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Browning reactions caused by oxidative stress occurring during postharvest procedures significantly compromise the quality of ready‐to‐eat (RTE) vegetables, negatively affecting their market value. Polyphenol oxidase (PPO) and peroxidase (POD) are two major enzymes involved in this phenomenon, as they oxidize phenolic compounds to quinones, which in turn polymerize to brown pigments. Recently, there has been an increasing interest in developing antibrowning treatments using food by‐products. Herein, the efficiency of a kiwi peel extract in reducing enzymatic browning of minimally processed lettuce (Lactuca sativa) has been investigated. PPO and POD activities showed an opposite spatial distribution within the leaf, with a higher POD activity in the midvein (MV) and in the inner lamina tissues, and a prevalence of PPO activity in the mesophyll. Considering that MV lignified tissues are those mainly affected by browning, the temporal trend of POD activity over a 20‐day storage period at 4°C was investigated. Data showed that treatment with a kiwi peel extract hinders both the increasing trend of POD activity and browning development compared to control leaves. These results could be potentially useful for the industry as they confirm that natural extracts, such as kiwi peel extract, can be valuable for extending the shelf‐life of RTE products. [ABSTRACT FROM AUTHOR]

Current genetic modification and phenotyping methods in teleost fish allow detailed investigation of vertebrate mechanisms of development, modeling of specific aspects of human diseases and efficient testing of drugs at an organ/organismal level in an unparalleled fast and large-scale mode. Fish-based experimental approaches have boosted the in vivo verification and implementation of scientific advances, offering the quality guaranteed by animal models that ultimately benefit human health, and are not yet fully replaceable by even the most sophisticated in vitro alternatives. Thanks to highly efficient and constantly advancing genetic engineering as well as non-invasive phenotyping methods, the small zebrafish is quickly becoming a popular alternative to large animals’ experimentation. This approach is commonly associated to invasive procedures and increased burden. Here, we present a rapid and minimally invasive method to obtain sufficient genomic material from single zebrafish embryos by simple and precise tail fin scratching that can be robustly used for at least two rounds of genotyping already from embryos within 48 h of development. The described protocol betters currently available methods (such as fin clipping), by minimizing the relative animal distress associated with biopsy at later or adult stages. It allows early selection of embryos with desired genotypes for strategizing culturing or genotype–phenotype correlation experiments, resulting in a net reduction of “surplus” animals used for mutant line generation. [ABSTRACT FROM AUTHOR]

Luteoma of pregnancy is a rare, benign condition characterized by a tumor-like mass of the ovary that emerges during pregnancy and regresses spontaneously after delivery. It is usually asymptomatic and the diagnosis is generally incidental. Luteoma arises from the proliferation of luteinised cell under the influence of β-hCG and can be hormonally active, with production of androgens resulting in maternal and fetal hirsutism and virilisation. We report a case of a 25-year-old primigravida who presented at 28 weeks of gestation with virilisation symptoms. Serum androgen levels were seven-hundred-fold higher than normal. A diagnosis of pregnancy luteoma was made at the time of caesarean section. The ovarian mass, serum androgen levels, and the condition of the patient improved after delivery. [ABSTRACT FROM AUTHOR]

The availability of accurate models for the spreading of infectious diseases has opened a new era in management and containment of epidemics. Models are extensively used to plan for and execute vaccination campaigns, to evaluate the risk of international spreadings and the feasibility of travel bans, and to inform prophylaxis campaigns. Even when no specific therapeutical protocol is available, as for the Ebola Virus Disease (EVD), models of epidemic spreading can provide useful insight to steer interventions in the field and to forecast the trend of the epidemic. Here, we propose a novel mathematical model to describe EVD spreading based on activity driven networks (ADNs). Our approach overcomes the simplifying assumption of homogeneous mixing, which is central to most of the mathematically tractable models of EVD spreading. In our ADN-based model, each individual is not bound to contact every other, and its network of contacts varies in time as a function of an activity potential. Our model contemplates the possibility of non-ideal and time-varying intervention policies, which are critical to accurately describe EVD spreading in afflicted countries. The model is calibrated from field data of the 2014 April-to-December spreading in Liberia. We use the model as a predictive tool, to emulate the dynamics of EVD in Liberia and offer a one-year projection, until December 2015. Our predictions agree with the current vision expressed by professionals in the field, who consider EVD in Liberia at its final stage. The model is also used to perform a what-if analysis to assess the efficacy of timely intervention policies. In particular, we show that an earlier application of the same intervention policy would have greatly reduced the number of EVD cases, the duration of the outbreak, and the infrastructures needed for the implementation of the intervention. [ABSTRACT FROM AUTHOR]

