Non-thermal emission in the lobes of radio galaxies.

Radio and gamma-ray measurements of radiogalaxy lobes are useful to determine whether emission in these widely separated spectral regions is mainly by non-thermal (NT) electrons. This is of interest as there is yet no proof for a significant emission component from pion decay following NT proton interactions in the ambient lobe gas. An assessment of the hadronic yield needs full accounting of the local (FGL) and background (EBL, CMB) radiation fields in the lobes. Assuming a truncated single-PL electron energy distribution, exact calculation of the emission by NT electrons in the magnetized plasma in the Fornax A lobes leads to the conclusion that its Fermi-LAT emission is mostly IC/GFL: this result weakens earlier conclusions on the hadronic origin of the LAT emission. Similar analyses of the lobe emissions of Cen A, Cen B, and NGC 6251 suggest their measured LAT emissions, too, to be of IC/(EBL, CFGL, CMB) nature. Measured emissions of distant radio-galaxy lobes (3C98, Pictor A, DA240, Cygnus A, 3C326, and 3C236) are currently limited to the radio and X-ray bands: they can give no information on the presence of NT protons, but do trace the properties of NT electrons, and allow calculations of the related IC gamma-ray emission to be performed. The e/B energy density ratios, U_e/U_B, turn out to be in the range ~1-100. The NT proton energy density, U_p, is spectrally constrained to be less than a few tens of eV/cm3. Despite this limit, arguably U_p >> U_e -- as suggested by arguments of lobe internal vs external pressure. Thus the lobes' NT energy budget is likely dominated by particles. Given the low thermal energy densities measured in lobes, NT energy dominance is probably a general feature of lobe energetics

Local solvability of a class of degenerate second order operators

In this paper we will first present some results about the local solvability property of a class of degenerate second order linear partial differential operators with smooth coefficients. The class under consideration (which in turn is a generalization of the Kannai operator) exhibits a degeneracy due to the interplay between the singularity associated with the characteristic set of a system of vector fields and the vanishing of a function. Afterward we will also discuss some local solvability results for two classes of degenerate second order linear partial differential operators with non-smooth coefficients which are a variation of the main class presented above

Gli inibitori dell'istone deacetilasi nel trattamento del linfoma non hodgkin diffuso a grandi cellule ricaduto/refrattario dell'adulto: studio di fase II con Panobinostat

Backgrounds:Treatment of patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) not eligible to high dose therapy represents an unmet medical need. Panobinostat showed encouraging therapeutic activity in studies conducted in lymphoma cell lines and in vivo in patients with advanced hematologic malignancies.Purpose:FIL-PanAL10 (NCT01523834) is a phase II, prospective multicenter trial of the Fondazione Italiana Linfomi (FIL) to evaluate safety and efficacy of single agent Panobinostat as salvage therapy for R/R DLBCL patients and to evaluate a possible relationships between response and any biological features. Patients and Methods:Patients with R/R DLBCL were included. The treatment plan included 6 induction courses with Panobinostat monotherapy followed by other 6 courses of consolidation. The primary objective was to evaluate Panobinostat activity in terms of overall response (OR); secondary objectives were: CR rate, time to response (TTR), progression-free survival (PFS), safety and feasibility of Panobinostat. We included evaluation of the impact of pharmacogenetics, immunohistochemical patterns and patient’s specific gene expression and mutations as potential predictors of response to Panobinostat as explorative objectives. To this aim a pre-enrollment new tissue biopsy was mandatory. ResultsThirty-five patients, 21 males (60%), were enrolled between June 2011 and March 2014. At the end of induction phase, 7 responses (20%) were observed, including 4 CR (11%), while 28 patients (80%) discontinued treatment due to progressive disease (PD) in 21 (60%) or adverse events in 7 (20%). Median TTR in 9 responders was 2.6 months (range 1.8-12). With a median follow up of 6 months (range 1-34), the estimated 12 months PFS and OS were 27% and 30.5%, respectively. Grade 3-4 thrombocytopenia and neutropenia were the most common toxicities (in 29 (83%) and 12 (34%) patients, respectively. Conclusions The results of this study indicate that Panobinostat might be remarkably active in some patients with R/R DLBCL, showing durable C

