Treatment of a Femur Nonunion with Microsurgical Corticoperiosteal Pedicled Flap from the Medial Femoral Condyle

Introduction.Te vascularized corticoperiosteal fap is harvested from the medial femoral condyle and it is nourished by the articular branch of the descending genicular artery and the superomedial genicular artery. Tis fap is usually harvested as a free fap for the reconstruction of bone defects at forearm, distal radius, carpus, hand, and recently at lower limb too. Case Report. A 50-year-old Caucasian man referred to our department for hypertrophic nonunion of the distal femur, refractory to the conservative treatments. Te frst surgical choice was the revision of the nail and the bone reconstruction with a corticoperiosteal pedicled fap from the medial femoral condyle. We considered union to have occurred 3.5 months afer surgery when radiographs showed bridging of at least three of the four bony cortices and clinically the patient was able to walk with full weight bearing without any pain. At the last follow-up (25 months), the patient was completely satisfed with the procedure. Discussion. Te corticoperiosteal fap allows a faster healing of fractures with a minimal morbidity at the donor site. We suggest that the corticoperiosteal pedicled fap graf is a reliable and efective treatment for distal femur nonunion

Online Learning with Off-Policy Feedback

We study the problem of online learning in adversarial bandit problems under a partial observability model called off-policy feedback. In this sequential decision making problem, the learner cannot directly observe its rewards, but instead sees the ones obtained by another unknown policy run in parallel (behavior policy). Instead of a standard exploration-exploitation dilemma, the learner has to face another challenge in this setting: due to limited observations outside of their control, the learner may not be able to estimate the value of each policy equally well. To address this issue, we propose a set of algorithms that guarantee regret bounds that scale with a natural notion of mismatch between any comparator policy and the behavior policy, achieving improved performance against comparators that are well-covered by the observations. We also provide an extension to the setting of adversarial linear contextual bandits, and verify the theoretical guarantees via a set of experiments. Our key algorithmic idea is adapting the notion of pessimistic reward estimators that has been recently popular in the context of off-policy reinforcement learning

Os perigos da desdiferenciação e a pandemia de covid-19: o caso da hidroxicloroquina no Brasil = The dangers of dedifferentiation and the covid-19 pandemic: the case of hydroxychloroquine in Brazil

DOI: https://doi.org/10.11606/issn.2316-9044.rdisan.2023.18168

CREB engages C/EBPδ to initiate leukemogenesis.

cAMP response element binding protein (CREB) is frequently overexpressed in acute myeloid leukemia (AML) and acts as a proto-oncogene; however, it is still debated whether such overactivation alone is able to induce leukemia as its pathogenetic downstream signaling is still unclear. We generated a zebrafish model overexpressing CREB in the myeloid lineage, which showed an aberrant regulation of primitive hematopoiesis, and in 79% of adult CREB-zebrafish a block of myeloid differentiation, triggering to a monocytic leukemia akin the human counterpart. Gene expression analysis of CREB-zebrafish revealed a signature of 20 differentially expressed human homologous CREB targets in common with pediatric AML. Among them, we demonstrated that CREB overexpression increased CCAAT-enhancer-binding protein-δ (C/EBPδ) levels to cause myeloid differentiation arrest, and the silencing of CREB-C/EBPδ axis restored myeloid terminal differentiation. Then, C/EBPδ overexpression was found to identify a subset of pediatric AML affected by a block of myeloid differentiation at monocytic stage who presented a significant higher relapse risk and the enrichment of aggressive signatures. Finally, this study unveils the aberrant activation of CREB-C/EBPδ axis concurring to AML onset by disrupting the myeloid cell differentiation process. We provide a novel in vivo model to perform high-throughput drug screening for AML cure improvement

Mouthwash Formulation Co-Delivering Quercetin and Mint Oil in Liposomes Improved with Glycol and Ethanol and Tailored for Protecting and Tackling Oral Cavity

: The aim of this work was the simultaneous loading of quercetin and mint essential oil (mint oil) in phospholipid vesicles specifically tailored to obtain an antibacterial and antioxidant mouthwash. The vesicles were prepared using soy lecithin and Tween 80 as bilayer components, and a mixture of phosphate buffer solution (33%), propylene glycol (33%) and ethanol (33%) as dispersing phase. The formation of regularly shaped, spherical and unilamellar vesicles was confirmed by cryogenic transmission electron microscopy analyses. Similarly, light scattering results disclosed that the size of the vesicles increased by increasing the concentration of mint oil, but at the same time the high amount of mint oil ensured high stability, as the size of these vesicles remained unchanged during 12 months of storage. All tested formulations were highly biocompatible towards epithelial cells and capable of counteracting oxidative cell damages caused by hydrogen peroxide. Moreover, the vesicles prepared with the highest concentration of mint oil inhibited the proliferation of the cariogenic Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus)

Entrapment of Citrus limon var. pompia Essential Oil or Pure Citral in Liposomes Tailored as Mouthwash for the Treatment of Oral Cavity Diseases

This work aimed at developing a mouthwash based on liposomes loading Citrus limon var. pompia essential oil or citral to treat oropharyngeal diseases. Vesicles were prepared by dispersing phosphatidylcholine and pompia essential oil or citral at increasing amounts (12, 25 and 50 mg/mL) in water. Transparent vesicle dispersions were obtained by direct sonication avoiding the use of organic solvents. Cryogenic transmission electron microscopy (cryo-TEM) confirmed the formation of unilamellar, spherical and regularly shaped vesicles. Essential oil and citral loaded liposomes were small in size (~110 and ~100 nm, respectively) and negatively charged. Liposomes, especially those loading citral, were highly stable as their physico-chemical properties did not change during storage. The formulations were highly biocompatible against keratinocytes, were able to counteract the damages induced in cells by using hydrogen peroxide, and able to increase the rate of skin repair. In addition, liposomes loading citral at higher concentrations inhibited the proliferation of cariogenic bacteriu

