Factors related to swallowing oral phase

Introduction: Efficacy of swallowing oral phase is often impaired in dysphagic patients and may impact on pharyngeal stage, meal consumption, nutritional status and quality of life. However, factors related to oral phase of swallowing have been little studied. Matherial & Methods: Thirty-nine adult patients with dysphagia of different etiology were enrolled. FEES and the Test of Mastication and Swallowing Solids (TOMASS) were performed. The Penetration-Aspiration scale, the Yale Pharyngeal Residue Severity Rating Scale and the Dysphagia Outcome and Severity Scale (DOSS) were used to assess the FEES. Tongue strength was assessed using the Iowa Oral Performance Instrument. Patients completed the Eating Assessment Tool-10. The time the patients needed to consume a meal, the Functional Oral Intake Scale score and the body mass index (BMI) were recorded. Correlations between the TOMASS and other variables were studied using Spearman\u2019s correlation coefficient. TOMASS scores were compared between patients with complete denture and those with partial edentulism through Mann-Whitney test. Results: The number of discrete bites correlated only with the BMI (r=-0.38; p=0.01). Statistically significant correlations were found between the number of masticatory cycles and tongue strength (r=-0.47; p<0.01), pharyngeal residue (r=0.42; p<0.01), DOSS (r=-0.38; p=0.01). The total time of the TOMASS correlated with tongue strength (r=-0.45; p<0.01), pharyngeal residue (r=0.48; p<0.01), time needed to consume a meal (r=0.41; p=0.01) and DOSS (r=-0.36; p=0.02). A significant difference was found between patients with complete denture and patients with partial edentulism for the number of masticatory cycles (p=0.02) and total time (p=0.03). Conclusions: Swallowing oral phase seems to correlate with tongue strength, denture, pharyngeal residue, overall dysphagia severity, duration of meals and BMI. Further studies involving a larger sample size are necessary to confirm present data

Impact load behaviour of Resin Transfer Moulding (RTM) hemp fibre composite laminates

13 pages, 23 figures.Aim of this work is to determine experimentally some important mechanical characteristics of RTM hemp plain weave fabric/epoxy laminates. Equipment and test methods are described and critically discussed. Main subjects of this work are: RTM process improvement, preliminary tensile and flexural tests and impact performance. The latter is analyzed with particular attention, also comparing data with other experimental results. Attention is devoted both to the process, which strongly influences the mechanical performance of natural long fibres reinforced composites and to the low-velocity impact behaviour. This is a very important requirement for future aeronautical applications, in that composite structures should retain sufficient residual compression properties (CAI: Compression After Impact) after a Barely Visible Impact Damage (B.V.I.D).Publicad

Anaerobic co-digestion effluent as substrate for chlorella vulgaris and scenedesmus obliquus cultivation

Anaerobic digestate supernatant can be used as a nutrient source for microalgae cultivation, thus integrating phytoremediation processes with high value products storage in microalgae biomass. Microalgae are able to use nitrogen and phosphorous from digestate, but high nutrient concentration can cause growth inhibition. In this study, two microalgae strains (C. vulgaris and S. obliquus) were cultivated on the anaerobic co-digestion supernatant (obtained from the organic fraction of municipal solid waste (OFMSW) and waste activated sludge (WAS)) in a preliminary Petri plate screening at different dilutions (1:10 and 1:5) using a synthetic medium (ISO) and tap water (TW). Direct Nile red screening was applied on colonies to preliminarily identify hydrophobic compound storage and then a batch test was performed (without air insufflation). Results show that C. vulgaris was able to grow on digestate supernatant 1:5 diluted, while Nile red screening allowed the preliminary detection of hydrophobic compound storage in colonies. The analysis carried out at the end of the test on ammonia, phosphate, nitrate and sulphate showed a removal percentage of 47.5 ± 0.8%, 65.0 ± 6.0%, 95.0 ± 3.0% and 99.5 ± 0.1%, respectively

Environmental infuence on calcifcation of the bivalve Chamelea gallina along a latitudinal gradient in the Adriatic Sea

