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Review of The Bloomsbury Handbook to Philip Roth, edited by Aimee Pozorski and Maren Scheurer.

Il fortuito ritrovamento di un dipinto raffigurante Le vesti insanguinate di Pompeo presentate alla moglie Giulia del pittore bolognese Lionello Spada (1576-1622) ha fornito l’occasione di studiarlo e, nell’ambito del progetto di ricerca ARTECA dell’Università Palacký di Olomouc, la possibilità di analizzarlo con le moderne tecnologie diagnostiche, i cui risultati vengono presentati in questa sede. L’opera è stata prima esaminata dal punto di vista storico-artistico e successivamente sottoposta ad una campagna di indagini esclusivamente non distruttive allo scopo di studiarne la tecnica esecutiva, i materiali impiegati e lo stato conservativo. Le novità emerse sul fronte storico-artistico sono state quindi integrate da un dettagliato resoconto delle indagini effettuate, tra cui fotografie e macrofotografie in luce diffusa e radente, fluorescenza indotta da radiazione UV, riflettografia IR, infrarosso in falsi colori, radiografia e fluorescenza dei raggi X (XRF). The discovery of a painting representing Pompey's bloody robes presented to his wife Giulia by the Bolognese painter Leonello Spada provided the opportunity to study it and – as part of the ARTECA research project of the Palacký University of Olomouc – the possibility of analyzing it with modern diagnostic technologies. The work was first examined from a historical-artistic point of view and subsequently subjected to a campaign of exclusively non-destructive investigations in order to study the executive technique, the materials used and the state of conservation. This contribution presents the novelties that have emerged on the historical-artistic front and a detailed report of the investigations carried out, including photographs and macro-photographs in diffused and grazing light, fluorescence induced by UV radiation, IR reflectography, infrared in false colors, radiography and fluorescence of X-rays (XRF).

This essay reflects upon the political and cultural significance of hair for Black women. The acclaimed novel Americanah (2013) by the Nigerian novelist Chimamanda Ngozi Adichie, and ABC's TV Series How to Get Away With Murder (2014-2020), cleverly address this issue as they both display their protagonists' struggles in accepting their natural hair. To be assimilated into the US society, Ifemelu and Annalise Keating feel forced to strighten their hair or wear wigs. I will also discuss how the myth of the melting pot has contributed, since the 18th century, to shape and influence ethnic identities in the US by positing the necessary features of Americanness. Instead, these twenty-first century narratives provocatively challenge the definition of American by giving an inside perspective on this unusual form of emancipation.

This paper questions archaeology as a practice that, by unearthing and interpreting the signs of the past, leaves its own traces on the present of a site, a district, a community. Archaeology can be used to do so by different stakeholders, through the creation of discontinuity both in a region’s landscape – i.e. by choosing to attract visitors towards an archaeological site/museum rather than towards others – and in the history of a community – by implicitly (but also explicitly) giving the status of historical apex of a civilization to a specific period/event/monument according to which every other age is adjusted. This creates an unbalanced picture made of centres and peripheries. The few key archaeological ‘centres’ spread around the world and the uncountable neglected ‘peripheries’ that derive from this practice have an impact on our understanding of humanity. Bearing in mind this inevitable capacity of archaeology to leave material and cultural traces on us, this paper asks if and how archaeology can be used to have a positive impact on present societies answering current social questions. Does such practice just generate an indiscriminate accumulation of objects that will never be either studied by specialists or exhibited to the public tending to make museums’ storages collapse? Or does it help local and global communities to reflect upon themselves bearing an historically deeper viewpoint on humanity? Is archaeology used to justify actions taken in the present, to look for signs of prestigious ancestry, or as a medium towards accepting and dignifying otherness? Answers to such questions vary sensibly depending on the semiotic stand that specific archaeologists, as actors within the discipline, take on archaeology as a practice, whether they see it, in synthesis, as a discipline of things or as a discipline of traces. Reflecting on a few case studies such as Koudelka’s “Walking Through Outdoors Ruins” project for Magnum, the archaeology or Bronze Age Sardinia, and the dominant paradigm of communicating archaeology to the public, this paper exposes the social roles that archaeological interpretation has had so far, attempting a prediction of its future paths until some of its possible extreme – Funes el-memorioso driven – consequences.

