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Objective: To investigate indications, surgical and functional outcomes of robotic or endoscopic facelift thyroid surgery (FTS) and whether FTS reported comparable outcomes of other surgical approaches. Data sources: PubMed, Cochrane Library, and Scopus. Review methods: A literature search was conducted about indications, clinical and surgical outcomes of patients who underwent FTS using PICOTS and PRISMA Statements. Outcomes reviewed included age; gender; indications; pathology; functional evaluations; surgical outcomes and complications. Results: Fifteen papers met our inclusion criteria, accounting for 394 patients. Endoscopic or robotic FTS was carried out for benign and malignant thyroid lesions, with or without central neck dissection. Nodule size and thyroid lobe volume did not exceed 6, 10 cm, respectively. FTS reported comparable outcome with transaxillary or oral approaches about operative time, complication rates or drainage features. The mean operative time ranged from 88 to 220 min, depending on the type of surgery (endoscopic vs robotic hemi- or total thyroidectomy). Conversion to open surgery was rare, occurring in 0–6.3% of cases. The most common complications were earlobe hypoesthesia, hematoma, seroma, transient hypocalcemia and transient recurrent nerve palsy. There was an important disparity between studies about the inclusion/exclusion criteria, surgical and functional outcomes. Conclusion: FTS is a safe and effective approach for thyroid benign and malignant lesions. FTS reports similar complications to conventional thyroidectomy and excellent cosmetic satisfaction. [ABSTRACT FROM AUTHOR]

The article focuses on a podcast conversation with Archbishop Rino Fisichella, delving into the major themes of the Directory for Catechesis. It mentions the dynamic and joyful nature of catechesis in response to contemporary challenges, highlights the emphasis on kerygmatic catechesis, and discusses the directory's treatment of mystagogy, along with its attention to diverse contexts like digital culture, bioethics, and the role of catechesis in varied life situations.

Inferring the magnitude and occurrence of real-world events from natural language text is a crucial task in various domains. Particularly in the domain of public health, the state-of-the-art document and token centric event detection approaches have not kept the pace with the growing need for more robust event detection in public health. In this paper, we propose UPHED, a unified approach, which combines both the document and token centric event detection techniques in an unsupervised manner such that events which are: rare (aperiodic); reoccurring (periodic) can be detected using a generative model for the domain of public health. We evaluate the efficiency of our approach as well as its effectiveness for two real-world case studies with respect to the quality of document clusters. Our results show that we are able to achieve a precision of 60% and a recall of 71% analyzed using manually annotated real-world data. Finally, we also make a comparative analysis of our work with the well-established rule-based system of MedISys and find that UPHED can be used in a cooperative way with MedISys to not only detect similar anomalies, but can also deliver more information about the specific outbreak of reported diseases. [ABSTRACT FROM AUTHOR]

Pig experiments often require anaesthesia, and a rapid stress-free induction is desired. Induction drugs may alter the subsequent anaesthesia. Therefore, the aim of the present study was to compare, in pigs, the effects of two different injectable anaesthetic techniques on the induction and on the physiological variables in a subsequent eight hours of total intravenous anaesthesia (TIVA). Twelve domestic castrates (Swedish Landrace/Yorkshire) 27‒31 kg were used. The pigs were randomly assigned to different induction drug combinations of zolazepam–tiletamine and medetomidine intramuscularly (ZTMe) or midazolam, ketamine intramuscularly and fentanyl intravenously (MiKF). Time from injection to unconsciousness was recorded and the ease of endotracheal intubation assessed. The TIVA infusion rate was adjusted according to the response exhibited from the nociceptive stimulus delivered by mechanically clamping the dewclaw. The time from injection to unconsciousness was briefer and intubation was easier in the ZTMe group. Results from the recorded heart rate, cardiac index and arterial blood pressure variables were satisfactorily preserved and cardiovascular function was maintained in both groups. Shivering was not observed in the ZTMe group, but was observed in four of the pigs in the MiKF group. The requirement of TIVA was lower in the ZTMe group. In conclusion, ZTMe had better results than MiKF in areas such as shorter induction time, better intubation scoring results and less adjustment and amount of TIVA required up to six hours of anaesthesia. The results may have been due to a greater depth of anaesthesia achieved with the ZTMe combination at the dose used. [ABSTRACT FROM AUTHOR]

In symptomatic young patients with gastroesophageal reflux symptoms, early identification of progressive gastroesophageal reflux disease (GERD) is critical to prevent long‐term complications associated with hiatal hernia, increased esophageal acid and nonacid exposure, release of proinflammatory cytokines, and development of intestinal metaplasia, endoscopically visible Barrett's esophagus, and dysplasia leading to esophageal adenocarcinoma. Progression of GERD may occur in asymptomatic patients and in those under continuous acid‐suppressive medication. The long‐term side effects of proton‐pump inhibitors, chemopreventive agents, and radiofrequency ablation are contentious. In patients with early‐stage disease, when the lower esophageal sphincter function is still preserved and before endoscopically visible Barrett's esophagus develops, novel laparoscopic procedures, such as magnetic and electric sphincter augmentation, may have a greater role than conventional surgical therapy. A multidisciplinary approach to GERD by a dedicated team of gastroenterologists and surgeons might impact the patients' lifestyle, the therapeutic choices, and the course of the disease. Biological markers are needed to precisely assess the risk of disease progression and to tailor surveillance, ablation, and management. [ABSTRACT FROM AUTHOR]