Fetal and neonatal outcomes of non primary cytomegalovirus maternal infection

OBIETTIVI: Valutazione del rischio di trasmissione verticale e delle conseguenze dell’infezione congenita da cytomegalovirus (CMV) in caso di infezione non primaria versus l’outcome delle gravidanze complicate da infezione primaria. MATERIALI E METODI: Studio retrospettivo di coorte di gravide con infezione recente da CMV diagnosticata c/o il nostro centro negli anni 2000-2013. Le pazienti sono state suddivise in 2 gruppi in base al risultato delle indagini sierologiche (avidità IgG e immunoblot): il primo con profilo sierologico compatibile con infezione non primaria e l'altro compatibile con infezione primaria da CMV. Sono stati confrontati il rischio di trasmissione e di infezione congenita sintomatica nei due gruppi. RISULTATI: Il follow-up è risultato disponibile in 1122 casi di cui 182 con infezione materna non-primaria e 940 con infezione primaria materna. L’infezione congenita è stata diagnosticata in 7 (3.86%) feti/neonati nei casi di infezione non primaria e in 217 (23%) feti/neonati nei casi di infezione primaria (p<0.001). Tra gli infetti, erano sintomatici 43 (19,8%) e 3 (42,8%) rispettivamente nell’infezione primaria e non primaria. COMMENTO: La preesistente immunità materna offre una protezione contro la trasmissione intrauterina nell’infezione da CMV ma non protegge dalla malattia congenita sintomatica.OBJECTIVE: To evaluate fetal and neonatal outcomes in case of non-primary cytomegalovirus (CMV) infection. STUDY DESIGN: Retrospective cohort study, including pregnant women with active CMV infection, referred to our units in a 13-year period (2000-2013). Patients were divided into two groups according to the results of confirmatory serologic testing (avidity test, immunoblotting): serologic profile consistent with non-primary infection and serologic profile suggestive of primary infection. The vertical transmission rate and the percentage of symptomatic congenital infection were compared into the two groups. RESULTS: Follow-up was available in 1122 cases, including 182 non-primary infections and 940 primary maternal infections. Congenital infection was diagnosed in 7 (3.86%) fetuses/neonates of non-primary infection group and in 217 (23%) fetuses/neonates of primary infection group (p<0.001). Symptomatic infected fetuses/neonates rate was similar into the two groups: 3 (42,8%) in non-primary infections versus 43 (19,8%) in primary infections (p = 0,13). CONCLUSION: Previous maternal immunity offers substantial protection against intrauterine transmission of CMV infection, but not against disease once the fetus is infected

Definition of Clinical and Immunological Phenotypes of Graft Dysfunction in Heart Transplant Recipients: Prognostic Implications and Role of Antibody Mediated Rejection

Background Despite its clinical relevance, there is a lack of consensus regarding the definition of graft dysfunction (GD) in heart transplant (HT). Herein we aim to characterize clinical phenotypes of patients with GD, either acute or chronic, comparing their outcomes with stable patients. In addition, we explored the risk factors outcomes in GD patients. Methods The patients were divided in 3 groups: Group A - Patients who recently underwent HT ( 5 years). Primary Endpoints were: overall mortality, hospitalizations for cardiovascular events and hospitalization for all-causes. The Combined Endpoints was death or /and hospitalizations for cardiovascular events (CV hospitalization). Results We enrolled 134 consecutive HT patients. Patients with GD 32(24%) had significant higher prevalence of class NYHA >II, low EF, CAV, longer QRS and Qtc on the ECG (p<0.01) and donor specific antibodies (DSA) (all p<0.05), as compared with group A and C. Clinical presentation was highly heterogeneous: 6(19%) had acute presentation, 3 for acute rejection, and 3 for acute coronary syndromes; 21(66%) had chronic presentation: 17(53%) associated with CAV, and 4(13%) as chronic dysfunction after antibody-mediated rejection. During the 2y follow-up, GD patients showed higher mortality (P=0.01) and higher CVE hospitalization rate (54; P< 0.01) than patients in group A and C. Low EF, time from HT, and chronic clinical presentation (p<0.01) were risk factors for the combined endpoint Conclusions GD after HT is characterized by highly variable clinical presentation and is correlated with a particularly poor prognosis. CAV is the most frequent etiology, and DSA are more often found in patients with GD than in stable ones, but do not seem to influence outcome

Design and fabrication of biocompatible scaffolds for the regeneration of tissues