We report the case of a patient arrived because of urological symptoms characterized by terminal hematuria, strangury and dysuria due to migration into the bladder of an intrauterine contraceptive device (IUD) placed 14 years before and penetrated into the bladder with formation of lithiasis. These cases have already been described in literature, but the particular feature of this case is that the patient had been pregnant and had a eutocic delivery, she never voluntarily removed the IUD and nor was it found during a gynecologic laparoscopy. The patient underwent the surgical removal of the IUD and of the bladder stone, without detecting adjacent connective routes between uterus and bladder. [ABSTRACT FROM AUTHOR]

Paraganglioma of the urinary bladder is a rare neoplasm that derives from ganglion cells located in the bladder wall and may morphologically simulate a urothelial carcinoma. The authors present the case of a vesical paraganglioma incidentally detected by ultrasound, and entirely removed by transurethral approach from detrusorial wall. Conventional approaches include surgery (partial cystectomy) or laparoscopic procedures, with inspection by transurethral endoscopy; in this case we wanted to avoid the combined approach considering the lesion diameter and the possibility of an easy removal. [ABSTRACT FROM AUTHOR]

Authors present a case of bilharziosis incidentally diagnosed in a patient undergoing TURB for suspected bladder cancer. The patient, who in 2005 had gone to Malaysia, had been suffering from recurrent hemorrhagic cystitis since 2007, which were treated with antibiotic therapy. In November 2009 he presented to our observation for persistent hematuria, underwent ultrasound examination, fibroscopy and TURB diagnostics for suspicious lesions. The histopathology diagnosis found granulomatous lesions with typical parasites eggs due to schistosomiasis eggs. As a consequence of that, the patient underwent medical therapy. The pathologist's role becomes nullifying not only for the diagnosis of parasitic infections but also for the exclusion or evidence of urothelial squamous neoplasia. The low incidence of this rare parasitic disease in European tourists and the presence of immigrants in our country require to spread the knowledge of these parasites and the most simple tests for early detection. [ABSTRACT FROM AUTHOR]

Fournier's disease is a necrotizing fasciitis that prefers the male and which is located in the perineal area. In view of possible complications related to sepsis, systemic organ impairment and high mortality, is now considered a urological emergency. The main causes are infections of urethral and anal-rectal tract, immunodepression syndromes, diabetes mellitus and trauma. Infections are mixed with aerobic and anaerobic germs responsible of necrosis of tissue disorders due to the phenomena of necrotizing immunovasculitis disease. We present a case of Fournier's disease in perineal area, with gangrenosum necrotic evolution treated with antibiotic therapy, curettage of the necrotic tissue and local disinfection with saline and antiseptics solution. A total parenteral nutrition to ensure maximum perineal decontamination has been made. The extensive loss of substance scrotal was rebuilt in 25–day while the anal wound has healed spontaneously after complete surgical curettage. [ABSTRACT FROM AUTHOR]

Plant defence responses to adverse environmental conditions include different stress signalling, allowing plant acclimation and survival. Among these responses one of the most common, immediate, and effective is the modulation of the stomatal aperture, which integrates different transduction pathways involving hydrogen peroxide (H2O2), calcium (Ca2+), nitric oxide (NO), phytohormones and other signalling components. The Arabidopsis thaliana copper amine oxidases β (AtCuAOβ) encodes an apoplastic CuAO expressed in guard cells and root protoxylem tissues which oxidizes polyamines to aminoaldehydes with the production of H2O2 and ammonia. Here, its role in stomatal closure, signalled by the wound-associated phytohormone methyl-jasmonate (MeJA) was explored by pharmacological and genetic approaches. Obtained data show that AtCuAOβ tissue-specific expression is induced by MeJA, especially in stomata guard cells. Interestingly, two Atcuaoβ T-DNA insertional mutants are unresponsive to this hormone, showing a compromised MeJA-mediated stomatal closure compared to the wild-type (WT) plants. Coherently, Atcuaoβ mutants also show compromised H2O2-production in guard cells upon MeJA treatment. Furthermore, the H2O2 scavenger N,N1-dimethylthiourea (DMTU) and the CuAO-specific inhibitor 2-bromoethylamine (2-BrEtA) both reversed the MeJA-induced stomatal closure and the H2O2 production in WT plants. Our data suggest that AtCuAOβ is involved in the H2O2 production implicated in MeJA-induced stomatal closure. [ABSTRACT FROM AUTHOR]

