Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology

Case-control studies on malignant sinonasal tumors and occupational risk factors are generally weakened by non-occupational confounders and the selection of suitable controls. This study aimed to confirm the association between sinonasal malignant tumors and patients' occupations with consideration for sinonasal inverted papillomas (SNIPs) as a control group. Thirty-two patients affected by adenocarcinoma (ADC) and 21 non-adenocarcinoma epithelial tumors (NAETs) were compared to 65 patients diagnosed with SNIPs. All patients were recruited in the same clinical setting between 2004 and 2016. A questionnaire was used to collect information on non-occupational factors (age, sex, smoking, allergies, and chronic sinusitis) and occupations (wood- and leather-related occupations, textile industry, metal working). Odds ratios (OR) with 95% confidence intervals (CI) associated with selected occupations were obtained by a multinomial and exact logistic regression. Between the three groups of patients, SNIP patients were significantly younger than ADC patients (p = 0.026). The risk of NAET increased in woodworkers (OR = 9.42; CI = 1.94\u207b45.6) and metal workers (OR = 5.65; CI = 1.12\u207b28.6). The risk of ADC increased in wood (OR = 86.3; CI = 15.2\u207b488) and leather workers (OR = 119.4; CI = 11.3\u207b1258). On the exact logistic regression, the OR associated to the textile industry was 9.32 (95%CI = 1.10\u207bInf) for ADC, and 7.21 (95%CI = 0.55\u207bInf) for NAET. Comparing sinonasal malignant tumors with controls recruited from the same clinical setting allowed demonstrating an increased risk associated with multiple occupations. Well-matched samples of cases and controls reduced the confounding bias and increased the strength of the association

Flashback analysis and avoidance in swirl burners

This study is aimed to investigate and demonstrate the feasibility and validity of various flame flashback resistance techniques for premixed fuel conditions. It presents a series of experiments to determine the impact of different configurations on flame flashback mechanisms. Experiments were performed using a 150 kW tangential swirl burner working on premixed mode with various swirl numbers; the flow field characteristics were measured by 1D LDA. The first part of the project targeted the effect of central fuel injector geometries on flame flashback mechanisms, especially combustion induced vortex breakdown (CIVB). It was found that changing the central fuel injector outside diameter can significantly alter the flame flashback mechanism. Large injector diameters result in boundary layer flashback (BLF), contrary, the use of small injectors diameter led to CIVB. Thus a dimensionless number (χ) which represent the ratio between the injector outside diameter and the nozzle inside diameter was introduced. Using this dimensionless number the critical value of transition from CIVB to BLF has been defined, the value being χ= 0.280 for Sg=1.12 and χ= 0.320 for Sg= 0.9. The second part was about the effect of using axial air injection instead of central fuel injectors. It was found that axial air jets have a considerable potential for flame stability requirements, they producing wider stability operation than that of central injectors. Moreover, the stability limits increase regarding both equivalence ratio and inlet tangential velocity. It appeared that using such air jets could reduce the combustor maintenance cost that arises due to a continuous harsh environment. However, it was found that axial air jets could enforce flame propagation during flashback via wall boundary layer. Thus, the third part of the study was about the validity of using micromeshes to improve BLF resistance in addition to axial air injection. It was found that using both techniques produced high flashback resistance for both mechanisms, i.e. CIVB and BLF

Oral ondansetron versus domperidone for acute gastroenteritis in pediatric emergency departments: Multicenter double blind randomized controlled trial

The use of antiemetics for vomiting in acute gastroenteritis in children is still a matter of debate. We conducted a double-blind randomized trial to evaluate whether a single oral dose of ondansetron vs domperidone or placebo improves outcomes in children with gastroenteritis. After failure of initial oral rehydration administration, children aged 1-6 years admitted for gastroenteritis to the pediatric emergency departments of 15 hospitals in Italy were randomized to receive one oral dose of ondansetron (0.15 mg/kg) or domperidone (0.5 mg/kg) or placebo. The primary outcome was the percentage of children receiving nasogastric or intravenous rehydration. A p value of 0.014 was used to indicate statistical significance (and 98.6% CI were calculated) as a result of having carried out two interim analyses. 1,313 children were eligible for the first attempt with oral rehydration solution, which was successful for 832 (63.4%); 356 underwent randomization (the parents of 125 children did not give consent): 118 to placebo, 119 to domperidone, and 119 to ondansetron. Fourteen (11.8%) needed intravenous rehydration in the ondansetron group vs 30 (25.2%) and 34 (28.8%) in the domperidone and placebo groups, respectively. Ondansetron reduced the risk of intravenous rehydration by over 50%, both vs placebo (RR 0.41, 98.6% CI 0.20-0.83) and domperidone (RR 0.47, 98.6% CI 0.23-0.97). No differences for adverse events were seen among groups. In a context of emergency care, 6 out of 10 children aged 1-6 years with vomiting due to gastroenteritis and without severe dehydration can be managed effectively with administration of oral rehydration solution alone. In children who fail oral rehydration, a single oral dose of ondansetron reduces the need for intravenous rehydration and the percentage of children who continue to vomit, thereby facilitating the success of oral rehydration. Domperidone was not effective for the symptomatic treatment of vomiting during acute gastroenteritis

