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In Sen’s capability approach well-being is evaluated not only in terms of functionings (what they do and who they are) but also in terms of capabilities (what people are free to do and to be). It implies that individuals with the same observed functionings may have different well-being because their choice sets (i.e. capabilities) are different. We utilise a Random Scale Model to measure the latent capability of Italian women to move based on observations of their realized choices. We demonstrate that such models can offer a suitable framework for measuring how individuals are restricted in their capabilities. Our estimations show that the percentage of women predicted to be restricted in their freedom of movement (have restricted capability sets) is 23-25%. If all women were unconstrained, our model predicts that 15-17% of them would choose to do more activities. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of canine diabetic ketoacidosis (DKA) usually is based on measurement of urinary acetoacetate (ketonuria). In humans, this test is less sensitive and specific than blood 3-β-hydroxybutyrate (ketonemia) evaluation. Hypothesis: Ketonemia measurement using a portable meter is more accurate than ketonuria determination with a dipstick to diagnose canine DKA. Animals: Seventy-two client-owned diabetic dogs with ketonemia, ketonuria, or both. Methods: Prospective observational study. Based on blood bicarbonate concentration and anion gap, dogs were divided into 2 groups: patients with DKA ( n= 25); patients with diabetic ketosis ( n= 47). Sensitivity, specificity, and positive and negative likelihood ratio (LR) at different cut-off points were determined for both ketonemia and ketonuria. Receiver operating characteristic (ROC) analysis was used to assess the accuracy of each diagnostic test to diagnose DKA. Results: With regard to ketonemia, cut-off values of 2.3 and 4.3 mmol/L revealed 100% sensitivity and 100% specificity, respectively, whereas cut-off values of 2.8 and 3.5 mmol/L showed a −LR of 0.05 and a + LR of 13.16, respectively. With regard to ketonuria, a cut-off value of 1+ revealed 92% sensitivity, 40% specificity, and −LR of 0.20, whereas a cut-off value of 3+ revealed 44% sensitivity, 94% specificity, and +LR of 6.89. The areas under the ROC curves for the ketonemia and ketonuria tests were significantly different (0.97 and 0.81, respectively, P= .003). Conclusions and Clinical Importance: Measurement of ketonemia is accurate and more effective than measurement of ketonuria to diagnose canine DKA. [ABSTRACT FROM AUTHOR]

Poster: Clinical track: Lower GI (colon, rectum, anus) PO-1093: Defecography for sphincter evaluation in rectal cancer patients irradiated with dose intensification C. Rosa, M. Di Tommaso, B. Seccia, A. Delli Pizzi, R. Cianci, R. Basilico, A. Di Pilla, M. Taraborrelli, L. Caravatta, D. Genovesi. [Extracted from the article]

Poster: Clinical track: Lower GI (colon, rectum, anus) PO-1094: Pathological complete response and outcomes in rectal cancer patients with treatment intensification C. Rosa, M. Di Tommaso, L. Caravatta, M. Taraborrelli, D. Fasciolo, A. Augurio, R. Cianci, M. Di Nicola, D. Genovesi. [Extracted from the article]

This article, published in the journal "Ultrasound in Obstetrics & Gynecology," examines the microvascular function in pregnancies complicated by pre-eclampsia and fetal growth restriction (FGR) compared to uncomplicated pregnancies. The study involved 25 women with pre-eclampsia and/or FGR and 25 uncomplicated pregnancies as controls. The researchers used laser speckle contrast imaging (LSCI) combined with post-occlusive reactive hyperemia (PORH) to assess microvascular function. The results showed that microvascular function was impaired in pregnancies with placental-related diseases, particularly pre-eclampsia. The authors suggest further investigation into the use of LSCI as a tool for predicting and diagnosing pre-eclampsia. [Extracted from the article]

