The application of structural retinal biomarkers to evaluate the effect of intravitreal ranibizumab and dexamethasone intravitreal implant on treatment of diabetic macular edema

Background: The aim of this study was to compare the therapeutic effect of intravitreal treatment with ranibizumab and dexamethasone using specific swept-source optical coherence tomography retinal biomarkers in patients with diabetic macular edema (DME). Methods: 156 treatment-naïve patients with DME were divided in two groups: 75 patients received 3 monthly intravitreal injections of ranibizumab 0.5 mg (Lucentis®) (Group 1) and 81 patients received an intravitreal implant of dexamethasone 0.7 mg (Ozurdex®) (Group 2). Patients were evaluated at baseline (V1), at three months post-treatment in Group 1, and at two months post-treatment in Group 2 (V2). Best-corrected visual acuity (BCVA) and swept source-OCT were recorded at each interval. Changes between V1 and V2 were analyzed using the Wilcoxon test and differences between the two groups of treatment were assessed using the Mann-Whitney test. Multiple regression analysis was performed to evaluate the possible OCT biomarker (CRT, ICR, CT, SND, HRS) as predictive factors for final visual acuity improvement. Results: In both groups, BCVA improved (p-value < 0.0001), and a significant reduction in central retinal thickness, intra-retinal cysts, red dots, hyper-reflective spots (HRS), and serous detachment of neuro-epithelium (SDN) was observed. A superiority of dexamethasone over ranibizumab in reducing the SDN height (p-value = 0.03) and HRS (p-value = 0.01) was documented. Conclusions: Ranibizumab and dexamethasone are effective in the treatment of DME, as demonstrated by functional improvement and morphological biomarker change. DME associated with SDN and HRS represents a specific inflammatory pattern for which dexamethasone appears to be more effective

Perinatal Depression and Anxiety Symptoms, Parental Bonding and Dyadic Sensitivity in Mother–Baby Interactions at Three Months Post-Partum

The quality of the early parent-infant relationship is crucial for the child's optimal development, and parental sensitivity plays a key role in early interactions. The purpose of the study was to evaluate the influence of maternal perinatal depression and anxiety symptoms on dyadic sensitivity at three months post-partum, also considering a large set of maternal and infant variables. At the third trimester of pregnancy (T1) and at three months postpartum (T2), 43 primiparous women filled in a set of questionnaires evaluating symptoms of depression (CES-D) or anxiety (STAI), the woman's parental bonding experiences (PBI), alexithymia (TAS-20), maternal attachment to the baby (PAI, MPAS) and the perceived social support (MSPSS). At T2 mothers also completed a questionnaire on infant temperament and took part in the CARE-Index videotaped procedure. Dyadic sensitivity was predicted by higher maternal trait anxiety scores in pregnancy. In addition, the mother's experience of being cared for by her father in childhood was predictive of her infant's lower compulsivity, while paternal overprotection predicted higher unresponsiveness. The results highlight the influence of perinatal maternal psychological well-being and maternal childhood experiences on the quality of the dyadic relationship. The results may be useful to foster mother-child adjustment during the perinatal period

COVID-19 and Seasonal Influenza Vaccination: Cross-Protection, Co-Administration, Combination Vaccines, and Hesitancy

SARS-CoV-2 and influenza are the main respiratory viruses for which effective vaccines are currently available. Strategies in which COVID-19 and influenza vaccines are administered simultaneously or combined into a single preparation are advantageous and may increase vaccination uptake. Here, we comprehensively review the available evidence on COVID-19/influenza vaccine coadministration and combination vaccine candidates from the standpoints of safety, immunogenicity, efficacy, policy and public acceptance. While several observational studies have shown that the trained immunity induced by influenza vaccines can protect against some COVID-19-related endpoints, it is not yet understood whether co-administration or combination vaccines can exert additive effects on relevant outcomes. In randomized controlled trials, co-administration has proved safe, with a reactogenicity profile similar to that of either vaccine administered alone. From the immunogenicity standpoint, the immune response towards four influenza strains and the SARS-CoV-2 spike protein in co-administration groups is generally non-inferior to that seen in groups receiving either vaccine alone. Several public health authorities have advocated co-administration. Different combination vaccine candidates are in (pre)-clinical development. The hesitancy towards vaccine co-administration or combination vaccines is a multifaceted phenomenon and may be higher than the acceptance of either vaccine administered separately. Public health implications are discussed

Early myocardial damage and microvascular dysfunction in asymptomatic patients with systemic sclerosis: A cardiovascular magnetic resonance study with cold pressor test