This article discusses the political aspect of the bilingual education program in the U.S. The efforts being made and the money being invested in the special programs to help immigrant, migrant and refugee school children who do not speak English when they enter U.S. schools is still largely misguided. The population of limited-English students is being treated in ways that earlier immigrant groups were not. The politically righteous assumption is that these students can not learn English quickly and must be taught all their school subjects in their native language for 3 to 7 years while having the English language introduced gradually. However, 27 years of classroom experience with this education policy and a growing body of research show no benefits for native-language teaching.

Analysis of cell cultures utilizing two-dimensional (2D) spheroid assays has been the standard to analyze toxicity screenings for decades, however the high cost and inefficiencies in producing in-vitro assays using this technique creates the need for more productive and costefficient methods. The newly introduced Magnetic 3D Bioprinting system addresses the shortcomings of the 2D systems. This method relies on magnetizing cells and rapidly printing them in a more organized formation, mimicking in-vitro environments and interaction. This study assesses the effectiveness of Magnetic 3D Bioprinting system in analyzing spheroid toxicity assays when compared to the 2D methods, we hypothesize that the cell cultures produced utilizing this system will result in superior detail, utility, and realistic representation of the in-vitro environment. Cardiomyocytes and hepatocytes were mixed with NanoShuttle (1 u/10000 cells) for 2 hours to become magnetized. The cells were separated, counted, and redistributed to a cell repellent 384-well plate. The cells were left to interact to form a mature spheroid with ECM. Results showed that the cultures were successfully imaged and yielded viable spheroid samples with greater efficiency and cell interactions. After 15 minutes of printing, viability, spheroid size and cell count increased in a time dependent manner. Day 1: the surface area increased from 3.2 to 3.45 x105 pixels in 12s; by day 7 the number increased to 8.18 x 105 pixels, while showing steadying beating patterns The Magnetic 3D Bioprinting system yielded cell cultures that revealed higher levels of activity, size, and interaction in the 3D environment. [ABSTRACT FROM AUTHOR]

Sarcomas of the retropehtoneum represent 0.2% of tumors and 15% of soft tissue sarcomas. Retro peritoneal differentiated liposarcoma must be distinguished from the connective neoplasm of kidney. The main features of these tumors are: the rapid growth, 'infiltration of surrounding tissue, the tendency to local relapse and very fast metastasis (60–80%). Authors report a clinical case of a patient 61 old years with occasional reflected ultrasound is performed for lombar pain a retro peritoneal mass. CT described a retro peritoneal mass that raised medially and displaced the left kidney. The patient was subjected to removal of the mass now to his kidney capsule, which was nevertheless preserved. The histological examination showed a picture of well-differentiated liposarcoma with areas of high-grade sarcoma with malignant morphology fibroistiocitoma-like aspects and fibromixomatosi. The well-differentiated liposarcoma has biological behavior similar to other sarcomas with high degree of adults with high local recurrence and distant metastases in 15–20% with overall mortality at 5 years about 30%. The most significant prognostic factor is the location of the cancer and the extent and degree of differentiation did not impact on the clinical prognosis is conditioned by the difficulty of obtaining a radical surgery in spite linfoadenectomia a retro peritoneal accurate. [ABSTRACT FROM AUTHOR]