The effectiveness of SARS-CoV-2 vaccines is currently undermined by the rapid spread of variants of concern affecting an increasing number of people worldwide. Thus, new vaccine candidates are required to limit new waves of infections. On the one hand, the development of personalized vaccines, both on a personal and population level, may overcome the inter-individual heterogeneity in vaccine-induced immune responses and in adverse side effects. On the other hand, the development of a universal coronaviruses vaccine broadly protective against all betacoronaviruses may overcome the coronaviruses genetic polymorphism due to the generation of new genomes and homologous genetic recombination in multiple species. The preparation of a tailored and universal vaccine, that is an “ideal” vaccine, could be realized with the contribution of the system biology approach and, in particular, of metabolomics, in conjunction with a global policy strategy and adequate public governance.

The present work aims to summarize the prehistoric artistic evidences already known in the Lepini Mountains and then hint at a possible unpublished evidence. Then the typological and morphologic differences and similarities between those contexts will be showed, also analysing the way in which they were realized. At last those evidences will be included in a national and international sphere, trying to establish a general chronology. The main aim is to refocus the attention on the symbolic representations in the Monti Lepini and Central Italy, in order to give a new impulse to archaeological research in this field.

The study of huts and other structures in "modern" agro-pastoral contexts is an important tool to retrieve valuable information to understand older contexts. The objective of this work is to highlight the potential for ethnoarchaeological studies of the context of the Lepini Mountains, which still today is marked in the landscape by the remains of these structures, through the crossing and synthesis of the information gathered in the various research carried out in the area.

Proceedings of the 15th International Workshop on Neonatology and the 40th Congress UMEMPS (Union of Middle-Eastern and Mediterranean Pediatric Societies) • Cagliari (Italy) • October 24th-26th, 2019 • Children of the Middle-Eastern and Mediter­ranean area: we can do better! Guest Editors: Vassilios Fanos (Cagliari, Italy), Enver Hasanoğlu (Ankara, Turkey), Michele Mussap (Cagliari, Italy), Robert Sacy (Beirut, Lebanon), Elie Saliba (Tours, France), Salvatore Vendemmia (Aversa, Italy) Nutrition in early life has important biological effects on immediate and lifetime health. In the light of these considerations, products such as specialized and standard infant formulas substitute for human milk have the potential to influence health outcomes differently depending on their composition. The recent knowledge of the long-term health benefits of breast-feeding has addressed research toward the creation of formulas ever closer to the needs of the infant both in term of nutritional and functional compounds. In this regard, metabolomics has proved to be a promising tool to investigate the metabolic composition of breast milk and the differences compared with formula milk. To the best of our knowledge, no metabolomics studies on the compositional differences between organic and conventionally produced infant milk have been performed so far. To fill this gap, the aim of the present work was to use the 1H NMR-based metabolomics approach to compare the metabolome of organic and conventionally produced formula milk designed for fulfill infants’ nutritional needs from birth to 12 months of age. Methionine content was found to be significantly (p = 0.001) higher in organic milk than in conventional formulas. For the sake of comparison, the metabolome of human milk samples was also analyzed. Although the study presents several limitations, our preliminary results further support the utility of metabolomics in research for infant nutrition.

