Evaluation of the management of Hr-HPV+/PapTest- women. Results at 1-year recall

With cervical cancer screening the choice of 1-year as a period of follow-up in positive high-risk HPV women without cytological lesions is still under discussion. We evaluated the management of these women and the role of HPV genotyping test. We did a cervical cancer screening study of women aged 35-64 with primary high-risk HPV test. Women positive for high-risk HPV with negative cytology were followed-up after 1 year. In this study we selected women with high-risk HPV+/PapTest- resulted high-risk HPV+ at recall and performed the PapTest and HPV genotyping test. The detection rate of squamous high grade (CIN2+) relative to the total screened cohort was 2.1‰, and it was 0.2‰ at the 1-year recall. The colposcopy performed in women referred at the 1-year recall accounted for 48.8% of the total (baseline + 1-year recall), and 84.3% of these women had no cytological lesions. The most frequent hr-HPV genotype detected was HPV16 and 66.7% of co-infections were due to HPV16 and HPV18. 54.5% of women presented a persistent infection at 1-year recall with the same HPV subtype, 50% of persistent infections was due to HPV16 and 16.7% of these were determined to be CIN2+ histological lesions. Our data show that it may be useful to extend the period of follow-up for women hr-HPV+/PapTest- so as to reduce the number of unnecessary colposcopies due to the transitory infections and that the genotyping test could help to identify the persistent infections in which HPV16 is involved

Evaluating Augmented and Virtual Reality in Education Through a User-Centered Comparative Study

none5Augmented and virtual reality proved to be valuable solutions to convey contents in a more appealing and interac- tive way. Given the improvement of mobile and smart devices in terms of both usability and computational power, contents can be easily conveyed with a realism level never reached in the past. Despite the tremendous number of researches related with the presentation of new fascinating applications of ancient goods and artifacts augmenta- tion, few papers are focusing on the real effect these tools have on learning. Within the framework of SmartMarca project, this chapter focuses on assessing the potential of AR/VR applications specifically designed for cultural heritage. Tests have been conducted on classrooms of teenagers to whom different learning approaches served as an evaluation method about the effectiveness of using these technologies for the education process. The chapter argues on the necessity of developing new tools to enable users to become producers of contents of AR/VR experiences.openPierdicca, Roberto; Frontoni, Emanuele; Puggioni, Maria Paola; Malinverni, Eva Savina; Paolanti, MarinaPierdicca, Roberto; Frontoni, Emanuele; Puggioni, Maria Paola; Malinverni, Eva Savina; Paolanti, Marin

Management of women aged 25-34 with diagnosis of ASCUS in the screening center of Latina.

In cervical cancer screening program of Latina (Italy) the hr-HPV as primary test is performed only on women aged 35-64 while women aged 25-34 are invited to perform PapTest. The aim of this study was to evaluate the impact of the application of the PapTest in women aged 25-34 and to evaluate the management of ASCUS. Women aged 25-34 were invited to perform PapTest according to the Italian guidelines; women with diagnosis of LSIL+ were referred to colposcopy while women with diagnosis of ASCUS were referred to hr-HPV test and only women resulted positive were referred to colposcopy. The 4.0% of women resulted positive to PapTest and the referral rate to colposcopy was 3.5%. The PPV value for CIN2+ at colposcopy was 7.2% and the Detection Rate (DR) for CIN2+ was 2.40‰. The ASCUS category was diagnosed in 41.8% of women resulted positive to PapTest and between them the 70.6% resulted positive to the hr-HPV test. The referral rate to colposcopy of women resulted positive to hr-HPV test was 1.1%. The PPV for CIN2+ at colposcopy and the DR of CIN2+ was 8.4% and 0.96‰ respectively. Between women with diagnosis of ASCUS, only 6 women showed a CIN2+ lesion (4 CIN2 and 2 CIN3). The present study showed that this algorithm, applied to women aged 25-34, obtained a good performance in term of test specificity (98%) and confirm that the application of hr-HPV test in the management of ASCUS leads to a decreased of inappropriate colposcopy due to transitory infection in young women

ScoolAR: An Educational Platform to Improve Students' Learning Through Virtual Reality

