Expanding the Scope of the AuNP Toolbox: Development of Interfacial oNQM Photoclick Reaction and Large AuNP Templates

In recent decades, gold nanoparticles (AuNPs) have been pushed to the forefront of nanomaterial research because of unique size-dependent physical, chemical and biological properties. As a result, proper surface functionalization would enable control over these desirable properties for potential applications in biomedicine, electronics or catalysis. Over the past few years, the Workentin research group has developed a toolbox of sophisticated methods for the functionalization of small (1-5 nm) AuNP systems by designing functional AuNP templates. These templates are easy to synthesize and can be used to effectively incorporate functionality on the AuNP surface using click and bioorthogonal interfacial chemistry. In this thesis I present the development of a novel ortho-naphthoquinone methide (oNQM) modified AuNP template that will allow for unprecedented photochemical spatial and temporal control of reactivity. I also present the first steps towards the development of an innovative large AuNP (\u3e 10 nm) template to expand the scope of interfacial functionalization and exploit their interesting optical properties

Comparison of a Minimally Invasive Tissue-Sparing Posterior Superior (TSPS) Approach and the Standard Posterior Approach for Hip Replacement

Purpose. The purpose of this study is to compare the functional and clinical outcomes, blood loss, complication rate, and hospital length of stay (LOS) of total hip replacement (THR) using a minimally invasive tissue-sparing posterior superior (TSPS) approach and the standard posterior approach. Materials and Methods. This retrospective, observational, double-centered study included 38 patients undergoing hip replacement. The patents were divided into two groups: control group (19 patients), who underwent surgery with the standard posterior approach, and treatment group (19 patients), who received the same type of implant with ceramic-on-ceramic bearing via the TSPS approach. Hemoglobin level was assessed preoperatively, on first and second postoperative days, and on discharge day. Harris hip score and Western Ontario and McMaster Universities Arthritis Index were used to measure the clinical and functional outcomes. Hospital LOS and incidence of early and late complications were assessed in both groups. Postoperative anteroposterior pelvis X-ray was performed to assess the correct positioning of implants. Results. Better early clinical outcomes (p=0.0155), lesser blood loss (p < 0.0001), and reduced hospital LOS (p < 0.0001) were observed in the TSPS group than in the control group. No major adverse effects occurred in both groups, and a satisfactory implant orientation was achieved in all patients. Conclusions. The TSPS approach is a reliable minimally invasive procedure for THR as it allows an accurate orientation of the components and provides better early postoperative functional outcomes, faster recovery, significantly lower blood loss, and shorter hospital LOS than the standard posterior approach. However, further research is needed to confirm the promising results and cost-effectiveness of the TSPS approach in larger cohorts with a longer follow-up period

Relationship of Serum Fetuin-A Levels with Coronary Atherosclerotic Burden and NAFLD in Patients Undergoing Elective Coronary Angiography

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The experience of setting up a resident-managed Acute Pain Service: A descriptive study

BACKGROUND: The benefits of an Acute Pain Service (APS) for pain management have been widely reported, but its diffusion is still limited. There are two APS models: anesthesiologist-based and a nurse-based model. Here we describe the development of a different APS model managed by anesthesia residents, and we report the first year of activity in a tertiary Italian university hospital (Careggi University Hospital, Florence, IT). METHODS: Patients were included in the APS were those undergoing abdominal and urologic surgery causing moderate or severe postsurgical pain. The service was provided for patients, beginning upon their exit from the operating room, for 4, 12, 24 and 48 h for iv, and up to 72 h for epidural therapy. Vital signs, static/dynamic VAS, presence of nausea/vomiting, sedation level, and Bromage scale in case of epidural catheter, were monitored. RESULTS: From September 2013 to April 2015, a total of 1054 patients who underwent major surgery were included in the APS: 542 from abdominal surgery and 512 from urological surgery. PCA and epidural analgesia were more adopted in general surgical patients than in urology (48 % vs 36 % and 15 % vs 2 %, respectively; P < 0.0001). Patients who underwent to abdominal surgery had a significantly higher self-administration of morphine (30.3 vs 22.7 mg; P = 0.0315). Elastomeric pump was the analgesic of choice in half of the urologic patients compared to a quarter of the general surgical patients (P < 0.0001). Among the different surgical techniques, epidural analgesia was used more in open (16.5 %) than in videolaparoscopic (1.9 %) and robotic technique (1.1 %), whereas PCA was predominant in videolaparoscopic (46.5 %) and robotic technique (55.5 %) than in open technique (31.4 %). CONCLUSIONS: The creation of APS, managed by anesthesia residents, may represent an alternative between specialist-based and nurse-based models

Capacitive actuation and switching of add\u2013drop graphene-silicon micro-ring filters