Background and objectives: Vitamin D and docosahexaenoic acid (DHA) insufficiency and deficiency could potentially have a great impact on health outcomes in preterm infant. Due to the importance of early nutrition intervention in this population and given the lack of metabolomic studies concerning the supplementations effect on the metabolome of preterm infants, 44 premature infants were studied, divided in two groups, one receiving only vitamin D (DS) and the second both vitamin D and DHA (D-DHAS) supplementation. Two were the main objectives of the study: 1) to look at changes over time in the urinary metabolic profiles of infants before and over two months of supplementation; 2) to compare the urinary metabolome of the two groups after supplementation. Methods: 1H NMR-based metabolomics approach was used to analyze urine samples obtained from preterm newborns at three different time points: at the time of hospital discharge and before supplementation (T0), 1 month (T1) and 2 months (T2) after the beginning of supplementation. Results: A clear temporal dynamics of the urinary metabolic profiles of preterm infants was highlighted by OPLS analysis. Both groups were characterized by growing levels of betaine, N,N-dimethylglycine, creatinine, creatine and guanidinoacetate and diminishing levels of myo-inositol and hydroxyproline with increasing postmenstrual age (PMA). Additionally, for D-DHAS citrate and dimethylamine increased, while lactate decreased over time. OPLS-DA clearly discriminated the two groups after two months of supplementation. Compared to DS, D-DHAS group was characterized by higher levels of betaine, N,N-dimethylglycine, creatinine and dimethylamine and lower amounts of lactate and myo-inositol. Conclusions: Metabolomic analysis of urine from the neonatal period could be a useful tool to understand metabolic processes linked to early nutrition and supplementation. According to our results, vitamin D supplementation exerts in preterm newborns positive effects evaluated with urinary metabolomics. Moreover, it seems that the supplementation with vitamin D and DHA exerts a higher antioxidant and protective action on newborns, and it could also positively affect the body fat composition.

Il contributo analizza il processo di ristrutturazione dello Stato etiopico alla frontiera nordoccidentale tra il 1941 e il 1972, utilizzando come caso di studio un progetto di sviluppo agricolo finanziato da Banca Mondiale e Nazioni Unite nel distretto di Setit Humera. Metodologicamente, l’articolo si avvale di fonti primarie inedite raccolte negli archivi britannici, etiopici e della Banca Mondiale, così come di interviste orali e letteratura grigia La ri- visitazione delle strategie di governo del bassopiano non è un processo line- are, ma il risultato delle negoziazioni tra i diversi livelli di governo de jure ede facto che esercitano prerogative di sovranità lungo il confine. La dialettica interna all’apparato statuale etiopico consente inoltre di rivedere in maniera critica il paradigma centro-periferia e cogliere le varie sfaccettature che si celano dietro la manifestazione dello Stato lungo la frontiera.

The relationship between placental calcifications and pregnancy outcome is still controversial. In this study, we examined the occurrence of placental calcifications, and we proposed a histopathological score system, Placental Calcification Score (PCS). We assigned a score (from 1 to 3) to calcifications according to their pattern (dusty = 1; single = 2; cluster = 3) and grading (low = 1; moderate = 2; high = 3). Multiplying the pattern score with that of grading, we obtained a score. After that, summing the score of each one of the three calcification patterns, we achieved the PCS. We examined 47 consecutive monochorionic placentas, searching calcifications in placental parenchyma (PP) (in which we distinguished four subsites: intervillous, intravillous, sub-amniotic fetal floor and decidua), extraplacental membranes and Wharton jelly of the umbilical cord. We collected clinical data relative to 47 mothers (age, gestational age at delivery, kind of gestation and hypertension) and 51 products of conception (kind of products of conception, gender, preterm birth, and intrauterine growth restriction [IUGR]), corresponding to the 47 placentas. We found calcifications in all placentas examined (47/47 = 100%), and all placentas showed calcifications in PP (47/47 = 100%). Calcifications were more frequent, respectively, in intravillous (36/47 = 77%) and intervillous (47/47 = 100%) subsite of PP. Besides, our preliminary data showed a mean PCS higher in mothers ≥ 35 years, with gestational age ≥ 37 W + 0 D and suffering from hypertension, than in mothers < 35 years, with gestational age < 37 W + 0 D and without hypertension. Not preterm newborns, male gender, and presence of IUGR were associated with a mean PCS higher than preterm newborns, female gender, and absence of IUGR. PCS is a new histopathological tool that might be useful to clarify the correlation between placental calcifications and clinical data of mothers and products of conception. Further investigations are needed, with a large number of placentas, to confirm the trend shown by our data.

