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The changes of starch properties induced by "Gluten Friendly" (GF) technology in wheat kernels have been described for modern and ancient wheat cultivars by studying the matrix water-solids interactions at molecular level, starch thermal properties and digestibility. demonstrate an increase of mobility of the less mobile population related to non-exchanging protons of rigid domains (starch and gluten strands not in contact with water) due to the treatment. Moreover, a shift of protons from the intragranular to the extragranular starch phase was generally observed. These outcomes highlighted the significant structural changes starch underwent during the GF technology treatment. Interestingly, GF technology generated a significantly increase of starch digestibility, especially for the slowly digestible starch rather than the rapid, while the resistant starch reduced significantly. These changes were in agreement with the thermal properties where it was found a reduction in starch gelatinization following treatment. However, the extent of the GF technology on starch appeared to be contingent on the specific variety under consideration. The physical-chemical process used in the GF technology on wheat kernels significantly changed the structure of starch domain. Given these results, an important gap on the effect of the GF technology on the wheat kernels has been covered. • Starch properties induced by Gluten Friendly technology in wheat kernels were described. • An increase of mobility of the less mobile population due to GF technology was found. • The thermal properties showed a reduction in starch gelatinization after GF treatment. • GF technology exhibited a significant impact on the starch fractions. • Resistant starch was completely converted in rapidly and slowly digestible starch. [ABSTRACT FROM AUTHOR]

Aim of the study was to evaluate the Florence intracorporeal neobladder (FloRIN) oncological and functional outcomes at the end of assessment phase (phase 3) IDEAL-Guidelines. This single-institution prospective series included consecutive patients treated with robot-assisted radical cystectomy (RARC) and FloRIN reconfiguration technique from February 2016 to June 2020. Functional features were evaluated six months after surgery. Patients were grouped into four quartiles according to time of radical cystectomy and impact of learning curve improvement was evaluated. One-hundred FloRIN were completed with a median console time of 373 (IQR: 312–415) minutes. Two cases were converted to open surgery. No intraoperative complications occurred. At pathological examination, 30% of patients were staged as pT ≤ 1 and 47% as pT ≥ 3. Transitional cell carcinoma was present in 87% of cases. Carcinoma in situ (CIS) and nodal involvement were observed in 38% and 29% of patients, respectively. At a median follow-up time of 17 (IQR: 7–28) months, 20 clinically relevant events (Clavien-Dindo≥3) occurred. Operative time significantly decreased throughout the series (median minutes 435; 395; 365 and 330 in the four quartiles, respectively; p < 0.001). Similarly, early Clavien-Dindo≥3 postoperative complications rate significantly decreased across the series (number of events: 1; 4; 0; 0; p = 0.03). Overall, 75% and 65% of patients achieved day-time and nigh-time continence, respectively. Twenty-seven patients experienced disease recurrence. Cancer-specific and overall survival were equal to 80%. RARC with FloRIN reconfiguration showed worthy functional and survival outcomes, with learning curve improvement significantly influencing operative time and early complications rate across series. [ABSTRACT FROM AUTHOR]

To investigate the association of NANOG polymorphisms with oral leukoplakia. Material and methods: In this case-control study, 68 cases of oral leukoplakia, and 21 of normal oral mucosa (control) were submitted to genotyping of tagSNPs polymorphisms: rs877716 and rs10845877 in NANOG, through real-time polymerase chain reaction (PCR). Pearson's chi-squared and Fisher's exact statistical tests were used, with a significance of 5%. For the dominant genetic model of the G allele of rs877716, the genotypes AG+GG revealed higher frequency in subjects in the oral leukoplakia group than in control subjects (75.4 and 50% respectively; p=0.031). Subjects with this genotype were 3.063 times more likely to develop oral leukoplakia compared to subjects with AA. In the allelic genetic model, for rs10845877, the C allele was more frequent in subjects with leukoplakia than in control subjects (25 and 7.5% respectively; p=0.01). There was no association found in the other genetic models. Polymorphisms in NANOG are associated with oral leukoplakia. [ABSTRACT FROM AUTHOR]

To investigate the association of SOX2 polymorphism with oral leukoplakia and to compare with immunohistochemistry expression of SOX-2. Case-control study. The sample was composed of 64 patients with oral leukoplakia and 20 presenting normal oral mucosa (control group) that were submitted to genotyping of SOX2 gene polymorphisms rs77677339 (G/A) by PCRP in real-time and to immunohistochemistry for SOX-2 (basal epithelium expression, suprabasal and total; nuclear area and intensity). The statistical tests included Chi-square and Fisher´s Exact Test, with 5% significance. There was no significance (p=0,578) in genotype distribution for rs77677339 (G/A) marker between oral leukoplakia and control. The genotype GG (96,9%) was observed in oral leukoplakia and 100% in controls. The genotype GA was not observed in the controls. The statistical crossings between immunohistochemistry and genetics results were not significant. There was no association between rs77677339 (G/A) polymorphism and immunohistochemistry on oral leukoplakia, but in the presence of allele A on heterozygotes with oral leukoplakia suggests an important role of this allele as a risk marker. [ABSTRACT FROM AUTHOR]

