Epidemiology, prevention and control of oral diseases in pediatric subjects

Caries and periodontal diseases are a neglected epidemic by millions of Italians who suffer unnecessarily from them. Both diseases are preventable and the combination of high prevalence, high morbidity and relative inattention from the National Health Service (NHS), makes caries and periodontal disease a significant public health problem. In this perspective, the World Health Organization and the University of Milan have promoted a national epidemiological study aimed at a sample of 4, 6 and 12-years-old students from schools in the North, Central and South of Italy. The study provides for the administration of a questionnaire to parents and a dental examination carried out at school by dentists trained by the WHO. In our town the epidemiological study planning and the survey were carried out by professors of the School of Specialization in "Pediatric Dentistry" (Prof. G. Giuliana and Prof. G. Pizzo) supported by specialist dentists from the same School, calibrated according to the WHO methodology. The survey was carried out between 2017 and 2019 involving 2701 children attending schools in the 8 districts of the town. The parents were sent a letter which explained the nature of the survey and contained a pre-printed form for the issue of informed consent to participate in the survey with a questionnaire regarding the family nuclear, the oral hygiene and eating habits of the minor and the child's previous dental experiences. The ICDAS (International Caries Detection and Assessment System) was used to detect the prevalence of carious lesions. The dentist used for each child visited a dental mirror and the CPI (Community Periodontal Index) index for periodontal assessment. Preliminary results showed that 25.3% of 12-years-old students had gingival bleeding and 41.1% had tartar. The caries index (ICDAS) shows us that as early as 4 years, 20% of children have initial carious lesions, 37% have dentine caries and that 34.38% have highly destructive caries. At 12 years, 34.95% had initial carious lesions, 46% had cavities that already affected dentin and that 42.44% had highly destructive cavities. The exigence to implement a program of prevention / early treatment of caries/gingivitis in pediatric subjects living in Palermo, since the first months of child's life, was born from the data analysis. The project "Un sorriso per 54 tutti i bambini", carried out at the U.O. of "Pediatric Dentistry" of Policlinico Paolo Giaccone in Palermo, was therefore finalised in order to 1) improve efficiency and effectiveness in the promotion of the oral health of minors, through the creation of a preventive / assistance route of significant social health impact; 2) assess the effectiveness of the preventive methodologies adopte

Gender and Sex in Medical Practice: An Exploratory Study on Knowledge, Behavior, and Attitude among Sicilian Physicians

Personalized medicine is a new paradigm in health care, and the concept of socio-cultural gender, as opposed to biological sex, emerged in several medical approaches. This exploratory study aimed to investigate the knowledge of sex and gender in clinical medicine among Sicilian physicians. Data collection was based on an online survey sent to the members of the Medical Councils of Sicily (Italy). The questionnaire included nine specific items about awareness and attitudes regarding gender medicine and its importance in clinical practice. 8023 Sicilian physicians received the solicitation e-mail and only 496 responded. Regarding the knowledge of gender medicine, 71.1% of participants stated that they know it, while 88.5% believe that gender medicine should be included in training programs. Similarly, a high percentage (77.6%) would like to keep up to date on this topic. Physicians sampled seem to understand the importance of gender medicine principles, although their experience of some gender issues (i.e., sex disparities in acute cardiovascular care and smoking cessation strategies) is low (55.44% and 21.57%, respectively). The results of this exploratory study should encourage facing the gender medicine gap in the current curricula of health professionals and should implement the transitional value of sex and gender principles in the clinical setting

Integrated multi-omics investigations of metalloproteinases in colon cancer: Focus on MMP2 and MMP9

Colorectal cancer (CRC) develops by genetic and epigenetic alterations. However, the molecular mechanisms underlying metastatic dissemination remain unclear and could benefit from multi-omics investigations of specific protein families. Matrix metalloproteinases (MMPs) are proteolytic enzymes involved in ECM remodeling and the processing of bioactive molecules. Increased MMP expression promotes the hallmarks of tumor progression, including angiogenesis, invasion, and metastasis, and is correlated with a shortened survival. Nevertheless, the collective role and the possible coordination of MMP members in CRC are poorly investigated. Here, we performed a multi-omics analysis of MMP expression in CRC using data mining and experimental investigations. Several databases were used to deeply mine different expressions between tumor and normal tissues, the genetic and epigenetic alterations, the prognostic value as well as the interrelationships with tumor immune-infiltrating cells (TIICs). A special focus was placed on to MMP2 and MMP9: their expression was correlated with immune markers and the interaction network of co-expressed genes disclosed their implication in epithelial to mesenchymal transition (EMT) and immune response. Finally, the activity levels of MMP2 and MMP9 in a cohort of colon cancer samples, including tissues and the corresponding sera, was also investigated by zymography. Our findings suggested that MMPs could have a high potency, as they are targeted in colon cancer, and might serve as novel biomarkers, especially for their involvement in the immune response. However, further studies are needed to explore the detailed biological functions and molecular mechanisms of MMPs in CRC, also in consideration of their expression and different regulation in several tissues

