peptide (P < 0.001), left atrial volume index (P < 0.001), lateral (P = 0.04) and septal (P = 0.002) E/e', systolic pulmonary artery pressure (P < 0.001) and lower ejection fraction (all P < 0.001). On cardiopulmonary exercise testing, peak VO2 was lower and VE/VCO2 higher in patients with RAE (P < 0.001). During a mean follow-up of 4 ± 2.1 years, 30 major adverse cardiac events in 24 patients (15%) were observed. Cox proportional hazards regression analysis identified RAE as an independent predictor of major adverse cardiac events (odds ratio = 2.6; confidence interval 1.5-4.6; P = 0.001). In patients with RAE who were genetically tested, there was a higher prevalence of sarcomeric gene mutations (68%), double mutations (16%) and troponin T mutations (21%). CONCLUSION: RAE is present in a small subset of patients with hypertrophic cardiomyopathy, and largely reflects increased pulmonary pressures because of severe diastolic and/or systolic left ventricular dysfunction. Patients with RAE had a higher prevalence of sarcomeric gene mutations, troponin T mutations and complex genotypes. In conclusion, RAE may serve as a very useful marker of disease progression and adverse outcome in patients with sarcomeric hypertrophic cardiomyopathy

Left atrial volume during stress is associated with increased risk of arrhythmias in patients with hypertrophic cardiomyopathy

Introduction: In patients affected by hypertrophic cardiomyopathy (HCM), left atrial volume index (LAVi) is associated with an increased risk of tachyarrhythmias and major clinical events. To date, the clinical meaning of LAVi measured during exercise (stress LAVi [sLAVi]) has not yet been investigated in HCM. This study sought to evaluate the correlation between LAVi/sLAVi and clinical outcome (risk of arrhythmias and heart failure [HF]) in patients with HCM. Methods and Results: We enrolled a total of 51 consecutive patients with HCM (39 men; mean age: 39.41 ± 17.9 years) who underwent standard and stress echocardiography, following a common protocol. During follow-up (median follow-up was 1.82 years), the following composite endpoints were collected: ARRHYT endpoint (atrial fibrillation, paroxysmal supraventricular tachycardia, nonsustained ventricular tachycardia (VT), sustained VT, ventricular fibrillation, syncope of likely cardiogenic nature, and sudden cardiac death) and HF endpoint (worsening of functional class and left ventricular ejection fraction, hospitalization, and death for end-stage HF). Eight patients were lost at follow-up. ARRHYT endpoint occurred in 13 (30.2%) patients (8, 18.6%, supraventricular and 10, 23.2%, ventricular arrhythmias), whereas HF endpoint occurred in 5 (11.6%) patients. sLAVi (mean value of 31.16 ± 10.15 mL/m2) performed better than rLAVi as a predictor of ARRHYT endpoint (Akaike Information Criterion: 48.37 vs. 50.37, if dichotomized according to the median values). A sLAVi value of 30 mL/m2 showed a predictive accuracy of 72.1% (C-statistics of 0.7346), with a high negative predictive value (87.5%). Conclusion: These findings encourage future studies on sLAVi, as a potential predictor of arrhythmias and adverse outcome in patients with HCM

Prevalence and direct costs of patients with neuromyelitis optica: data from Campania region in southern Italy

The study aimed to estimate the prevalence and direct costs of neuromyelitis optica (NMO) patients in Campania, Italy. Materials &amp; methods: We retrospectively evaluated 53 NMO patients (mean age: 50.9 ± 16.5 years; 34% men) from the Campania Region administrative databases identified through disease exemption codes in 2018 and analyzed the incidence of NMO among the Campania region population and the disease-related cost. Results: The prevalence of NMO was 0.91 per 100,000 individuals. The average regional cost per NMO patient was 10,836.2 euros. The highest cost was related to drugs (60.6%), followed by hospitalizations (32.7%), diagnostics (4.8%) and laboratory tests (1.0%). Conclusion: NMO is an extremely rare disease with an annual disease-related cost of 0.005% of public health expenditur