Multicenter retrospective analysis of robotic partial nephrectomy for completely endophytic renal tumors (i.e. 3 points for the 'E' domain of the R.E.N.A.L. nephrometry score) was performed. Patients' demographics, tumor characteristics, perioperative, functional, pathological and oncological data were analyzed and compared with those of patients with exophytic and mesophytic masses (i.e. 1 and 2 points for the 'E' domain, respectively). Multivariable logistic regression analysis was used to assess variables for trifecta achievement (negative margin, no postoperative complications, and 90% estimated glomerular filtration rate [eGFR] recovery). Overall, 147 patients were included in the study group. Patients with a completely endophytic mass had bigger tumors (mean 4.2 vs. 4.1 vs. 3.2 cm; p < 0.001) on preoperative imaging and higher overall R.E.N.A.L. score. There was no difference in mean operative time. Estimated blood loss was higher in the endophytic group (mean 177.75 vs. 185.5 vs. 130 ml; p = 0.001). Warm ischemia time was shorter for the exophytic group (median 16 vs. 21 vs. 22 min; p < 0.001). Postoperative complications were more frequent in patients with endophytic tumor (24.8% vs. 19.5% vs. 14.8%; p < 0.001). Six (4.5%) patients had positive surgical margins, there was no difference between groups. Trifecta was achieved in 44 patients in endophytic group (45.4 vs. 68.8 and 50.9%, p < 0.001). Multivariable analysis for trifecta revealed that clinical tumor size (odds ratio: 0.667, 95% confidence interval: 0.56–0.79, p < 0.001) was only significant predictor for trifecta achievement. Our findings confirm that RAPN in case of completely endophytic renal masses can be performed with acceptable outcomes in centers with significant robotic expertise. [ABSTRACT FROM AUTHOR]

In search of novel prognostic biomarkers for clear cell renal carcinoma (ccRCC), we analysed the expression of several proteins related to angiogenesis and hypoxia. A monocentric study on 30 consecutive surgical samples from surgically-treated ccRCC patients with a 10-year follow up was performed. The following proteins were analysed by immunohistochemistry: Vascular Endothelial Growth Factor- A (VEGF-A), Platelet-Derived Growth Factor β Receptor (PDGFRβ), VEGF-receptor 1 (Flt1), VEGF-receptor 2 (KDR), Glucose Transporter 1 (GLUT1), Carbonic anhydrase IX (CA-IX) and the hERG1 potassium channel. Data were analysed in conjunction with the clinico-pathological characteristics of the patients and follow up. All the proteins were expressed in the samples, with statistically significant associations of VEGF-A with PDGFRβ and Flt1 and hERG1 with CA IX. Notably, hERG1 and CAIX co-immunoprecipitated in primary ccRCC samples and survival analysis showed that the positivity for hERG1 and CA IX had a negative impact on Recurrence Free Survival (RFS) at the univariate analysis. At the multivariate analysis only hERG1 maintained its statistically significant negative impact. Conclusions: hERG1 expression can be exploited to predict recurrence in surgically-treated ccRCC patients. hERG1 channels form a multiprotein complex with the pH regulator CA IX in primary ccRCC samples their potential use as therapeutic target might be suggested. [ABSTRACT FROM AUTHOR]

Open Simple Enucleation (OSE) has been demonstrated to be an oncologically safe alternative to standard partial nephrectomy. We assessed the mid-term oncologic outcomes and predictors of disease recurrence in patients treated with Endoscopic Robot-Assisted Simple Enucleation (ERASE) verified through a standardized reporting system at a single institution. The clinical data of patients treated with ERASE for renal cell carcinoma at our Institution from January 2012 to September 2018 were retrospectively reviewed. Surface-Intermediate-Base (SIB) score was evaluated immediately after surgery. Patients with a ≥2 SIB score were excluded. The local and distant recurrence rates, the recurrence-free (RFS), cancer-specific (CSS) and overall (OS) survival were assessed. Kaplan-Meier and log-rank test were used to estimate survivals and to compare recurrence-free survival. Overall, 259 patients were considered eligible for the present study. The median PADUA score was 7 (interquartile range [IQR] 6–9). Positive surgical margins (PSM) were registered in 7 (2.7%) cases. Median (IQR) follow-up time was 36 (27–51) months. Overall, 4 (1.5%) patients experienced systemic recurrence (SR) and 5 (1.9%) patients experienced local recurrence alone (LR) of whom 3 (1.1%) were on tumor resection bed, and 2 (0.8%) experienced recurrence elsewhere in the ipsilateral kidney. The 5-year RFS, CSS and OS were 94.2%, 98.9% and 93.6%, respectively. Higher nucleolar grade and PSM were the two factors significantly associated with worse RFS. ERASE is a safe procedure, achieving negative surgical margins in the vast majority of patients and providing excellent mid-term local control and oncologic outcomes. [ABSTRACT FROM AUTHOR]