We propose and experimentally demonstrate capacitive actuation of a graphene\u2013silicon micro-ring add/drop filter. The mechanism is based on a silicon\u2013SiO2\u2013graphene capacitor on top of the ring waveguide. We show the capacitive actuation of the add/drop functionality by a voltage-driven change of the graphene optical absorption. The proposed capacitive solution overcomes the need for continuous heating to keep tuned the filter\u2019s in/out resonance and therefore eliminates \u201cin operation\u201d energy consumption

Integration of III-V light sources on a silicon photonics circuits by transfer printing

We report on the integration by transfer printing of III-V Fabry-Perot cavities on a silicon photonic circuit. We pre-process the III-V coupons on their native substrate, transfer print onto the target SOI, and post-process the printed coupons. We report light coupling into the photonic circuit

Variability analysis of muscle activation symmetry to identify indicators of individual motor strategy: a case series on elite Paralympic powerlifters

IntroductionIn Paralympic powerlifting competitions, movement execution symmetry is a technical requirement influenced by individual athlete characteristics and motor strategies. Identifying the elements associated with individual motor strategies can offer valuable insight for improving sport performance. Therefore, this case series study aimed to explore muscle activation symmetry and its intra- and inter-individual variability to determine the muscles mostly related to individual motor strategies in elite Paralympic powerlifters.MethodsBilateral electromyographic activation of the anterior deltoid (AD), pectoralis major (PM), latissimus dorsi (LD), triceps (TRI) and external oblique (EO) muscles were analysed in five elite Paralympic powerlifters while performing four sets of one-repetition maximum of Paralympic bench press. Muscle activation symmetry indexes (SI) were obtained and transformed to consider individual-independent evaluation. The coefficient of variation (CV), variance ratio (VR), and mean deviation (MD) were computed to assess inter- and intra-individual variability in electromyographic waveforms and SI.ResultsBoth transformed and non-transformed SI indicated overall symmetric activation in DA, PM, TRI, and LD. Transformed SI revealed asymmetrical muscle activation of EO when grouping data (mean bilateral difference: 10%). Athletes exhibited low intra-individual SI variability in all analysed muscles (CV &lt; 10%) and low inter-individual variability in DA, PM, LD, and TRI (CV &lt; 10%; VR: 4%–11%; MD: 29%–43%). In contrast, higher inter-individual variability was observed in EO (CV: 23%; VR: 23%; MD: 72%–81%).ConclusionThe highest variability and asymmetry in abdominal muscle activation among athletes emphasize the importance of personalized training approaches for targeting these muscles due to their role in individualizing motor strategies

A machine-learning based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease

Background: Mechanisms of myocardial ischemia in obstructive and non-obstructive coronary artery disease (CAD), and the interplay between clinical, functional, biological and psycho-social features, are still far to be fully elucidated. Objectives: To develop a machine-learning (ML) model for the supervised prediction of obstructive versus non-obstructive CAD. Methods: From the EVA study, we analysed adults hospitalized for IHD undergoing conventional coronary angiography (CCA). Non-obstructive CAD was defined by a stenosis &lt; 50% in one or more vessels. Baseline clinical and psycho-socio-cultural characteristics were used for computing a Rockwood and Mitnitski frailty index, and a gender score according to GENESIS-PRAXY methodology. Serum concentration of inflammatory cytokines was measured with a multiplex flow cytometry assay. Through an XGBoost classifier combined with an explainable artificial intelligence tool (SHAP), we identified the most influential features in discriminating obstructive versus non-obstructive CAD. Results: Among the overall EVA cohort (n = 509), 311 individuals (mean age 67 ± 11&nbsp;years, 38% females; 67% obstructive CAD) with complete data were analysed. The ML-based model (83% accuracy and 87% precision) showed that while obstructive CAD was associated with higher frailty index, older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was associated with a higher gender score (i.e., social characteristics traditionally ascribed to women) and with a cytokine signature characterized by IL-18, IL-8, IL-23. Conclusions: Integrating clinical, biological, and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of these associations. Clinical trial registration: NCT02737982

Bacterial and Viral Infections in Liver Transplantation: New Insights from Clinical and Surgical Perspectives

End-stage liver disease patients undergoing liver transplantation are prone to develop numerous infectious complications because of immunosuppression, surgical interventions, and malnutrition. Infections in transplant recipients account for the main cause of mortality and morbidity with rates of up to 80%. The challenges faced in the early post-transplant period tend to be linked to transplant procedures and nosocomial infections commonly in bloodstream, surgical, and intra-abdominal sites. Viral infections represent an additional complication of immunosuppression; they can be donor-derived, reactivated from a latent virus, nosocomial or community-acquired. Bacterial and viral infections in solid organ transplantation are managed by prophylaxis, multi-drug resistant screening, risk assessment, vaccination, infection control and antimicrobial stewardship. The aim of this review was to discuss the epidemiology of bacterial and viral infections in liver transplants, infection control issues, as well as surgical frontiers of ex situ liver perfusion