First trimester diagnosis of iniencephaly associated with fetal malformations and trisomy 18: Report of a new case and gene analysis on folate metabolism in parents

ABSTRACT  Iniencephaly is a rare congenital malformation consisting of a complex alteration of the embryonic development occurring around the third post‐fertilization week and characterized by a hyper‐retroflexion of the cephalic pole. We report a case of iniencephaly associated with acrania‐encephalocele, spina bifida and abnormal ductus venosus in a fetus with trisomy 18 diagnosed at 12 week's gestation in a 41‐year‐old woman. A co‐occurrence between aneuploidy and iniencephaly was documented and polymorphisms on folate metabolism‐related genes were investigated in the parents to assess possible etiologic factors and recurrence risk for neural tube defects (NTD). An homozygous state for the MTRR polymorphism was diagnosed in the mother, identifying a clinical risk for NTD. Once iniencephaly or any other NTD are suspected, genetic analysis, second level ultrasound and fetal karyotype are recommended. Autopsy should also be performed in all cases of early ultrasound‐based diagnosis of fetal malformations

Temporomandibular joint involvement in patients with Juvenile Idiopathic Arthritis: comparison of ultrasonography and magnetic resonance imaging in assessing the periarticular space width

ObjectivesThis study aimed to compare the performance of Ultrasonography (US) and Magnetic Resonance Imaging (MRI) in assessing the Lateral Periarticular Space (LPAS) of Temporomandibular Joints (TMJs) in patients with Juvenile Idiopathic Arthritis (JIA).MethodsThe LPAS width was evaluated in two different patient groups. In the JIA group, including 29 children (13 & PLUSMN; 2.8 years) with JIA, the LPAS width was measured with both MRI and US. In the healthy group, including 28 healthy children (12.6 & PLUSMN; 2.5 years), the LPAS width was measured only with US. Comparisons of LPAS width based on patient groups and TMJ contrast enhancement in MRI were evaluated by applying the Mann-Whitney U test. Correlation and agreement between MRI and US measurements in JIA group were tested using Spearman rank correlation and Bland-Altman method.ResultsThe LPAS width was significantly greater in the JIA group than in the healthy group. In the JIA group, the LPAS width was significantly greater in TMJs with moderate/severe enhancement than those with mild enhancement. A positive significant correlation between MRI and US measurements of LPAS width was found in the JIA group. In the same group, Bland-Altman method showed a good level of agreement between MRI and US measurements.ConclusionAlthough, US cannot replace MRI in the evaluation of TMJ in patients with JIA, US could be used as a supplementary imaging method to MRI in assessing the TMJ disease

Condylar asymmetry in patients with juvenile idiopathic arthritis: Could it be a sign of a possible temporomandibular joints involvement?

OBJECTIVES: The aim of the study was to evaluate the condylar and ramal asymmetry of the mandible in patients with juvenile idiopathic arthritis (JIA) using orthopantomographies (OPTs). METHODS: A total of 30 JIA patients with confirmed diagnosis of JIA and a routine OPT, seeking for orthodontic therapy, free of specific symptoms of temporomandibular joint involvement, and 30 normal matched subjects with OPT were comprised in the study. The method of Habets et al. was used to compare the condyles and rami in OPT. The significance of between-group differences were assessed using Mann-Whitney test. RESULTS: The results showed a high significant difference in the range of asymmetry of the condyle, being the patient group highly asymmetrical (P < 0.0001). No differences were found in the range of asymmetry of the ramus between groups (P = 0.47). The intra-group comparison between males and females showed a difference in the patient group (P = 0.04), being the females more asymmetric. CONCLUSIONS: Knowing that the temporomandibular joint (TMJ) is highly susceptible to inflammatory alterations during growth, even in absence of symptomatology, and being the OPT a cost-benefit favorable imaging tool widespread in the dental field, the latter could be used as a first screening examination in JIA patients to calculate the condylar asymmetry index. The use of this screening tool will help the physicians in addressing the patients that should undergo a more detailed TMJ imaging to early detect TMJ abnormalities and to early set up a targeted therapy of the related cranial growth alteration

Soil Biological Quality Assessment to Improve Decision Support in the Wine Sector

Biodiversity is an increasingly important aspect of wine production. The assessment of agro-ecosystem biodiversity is highly complex due to the heterogeneity of the elements involved in the evaluation. For this reason, wine companies have expressed a need for a decision support system (DSS) capable of dealing with this complexity, integrating assessments referring to the whole production system within a single tool. In this study a DSS developed for wine sector biodiversity management assessment is introduced. The DSS, called BIOPASS®, is made up of different sections relating to three compartments in the winemaking process (the soil, the vine and wine). Assessment of the physical, chemical and biological components of soil is a key element of the DSS. We investigate the relationship between biological soil quality (represented by the QBS-ar index), environmental conditions and the type of farming (organic or conventional). 70 soil samples were analysed in different Italian viticultural contexts. The model highlighted the relationships between QBS-ar and meteorological variables (air temperature and precipitation) as well as a positive relationship with organic farming systems. These results provide useful information for understanding agroecosystem biodiversity and will be integrated within the DSS for assessment of soil quality

2D vs. 3D Radiological Methods for Dental Age Determination around 18 Years: A Systematic Review