Proteomic Profiling of Colon Cancer Tissues: Discovery of New Candidate Biomarkers

Colon cancer is an aggressive tumor form with a poor prognosis. This study reports a comparative proteomic analysis performed by using two-dimensional differential in-gel electrophoresis (2D-DIGE) between 26 pooled colon cancer surgical tissues and adjacent non-tumoral tissues, to identify potential target proteins correlated with carcinogenesis. The DAVID functional classification tool revealed that most of the differentially regulated proteins, acting both intracellularly and extracellularly, concur across multiple cancer steps. The identified protein classes include proteins involved in cell proliferation, apoptosis, metabolic pathways, oxidative stress, cell motility, Ras signal transduction, and cytoskeleton. Interestingly, networks and pathways analysis showed that the identified proteins could be biologically inter-connected to the tumor-host microenvironment, including innate immune response, platelet and neutrophil degranulation, and hemostasis. Finally, transgelin (TAGL), here identified for the first time with four different protein species, collectively down-regulated in colon cancer tissues, emerged as a top-ranked biomarker for colorectal cancer (CRC). In conclusion, our findings revealed a different proteomic profiling in colon cancer tissues characterized by the deregulation of specific pathways involved in hallmarks of cancer. All of these proteins may represent promising novel colon cancer biomarkers and potential therapeutic targets, if validated in larger cohorts of patients

Window-Based Energy Selecting X-ray Imaging and Charge Sharing in Cadmium Zinc Telluride Linear Array Detectors for Contaminant Detection

The spectroscopic and imaging performance of energy-resolved photon counting detectors, based on new sub-millimetre boron oxide encapsulated vertical Bridgman cadmium zinc telluride linear arrays, are presented in this work. The activities are in the framework of the AVATAR X project, planning the development of X-ray scanners for contaminant detection in food industry. The detectors, characterized by high spatial (250 µm) and energy (<3 keV) resolution, allow spectral X-ray imaging with interesting image quality improvements. The effects of charge sharing and energy-resolved techniques on contrast-to-noise ratio (CNR) enhancements are investigated. The benefits of a new energy-resolved X-ray imaging approach, termed window-based energy selecting, in the detection of low- and high-density contaminants are also shown

Insights about the ability of folate based supramolecular gels to act as targeted therapeutic agents

With the aim to obtain targeted chemotherapeutic agents, imidazolium and ammonium-based folate salts were synthesized. Their photophysical behavior was investigated both in buffer and buffer/DMSO solution as well as in solid phase, performing UV-vis and fluorescence investigations. Properties of the aggregates were also analyzed by dynamic light scattering. Gelation ability of the salts was analyzed in biocompatible solvents, and gel phases obtained were characterized by determining critical gelation concentrations and gel-solution transition temperatures. Insights about gelator interactions in the tridimensional network were also gained performing ATR-FTIR investigation. Properties of soft materials were further analyzed performing rheology measurements, scanning electron microscopy, fluorescence and resonance light scattering investigations. Antiproliferative activity of organic salts was tested towards two breast cancer cell lines, expressing different levels of folate receptor, namely MDA-MB-231 and MCF-7, and a normal epithelial cell line, like h-TER T-RPE-1, by using MTT assay. Dichlodihydrofluorescein acetate test was performed to verify the role of oxidative stress in cell death. Finally, antiproliferative activity was also evaluated in gel phase, to verify if salts were able to retain biological activity also after the entrapment in the gelatinous network. Results collected evidence that folate based organic salts were able to behave as targeted chemotherapeutic agents both in solution and gel phase, showing uptake mechanism and selectivity indexes that depend on both cancer cell line nature and salt structure

High performance platinum contacts on high-flux CdZnTe detectors

The need for direct X-ray detection under high photon flux with moderate or high energies (30–100 keV range) has strongly increased with the rise of the 4th Generation Synchrotron Light Sources, characterised by extremely brilliant beamlines, and of other applications such as spectral computed tomography in medicine and non-destructive tests for industry. The novel Cadmium Zinc Telluride (CZT) developed by Redlen Technologies can be considered the reference material for high-flux applications (HF-CZT). The enhanced charge transport properties of the holes allow the mitigation of the effects of radiation induced polarization phenomena, typically observed in standard CZT materials (LF-CZT) under high photon flux. However, standard LF-CZT electrical contacts led to inacceptable high dark leakage currents on HF-CZT devices. In this work, a detailed study on the characteristics of new optimized sputtered platinum electrical contacts on HF-CZT detectors is reported. The results from electrical and spectroscopic investigations, showed the best performances on HF-CZT detectors with platinum anode, coupled with both platinum or gold cathode. The morphology, structure, and composition of Pt/CZT contact have been analysed by means of Transmission Electron Microscopy (TEM) on microscopic lamellas obtained by Focused Ion Beam (FIB), highlighting the presence of CdTeO3 oxide at the metal semiconductor interface

