Enchanted teleidoscopes : multimodal interfaces reframing experience in the museum

University of Technology Sydney. Faculty of Design, Architecture and Building.A teleidoscope is a form of kaleidoscope that has a lens and an open view. It is used to form kaleidoscopic patterns from objects outside the instrument itself. I use the image of a teleidoscope to introduce the context of the research which explores mediatised environments in museums, here referred to as ‘multimodal interfaces’ given their potential to reflect and refract ‘objects’ from the outer world and to translate them within the time and space of the museum. Objects, in this context, comprise the tangible legacy of physical artefacts, artworks, material records, cultural objects, buildings and landscapes, and the intangible heritage of oral histories, customs, and knowledge that was inherited from past generations and held for the benefit of future generations. Technology is transforming all aspects of museum activity, from access, to interpretation, representation, engagement and learning. Museums, heritage sites and landscapes can all be looked as part of an electronic ecology, that is, the pervasive and networked technological world in which we are immersed. Exploring ‘experience’ as a new territory for curatorial design, the research argues for an ‘ecological’ approach to the artistry of experience-making in museums and the devising of integrative strategies that enable encounter, intimacy and embodied interactions between people, places, memory, cultural objects and the things we preserve from the past. Opening up a discussion around experiential approaches to the interpretation of cultural heritage and its inherent ambiguities and paradoxes, questions are posed regarding the opportunities of digital technologies for embodied engagement as a new way of knowing about the world, the ‘other’, memory and ourselves. Participating in the current discourse on the inclusive role of the multimedia museum in a multicultural society, the research poses questions on how curatorial design practices can develop an integrative approach combining spatial design and digital mediation in order to create a zone of contact between cultures and histories that is both responsive to interaction and open to participation. The research case studies explore from a critical perspective the strategies adopted by designers and curators to mediate difference and facilitate intimacy with contested topics and representation of marginal and counter-histories. The studies comprise both critical analysis of existing exhibitions in various museums, as well as original creative works developed by myself as a curator and designer. The research practices offer an experimental ground where to critically explore and reflect on the possibilities of the mediation of curatorial design in negotiating experience and (re)constructing the past, thus extending the notion of the museum beyond exhibition spaces to comprise landscapes, objects, digital spaces as well as physical bodies