The use of marijuana, which today is the most used recreational drug, has been demonstrated to affect adversely reproduction. Marijuana smokers, both men and women, show impaired fertility, owing to defective signalling pathways, aberrant hormonal regulation, or wrong timing during embryo implantation. Anandamide ( N-arachidonoylethanolamine, AEA) and 2-arachidonoylglycerol (2-AG) mimic Δ9-tetrahydrocannabinol (THC), the psychoactive principle of Cannabis sativa, by binding to both the brain-type (CB1) and the spleen-type (CB2) cannabinoid receptors. These ‘endocannabinoids’ exert several actions either in the central nervous system or in peripheral tissues, and are metabolised by specific enzymes that synthesise or hydrolyse them. In this review, we shall describe the elements that constitute the endocannabinod system (ECS), in order to put in a better perspective the role of this system in the control of human fertility, both in females and males. In addition, we shall discuss the interplay between ECS, sex hormones and cytokines, which generates an endocannabinoid−hormone−cytokine array critically involved in the control of human reproduction. [ABSTRACT FROM AUTHOR]

Objective: To assess whether repeat cervical-length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth.Methods: This was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL < 10 mm at the time of hospital discharge or at any follow-up evaluation could predict spontaneous delivery prior to 37 weeks of gestation.Results: Of 226 women discharged after a diagnosis of threatened preterm labor, 57 (25.2%) delivered spontaneously prior to 37 weeks' gestation. The risk of spontaneous preterm birth was higher among women with CL < 10 mm at hospital discharge compared to those with CL ≥ 10 mm (adjusted odds ratio (aOR), 3.3; 95% CI, 1.2-9.2). Moreover, spontaneous preterm delivery was more common when CL < 10 mm was detected up to 2 weeks (aOR, 2.9; 95% CI, 1.1-7.3) or up to 4 weeks (aOR, 7.3; 95% CI, 2.3-22.8) post discharge, as compared with when CL was persistently ≥ 10 mm. The association was not significant when considering CL measurements at 8 weeks, and there was insufficient information to assess the effect of measurements obtained at 12 weeks.Conclusions: Women who remain undelivered after their first episode of threatened preterm labor continue to be at high risk of spontaneous preterm birth if their CL is below 10 mm at the time of hospital discharge or at any follow-up visit up to 4 weeks later. CL measurement could be included in the antenatal care of these women in order to stratify their risk of preterm birth, rationalize resource utilization and help clinicians improve pregnancy outcome. © 2020 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Congenital cytomegalovirus (CMV) infection is the leading infectious cause of neurological impairment for which, currently, there are no approved antenatal treatment options. The aim of this article was to summarize the available evidence on the use of valacyclovir during pregnancy to prevent and treat congenital CMV infection and disease. Two databases (PubMed and ClinicalTrial.gov) were reviewed. Six relevant documents were identified, namely one observational study, three clinical trials, two case reports. Most relevant findings were those from two clinical trials. A phase 2/3 placebo-controlled study showed a decrease of 71% (5 of 45 vs 14 of 47) in rate of CMV vertical transmission in women treated with 8 g/day valacyclovir following primary CMV infection in pregnancy. A phase 2, single-arm clinical trial, showed that 8 g/day valacyclovir administered to mothers of symptomatic infected foetuses increased the portion of asymptomatic neonates to 82% (34 of 41), compared with 43% (20 of 47) in untreated pregnancies from a historical cohort. Studies in favour of using valacyclovir during pregnancy for prevention and treatment of congenital CMV infection are emerging but are still few. Randomized clinical trials on large cohorts of patients investigating the efficacy on prevention and treatment of congenital CMV are required. Unfortunately, this will be probably not be feasible at least in the short period. In the meantime, data on the 'off label' use of valacyclovir for CMV in pregnancy could be collected within a multicentre observational study. [ABSTRACT FROM AUTHOR]