Background: The introduction of high‐resolution manometry and the Chicago classification has made it possible to diagnose achalasia and predict treatment response accurately. The aim of this study was to compare the effect of the different treatments available on symptomatic outcomes across all achalasia subtypes. Methods: The study was conducted according to PRISMA and MOOSE guidelines. A literature search of PubMed and MEDLINE databases was undertaken to identify all relevant articles reporting clinical outcomes of patients with achalasia after botulinum toxin injection, pneumatic dilatation, laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy (POEM) based on manometric subtypes. Patients were grouped according to the Chicago classification and the success rate in treating symptoms was measured as the primary endpoint. Results: Twenty studies (1575 patients) were selected, and data on botulinum toxin, pneumatic dilatation, LHM and POEM were extracted. Success rates for LHM in type I, II and III achalasia were 81, 92 and 71 per cent respectively. Those for POEM were 95, 97 and 93 per cent respectively. POEM was more likely to be successful than LHM for both type I (odds ratio (OR) 2·97, 95 per cent c.i. 1·09 to 8·03; P = 0·032) and type III (OR 3·50, 1·39 to 8·77; P = 0·007) achalasia. The likelihood of success of POEM and LHM for type II achalasia was similar. Conclusion: Pneumatic dilatation had a lower but still acceptable success rate compared with POEM or LHM in patients with type II achalasia. POEM is an excellent treatment modality for type I and type III achalasia, although it did not show any superiority over LHM for type II achalasia. Good response rates but longer follow‐up needed [ABSTRACT FROM AUTHOR]

The contribution aims at combining two perspectives: the historical research on the youth," Giovanni Battista Montini" and his teaching addressed to young people during the period of his Pontificate. It highlights the word and the magisterium of the Pope that were the results of his own seriously lived personal experience. The conviction of Paul VI, in fact, was that, when speaking with young people one should not use a rhetorical language, but rather personal testimony, the only true criterion that enables them to listen and to receive their effective positive response. [ABSTRACT FROM AUTHOR]

Obesity currently affects 78.6 million people (33%) in the United States and is expected to increase to over 50% of the population by 2030. This epidemic is fueled by the growing rate of obesity in adolescents. The new science of obesity indicates that there is a tipping point at which genetic resetting occurs and it is reached when adipose tissue dysfunction occurs. It is becoming clear that obesity is less an ongoing personal choice than a fact of biology. With this review, we aim to describe the epidemiology of obesity and the associated comorbidities. [ABSTRACT FROM AUTHOR]

The hot electron transistor (HET) is an unipolar majority carrier vertical device with great potential for high frequency (THz) applications. Recently, graphene (Gr) heterostructures with Nitrides have been considered as a promising material system to implement this device concept, with GaN/AlGaN (or GaN/AlN) working as emitter/emitter‐base barrier and Gr as the ultrathin base enabling ballistic transit of hot electrons. In this work, the main issues related to the fabrication of Gr/Nitrides heterojunctions are discussed. An optimized transfer procedure of large‐area Gr membranes onto AlGaN/GaN grown on Si(111) is illustrated. In particular, a soft O2 plasma pretreatment of the AlGaN surface is found to greatly improve the Gr adhesion, resulting in a reduced cracks density. A nanoscale electrical characterization of the obtained Gr/AlGaN/GaN heterostructures was carried out by conductive atomic force microscopy, to evaluate the effect of typical nanometric corrugations (wrinkles) of the Gr membrane on the current transport. These morphological features introduce resistive contributions both to the lateral current transport in the Gr membrane and to the vertical current injection across the heterojunction. The impact of these results on the relevant electrical parameters (i.e., the base resistance and the emitter‐base injection efficiency) of a HET based on this heterostructure is also discussed. [ABSTRACT FROM AUTHOR]

Dysregulation of the transforming growth factor-β1 (TGF-β1)/selected small mother against decapentaplegic (SMAD) pathway can be implicated in development of age-related macular degeneration (AMD), and the delivery of TGF-β1 could be beneficial for AMD. We developed a new ophthalmic formulation of TGF-β1 assessing the ocular pharmacokinetic profile of TGF-β1 in the rabbit eye. Small unilamellar vesicles (SUV) loaded with TGF-β1 were complemented with Annexin V and Ca2+, and the vitreous bioavailability of TGF-β1 was assessed after topical ocular administration by a commercial ELISA kit. We detected high levels of TGF-β1 (Cmax 114.7 ± 12.40 pg/mL) in the vitreous after 60 min (Tmax) from the topical application of the liposomal suspension. Ocular tolerability was also assessed by a modified Draize's test. The new formulation was well tolerated. In conclusion, we demonstrated that the novel formulation was able to deliver remarkable levels of TGF-β1 into the back of the eye after topical administration. Indeed, this TGF-β1 delivery system may be useful in clinical practice to manage ophthalmic conditions such as age-related macular degeneration, skipping invasive intraocular injections. [ABSTRACT FROM AUTHOR]

Introduction: Gastroesophageal reflux disease (GERD) may present with heartburn, regurgitation, dysphagia, chronic cough, laryngitis, or even asthma. The clinical presentation of GERD is therefore varied and poses certain challenges to the physician, especially given the limitations of the diagnostic testing. Discussion: The evaluation of patients with suspected GERD might be challenging. It is based on the evaluation of clinical features, objective evidence of reflux on diagnostic testing, correlation of symptoms with episodes of reflux, evaluation of anatomical abnormalities, and excluding other causes that might account for the presence of the patient's symptoms. Conclusions: The diagnostic evaluation should include multiple tests, in addition to a thorough clinical examination. [ABSTRACT FROM AUTHOR]