Polymeric and ceramic biomaterials in bone regeneration

Bone is a dynamic, vascular, connective tissue, that changes throughout life, characterized by different types of cells (osteoblasts, osteocytes, osteoclasts and osteoprogenitor cells) that become embedded in their own extracellular matrix (ECM). Bone is a highly specialized tissue with a complex, hierarchical structure over multiple levels. Its ability to adapt its mass and morphology to functional demands, to repair itself without leaving a scar, and to rapidly mobilize mineral stores on metabolic demand, makes bone to be considered the ultimate “smart” material and a dynamic example of “form follows function” in biological systems. The principal role of the bone is to provide structural support for the body but it also serves as the body’s mineral reservoir and producer of blood cells. Bone is composed of ECM characterized by an organic phase, composed by collagenous (collagen I, III, IV and V) and non collagenous (mainly osteocalcin, osteonectin, sialoproteins, proteoglycans, osteopontin, fibronectin, Growth Factors and bone morphogenetic proteins) proteins, reinforced with inorganic component, characterized by calcium phosphate hydroxyapatite [(Ca10(PO4)6(OH)2)] crystals (HA, TCP) with a Ca:P ratio of 5:3, sodium (Na), magnesium (Mg) and potassium (K). Bone tissue is arranged in two macroarchitectural forms-cortical and cancellous- which are employed in various proportions and geometries to form the individual bones of the body. Bone has the ability to adapt to mechanical loads through continuous bone resorption and bone formation that, in a homeostatic equilibrium, are balanced and old bone is continuously replaced by new tissue. This ensures that the mechanical integrity of the bone is maintained but it causes no global changes in morphology (remodeling). The continuity of a bone is disrupted, when a fracture or bone defect occurs, and the healing process can be developed on 4 phases: haematoma formation, soft callus formation, hard callus formation and remodeling phases. Bone regeneration is highly efficient and tightly regulated and the majority of fractures heals well under standard conservative or surgical therapy, but when complicated fractures and large bone defects have to be bridged, the healing process fails in many cases and non-union or pseudoarthrosis can occur. Nearly 5-10% of all fractures is associated with impaired healing, resulting in delayed union or non-union. Extended bone defects, following trauma or cancer resection, non-unions of fractures and loss of substance may require more sophisticated treatments, such as bone grafting procedures, segmental bone transport, distraction osteogenesis and scaffolds, that are applied for reconstruction. A tissue graft is a medical procedure in which tissue from a donor is used to replace missing or damaged tissue on a patient and can be divided into 3 major categories according to the genetic relationship between the donor and the recipient: autogenous tissue graft (a tissue graft from one site to another within the same individual); allogenous tissue graft (a tissue graft between individuals of the same species); xenogenous tissue graft (donor and recipient are individuals from different species). Among them, the first is defined as the 'gold standard' for regeneration, is a safe solution for compatibility and the absence of immune response, and it is considered to be the most suitable material, because the graft has osteogenic (marrow-derived osteoblastic cells as well as preosteoblastic precursor cells), osteoinductive (noncollagenous bone matrix proteins, including growth factors) and osteoconductive (bone mineral and collagen) properties. Nowadays, bone graft materials with completely different origins are commercially available for many applications throughout the human body. They are variable in their composition, their mechanism of action and, therefore, their indication, but problems related to the availability of graft material, donor-site morbidity, immunogenicity and biomechanical integrity represent some limitations of bone grafts and clinical success. Bone substitute materials are generally considered to be a highly important alternative to bone grafting. Due to the numerous disadvantages present in all kinds of grafts, there is a rationale for the designing and developing of artificial supports (scaffolds) for tissue engineering applications and their demand is growing steadily. Tissue engineering is a promising strategy to overcome the need to restore or regenerate tissues and proposes an alternative to tissue grafting with the use of artificial designed scaffolds or implants, fabricated using various materials (biomaterials). Scaffolds are tissue engineered product biomaterials, which function as an ECM, defined as degradable materials used, through implantation or injection, in a host for the purpose of stimulating tissue engineering or cell therapy process. Nowadays, natural (for example, collagen, hyaluronic acid, fibrin, silk) and synthetic (metals, ceramics, polymers and composites) materials, are used clinically for implants and medical devices in many medical areas. Biocompatibility is a fundamental requirement of scaffolds and is defined as “the ability of a material to perform with an appropriate host response in a specific application”. Biocompatibility ensures the absence of toxicity, teratogenicity or carcinogenicity and the lack of antigenicity guarantees the avoidance of pro-inflammatory and immunogenic reactions. All such requirements serve as a basis for effective long-term tolerance and such criteria are mainly fulfilled by available synthetic materials. It can be assessed by in vitro and in vivo studies and the results of these evaluations help to provide an objective picture of the associated composite biocompatibility. Generally, the sequence of evaluations increases in complexity and scope over time, from basic in vitro cell culture cytotoxicity evaluation to in vivo large animal anatomically relevant evaluations of biocompatibility and biofunctionality. Moreover, a scaffold, for bone tissue engineering, must be osteoinductive (to stimulate bone formation through the recruitment and differentiation of pluripotent stromal cells into osteoblasts), osteoconductive (for the bony ingrowth from local osseous tissue onto surface), osseointegrated (to achieve stable direct anchorage and contact between bone and scaffold surface), and bioactive (a phenomenon by which a biomaterial elicits or modulates biological activity). Besides biological characteristics, the scaffolds may be bioactive because of the appropriate chemical