AIM: We hypothesized that elevated vaginal levels of matrix metalloproteinase-8 (MMP-8), interleukin-8 (IL-8) and the 70kDa heat shock protein (hsp70), compounds involved in infl ammatory responses, correlated with a short cervix in pregnant women. METHODS: This prospective cohort study used a convenience sample of 64 women in their early third trimester with a singleton pregnancy. A short cervical length was present in 35 women (54.7 %). Vaginal fl uid was tested for levels of MMP-8, IL-8 and hsp70 by enzyme-linked immunosorbent assay (ELISA). A receiver operating charasteristic (ROC) analysis was used to calculate the area under the curve (AUC) for each mediator in predicting short cervical length. RESULTS: MMP-8 (109 vs 29.6 ng/ml, p=0.014), IL-8 (689 vs 330 pg/ml, p=0.007) and hsp70 (4.4 vs 2.9 ng/ml, p=0.036) were all elevated in vaginal samples from women with a short cervix. In addition, there was a negative association between the concentration of each compound in vaginal fl uid and cervical length p≤0.026). The vaginal IL-8 concentration had the highest negative correlation with a short cervix (AUC=0.7, p=0.007). CONCLUSION: MMP-8, hsp70 and IL-8 contribute to a pro-infl ammatory cervico-vaginal milieu that weakens cervical integrity and leads to a shortening in cervical length (Tab. 4, Fig. 1, Ref. 27). Text in PDF www.elis.sk. [ABSTRACT FROM AUTHOR]

To retrospectively evaluate the inter-observer agreement between a radiologist and a radiation oncologist and volume differences, in T2 and diffusion-weighted (DWI) MRI of gross tumor volume (GTV) delineation, in rectal cancer patients. Two observers, a radiologist and a radiation oncologist, delineated GTVs of 50 patients on T2-weighted MRI (T2 GTV) and echo planar DWI (DWI GTV). Observers agreement was assessed using DICE index, Bland-Altman analysis and intra-class correlation coefficient (ICC). Student's t -test was used for GTV comparison. Median T2 GTV and DWI GTV were 17.09 ± 14.12 cm3 (1.92–62.03) and 12.79 ± 12.31 cm3 (1.23–62.25) for radiologist, and 16.82 ± 13.66 cm3 (1.78–65.9) and 13.72 ± 12.77 cm3 (1.29–69.75) for radiation oncologist. T2 GTV were significantly larger compared to DWI GTV (P < 0.001 and P < 0.001, for both observers). Mean DICE index for T2 GTV and DWI GTV were 0.80 ± 0.07 and 0.77 ± 0.06. The mean difference between the two observers were 0.26 cm3 (95% CI: −5.36 to 5.88) and −1.13 cm3 (95% CI: −5.70 to 3.44) for T2 and DWI volumes. The ICC for T2 volumes was 0.989 (95% CI: 0.981–0.994) (P < 0.001) and 0.992 (95% CI: 0.986–0.996) (P < 0.001) for DWI volumes. DWI resulted in smaller volumes delineation compared to T2-weighted MRI. Substantial and almost perfect agreements were reported for DWI GTV and T2 GTV between radiologist and radiation oncologist. Due to the fact that DWI could be considered a simple technique for volume delineation for radiation oncologist, DWI could be used to improve quality in radiation planning for an accurate boost volume delineation when a dose escalation is investigated. [ABSTRACT FROM AUTHOR]

Purpose The aim of our study was to evaluate hippocampal irradiation in patients treated with fractionated stereotactic brain radiotherapy. Patients and methods Retrospective hippocampal dosimetric analysis performed on 22 patients with one to four brain metastases treated with fractionated stereotactic radiotherapy using volumetric intensity-modulated arc therapy. Original plans did not include hippocampus as avoidance structure in optimization criteria; hippocampus was retrospectively delineated on magnetic resonance coregistered with planning CT and using as reference the RTOG 0933 atlas. Hippocampus was defined both as a single and as pair organ. Constraints analysed were: Dmax < 16 Gy, D40% < 7.3 Gy, D100% = Dmin < 9 Gy. Assuming a α/β ratio of 2 Gy, biologically equivalent dose in 2 Gy fractions was calculated. Hippocampal-sparing plans were developed in cases where hippocampal constraints were not respected in the original plan. Results Among constraints analysed Dmax and D40% have been exceeded in ten out of 22 cases. The constraints were not respected in patients with more than one metastatic lesion and in three patients with only one lesion. Considering all exceeded constraints values in non-hippocampal sparing plans, the 50% of them was respected after replanning. No significant differences were found among conformity and homogeneity index between non-hippocampal sparing and hippocampal sparing plans. Conclusion Volumetric intensity-modulated arc therapy hippocampal sparing plans significantly decreases dose to hippocampus assuring an equal target coverage and organs at risk avoiding. [ABSTRACT FROM AUTHOR]

