Photocatalytic Activity in CH

Some TiO2 powders, prepared from titanium(IV)tetraisopropoxide by the sol-gel method and thermally treated between 100 and 1000∘C, have been characterized by X-ray powder diffraction and by nitrogen adsorption and desorption at 77 K to calculate the BET-specific surface area, from which the micropore volume and the external surface area can be derived. The photocatalytic activity (ka) of the above powders has been evaluated considering the TiO2-sensitized photo-oxidation of 4-methoxybenzyl alcohol in CH3CN as the test reaction. The decrease of ka have been related to the decrease of the BET surface area, the micropore volume, and the external surface area of the TiO2 powders, but a satisfactory linear correlation is observed only for the last superficial parameter

Prognostic value of non-invasive scores based on liver stiffness measurement, spleen diameter and platelets in HIV-infected patients

BACKGROUND AND AIMS: People living with HIV (PLWH) are at high risk for advanced chronic liver disease and related adverse outcomes. We aimed to validate the prognostic value of non-invasive scores based on liver stiffness measurement (LSM) and on markers of portal hypertension (PH), namely platelets and spleen diameter, in PLWH. METHODS: We combined data from eight international cohorts of PLWH with available non-invasive scores, including LSM and the composite biomarkers liver stiffness-spleen size-to-platelet ratio score (LSPS), LSM-to-Platelet ratio (LPR) and PH risk score. Incidence and predictors of all-cause mortality, any liver-related event and classical hepatic decompensation were determined by survival analysis, controlling for competing risks for the latter two. Non-invasive scores were assessed and compared using area under the receiver operating curve (AUROC). RESULTS: We included 1695 PLWH (66.8% coinfected with hepatitis C virus). During a median follow-up of 4.7 (interquartile range 2.8-7.7) years, the incidence rates of any liver-related event, all-cause mortality and hepatic decompensation were 13.7 per 1000 persons-year (PY) (95% confidence interval [CI], 11.4-16.3), 13.8 per 1000 PY (95% CI, 11.6-16.4) and 9.9 per 1000 PY (95% CI, 8.1-12.2), respectively. The AUROC of LSM was similar to that of the composite biomarkers, ranging between 0.83 and 0.86 for any liver-related event, 0.79-0.85 for all-cause mortality and 0.87-0.88 for classical hepatic decompensation. All individual non-invasive scores remained independent predictors of clinical outcomes in multivariable analysis. CONCLUSIONS: Non-invasive scores based on LSM, spleen diameter and platelets predict clinical outcomes in PLWH. Composite biomarkers do not achieve higher prognostic performance compared to LSM alone

Prognostic value of non-invasive scores based on liver stiffness measurement, spleen diameter and platelets in HIV-infected patients.

BACKGROUND AND AIMS People living with HIV (PLWH) are at high risk for advanced chronic liver disease and related adverse outcomes. We aimed to validate the prognostic value of non-invasive scores based on liver stiffness measurement (LSM) and on markers of portal hypertension (PH), namely platelets and spleen diameter, in PLWH. METHODS We combined data from eight international cohorts of PLWH with available non-invasive scores, including LSM and the composite biomarkers liver stiffness-spleen size-to-platelet ratio score (LSPS), LSM-to-Platelet ratio (LPR) and PH risk score. Incidence and predictors of all-cause mortality, any liver-related event and classical hepatic decompensation were determined by survival analysis, controlling for competing risks for the latter two. Non-invasive scores were assessed and compared using area under the receiver operating curve (AUROC). RESULTS We included 1695 PLWH (66.8% coinfected with hepatitis C virus). During a median follow-up of 4.7 (interquartile range 2.8-7.7) years, the incidence rates of any liver-related event, all-cause mortality and hepatic decompensation were 13.7 per 1000 persons-year (PY) (95% confidence interval [CI], 11.4-16.3), 13.8 per 1000 PY (95% CI, 11.6-16.4) and 9.9 per 1000 PY (95% CI, 8.1-12.2), respectively. The AUROC of LSM was similar to that of the composite biomarkers, ranging between 0.83 and 0.86 for any liver-related event, 0.79-0.85 for all-cause mortality and 0.87-0.88 for classical hepatic decompensation. All individual non-invasive scores remained independent predictors of clinical outcomes in multivariable analysis. CONCLUSIONS Non-invasive scores based on LSM, spleen diameter and platelets predict clinical outcomes in PLWH. Composite biomarkers do not achieve higher prognostic performance compared to LSM alone

NEW PERSPECTIVES IN DIAGNOSIS OF INTERSTITIAL LUNG DISEASE RELATED TO RHEUMATOID ARTHRITIS. VALIDATION STUDY OF AN ELECTRONIC STETHOSCOPE AND AD HOC SOFTWARE FOR DETECTION OF PULMONARY CRACKLES