Regenerative medicine and tissue engineering attempt to repair or improve the biological functions of tissues that have been damaged or have ceased to perform their role through three main components: a biocompatible scaffold, cellular component and bioactive molecules. Nanotechnology provide a toolbox of innovative scaffold fabrication procedures in regenerative medicine. In fact, nanotechnology, using manufacturing techniques such as conventional and unconventional lithography, allows fabricating supports with different geometries and sizes as well as displaying physical chemical properties tunable over different length scales. Soft lithography techniques allow to functionalize the support by specific molecules that promote adhesion and control the growth of cells. Understanding cell response to scaffold, and viceversa, is a key issue; here we show our investigation of the essential features required for improving the cell-surface interaction over different scale lengths. The main goal of this thesis has been to devise a nanotechnology-based strategy for the fabrication of scaffolds for tissue regeneration. We made four types of scaffolds, which are able to accurately control cell adhesion and proliferation. For each scaffold, we chose properly designed materials, fabrication and characterization techniques

Quantifying and modeling ecosystem services provided by urban greening in cities of the Southern Alps, N Italy

Population growth in urban areas is a world-wide phenomenon. According to a recent United Nations report, over half of the world now lives in cities. Numerous health and environmental issues arise from this unprecedented urbanization. Recent studies have demonstrated the effectiveness of urban green spaces and the role they play in improving both the aesthetics and the quality of life of its residents. In particular, urban green spaces provide ecosystem services such as: urban air quality improvement by removing pollutants that can cause serious health problems, carbon storage, carbon sequestration and climate regulation through shading and evapotranspiration. Furthermore, epidemiological studies with controlled age, sex, marital and socio-economic status, have provided evidence of a positive relationship between green space and the life expectancy of senior citizens. However, there is little information on the role of public green spaces in mid-sized cities in northern Italy. To address this need, a study was conducted to assess the ecosystem services of urban green spaces in the city of Bolzano, South Tyrol, Italy. In particular, we quantified the cooling effect of urban trees and the hourly amount of pollution removed by the urban forest. The information was gathered using field data collected through local hourly air pollution readings, tree inventory and simulation models. During the study we quantified pollution removal for ozone, nitrogen dioxide, carbon monoxide and particulate matter (<10 microns). We estimated the above ground carbon stored and annually sequestered by the urban forest. Results have been compared to transportation CO2 emissions to determine the CO2 offset potential of urban streetscapes. Furthermore, we assessed commonly used methods for estimating carbon stored and sequestered by urban trees in the city of Bolzano. We also quantified ecosystem disservices such as hourly urban forest volatile organic compound emissions

New techniques for the treatment of perianal Crohn's disease

Studio prospettico su 75 pazienti con malattia paranale di Crohn che ha come obiettivo quello di confrontare i risultati tra le nuove terapie medico-chirurgiche emergenti. La prima procedura è comune a tutti i pazienti e consiste in un intervento di incisione degli ascessi, fistulectomia e posizionamento di setoni di drenaggio nei tramiti fistolosi per il controllo della sepsi.Successivamente i pazienti vengono divisi in cinque gruppi e sottoposti ai trattamenti per la chiusura dei tramiti fistolosi: terapia sistemica con Infliximab,terapia sistemica con Adalimumab,confezionamento di Flap endoanale, instillazione di colla di fibrina o posizionamento di protesi biologiche. Abbiamo osservato una chiusura completa dei tramiti fistolosi nel 60% dei pazienti trattati con Infliximab, 53% di quelli trattati con Adalimumab, 40% di quelli in terapia con colla di fibrina, 80% di quelli sottoposti a Flap endoanale e 60% di quelli trattati con protesi biologiche. Gli ottimi risultati raggiunti in con le diverse metodiche di trattamento chirurgico locale rappresentano una valida alternativa alla terapia con farmaci biologici. Tali nuove metodiche risultano anzi fondamentali per il trattamento di quei pazienti che dopo una terapia con farmaci biologici non hanno raggiunto una completa risoluzione del quadro (rescue therapy). Terapia biologica e nuove tecniche chirurgiche risultano pertanto complementari, la prima contribuendo al miglioramento della qualità della mucosa del canale anale e del retto basso sulla quale risulta quindi più agevole agire con le seconde con una percentuale di successo sempre maggiore.Prospective study on 75 patients with perianal Crohn's disease that aims to compare the results between the new emerging medical and surgical therapies. The first procedure is common to all patients and consists of incision of abscesses, fistulectomy and setone placement in fistulas.Subsequently patients are divided into five groups and submitted to treatments to reach fistula healing: systemic therapy with Infliximab , systemic therapy with Adalimumab, endoanal advancement Flap, instillation of fibrin glue or placement of biological prostheses. We observed a complete closure of fistulas in 60% of patients treated with Infliximab , 53% of those treated with Adalimumab, 40% of those treated with fibrin glue , 80% of those who underwent endoanal flap and 60% of those treated with biological prostheses . The excellent results achieved with the different methods of local surgical treatment represent a valid alternative to treatment with biologics. These new methods are useful for the treatment of those patients that after treatment with biologic agents have not achieved a complete healing(rescue therapy). Biological therapy and new surgical techniques are therefore complementary, the first contributing to the healing of rectal and anal canal mucosa, on which is therefore easier to work with the second with an higher success rate

Comparison between in-bag manual morcellation and classic power morcellation during laparoscopic myomectomy: a randomized controlled trial.