• Intact and fractured cells were identified in legumes using optical microscope. • Legumes flour properties were affected by cell wall structure. • Cell wall intactness enhanced color and decreased firmness of gluten free bread. • Intact cell walls significantly reduced the starch hydrolysis in gluten free bread. Cell integrity has recently been recognized being a key factor in modulating nutrients accessibility, but it has not been assessed in the application of legumes flours in complex matrices. In this study, cell wall intactness [fractured cells (FC) or intact cells (IC)] and particle size significantly influenced the functional properties of legumes flours. Cannellini bean (CB) flour rich in IC was characterized by high water holding capacity and low starch gelatinization enthalpy, which are features appreciated in gluten-free (GF) bread. Regardless of cell structure, adding 20% of CB to a GF bread decreased breadcrumb hardness and increased crust yellowness. Bread made with IC was softer than that with unfractionated flour, FC and 100% rice. Noteworthy, the extent of starch hydrolysis was reduced when IC (≈33%) was used followed by unfractionated flour (≈40%), FC (≈46%) and 100% rice (≈64%). Predominance of IC enabled a natural barrier against amylolytic enzymes. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the surgical and functional outcomes of a matched-paired series of on-clamp vs off-clamp endoscopic robot-assisted simple enucleation (ERASE) and standardized renorraphy in a tertiary referral institution, to search for predictors of functional drop after surgery and to investigate the influence of off-clamp technique in patients presenting these characteristics. Materials and methods A matched-pair comparison of 120 on-clamp vs 120 off-clamp over 491 patients treated with ERASE was performed. Perioperative and functional outcomes were compared between groups. Results Patients treated with on-clamp and off-clamp technique had comparable complication and positive surgical margin rate. The off-clamp group had a significantly lower eGFR drop compared to the on-clamp group at 3rd postoperative day (POD) (1% vs 7%, p = 0.0001) and at 30th POD (2.5% vs 9%, p = 0.01) from baseline. This difference lost its statistical significance at 6th month and at last follow-up (median 40 months). At multivariable analysis the Charlson comorbidity index (OR 2.06, p < 0.0001), uncontrolled type 2 diabetes mellitus (OR 4.13, p < 0.001) were independent predictive factors of a >15% eGFR drop from baseline to last follow-up. In a subanalysis over 64 comorbid patients, those patients who underwent off-clamp ERASE had a significantly lower eGFR drop compared to the comorbid counterpart during the whole follow-up. Conclusions The off-clamp ERASE is a safe surgical technique with a significantly lower renal function drop compared to on-clamp ERASE in the early perioperative time. Patients with comorbidity might represent a subgroup of patients having a functional benefit after off-clamp RAPN even in the long-term period. [ABSTRACT FROM AUTHOR]

Several mechanisms to form nanoemulsions are reported in the literature. However, there are still gaps in the relationship between the process variables with physicochemical and bioactive properties. This study applied a central composite rotatable design (CCRD) to describe the processing variables of a high-speed homogenizer (rotor/stator) on the physicochemical properties of a thymol nanoemulsion. Droplet sizes of 68.47 nm, 0.112 PDI, and −11.00 mV zeta potential could be obtained with improved conditions of 1.0% thymol, 4.63% Tween 80, 6600 rpm, and 3.13 min rotation. The improved nanoemulsions stored at 4 °C under different conditions (NaCl 0.5%, NaCl 1.0%, pH 4.5, and pH 7.5) showed droplet size stability over 45 days (<200 nm). In addition, the improved thymol nanoemulsions showed better antibacterial activity than non-nanoemulsified thymol for all clinically significant pathogens studied (Staphylococcus aureus , Listeria monocytogenes , Pseudomonas aeruginosa , Escherichia coli , and Salmonella Enteritidis). The properties of nanodroplets observed in this study highlight the use of high-speed homogenizers as a viable alternative in the development of nanoemulsions. • The preparation conditions of nanoemulsions were improved using CCRD. • The thymol nanoemulsions (n THY) were developed with droplet sizes smaller than 150 nm. • Tween 80 concentration was the most important variable for droplet properties. • n THY were stable over 30 days of storage at 4 °C with nanodroplets not exceeding 180 nm. • n THY showed superior antibacterial activity than non-nanoemulsified thymol for all pathogens evaluated. [ABSTRACT FROM AUTHOR]

Differences have often been reported in the outcomes of bladder cancer (BC) patients according to gender. This study aims to provide data on patients undergoing radical cystectomy (RC) in a high-volume tertiary urologic center and to assess whether gender discrepancies do exist in terms of surgical options and clinical outcomes. Consecutive BC patients treated between 2016 and 2020 at a single center (Careggi University Hospital, Florence, Italy) were included in the study. The impact of gender on disease stage at diagnosis, overall survival (OS), and type of surgery was analyzed. The study series comprised 447 patients (85 females and 362 males). At a median follow-up of 28.3 months (IQR: 33.5), OS was 52.6% and cancer-specific survival was 67.6%. Significant differences in OS emerged for age, acute myocardial infarction (AMI), Charlson Comorbidity Index (CCI), pT, and pN. OS rates were higher in patients undergoing robot-assisted surgery and in those receiving open orthotopic neobladder (ONB) (p = 0.0001). No statistically significant differences were found between male and female patients regarding surgical offer in any age group, surgical time, early postoperative complications, pathologic stage, and OS. After adjustment for pathologic tumor stage and treatment modalities, female and male patients showed similar oncologic outcomes. Further studies should be undertaken to evaluate functional results in women subjected to RC. [ABSTRACT FROM AUTHOR]