Background: Several randomized controlled trials (RCTs) compared induction of labour with expectant management in non-diabetic women with suspected fetal macrosomia.Objective: To evaluate the effects of labour induction for suspected fetal macrosomia.Search Strategy: Literature search in electronic databases.Selection Criteria: We included all RCTs of suspected fetal macrosomia comparing labour induction with expectant management in term pregnancy.Data Collection and Analysis: The primary outcome was the incidence of caesarean delivery.Main Results: Four RCTs, including 1190 non-diabetic women with suspected fetal macrosomia at term, were analysed. Pooled data did not show a significant difference in incidence of caesarean delivery [relative risk (RR) 0.91, 95% confidence interval (CI) 0.76-1.09], operative and spontaneous vaginal delivery, shoulder dystocia, intracranial haemorrhage, brachial plexus palsy, Apgar score <7 at 5 min, cord blood pH <7, and mean birth weight comparing women who received induction of labour with those who were managed expectantly. The induction group had a significantly lower time to delivery (mean difference -7.55 days, 95% CI -8.20 to -6.89), lower rate of birth weight ≥4000 g (RR 0.50, 95% CI 0.42-0.59) and ≥4500 g (RR 0.21, 95% CI 0.11-0.39), and lower incidence of fetal fractures (RR 0.17, 95% CI 0.03-0.79) compared with expectant management group.Conclusion: Induction of labour ≥38 weeks for suspected fetal macrosomia is associated with a significant decrease in fetal fractures, and therefore can be considered as a reasonable option. TWEETABLE ABSTRACT: #Induction of labour for #macrosomia improves neonatal outcome. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The present observational study reports the results of a multi-institutional dummy-run designed to estimate the consistency of interobserver variability in clinical target volume delineation in two different cases of soft-tissue sarcomas in which postoperative and preoperative radiotherapy were prescribed, respectively. The purpose of this work was to quantify interobserver variability in routine clinical practice. Patients and methods: Two different cases of soft-tissues sarcomas were chosen: a case of postoperative and a case of preoperative radiation therapy. Participating centres were requested to delineate clinical target volumes according to their experience in both cases. Descriptive statistic was calculated for each variable (volume, diameters) separately for two cases. Box-whiskers plots were used for presentation of clinical target volume. A Shapiro-Wilk's test was performed to evaluate the departures from normality distribution for each variable. The comparison between relative variations of diameters was evaluated using the Student's t test. Results: Several variations affecting both volumes and diameters were observed. Main variations were observed in the craniocaudal and laterolateral diameters. Each case showed similar dispersion, indicating a lack of reproducibility in volumes definition. Conclusions: This observational study highlighted that, in the absence of specific instructions or guidelines, the interobserver variability can be significant both in postoperative and preoperative radiotherapy of soft-tissue sarcomas. [Copyright &y& Elsevier]