and physical (topography and microstructure) properties, which are very important for processing and performance, as they are directly related to the mechanical and biological properties of the scaffolds. For bone tissue engineering applications, an important aspect, in the design of scaffolds, is their required 3D porous architecture because porosity is important for the development of new tissue. A scaffold should provide an open porous network to assure an uniform cell distribution and tissue regeneration, an appropriate transport of soluble signaling molecules, as well as nutrients and oxygen, and metabolic waste removal, and this aim is reached by the combination of different pore sizes (micro- and macro-pores) and their interconnectivity. Synthetic scaffolds, due to their non-biological origin, have no cross contamination risk, but there is the stringent need to study their biocompatibility and clinical behaviour. Synthetic polymers, such as polylactic acid (PLA), polyglycolic acid (PGA) and poly ε-caprolactone (PCL), are largely used in orthopaedic applications because they can exhibit predictable and reproducible mechanical and physical properties, such as tensile strength, elastic modulus and degradation rate, by fine controlling their chemical synthesis and processing. Compared to metal and ceramic, they are easy to be fabricated into various shapes, with easy secondary processability and reasonable cost. Synthetic polymers have the advantage to be tailored to give a wide range of properties and more predictable uniformity, and they are generally free from the problems of immunogenicity, which can be a concern for naturally derived materials. PCL is a semicrystalline polymer that degrades at a much lower rate than the other, indeed the homopolymer has a degradation time of the order of two to three years. PCL is biocompatible and has a propensity to form blends with a wide variety of polymers. For this reason, PCL is used for developing long-term implantable materials. Among synthetic materials, in recent years, studies of scaffold composite materials have been performed as to successfully reproduce the microenvironment required to support and improve the molecular interactions which occur within tissues, between cells and within the mineralized extracellular matrix. To date, polymer matrices reinforced by ceramic fillers such as hydroxyapatite (PCL/HA) represent promising composite materials, able to mimic the collagen/hydroxyapatite micro/macromorphology of “native bone material”. The main benefit of using composite scaffolds is the ability to tailor their properties as per need, providing significant advantage over homogeneous materials. It has been demonstrated that the incorporation of biocompatible insoluble signals, such as hydroxyapatite (HA), into polymer matrix, promotes cell activity, due to the well-known osteoconductive and osteogenic potential, as well as an improvement of mechanical properties for its reinforcement action. The idea of combining bioactive ceramics and degradable polymers to produce 3D scaffolds with high porosity is a promising strategy for the design and development of composite system for hard tissue regeneration materials. In this thesis, for the regeneration of bone defects, the “in situ tissue regeneration” approach (in vivo implant of biological scaffolds in order to stimulate tissue regeneration) was taken into consideration and two scaffolds were investigated: a PCL and a composite PCL/HA scaffolds. PCL and PCL/HA were manufactured by researchers from the Interdisciplinary Research Centre on Biomaterials, CRIB and the Institute of Composite and Biomedical Materials, National Research Council, respectively, from the University of Naples Federico II. The scaffolds were fabricated with two different methods: (1) gas foaming (GF) and selective polymer extraction (PE) from co-continuous blends, for PCL scaffold; (2) phase inversion/salt leaching for the composite PCL/HA 13% scaffold. These research groups have also performed chemical-physical tests on the scaffolds with microstructural (macro- and micro- porosity, pore size and pore size distribution) and mechanical (compressive mechanical properties) studies, wettability and in vitro degradation mechanisms and kinetics tests. They found that a highly controlled porosity, characterized by a µ-bimodal distribution of pore size, was achieved: an open macroporous network that assures a uniform cell distribution and tissue regeneration, appeared interconnected by micropores that provide an efficient transport of soluble signaling molecules, as well as nutrients and oxygen, and metabolic waste removal. The aim of the thesis was to comparatively investigate the in vitro and in vivo behaviour of these two kinds of scaffolds. During my PhD, at the Preclinical and Surgical Studies laboratory of Rizzoli Orthopaedic Institute of Bologna, microtomographic, in vitro and in vivo evaluations were performed, to assess the two scaffolds in terms of porosity, cell colonization of the scaffolds, biocompatibility, bioactivity, biofunctionality, biodegradability, and new bone formation. More precisely, before in vitro and in vivo studies, tests were conducted with a new microtomographic approach (Micro-CT, SkyScan 1172) to evaluate the overall porosity, macroporosity and microporosity of these new scaffolds, at rest and after three different compression stages (1 mm, 3mm and at maximum compression of 222N). Moreover, a visualization and a quantification of the distribution of cells through the entire PCL scaffold were performed with Micro-CT technique, after the seeding of cells (MG63) on the scaffold, because in literature, porous scaffolds with novel porous architecture should promote and guide the in vitro and in vivo cell adhesion, proliferation and 3D colonization. Microtomography is based on the same principles of a normal X-ray tomography used in clinical medicine but avails itself of a microscopic level resolution. Micro-CT is extremely helpful when it comes to characterize devices in the preimplant phase and evaluating possible deformations and/or degradations after the explantation phase, moreover it is useful for the analysis of both tissue engineering scaffolds and bone tissue regeneration after the preclinical application of innovative biomaterials and biocomposites. Micro-CT shows some advantages over the classical histology, such as the maintenance of the integrity of the analyzed specimen, the lower acquisition time and the higher spatial resolution and number of analyzed sections than histology and the possibility to perform 2D and 3D studies. Subsequently, in vitro and in vivo tests, for