Amino acids are essential building blocks of life and fluorinated derivatives have gained interest in chemistry andmedicine.Modern mass spectrometry has enabled the study of oligo- and polypeptides as isolated entities in the gas phase, but predominantly as singly or even multiply charged species.While laser desorption of neutral peptides into adiabatically expanding supersonic noble gas jets is possible, UV-VIS spectroscopy, electric or magnetic deflectometry as well as quantum interferometry would profit from the possibility to prepare thermally slow molecular beams. This has typically been precluded by the fragility of the peptide bond and the fact that a peptide would rather 'fry', i.e. denature and fragment than 'fly'. Here, we explore how tailored perfluoroalkyl functionalization can reduce the intermolecular binding and thus increase the volatility of peptides and compare it to previously explored methylation, acylation and amidation of peptides. We show that this strategy is essential and enables the formation of thermal beams of intact neutral tripeptides, whereas only fragments were observed for an extensively fluoroalkyl-decorated nonapeptide. © 2017 The Authors. Journal of Mass Spectrometry Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of Urinary tract endometriosis (UTE) ranges from 1% to 3%; bladder is the most affected organ (85% of UTE), followed by ureter (12–14% of UTE), for which we distinguish an intrinsic very rare form and an extrinsic variety most frequently occurring in advanced pelvic endometriosis. Materials and Methods. From 1997 to 2010, 33 surgical procedures for urologic endometriosis were performed, involving the urinary tract, in 28 patients with mean age of 31 years (25–43). The localization of endometriosis were: 7 cases in the bladder, 2 cases in the vesicoureteral tract, and 19 cases of ureteral tract only. Of these, two cases were diagnosed with an intrinsic localization. Results: Overall, we performed 3 TURB, 5 partial cystectomies (2 with open surgical approach and 3 by laparoscopy procedure), 12 laparoscopic ureterolysis and simultaneous protection of the upper urinary tract with stent, 9 cases of ureterocystoneostomy (UCNS) according to Lich-Gregoire procedure, and 3 according to Boari–Kuess procedure. Of the 12 patients who underwent ureterolysis with laparoscopic and stenting procedure, five cases required a UCNS according to Lich-Gregoire technique for persistent ureteral obstruction. Conclusions: The limits of endoscopic procedures in endometriosis of the urinary tract are correlated both to the degree of extension and the localization of the disease. It is mandatory to achieve an interdisciplinary consensus in order to ensure the disease removal and the simultaneous functional results of the upper urinary tract. [ABSTRACT FROM AUTHOR]

Background: Ebola virus disease case definition is a crucial surveillance tool to detect suspected cases for referral and as a screening tool for clinicians to support admission and laboratory testing decisions at Ebola health facilities. We aimed to assess the performance of the WHO Ebola virus disease case definitions and other screening scores.Methods: In this systematic review and meta-analysis, we searched PubMed, Scopus, Embase, and Web of Science for studies published in English between June 13, 1978, and Jan 14, 2020. We included studies that estimated the sensitivity and specificity of WHO Ebola virus disease case definitions, clinical and epidemiological characteristics (symptoms at admission and contact history), and predictive risk scores against the reference standard (laboratory-confirmed Ebola virus disease). Summary estimates of sensitivity and specificity were calculated using bivariate and hierarchical summary receiver operating characteristic (when four or more studies provided data) or random-effects meta-analysis (fewer than four studies provided data).Findings: We identified 2493 publications, of which 14 studies from four countries (Sierra Leone, Guinea, Liberia, and Angola) were included in the analysis. 12 021 people with suspected disease were included, of whom 4874 were confirmed as positive for Ebola virus infection. Six studies explored the performance of WHO case definitions in non-paediatric populations, and in all of these studies, suspected and probable cases were combined and could not be disaggregated for analysis. The pooled sensitivity of the WHO Ebola virus disease case definitions from these studies was 81·5% (95% CI 74·1-87·2) and pooled specificity was 35·7% (28·5-43·6). History of contact or epidemiological link was a key predictor for the WHO case definitions (seven studies) and for risk scores (six studies). The most sensitive symptom was intense fatigue (79·0% [95% CI 74·4-83·0]), assessed in seven studies, and the least sensitive symptom was pain behind the eyes (1·0% [0·0-7·0]), assessed in three studies. The performance of fever as a symptom varied depending on the cutoff used to define fever.Interpretation: WHO Ebola virus disease case definitions perform suboptimally to identify cases at both community level and during triage at Ebola health facilities. Inclusion of intense fatigue as a key symptom and contact history could improve the performance of case definitions, but implementation of these changes will require effective collaboration with, and trust of, affected communities.Funding: Médecins sans Frontières. [ABSTRACT FROM AUTHOR]