Environmental factors are encoded in shells of marine bivalves in the form of geochemical properties, shell microstructure and shell growth rate. Few studies have investigated how shell growth is affected by habitat conditions in natural populations of the commercial clam Chamelea gallina. Here, skeletal parameters (micro-density and apparent porosity) and growth parameters (bulk density, linear extension and net calcification rates) were investigated in relation to shell sizes and environmental parameters along a latitudinal gradient in the Adriatic Sea (400 km). Net calcification rates increased with increasing solar radiation, sea surface temperature and salinity and decreasing Chlorophyll concentration in immature and mature shells. In immature shells, which are generally more porous than mature shells, enhanced calcification was due to an increase in bulk density, while in mature shells was due to an increase in linear extension rates. The presence of the Po river in the Northern Adriatic Sea was likely the main driver of the fluctuations observed in environmental parameters, especially salinity and Chlorophyll concentration, and seemed to negatively affect the growth of C. gallina

Emotional, Behavioral, and Physical Health Consequences in Caregivers of Children with Cancer: A Network Analysis Differentiation in Mothers’ and Fathers’ Reactivity

Background: Pediatric cancer presents mental and physical challenges for patients and their caregivers. However, parental distress has been understudied despite its negative impact on quality of life, disability, and somatic disorders. Parents of oncopediatric patients experience high levels of suffering with their resilience tested throughout their children’s illness. Identifying at-risk parents and offering specific treatments is crucial and urgent to prevent or alleviate negative outcomes. Methods: This study used statistical and network analyses to examine symptom patterns assessed by the Kellner Symptom Questionnaire in 16 fathers and 23 mothers at different time points: diagnosis, treatment, and discharge. Results: The results indicated significantly higher distress levels in parents of oncopediatric children compared to the control reference population. Gender-specific differences in symptom profiles were observed at each time point, and symptoms showed a gradual but non-significant decrease over time. Conclusions: The network analysis yielded valuable insights that, when applied in clinical practice, can guide the implementation of timely treatments to prevent and manage parental distress, thus addressing long-term, stress-related issues in primary caregivers of children diagnosed and treated for cancer

Palaeoclimatic and palaeoenvironmental evolution of the Lower Pleistocene Arda River succession

The Arda River marine succession, cropping out in western Emilia (northern Italy) represents an excellent site to study past ecosystems dynamics in the frame of Early Pleistocene climate change and tectonic activity. This one-day excursion leads the participants to discover the palaeoclimatic and palaeoenvironmental evolution of the Lower Pleistocene Arda River marine section, unraveled through an integrated use of sedimentological, palaeoecological (molluscs and trace fossils) and geochemical tools. Upsection, the succession was deposited in progressively shallower water and colder climate during phases of advance of fan deltas affected by hyperpycnal flows. It culminates at the top with clast supported alluvial conglomerates and freshwater/terrestrial biota indicating a sea level drop and the establishment of a continental environment. It is very rich in fossils: in the marine part molluscs, brachiopods, corals and echinoderms, besides well preserved trace fossils, are abundant; whereas in the continental part a mammal fauna and freshwater/terrestrial molluscs are occasionally found. Sclerochemical analyses undertaken on bivalve shells indicate that seawater temperature seasonality was the main variable of climate change within the study area during the Early Pleistocene. In particular, strong seasonality and low winter palaeotemperatures were assumed to be the main drivers for the widespread establishment of Arctica islandica populations in the palaeo-Adriatic Sea around 1.80 Ma. During the excursion not only fossils are shown, but also interesting biocalcarenitic bodies with a complex geometry cropping out in the town of Castell\u2019Arquato. The excursion is complemented by the visit to the Giuseppe Cortesi geological and palaeontological museum, housing vertebrate and invertebrate fossil collections

Allelic Variants of HLA-C Upstream Region, PSORS1C3, MICA, TNFA and Genes Involved in Epidermal Homeostasis and Barrier Function Influence the Clinical Response to Anti-IL-12/IL-23 Treatment of Patients with Psoriasis

Several biologic therapies have been developed to treat moderate-to-severe psoriasis, with patients exhibiting different clinical benefits, possibly due to the heterogeneity of pathogenic processes underlying their conditions. Ustekinumab targets the IL-12/IL-23-p40 subunit and inhibits type-1 and type-17 T-cell responses. Although ustekinumab is effective as both short- and long-term treatment, therapeutic response varies considerably among patients. Ustekinumab biosimilars will be commercialized in the very next future, likely broadening the use of this drug in the treatment of psoriasis patients. Our pharmacogenomic study evaluated the influence of 417 single-nucleotide polymorphisms (SNPs) in psoriasis-risk alleles on the clinical response to ustekinumab in a cohort of 152 patients affected by moderate-to-severe plaque-type psoriasis. Differences in SNP pattern characterizing HLA-Cw6(+) or HLA-Cw6(-) patients, showing high or low responses to ustekinumab, were also analysed. We identified twelve SNPs in HLA-C upstream region (rs12189871, rs4406273, rs9348862 and rs9368670), PSORS1C3 (rs1265181), MICA (rs2523497), LCE3A-B intergenic region (rs12030223, rs6701730), CDSN (rs1042127, rs4713436), CCHCR1 (rs2073719) and in TNFA (rs1800610) genes associated with excellent response to ustekinumab. We also found that HLA-Cw6(+) and HLA-Cw6(-) patients carried out distinct patterns of SNPs associated with different clinical responses. The assessment of HLA-C alleles, together with other genetic variants, could be helpful for defining patients who better benefit from anti-IL-12/IL-23 therapy

