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International audience; Photocatalysis using semiconductor materials like titania (TiO 2) is a key method for environmental purification or solar fuel generation. Nanostructures that maximize incident light absorption are highly desired to enhance depollution rate or solar-to-fuel conversion efficiency in limited volumes of catalysts. Here, we report on structural and optical properties of metasurfaces based on a 20 nm thick anatase layer conformally deposited onto a wavelength-scale two-dimensional periodic photonic lattice. We investigate the NO degradation using such metasurfaces, and evaluate the impact of the patterning on photocatalytic activities between 340 and 400 nm. In the 380-385 nm range, the mean photochemical efficiency is increased by a factor up to 5.7 compared to flat references, with an overall threefold enhancement within the whole spectral range of interest. This approach can be applied to numerous types of systems by varying active materials, leading to substantial improvements in air/water depollution, water splitting or artificial photosynthesis processes.

Background and Aims: Several studies have found Golimumab (GOL) effective and safe in the short-term treatment of ulcerative colitis (UC), but few long-term data are currently available from real world. Our aim was to assess the long-term real-life efficacy and safety of GOL in managing UC outpatients in Italy. Methods: A retrospective multicenter study assessing consecutive UC outpatients treated with GOL for at least 3-month of follow-up was made. Primary endpoints were the induction and maintenance of remission in UC, defined as Mayo score ≤2. Several secondary endpoints, including clinical response, colectomy rate, steroid free remission and mucosal healing, were also assessed during the follow-up. Results: One hundred and seventy-eight patients were enrolled and followed up for a median (IQR) time of 9 (3-18) months (mean time follow-up: 33.1±13 months). Clinical remission was achieved in 57 (32.1%) patients: these patients continued with GOL, but only 6 patients (3.4%) were still under clinical remission with GOL at the 42nd month of follow-up. Clinical response occurred in 64 (36.4%) patients; colectomy was performed in 8 (7.8%) patients, all of them having primary failure. Steroid-free remission occurred in 23 (12.9%) patients, and mucosal healing was achieved in 29/89 (32.6%) patients. Adverse events occurred in 14 (7.9%) patients. Conclusions: Golimumab does not seem able to maintain long-term remission in UC in real life. The safety profile was good.

BACKGROUND: This observational study evaluates retrospectively the long-term outcomes after pleurectomy/decortication for pleural mesothelioma, with and without the resection/reconstruction of diaphragm and pericardium. METHODS: Data from 155 consecutive patients undergoing lung-sparing surgery for epithelial pleural mesothelioma were reviewed. Selection criteria for surgery were cT1-3, cN0-1, good performance status, age 12 months was strongly related to the overall survival (P12 months is predictive of an increased survival when the macroscopic complete resection is achieved.

Background Infections caused by Bordetella pertussis are frequent and responsible for cases of huge severity in unvaccinated young infants. However, clinical manifestations vary and mimic other respiratory diseases as respiratory viruses. Methods A prospective cohort study was performed with infants under 1 old, hospitalized with suspected pertussis. All infants were submitted to etiological research to identify Bordetella pertussis (nasopharynx swab for culture and/or PCR) and respiratory viruses (nasopharyngeal aspirate for indirect immunofluorescence). Clinical and demographic data were collected. Results Among 59 infants, an etiological agent was identified in 37 (62.8%). Respiratory virus was identified in 19 (32%) and Bordetella pertussis in 14 (23.7%) as sole agent. Codetection was found in 4 (7%). Younger age, absence of fever, lack of BP immunization, leukocytosis > 20,000/mm3, lymphocytosis >10,000/mm3 were associated to a greater chance of pertussis. Wheezing and living with siblings were associated with viral infection. After adjustment for confounders, the most important predictors were presence of wheezing for respiratory virus and leukocytosis for pertussis. The severity of infections by RV and BP were similar. Conclusion Respiratory virus infections are frequent in cases of clinical suspicion of pertussis and may actually exceed the prevalence of BP. Clinical/laboratory characteristics may suggest the etiology, but they are not pathognomonic, which stresses the need for respiratory virus and Bordetella pertussis research in this clinical situation.

Background Infliximab and adalimumab are widely used for the treatment of Crohn's disease and ulcerative colitis. Aim To compare the long-term efficacy and safety of infliximab and adalimumab in a large cohort of Crohn's disease and ulcerative colitis patients reflecting real-life clinical practice. Methods Seven hundred twelve patients were retrospectively reviewed, 410 with Crohn's disease (268 treated with adalimumab and 142 with infliximab; median follow-up 60 months, range, 36-72) and 302 with ulcerative colitis (118 treated with adalimumab and 184 with infliximab; median follow-up 48 months, range, 36-84). Results In Crohn's disease, clinical remission was maintained in 75.0% of adalimumab vs. in 72.5% of infliximab patients (P = 0.699); mucosal healing and steroid-free remission were maintained in 49.5% of adalimumab vs. 63.9% of infliximab patients (P = 0.077) and in 77.7% of adalimumab vs. 77.3% in infliximab group (P = 0.957), respectively. In ulcerative colitis, clinical remission was maintained in 50.0% of adalimumab vs. 65.8% of infliximab patients (P 10 were predictors of failure in Crohn's disease; treatment with adalimumab, BMI ≥30 and Mayo score >10 were predictors of failure in ulcerative colitis. infliximab was more likely to cause adverse events than adalimumab (16.6 vs. 6.2%, P Conclusion Both adalimumab and infliximab are effective in long-term outpatients management of inflammatory bowel diseases. Adalimumab had a lower rate of adverse events.