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial joint swelling and tenderness, secondary to the immune-system dysfunction, often complicated by extra-articular manifestations. Among them, lung involvement is very frequent and interstitial lung disease (ILD) represents one of the deleterious complications of RA with impact on both therapeutic approach and overall prognosis. Nevertheless, diagnosis of ILD often remains missing or delayed. Objectives: To preliminarily evaluate the predictive value of pulmonary sound recorded by an electronic stethoscope (ES) and elaborated by an ad hoc software in identification of RA-ILD diagnosed by mean of high resolution computed tomography (HRCT) in a multicenter study. Methods: RA patients who underwent HRCT in the last 12 months were enrolled. They were all auscultated with the ES (Littmann 3200TM 3M, USA), bilaterally, at dorsal level, in at least 3 pulmonary fields (medium and basal). All tracks recorded were analyzed by a suitably developed software capable of recognizing pathological crackles in lung sounds. Results were compared with radiologic findings detected in a blind manner by an expert radiologist. Results: One hundred and six RA patients were enrolled (M/F: 1/2.5, mean age 68.7\ub110.3); among them 45 (42.5%) showed ILD at HRCT. Three patients were excluded because of a low quality of the sound recorded. The algorithm showed a sensitivity and specificity of 72.1% and 84.4%, respectively and a positive/negative predictive value of 69.1% and 86.3%, respectively. Conclusions: Despite preliminary, these data suggest an important role of ES in clinical practice for an early diagnosis of ILD in RA patients and a significant reduction of inappropriate prescription of HRCT. Since very different types of ILD can occur in course of RA, with different radiologic features and localization, proper development of the measurement setup (ES and ad hoc software for the detection of PC) could further increase its predictive value, in particular to avoid incorrect records and misdiagnosis. The routinely employment of ES and proper software, combined to clinical findings (cough, dyspnea) and respiratory lung function, could increase our ability to early identify ILD in RA patients

Geographical heterogeneity of clinical and serological phenotypes of systemic sclerosis observed at tertiary referral centres. The experience of the Italian SIR-SPRING registry and review of the world literature

Introduction: Systemic sclerosis (SSc) is characterized by a complex etiopathogenesis encompassing both host genetic and environmental -infectious/toxic- factors responsible for altered fibrogenesis and diffuse microangiopathy. A wide spectrum of clinical phenotypes may be observed in patients' populations from different geographical areas. We investigated the prevalence of specific clinical and serological phenotypes in patients with definite SSc enrolled at tertiary referral centres in different Italian geographical macro-areas. The observed findings were compared with those reported in the world literature.Materials and methods: The clinical features of 1538 patients (161 M, 10.5%; mean age 59.8 +/- 26.9 yrs.; mean disease duration 8.9 +/- 7.7 yrs) with definite SSc recruited in 38 tertiary referral centres of the SPRING (Systemic sclerosis Progression INvestiGation Group) registry promoted by Italian Society of Rheumatology (SIR) were obtained and clustered according to Italian geographical macroareas.Results: Patients living in Southern Italy were characterized by more severe clinical and/or serological SSc phenotypes compared to those in Northern and Central Italy; namely, they show increased percentages of diffuse cutaneous SSc, digital ulcers, sicca syndrome, muscle involvement, arthritis, cardiopulmonary symptoms, interstitial lung involvement at HRCT, as well increased prevalence of serum anti-Scl70 autoantibodies. In the same SSc population immunusppressive drugs were frequently employed. The review of the literature underlined the geographical heterogeneity of SSc phenotypes, even if the observed findings are scarcely comparable due to the variability of methodological approaches.Conclusion: The phenotypical differences among SSc patients' subgroups from Italian macro-areas might be correlated to genetic/environmental co-factors, and possibly to a not equally distributed national network of information and healthcare facilities

Development of new cellular materials by gel-casting technique

In this PRISMA project new cellular materials will be developed by a gel casting technique. The process was initially set up to produce dense ceramics, andwill be adapted in a second stage to the formation of cellular solids with the addition of a pore forming agent (poly(ethylene)), which decomposes during thermal treatment at high temperature, leaving calibrated porosities. Commercial ZrO2 powders (Tosoh TZ-3Y and TZ-3YS, 3 mol % Y2O3) as a ceramic material and gelatine as a gelling agent were employed. Selected powders were preliminary characterised by Transmission Electron Microscopy (BF and SADP), in order to acquire information about size distribution and microstructure. The first step of the work was the optimisation of the zirconia suspension with respect to its stability, because while the gelling process is occurring there should be no powder sedimentation. The best results were obtained bywith dispersing the powders in distilled water under natural pH (ca. 4.7) and after 10 minutes of sonication by means of an u.s. probe, as evidenced by laser granulometry. Then, slurries with varying solid/liquid ratios and various amounts of gelatine were prepared. The influence of the dispersion method, of the temperature of gelatine dissolution and of casting, gelation and drying conditions were studied. In particular, an increase of the viscosity of the suspension was observed with the TZ- 3Y powder, which made the casting very difficult, then this powder was given up. The best results were reached with a solid content of 50 wt% and a gelatine content of 3 wt.% respect to the water amount. Knoop micro-hardness technique, performed on a section carefully cut and polished, was used to investigate the effectiveness of the drying phase: differences in hardness between surface and core were found, possibly as a consequence of differential drying rate which involves an internal gradient of density, useful for an effective comparison between different drying procedures. Density measurements by Archimede’s principle on fired samples at 1400°C for 1 hour indicated that it was possible to reach at least 95% t.d.. Then, poly(ethylene) granules (125-300 microns) were added to create porosities inside the gel cast pieces (50 vol.%). The thermal cycle was set up to allow the polymer to decompose, without foam collapsing prior to high temperature sintering. Dense products were machined to the final standard size of 10x30 mm for cylinders and 4x3x50 mm for prismatic bars, obtaining parallel planar surfaces and removing surface defects such as voids and irregular profiles. Samples were tested for mechanical properties by means of Instron 8033 (200 kN) and Zwick Roell Z010 (10kN) electromechanical testing machines. Uniaxial compressive strength was measured on cylinders, tensile strength and elastic modulus were measured by four points bending test on prismatic samples equipped with strain gauges. Hardness and fracture toughness of bulk samples were finally evaluated by Vickers micro-hardness testing adopting models available in literature