Multidisciplinarity in Transition Pathways for Patients With Kidney Disease: The Current State of Play

In the field of medical care, successful transition from pediatric-centered to adult-oriented healthcare can provide a sense of continuity in the development of youth, and prepare them to accept responsibility for and manage their own chronic kidney condition in complete autonomy. The so-called transition process requires the presence of some basic aspects: a multidisciplinary team, which acts as a bridge between child and adult services; a comprehensive clinical, cognitive, psychological, and social change for the young people; the involvement of family and caregivers. Within the framework of transition and chronicity during the developmental age, we selected international papers explaining models which agreed on some important steps in the transition process, although many differences can be observed between different countries. In fact, in Europe, the situation appears to be heterogeneous as regards certain aspects: the written transition plan, the educational programmes, the timing of transfer to adult services, the presence of a transition coordinator, a dedicated off-site transition clinic. We then analyzed some studies focusing on patients with renal diseases, including the first to contain a standardized protocol for transition which was launched recently in the USA, and which seems to have already achieved important positive, although limited, results. In Italy, the issue of transition is still in its infancy, however important efforts in the management of chronic kidney disease have already been initiated in some regions, including Emila Romagna, which gives us hope for the future of many young people

Impact behavior of sandwich structures made of flax/epoxy face sheets and agglomerated cork

The unremitting quest of natural and renewable materials able to replace their synthetic counterparts in high-performance applications has involved also sandwich structures. In this regard, the aim of this work is to characterize the impact response, in both high- and low-velocity conditions, of green sandwich structures made of agglomerated cork as core and flax/epoxy laminates as face sheets. Both bare cork, flax skins, and complete sandwich structures were subjected to impacts at three different energy levels representing the 25%, 50%, and 75% of the respective perforation thresholds. A gas gun was instead used to assess the high-velocity impact behavior of these green sandwich structures and evaluate their ballistic limit. This study shows that the buckling of cell walls of agglomerated cork enables to tailor the damage extension through-the-thickness in low-velocity impacts compared to traditional synthetic foams coupled with a considerable amount of energy absorption

Does an antibiotic-loaded hydrogel coating reduce early post-surgical infection after joint arthroplasty?

Background: Infection remains among the main reasons for joint prosthesis failure. Preclinical reports have suggested that antibacterial coatings of implants may prevent bacterial adhesion and biofilm formation. This study presents the results of the first clinical trial on an antibiotic-loaded fast-resorbable hydrogel coating (Defensive Antibacterial Coating, DAC®) in patients undergoing hip or knee prosthesis. Methods: In this multicenter, randomized prospective study, a total of 380 patients, scheduled to undergo primary (n=270) or revision (n=110) total hip (N=298) or knee (N=82) joint replacement with a cementless or a hybrid implant, were randomly assigned, in six European orthopedic centers, to receive an implant either with the antibiotic-loaded DAC coating (treatment group) or without coating (control group). Pre- and postoperative assessment of clinical scores, wound healing, laboratory tests, and x-ray exams were performed at fixed time intervals. Results: Overall, 373 patients were available at a mean follow-up of 14.5 ± 5.5 months (range 6 to 24). On average, wound healing, laboratory and radiographic findings showed no significant difference between the two groups. Eleven early surgical site infections were observed in the control group and only one in the treatment group (6% vs. 0.6%; p=0.003). No local or systemic side effects related to the DAC hydrogel coating were observed, and no detectable interference with implant osteointegration was noted. Conclusions: The use of a fast-resorbable, antibiotic-loaded hydrogel implant coating can reduce the rate of early surgical site infections, without any detectable adverse events or side effects after hip or knee joint replacement with a cementless or hybrid implant