To analyze the immunoexpression of MMP-1 and MMP-8 in the process of repair of oral lesions in rats treated topically with watercress. Sixty-four rats were ulcerated in the back of tongue with a punch of 0.5 cm and divided into groups: experimental (n = 32) use of watercress solution and control (n = 32) with saline solution. The rats (n = 8 per group) were euthanized at 2, 7, 14, and 21 days. The tongues were submitted to immunohistochemistry for MMP-1 and MMP-8 counts. The slides were digitized using the ZEN program and images of the ulcers (200 ×) were captured. The photomicrographs were edited with Photoshop and then analyzed using Image ProplusT 4.5, which calculated the MMP-1 and MMP-8 immunoexpression areas. Kruskal-Wallis test and comparison of Dunn's test were used, with a 5% level of significance. A significant difference was perceived on MMP-1 immunoexpression between the experimental and control groups at 2 days (median (MED) = 1.0088 and 7.0117, respectively) and in the immunoexpression of MMP-8 at 2 days (MED = 0.1671 and 20.6826) and 7 days (MED = 8.8771 and 2.0007). The results suggest that the watercress has an action on MMP-1 and -8 in the first phases of the tissue repair process in rats. [ABSTRACT FROM AUTHOR]

Background: Many potential chemopreventive agents have been used in PCa prevention, including selenium (Se) and lycopene (Ly). However, their role has been matter of debate over the years, due to potential of promotion of PCa.Purpose: In this study we aimed at evaluating the incidence risk of prostate cancer (PCa) in a cohort of patients treated with Se and Ly.Methods: The Procomb trial design has been previously published (ISRCTN78639965). From April 2012 to April 2014 209 patients were followed and underwent prostate biopsy when PSA ≥4 ng/ml and/or suspicion of PCa. The all cohort was composed by patients treated with Se and Ly (Group A = 134 patients) and control (Group B = 75 patients).Results: During the follow-up time of 2 years, a total of 24 patients (11.5%) underwent prostate biopsy, of which 9 (4.3%) where diagnosed with PCa and 15 (7.2%) where diagnosed with benign prostatic hyperplasia. We did not observe statistical differences in terms of mean changes of PSA between the two groups (p-value for trend = 0.33). The relative risk (RR) for PCa was 1.07 and 0.89 in group A and B, respectively (p = 0.95). At the multivariate Cox regression analysis supplementation with Se and Ly was not associated with greater risk of PCa (hazard ratio: 1.38; p = 0.67).Conclusion: In this analysis we did not show evidences supporting a detrimental role of Selenium and Lycopene supplementation in increasing PCa after 2 years of therapy, nor supporting a protective role. [ABSTRACT FROM AUTHOR]

Introduction and objectives To analyze postoperative complications and to assess for significant predictive factors during partial nephrectomy (PN) using a large multicenter dataset. Methods Patients who underwent PN for clinical T1 renal tumors at 19 urological Italian centers (Registry of Conservative Renal Surgery [RECORd] project) were evaluated between 2009 and 2012. Anthropometric data, comorbidities and perioperative outcomes were analyzed. Complications were divided as intra- and postoperative, medical and surgical, as appropriate. The severity of postoperative complications was graded according to the modified Clavien classification system. Patients who experienced intraoperative complications were excluded from the analyses for the potential confounding effect in the evaluation of predicting factors for postoperative complications. Results Overall, 979 patients were analyzed: open, laparoscopic and robot-assisted (available since 2011) surgical approaches were used in 522 (56.4%), 286 (30.9%) and 117 (12.6%) cases, respectively. Surgical postoperative complications were reported in 121 (13.1%) cases (32 (3.5%) were Clavien 3), medical were reported in 52 (5.6%) cases (3 (0.3%) were Clavien 3). No Clavien 4 complications were reported. At multivariable analysis, ECOG score ≥1 (OR 1.98; p = 0.002), lower preoperative hemoglobin (OR 0.71; p < 0.0001) and open surgical approach (2.91; p = 0.02) were significant predictive factors of overall surgical postoperative complications, ECOG score ≥1 (OR 1.93; p = 0.04) and surgical approach (p = 0.05) were significant predictive factors of Clavien 3 either surgical or medical postoperative complications. Conclusions Comorbidities and surgical approach should be considered in preoperative evaluation of patients undergoing PN, as they resulted to play a significant role in the occurrence of postoperative complications. [ABSTRACT FROM AUTHOR]