Accidental discovery of a fluid collection within the posterior cranial fossa in a fetus or a newborn can be a tricky incidental finding during a routine scan, alarming for a Dandy-Walker Malformation (DWM). The main cystic lesions of the posterior cranial fossa are DWM, Blake’s Pouch Cyst (BPC), Arachnoid Cyst (AC) and Mega Cisterna Magna (MCM), although the latter is not a proper cyst. The key event for the development of a DWM is a cerebellar vermis hypoplasia that causes the persistence of the superior membranous area, which expands into the posterior fossa forming a large cystic 4th ventricle. BPC is caused by the persistence and herniation of a different membrane, the inferior membranous area, that is supposed to disappear leaving a median opening that would become the foramen of Magendie. MCM originates if this membrane eventually disappears, leaving an enlarged posterior fossa cavity filled with cerebrospinal fluid physiologically connected with the subarachnoid fluid. Finally, ACs are caused by a defined duplication of the arachnoid membrane filled with CSF-like fluid. Consequently, the radiological finding of a regular cerebellar vermis excludes the hypothesis of DWM and the position of the choroid plexus helps differentiating between DWM and BPC in controversial cases. Moreover, radiological findings in DWM include cystic dilatation of the 4th ventricle and enlargement of the posterior fossa. Absence of hydrocephalus comes out in favor of MCM. Absence of communication with surrounding cerebrospinal fluid defines an AC. This review assesses the cystic lesions of posterior cranial fossa on the basis of embryological development, radiological findings and associated clinical aspects, in order to clarify the radiological differential diagnosis through embryology.

Neonatal respiratory distress is a potentially life-threatening condition, representing a diagnostic and therapeutic challenge for physicians, especially when it is caused by rare pathologies. Head and neck remnants are benign congenital neoplasms rarely observed in newborns. Teratoma is the most common congenital tumor in childhood, while head and neck epithelial and mesenchymal hamartomas are uncommon. We report three cases of pharyngeal congenital remnants presenting with neonatal airway obstruction. We observed a 9-month-old, 35-day-old, and 15-hour-old patients, who have been referred to our Department of Otorhinolaryngology with acute airway distress. All the patients showed a pharyngeal benign lesion, since teratomas originated from the left lateral wall of the pharynx in two cases and one “fibrovascular” hamartoma originated from the base of the tongue. Timely surgical excision through transoral CO2 laser microsurgery was curative in all the cases. Dyspnoea in newborns is a challenging condition and must be managed, when possible, by a well-trained paediatric team. When clinicians face obstructive airway congenital remnants, a timely and radical surgical excision is necessary to avoid potentially lethal asphyxia.

The mature renal papilla is characterized by medullary collecting ducts, Henle’s loops, vasa recta and the interstitium. Cortical and medullary stromal cells are essential for the regulation of urine concentration and other specialized kidney functions. Mechanisms that direct the renal papilla development are not clearly understood. In recent years, the renal papilla has been identified as a niche for renal stem/progenitor cells in the adult mouse. Studies on experimental animals evidenced a probably common interstitial progenitor for the medullary and cortical stromal cells, characterized by the Foxd1+/PAX2- phenotype. Moreover, Hox10 and Hox11 expression is required for differentiation and patterning of the multiple subtypes of developing medullary interstitial cells. Given the scarcity of morphological and molecular studies on the human renal papilla, this work aimed to evidence morphological changes during human gestation, both in the architecture of the medullary interstitium and in cell types differentiating between the collecting tubules and the Henle’s loops. Future immunohistochemical studies are needed to better identify different interstitial cell types giving rise to the mature interstitium of the renal papilla.