Since 1980, Field Epidemiology Training Programs (FETPs) have trained highly qualified field epidemiologists to work for ministries of health (MOH) around the world. However, the 2013-2015 Ebola epidemic in West Africa, which primarily affected Guinea, Liberia, and Sierra Leone, demonstrated a lack of field epidemiologists at the local levels. Trained epidemiologists at these levels could have detected the Ebola outbreak earlier. In 2015, the US Centers for Disease Control and Prevention (CDC) launched FETPFrontline, a 3-month field training program targeting local MOH staff in 24 countries to augment local public health capacity. As of December 2016, FETP-Frontline has trained 1,354 graduates in 24 countries. FETP-Frontline enhances global health security by training local public health staff to improve surveillance quality in their jurisdictions, which can be a valuable strategy to strengthen the capacity of countries to more rapidly detect, respond to, and contain public health emergencies at the source. [ABSTRACT FROM AUTHOR]

The 2014-2015 epidemic of Ebola virus disease in West Africa primarily affected Guinea, Liberia, and Sierra Leone. Several countries, including Mali, Nigeria, and Senegal, experienced Ebola importations. Realizing the importance of a trained field epidemiology workforce in neighboring countries to respond to Ebola importations, the Centers for Disease Control and Prevention Field Epidemiology Training Program unit implemented the Surveillance Training for Ebola Preparedness (STEP) initiative. STEP was a mentored, competency-based initiative to rapidly build up surveillance capacity along the borders of the at-risk neighboring countries Côte d'Ivoire, Mali, Senegal, and Guinea-Bissau. The target audience was district surveillance officers. STEP was delivered to 185 participants from 72 health units (districts or regions). Timeliness of reporting and the quality of surveillance analyses improved 3 months after training. STEP demonstrated that mentored, competency-based training, where learners attain competencies while delivering essential public health services, can be successfully implemented in an emergency response setting. [ABSTRACT FROM AUTHOR]

Objective: Intensified surveillance will be vital in the elimination phase to verify Ebola-free status and mitigate potential reemergence of the disease in West Africa. Zero-reporting from high-risk districts is a key strategy for surveillance. Our objective was to implement a pilot investigation to assess the feasibility of using short message service (SMS) texting for daily reporting of Ebola cases under investigation (CUI) in Guinea-Bissau in the context of an ongoing emergency-response training program known as Surveillance Training for Ebola Preparedness (STEP). Study Design: Prospective cohort (pilot investigation) Methods: The reporting period for the SMS pilot was January 24eMarch 24, 2015. STEP was conducted for two sequential groups during January 19eMarch 27, 2015 in Bissau, Guinea- Bissau. Training on SMS daily reporting occurred over one hour during the first week of didactic training of each group. Fourteen participants (nine from the first group and five from the second), including one surveillance officer from each of the 13 regions in Guinea- Bissau and one from the national laboratory, were selected as reporters, receiving a simple cell phone for sending SMS indicating the number of CUI for Ebola. The WHO suspect Ebola case definition was used initially and then modified on day 32 of the pilot. The text message was sent to the WiFi-connected smartphone at the Instituto Nacional Sau' de Pu' blica (INASA). The smartphone utilised an SMS-gateway application (Ushahidi SMSsync Android App) to upload the data to the Magpi cloud application. Results: The average daily reporting from the first group was 7.7 of 9 (86%) and for the second group was 4.1 of 5 (82%). For the two groups combined, the reporting rate was 85%. Among the 14 reporters the median reporting rate was 85% (range 36%e100%). No cases meeting the definition for an Ebola CUI were reported during the 60 days. Conclusions: Real-time, SMS-based, daily zero-reporting can be implemented in a rapid, simple way in a low resource country. We believe that the high compliance rates were due to the simplicity and familiarity of SMS and heightened sensitivity that resulted from STEP to the importance of zero-reporting in the midst of an Ebola epidemic in neighbouring countries. This model could be useful for rapid scale-up and implementation of alert systems in other outbreaks and public health emergencies. [ABSTRACT FROM AUTHOR]