the evaluations of cytotoxicity, biocompatibility, bioactivity, biofunctionality and biodegradability of the scaffolds, were carried out with osteoblastic-like cells (MG63), seeded at a concentration of 1X10^5 cells/ml on both scaffolds in 24-wells plates, and by implantation of the two scaffolds, without cells, in rabbit bone defects. In in vitro tests, early evaluation of cell adhesion (at 4 hours), morphology and lactate dehydrogenase (LDH) production (both at 24 hours) were tested for the assessment of cytotoxicity; Bone-specific alkaline phosphatase (BAP) activity, Osteocalcin (OC) measurements, Type I pro-collagen (CICP) production, and Transforming growth factor β1 (TGF-β1), Tumor necrosis factor α (TNF-α) and Interleukin-6 (IL-6) release were assessed at 7 and 14 days. Moreover, at 24 hours, 7 and 14 days, cell proliferation and viability were also evaluated. For all the parameters tested, as control, the same amount of cells (1X10^5 cells/ml) was seeded in empty wells of every plates, without scaffolds. In the subsequent in vivo study, according to the Law by Decree 116, 1992, 14 skeletally mature, adult New Zealand rabbits were used. Under general anaesthesia, bilateral confined cancellous defects were drilled in both limbs, obtaining a defect with 5 mm in diameter and 10 mm in depth. The left defect was treated with PCL/HA scaffold, while the right with PCL. Seven rabbits were euthanized after 4 weeks and the others after 12 weeks. The bone defect healing and the new bone growth were calculated with histology, static (% of bone healing rate-BHR, bone area inside-BAr/TAr.int and around-BAr/TAr the implanted scaffolds) and dynamic (mineral apposition rate-MAR and bone forming rate-BFR) histomorphometric parameters, at the end of experimental times, for the in vivo biocompatibility and biofunctionality assessment. The Micro-CT results about the porosity (overall porosity, macroporosity and microporosity) of the two scaffolds, before and after compression, revealed that PCL/HA scaffold showed higher overall porosity and macroporosity in comparison to PCL and that both scaffolds possessed a good interconnectivity of nearly 99%. A slight improvement in porosity in the first phase of compression due to an initial expansion of pores and then a progressive loss, an improvement in the microporosity and a reduction in overall porosity, after the compression step, were observed for both scaffolds. Moreover, the scaffolds possessed good mechanical properties during the compression stages. In this thesis a new method to detect cells, within the PCL scaffold, was established. The nominal resolution used here (2.5 µm of pixel size) allowed the presence of cells to be detected, even in Micro-CT sections far from the surface. Thus, this characteristic was used to ensure the presence of cell colonization even in deeper layers of the scaffold. The method described is good for 3D quantification of cell distribution and Micro-CT allows the results obtained by qualitative surface analysis to be combined and gives a more complete understanding of cell colonization. A good cell infiltration capacity was observed within the PCL scaffold according to the topological properties of its pore structure. The results of cell-scaffold interaction study demonstrated that high cell seeding efficiency and 3D colonization may be achieved by fine tuning the topological characteristics of the scaffold. In particular, the μ-bimodal scaffolds, used in the thesis, promoted selective 3D cell colonization into the macroporosity, and consequently ensured the presence of a separate porous network for fluid transport. Results of the in vitro study showed that both PCL and PCL/HA possessed a good in vitro biocompatibility. The cells, grown on both scaffolds, appeared spindly, well stained with a normal morphology as cells of control, with well defined cellular membranes and without lysis or reduced proliferation, in comparison to the control. The materials did not affect cell proliferation and did not evoke cytotoxic or inflammatory effects as explained by the TNF-α, IL-6, LDH production by the materials, that did not differ from control. In addition, cells cultured on the scaffolds showed a good biofunctionality and bioactivity, as demonstrated by the amount of ECM components, at both experimental times. More precisely, proliferation increased between 24 hours and 7 days and was maintained between 7 and 14 days. In particular, at 7 days PCL/HA cells showed a lower proliferation than PCL and control cells, probably due to the starting of the differentiation process. Indeed, at 7 days, PCL/HA cells produced significantly higher level of BAP than PCL and control, and OC and CICP than PCL. At 14 days, BAP was produced significantly more by cells on PCL/HA in comparison to control. The production of OC increased between 7 and 14 days in all materials and control, in significantly manner, underlying its role as a late differentiation marker of osteoblasts, whereas the production of BAP and CICP did not show significant differences among experimental times. As about TGF-β, TNF-α and IL-6 synthesis, no differences were observed nor between scaffolds and control at both experimental times, nor between 7 and 14 days. Moreover, the production of TNF-α, was significantly lower, on PCL/HA, at 14 days in comparison to 7 days. All in vitro results underlined that PCL/HA revealed better biocompatibility and bioactivity when compared to PCL and control. In vivo results showed that the initial area of the defect was reduced of about 40-50%, after 4 weeks, without significant differences between the two materials and between the two experimental times, indicating that within 4 weeks the healing process started faster and then proceeded slower between 4 and 12 weeks. The formation of new bone trabeculae outside the implanted materials (BAr/TAr) and inside the scaffolds (BAr/TAr.int), and MAR and BFR parameters showed significantly higher values for PCL/HA than PCL at both experimental times. Moreover, the new bone trabeculae started to penetrate the porosity of the two scaffolds slowly, at 4 weeks till 12 weeks, when the new bone was present inside the porosity, also in the central portion of the both scaffolds, especially for PCL/HA. Due to the low degradation rate of PCL material, scaffolds were present also at 12 weeks and they were only partially degraded. For this reason, in the future, further research will be mandatory with longer experimental times for the in vivo studies. Even if further studies will be performed and refined, the composite scaffold PCL/HA showed a better behaviour in the regeneration of bone defects