Lipotoxicity and immunoinflammation are associated with the evolution of steatosis toward nonalcoholic steatohepatitis (NASH). This study reports the ability of adenosine A2a receptor (A2aR) activation to inhibit NASH development by modulating the responses of CD4+ T-helper (Th) cells to avoid an immuno-mediated potentiation of lipotoxicity. The effect of the A2aR agonist CGS21680 on immunoinflammatory signals, CD4+Th cell infiltration and immunolipotoxicity was analyzed in steatotic C57BL/6 mice fed with a methionine-choline-deficient (MCD) diet and in mouse hepatocytes exposed to palmitic acid (PA). CGS21680 inhibited NASH development in steatotic mice and decreased cytokines and chemokines involved in Th cell recruitment or polarization (namely CXCL10, CCL2, tumor necrosis factor alfa [TNFα], tumor growth factor [TGFβ], and IL-12). CGS21680 also reduced the expansion of Th17, Th22, and Th1 cells and increased the immunosuppressive activity of T regulatory cells. In PA-treated mice hepatocytes, CGS21680 inhibited the production of CXCL10, TNFα, TGFβ, IL-12, and CCL2; CGS21680 also prevented JNK-dependent lipotoxicity and its intensification by IL-17 or IL-17 plus IL-22 through Akt/PI3-kinase stimulation and inhibition of the negative regulator of PI3-kinase, (phosphatase and tensin homologue deleted from chromosome 10 (PTEN), which is upregulated by IL-17. In MCD livers, CGS21680 reduced JNK activation and PTEN expression and increased Akt phosphorylation. In conclusion, A2aR stimulation inhibited NASH development by reducing Th17 cell expansion and inhibiting the exacerbation of the IL-17-induced JNK-dependent lipotoxicity. These data promote the implementation of further studies to evaluate the potential clinical application of A2aR agonists that, by being able to function as both cytoprotective and immunomodulatory agents, could efficiently antagonize the multi-faced pathogenesis of NASH. [ABSTRACT FROM AUTHOR]

Objective We previously reported a case series of acute pancreatitis (AP) and macrophage activation syndrome (MAS) in childhood (cSLE) patients; however, there are no data regarding the comparison of AP and MAS in large populations of cSLE and adult SLE (aSLE). Methods A study included 362 cSLE and 1830 aSLE patients. MAS was diagnosed according to preliminary diagnostic guidelines and AP according to the presence of abdominal pain or vomiting associated to an increase of pancreatic enzymes and/or pancreatic radiological abnormalities. Demographic data, clinical features, SLEDAI-2K, SLICC/ACR-DI, and treatment were assessed. Results Age in MAS patients was significantly lower compared with those without this complication [15 (8.8–55) vs. 33.5 (10.2–45.7) years, p = 0.007]. The frequencies of fever (94% vs. 37%, p = 0.001), leucopenia (82% vs. 19%, p = 0.0001), thrombocytopenia (65% vs. 19%, p = 0.013), hypertriglyceridemia (87% vs. 42%, p = 0.037), and hyperferritinemia (93% vs. 37%, p = 0.011) were also more frequently observed in AP patients with MAS compared in AP patients without MAS. Fever and hyperferritinemia concomitantly were more frequent in the former group (86% vs. 12%, p = 0.0015). Higher and significant frequency of AP in cSLE compared to aSLE patients [12/362 (3.3%) vs. 20/1830 (1.1%), p = 0.003], with similar AP duration [22 (6–60) vs. 15 (4–90) days, p = 0.534]. MAS (85% vs. 30%, p = 0.003) and death by MAS complication (31% vs. 0%, p = 0.017) were significantly higher in children compared with aSLE. Conclusions This study provides novel data demonstrating that MAS occur in the majority of cSLE with AP with a higher mortality compared to aSLE. In addition, we identified in AP patients, a cluster of MAS clinical and laboratorial parameters more associated with this complication. [ABSTRACT FROM AUTHOR]

Many beneficial effects of coffee have been ascribed to the presence of chlorogenic acids. For this reason, some green coffee bean decaffeinated extracts claiming several beneficial effects are actually on the market as either nutraceuticals or food supplements. Herein, we compared the polyphenol content of green coffee beans, roasted coffee, spent coffee and silver-skins. The phenolic fraction of all samples was assessed using both colorimetric and HPLC-UV approaches, performing a full detailed identification and quantification of the phenols by liquid chromatography high-resolution mass spectrometry. Furthermore, we also evaluated the antioxidant activity of the different extracts. Notably, silver-skin extract possesses a superimposable profile compared to green coffee beans extract, and such a profile was unaltered by silver-skin decaffeination. This study reveals the perspective of using decaffeinated silver-skins as a low-cost raw material for the preparation of caffeine-free, chlorogenic acid-based food supplements and nutraceuticals. [ABSTRACT FROM AUTHOR]

Aim To assess the role of simple enucleation (SE) for the treatment of highly complex renal tumors. Methods Overall, 96 Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) classification score 10 to 13 renal tumors were treated with SE at our institution. All conventional perioperative variables, surgical, functional and oncological results were gathered in a prospectively maintained database. Survival curves were generated using a Kaplan–Meier method. Univariate analysis assessed the outcome differences. Results Mean (±1s.d.) clinical tumor diameter was 4.8 (±1.6 cm). 70.8% of patients had ≥cT1b stage. The PADUA score was recorded as 10, 11, 12 and 13 in 57.3%, 29.2%, 11.5%, and 2.1% of tumors respectively. Overall, 76 patients were treated with an open approach and 20 robotically. Mean warm ischemia time (WIT) was 19.2 min, and WIT greater than 25 min occurred in 14.6% of cases. Positive surgical margin (PSM) rate was 3.6% and trifecta was achieved in 64.3% of patients. Postoperative surgical complications occurred in 24% of patients, with 14.6% Clavien-Dindo grade 1–2, 8.3% grade 3, and 1% grade 4. Five-year cancer specific survival (CSS), recurrent free survival (RFS), and overall survival (OS) rates resulted 96.1%, 90.8% and 88.0%, respectively. Overall, 4.2% of patients experienced progressive disease. At follow-up, the mean decrease of eGFR from preoperative value was 13.9 ml/min. This was not significantly correlated with PADUA score (p = 0.69). The surgical approach was neither a predictor of Trifecta outcome, nor of postoperative complications, WIT >25 min or PSM rate. Conclusions SE is an effective treatment for highly-complex renal tumors, with a potential key role to widen the NSS (nephron sparing surgery) indications according to guidelines. [ABSTRACT FROM AUTHOR]