Background Celiac disease (CD) is a chronic autoimmune illness of the small intestine triggered by gluten consumption in genetically predisposed individuals. CD presentation is not limited to the gastrointestinal tract and it is still under-diagnosed. Complete resolution of clinical manifestations follows if a gluten-free diet is adopted. In western countries, CD prevalence is approximately 1%. Age of onset is often between 6 months and 7 years. We assessed the approach to diagnosis and management of celiac patients by the paediatricians in Puglia Region, Italy. Methods We conducted a cross-sectional survey among the 589 Apulian Family Paediatricians (FPs) during January 2011-January 2012 using a self-administered web-based standardized questionnaire including self-assessment of their knowledge, diagnostic path and type of management they would follow for CD, clinical information on their celiac patients. We assessed associations among the explored variables by defining double-entry contingency tables and calculating Odds Ratio (OR) with 95% Confidence Intervals (CIs). Results The 218 (37%) FPs participating in the study reported 1,020 CD patients (representing approximately 1% of the child population covered by the enrolled FPs). Of them, 55% were female; 45% were aged 5-10 years. Weight loss and stunting were the main reported symptoms at diagnosis (41%). The majority (98%) of FPs requested anti-transglutaminase antibody (tTG-Ab) titres for CD diagnosis. Approximately 78% of FPs recommended gluten introduction in the diet of infants at the age of 6 months; 12% and 8% recommended introduction of gluten before and after 6 months of age respectively. The degree of knowledge for either CD diagnosis making process or CD related diseases was medium/high in 97% and 82% of the participating FPs respectively. FPs (83%) who had a medium or high degree of knowledge of CD patients' diet were more likely to experience low or no difficulty in providing their patients with dietary advices (OR:5.5;95%CI:1.7-17.5). Conclusions Apulian FPs report a good degree of knowledge of CD, its diagnosis and its management. We will diffuse results and recommendations to all paediatricians in the Region. Actions aiming to continued education on CD in medical under and postgraduate trainings are crucial to prevent under-diagnosis. [ABSTRACT FROM AUTHOR]

Summary: Background: Reactivation of latent varicella-zoster virus in sensory neurons to cause herpes zoster (shingles) is common in adults 50 years of age and older; half of adults experience an episode by age 85 years. Herpes zoster is attributable to the progressive decline in the VZV-specific cell-mediated immunity that occurs with aging or other conditions that cause immune compromise. Herpes zoster and complications, such as postherpetic neuralgia (PHN), can have a substantial negative impact on quality of life. Discussion: The incidence of herpes zoster and its associated morbidity is increasing worldwide as the population ages. Nevertheless, the severity and impact of this condition, and its painful sequelae, are often unrecognized. Many patients delay seeking medical attention, complicating both diagnosis and treatment. Prevention appears to be the best option. A new herpes zoster vaccine significantly reduced the burden of illness (61.1%), the incidence of PHN (66.5%), and the incidence of herpes zoster (51.3%) (p < 0.001). Vaccine tolerability was good, with minor local injection site reactions the most common adverse event. Conclusions: Herpes zoster and PHN represent a substantial burden in terms of suffering and associated costs. Immunization of older adults is a good option to prevent herpes zoster and PHN. [Copyright &y& Elsevier]

To evaluate oral poliovirus vaccine (OPV) coverage of the November 2009 round in five Northern Nigeria states with ongoing wild poliovirus transmission using clustered lot quality assurance sampling (CLQAS). We selected four local government areas in each pre-selected state and sampled six clusters of 10 children in each Local Government Area, defined as the lot area. We used three decision thresholds to classify OPV coverage: 75-90%, 55-70% and 35-50%. A full lot was completed, but we also assessed in retrospect the potential time-saving benefits of stopping sampling when a lot had been classified. We accepted two local government areas (LGAs) with vaccination coverage above 75%. Of the remaining 18 rejected LGAs, 11 also failed to reach 70% coverage, of which four also failed to reach 50%. The average time taken to complete a lot was 10 h. By stopping sampling when a decision was reached, we could have classified lots in 5.3, 7.7 and 7.3 h on average at the 90%, 70% and 50% coverage targets, respectively. Clustered lot quality assurance sampling was feasible and useful to estimate OPV coverage in Northern Nigeria. The multi-threshold approach provided useful information on the variation of IPD vaccination coverage. CLQAS is a very timely tool, allowing corrective actions to be directly taken in insufficiently covered areas. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma with sarcomatoid differentiation has an incidence of 4–6%. It occurs more frequently with clinical advanced presentation in relation to the greater biological aggressiveness. This variant was also found both in transplanted kidneys and in patients with von Hippel-Lindau syndrome. The authors present three cases of cancer all clinically evolving to rapidly progressive conditions. The pathologic staging was, respectively: Case 1 pT4 NO MO G4 case, Case 2 P G4 T3a N2 MO, Case 3 pT3a N0 M1 G4. The clinical responses related to protocols with VEGF drugs that seem to have better clinical response compared to immunotherapy are still being studied. From the pathologic point of view it is necessary, for all renal cell cancers, to search and identify the sarcomatoid components that, although poorly represented, give a negative prognosis. [ABSTRACT FROM AUTHOR]