Association of Klotho with physical performance and frailty in middle-aged and older adults: A systematic review

Abstract Ageing is an inevitable process of physical deterioration that impairs functional autonomy and quality of life, becoming a public health issue. Since the percentage of people over 60 years is increasing worldwide, the use of easily detectable biomarkers of ageing is a relevant tool for monitoring of the ageing process and treatment. Among them, Klotho, an ageing suppressor gene because its deficiency leads to ageing like phenotype, seems particularly promising. This systematic review includes the last 10 years clinical studies that evaluated the association between plasma Klotho and body composition, physical performance and frailty in both sedentary and active middle-aged and older adults. Sixteen studies have been found: nine regarding the association between Klotho and body composition, two the association of Klotho and frailty and finally five concerning the effects of physical activity on Klotho. The results of these studies, albeit with some exceptions, point out that Klotho is positively associated with muscle strength and negatively with osteoporosis, frailty, disability and mortality while physical activity generally increases Klotho levels. Moreover, even if there are still few clinical studies, Klotho might be positively associated with bone mineral density, muscle strength, longevity, mobility and robustness during ageing

breast conservation and sentinel lymph node biopsy after neoadjuvant systemic therapy

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Clinical investigation on Theileria equi and Babesia caballi infections in Italian donkeys

Background: Interest in the welfare and diseases of donkeys is constantly increasing in several countries. Despite this, clinical research into donkeys needs to be in continual development since they show different reactions compared to horses in many conditions, including infectious diseases, and need specific clinical and therapeutic approaches. No reports are currently available on clinical and clinical pathology data regarding donkeys with natural piroplasms infection. Results: Venous blood samples were taken from one hundred and thirty eight donkeys and underwent indirect fluorescent antibody test (IFAT) to detect IgG antibodies against Theileria equi and Babesia caballi and real-time polimerase chain reaction (PCR) to detect Babesia spp. and Theileria spp.. Clinical examinations, haematological analyses and serum bilirubin evaluation were also performed and compared with positive or negative status. A seroprevalence of 40.6% and 47.8% was found for T. equi and B. caballi, respectively; double positivity was detected in 19.6% of the animals. PCR results showed that 17.4% of the animals tested positive for T.equi and 3.6% for B. caballi with no double positivity. Twelve donkeys (8.7%) had clinical signs consistent with chronic forms of the disease and no acute forms were detected. Fifty-eight donkeys had haematological and serum bilirubin alterations and 56 (96.6%) of them were IFAT and/or PCR positive. Changes in erythrocyte number, packed cell volume, hemoglobin concentration, mean corpuscular hemoglobin, platelets number and total bilirubin were significantly associated with positive and symptomatic animals. Conclusion: Nonspecific clinical presentation seems to be very common in donkeys and several clinical pathology alterations persist after natural infection. Therefore, apparently healthy donkeys can have masked but severe clinical pathology alterations. Acute forms are very seldom observed in donkeys. Clinical monitoring of chronically infected donkeys is recommended since such animals represent a risk both for transmission to other animals and for their own health; furthermore, their production performances could be reduced. The study should also be intended as a contribution for veterinary practitioners because it describes the most usual clinical presentations and laboratory findings of equine piroplasmosis in naturally infected donkeys in endemic areas

