4,722 research outputs found

    Coral facies and cyclicity in the Castelgomberto Limestone (Early Oligocene, Eastern Lessini Mountains, Northern Italy).

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    The Castelgomberto Limestone is a 200 m thick unit of Early Oligocene age (Rupelian) outcropping in the eastern Lessini Mountains (Southern Alps of Northern Italy). The internal cyclic organization of this Oligocene unit is described and analyzed on the basis of four selected sections; about 13 well-bedded grainstone units alternate with marly horizons rich in corals. This peculiar cyclicity is here interpreted as a response to variations in platform hydrodynamics, i.e. to smaller eustatic fluctuations affecting the Lessini Shelf reef-lagoonal complex. During highstand periods, the shelf was open and relatively deep (20-50m), and tidal currents and periodic storms were able to distribute bioclastic sands. During lowstands the shelf was more protected by the occurrence of marginal reefs and was colonized by patches of poritid corals, mainly branching. Moreover, the largely exposed northern areas supplied fine detritus to the shelf itself

    New specimen of the rare requiem shark Eogaleus bolcensis from the Bolca Lagerst\ue4tte, Italy

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    A rare carcharhinid specimen (slab and counter-slab, MSNPV 24625-24626) from the world-renowned Eocene Bolca locality was recently rediscovered during a restoration project started in 1989 by the Museo di Storia Naturale di Pavia. The individual, the largest Eogaleus bolcensis known from Bolca, is disarticulated and lies in a massive limestone matrix, suggesting its provenience from the Monte Postale site. While assessing its taxonomic status, multiple morphological affinities and ontogenetic trends within the Bolca Carcharhiniformes assemblage where documented. Eogaleus bolcensis is here distinguished from the school shark Galeorhinus cuvieri exclusively according to dermal denticle morphology, suggesting partial overlap of ecologic and trophic niches between the two species. Further, measurements and meristic counts taken on different traits of E. bolcensis (two individuals) and G. cuvieri (five individuals) specimens show high degree of similarities. The ratios "trunk length/total length"and "sum of vertebral centra (head region)/total length"of four complete individuals of the fossil assemblage were averaged and employed to estimates the total length of MSNPV 24625-24626. Here, the total length of MSNPV 24625-24626 is estimated in about 172.1\ub10.1 cm. The same approach is applied to MCSNV T.311 (E. bolcensis, holotype) and MNHN F.Bol.516 (G. cuvieri, holotype), two partially-preserved fossil individuals from Bolca locality. To support the ontogenetic variability among the Bolca shark assemblage, the age of the fossil individuals was estimated following the Von Bertalanffy Growth Function, using the modern chondrichthyans growth parameters as a reference. Data presented here suggest that all G. cuvieri specimens are juvenile individuals, whereas the E. bolcensis specimens were young-adult

    Parenting infants at the times of COVID-19: A cross-sectional study on parental stress in the province of Modena (Northern Italy)

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    Background and aim of the work: The advent of the COVID-19 pandemic and the consequent measures to prevent virus’s spread particularly affected families with young children, that represent a complex system characterized by a constant interaction between the infant’s and the parent’s well-being. The present study aims to investigate the parenting stress experienced by parents with 6-month-old healthy infants surveyed from September 2019 to April 2021 in the Modena province (Northern Italy). Research design and methods: We carried out a cross-sectional study using the Parenting Stress Index-Short Form (PSI-SF) questionnaire to assess stress levels in the parent-child system. Since the questionnaire is meant to be self-completed by the participant, the survey could continue to be conducted remotely during the pandemic lockdown months. Results: Most parents exhibited physiological stress scores, but parents who have been interviewed during the pandemic period had a higher prevalence of stress problems. Subjects in the COVID group also showed a drop in the defensive response and a lower prevalence of stress problems when parenting siblings. Conclusions: These findings underline the importance of early detection of isolation’s negative effects on households and strengthen the need for tailored familial support during stressful events, in order to pro-mote parent and children’s emotional well-being

    Treatment of hepatocellular carcinoma with immune checkpoint inhibitors and applicability of first-line atezolizumab/bevacizumab in a real-life setting

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    Immune checkpoint inhibitors (ICIs) are the new frontier for the treatment of advanced hepatocellular carcinoma (HCC). Since the first trial with tremelimumab, a cytotoxic T-lymphocyte-associated protein 4 inhibitor, increasing evidence has confirmed that these drugs can significantly extend the survival of patients with advanced hepatocellular carcinoma (HCC). As a matter of fact, the overall survival and objective response rates reported in patients with advanced HCC treated with ICIs are the highest ever reported in the second-line setting and, most recently, the combination of the anti-programmed death ligand protein-1 atezolizumab with bevacizumab—an anti-vascular endothelial growth factor monoclonal antibody—demonstrated superiority to sorafenib in a Phase III randomized clinical trial. Therefore, this regimen has been approved in several countries as first-line treatment for advanced HCC and is soon expected to be widely used in clinical practice. However, despite the promising results of trials exploring ICIs alone or in combination with other agents, there are still some critical issues to deal with to optimize the prognosis of advanced HCC patients. For instance, the actual proportion of patients who are deemed eligible for ICIs in the real-life ranges from 10% to 20% in the first-line setting, and is even lower in the second-line scenario. Moreover, long-term data regarding the safety of ICIs in the population of patients with cirrhosis and impaired liver function are lacking. Lastly, no biomarkers have been identified to predict response, and thus to help clinicians to individually tailor treatment. This review aimed to summarize the state of the art immunotherapy in HCC and, by analyzing a large, multicenter cohort of Italian patients with HCC, to assess the potential applicability of the combination of atezolizumab/bevacizumab in the real-life setting