Group III nitride semiconductors (III-N), including GaN, AlN, InN, and their alloys, are currently the materials of choice for many applications in optoelectronics (light-emitting diodes, laser diodes), and high-power and high-frequency transistors. Due to its attractive electrical, optical, mechanical, and thermal properties, graphene (Gr) integration with III-N technology has been considered in the last few years, in order to address some of the major issues which still limit the performances of GaN-based devices. To date, most of the studies have been focused on the use of Gr as transparent conductive electrode (TCE) to improve current spreading from top electrodes and light extraction in GaN-LEDs. This paper will review recent works evaluating the benefits of Gr integration with III-N for high power and high frequency electronics. From the materials side, recent progresses in the growth of high quality GaN layers on Gr templates and in the deposition of Gr on III-N substrates and templates will be presented. From the applications side, strategies to use Gr for thermal management in high-power AlGaN/GaN transistors will be discussed. Finally, recent proposals of implementing new ultra-high-frequency (THz) transistors, such as the Gr base hot electron transistor (GBHET), by Gr integration with III-N will be highlighted. [ABSTRACT FROM AUTHOR]

Background: Postoperative pain remains undertreated in critically ill patients. We hypothesized that the adequacy of pain control in our Surgical Intensive Care Unit (SICU) was above the reported average of 71 % in the literature and that the introduction of the critical care pain observation tool (CPOT) could improve it. We used a Lean Six Sigma methodology to improve our processes and quantify our improvement. Patients and methods: We retrospectively review 713 consecutive veterans admitted to our SICU. Between December 2014 and February 2015, postoperative pain was assessed every 2 h and rated 'acceptable,' 'unacceptable,' or 'unable to assess'. Between March 2015 and October 2015, postoperative pain was assessed with CPOT. Concurrently, we implemented a postoperative pain education program and documented this activity in the electronic medical record. Results: The baseline adequacy of pain control was 78 %, which improved to 99 % after the introduction of CPOT. We concurrently achieved a 100 % median documentation of postoperative pain education in the electronic medical record. The introduction of CPOT improved the process σ from 2.3 to 3.8. The process of documenting pain education achieved a process σ of 3.1. Conclusions: The proportion of veterans with acceptable pain control in our SICU is higher than that reported in the literature and the application of a Six Sigma methodology that involved the introduction of the CPOT has allowed us to improve the perception of pain control and comply with the newest regulatory directives. [ABSTRACT FROM AUTHOR]

Background Phone triaging patients with suspected malignant pleural mesothelioma (MPM) within the Veterans Healthcare Administration (VHA) system offers a model for rapid, expert guided evaluation for patients with rare and treatable diseases within a national integrated healthcare system. To assess feasibility of national open access telephone triage using evidence-based treatment recommendations for patients with MPM, measure timelines of the triage and referral process and record the impact on “intent to treat” for patients using our service. Methods A retrospective study. The main outcome measures were: (1) ability to perform long distance phone triage, (2) to assess the speed of access to a mesothelioma surgical specialist for patients throughout the entire VHA, and (3) to determine if access to a specialist would alter the plan of care. Results Sixty veterans were screened by our phone triage program, 38 traveled an average of 997 miles to VA Boston Healthcare system. On average, 14 d elapsed from initial phone contact until the patient was physically evaluated in our general thoracic clinic in Boston. The treatment plan was altered for 71% of patients evaluated at VA Boston Healthcare system based on 2012 International Mesothelioma Interest Group guidelines. Conclusions Our initial experience demonstrates that in-network centralized care for Veterans with MPM is feasible within the VHA. National open access phone triage improves access to expert surgical advice and can be delivered in a timely manner for Veterans using our service. Guideline-based treatment recommendations (“intent to treat”) changed the therapeutic course for the majority of patients who used our service. [ABSTRACT FROM AUTHOR]

Introduction: Traditionally, epiphrenic diverticula have been managed through a left thoracotomy. With the advancement of minimally invasive techniques, a laparoscopic approach has gained widespread popularity. Unfortunately, the preoperative evaluation of patients with epiphrenic diverticula, and their surgical management, is still not well characterized.Discussion: The goal of this article is to illustrate our approach to patients with epiphrenic diverticula in terms of preoperative evaluation and surgical technique. The final discussion will focus on the evidence-based rationale for our preoperative assessment and surgical approach. [ABSTRACT FROM AUTHOR]

Objectives: Although the technique of distal pancreatectomy with or without en bloc splenectomy has been well described, the execution of this procedure may be technically challenging when performed laparoscopically. In this technical report, we aimed to describe the technique of laparoscopic distal pancreatectomy with or without splenic preservation.Discussion: Laparoscopic distal pancreatectomy with or without splenectomy is a safe and effective surgical approach for the correction of various conditions. It has been proven to be a feasible solution for the treatment of benign inflammatory conditions as well as neoplasms. Splenic preservation requires careful and meticulous dissection, but may be done safely. [ABSTRACT FROM AUTHOR]

Aims: We compared the prevalence of noise-related artefacts and lesion perception on three-dimensional (3D) CT colonography (CTC) at standard and low radiation doses.Methods: Forty-eight patients underwent CTC (64 x 0.625 mm collimation; tube rotation time 0.5 s; automatic tube current modulation: standard dose 40-160 mA, low dose 10-50 mA). Low- and standard-dose acquisitions were performed in the supine position, one after the other. The presence of artefacts (cobblestone and snow artefacts, irregularly delineated folds) and the presence of polyps were evaluated by five radiologists on 3D images at standard dose, the original low dose and a modified low dose, i.e. after manipulation of opacity on 3D.Results: The mean effective dose was 3.9 +/- 1.3 mSv at standard dose and 1.03 +/- 0.4 mSv at low dose. The number of images showing cobblestone artefacts and irregularly delineated folds at original and modified low doses was significantly higher than at standard dose (P < 0.0001). Most of the artefacts on modified low-dose images were mild. No significant difference in sensitivity between the dose levels was found for polyps > or =6 mm.Conclusions: Reduction of the effective dose to 1 mSv significantly affects image quality on 3D CTC, but the perception of > or =6 mm lesions is not significantly impaired. [ABSTRACT FROM AUTHOR]

