Diabetes and obesity as independent risk factors for osteoporosis: Updated results from the ROIS/EMEROS registry in a population of five thousand post-menopausalwomen living in a region characterized by heavy environmental pressure

Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m2. Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05-1.83) and 1.46 (CI: 1.20-1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis

Integrated CGH/WES Analyses Advance Understanding of Aggressive Neuroblastoma Evolution: A Case Study

Neuroblastoma (NB) is the most common extra-cranial malignancy in preschool children. To portray the genetic landscape of an overly aggressive NB leading to a rapid clinical progression of the disease, tumor DNA collected pre- and post-treatment has been analyzed. Array comparative genomic hybridization (aCGH), whole-exome sequencing (WES), and pharmacogenetics approaches, respectively, have identified relevant copy number alterations (CNAs), single nucleotide variants (SNVs), and polymorphisms (SNPs) that were then combined into an integrated analysis. Spontaneously formed 3D tumoroids obtained from the recurrent mass have also been characterized. The results prove the power of combining CNAs, SNVs, and SNPs analyses to assess clonal evolution during the disease progression by evidencing multiple clones at disease onset and dynamic genomic alterations during therapy administration. The proposed molecular and cytogenetic integrated analysis empowers the disease follow-up and the prediction of tumor recurrence

Diabetes and Obesity as Independent Risk Factors for Osteoporosis: Updated Results from the ROIS/EMEROS Registry in a Population of Five Thousand Post-Menopausal Women Living in a Region Characterized by Heavy Environmental Pressure

EMEROS/ROIS Registry is a project funded by ISBEM and supported by Medicina Futura Research

Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience

Background: Robotic-assisted thoracic surgery (RATS) has seen increasing interest in the last few years, with most procedures primarily being performed in the conventional multiport manner. Our team has developed a new approach that has the potential to convert surgeons from uniportal video-assisted thoracic surgery (VATS) or open surgery to robotic-assisted surgery, uniportal-RATS (U-RATS). We aimed to evaluate the outcomes of one single incision, uniportal robotic-assisted thoracic surgery (U-RATS) against standard multiport RATS (M-RATS) with regards to safety, feasibility, surgical technique, immediate oncological result, postoperative recovery, and 30-day follow-up morbidity and mortality. Methods: We performed a large retrospective multi-institutional review of our prospectively curated database, including 101 consecutive U-RATS procedures performed from September 2021 to October 2022, in the European centers that our main surgeon operates in. We compared these cases to 101 consecutive M-RATS cases done by our colleagues in Barcelona between 2019 to 2022. Results: Both patient groups were similar with respect to demographics, smoking status and tumor size, but were significantly younger in the U-RATS group [M-RATS =69 (range, 39-81) years; U-RATS =63 years (range, 19-82) years; P<0.0001]. Most patients in both operative groups underwent resection of a primary non-small cell lung cancer (NSCLC) [M-RATS 96/101 (95%); U-RATS =60/101 (59%); P<0.0001]. The main type of anatomic resection was lobectomy for the multiport group, and segmentectomy for the U-RATS group. In the M-RATS group, only one anatomical segmentectomy was performed, while the U-RATS group had twenty-four (24%) segmentectomies (P=0.0006). All M-RATS and U-RATS surgical specimens had negative resection margins (R0) and contained an equivalent median number of lymph nodes available for pathologic analysis [M-RATS =11 (range, 5-54); U-RATS =15 (range, 0-41); P=0.87]. Conversion rate to thoracotomy was zero in the U-RATS group and low in M-RATS [M-RATS =2/101 (2%); U-RATS =0/101; P=0.19]. Median operative time was also statistically different [M-RATS =150 (range, 60-300) minutes; U-RATS =136 (range, 30-308) minutes; P=0.0001]. Median length of stay was significantly lower in U-RATS group at four days [M-RATS =5 (range, 2-31) days; U-RATS =4 (range, 1-18) days; P<0.0001]. Rate of complications and 30-day mortality was low in both groups. Conclusions: U-RATS is feasible and safe for anatomic lung resections and comparable to the multiport conventional approach regarding surgical outcomes. Given the similarity of the technique to uniportal VATS, it presents the potential to convert minimally invasive thoracic surgeons to a robotic-assisted approach.info:eu-repo/semantics/publishedVersio

Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience

Background: Robotic-assisted thoracic surgery (RATS) has seen increasing interest in the last few years, with most procedures primarily being performed in the conventional multiport manner. Our team has developed a new approach that has the potential to convert surgeons from uniportal video-assisted thoracic surgery (VATS) or open surgery to robotic-assisted surgery, uniportal-RATS (U-RATS). We aimed to evaluate the outcomes of one single incision, uniportal robotic-assisted thoracic surgery (U-RATS) against standard multiport RATS (M-RATS) with regards to safety, feasibility, surgical technique, immediate oncological result, postoperative recovery, and 30-day follow-up morbidity and mortality. Methods: We performed a large retrospective multi-institutional review of our prospectively curated database, including 101 consecutive U-RATS procedures performed from September 2021 to October 2022, in the European centers that our main surgeon operates in. We compared these cases to 101 consecutive M-RATS cases done by our colleagues in Barcelona between 2019 to 2022. Results: Both patient groups were similar with respect to demographics, smoking status and tumor size, but were significantly younger in the U-RATS group [M-RATS =69 (range, 39-81) years; U-RATS =63 years (range, 19-82) years; P<0.0001]. Most patients in both operative groups underwent resection of a primary non-small cell lung cancer (NSCLC) [M-RATS 96/101 (95%); U-RATS =60/101 (59%); P<0.0001]. The main type of anatomic resection was lobectomy for the multiport group, and segmentectomy for the U-RATS group. In the M-RATS group, only one anatomical segmentectomy was performed, while the U-RATS group had twenty-four (24%) segmentectomies (P=0.0006). All M-RATS and U-RATS surgical specimens had negative resection margins (R0) and contained an equivalent median number of lymph nodes available for pathologic analysis [M-RATS =11 (range, 5-54); U-RATS =15 (range, 0-41); P=0.87]. Conversion rate to thoracotomy was zero in the U-RATS group and low in M-RATS [M-RATS =2/101 (2%); U-RATS =0/101; P=0.19]. Median operative time was also statistically different [M-RATS =150 (range, 60-300) minutes; U-RATS =136 (range, 30-308) minutes; P=0.0001]. Median length of stay was significantly lower in U-RATS group at four days [M-RATS =5 (range, 2-31) days; U-RATS =4 (range, 1-18) days; P<0.0001]. Rate of complications and 30-day mortality was low in both groups. Conclusions: U-RATS is feasible and safe for anatomic lung resections and comparable to the multiport conventional approach regarding surgical outcomes. Given the similarity of the technique to uniportal VATS, it presents the potential to convert minimally invasive thoracic surgeons to a robotic-assisted approach

Microbial communities and bioactive compounds in marine sponges of the family Irciniidae-a review

Marine sponges harbour complex microbial communities of ecological and biotechnological importance. Here, we propose the application of the widespread sponge family Irciniidae as an appropriate model in microbiology and biochemistry research. Half a gram of one Irciniidae specimen hosts hundreds of bacterial species-the vast majority of which are difficult to cultivate-and dozens of fungal and archaeal species. The structure of these symbiont assemblages is shaped by the sponge host and is highly stable over space and time. Two types of quorum-sensing molecules have been detected in these animals, hinting at microbe-microbe and host-microbe signalling being important processes governing the dynamics of the Irciniidae holobiont. Irciniids are vulnerable to disease outbreaks, and concerns have emerged about their conservation in a changing climate. They are nevertheless amenable to mariculture and laboratory maintenance, being attractive targets for metabolite harvesting and experimental biology endeavours. Several bioactive terpenoids and polyketides have been retrieved from Irciniidae sponges, but the actual producer (host or symbiont) of these compounds has rarely been clarified. To tackle this, and further pertinent questions concerning the functioning, resilience and physiology of these organisms, truly multi-layered approaches integrating cutting-edge microbiology, biochemistry, genetics and zoology research are needed.Portuguese Foundation [PTDC/MAR/101431/2008, PTDC/BIA-MIC/3865/2012]; European Regional Development Fund (ERDF) through the Operational Competitiveness Programme (COMPETE); national funds through FCT (Foundation for Science and Technology) [PEst-C/MAR/LA0015/2011]; FCT [SFRH/BD/60873/2009]info:eu-repo/semantics/publishedVersio

Development of Gene Expression Markers of Acute Heat-Light Stress in Reef-Building Corals of the Genus Porites