Purpose: Cardiac involvement in Systemic Sclerosis (SSc) is increasingly recognized as a mayor cause of morbidity and mortality. The aim of present study is to investigate the early stages of cardiac involvement in SSc by Cardiovascular magnetic resonance (CMR), combining the non-invasive detection of myocardial inflammation and fibrosis using T2 and T1 mapping techniques and the assessment of microcirculatory impairment through perfusion response to cold pressor test (CPT). Methods: 40 SSc patients (30 females, mean age: 42.1 years) without cardiac symptoms and 10 controls underwent CMR at 1.5 T unit. CMR protocol included: native and contrast-enhanced T1 mapping, T2 mapping, T2-weighted, cineMR and late gadolinium enhancement (LGE) imaging. Microvascular function was evaluated by comparing myocardial blood flow (MBF) on perfusion imaging acquired at rest and after CPT. Native myocardial T1 and T2 relaxation times, extracellular volume fraction (ECV), T2 signal intensity ratio, biventricular volumes and LGE were assessed in each patient. Results: SSc patients had significantly higher mean myocardial T1 (1029±32ms vs. 985±18ms, p<0.01), ECV (30.1±4.3% vs. 26.7±2.4%, p<0.05) and T2 (50.1±2.8ms vs. 47±1.5ms, p<0.01) values compared with controls. No significant differences were found between absolute MBF values at rest and after CPT; whereas lower MBF variation after CPT was observed in SSc patients (+33 ± 14% vs. +44 ± 12%, p<0.01). MBF variation had inverse correlation with native T1 values (r: -0.32, p<0.05), but not with ECV. Conclusions: Myocardial involvement in SSc at preclinical stage increases native T1, T2 and ECV values, reflecting inflammation and fibrosis, and reduces vasodilatory response to CPT, as expression of microvascular dysfunction

Does transperineal ultrasound predict the risk of perineal trauma in women with term pregnancy? A prospective observational study

Purpose: This study was conducted to evaluate the prevalence of perineal trauma during childbirth and to assess the correlations of the pelvic floor dimensions and fetal head station with obstetric trauma in a prospectively recruited cohort of women. Methods: The study included women with a gestational age of at least 37 weeks, who were carrying a single fetus in a cephalic presentation. Transperineal ultrasound (TPU) was performed prior to the onset of labor or labor induction. The purpose was to measure the anteroposterior diameter (APD) of the levator ani muscle (LAM) and the angle of progression, at both rest and maximum Valsalva maneuver. The head-perineum distance was assessed only at rest. Results: A total of 296 women were included. Of the 253 women who delivered vaginally, 19.0% (48/253) experienced no perineal trauma, 18.2% (46/253) received an episiotomy during childbirth, 34.4% (87/253) sustained a first-degree laceration, 25.3% (64/253) had a second-degree laceration, and 3.2% had a third-or fourth-degree laceration (8/253). Women with episiotomy had a significantly shorter median APD under Valsalva than women without perineal trauma. Furthermore, women with LAM coactivation (identified by a negative difference between the APD at Valsalva and the APD at rest) were approximately three times more likely to undergo an operative vaginal delivery and over five times more likely to sustain a third-or fourth-degree tear during childbirth than women who exhibited normal relaxation of the LAM during the Valsalva maneuver. Conclusion: TPU may predict the risk of perineal trauma in women with term pregnancy during childbirth

Improving pre-operative planning of robot assisted nephron sparing surgery using three-dimensional anatomical model

Introduction Despite the introduction of robot-assisted surgery in daily clinical practice, complex renal masses are still challenging even for expert surgeon. In this scenario 3D anatomical models and augmented reality represent valuable tools for the surgeon. Materials and methods We present a challenging case where PN was mandatory to preserve the overall renal function. The patient was 69 years old, with indwelling catheter for BPH and Parkinson disease. After a single episode of hematuria with negative cystoscopy, a cT1N0M0 renal cancer was diagnosed (38 mm maximum diameter). Pre-operative three-dimensional (3D) model was obtained. After multidisciplinary discussion robot-assisted partial nephrectomy was proposed. The surgery was planned according to the anatomical model. Results Before the procedure a 7Ch single loop ureteral stent was placed. The surgery was carried out in 220 minutes. Selective ischaemia was perfomed for 24 minutes. Estimated blood loss was 400cc. No post-operative complications were observed. Ureteral stent was removed 4 days after the surgery. Definitive histological examination described a pG2-3 T1a Nx R0 clear cell renal carcinoma. Conclusion In selected cases 3D model result to be a useful tool for the pre-operative planning of the surgery

Implantation of a Poly-L-Lactide GCSF-Functionalized Scaffold in a Model of Chronic Myocardial Infarction

A previously developed poly-L-lactide scaffold re- leasing granulocyte colony-stimulating factor (PLLA/GCSF) was tested in a rabbit chronic model of myocardial infarction (MI) as a ventricular patch. Control groups were constituted by healthy, chronic MI and nonfunctionalized PLLA scaffold. PLLA-based electrospun scaffold efficiently integrated into a chronic infarcted myocardium. Functionalization of the bio- polymer with GCSF led to increased fibroblast-like vimentin- positive cellular colonization and reduced inflammatory cell infiltration within the micrometric fiber mesh in comparison to nonfunctionalized scaffold; PLLA/GCSF polymer induced an angiogenetic process with a statistically significant increase in the number of neovessels compared to the nonfunctionalized scaffold; PLLA/GCSF implanted at the infarcted zone induced a reorganization of the ECM architecture leading to connective tissue deposition and scar remodeling. These findings were coupled with a reduction in end-systolic and end-diastolic vol- umes, indicating a preventive effect of the scaffold on ventricu- lar dilation, and an improvement in cardiac performance

