Solution and gelling properties of gellan benzyl esters

Gellan benzyl esters of different degrees of esterification were prepared, and their gelation behavior was examined. Native gellan and gellan benzyl ester aqueous solutions and the ensuing aqueous gels obtained by cooling their solutions with added salt were studied by means of rheological and small-angle X-ray scattering experiments. Although esterification causes no fundamental changes in the gellan ordered structure, the introduction of bulky benzyl ester groups reduces the backbone propensity of double-helix formation and subsequent helix-helix association (gelation). In consequence, gellan-based gels become less stable both mechanically and thermally with esterification

Neurological features of COVID-19 infection: A case series of geriatric patients

The coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which is responsible for the coronavirus disease 2019 (COVID-19), is known to cause substantial pulmonary disease. However, clinicians observed many extrapulmonary manifestations of COVID-19. Neurological manifestations are being recognised increasingly. On the basis of knowledge of other coronaviruses, especially those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome epidemics, cases of central nervous system disease caused by SARS-CoV-2 might be expected to be rare. We report four cases of neurologic manifestations of SARS-CoV-2 in elderly patients who presented to the Geriatric Department of Pescara Hospital (Italy)

AIRO Breast Cancer Group Best Clinical Practice 2022 Update

Introduction: Breast cancer is the most common tumor in women and represents the leading cause of cancer death. Radiation therapy plays a key-role in the treatment of all breast cancer stages. Therefore, the adoption of evidence-based treatments is warranted, to ensure equity of access and standardization of care in clinical practice.Method: This national document on the highest evidence-based available data was developed and endorsed by the Italian Association of Radiation and Clinical Oncology (AIRO) Breast Cancer Group.We analyzed literature data regarding breast radiation therapy, using the SIGN (Scottish Intercollegiate Guidelines Network) methodology (www.sign.ac.uk). Updated findings from the literature were examined, including the highest levels of evidence (meta-analyses, randomized trials, and international guidelines) with a significant impact on clinical practice. The document deals with the role of radiation therapy in the treatment of primary breast cancer, local relapse, and metastatic disease, with focus on diagnosis, staging, local and systemic therapies, and follow up. Information is given on indications, techniques, total doses, and fractionations.Results: An extensive literature review from 2013 to 2021 was performed. The work was organized according to a general index of different topics and most chapters included individual questions and, when possible, synoptic and summary tables. Indications for radiation therapy in breast cancer were examined and integrated with other oncological treatments. A total of 50 questions were analyzed and answered.Four large areas of interest were investigated: (1) general strategy (multidisciplinary approach, contraindications, preliminary assessments, staging and management of patients with electronic devices); (2) systemic therapy (primary, adjuvant, in metastatic setting); (3) clinical aspects (invasive, non-invasive and micro-invasive carcinoma; particular situations such as young and elderly patients, breast cancer in males and cancer during pregnancy; follow up with possible acute and late toxicities; loco-regional relapse and metastatic disease); (4) technical aspects (radiation after conservative surgery or mastectomy, indications for boost, lymph node radiotherapy and partial breast irradiation).Appendixes about tumor bed boost and breast and lymph nodes contouring were implemented, including a dedicated web application. The scientific work was reviewed and validated by an expert group of breast cancer key-opinion leaders.Conclusions: Optimal breast cancer management requires a multidisciplinary approach sharing therapeutic strategies with the other involved specialists and the patient, within a coordinated and dedicated clinical path. In recent years, the high-level quality radiation therapy has shown a significant impact on local control and survival of breast cancer patients. Therefore, it is necessary to offer and guarantee accurate treatments according to the best standards of evidence-based medicine

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Wind energy: an application of Bernoulli's theorem generalized to isentropic flow of ideal gases

By considering the extension of Bernoulli’s theorem to the case of the isentropic flow of ideal gases we conceive a small-scale wind–energy system able to work in the presence of low wind velocities in any direction. The flow of air inside a hyperbolically shaped pipe is studied using elementary physics concepts. The results obtained show that wind velocity in the system increases for decreasing cross-sectional areas, allowing a lower cut-in wind speed and an increase in the annual energy production of the device

Synthesis and physicochemical characterization of gellan gels

Thermally stable hydrogels have been prepared starting from aqueous gellan physical gels by partial self-cross-linking of the polysaccharide chains (formation of essentially interchain ester bonds, with no added bridging moieties) with the aid of the water-soluble 1-ethyl-3-[3-(dimethylammino)propyl]-carbodiimide (EDC). The structure of the hydrated networks-physicochemical gels-was analyzed on the basis of the results of small-angle X-ray scattering experiments. Here a molecular model, which is composed of a bundle of 48 gellan double helices aligned in parallel, was proposed to represent the ordered domains in the hydrogels. The rigid bundles formed by associated gellan double helices constitute the junction zones which sustain the overall gel structure displaying solidlike properties. Relatively large cavities supported by rigid bundles inside the gels absorb water quickly as indicated by kinetic water uptake data. A network structure formed by rigid microfibrils of associated gellan double helices connected by flexible joints of disentangled short gellan chains-In which most of the chemical cross-linking should have taken place-is consistent with the rheological and swelling behavior of the new polymeric materials

Could the tendon degeneration and the fatty infiltration of the gluteus medius affect clinical outcome in total hip arthroplasty?

Purpose The aim of this prospective study was to perform a clinical and radiologic evaluation of patients undergoing total hip arthroplasty (THA). The hypothesis is that there is a correlation between the pre-operative degeneration state of the gluteal muscle-tendinous unit and the clinical outcome in terms of functional recovery. Methods Fifty-five patients have met inclusion criteria. All patients included in the sample were subjected to clinical evaluation. The ultrasound examination of the patients of the study was conducted and the following parameters were assessed: Thickness in mm of the gluteus medius tendon; Quality of the gluteus medius tendon; and Trophy and muscular composition. Results The degree of degeneration of the pre-operative tendon shows a negative statistical correlation with all the pre- and post-operative clinical scales, but presents statistical significance (p < 0.05) only with the post-operative Harris, the post-operative Oxford, the Harris and HOOS-modified post-operative, lameness, and Trendelenburg; it correlates positively with the quality of the macroscopic tendon detected intra-operatively, the degree of the pre-operative contralateral tendon, and the operated and contralateral pre-operative muscle (p < 0.05). The degree of fatty degeneration of the pre-operatively operated muscle correlates negatively (p < 0.05) with all pre- and post-operative clinical scales except for the pre-operative WOMAC and HOOS modified, with the lameness and the Trendelenburg sign; it correlates positively (p < 0.05) with age, the quality of the macroscopic tendon detected intra-operatively, degree of tendon degeneration, fatty infiltration of the contralateral pre- and post-operative muscle and of the post-operative operated muscle. Conclusion Tendon degeneration and fatty infiltration of the gluteus medius muscle appeared to be determinants of the post-operative persistence of lameness and Trendelenburg sign positivity in patients undergoing hip arthroplasty