Perioperative characterization of anastomotic doughnuts with high-resolution probe-based confocal laser endomicroscopy in colorectal cancer surgery: a feasibility study.

BACKGROUND: Confocal laser enables in vivo real-time histopathology of the mucosa layer of gastrointestinal tract. The aim of this study was to assess the feasibility and the role of probe-based confocal laser endomicroscopy in extemporary examination of staple rings of patients with colorectal cancer. METHODS: This was a prospective, single-center pilot study. Patients who underwent end-to-end stapled surgical resection for colorectal cancer were included. Confocal imaging was analyzed with great attention to image quality evaluation of cellular morphology and cellular structures of the serosal, muscular, and mucosal layers of the doughnuts than comparing results with definitive histopathology. RESULTS: Twenty-six doughnuts were analyzed. Real-time video sequences were obtained in all patients, with a total of 204 mosaic images. For each doughnut, most of the images were adequate for evaluation of cellular morphology and cellular structure of the serosal, muscular, and mucosal layers. CONCLUSIONS: Perioperative assessment of doughnut tissues in patients with colorectal cancer by confocal laser endomicroscopy is feasible and safe. Prospective studies are warranted for further evaluation of the clinical impact of this technology during surgery

Methacarn preserves mucus integrity and improves visualization of amoebae in gills of Atlantic salmon (Salmo salar L.)

Two aqueous fixation methods (modified Davidson's solution and modified Davidson's solution with 2% (w/v) Alcian blue) were compared against two non‐aqueous fixation methods (methacarn solution and methacarn solution with 2% (w/v) Alcian blue) along with the standard buffered formalin fixation method to (a) improve preservation of the mucous coat on Atlantic salmon, Salmo salar L., gills and (b) to examine the interaction between the amoebae and mucus on the gill during an infection with amoebic gill disease. Aqueous fixatives demonstrated excellent cytological preservation but failed to deliver the preservation of the mucus when compared to the non‐aqueous‐based fixatives; qualitative and semi‐quantitative analysis revealed a greater preservation of the gill mucus using the non‐aqueous methacarn solution. A combination of this fixation method and an Alcian blue/Periodic acid–Schiff staining was tested in gills of Atlantic salmon infected with amoebic gill disease; lectin labelling was also used to confirm the mucus preservation in the methacarn‐fixed tissue. Amoebae were observed closely associated with the mucus demonstrating that the techniques employed for preservation of the mucous coat can indeed avoid the loss of potential mucus‐embedded parasites, thus providing a better understanding of the relationship between the mucus and parasite

Preliminary analysis and design for an end-to-end Mars flyby manned mission

The purpose of this preliminary investigation is to analyze an end-to-end two-person Mars flyby mission. The main weakness of previous studies seemed to be an inadequate technology readiness level (TRL) compared to the chosen launch window, which would have required an excessive technology development, launch capacity and schedule demands for the mission. The development of a feasible mission that could be launched between 2020 and 2024 has been, therefore, the guideline for the study in order to reach a proper TRL and, at the same time, a concrete human to Mars program underway. On the other hand, equal importance has been given to finding the best trade-off among cost, safety and operational simplicity. The technological advantages, gained from the postponement of the launch date to the 2020, contrast with a greater characteristic energy (C3) required to reach Mars. Nevertheless, through a Venus flyby there were simultaneously optimized two usually conflicting parameters, the mission Time-Of-Flight (TOF) and the total deltaV required. An iterative design process, which involved both the trajectory optimization and the characterization of the other parts of the mission, has been conducted. In particular, concerning the flight systems (TCS, ECLSS, radiation protections, and others), has been adopted a multipurpose approach in order to optimize and integrate the exploitation of resources. Practical solutions concern, for example, a partially regenerative ecosystem-based life support system and the development of unconventional methods and components to improve the effectiveness of the radiation shield without having to use specialized components with no other purposes. In terms of mission TOF, disposable deltaV and life support for the crew, the best result achieved resulted in an end-to-end mission of 582 days with a total deltaV of 6.88 km/s for a re-entry in February 2022. As part of a possible long-term deep space exploration plan, the return trajectory has been chosen so that it would be possible to obtain an advantageous rendezvous with the ISS. In this way, in order to achieve an as high as possible reusability level, every component with a long-term operational life is docked to the ISS for a fruitful future use. A mission of this kind represents a unique springboard to merge science, technology and human achievements, not only to pave the way to the Red Planet, but also for the human deep space exploration

GESTIONE DELLA FISTOLA ENTEROCUTANEA E DELLA NUTRIZIONE CLINICA IN PAZIENTE CON PROTESI INFETTA DOPO TRATTAMENTO DI LAPAROCELE ADDOMINALE. SUGGERIMENTI, TRUCCHI E REVISIONE DELLA LETTERATURA