Presupposti: La miomectomia laparoscopica rappresenta il trattamento di scelta dei miomi uterini sintomatici in donne in età fertile. La morcellazione è un passaggio fondamentale di questo intervento, permettendo l’asportazione del pezzo operatorio dalla cavità addominale attraverso una breccia laparoscopica. Dal 2014, tuttavia, la Food and Drugs Administration scoraggia l’utilizzo della morcellazione elettromeccanica per il possibile rischio di disseminazione di cellule mesenchimali. La morcellazione manuale all’interno di un sacchetto endoscopico potrebbe ridurre questo rischio senza dover abbandonare i benefici dell’approccio laparoscopico. Obiettivo dello studio: Valutare la fattibilità e la sicurezza della morcellazione manuale all’interno di un sacchetto endoscopico confrontandola con la morcellazione elettromeccanica classica. Materiali e Metodi: settantadue donne sottoposte a miomectomia laparoscopica sono state randomizzate in due gruppi: 34 sono state sottoposte a morcellazione manuale all’interno di un sacchetto endoscopico (gruppo sperimentale) mentre 38 sono state sottoposte a morcellazione elettromeccanica classica (gruppo di controllo). Il confronto del tempo operatorio di morcellazione (Morcellation Operative Time, MOT) nei due gruppi ha rappresentato l’obiettivo primario dello studio. Obiettivi secondari sono stati: il tempo operatorio totale (Total Operative Time, TOT), il tasso di complicanze intraoperatorie e gli esiti postoperatori. Risultati: Nel gruppo sperimentale il MOT medio ed il TOT medio sono risultati maggiori rispetto al gruppo di controllo (rispettivamente MOT: 9.47 ± 5.05 vs 6.16 ± 7.73 minuti; p = .01; TOT: 113.24 ± 28.12 vs 96.74 ± 33.51 minuti; p = .01). Non sono state riportate complicanze intraoperatorie in nessuno dei due gruppi, né sono stati descritti casi di rottura del sacchetto endoscopico o di conversione laparotomica. Non è stata riportata alcuna differenza in termini di calo postoperatorio dell’emoglobina, durata della degenza ed esiti postoperatori tra i due gruppi. Conclusioni: La morcellazione manuale nel sacchetto endoscopico è una procedura sicura e fattibile e potrebbe rappresentare un’alternativa alla morcellazione elettromeccanica classica.Background: Laparoscopic myomectomy represents the gold standard in the treatment of symptomatic premenopausal women affected by myomas. Morcellation is an important part of the laparoscopic procedure, allowing the removal of a large specimen through a small incision. In April 2014, the FDA discouraged the use of power morcellators, because of the risk of inadvertent dissemination of small tissue pieces through the abdominal cavity. In-bag manual morcellation could reduce this risk, preventing surgeons from abandoning a laparoscopic approach. Objective: To compare in-bag manual morcellation and classic power morcellation during laparoscopic myomectomy in terms of feasibility and safety. Matherials and Methods: Patients submitted to laparoscopic myomectomy at our Centre from November 2015 and October 2016 were considered for the study. Seventy-two patients were therefore included and randomly divided into two groups: 38 underwent classic power morcellation (control group) while 34 patients were submitted to in-bag manual morcellation (experimental group). The comparison of morcellation operative time (MOT) between the two groups represented the primary objective. Secondary objectives were: total operative time (TOT), rate of intraoperative complications and postoperative outcomes. Results: in the experimental group, longer MOT (9.47 ± 5.05 vs 6.16 ± 7.73 minutes; p = .01) and TOT (113.24 ± 28.12 vs 96.74 ± 33.51 minutes; p = .01) were required compared to the control group. No intraoperative complications, bag tear or conversion to laparotomy were reported. The two study groups presented similar hemoglobin drop, hospitalization and postoperative outcomes. Conclusion: In-bag manual morcellation could represent a safe and feasible alternative to classic power morcellation, despite slightly longer operative time required