Augmented Reality (AR) and Virtual Reality (VR) applications has been investigated in several domains. As such, their application in educational settings has witnessed to a growing interest by the research community. Teachers can be assisted by AR/VR, in a way that students can strength the learning outcomes, gained during the classroom lecture. However, despite their potential has been widely assessed, there still exists a bottleneck preventing a widespread adoption in the education domain: the lack of easy to use platforms enabling teachers and students to become producers of AR/VR experiences. This paper fills this gap, by proposing a novel platform named ScoolAR, developed for didactic purposes. ScoolAR allows to create AR/VR applications without any programming skills. Up to now, there is no evidence in the state-of-art of a didactic tool that allows to create AR/VR applications without programming skills. From such premises, ScoolAR has been developed to overcome these limitations and to enable an autonomous content creation system and thus boosting more engagement and awareness in the exploitation of AR and VR applications in everyday educational scenarios. Beside describing the architectural framework of the proposed platform, this paper presents the results of experiments conducted in a real didactic scenario. Considering two group of students, the first group was assisted with the ScoolAR framework, the second one conducted the study phase with frontal lecture. The test performed proved that the first group outperformed the second one on all metrics of evaluation. Thus, the combined effort between common didactic activities and technological innovation permits to achieve superior results in terms of both knowledge and competences, especially for those disciplines (e.g. Cultural Heritage and History of Architecture and more) where the transversal learning is fundamental

BRAF and NRAS mutations are heterogeneous and not mutually exclusive in nodular melanoma

Inhibitors of RAF inhibit the MAPK pathway that plays an important role in the development and progression of those melanoma carrying the V600E BRAF mutation, but there's a subset of such patients who do not respond to the therapy. Various mechanisms of drug resistance have been proposed which include the clonal heterogeneity of the tumor. We have studied a population of nodular melanoma to investigate the intratumor and intertumor heterogeneity by Laser Capture Microdissection (LCM) analysis. Our results showed that BRAF and NRAS mutations were detected in 47% and 33% of nodular melanoma, respectively, and that there is a discrepancy in mutational pattern of tumoral sample because in the 36% of patients a different mutation, in at least 1 area of the tumor, was found by LCM analysis, giving evidence of the presence of different clonal cells populations. Moreover, we found that mutations in BRAF and NRAS are not mutually exclusive because they were simultaneously present in the same tumor specimens and we observed that when the 2 different mutations were present one is a high-frequency mutation and the other is a low-frequency mutation. This was more evident in lymphonodal metastasis that resulted from wild type to mutational analysis, but showed different mutations following LCM analysis. Therefore, we believed that, when primary tumoral sample results negative to mutational analysis, if it is possible, metastases should be investigated to verify the presence of mutations. Generally, it should be searched for other mutations, in addition to BRAF V600E, so as to better understand the mechanism of drug resistance.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Filologia, Teatro, Spettacolo. Dai greci alla contemporaneità

Dai numerosi cantieri editoriali che hanno visto la luce negli ultimi decenni e dalla crescente attenzione per le arti performative sono emersi aspetti e problemi legati tanto alla ricerca scientifica quanto alle rappresentazioni contemporanee. Esiste una filologia dello spettacolo? Può accontentarsi dei canoni di una tradizione operativa o richiede una profonda revisione degli statuti disciplinari? Quali sono le specificità dell’edizione critica di un testo teatrale o di una sceneggiatura? E, se ve ne sono, dipendono dalle caratteristiche dell’oggetto o dall’approccio metodologico dello studioso che se ne occupa? Come si confronta la pratica del palcoscenico con le questioni che emergono dalla studio approfondito dei testi? Questo volume nasce da un incontro di studi intorno a questi interrogativi e raccoglie saggi che propongono riflessioni, da prospettive diverse e su un lungo arco cronologico, sull’incontro/scontro fra l’esigenza di preservare lo spettacolo nella memoria e il suo carattere inevitabilmente effimero. Dai Greci alle avanguardie, dal Rinascimento alla scena dialettale, si tratta di cogliere caratteri permanenti e strategie di indagine e rilettura specifiche per ogni cultura, per ogni contesto produttivo