Coral reefs are declining worldwide due to increased incidence of climate-induced coral bleaching, which will have widespread biodiversity and economic impacts. A simple method to measure the sub-bleaching level of heat-light stress experienced by corals would greatly inform reef management practices by making it possible to assess the distribution of bleaching risks among individual reef sites. Gene expression analysis based on quantitative PCR (qPCR) can be used as a diagnostic tool to determine coral condition in situ. We evaluated the expression of 13 candidate genes during heat-light stress in a common Caribbean coral Porites astreoides, and observed strong and consistent changes in gene expression in two independent experiments. Furthermore, we found that the apparent return to baseline expression levels during a recovery phase was rapid, despite visible signs of colony bleaching. We show that the response to acute heat-light stress in P. astreoides can be monitored by measuring the difference in expression of only two genes: Hsp16 and actin. We demonstrate that this assay discriminates between corals sampled from two field sites experiencing different temperatures. We also show that the assay is applicable to an Indo-Pacific congener, P. lobata, and therefore could potentially be used to diagnose acute heat-light stress on coral reefs worldwide

La realta' virtuale: dall'analisi applicativa in ambito militare alla sperimentazione di un possibile caso d'uso

Il presente elaborato nasce a seguito dalla mia personale esperienza in Accademia Navale. Durante il mio percorso in Istituto ho maturato l’idea di migliorare uno strumento fondamentale nella formazione dell’Ufficiale di Vascello, ovvero il Simulatore di Plancia. Approfondendo gli studi nel settore del Modelling & Simulation, sia in ambito Marina Militare che Interforze, è infatti emerso come il SIMAP risulti appartenere a un’era di simulatori a cavallo tra la prima e la seconda generazione. Implementarlo attraverso l’impiego della Realtà Virtuale, con le procedure tipiche del bordo, avrebbe quindi un duplice scopo. Il primo, il più intuitivo, sarebbe quello di addestrare nel modo più realistico ed immersivo possibile il personale che si accinge ad affrontare l’impegnativo periodo di imbarco. Il secondo, ma non meno importante, quello di far comprendere all’allievo la strada che ha intrapreso, mettendolo di fronte a difficoltà “reali”, che dovrà affrontare a termine del proprio percorso formativo. Tuttavia anche a livello operativo, l’applicazione della realtà virtuale potrebbe portare molteplici benefici, dalla rappresentazione tridimensionale delle tracce radar/sonar presenti nello scenario tattico, al puntamento dei sistemi d’arma nella direzione in cui volge lo sguardo il direttore del tiro. Per dimostrare l’efficacia di questa tecnologia ho deciso quindi di introdurre l’argomento partendo dalla sua storia e dalla sua comparsa sul mercato commerciale. Ho descritto successivamente, l’architettura tecnica, le sue peculiarità a livello emotivo-cognitivo e dettagliato le applicazioni della tecnologia virtuale nella nostra Forza Armata. Ciò che però non deve passare inosservato allo sguardo attento del lettore, non è tanto la componentistica, quanto la capacità di questo sistema di catapultare l’utente in un mondo parallelo, tridimensionale e del tutto simile a quello vero. Riuscire ad affrontare un addestramento in un “luogo” così vicino a quello reale, risulta oggi più che mai un bisogno incessante. Questo si dimostra vero soprattutto in un mestiere come il nostro, ricco di soddisfazioni ma pieno di rischi e pericoli, che in alcune occasioni potrebbero mettere seriamente a repentaglio l’incolumità dei nostri marinai. Per dimostrare questo ho descritto le cosiddette situazioni “fight or flight”, che ben raccontano quanto possa essere efficace il sottoporsi allo stesso tipo di stress che potremmo dover affrontare nella realtà. Ho inoltre deciso di sfruttare lo strumento della “proof of concept”, ricreando virtualmente la sequenza di eventi che tipicamente caratterizzano un incendio a bordo. Quest’ultima sperimentazione è appunto la prova di funzionamento definitiva del concetto addestrativo/operativo posto alla base della tecnologia VR. Infine, ho focalizzato l’attenzione sui costi di produzione che la Forza Armata dovrebbe sostenere per implementare tale tecnologia sui simulatori già presenti. Dall’analisi di spesa sarà possibile confrontare l’applicazione cardboard realizzata personalmente, ovvero ricreata da personale non adeguatamente formato e competente, con una scena tridimensionale realizzata, questa volta, dall’industria nazionale di nicchia o da esperti del settore. L’obiettivo finale è quindi quello di far riflettere il lettore sulla capacità peculiare di questo sistema di ricreare scenari molto realistici, in grado di proiettare anche strategicamente la nostra Marina verso il futuro che la attende, ottenendo vantaggi a livello addestrativo, operativo ed economico. Chiudo così questa breve presentazione con la stessa citazione che introduce l’elaborato, definendone gli obiettivi nella relativa introduzione