Introduction Nephron-sparing surgery (NSS) has become the standard of care for the surgical management of small and clinically localized renal cell carcinoma (RCC). The conservative management of those RCCs is increasing over time. Aim of this study was to report a snapshot of the clinical, perioperative and oncological results after NSS for RCC in Italy. Material and methods We evaluated all patients who underwent conservative surgical treatment for renal tumours between January 2009 and December 2012 at 19 urological Italian Centers (RECORd project). Perioperative, radiological and histopathological data were recorded. Surgical eras (2009 vs 2012 and year periods 2009–2010 vs 2011–2012) were compared. Results Globally, 983 patients were evaluated. More recently, patients undergoing NSS were found to be significantly younger (p = 0.05) than those surgically treated in the first study period, with a significantly higher rate of NSS with relative and imperative indication (p < 0.001). More recently, a higher percentage of procedures for cT1b or cT2 renal tumours was observed (p = 0.02). Utilization rate of open partial nephrectomy (OPN) constantly decreased during years, laparoscopic partial nephrectomy (LPN) remained almost constant while robot-assisted partial nephrectomy (RAPN) increased. The rate of clampless NSS constantly increased over time. The use of at least one haemostatic agent has been significantly more adopted in the most recent surgical era (p < 0.001). Conclusions The utilization rate of NSS in Italy is increasing, even in elective and more complex cases. RAPN has been progressively adopted, as well as the intraoperative utilization of haemostatic agents and the rate of clampless procedures. [ABSTRACT FROM AUTHOR]

Clean label ingredients able to reduce sugar in food are highly demanded by the food industry. A new fibre syrup based on corn (Zea mays) dextrin and seed coats of chickpeas (testa of Cicer arietinum seed) has been used to formulate reduced-sugar fruit fillings. Three reduced-sugar (by 30, 50 and 70%) recipes were developed starting from a standard formulation, in order to reach the "reduced in sugar" and "high in fibre" label claims. Physicochemical and sensory properties of the fruit fillings were assessed during 180 days of storage at two different temperatures (5 °C and 25 °C). Increased firmness, adhesiveness, consistency coefficient (K, flow behaviour), bake stability and colour differences have been observed in reformulated recipes with increasing fibre syrup content if compared to the control. Storage decreased bake stability and induced darkening of the product in all samples. 30% sugar-reduced filling were the most appreciated by consumers, and not distinguishable from the control. Overall results confirmed the syrup technological functionality when used to obtain a 30% sugar-reduction. [ABSTRACT FROM AUTHOR]

Abstract: Background: To evaluate the correlation between the side of positive biopsy (Bx) and the risk of lymph-node metastases (LNMs) on each side and to quantify the risk of contralateral LNMs in patients with unilateral positive biopsy. Methods: We analyzed the outcomes of 1599 patients with complete data regarding the sides of positive Bx and LN (lymph-node). By dividing each prostate into two separate sides, we assessed the accuracy of the side-specific Bx details in determining the side of positive nodes; the area under the receiver-operating characteristic (ROC) (AUCs) was used. For patients with unilateral positive Bx, we assessed the risk of homolateral and contralateral LNMs according to the number of total Bx taken and the preoperative risk of LN invasion. Results: Considering the 3198 prostate sides, there was a strict correlation between the side of positive Bx and the side of LNMs. The ratio of positive/total Bx was more informative than the number of positive core. The AUC for ipsilateral LNMs was significantly higher than that for contralateral LNMs (P = 0.039). In the 805 patients with unilateral positive Bx, the percentage of contralateral LNMs was >30% even considering a more meticulous biopsy scheme and increased in the patients at a higher clinical risk for LN invasion. Conclusion: PCa preferentially metastasizes to ipsilateral LNs but >30% of contralateral LNMs are present. A unilateral LN dissection that is limited to the tumor-bearing side of the gland should not be recommended because of the substantial risk of missing contralateral metastases. [Copyright &y& Elsevier]

Abstract: The aim of this research is to evaluate in vivo the characteristics of microcirculation after taking a biopsy sample from the oral mucosa. 20 patients were recruited to the study and all underwent an oral mucosa biopsy for the excision of benign neoformations. The modifications in the oral microcirculation were evaluated in vivo in correspondence to the surgical site through videocapillaroscopy at three different times: 30min before the biopsy; 48h after the biopsy; and 7 days after the biopsy. The statistical significance was checked with the Mann–Whitney U-test (P <0.05). The analysis of videocapillaroscopic patterns showed statistically significant variations relative to the capillary loop density; the diameter of the outgoing loop; and the length of the capillary loop. In conclusion, the study describes a simple and reproducible model for the study of wound healing from a microcirculatory point of view. [Copyright &y& Elsevier]