The basic structures involved in the development of auditory function and consequently in language acquisition are directed by genetic code, but the expression of individual genes may be altered by exposure to environmental factors, which if favorable, orient it in the proper direction, leading its development towards normality, if unfavorable, they deviate it from its physiological course. Early sensorial experience during the foetal period (i.e. intrauterine noise floor, sounds coming from the outside and attenuated by the uterine filter, particularly mother’s voice) and modifications induced by it at the cochlear level represent the first example of programming in one of the earliest critical periods in development of the auditory system. This review will examine the factors that influence the developmental programming of auditory learning from the womb to the infancy. In particular it focuses on the following points: • the prenatal auditory experience and the plastic phenomena presumably induced by it in the auditory system from the basilar membrane to the cortex; • the involvement of these phenomena on language acquisition and on the perception of language communicative intention after birth; • the consequences of auditory deprivation in critical periods of auditory development (i.e. premature interruption of foetal life).

The growing interest of research in the field of renal stem cells and kidney regeneration aims to get results that allow its clinical application, favoring the birth and development of regenerative medicine. Nephrogenesis requires differentiation into epithelial cells of a population of progenitor mesenchymal cells. Since this process ends at 36-38 weeks of gestational age, it is quite likely to imagine that such a population disappears in the human kidney after birth. However, several studies have identified in different parts of the adult kidney cells having the characteristics of stem cells that would be involved in renal regenerative processes. They may be classified as resident mesenchymal/epithelial progenitors and often share the same genetic and epigenetic profile as progenitor stem cells active during embryonic life, thus suggesting a common origin. Current literature includes two lines of thought: one attributes to stem cells a fundamental role in renal regeneration processes while the other sustains the intervention of other mechanisms. The aim of this review is to report on progress made in research in the field of kidney regeneration starting from the past century and arriving at the present, with an analysis of scientific works that have produced the most important results in this field. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

The renal stem cell niche represents the most important structure of the developing kidney, responsible for nephrogenesis. Recently, some Authors have reported, at ultrastructural level, a previously unknown complexity of the architecture of renal stem cell niche in experimental models. This study was aimed at studying, at histological level, the anatomy of renal stem cell niches in the human fetal kidney. To this end, ten fetal kidneys, whose gestational ages ranged from 11 up to 24 weeks, were studied. H&E-stained sections were observed at high power. The study of the anatomy of renal stem cell niches in the human kidney revealed a previously unreported complexity: some niches appeared as a roundish arrangement of mesenchymal cells; others showed the initial phases of induction by ureteric buds; in other niches the process of mesenchymal epithelial transition was more evident; finally, in other stem cell niches the first signs of nephron origin were detectable. These findings suggest the existence of niches with different anatomy in the same kidney, indicating different stages of evolution even in adjacent niches. All stem cell niches were in strict contact with the capsular cells, suggesting a major role of the renal capsule in nephrogenesis. Finally, our study confirms the existence of a strict contact between the bud tip cells and the surrounding mesenchyme in the human developing kidney, giving a morphological support to the theory of intercellular channels allowing the passage of transcription factors from the epithelial to the mesenchymal stem/progenitors cells. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

It is possible to distinguish two phases in the development and maturation of the intestine: intra-uterine and extra-uterine. Up until the 13th week of the embryological phase, a fetus’ development is not controlled by factors external to the alimentary canal. It is instead guided by the homeotic genes that control the proliferation and differentiation during the embryogenesis. A fetus’ interaction with the external environment starts with the perforation of the buccal membrane, when the fetus starts swallowing the amniotic fluid. Both in pathological and physiological conditions, the encounter with the microbiota – that surely happens at birth, but could happen before as well – furnishes to the developing intestine elements which are necessary and essential to the growth of the organ, the barrier function, and the specific and nonspecific immunity. The link between development, maturation and inflammation is very important and influences the entire intestinal homeostasis. In case of preterm birth, the immaturity of the system creates a proinflammatory environment where the tolerance of the commensal microbiota cannot be taken for granted, and the maternal milk is not always available. These grounds are preconditions for the Necrotizing Enterocolitis (NEC). NEC is a calamitous pathology for a preterm baby, able to increase mortality, morbidity and the length of hospitalization. This review aims at understanding how to prevent NEC. It will do so by analyzing the mechanisms of the development of the inflammation at intestinal level, and at the level of its regulation. Several evidences, both clinical and experimental, show that the main form of NEC prevention is the dispensation of maternal milk. Maternal milk allows a proper growth and development of the intestine, a proper settlement of the microbiota, and control over the intestinal inflammation. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