Fibroscan-aspartate aminotransferase (FAST) score predicts liver-related outcomes, but not extra-hepatic events, in a multicenter cohort of people with HIV

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is frequent in people with HIV (PWH). The Fibroscan-aspartate aminotransferase (FAST) score was developed to identify patients with nonalcoholic steatohepatitis (NASH) and significant fibrosis. We investigated prevalence of NASH with fibrosis and the value of FAST score in predicting clinical outcomes in PWH. METHODS: Transient elastography (Fibroscan) was performed in PWH without viral hepatitis coinfection from four prospective cohorts. We used FAST>0.35 to diagnose NASH with fibrosis. Incidence and predictors of liver-related outcomes (hepatic decompensation, hepatocellular carcinoma) and extra-hepatic events (cancer, cardiovascular disease) were evaluated through survival analysis. RESULTS: Of the 1472 PWH included, 8% had FAST>0.35. On multivariable logistic regression, higher BMI (adjusted odds ratio [aOR] 1.21, 95% confidence interval [CI] 1.14-1.29), hypertension (aOR 2.24, 95% CI 1.16-4.34), longer time since HIV diagnosis (aOR 1.82, 95% CI 1.20-2.76) and detectable HIV viral load (aOR 2.22, 95% CI 1.02-4.85) were associated with FAST>0.35. 882 patients were followed for a median of 3.8 years (interquartile range 2.5-4.2). Overall, 2.9% and 11.1% developed liver-related and extra-hepatic outcomes, respectively. Incidence of liver-related outcomes was higher in patients with FAST>0.35 vs. FAST0.35 remained an independent predictor of liver-related outcomes (adjusted hazard ratio 4.97, 95% CI 1.97-12.51). Conversely, FAST did not predict extra-hepatic events. CONCLUSION: A significant proportion of PWH without viral hepatitis coinfection may have NASH with significant liver fibrosis. FAST score predicts liver-related outcomes and can help risk stratification and management in this high-risk population

Fibroscan-aspartate aminotransferase (FAST) score predicts liver-related outcomes, but not extra-hepatic events, in a multicenter cohort of people with HIV

Background: Nonalcoholic fatty liver disease (NAFLD) is frequent in people with HIV (PWH). The Fibroscan-aspartate aminotransferase (FAST) score was developed to identify patients with nonalcoholic steatohepatitis (NASH) and significant fibrosis. We investigated prevalence of NASH with fibrosis and the value of FAST score in predicting clinical outcomes in PWH. Methods: Transient elastography (Fibroscan) was performed in PWH without viral hepatitis coinfection from four prospective cohorts. We used FAST>0.35 to diagnose NASH with fibrosis. Incidence and predictors of liver-related outcomes (hepatic decompensation, hepatocellular carcinoma) and extra-hepatic events (cancer, cardiovascular disease) were evaluated through survival analysis. Results: Of the 1472 PWH included, 8% had FAST>0.35. On multivariable logistic regression, higher BMI (adjusted odds ratio [aOR] 1.21, 95% confidence interval [CI] 1.14-1.29), hypertension (aOR 2.24, 95% CI 1.16-4.34), longer time since HIV diagnosis (aOR 1.82, 95% CI 1.20-2.76) and detectable HIV viral load (aOR 2.22, 95% CI 1.02-4.85) were associated with FAST>0.35. 882 patients were followed for a median of 3.8 years (interquartile range 2.5-4.2). Overall, 2.9% and 11.1% developed liver-related and extra-hepatic outcomes, respectively. Incidence of liver-related outcomes was higher in patients with FAST>0.35 vs. FAST<0.35 (45.1, 95% CI 26.2-77.7 vs. 5.0, 95% 2.9-8.6 per 1000 person-years). On multivariable Cox regression analysis, FAST>0.35 remained an independent predictor of liver-related outcomes (adjusted hazard ratio 4.97, 95% CI 1.97-12.51). Conversely, FAST did not predict extra-hepatic events. Conclusion: A significant proportion of PWH without viral hepatitis coinfection may have NASH with significant liver fibrosis. FAST score predicts liver-related outcomes and can help risk stratification and management in this high-risk population