The age of a living human being can be determined by applying a number of dierent methods; the most diused are skeletal and dental methods, both principally based on X-rays examinations. This systematic review assesses the current evidence regarding the accuracy and reliability of Cone Beam Computed Tomography (CBCT) vs. Orthopantomography (OPG) in age determination. A computerized systematic literature search of studies published up to January 2020 was conducted without language restrictions in order to identify articles comparing CBCT vs. OPG in dental anatomy evaluation, articles evaluating the accuracy of dental methods for age estimation, both with CT andOPG exams, and articles comparing CBCT vs. OPG in terms of radiation dose. CBCT was found to be more accurate compared to OPG in dental anatomy evaluation. When analyzing young adults, an estimation error of two years is considered forensically acceptable. The radiation dose of a CBCT exam is higher compared to an OPG exam. However, the dierence is not as marked with small Fields Of View (FOV) and low-resolution protocols. Final conclusion was that a small FOV CBCT centered on the mandibular angle of a young patient is an accurate and safe method for dental age estimation around the age of 18

Evaluation of a Digital Protocol for Pre-Surgical Orthopedic Treatment of Cleft Lip and Palate in Newborn Patients: A Pilot Study

The aim of this study was to evaluate the accuracy, invasiveness and impact on clinical results of a digital oral impression protocol in the pre-surgical orthopedic treatment (PSOT) of newborn cleft lip and palate (CLP) patients undergoing primary alveolar surgical repair. Six patients were divided, according to impression technique used, into a digital (intraoral scanner (IOS)) and a non-digital (tray and putty (T&P)) group. Parents considered IOS impressions to be less invasive, compared to T&P impressions. The clinician that took all the impressions considered the IOS to be less stressful compared to the T&P method. In two T&P patients, the impression was repeated because some important anatomical details were missing, in one case due to patient regurgitation during the first attempt. No impression was repeated, and any adverse event was reported in the IOS group. There were no significant differences between these two protocols in pre-surgical alveolar gap reduction and surgical challenge. The study results indicate that this digital protocol can accelerate the production process of the passive molding plate with an instantaneous transmission of the digital impression to the dental lab, maintaining the same accuracy level and clinical outcomes of classical techniques and reducing the invasiveness of impression taking, avoiding any risk of impression material ingestion or inhalation

Reliability analysis of riverbank stability accounting for the intrinsic variability of unsaturated soil parameters

The paper presents a probabilistic study aimed at investigating the role of the soil hydraulic response on the stability of existing riverbanks, for which the uncertainty and the inherent variability of geotechnical and hydraulic properties are typically greater when compared to new flood defence structures. The study has been carried out with reference to a specific, thoroughly investigated 20 m-long segment of the river Secchia banks (northern Italy), which experienced a catastrophic sudden failure after a period of intense rainfall, in January 2014. By taking such well-documented case as a base, the proposed probabilistic analyses consider three key aspects, typically disregarded in routine risk assessment procedures: i) transient seepage flow through earth structures due to time dependent hydraulic loads, ii) unsaturated conditions of soils forming the riverbank, iii) uncertainty of the soil model parameters, with special emphasis placed on the impact of intrinsic variability of unsaturated soil parameters. The numerical results, obtained from the application of the Point Estimate Method, allow identifying the crucial role of suction distribution on the probability of failure of the riverbank slopes and clearly show that such probability can be significantly underestimated when the variability of hydraulic parameters is neglected

Impact of Environmental Conditions and Management on Soil Arthropod Communities in Vineyard Ecosystems

The importance of soil biodiversity and soil-based ecosystem services in the context of viticulture has recently been emphasized. Over 85% of soil fauna species richness is represented by edaphic arthropod communities. Edaphic arthropod responses to soil characteristics and management practices can be considered as good bioindicators of soil quality. Here, 168 soil samples that were collected from 2014 to 2019 in several vineyards of different Italian wine-growing areas were analyzed to explore how arthropod communities respond to several factors that are characteristic of vineyard ecosystems. The analysis of the combined effects of the primary abiotic variables (the chemical and physical characteristics of soil) and management practices (organic vs. conventional, soil inter-row management) on soil biological quality (assessed by QBS-ar index) identified soil temperature and soil texture as the abiotic factors exerting the most significant effect on the QBS-ar values. Organic vineyards exhibited higher QBS-ar values compared to those of conventionally managed vineyards, and subsoiling negatively influenced the soil biological quality

PROBABILIT\uc0 DI COLLASSO DI UN TRATTO DI ARGINE MAESTRO DEL FIUME PO

La rottura dell\u2019argine di un grande fiume come il Po con la conseguente formazione di una breccia \ue8 un fenomeno non trascurabile che deve essere messo in conto per una stima corretta del rischio idraulico. La metodologia di analisi presentata, applicata ad un tratto di argine maestro in sponda destra del fiume Po, prevede che l\u2019analisi della probabilit\ue0 di collasso di una sezione d\u2019argine avvenga attraverso la determinazione delle curve di fragilit\ue0 al variare dell\u2019altezza idraulica del fiume. I principali meccanismi di collasso analizzati sono sormonto, erosione interna, scour, instabilit\ue0 delle scarpate, filtrazione sotto l\u2019argine e liquefazione. La stima della probabilit\ue0 di collasso \ue8 eseguita con metodo di Taylor (FOSM) e/o con il metodo MonteCarlo (MC). \uc8 quindi proposta una procedura semplificata per determinare la curva di fragilit\ue0 composta di un tratto di argine omogeneo, assumendo come variabile aleatoria indipendente la portata del corso d\u2019acqu