The transfer characteristics ( ID- VG) of multilayers MoS2 transistors with a SiO2/Si backgate and Ni source/drain contacts have been measured on as-prepared devices and after annealing at different temperatures ( Tann from 150 °C to 200 °C) under a positive bias ramp ( VG from 0 V to +20 V). Larger Tann resulted in a reduced hysteresis of the ID- VG curves (from ∼11 V in the as-prepared sample to ∼2.5 V after Tann at 200 °C). The field effect mobility (∼30 cm2 V-1 s-1) remained almost unchanged after the annealing. On the contrary, the subthreshold characteristics changed from the common n-type behaviour in the as-prepared device to the appearance of a low current hole inversion branch after annealing. This latter effect indicates a modification of the Ni/MoS2 contact that can be explained by the formation of a low density of regions with reduced Schottky barrier height (SBH) for holes embedded in a background with low SBH for electrons. Furthermore, a temperature dependent analysis of the subthreshold characteristics revealed a reduction of the interface traps density from ∼9 × 1011 eV-1cm-2in the as-prepared device to ∼2 × 1011 eV-1cm-2after the 200 °C temperature-bias annealing, which is consistent with the observed hysteresis reduction. [ABSTRACT FROM AUTHOR]

Surgical correction of achalasia using laparoscopic Heller myotomy with Dor fundoplication is argued to be the gold standard treatment for patients with achalasia. The goal of this technical report is to illustrate our preferred approach to patients with achalasia and to provide the reader with a detailed description of our operative technique, its rationale, and our pre and postoperative management. [ABSTRACT FROM AUTHOR]

To set up a retinal degenerative model in rat that mimics pathologic conditions such as age-related macular degeneration (AMD) using amyloid-β (Aβ) oligomers, and assess the effect of TGF-β1. Sprague-Dawley male rats were used. Human Aβ 1–42 oligomers were intravitreally (ITV) injected (10 µM) in the presence or in the absence of recombinant human TGF-β1 (1 ng/μl ITV injected). After 48 h, the animals were sacrificed and the eyes removed and dissected. The apoptotic markers Bax and Bcl-2 were assessed by western blot analysis in retina lysates. Gene-pathway network analysis was carried out in order to identify pathways involved in AMD. Treatment with Aβ oligomers induced a strong increase in Bax protein level (about 4-fold; p <0.01) and a significant reduction in Bcl-2 protein level (about 2-fold; p <0.05). Co-injection of TGF-β1 triggered a significant reduction of Bax protein induced by Aβ oligomers. Bioinformatic analysis revealed that Bcl-2 and PI3K-Akt are the most connected nodes, for genes and pathways respectively, in the enriched gene-pathway network common to AMD and Alzheimer disease (AD). Overall, these data indicate that ITV injection of Aβ 1–42 oligomers in rat induces molecular changes associated with apoptosis in rat retina, highlighting a potential pathogenetic role of Aβ oligomers in AMD. Bioinformatics analysis confirms that apoptosis pathways can take part in AMD. Furthermore, these findings suggest that human recombinant TGF-β1 can prevent retinal damage elicited by Aβ oligomers. [ABSTRACT FROM AUTHOR]

Contacts with MoS 2 are currently the object of many investigations, since current injection through metal/MoS 2 interfaces represents one of the limiting factors to the performance of MoS 2 thin film transistors. In this paper, we employed conductive atomic force microscopy (CAFM) to investigate the current injection mechanisms from a nanometric contact (a Pt coated tip) to the surface of MoS 2 thin films exfoliated on SiO 2 . The analysis of local current–voltage ( I – V ) characteristics on a large array of tip positions provided high spatial resolution information on the lateral homogeneity of the tip/MoS 2 Schottky barrier Φ B and of the ideality factor n . From the histograms of the measured Φ B and n values, an average Schottky barrier height of 297 meV with standard deviation of 22 meV and an average ideality factor of 1.65 with a standard deviation is 0.15 have been estimated. The implications of these lateral variations of Φ B and n in MoS 2 nano-Schottky diodes on the electrical properties of macroscopic contacts to MoS 2 have been discussed also in relation with recent literature results. [ABSTRACT FROM AUTHOR]

For low energy reaction studies involving radioactive ion beams, the experimental reaction yields are generally small due to the low intensity of the beams. For this reason, the stacked target technique has been often used to measure excitation functions. This technique offers considerable advantages since the reaction cross-section at several energies can be simultaneously measured. In a further effort to increase yields, thick targets are also employed. The main disadvantage of the method is the degradation of the beam quality as it passes through the stack due to the statistical nature of energy loss processes and any nonuniformity of the stacked targets. This degradation can lead to ambiguities of associating effective beam energies to reaction product yields for the targets within the stack and, as a consequence, to an error in the determination of the excitation function for the reaction under study. A thorough investigation of these ambiguities is reported, and a best practice procedure of analyzing data obtained using the stacked target technique with radioactive ion beams is recommended. Using this procedure a re-evaluation is reported of some previously published sub-barrier fusion data in order to demonstrate the possibility of misinterpretations of derived excitation functions. In addition, this best practice procedure has been used to evaluate, from a new data set, the sub-barrier fusion excitation function for the reaction 6Li + l20Sn. [ABSTRACT FROM AUTHOR]