Objective: To confirm the role of fetal growth restriction (FGR) as a cause of stillbirth, and to compare diagnostic accuracy of customized fetal growth and population-based standards in identifying FGR within a pathological population of early and late stillbirths. Methods: Retrospective study on a cohort of 189 stillbirths occurred in single pregnancy between January 2006 and September 2011. Unexplained stillbirths, defined by Aberdeen-Wigglesworth and ReCoDe classifications, were evaluated on the basis of fetal birthweight with both Tuscany population and Gardosi customized standards. Unexplained stillbirths have been classified as early or late depending on the gestational age of occurrence. Results: Aberdeen-Wigglesworth classification, applied to the 189 cases of stillbirth, left 94 unexplained cases (49.7%), whereas the ReCoDe classification left only 40 (21%). By applying population standards to the 94 unexplained stillbirths we have identified 31 FGRs (33% of sample), while customized standards identified 54 FGRs (57%). Customised standards identified a larger number of FGRs with respect to population standards during the third trimester (i.e. 51% vs. 25% respectively) than in the second trimester (73% vs. 54% respectively) ( p = 0.05). Conclusions: Customized standards have a higher diagnostic accuracy in identifying FGRs especially during the third trimester. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension (PH) is a disease condition leading to right-sided cardiac hypertrophy and, eventually, right-sided heart failure. Cardiac troponin I (cTnI) is a circulating biomarker of cardiac damage. Hypothesis: Myocardial damage can occur in dogs with precapillary and postcapillary PH. Animals: One hundred and thirty-three dogs were examined: 26 healthy controls, 42 dogs with mitral valve disease (MVD) without PH, 48 dogs with pulmonary hypertension associated with mitral valve disease (PH-MVD), and 17 dogs with precapillary PH. Methods: Prospective, observational study. Serum cTnI concentration was measured with a commercially available immunoassay and results were compared between groups. Results: Median cTnI was 0.10 ng/mL (range 0.10–0.17 ng/mL) in healthy dogs. Compared with the healthy population, median serum cTnI concentration was increased in dogs with precapillary PH (0.25 ng/mL; range 0.10–1.9 ng/mL; P < .001) and in dogs with PH-MVD (0.21 ng/mL; range 0.10–2.10 ng/mL; P < .001). Median serum cTnI concentration of dogs with MVD (0.12 ng/mL; range 0.10–1.00 ng/mL) was not significantly different compared with control group and dogs with PH-MVD. In dogs with MVD and PH-MVD, only the subgroup with decompensated PH-MVD had significantly higher cTnI concentration compared with dogs with compensated MVD and PH-MVD. Serum cTnI concentration showed significant modest positive correlations with the calculated pulmonary artery systolic pressure in dogs with PH and some echocardiographic indices in dogs with MVD and PH-MVD. Conclusions and Clinical Importance: Serum cTnI is high in dogs with either precapillary and postcapillary PH. Myocardial damage in dogs with postcapillary PH is likely the consequence of increased severity of MVD. [ABSTRACT FROM AUTHOR]

F. Patani, D. Fasciolo, A. Allajbej, M. Trignani, M. Di Tommaso, A. Augurio, A. Vinciguerra, L. Caravatta, D. Genovesi, Poster: Clinical track: Prostate PO-1183: Do we need sigma constraints in era of intensity-modulated radiation therapy for prostate cancer?. [Extracted from the article]

Poster discussion: CL: Gynaecology PD-0656: A contouring atlas on MRI of emerging pelvic female organs at risk for daily practice radiotherapy A. Allajbej, F. Patani, L. Gasparini, F.C. Di Guglielmo, C. Bonfiglio, D. Fasciolo, C. Rosa, M. Trignani, A. Vinciguerra, L. Caravatta, M. Di Tommaso, R. Cianci, R. Basilico, A. Augurio, D. Genovesi. [Extracted from the article]

Waldenström Macroglobulinemia is a low-grade immunosecretory disorder associated with lymphoid tumours, which is rarely reported in veterinary medicine. In this study, we describe two clinical cases of this rare syndrome in dogs, each characterized by a different onset and clinical course. In one case, a hyperacute onset and aggressive behaviour of the neoplasm was observed. Absolute serum viscosity (SV) was retrospectively evaluated in order to explain clinical findings. Rotational viscosimetry showed good precision in measuring SV. Both dogs had SV values higher than a control groups of healthy dogs although only one subject developed hyperviscosity symptoms and complications. At high paraprotein concentrations, a slight reduction of the M-component was associated with a marked decrease in SV. Thus, this work suggests that SV assessment is a relevant tool for managing monoclonal gammopathies, whose usefulness should be further confirmed in larger cohorts of dogs. [ABSTRACT FROM AUTHOR]

An abstract of the article "Association between isolated mild ventriculomegaly and fetal infections: a six-year experience" by G. Masini and colleagues is presented.

An abstract of the article "Infection's screening and polyhydramnios: our experience on 342 cases" by C. Gaini and colleagues is presented.