The finding of stem/progenitor cells in the maternal milk and the discovery of their multilineage potential, associated with some evidence regarding the ability of maternal cells to cross the gastrointestinal barrier and integrate into the organs of the breastfed neonate, has opened an intriguing debate, regarding the strict relationship between mother and son in the postnatal period. In particular, thanks to the discovery of the presence in high quantities of mammary stem cells, a new vision of maternal milk is emerging, in which breastfeeding appears as an unique occasion for reinforcing the physiological development of the newborn, putting all the formulas at a different level of relevance for the neonate. In this contribution the authors try to give an answer to the following 4 questions: • is there heterogeneity and a hierarchy among breast milk stem cells? • can stem cells present in breast milk enter into the newborn organism? • can breast milk stem cells integrate in the neonatal organs and differentiate toward different tissues, including neurons and neuroglia? • could metabolomics be useful for the study of stem cells in the human milk? Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

The lactating mammary gland contains a stem cells population with multilineage potentialities. Recently it was also shown that breast milk contains a heterogeneous population of stem cells that have the potential to differentiate in vitro, under the control of specific differentiation conditions, into mammary epithelial as well as into adipogenic, chondrogenic and osteogenic cell lineages. While the different types of cells present in the milk is known, what is less understood is the proportion of different milk cell types, their significance for the mother and the infant and factors influencing them. In this manuscript we summarize some of the latest knowledge from in vivo and in vitro investigations on breast milk stem cells, we discuss their potential functions and applications and we present some of our preliminary data obtained in fresh human breast milk cells. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

In recent years the presence of stem cells (hBSCs: human breastmilk-derived stem cells) and epithelial progenitors has been demonstrated in mother’s milk (MM). Stem cells present in samples of fresh MM exhibit a high degree of vitality and this makes possible the performance of cell cultures and to evaluate the differentiation capacity of the hBSCs. The most important datum that expresses the enormous potential of the use of MM stem cells is the presence of a cell population capable of differentiating into the three mesoderm, endoderm and ectoderm lines. The small number of studies and MM samples analyzed and the different sampling methods applied suggest standardization in the collection, analysis and culture of MM in future studies, in consideration of the well-known extreme variability of MM composition, also from the standpoint of cells. The analysis of literature data confirms the uniqueness of MM and its enormous potential. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

Background: A variety of renal and urological abnormalities have been reported in subjects with Down syndrome (DS). With increased longevity, it appears that a growing number of these subjects presents chronic renal failure. Definition of underlying cause of renal failure could lead to the prevention of progressive renal dysfunction in these patients. The aim of this study was to improve the understanding of the morphological changes that occur in the kidney of fetuses with DS. Methods: To this end, 25 subjects were examined. Kidney sections were stained with H&E and digitally scanned. Subjects were subdivided into two groups: fetuses with DS (DS-fetuses, n = 11) with a gestational age ranging from 13 up to 21 weeks, and healthy fetuses (N-fetuses, n = 14) with a gestational age ranging from 9 up to 22 weeks. Results: DS-fetuses showed slightly larger glomeruli as compared to N-fetuses. Moreover, glomeruli in DS-fetuses group were characterized by an enlarged Bowman’s space as compared to glomeruli in N-fetuses (p = 0.0028). Differences in the nephrogenic zone width were also observed; DS-fetuses showed a greater width of this zone as compared with N-fetuses. Discussion: In conclusion, we found relevant morphological differences, which suggests delayed renal maturation. Furthermore, there was a significant increase in glomerular area and several glomeruli were morphologically abnormal. These harmful changes in the glomerular structure may result in a nephron deficit, which may be associated with development of renal diseases and hypertension later in life. Conclusions: We hypothesize that the observed morphological anomalies could have significant implications for both the short- and long-term renal health of subjects with DS.