Ion uptake and YSL1 gene identification in tomato

Tomato breeder are using wild tomato relatives, even non-cross compatibles ones, in order to obtain cultivars with highly commercial values bearing new traits. However, the introgression of a wild genome into the cultivated one produces a new gene combinations that may lead to the expression of undeliverable traits, perhaps not so easy to recognise; even more, phenotypic variations may escape during the selection procedure when minor genes or non-abnormal phenotypes are involved. In the frame of the “GenoPom” project funded by MIUR, we have focused our interest on the alteration of heavy metals uptake from the soil and their loading into edible organs in commercial lines coming from Solanum interspecific crosses. Our final aim is to put together data coming from ion homeostasis and gene expression analyses, thus obtaining a ionomic map of tomato. To pursue our goal, we have started to study the cv M82 of Solanum lycopersicon, the wild relative Solanum pennelli and their introgression lines IL. Regarding the experiments on ion homeostasis, S. lycopersicon M82 and the introgression line IL 6-4-2 were grown in hydroponics under controlled environmental conditions. Twenty day-old plants were left to grow for 10 days in the presence of non-toxic concentration of Cd (10 mM), Pb (3 mM), Zn (100 mM) given separately or combined. Control and treated roots and leaves were then harvested and stored at -80°C for ionic and gene expression analyses. Ions analysis of Solanum lycopersicon M82 and IL 6-4-2 showed that traits correlated to ionic homeostasis is significantly modified in response to all metals and to the genotype. The analysis of ions data, obtained by ICP-MS, give a pictures of the different responses performed both to different stress and to combined stress, probably correlated to the up-regulation and/or down regulation of metal uptake proteins. Performed experiments demonstrate that the introgression of the wild genome into the cultivated one produces a new phenotype, perhaps due to the expression of traits linked to uptake, translocation and accumulation of useful and/or toxic metal into plant tissues and organs. Regarding the functional genomics approach for gaining insight into gene networks involved in mineral-ion accumulation in tomato plants, in literature has been reported that at least 25 major family genes are involved for metal homeostasis in plants. Among them, the genes ysl, hma, mtp, znt, zrt have been already studied at least in the plant species Arabidopsis thaliana, A. halleri and Thlaspi caerulescens. So far, no such genes have been reported to be cloned in Solanum species. We have focused our study on the genes YSL1, ZNT1 and MTP1 responsible for uptake, translocation and accumulation of metal such as zinc, cadmium, and iron into plant compartment. For all of them, consensous sequences from nucleotide multialignment have been obtained. Then, each of those were blasted in a Solanum EST collection databank and an assembled UniGene sequence was obtained.. Finally, we have designed primers and performed PCR analysis on S. lycopersicon and S. pennelli genomic DNA. So far, we have cloned a putative ysl1 sequence from tomato, that has shown that a very high percentage of identity (92%) with whole ysl1 gene of Nicotiana tabacum; the in silico translated sequence of this sequence has shown a 89% of identity with the same tobacco protein

Oximetry: a new non-invasive method to detect metabolic effects induced by a local application of mechanical vibration

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Rifampicin-loaded electrospun polycaprolactone membranes: Characterization of stability, antibacterial effects and urotheliocytes proliferation

Pathological conditions such as infections, cancer, inflammation, or iatrogenic lesions, can hinder the cor-rect functionality of the ureter and its structural integrity. Several strategies for the regeneration of the ureter and the restoration of its functionality are available but the best strategy has not been reached yet. Among the proposed strategies, a promising one is the development of tubular scaffolds, in particular exploiting electrospinning technique. In this work, antibacterial electrospun polycaprolactone/rifampicin (PCL/Rif) membranes were prepared and characterized. The membranes are characterized by randomly oriented nanofibers with a homogeneous diameter, as determined by scanning electron microscopy. The mechanical characterization, performed with uniaxial tensile tests, showed a suitable stability over time and a proper deformability. The rifampicin release, investigated by UV spectrophotometry, showed a burst release in the first part of the experiment and a sustained release over time. The membranes are biocompatible and able to support the adhesion and proliferation of urotheliocytes. Moreover, PCL/Rif membranes showed an antibacterial activity against Escherichia coli and other bacterial strains belonging to the "ESKAPE" group. Considering the possibility to use the electrospinning for the production of tubu-lar scaffolds, the described membranes represent a promising starting point for the preparation of uret-eral scaffolds with antibacterial properties.(c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)