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Aims: To evaluate the role of nephron-sparing surgery (NSS) compared to radical nephrectomy (RN) for treating multiple ipsilateral renal tumors. Methods: We retrospectively reviewed the clinical and pathological data of 960 patients who had surgery for pathologically confirmed RCC between 1986 and 2006. Thirty-four patients were diagnosed as having at least one ipsilateral smaller solid lesion associated with the primary RCC: 22 had RN while 12 had NSS for tumor enucleation. Results: All patients who had NSS had tumors confined within the kidney, as did 82% of patients treated with RN. The sole presence of concomitant accompanying benign histology to the primary RCC was diagnosed in 20% of patients. The mean (median, range) follow-up for patients treated with RN and NSS was 69 (58, 12–214) and 58 (44, 12–151) months. Tumor stage was significantly associated with tumor-specific survival (TSS) in the RN group (p <0.001). None of the patients who had tumor enucleation had positive surgical margins. Two patients recurred locally after NSS, elsewhere in the kidney, resulting in a crude ipsilateral recurrence rate of 17%. The analysis of TSS for patients with multiple ipsilateral tumors with a pT1 primary lesion showed no statistically significant differences between patients who had RN or NSS. Two patients had contralateral recurrence, resulting in a crude rate of 6%. Conclusions: For patients with multiple ipsilateral renal tumors, 20% of the satellite lesions are benign and 6% develop a contralateral metachronous recurrence. We also observed similar TSS for patients treated with NSS and RN. [Copyright &y& Elsevier]

Abstract: The aim of our 10-year study was to test the effectiveness of topical therapy based on 0.18% isotretinoin, comparing it with that most frequently used, i.e. at 0.05% concentration. Seventy patients with an established diagnosis of oral lichen planus were involved in the study. The patients were randomly divided into two groups, and the drug was administered topically at 0.05% and 0.18% concentrations. The drug at the higher concentration, according to the same protocol, was administered to the patients who did not benefit from the therapy at the lower concentration. None of the cases of reticular lichen planus showed clinical or histological improvement. In contrast, the atrophic–erosive forms showed a significant improvement, both clinical and histological: in 26 patients (at 0.18% concentration) and in nine patients (at 0.05% concentration), the symptoms, as well as the erosions or ulcers observed, disappeared. The disappearance of dysplasic phenomena was observed at 0.18% concentration. Topical application of the drug was accompanied by an increase in soreness and pain, as well as greater sensitivity to hot foods. However, these side effects were transitory, and considered acceptable by the patients. The proposed therapeutic protocol was effective towards highly active atrophic–erosive oral lichen planus with dysplasic phenomena, which is the form of the disease at higher risk of malignant evolution. [Copyright &y& Elsevier]

A consumer-recognized fibre syrup was used as bulking agent in a sugar reduction reformulation strategy of a strawberry ripple sauce, in order to satisfy the consumer needs of healthier and clean label products. Three sugar reduced recipes of ripple sauces (by 30 %, 50 % and 70 %) were developed and characterized together with a full sugar counterpart. The technological functionality of the fibre syrup was tested analysing the ripple sauces during 60 days of storage at two temperatures (5 °C and 25 °C) considering their physicochemical, stability, rheological and sensorial features. The use of the fibre syrup increased the water activity and the moisture content of the reformulated ripples; however, no water syneresis occurred during storage in these samples. The consumer acceptability of ripples in which sugar was reduced by 30 % furthermore confirm the possibility to use the fibre syrup as sugar substitute in high sugar products. The industrial scalability was confirmed for the ripple sauce in which sugar was reduced by 30 % as it resulted similar at rheological and sensory level to the full sugar counterpart also during storage. • Reduced sugar ripple sauces were developed using a clean label fibre syrup. • Reformulated ripples can claim "Reduced in sugar" and "high in fibre" on label. • 30 % reduced sugar ripple had similar rheological properties than the control. • Consumer outcomes confirmed the industrial scalability of 30 % reduced sugar ripple. [ABSTRACT FROM AUTHOR]

Integrated multi-trophic aquaculture (IMTA) is increasingly recognized as a means to improve the sustainability of aquaculture and to mitigate its environmental impact. Macroalgae can play an important role in IMTA and here a six-week feeding trial was conducted to examine the efficacy of Ulva lactuca as a functional food ingredient and a water bioremediation agent in Litopenaeus vannamei aquaculture. Treatments including a diet with 4% algae or algal bioremediation of recirculating rearing water, either alone or in combination, had significant positive influences on the daily growth of the shrimp. Overall, the combination of feeding shrimp with the algal diet and rearing them the algal bioremediation system resulted in twice the specific growth rate (SGR, 4.92 ± 0.4% day−1) compared to feeding a control diet in a flow through system (SGR 2.41 ± 0.3% day−1). Both the algal bioremediation system and the algal diet promoted the establishment of known aquaculture probiotics, including Agarivorans , Sphingomonas , Lactobacillus , Leuconostoc , Peredibacter and Bdellovibrio -and-like organisms, and suppressed or decreased potential pathogens, such as Vibrio alginolyticus and Photobacterium sp. The significant increase of known probiotic bacteria as well as the suppression of potential pathogens in both the shrimp hepatopancreas and the cultivation water provide strong evidence that the use of macroalgae as feed supplement, prebiotic treatment and bioremediation agent has the potential to stimulate animal growth and contribute to the overall health of the aquaculture environment. • Efficacy of a dietary inclusion of U. lactuca on the growth, health and survival of L. vannamei. • Effect of U. lactuca on the microbial communities of the water in the RAS and FTS cultivation of L. vannamei • The effect of a dietary inclusion of U. lactuca on the microbial communities of the shrimp hepatopancreas • The pre- and probiotic effects of the inclusion of U. lactuca in the production of L. vannamei. [ABSTRACT FROM AUTHOR]