Background: The province of North Kivu in the Democratic Republic of Congo has been afflicted by conflict for over a decade. After months of relative calm, offences restarted in September 2008. We did an epidemiological study to document the impact of violence on the civilian population and orient pre-existing humanitarian aid. Methods: In May 2009, we conducted three cross-sectional surveys among 200 000 resident and displaced people in North Kivu (Kabizo, Masisi, Kitchanga). The recall period covered an eight month period from the beginning of the most recent offensives to the survey date. Heads of households provided information on displacement, death, violence, theft, and access to fields and health care. Results: Crude mortality rates (per 10 000 per day) were below emergency thresholds: Kabizo 0.2 (95% CI: 0.1-0.4), Masisi 0.5 (0.4-0.6), Kitchanga 0.7 (0.6-0.9). Violence was the reported cause in 39.7% (27/68) and 35.8% (33/92) of deaths in Masisi and Kitchanga, respectively. In Masisi 99.1% (897/905) and Kitchanga 50.4% (509/1020) of households reported at least one member subjected to violence. Displacement was reported by 39.0% of households (419/1075) in Kitchanga and 99.8% (903/905) in Masisi. Theft affected 87.7% (451/514) of households in Masisi and 57.4% (585/1019) in Kitchanga. Access to health care was good: 93.5% (359/384) of the sick in Kabizo, 81.7% (515/630) in Masisi, and 89.8% (651/725) in Kitchanga received care, of whom 83.0% (298/359), 87.5% (451/515), and 88.9% (579/651), respectively, did not pay. Conclusions: Our results show the impact of the ongoing war on these civilian populations: one third of deaths were violent in two sites, individuals are frequently subjected to violence, and displacements and theft are common. While humanitarian aid may have had a positive impact on disease mortality and access to care, the population remains exposed to extremely high levels of violence. [ABSTRACT FROM AUTHOR]

INTRODUCTION. The activities of Risk Management at a department of urology involve specialist health workers, technical and administrative staff as the common denominator is communication, simplification of processes and the quality of health care provision. The Authors present their experience on the management of risk in urology and an attempted classification of adverse events with possible dysfunction in the clinical management in urology department. MATERIALS AND METHODS. Our analysis included those adverse events that occurred from January to December 2008. A total of 18 adverse events were identified from 638 urological procedures divided according to diagnosis, treatment and type of hospitalization. RESULTS. The following events were assessed: number of cases with wound infection: 5 (4.7%), diastasis of the surgical wound: 3 (0.47%), catheter obstructions that required therapeutic endoscopic or surgical haemostatic procedures: 5 (0.78%), delayed administration of treatment: 3 (0.47%) and accidental fall out of bed: 2 (0.31%). CONCLUSIONS. The transition from a reactive to a preventive system remains the key to provide the citizen with the best health care in safety conditions. The involvement of different organizational and managerial levels in an optimal atmosphere in the absence of stress appears to be the most balanced and successful approach, especially putting aside the attitude of assigning error culpability. The transmission of individual experiences at a regional and national level will allow refining the project, which foresees the identification and classification of possible events and especially the ways and preventive procedures to achieve them. [ABSTRACT FROM AUTHOR]

This paper presents the results obtained using radiochromic (MD-55 GafChromic TM ) film for the 2D and 3D dosimetric reconstruction of the dose delivered by a proton beam under the real conditions of a programme of radiotherapy treatment for ocular tumours. Standard microdensitometric measurements were used to determine the variation in film optical density (O.D.) vs dose. Calibration curves were obtained by least-square fitting of the experimental OD values using a second order polynomial. This allows conversion of O.D. to dose. With this procedure it was possible to determine the distribution of the dose delivered by the proton beam in a phantom composed of layers of GafChromic TM film, with high surface spatial resolution and, through sections, the complete mapping of the dose delivered to a volume subjected to irradiation, as in a course of radiotherapy treatment. [ABSTRACT FROM AUTHOR]