Total Value of Ownership and Overall Equipment Effectiveness analysis to evaluate the impact of automation on time and costs of therapeutic drug monitoring

Abstract Total Value of Ownership (TVO) and Overall Equipment Effectiveness (OEE) analysis are novel tools capable of monitoring and analyzing industrial processes by assessing the efficiency of the entire instrumental equipment and calculating instrument capacity utilization. Such integrated analysis, measuring quality indicators of the testing process, could also provide new perspectives and methodologies for the workflow organization of clinical laboratories. In this study, TVO and OEE were employed for the evaluation of two different configurations of a therapeutic drug monitoring sector, comparing the results obtained for immunosuppressant (ISD) and anti-epileptic drugs (AED) analysis as well as checking their quantitative performance in terms of limit of quantification, accuracy and precision. TVO analysis was performed for ISDs, including the Total Direct Labor Time, Total Cycle Time and Turnaround Time as well as cost of testing. Instruments' performance and workload were assessed using OEE indicator, studying Availability, Performance and Quality factors. Total Cycle Time for a batch was 3.55 h, decreasing of 1.5 h in the new setting where personnel are engaged for 0.98 h, 25% of total testing time. The calculated cost per sample was 6.60 euro. Availability values were significantly higher for automated sample-handling system and ISDs analysis by LC-MS. Higher Performance values were obtained for LC-MS system for AED and other TDM. Quality values were >0.94 for all instruments. TVO and OEE proved to be applicable to clinical laboratory environment, quantifying benefits and costs of newly developed semi-automated therapeutic drug monitoring sector. This novel approach based on an integrated analysis may help activity planning and quality improvement and could be used in the future for benchmarking progress as a product/process comparison tool in other laboratory fields

In planta production of two peptides of the Classical Swine Fever Virus (CSFV) E2 glycoprotein fused to the coat protein of potato virus X

BACKGROUND: Classical Swine Fever (CSFV) is one of the most important viral infectious diseases affecting wild boars and domestic pigs. The etiological agent of the disease is the CSF virus, a single stranded RNA virus belonging to the family Flaviviridae. All preventive measures in domestic pigs have been focused in interrupting the chain of infection and in avoiding the spread of CSFV within wild boars as well as interrupting transmission from wild boars to domestic pigs. The use of plant based vaccine against CSFV would be advantageous as plant organs can be distributed without the need of particular treatments such as refrigeration and therefore large areas, populated by wild animals, could be easily covered. RESULTS: We report the in planta production of peptides of the classical swine fever (CSF) E2 glycoprotein fused to the coat protein of potato virus X. RT-PCR studies demonstrated that the peptide encoding sequences are correctly retained in the PVX construct after three sequential passage in Nicotiana benthamiana plants. Sequence analysis of RT-PCR products confirmed that the epitope coding sequences are replicated with high fidelity during PVX infection. Partially purified virions were able to induce an immune response in rabbits. CONCLUSION: Previous reports have demonstrated that E2 synthetic peptides can efficiently induce an immunoprotective response in immunogenized animals. In this work we have showed that E2 peptides can be expressed in planta by using a modified PVX vector. These results are particularly promising for designing strategies for disease containment in areas inhabited by wild boars

In Vivo Model of Osteoarthritis to Compare Allogenic Amniotic Epithelial Stem Cells and Autologous Adipose Derived Cells