Il trattamento della fistola entero-cutanea (FEC) richiede un approccio multidisciplinare, genera costi elevati e mostra tassi critici di morbilità e mortalità. E’ una complicanza tra le più impegnative nella Chirurgia dell'Ernia post-incisionale (laparocele addominale) e nella Chirurgia colorettale. L’età dei pazienti, in media avanzata, e la coesistenza di una o più patologie croniche, determinano un esito infausto, nonostante i trattamenti applicati. Materiali e metodi: Si illustrano gli attuali sistemi di classificazione della FEC, le metodiche attualmente utilizzate nella gestione della complicanza, una revisione bibliografica approfondita sul controllo della fonte settica, sul metodo da seguire nell’applicazione della nutrizione clinica, ossigenoterapia iperbarica e drenaggio a pressione negativa. Abbiamo valutato l’impiego della pancera che, seppure la bibliografia scientifica non ne evidenzi l’utilità, in questo tipo di pazienti è consigliabile. Risultati: Maschio 71 anni, settico, displasia midollare, fistolizzato a 100 cm dal Treitz dopo rimozione di protesi infetta impiantata per laparocele. Scenario complesso per malattia del sistema eritropoietico. Confrontiamo i nostri risultati con la letteratura scientifica internazionale. I pazienti con FEC necessitano il supporto nutrizionale per contrastare ipercatabolismo, flogosi e sepsi, perdita di liquidi, proteine e sali minerali. BMI medio / velocità infusionale media / output medio alla domiciliarizzazione / in domiciliare, e in fase terminale sono stati 21.8/82.8 (ml/h)/83,2 (ml/24 ore); 23.3/59.2/70.1; 22.9/70/100.3 rispettivamente. L’Hb media/Hct medio/PLT medie nelle tre fasi 8.8(g/dL) / 27(%) / 98.5(x10^9/L) (nessuna trasfusione), 7/20.9/84 (2 trasfusioni), 7.3/21.1/46 (10 trasfusioni). Conclusione: Nel trattamento della FEC è indispensabile l’approccio multidisciplinare aggressivo, espianto della fonte settica, ipernutrizione (iniziando con Nutrizione Parenterale Totale-NPT, seguita da Nutrizione Enterale-NE) prima possibile. Nella fase intermedia l’output lasciava ben sperare nella chiusura spontanea. La/le patologie associate hanno un peso determinante nella riuscita. Teduglutide potrebbe essere utile out label. Necessaria la stesura di linee guide condivise ottenendo dati omogenei, schematizzare la metodologia per disegnare studi randomizzati dai risultati accettabili alla comunità scientifica

Probe-Based Confocal Laser Endomicroscopy Evaluation of Colon Preneoplastic Lesions, with Particular Attention to the Aberrant Crypt Foci, and Comparative Assessment with Histological Features Obtained by Conventional Endoscopy

The colorectal carcinoma represents one of the most common and aggressive malignancies, still characterized by an unacceptable mortality rate, mainly due to the high metastatic potential and to a late diagnosis. In the last years, the research community focused on the chance of improving the endoscopic screening to detect neoplastic lesions in a very early stage. Several studies proposed aberrant colonic crypt foci as the earliest recognizable step of transformation in colonic multiphase carcinogenesis. We previously demonstrated the clinical applicability and predictive power of probe-based confocal laser endoscopy (pCLE) in superficial colorectal neoplastic lesions and also characterized in vivo a case of dysplasia-associated lesional mass (DALM) in ulcerative colitis. Now, we aim to evaluate the accuracy of pCLE in the detection of ACF comparing in double-blind manner the microendoscopic and histopathological features resulting from colonic biopsy. By pCLE, we identified specific crypt architecture modifications associated with changes in cellular infiltration and vessels architecture, highlighting a good correspondence between pCLE features and histology

Investigating the impacts of H(2)O(2) treatment on gills of healthy Atlantic salmon reveals potential changes to mucus production with implications on immune activity

Current treatment strategies for relevant infectious diseases in Atlantic salmon (Salmo salar L.) include the use of low salinity or freshwater bathing. However, often availability is restricted, and hydrogen peroxide (H2O2) is used as an alternative. The potential impacts of H2O2 on fish mucosal tissues, especially the gills therefore need to be considered. In this study the mucosal and immunological effects of H2O2 treatment on the gills of healthy Atlantic salmon were examined by gene expression (qPCR) and immunohistochemistry (IHC) investigating T-cell, B-cell, and mucin activity. Healthy fish were treated with H2O2 and sampled at different times: 4 h, 24 h and 14 days post-H2O2 treatment (dpt) (total n = 18) to investigate the effect of holding time and H2O2 treatment. Treatment with H2O2 resulted in up-regulation of markers for T-cell activity and anti-inflammatory response and down-regulation of mucin expression in the gills at 14 dpt compared to fish sampled prior to treatment (0h; n = 5 fish). These findings were supported by IHC analysis, which despite being highly variable between samples, showed an increase in the number of CD3+ T cells at 14 dpt in 50% of treated fish compared to pre-treatment fish. The results from this study suggest that H2O2 treatment does not immune compromise healthy Atlantic salmon after 14 dpt (i.e., post-recovery) but modulates gill immune activity and disrupts the mucus covering of the gills. However, further studies are required to determine whether the effects observed are related to H2O2 treatment in isolation or other variables such as holding time or environmental factors

Interplanetary cubesats for asteroid exploration: mission analysis and design

The purpose of this study is to show CubeSats capabilities in support of an interplanetary mission. The feasibility study of a CubeSat mission for asteroid exploration was performed. The study is based on the proposed AIDA (Asteroid Impact & Deflection Assessment) mission, an ESA/NASA joint effort. Mission objectives and requirements was defined, followed by the development of concepts of operations and mission architectures proposals. The mission baseline was defined with the use of multiple trade-off tools. The proposed mission concept represents a valuable low-cost piggyback solution with high scientific return, also adaptable to other mission contexts

Consumo di suolo, dinamiche territoriali e servizi ecosistemici

Il Rapporto “Consumo di suolo, dinamiche territoriali e servizi ecosistemici” è un prodotto del Sistema Nazionale per la Protezione dell’Ambiente (SNPA), che assicura le attività di monitoraggio del territorio e del consumo di suolo. Il Rapporto, insieme alla cartografia e alle banche dati di indicatori allegati, fornisce il quadro aggiornato dei processi di trasformazione della copertura del suolo e permette di valutare l’impatto del consumo di suolo sul paesaggio e sui servizi ecosistemici