Perinatal asphyxia is one of the leading causes of morbidity and mortality in the perinatal period, with 4 million neonates suffering annually from birth asphyxia. Tissue hypoxia can cause several pathological changes in multiple organs, hypoxic-ischemic encephalopathy (HIE) representing one of the most severe consequences in the newborn, occasionally leading to the insurgence of the multi-organ dysfunction syndrome. The pathological diagnosis of neonatal asphyxia is complex, histological markers of tissue hypoxia often overlapping with pathological changes due to other etiologies. This work is aimed at summarizing the most important pathological markers of asphyxia occurring in a newborn in the different organs. The endothelial lesions (swelling, apoptosis, detachment and loss of the endothelial barrier) in our experience, represent the most relevant pathological changes induced by hypoxia in all the organs. The finding of increased hepatic hemopoiesis represents one of the most important markers of chronic tissue hypoxia. In conclusion, the accurate histological study of all the organs in every case of perinatal asphyxia may allow, in expert hands, perinatal pathologists to give important data to neonatologists for reaching, together, a complex clinical/pathological diagnosis, able to explain the clinical course in the majority of asphyxiated newborns undergoing multiple organ dysfunction. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014) · Cagliari (Italy) · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

Placental Growth Factor (PlGF) is a very important angiogenic protein secreted by the placenta, necessary for the proper functioning of the endothelial cells during pregnancy. In normal pregnancies, PlGF plasma circulating levels increase up to the 32nd week of pregnancy, and then decrease until the end of pregnancy. Low PlGF plasma levels are a marker of preeclampsia and of placental function deficiency. The aim of our study was to evaluate whether a deficiency of placenta function, diagnosed through the PlGF assay, could be a cause of preterm delivery without known causes. The PlGF levels were measured in plasma samples collected by 250 pregnant women (20-35 weeks of pregnancy). In our study, PlGF levels were significantly lower than cut off values in all women with preterm delivery without known causes. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014) · Cagliari (Italy) · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

CNS (Congenital nephrotic syndrome) is a disorder characterized by the presence of a nephrotic syndrome in the first three months of life. Different pathologies can cause this syndrome. In general, we can distinguish primary forms (sporadic and hereditary) and secondary forms (acquired and associated with other syndromes). The most common form is the Finnish CNS (CNF, congenital nephrotic syndrome of the Finnish type), a hereditary form whose name derives from the fact that the highest incidence is described in that country (1.2:10,000). The pathogenesis, the clinical picture, the diagnostic criteria, the therapy and the outcome are described in details. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014) · Cagliari (Italy) · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

Necrotizing enterocolitis (NEC) is an acute inflammatory disease of the neonatal intestine that strikes in 1 of 1,000 live births. Its etiology is unknown. This review describes in detail the new NECs especially those which affect preterm infants: contagion or lymphocytosis associated, transfusion associated and cow’s milk allergy associated. A wide repertory of images are presented, together with algorithms for differential diagnosis. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014) · Cagliari (Italy) · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

Idiopathic infantile arterial calcification (IIAC) is a rare disease characterized by abnormal calcification of the arterial vessels, resulting in calcium deposits in the wall of medium-sized and large arteries. IIAC is caused by mutations in the ENPP1 gene, localized on chromosome 6q22, resulting in deficiency of the enzyme PC-1 nucleoside triphosphate pyrophosphohydrolase (NPP). Clinical presentation may occur during the intrauterine life, with fetal hydrop, aorto-pulmonary calcification, or as fatal hypertensive cardiomyopathy. In other patients, the clinical presentation is in the postnatal period with hypertrophic cardiomyopathy, with a fatal outcome within 6 months due to intractable heart failure. Here we report the clinico-pathological findings of a preterm affected with IIAC, with particular emphasis on renal glomerular pathological lesion not previously described in this disease.