SIMPLE SUMMARY: An early resolution of osteoarthritis (OA), through minimally invasive orthobiological solutions, would be important to enable a return to daily and sport activities, and delay prosthesis solutions. No study has yet evaluated amniotic epithelial stem cells (AECs) in OA. They could be considered a valid alternative to adipose derived cells, expanded or concentrated, because they differentiate into three lineages and express mesenchymal and embryonic markers, without a tumorigenic phenotype. The innovative aspects of this study are the comparison of three injective orthobiological treatments, the in vivo use of AECs in OA, and the evaluation of structural and inflammatory fronts of OA for up to six months. ABSTRACT: The challenge of osteoarthritis (OA) is to find a minimally invasive orthobiological therapy to contrast OA progression, on inflammatory and structural fronts. The aim of the present study is to compare the effects of an intra-articular injection of three orthobiological treatments, autologous culture expanded adipose-derived mesenchymal stromal cells (ADSCs), autologous stromal vascular fraction (SVF) and allogenic culture expanded amniotic epithelial stem cells (AECs), in an animal model of OA. OA was induced in 24 sheep by bilateral lateral meniscectomy and, at 3 and 6 months post-treatment, the results were analyzed with macroscopy, histology, histomorphometry, and biochemistry. All the three treatments showed better results than control (injection of NaCl), but SVF and AECs showed superiority over ADSCs, because they induced higher cartilage regeneration and lower inflammation. SVF showed better results than AECs at 3 and 6 months. To conclude, SVF seems to be more favorable than the other biological options, because it is easily obtained and rapidly used after harvesting, with good healing potential. AECs cause no discomfort and could be also considered for the treatment of OA joints

is 18f fluorodeoxyglucose uptake by the primary tumor a prognostic factor in breast cancer

Abstract Background We retrospectively investigated 18F-FDG uptake by the primary breast tumor as a predictor for relapse and survival. Patients and methods We studied 203 patients with cT1-T3N0 breast cancer. Standardized uptake value (SUVmax), was measured on the primary tumor. After a median follow-up of 68 months (range 22–80), the relation between SUVmax and tumor factors, disease free-survival (DFS) and overall survival (OS) was investigated. Results In the PET-positive patients, the median FDG uptake by the tumor was 4.7. FDG uptake was significantly related to tumor size, number of involved axillary nodes, grade, negative ER, high Ki-67 and HER2 overexpression. No distant metastases or deaths occurred in the PET-negative group. Five-year DFS was 97% and 83%, respectively in the PET-negative and PET-positive groups (P = 0.096). At univariate analysis, DFS was significantly lower in patients with SUVmax >4.7 compared to the patients with negative PET (P = 0.042), but not to the patients with SUVmax ≤4.7 (P = 0.106). At multivariable analysis, among PET-positive patients, SUVmax was not an independent prognostic factor for DFS (HR>4.7 vs ≤4.7: 1.02 (95% CI 0.45–2.31)). Five-year OS was 100% and 93%, respectively, in the PET-negative and PET-positive groups (P = 0.126). Conclusion FDG uptake by the primary lesion was significantly associated with several prognostic variables, but it was not an independent prognostic factor

The impact of gender bias in cardiothoracic surgery in Europe: a European Society of Thoracic Surgeons and European Association for Cardio-Thoracic Surgery survey

OBJECTIVES The European Society of Thoracic Surgeons and the European Association for Cardio-Thoracic Surgery designed a questionnaire to assess the impact of gender bias on a cardiothoracic surgery career. METHODS A 46-item survey investigating gender bias was designed using online survey software from December 2020 to January 2021. All European Society of Thoracic Surgeons and European Association for Cardio-Thoracic Surgery members and non-members included in the mailing lists were invited to complete an electronic survey. Descriptive statistics and a comparison between gender groups were performed. RESULTS Our overall response rate was 11.5% (1118/9764), of which 36.14% were women and 63.69% were men. Women were more likely to be younger than men (P < 0.0001). A total of 66% of the women reported having no children compared to only 19% of the men (P < 0.0001). Only 6% of women vs 22% of men were professors. More women (72%) also reported never having been a formal mentor themselves compared to men (38%, P < 0.0001). A total of 35% of female respondents considered leaving surgery because of episodes of discrimination compared to 13% of men; 67% of women said that they experienced being unfairly treated due to gender discrimination. Of the male surgeons, 31% reported that they were very satisfied with their career compared to only 17% of women (P < 0.0001). CONCLUSIONS Women in cardiothoracic surgery reported significantly high rates of experiences with bias that may prevent qualified women from advancing to positions of leadership. Efforts to mitigate bias and support the professional development of women are at the centre of newly formed European committees