The process of dispersive liquid liquid microextraction (DLLME) was successfully applied for the simultaneous extraction and subsequent ultrahigh performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS) determination of many different classes of drugs from whole blood samples. Main drugs of abuse (cocaine and metabolites, amphetamines and analogues, LSD, ketamine, opiates including buprenorphine, methadone and fentanyl and analogues), benzodiazepines, Z-compounds and other psychotropic drugs were effectively extracted in a single step and determined with satisfactory sensitivity, accuracy, repeatability and linearity. The matrix effect obtained was very low for all the analytes (maximum of 26% of ion suppression or 28% enhancement at low concentrations), demonstrating the effectiveness of sample purification. The limits of detection (LODs) varied from 0.05 to 2 ng/mL, limits of quantitation (LOQs) from 0.2 to 10 ng/mL. Accuracy and precision were satisfactory: %errors spanned from 0.1 to 15% for drugs of abuse and from 0.4 to 18%, at LOQs, for benzodiazepines and other psychotropic drugs. Interday %CV ranged from 2 to 15 % for drugs of abuse and from 0.2 to 18% (at low concentrations) for other drugs. The method was linear for all the studied analytes, giving regression coefficients (R 2 ) always higher than 0.994. The developed method was successfully applied to the analysis of 50 blood samples from forensic cases, allowing determining the presence of different benzodiazepines in 13 cases, of drugs of abuse in 14 cases, and of other psychotropic drugs in four cases. [ABSTRACT FROM AUTHOR]

The increasing number of new psychoactive substances (NPS) present in the illicit market render their identification in biological fluids/tissues of great concern for clinical and forensic toxicology. Analytical methods able to detect the huge number of substances that can be used are sought, considering also that many NPS are not detected by the standard immunoassays generally used for routine drug screening. The aim of this work was to develop a method for the screening of different classes of NPS (a total of 78 analytes including cathinones, synthetic cannabinoids, phenethylamines, piperazines, ketamine and analogues, benzofurans, tryptamines) from blood samples. The simultaneous extraction of analytes was performed by Dispersive Liquid/Liquid Microextraction DLLME, a very rapid, cheap and efficient extraction technique that employs microliters amounts of organic solvents. Analyses were performed by a target Ultrahigh Performance Liquid Chromatography tandem Mass Spectrometry (UHPLC–MS/MS) method in multiple reaction monitoring (MRM). The method allowed the detection of the studied analytes with limits of detection (LODs) ranging from 0.2 to 2 ng/mL. The proposed DLLME method can be used as an alternative to classical liquid/liquid or solid-phase extraction techniques due to its rapidity, necessity to use only microliters amounts of organic solvents, cheapness, and to its ability to extract simultaneously a huge number of analytes also from different chemical classes. The method was then applied to 60 authentic real samples from forensic cases, demonstrating its suitability for the screening of a wide number of NPS. [ABSTRACT FROM AUTHOR]

Conductive atomic force microscopy (CAFM) is employed to investigate the current injection from a nanometric contact (a Pt coated tip) to the surface of MoS2 thin films. The analysis of local current-voltage characteristics on a large array of tip positions provides high spatial resolution information on the lateral homogeneity of the tip/MoS2 Schottky barrier ΦB and ideality factor n, and on the local resistivity ρloc of the MoS2 region under the tip. Here, ΦB=300±24meV, n=1.60±0.23, and ρloc=2.99±0.68Ωcm are calculated from the distributions of locally measured values. A linear correlation is found between the ρloc and ΦB values at each tip position, indicating a similar origin of the ρloc and ΦB inhomogeneities. These findings are compared with recent literature results on the role of sulfur vacancy clusters on the MoS2 surface as preferential paths for current injection from metal contacts. Furthermore, their implications on the behavior of MoS2 based transistors are discussed. [ABSTRACT FROM AUTHOR]

Nickel oxide and cerium oxide thin films have been grown by metal-organic chemical vapor deposition on AlGaN/GaN heterostructures. Thin and epitaxial layers have been already obtained at low temperature (500 °C). Despite the two oxides possess the same crystal structure (face cubic centered compounds), different structural relationships have been observed with respect to the substrate. In particular, nickel oxide films were epitaxially grown along the <111> direction, while cerium oxide thin films showed <111> and <100> preferential orientations. These structural relationships have been justified by geometric and/or kinetics factors. In both cases, the epitaxial growth has been obtained at low temperature by the implementation of two second generation metal precursors, namely the nickel 2-thenoyl-trifluoroacetonate adduct with the tetramethylethylendiamine and cerium 1,1,1,5,5,5-hexafluoroacetlyacetonate adduct with bis(2-methoxyethyl) ether. Electrical characterization demonstrated that these films can be very promising as gate dielectrics for AlGaN/GaN transistors technology. In fact, the two oxide films showed really interesting electric properties such as dielectric constants (ε NiO = 11.7 and ε CeO2 = 26) close to the bulk values. Finally, it is noteworthy that among the widely used physical deposition methods, in this paper a chemical based deposition technique has been addressed for the epitaxial growth at low temperature of oxide thin films to be implemented in microelectronics applications. [ABSTRACT FROM AUTHOR]