    Desire thinking as a predictor of drinking status following treatment for alcohol use disorder: A prospective study

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    © 2019 Elsevier Ltd Research has indicated that craving is one of the strongest predictors of treatment outcome and relapse in Alcohol Use Disorders (AUD) but there is little consensus on the factors that may influence its activation and escalation. Research has also shown that desire thinking is an important cognitive process which may exacerbate craving in problem drinkers. The aim of present study was to explore, for the first time, the role of desire thinking in prospectively predicting relapse, craving and binge drinking in patients receiving treatment for AUD. One hundred and thirty-five patients admitted to two rehabilitation centres and two outpatient services for addiction and mental health problems were administered baseline, treatment completion and three months follow-up measures of anxiety and depression, AUD severity, binge drinking frequency, craving and desire thinking. Results indicated that the verbal perseveration component of desire thinking at treatment completion was the only significant predictor of relapse at follow-up over and above baseline AUD severity and binge drinking frequency. Furthermore, the imaginal prefiguration component of desire thinking and craving levels at treatment completion were found to predict craving levels at follow-up independently of AUD severity and binge drinking frequency at baseline. Finally, both the imaginal prefiguration and verbal perseveration components of desire thinking at treatment completion were found to be the only predictors of binge drinking frequency at follow-up independently of AUD severity and binge drinking frequency at baseline. Treatments for AUD should aim to reduce desire thinking in people to enhance clinical outcomes and reduce relapse risk

    Lidocaine for systemic sclerosis: a double-blind randomized clinical trial

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    Background: Systemic sclerosis (scleroderma; SSc) is an orphan disease with the highest case-specific mortality of any connective-tissue disease. Excessive collagen deposit in affected tissues is a key for the disease's pathogenesis and comprises most of the clinical manifestations. Lidocaine seems to be an alternative treatment for scleroderma considering that: a) the patient's having excessive collagen deposits in tissues affected by scleroderma; b) the patient's demonstrating increased activity of the enzyme prolyl hydroxylase, an essential enzyme for the biosynthesis of collagen; and c) lidocaine's reducing the activity of prolyl hydroxylase. the aim of this study was to evaluate the efficacy and safety of lidocaine in treating scleroderma.Methods: A randomized double-blind clinical trial included 24 patients with scleroderma randomized to receive lidocaine or placebo intravenously in three cycles of ten days each, with a one-month interval between them. Outcomes: cutaneous (modified Rodnan skin score), oesophageal (manometry) and microvascular improvement (nailfold capillaroscopy); improvement in subjective self-assessment and in quality of life (HAQ).Results: There was no statistically significant difference between the groups for any outcome after the treatment and after 6-months follow-up. Improvement in modified Rodnan skin score occurred in 66.7% and 50% of placebo and lidocaine group, respectively (p = 0.408). Both groups showed an improvement in subjective self-assessment, with no difference between them.Conclusions: Despite the findings of a previous cohort study favouring the use of lidocaine, this study demonstrated that lidocaine at this dosage and means of administration showed a lack of efficacy for treating scleroderma despite the absence of significant adverse effects. However, further similar clinical trials are needed to evaluate the efficacy of lidocaine when administered in different dosages and by other means.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Brazilian Cochrane Ctr, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Discipline Emergency Med & Evidence Based Med, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Discipline Rheumatol, São Paulo, BrazilUniv Santo Amaro, Discipline Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Brazilian Cochrane Ctr, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Discipline Emergency Med & Evidence Based Med, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Discipline Rheumatol, São Paulo, BrazilFAPESP: 01-13895-9Web of Scienc

    Diprosopus: A Rare Case of Craniofacial Duplication and a Systematic Review of the Literature

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    In 1990, Gorlin et al. described four types of craniofacial duplications: (1) single mouth with duplication of the maxillary arch; (2) supernumerary mouth laterally placed with rudimentary segments; (3) single mouth with replication of the mandibular segments; and (4) true facial duplication, namely diprosopus. We describe a newborn born with wide-spaced eyes, a very broad nose, and two separate mouths. Workup revealed the absence of the corpus callosum and the presence of a brain midline lipoma, wide sutures, and a Chiari I malformation with cerebellar herniation. We conducted a systematic review of the literature and compared all the cases described as diprosopus. In 96% of these, the central nervous system is affected, with anencephaly being the most commonly associated abnormality. Other associated anomalies include cardiac malformations (86%), cleft palate (63%), diaphragmatic hernia (13%), and disorder of sex development (DSD) (13%). Although the facial features are those that first strike the eye, the almost obligate presence of cerebral malformations suggests a disruptive event in the cephalic pole of the forming embryo. No major monogenic contribution has been recognized today for this type of malformation
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