Potential of Energy Saving of Propane Heat Pump as replacement of gas boilers with low and high temperature emitters

This work deals with the analysis of the energy performance and the environmental impact of a Heating, Ventilation and Air Conditioning (HVAC) system based on an innovative Air-to-Water electrical Heat Pump (AWHP) using propane (R290) as the refrigerant. A building of the University of Bologna located in Forlì (North of Italy) is considered for replacing a condensing gas boiler and a conventional chiller with an AWHP using R290. To evaluate the efficiency of the existing heating system and the potential savings linked to the adoption of the propane AWHP, the building energy model was created and calibrated by collecting monthly thermal and electrical consumptions as a function of the actual climate data. In this paper, the main features of the R290-based AWHP are described in detail by emphasising the device performance as a function of the operating conditions (i.e., air and water temperature and speed of the scroll compressor). A series of scenarios have been studied to evaluate the energy performance of the propane AWHP with respect to the reference scenario under various operating conditions. The results show that while the total primary energy demand increases adopting the propane AWHP with respect to the case of a gas boiler, the non-renewable primary energy fraction decreases significantly, with a dramatic increase in the renewable quote. From an economic point of view, lower annual costs are obtained by adopting a propane AWHP coupled to fan coils, mainly when the electrical heat pump is used in a thermally insulated building in which a photovoltaic system is installed

The Northern Cross Fast Radio Burst project -- III. The FRB-magnetar connection in a sample of nearby galaxies

Fast radio bursts (FRBs) are millisecond radio transients observed at cosmological distances. The nature of their progenitors is still a matter of debate, although magnetars are invoked by most models. The proposed FRB-magnetar connection was strengthened by the discovery of an FRB-like event from the Galactic magnetar SGR J1935+2154. In this work, we aim to investigate how prevalent magnetars such as SGR J1935+2154 are within FRB progenitors. We carried out an FRB search in a sample of seven nearby (< 12 Mpc) galaxies with the Northern Cross radio telescope for a total of 692 h. We detected one 1.8 ms burst in the direction of M101 with a fluence of $58 \pm 5$ Jy ms. Its dispersion measure of 303 pc cm$^{-3}$ places it most-likely beyond M101. Considering that no significant detection comes indisputably from the selected galaxies, we place a 38 yr$^{-1}$ upper limit on the total burst rate (i.e. including the whole sample) at the 95\% confidence level. This upper limit constrains the event rate per magnetar $\lambda_{\rm mag} < 0.42$ magnetar$^{-1}$ yr$^{-1}$ or, if combined with literature observations of a similar sample of nearby galaxies, it yields a joint constraint of $\lambda_{\rm mag} < 0.25$ magnetar$^{-1}$ yr$^{-1}$. We also provide the first constraints on the expected rate of FRBs hypothetically originating from ultraluminous X-ray (ULX) sources, since some of the galaxies observed during our observational campaign host confirmed ULXs. We obtain $< 13$ yr$^{-1}$ per ULX for the total sample of galaxies observed. Our results indicate that bursts with energies $E>10^{34}$ erg from magnetars like SGR J1935+2154 appear more rarely compared to previous observations and further disfavour them as unique progenitors for the cosmological FRB population, leaving more space open to the contribution from a population of more exotic magnetars, not born via core-collapsed supernovae.Comment: 9 pages, 4 figures, published in A&

Ultrastructural and functional differences between normal and tumor endothelial progenitor cells

Endothelial progenitor cells (EPCs) may be released from bone marrow to sustain the angiogenic switch that promotes tumor growth and metastatization of several solid cancers (Moccia et al., 2014). It has long been thought that tumor endothelium represents a rather stable structure, devoid of the genetic heterogeneity featuring neoplastic cells; however, more recent studies showed that tumor endothelial cells (TECs) present with an altered gene expression profile that bestows massive morphological and functional differences on them as compared to normal cells (Aird, 2012). Similarly, circulating EPCs isolated from individuals suffering from metastatic renal cellular carcinoma (mRCC) undergo a significant remodelling of their Ca2+ machinery, which is a master regulator of both angiogenesis and vasculogenesis. The present study clearly indicate that EPCs isolated from RCC (RCC-EPCs) and breast carcinoma (BC-EPCs) patients display ultrastructural and functional differences as compared to normal cells (N-EPCs)

Oil Essential Mouthwashes Antibacterial Activity against Aggregatibacter actinomycetemcomitans: A Comparison between Antibiofilm and Antiplanktonic Effects

The aim of this work is to determine the antibacterial activity of three marketed mouthwashes on suspended and sessile states of Aggregatibacter actinomycetemcomitans. The efficacy of two commonly used products in clinical practice, containing essential oils as active ingredients (menthol, thymol, methyl salicylate, and eucalyptol) in association with or without alcohol, has been evaluated in comparison with a chlorhexidine-based mouthwash. The microtiter plate assay, in order to obtain a spectrophotometric measurement of bacterial responses at growing dilutions of each antiseptic, was used for the study. The analysis revealed that a good antibacterial activity is reached when the abovementioned mouthwashes were used at concentration over a 1/24 dilution and after an exposure time of 30 seconds at least. In conclusion, the alcoholic mouthwash appears to have a better biofilm inhibition than its antiplanktonic activity while the nonalcoholic product demonstrates an opposite effect with a better antiplanktonic behavior