Incomplete Charge Collection at Inter-Pixel Gap in Low-and High-Flux Cadmium Zinc Telluride Pixel Detectors

The success of cadmium zinc telluride (CZT) detectors in room-temperature spectroscopic X-ray imaging is now widely accepted. The most common CZT detectors are characterized by enhanced-charge transport properties of electrons, with mobility-lifetime products µeτe > 10−2 cm2/V and µhτh > 10−5 cm2/V. These materials, typically termed low-flux LF-CZT, are successfully used for thick electron-sensing detectors and in low-flux conditions. Recently, new CZT materials with hole mobility-lifetime product enhancements (µhτh > 10−4 cm2/V and µeτe > 10−3 cm2/V) have been fabricated for high-flux measurements (high-flux HF-CZT detectors). In this work, we will present the performance and charge-sharing properties of sub-millimeter CZT pixel detectors based on LF-CZT and HF-CZT crystals. Experimental results from the measurement of energy spectra after charge-sharing addition (CSA) and from 2D X-ray mapping highlight the better charge-collection properties of HF-CZT detectors near the inter-pixel gaps. The successful mitigation of the effects of incomplete charge collection after CSA was also performed through original charge-sharing correction techniques. These activities exist in the framework of international collaboration on the development of energy-resolved X-ray scanners for medical applications and non-destructive testing in the food industry

Advances in High-Energy-Resolution CdZnTe Linear Array Pixel Detectors with Fast and Low Noise Readout Electronics

: Radiation detectors based on Cadmium Zinc Telluride (CZT) compounds are becoming popular solutions thanks to their high detection efficiency, room temperature operation, and to their reliability in compact detection systems for medical, astrophysical, or industrial applications. However, despite a huge effort to improve the technological process, CZT detectors' full potential has not been completely exploited when both high spatial and energy resolution are required by the application, especially at low energies (<10 keV), limiting their application in energy-resolved photon counting (ERPC) systems. This gap can also be attributed to the lack of dedicated front-end electronics which can bring out the best in terms of detector spectroscopic performances. In this work, we present the latest results achieved in terms of energy resolution using SIRIO, a fast low-noise charge sensitive amplifier, and a linear-array pixel detector, based on boron oxide encapsulated vertical Bridgman-grown B-VB CZT crystals. The detector features a 0.25-mm pitch, a 1-mm thickness and is operated at a -700-V bias voltage. An equivalent noise charge of 39.2 el. r.m.s. (corresponding to 412 eV FWHM) was measured on the test pulser at 32 ns peaking time, leading to a raw resolution of 1.3% (782 eV FWHM) on the 59 keV line at room temperature (+20 °C) using an uncollimated 241Am, largely improving the current state of the art for CZT-based detection systems at such short peaking times, and achieving an optimum resolution of 0.97% (576 eV FWHM) at 1 µs peaking time. The measured energy resolution at the 122 keV line and with 1 µs peaking time of a 57Co raw uncollimated spectrum is 0.96% (1.17 keV). These activities are in the framework of an Italian collaboration on the development of energy-resolved X-ray scanners for material recycling, medical applications, and non-destructive testing in the food industry

Advances in High-Energy-Resolution CdZnTe Linear Array Pixel Detectors with Fast and Low Noise Readout Electronics

Radiation detectors based on Cadmium Zinc Telluride (CZT) compounds are becoming popular solutions thanks to their high detection efficiency, room temperature operation, and to their reliability in compact detection systems for medical, astrophysical, or industrial applications. However, despite a huge effort to improve the technological process, CZT detectors’ full potential has not been completely exploited when both high spatial and energy resolution are required by the application, especially at low energies (<10 keV), limiting their application in energy-resolved photon counting (ERPC) systems. This gap can also be attributed to the lack of dedicated front-end electronics which can bring out the best in terms of detector spectroscopic performances. In this work, we present the latest results achieved in terms of energy resolution using SIRIO, a fast low-noise charge sensitive amplifier, and a linear-array pixel detector, based on boron oxide encapsulated vertical Bridgman-grown B-VB CZT crystals. The detector features a 0.25-mm pitch, a 1-mm thickness and is operated at a −700-V bias voltage. An equivalent noise charge of 39.2 el. r.m.s. (corresponding to 412 eV FWHM) was measured on the test pulser at 32 ns peaking time, leading to a raw resolution of 1.3% (782 eV FWHM) on the 59 keV line at room temperature (+20 °C) using an uncollimated 241Am, largely improving the current state of the art for CZT-based detection systems at such short peaking times, and achieving an optimum resolution of 0.97% (576 eV FWHM) at 1 µs peaking time. The measured energy resolution at the 122 keV line and with 1 µs peaking time of a 57Co raw uncollimated spectrum is 0.96% (1.17 keV). These activities are in the framework of an Italian collaboration on the development of energy-resolved X-ray scanners for material recycling, medical applications, and non-destructive testing in the food industry