The European Modern Pollen Database (EMPD) project

Modern pollen samples provide an invaluable research tool for helping to interpret the quaternary fossil pollen record, allowing investigation of the relationship between pollen as the proxy and the environmental parameters such as vegetation, land-use, and climate that the pollen proxy represents. The European Modern Pollen Database (EMPD) is a new initiative within the European Pollen Database (EPD) to establish a publicly accessible repository of modern (surface sample) pollen data. This new database will complement the EPD, which at present holds only fossil sedimentary pollen data. The EMPD is freely available online to the scientific community and currently has information on almost 5,000 pollen samples from throughout the Euro-Siberian and Mediterranean regions, contributed by over 40 individuals and research groups. Here we describe how the EMPD was constructed, the various tables and their fields, problems and errors, quality controls, and continuing efforts to improve the available dat

Regenerative Surgery with Dental Implant Rehabilitation in a Haemophiliac Patient

This study aimed to describe the first case of regenerative surgery in haemophiliac implant. Patients with haemophilia often present dental problems. A multidisciplinary approach is suggested in case of dental surgeries to reduce the high bleeding risk. A 41-year-old male patient with mild haemophilia A (FVIII 8.4%), presenting previous epistaxis, noncomplicated tooth extractions and traumatic haemartroses, all treated with single infusions of coagulation factor concentrates, was referred to the dental clinic of the Padua University Hospital based on the recommendation of his attending dentist. At first dental visit the patient reported intense pain in the right lower second molar, with impaired chewing function. After an endodontic unsuccessful treatment the element was judged as no longer recoverable. In agreement with the patient the dental element was then extracted, after a combined administration of recombinant factor VIII 3000 IU (35 IU/kg), and tranexamic acid 1,000 mg. The extraction was performed under local anaesthesia, paraperiosteal and truncular, moderate sedation, elevation of an envelope flap. After extraction, a preservation of the alveolus was carried out with bovine matrix bone graft covered with a resorbable membrane. Three months after the surgery a flapless implant was placed after a single infusion of factor VIII 2000 IU, tranexamic acid 1,000 mg, and a local para-periostal anaesthesia, without any complication. Oral surgeon and haematologist expert in coagulation diseases must therefore collaborate together to define a shared protocol for managing surgery in those patients

Levofloxacin Versus Ciprofloxacin-Based Prophylaxis during the Pre-Engraftment Phase in Allogeneic Hematopoietic Stem Cell Transplant Pediatric Recipients: A Single-Center Retrospective Matched Analysis

Infectious complications are the most common and significant cause of mortality and morbidity after allogeneic hematopoietic stem cell transplantation (HSCT). Antibacterial prophylaxis in pediatric cancer patients is a controversial issue. Our study compared the outcomes of levofloxacin versus ciprofloxacin prophylaxis in allogeneic HSCT pediatric recipients treated for hematological malignancies. A total of 120 patients received levofloxacin prophylaxis, and 60 patients received ciprofloxacin prophylaxis. Baseline characteristics such as age, gender, primary diagnosis, type of conditioning, donor type, stem cell source, and supportive care of the patients were similar, and duration of antibiotics prophylaxis was similar. Both prophylaxis regimens demonstrated the same efficacy on the risk of febrile neutropenia and severe complications such as sepsis, the same rate of overall mortality, hospital readmission, and length of hospital stay. Levofloxacin prophylaxis was associated with significantly lower cumulative antibiotic exposure. The median of Gram-positive infection-related antibiotic days was 10 days in the levofloxacin group versus 25 days in the ciprofloxacin group (p < 0.0001). The median of Gram-negative infection-related antibiotics was 10 days in the levofloxacin group compared with 20 days in the ciprofloxacin group (p < 0.0001). The number of days with body temperature ≥38 °C was significantly less in the levofloxacin group (p < 0.001)

Tumor Diagnosis and Treatment: Imaging Assessment

At present, oncologic imaging is crucial for clinical decision-making [...]

A scale for assessing Italian schools and classes inclusiveness

The paper presents in detail the procedures for developing and validating a tool for assessing the inclusive process pertaining to school contexts called “Inclusive Process Assessment Scale”. The Scale, which is the outcome of the joined work of the authors, sets itself both as an assessing and self-assessing tool, useful for allowing on one hand specific types of evaluation and, on the other, promoting thoughts on inclusive education’s quality indicators, thus contributing to the planning and ongoing adjustment of the educational project of the school and the class. The tool, in its computer version as well, allows for the planning of researches that can collect evidences supporting the full inclusion organization of Italian schools. Una scala per valutare l’inclusività delle scuole e delle classi italiane Il contributo presenta in dettaglio le procedure di costruzione e validazione di uno strumento per valutare i processi inclusivi riferiti ai contesti scolastici, chiamato “Scala di Valutazione dei Processi Inclusivi”. Frutto del lavoro congiunto svolto dagli autori, la Scala si pone come uno strumento valutativo e autovalutativo utile a consentire da un lato, la realizzazione di specifiche forme di misurazione e, dall’altro, la promozione di processi di riflessione sugli indicatori di qualità dell’educazione inclusiva, per contribuire alla progettazione e alla regolazione in itinere del progetto educativo della scuola e della classe. Lo strumento, anche nella sua versione digitale, consente di pianificare ricerche, che possono raccogliere evidenze in grado di avvalorare l’organizzazione scolastica italiana di full inclusion