New trends have emerged regarding the best minimally invasive access approaches to perform gastrointestinal surgery. However, these newer approaches are seen critically by those who demand a more strict assessment of outcomes and safety. An international panel of expert gathered at the 2014 American College of Surgeons Meeting with the goal of providing an evidence-based understanding of the real value of these approaches in gastrointestinal surgery. The panel has compared the efficacy and safety of most established approaches to gastrointestinal diseases to those of new treatment modalities: peroral esophageal myotomy vs. laparoscopic myotomy for achalasia, transgastric vs. transvaginal approach, and single-incision vs. multi-port access minimally invasive surgery. The panel found that (1) the outcome of these new approaches was not superior to that of established surgical procedures; (2) the new approaches are generally performed in few highly specialized centers; and (3) transgastric and transvaginal approaches might be safe and feasible in very experienced hands, but cost, training, operative time, and tools seem to limit their application for the treatment of common procedures such as cholecystectomy and appendectomy. Because the expected advantages of new approaches have yet to be proven in controlled trials, new approaches should be considered for adoption into practice only after thorough analyses of their efficacy and effectiveness and appropriate training. [ABSTRACT FROM AUTHOR]

From the earliest description of dysphagia relieved by dilatation with a whalebone in 1674 we have witnessed the evolution of esophageal function testing from the conventional manometry to the high-resolution manometry (HRM) and esophageal topography pressure plotting that have led to the revised Chicago classification for esophageal motility disorders in 2014. The goals of this paper are, therefore, (1) to highlight the historical milestones that have led to the diagnostic definition of achalasia, as we know it today; (2) to describe the evaluation process of patients with suspected achalasia; (3) to describe the diagnostic value of the HRM and the usefulness of the Chicago classification in predicting treatment outcomes. The value of Chicago classification is linked to the ability of the clinician to perform a thorough clinical evaluation to identify and correlate specific clinical phenotypes to specific manometric subtypes and predict treatment outcomes. Chicago classification, however, cannot predict which treatment, pneumatic dilatation, or Heller myotomy, should be selected for those with a specific subtype of achalasia. [ABSTRACT FROM AUTHOR]

Epiphrenic diverticula are a rare disease almost always associated with an underlying motility disorder of the esophagus, such as achalasia. Treatment of any underlying motility disorder must be included in the management of epiphrenic diverticula to prevent postoperative complications and recurrences. Therefore, the goal of this paper is to describe the pathophysiology, clinical presentation, and proper methods of diagnosis and treatment of patients with epiphrenic diverticula. In addition, we aim to provide an overview of the surgical management and discuss the indications for surgery and choice of surgical approach. In general, surgical intervention is favored for symptomatic patients and the optimal surgical approach depends on the size and location of the diverticulum. Surgery is not without seemingly high rates of morbidity when a myotomy is not performed together with the diverticulectomy, even in those with normal manometry. The risk of carcinoma is exceedingly rare and it is usually discovered at later stages; therefore, no surveillance programs have been established in asymptomatic patients with unresected diverticula. [ABSTRACT FROM AUTHOR]

Introduction: Morbid obesity and achalasia may coexist in the same patient. The surgical management of the morbidly obese patient with achalasia is complex, and the most effective treatment still remains controversial. The goal of our report is to provide our evidence-based approach for the surgical management of the patient with achalasia and morbid obesity. Results: Three main surgical approaches have been used for the concomitant treatment of morbid obesity and achalasia: 1) a laparoscopic Heller myotomy and a laparoscopic Roux-en-Y gastric bypass (LRYGB); 2) a laparoscopic Heller myotomy with bilio-pancreatic diversion; and 3) a laparoscopic Heller myotomy with a sleeve gastrectomy. Our approach of choice is the first one discussed, that is the laparoscopic Heller myotomy with a LRYGB, as this approach can provide excellent relief of symptoms and control of reflux while at the same time treating obesity and its comorbidities. Conclusions: Achalasia and obesity can coexist, albeit infrequently. A laparoscopic Heller myotomy with a LRYGB allows the simultaneous treatment of both diseases. When a morbidly obese patient with achalasia chooses to have a myotomy alone and not a LRYGB, a thorough discussion of the risks and benefits should occur and the autonomy of the patient's decision-making should be respected. [ABSTRACT FROM AUTHOR]

L'autore fonda una teologia cristocentrica del carisma della vita consacrata. Come la rivelazione di Gesù si pone al culmine della storia della salvezza, allo stesso modo la vita della chiesa e la vita consacrata hanno bisogno di essere illuminate da questo evento che fonda la fede stessa. Il dono del carisma è offerto alla vita consacrata, e a tutta la chiesa, per mantenere viva l'attesa del Signore. Per fare questo, il carisma va anzitutto inserito nell'orizzonte profetico. La profezia permette di allargare l'orizzonte del carisma recuperando il primato della parola di Dio. Un'altra dimensione importante è quella dell'escatologia. L'aver dimenticato l'orizzonte escatologico è, forse, il motivo dell'odierna crisi della vita consacrata. È necessario che la chiesa recuperi la consapevolezza di essere nel tempo della vigilanza, che trova riflesso nel carisma della vita consacrata, profezia della venuta del regno di Cristo. [ABSTRACT FROM AUTHOR]

Background: The topic of 'when and what' for gastroesophageal reflux disease (GERD) procedures centers on the correct indications for antireflux surgery gleaned from a thorough preoperative evaluation (the 'when') and on the right antireflux operation to perform once the ideal candidate is identified (the 'what'). Aims: The goals of this evidence-based review are the following: (1) to identify the key indications for surgery and predictors of good outcomes in the initial evaluation of patients with symptoms of GERD; (2) to describe the operations for GERD in the armamentarium of the general surgeon and their indications, as well as the technical elements of the operation; and (3) to describe the optimal surgical treatment of GERD and obesity when the two diseases coexist. [ABSTRACT FROM AUTHOR]