To investigate the influence of the body weight on peri- and postoperative outcome in a series of pediatric patients with a diagnosis of uretero–pelvic junction obstruction (UPJO) treated with robot-assisted laparoscopic pyeloplasty (RALP) at a single tertiary referral center. In this study, outcomes of RALP in children divided according to the weight are evaluated. Sixty-one consecutive patients treated with RALP from January 2016 to May 2019 were recorded retrospectively and divided according to their weight: group A < 15 kg, group B ≥ 15 kg and were included in this study. Eligible criteria for surgery were symptomatic UPJO, worsening of hydronephrosis, or obstructive pattern at renogram. Success criteria were the reduction of the hydronephrosis at imaging and the absence of flank pain. All procedures were performed by one expert robotic surgeon. 18 patients were included in group A (median weight 12 kg) and 43 patients in group B (median weight 33 kg). The median (IQR) operative was 95 (90–120) for group A compared to 90 (85–110) of control group. No significant difference has been found (P = 0.93). We registered one (5.6%) Clavien 3b complication (omental hernia after removal of the drainage requiring surgical correction) and two (4.7%) Clavien 2 complication in group B (urinary infections). No difference has been found in the length of hospital stay, length of catheterization, and duration of procedure between the groups (P > 0.05). At a median follow-up of 23 months (IQR 9–27 vs 9–33), the success rate was comparable between the two groups (94.4% vs 97.7%; P = 0.51). Relapse was recorded in one child per group and both required nephrostomy placement. Our study tried to fill the gaps in the evidence on the feasibility of RALP in low-weight children reporting favorable peri-operative and long-term outcomes; however, this study shows some intrinsic limitations. The relatively small numbers of patients in the <15 kg may have underpowered the comparison with heavier patients. Moreover, only two patients were <10 kg so that no definitive conclusions on the safety and feasibility of RALP in this cohort of patients can be drawn. RALP in children <15 kg was feasible and effective to treat UPJO with superimposable results to heavier counterparts. In our experience, the need for a different trocar placement and limited space in patients <15 kg did not affect peri-operative and functional outcomes. Summary Fig. Image 1 [ABSTRACT FROM AUTHOR]

In the context of a civil action for medical mala praxis a dry gallstone, a gallstone immersed in formalin and a gallbladder in the same preservative were submitted to our lab in order to analyze the identity of the donor. A blood sample of the victim was sent as reference. The dry gallstone showed the appearance of an irregular dark brown stone. Chemical analysis revealed that it was composed mainly of cholesterol. No DNA profiles were recovered from the samples immersed in formalin whereas the dry gallstone rendered a full DNA profile only from samples collected by surface scraping. A female genetic profile that did not match the victim was obtained. Although a gallstone is an unusual sample source, in this case the DNA analysis provided important evidence in solving the dispute. [ABSTRACT FROM AUTHOR]

The detection of foreign DNA from the fingernail hyponychium may be relevant in the investigation of certain criminal acts, providing evidence of any sort of contact between the victim and the suspect. In this report, we analyzed results obtained from 164 fingernail samples collected by three different methods: extraction, clipping and swabbing. Samples were taken, mostly during the autopsy operation, and submitted to our Lab in the context of 71 different criminal cases. In 74.6% of the reviewed cases, a reportable DNA profile which matched the victims was recovered. In 13.2% of these profiles, foreign DNA was also detected as a minor contributor, representing almost a 10% of the analyzed cases. The estimated prevalence of foreign DNA samples beneath fingernails is comparable with that reported from volunteer donors screenings. [ABSTRACT FROM AUTHOR]

Laser therapy and fluorescence-guided surgery are highly reliable and predictable methods, but their combination has not been found to yield useful outcomes. We present a new therapeutic approach combining fluorescence-guided Er:YAG laser ablation with Nd:YAG/diode laser biostimulation for bisphosphonate-related osteonecrosis of the jaw (BRONJ). A woman was treated with zoledronic acid for bone metastasis from clear cell renal cell carcinoma and subsequently developed BRONJ in the left jaw. The management protocol included perioperative medical therapy (1% chlorhexidine gel, rifamycin, and doxycycline for 10 preoperative and 7 postoperative days), Er:YAG laser ablation guided by doxycycline fluorescence in vital bone under UV light, and Nd:YAG/diode laser biostimulation. The lesion regressed from stage 3 to stage 1 and showed nearly complete healing after laser therapy (3 and 23 cycles of ablation and biostimulation, respectively). These preliminary findings suggest the feasibility of the new approach, which is minimally invasive and biostimulative and causes very low morbidity. [ABSTRACT FROM AUTHOR]