The 2014-2015 epidemic of Ebola virus disease in West Africa primarily affected Guinea, Liberia, and Sierra Leone. Several countries, including Mali, Nigeria, and Senegal, experienced Ebola importations. Realizing the importance of a trained field epidemiology workforce in neighboring countries to respond to Ebola importations, the Centers for Disease Control and Prevention Field Epidemiology Training Program unit implemented the Surveillance Training for Ebola Preparedness (STEP) initiative. STEP was a mentored, competency-based initiative to rapidly build up surveillance capacity along the borders of the at-risk neighboring countries Côte d'Ivoire, Mali, Senegal, and Guinea-Bissau. The target audience was district surveillance officers. STEP was delivered to 185 participants from 72 health units (districts or regions). Timeliness of reporting and the quality of surveillance analyses improved 3 months after training. STEP demonstrated that mentored, competency-based training, where learners attain competencies while delivering essential public health services, can be successfully implemented in an emergency response setting. [ABSTRACT FROM AUTHOR]

Since 1980, Field Epidemiology Training Programs (FETPs) have trained highly qualified field epidemiologists to work for ministries of health (MOH) around the world. However, the 2013-2015 Ebola epidemic in West Africa, which primarily affected Guinea, Liberia, and Sierra Leone, demonstrated a lack of field epidemiologists at the local levels. Trained epidemiologists at these levels could have detected the Ebola outbreak earlier. In 2015, the US Centers for Disease Control and Prevention (CDC) launched FETP-Frontline, a 3-month field training program targeting local MOH staff in 24 countries to augment local public health capacity. As of December 2016, FETP-Frontline has trained 1,354 graduates in 24 countries. FETP-Frontline enhances global health security by training local public health staff to improve surveillance quality in their jurisdictions, which can be a valuable strategy to strengthen the capacity of countries to more rapidly detect, respond to, and contain public health emergencies at the source. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is a chronic autoimmune illness of the small intestine triggered by gluten consumption in genetically predisposed individuals. CD presentation is not limited to the gastrointestinal tract and it is still under-diagnosed. Complete resolution of clinical manifestations follows if a gluten-free diet is adopted. In western countries, CD prevalence is approximately 1%. Age of onset is often between 6 months and 7 years.We assessed the approach to diagnosis and management of celiac patients by the paediatricians in Puglia Region, Italy.Methods: We conducted a cross-sectional survey among the 589 Apulian Family Paediatricians (FPs) during January 2011-January 2012 using a self-administered web-based standardized questionnaire including self-assessment of their knowledge, diagnostic path and type of management they would follow for CD, clinical information on their celiac patients. We assessed associations among the explored variables by defining double-entry contingency tables and calculating Odds Ratio (OR) with 95% Confidence Intervals (CIs).Results: The 218 (37%) FPs participating in the study reported 1,020 CD patients (representing approximately 1% of the child population covered by the enrolled FPs). Of them, 55% were female; 45% were aged 5-10 years. Weight loss and stunting were the main reported symptoms at diagnosis (41%). The majority (98%) of FPs requested anti-transglutaminase antibody (tTG-Ab) titres for CD diagnosis. Approximately 78% of FPs recommended gluten introduction in the diet of infants at the age of 6 months; 12% and 8% recommended introduction of gluten before and after 6 months of age respectively.The degree of knowledge for either CD diagnosis making process or CD related diseases was medium/high in 97% and 82% of the participating FPs respectively. FPs (83%) who had a medium or high degree of knowledge of CD patients' diet were more likely to experience low or no difficulty in providing their patients with dietary advices (OR:5.5; 95%CI:1.7-17.5).Conclusions: Apulian FPs report a good degree of knowledge of CD, its diagnosis and its management. We will diffuse results and recommendations to all paediatricians in the Region. Actions aiming to continued education on CD in medical under and postgraduate trainings are crucial to prevent under-diagnosis. [ABSTRACT FROM AUTHOR]