In this paper, we describe a highly reproducible method to transfer graphene (Gr) grown on copper by chemical vapour deposition to the surface of AlGaN/GaN heterostructures and we report a nanoscale electrical characterization of current transport at Gr contact to AlGaN. This latter investigation has been carried out using local current-voltage measurements by conductive atomic force microscopy (CAFM), performed both on the Gr-coated and bare AlGaN surface (reference). These analyses provide information on the lateral uniformity of the Schottky barrier height (SBH) between Gr and AlGaN. Gr contacts to AlGaN exhibit much more uniform and significantly lower SBH (∼0.4 eV) than common metals, such as gold, with SBH∼0.96 eV. These results can be useful for future applications in high frequency transistors based on AlGaN/GAN heterostructures and Gr. (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [ABSTRACT FROM AUTHOR]

Background: The year 2014 marks the 100th anniversary of Dr. Heller's description of the surgical treatment of patients with achalasia with a cardiomyotomy. This 100-year-old operation, which is today performed laparoscopically with the addition of a partial fundoplication, is considered the treatment of choice for patients with achalasia. Purpose: Our goals are to revisit the accounts from the beginning of the twentieth century in which surgeons tried to identify the pathophysiology of achalasia and proposed several operative techniques and to follow the evolution of the surgical treatment until modern days. [ABSTRACT FROM AUTHOR]

Background: Esophageal achalasia is a primary motility disorder of unknown etiology. It is characterized by lack of esophageal peristalsis and failure of the lower esophageal sphincter to relax appropriately in response to swallowing. The goal of treatment is to improve esophageal emptying and patient's symptoms by decreasing the functional obstruction at the level of the gastroesophageal junction. This can be accomplished by either endoscopic modalities (intra-sphincteric injection of botulinum toxin, pneumatic dilatation, per oral endoscopic myotomy) or by a laparoscopic Heller myotomy. Results: Review of the current literature suggests that a laparoscopic Heller myotomy should be considered today the primary form of treatment for achalasia and recommends a treatment algorithm for this disease. [ABSTRACT FROM AUTHOR]

The electrical behaviour of graphene (Gr) contacts to AlxGa1-xN/GaN heterostructures has been investigated, focusing, in particular, on the impact of the AlGaN microstructure on the current transport at Gr/AlGaN interface. Two Al0.25Ga0.75N/GaN heterostructures with very different quality in terms of surface roughness and defectivity, as evaluated by atomic force microscopy (AFM) and transmission electron microscopy, were compared in this study, i.e., a uniform and defect-free sample and a sample with a high density of typical V-defects, which locally cause a reduction of the AlGaN thickness. Nanoscale resolution current voltage (I-V) measurements by an Au coated conductive AFM tip were carried out at several positions both on the bare and Gr-coated AlGaN surfaces. Rectifying contacts were found onto both bare AlGaN surfaces, but with a more inhomogeneous and lower Schottky barrier height (ΦB ≈ 0.6 eV) for AlGaN with V-defects, with respect to the case of the uniform AlGaN (ΦB ≈ 0.9 eV). Instead, very different electrical behaviours were observed in the presence of the Gr interlayer between the Au tip and AlGaN, i.e., a Schottky contact with reduced barrier height (ΦB ≈ 0.4 eV) for the uniform AlGaN and an Ohmic contact for the AlGaN with V-defects. Interestingly, excellent lateral uniformity of the local I-V characteristics was found in both cases and can be ascribed to an averaging effect of the Gr electrode over the AlGaN interfacial inhomogeneities. Due to the locally reduced AlGaN layer thickness, V defect act as preferential current paths from Gr to the 2DEG and can account for the peculiar Ohmic behaviour of Gr contacts on defective AlGaN. [ABSTRACT FROM AUTHOR]

Background: Engineered nanomaterials may release nanosized residues, by degradation, throughout their life cycle. These residues may be a threat for living organisms. They may be ingested by humans through food and water. Although the toxicity of pristine CeO2 nanoparticles (NPs) has been documented, there is a lack of studies on manufactured nanoparticles, which are often surface modified. Here, we investigated the potential adverse effects of CeO2 Nanobyk 3810™ NPs, used in wood care, and their residues, altered by light or acid. Results: Human intestinal Caco-2 cells were exposed to residues degraded by daylight or in a medium simulating gastric acidity. Size and zeta potential were determined by dynamic light scattering. The surface structure and redox state of cerium were analyzed by transmission electronic microscopy (TEM) and X-ray absorption spectroscopy, respectively. Viability tests were performed in Caco-2 cells exposed to NPs. Cell morphology was imaged with scanning electronic microscopy. Gene expression profiles obtained from cells exposed to NPs before and after their alteration were compared, to highlight differences in cellular functions. No change in the cerium redox state was observed for altered NPs. All CeO2 NPs suspended in the culture medium became microsized. Cytotoxicity tests showed no toxicity after Caco-2 cell exposure to these various NPs up to 170 μg/mL (24 h and 72 h). Nevertheless, a more-sensitive whole-gene-expression study, based on a pathway-driven analysis, highlighted a modification of metabolic activity, especially mitochondrial function, by altered Nanobyk 3810™. The down-regulation of key genes of this pathway was validated by qRT-PCR. Conversely, Nanobyk 3810™ coated with ammonium citrate did not display any adverse effect at the same concentration. Conclusion: The degraded nanoparticles were more toxic than their coated counterparts. Desorption of the outside layer was the most likely cause of this discrepancy in toxicity. It can be assumed that the safe design of engineered nanoparticles could include robust protective layers conferring on them greater resistance to alteration during their life cycle. [ABSTRACT FROM AUTHOR]

