Tackling hepatocellular carcinoma with individual or combinatorial immunotherapy approaches.

Abstract Hepatocellular carcinoma (HCC) is the third leading cause of death from cancer globally. Indeed, there is a single drug approved as first-line systemic therapy in advanced unresectable HCC, providing a very limited survival benefit. In earlier stages, 5-year survival rates after surgical and loco-regional therapies are extremely variable depending on the stage of disease. Nevertheless, HCC is considered an immunogenic tumor arising in chronically inflamed livers. In such a scenario, immunotherapy strategies for HCC, in particular combinations including cancer vaccines, may represent a key therapeutic tool to improve clinical outcome in HCC patients. However, a lot of improvement is needed given the disappointing results obtained so far

Bilateral benign multinodular goiter: what is the adequate surgical therapy? A review of literature

Benign multinodular goiter (BMNG) is the most common endocrine disease requiring surgery. During the last few years a more aggressive approach has become the trend for bilateral BMNG treatment

Acid hydrolysis of spent coffee grounds: effects on possible prebiotic activity of oligosaccharides

Abstract Background Spent coffee grounds (SCG) are a promising source of natural by-products which can be used for different purposes. In this work, a possible use of oligosaccharides isolated from SCG as functional ingredients was investigated. SCGs were treated with an acid hydrolysis at high temperature (200 °C) in a closed reactor setting reaction time of 30, 60 and 90 s depending on the sample (original or defatted). A comprehensive study of the resulted water-soluble hydrolysate using a high-resolution mass spectrometry analysis was performed. Additionally, the growth of four Lactobacillus strains was tested to assess the prebiotic potential of the hydrolysate. Results Oligosaccharide chains formed by hexoses with a degree of polymerization ranging from 3 to 6 were identified and characterized. Regardless of the composition and the reaction time of hydrolysis, the bacterial activity of SCG extracts exhibited significantly higher values than the well-known versatile carbohydrate used by food industry, i.e., inulin. Conclusions The results pave the way toward the use of hydrolysate SCG as an innovative ingredient intended to fortify food formulations. The diversity in coffee oligosaccharides composition suggests their selective prebiotic activity for specific bacterial strains. Graphical Abstrac

Multimodality Imaging in Cardiomyopathies with Hypertrophic Phenotypes

Multimodality imaging is a comprehensive strategy to investigate left ventricular hypertrophy (LVH), providing morphologic, functional, and often clinical information to clinicians. Hypertrophic cardiomyopathy (HCM) is defined by an increased LV wall thickness not only explainable by abnormal loading conditions. In the context of HCM, multimodality imaging, by different imaging techniques, such as echocardiography, cardiac magnetic resonance, cardiac computer tomography, and cardiac nuclear imaging, provides essential information for diagnosis, sudden cardiac death stratification, and management. Furthermore, it is essential to uncover the specific cause of HCM, such as Fabry disease and cardiac amyloidosis, which can benefit of specific treatments. This review aims to elucidate the current role of multimodality imaging in adult patients with HCM

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

SPME-GC method as a tool to differentiate VOC profiles in Saccharomyces cerevisiae wine yeasts

The aim of this work was to study the variability of 36 Saccharomyces cerevisiae wild strains isolated from different grape varieties and from two very distant zones, located in Northern and Southern Italy. The strains were differentiated on the basis of parameters of technological interest, such as resistance to antimicrobial compounds frequently present in wine, and the production of volatile aromatic compounds (VOC), determined by SPME procedure in the experimental wines obtained by inoculated fermentations. The VOC profile allowed to differentiate the yeasts in function of isolation area: S. cerevisiae isolated from Southern Italy grapes were able to produce more volatile compounds than those from Northern Italy. The compounds synthesized by all the yeasts, besides the ethanol, were 3-methyl-1-butanol and ethyl acetate. The production of acids during the alcoholic fermentation was a characteristic of Southern yeast strains. The screening of S. cerevisiae strains for technological parameters, such as sulphur dioxide, copper and ethanol resistance or hydrogen sulphide production, revealed similar behaviour for sulphur dioxide resistance among Northern and Southern S. cerevisiae strains. Copper resistance and sulphur dioxide production were correlated to isolation area: S. cerevisiae ‘‘Northern’’ strains showed higher copper resistance and lowest hydrogen sulphide production than that exhibited from ‘‘Southern’’ strains

Sustainable Exploitation of Coffee Silverskin in Water Remediation

Coffee silverskin (CS), the main solid waste produced from the coffee industry, has efficiently been used as adsorbent material to remove potential toxic metals (PTMs). In order to assess its suitability in water remediation, kinetic adsorption experiments of Cu2+, Zn2+, and Ni2+ ions from wastewater were carried out and the adsorption performance of the waste material was compared with that of another well-known waste from coffee industry, spent coffee grounds (SCG). By using CS as sorbent material, ion removal follows the order Cu2+ > Zn2+ > Ni2+ with the adsorption equilibrium occurring after about 20 min. The adsorption efficiency of Ni2+ ions is the same for both investigated materials, while Cu2+ and Zn2+ ions are removed to a lesser extent by using CS. Equilibrium-adsorption data were analyzed using two different isotherm models (Langmuir and Freundlich), demonstrating that monolayer-type adsorption occurs on both CS and SCG surfaces. The overall results support the use of coffee silverskin as a new inexpensive adsorbent material for PTMs from wastewater