Childhood polyarteritis nodosa (PAN) is a necrotizing vasculitis, affecting small and medium size blood vessels. This condition was first described by Kussmaul and Maier in 1866. Although comparatively rare in childhood, it is the most common form of systemic vasculitis in children. PAN includes two different subtypes, the classical systemic form presenting with a wide range of clinical manifestations including dermatologic, musculoskeletal, nervous, renal, and gastrointestinal systems and the more frequent cutaneous form (CPAN) that involves only the skin. The main clinical features of PAN are malaise, fever, weight loss, skin rash, myalgia, abdominal pain and arthropathy. Systemic involvement is variable, but the skin, the musculoskeletal system, the kidneys and the gastrointestinal tract are most prominently affected, with cardiac, neurological and respiratory manifestations occurring less frequently. However, clinical manifestations can be very confusing, with absence of conclusive diagnostic evidence in the early phase and sometimes in the late phase of the illness. The etiology of PAN remains unclear, but there are data to support roles for hepatitis B and reports of a higher frequency of exposure to parvovirus B19 and cytomegalovirus in PAN patients compared with control populations. However, in childhood, associations between PAN and these infections or other conditions are rare. Evidence has emerged suggesting that bacterial superantigens may play a role in some cases. Here we report the clinico-pathological findings of a 21-month-old child affected with PAN, with particular emphasis on the severity of renal pathological lesions.

A male child aged 21 months was admitted fifteen days after abdominal pain and vomits. At clinical examination, he had a pale skin, erythematous eruptions on the arms and abdomen, edema of the eyelids and feet, whitish patches on the oral mucosa of the cheek, hypertrophic tonsils and latero cervical lymphadenopathy. Laboratory tests were within the normal range. The patient was not febrile. A few days later, the child’s general condition worsened and fever appeared. Seven days after admission, the child showed a skin rash on the face. He received several drugs, including aspirin and antibiotics. The patient general condition continued to worsen (body weight decreased, blood pressure and fever increased) until death. 1. Which is your macroscopic diagnosis? 2. Which is your histological diagnosis?

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Analyzing Vincenzo Camuccini as a draftsman, it is possible to accurately reconstruct the set of sources and models that have permeated his art, contributing to the definition of the stages of his training process. Among these, the attention paid to Raphael's oeuvre can undoubtedly be considered unparalleled, not only from a strictly quantitative point of view - the drawings of Raphaelesque derivation being the most numerous within the Camuccinian graphic corpus - but also for the overall impact it had on the development of the neoclassical artist's pictorial language, an aspect that strongly emerges from the observation of his historical and religious paintings. Through the examination of unpublished drawings, the article traces two different types of approach that characterized the study of Raphael carried out by Camuccini from a young age: on the one hand the faithful copy, in particular of heads and full-length characters, on the other a freer reworking of Raphaelesque inventions, remodeled with variations. In this context, Camuccini's extensive use of printed reproductions for the exercise of copying clearly emerges. [ABSTRACT FROM AUTHOR]

A female preterm infant, weighing 2,480 g, was born in a first level Hospital, with caesarean section performed for acute fetal distress. The mother, a 34 years old woman, had a previous healthy child. At birth the general conditions were good. At cardiological examination a patent ductus arteriosus was diagnosed. Laboratory values were within normal range. The newborn was discharged after 11 days, in good general conditions and with spontaneous feeding. During a planned cardiologic follow-up control at day 50, cardiac ultrasounds revealed an increase of volume of left atrium and ventriculus, which appears severely hypokinetic. The baby was urgently transferred in a NICU, where she died after 12 hours for heart insufficiency. At autopsy, deposition of amorphous material, mainly stained by haematoxylin, in periglomerular location was found in the kidney. 1. What is your morphological diagnosis? 2. Which complementary investigations do you suggest? 3. Could be important the examination of large and medium-sized arteries in the heart?