Abstract: Background: Patients with scleroderma and end-stage lung disease (ESLD) have a very high prevalence of gastroesophageal reflux disease (GERD). Because GERD has been associated with aspiration in those with ESLD, and because those with scleroderma are particularly prone to develop severe GERD, there is some concern that GERD may contribute to shorten survival in patients with scleroderma awaiting lung transplantation. Therefore, we hypothesized that esophageal pH monitoring could predict survival of those with scleroderma and ESLD awaiting lung transplantation and that the severity of reflux can impact survival. Methods: We conducted a retrospective analysis of all scleroderma patients referred for lung transplantation who underwent esophageal manometry and pH monitoring since August 2008. We identified 10 patients in whom we calculated and compared the area under the curve for each receiver operating characteristic curve of the following variables: DeMeester score, forced expiratory volume in 1 s (FEV1), %predicted FEV1, forced vital capacity (FVC), %predicted FVC, diffusion capacity for carbon monoxide (DLco), and %predicted DLco. Results: The DeMeester score nominally outperformed FEV1, FVC, and DLco. Receiver operating characteristic curve analysis was also used to define the optimal DeMeester score (65.2) in differentiating survival status, as determined by maximizing sensitivity and specificity. Based on this value, we calculated the 1-y survival from the time of the esophageal function testing, which was 100% in seven patients with a DeMeester score of <65.2, and 33% in three patients with a score >65.2 (P = 0.01). The latter patients had greater total time pH < 4, greater time pH < 4 in the supine position, greater total episodes of reflux, and higher prevalence of absent peristalsis. The single survivor with a DeMeester score >70 had also proximal reflux, underwent antireflux surgery, and is alive 1201 d after transplant. Conclusions: Our study shows that esophageal pH monitoring can predict survival status in patients with scleroderma awaiting lung transplantation and that the severity of reflux can impact the 1-y survival rate. Therefore, esophageal pH monitoring should be considered early in patients with scleroderma and ESLD, as this test could appropriately identify those in whom laparoscopic antireflux surgery should be performed quicker to prevent GERD and its detrimental effects in patients awaiting lung transplantation. [Copyright &y& Elsevier]

In this paper, hydrogen bubbling delamination of graphene (Gr) from copper using a strong electrolyte (KOH) water solution was performed, focusing on the effect of the KOH concentration (CKOH) on the Gr delamination rate. A factor of ~10 decrease in the time required for the complete Gr delamination from Cu cathodes with the same geometry was found increasing CKOH from ~0.05M to ~0.60 M. After transfer of the separated Gr membranes to SiO2 substrates by a highly reproducible thermo-compression printing method, an accurate atomic force microscopy investigation of the changes in Gr morphology as a function of CKOH was performed. Supported by these analyses, a microscopic model of the delamination process has been proposed, where a key role is played by graphene wrinkles acting as nucleation sites for H2 bubbles at the cathode perimeter. With this approach, the H2 supersaturation generated at the electrode for different electrolyte concentrations was estimated and the inverse dependence of td on CKOH was quantitatively explained. Although developed in the case of Cu, this analysis is generally valid and can be applied to describe the electrolytic delamination of graphene from several metal substrates. [ABSTRACT FROM AUTHOR]

A multi-analyte method for the detection and quantification of 87 psychoactive drugs (antidepressants, antipsychotics, benzodiazepines, and z-drugs) in human hair has been developed and fully validated using the liquid chromatography-tandem mass spectrometry system. Due to the remarkable increase in requests of hair sample tests (such as for driver's license renewals, child custody, DFA cases, and postmortem toxicology), we focused on the development of a rapid sample preparation. About 20 mg of hair samples, previously washed and cut into snippets, was ultrasonicated with 700 μl of methanol. Samples were then directly analyzed using a 4000 QTRAP (AB SCIEX, Foster City, CA, USA) with an electrospray ionization (ESI) Turbo V Ion Source. The validation criteria parameters were satisfactory and in accordance with the international guidelines. All the compounds tested were successfully detected. One important aspect is the LODs in the low picogram per milligram concentration which may suggest a potential use of this method in cases of detection of single drug exposure. However, the LC-MS/MS method has been successfully applied for the analysis of postmortem cases ( n = 9). [ABSTRACT FROM AUTHOR]

Since their introduction in the early 1990s, minimally invasive techniques have gained widespread acceptance because of the significant benefits that patients are able to experience. Some of these benefits include reduced postoperative pain, earlier return to normal activity, and improved cosmesis when compared with open surgery. For these reasons, since its first description by Delaitre and Maignien in 1991, laparoscopic splenectomy (LS) has been increasingly utilized for a safe surgical removal of the spleen with nearly equivalent or superior short- and long-term outcomes when compared with the open approach. In this technical report, we aim to describe our preoperative and postoperative management of patients undergoing LS and to illustrate our preferred surgical technique, its rationale, and our results. [ABSTRACT FROM AUTHOR]

The authors reflect on curriculum design in medical education, suggesting that the development of simulation technology should be used to create more rigorous scientific methods to create educational programmes that will identify medical skills. Particular attention is given to simulation-based mastery learning (SBML), which has been used to help medical students acquire clinical skills.