In the Apuan Alps (Tuscany, Italy), long-lasting mining activities have favored the mobilization of numerous metals present in sulfosalts originated from low-grade metamorphism mineralization. Such materials, rich in potentially toxic elements such as antimony, arsenic, barium, copper, lead, thallium, tin and zinc, represent the substrate on which soils of different thicknesses have been formed and is currently used for agricultural activities. High concern is particularly arising about the food safety due to traditional horticultural practices, since it is very common in this area to cultivate vegetables in private gardens for both self-consuming and/or local market. In this context, a monitoring survey on both soils and vegetables was performed over the area, with particular attention to Brassica oleracea L. as traditional food crop, to assess the degree of contamination of the area, the possible translocation to vegetables and the potential human risk linked to vegetable ingestion. This analysis reveals a different degree of soil contamination in the area and a general high human risk linked to cabbage cultivation and ingestion in the whole area.

The transition period of dairy cattle is characterized by a number of metabolic, endocrine, physiologic, and immune adaptations, including the occurrence of negative energy balance, hypocalcemia, liver dysfunction, overt systemic inflammatory response, and oxidative stress status. The degree and length of time during which these systems remain out of balance could render cows more susceptible to disease, poor reproductive outcomes, and less efficient for milk production and quality. Studies on both monogastrics and ruminants have reported the health benefits of nutraceuticals (e.g. probiotics, prebiotics, dietary lipids, functional peptides, phytoextracts) beyond nutritional value, interacting at different levels of the animal’s physiology. From a physiological standpoint, it seems unrealistic to disregard any systemic inflammatory processes. However, an alternate approach is to modulate the inflammatory process per se and to resolve the systemic response as quickly as possible.To this aim, a growing body of literature underscores the efficacy of nutraceuticals (active compounds) during the critical phase of the transition period. Supplementation of essential fatty acids throughout a 2-month period (i.e. a month before and a month after calving) successfully attenuates the inflammatory status with a quicker resolution of phenomenon. In this context, the inflammatory and immune response scenario has been recognized to be targeted by the beneficial effect of methyl donors, such as methionine and choline, directly and indirectly modulating such response with the increase of antioxidants GSH and taurine. Indirectly by the establishment of a healthy gastrointestinal tract, yeast and yeast-based products showed to modulate the immune response, mitigating negative effects associated with parturition stress and consequent disorders.The use of phytoproducts has garnered high interest because of their wide range of actions on multiple tissue targets encompassing a series of antimicrobial, antiviral, antioxidant, immune-stimulating, rumen fermentation, and microbial modulation effects. In this review, we provide perspectives on investigations of regulating the immune responses and metabolism using several nutraceuticals in the periparturient cow.

Objective To evaluate the clinical and epidemiological profile of bacterial meningitis and meningococcal disease in pediatric patients admitted to a Brazilian Secondary Public Hospital. Methods A descriptive observational study was conducted. Microbiologically proven bacterial meningitis or meningococcal disease diagnosed from 2008 to 2018 were included. Results A total of 90 patients were diagnosed with proven bacterial meningitis. There were 64 confirmed cases of meningococcal disease. The prevalence was higher in boys (n = 38), median age 30 months (1–185). The main clinical manifestations were: meningococcal meningitis (n = 27), meningococcemia without meningitis (n = 14), association of meningococcemia with meningitis (n = 13), and fever without a known source in infants (n = 7). Admissions to intensive care unit were necessary for 45 patients. Three deaths were notified. Serogroup C was the most prevalent (n = 32) followed by serogroup B (n = 12). Pneumococcal meningitis was identified in 21 cases; out of the total, 10 were younger than two years. The identified serotypes were: 18C, 6B, 15A, 28, 7F, 12F, 15C, 19A and 14. Pneumococcal conjugate 10-valent vaccine covered four of the nine identified serotypes. Haemophilus influenzae meningitis serotype IIa was identified in three patients, median age 4 months (4–7). All of them needed intensive care. No deaths were notified. Conclusion Morbidity and mortality rates from bacterial meningitis and meningococcal disease remain high, requiring hospitalization and leading to sequelae. Our study observed a reduced incidence of bacterial disease over the last decade, possibly reflecting the impact of vaccination.

Background: Autoimmune hepatitis (AIH) is a chronic and aggressive liver disease that rapidly evolves into cirrhosis and end-stage liver disease if not timely diagnosed and treated with immunosuppressive therapy. AIH is classified into type 1 and type 2 according to the autoantibody pattern, with smooth muscle antibodies and/or antinuclear antibodies as serological markers of AIH-1, while antiliver cytosol antibody type 1 and/or antiliver/kidney microsomal antibody type 1 characterize type 2 AIH, which mainly affects children, including infants, and adolescents. Case Summary: We describe a case of type 2 AIH, clinically onset in a 34-year-old woman with decompensated cirrhosis. Only a thorough analysis of the autoantibody profile allowed for a diagnosis of an AIH-2 evolved into cirrhosis. The patient received a moderate corticosteroid therapy without achieving optimal disease control. We discuss the controversial decision of whether or not to treat the patient with immunosuppressive therapy, which should be balanced with the potential risk of infectious and other complications. A review of the literature on the management of patients with autoimmune cirrhosis is also presented. Conclusions: AIH-2 can be clinically onset in adult patients with cirrhosis and its complications, without being preceded by major clinical signs. Due to the difficult management of cirrhosis with immunosuppressive treatments, a patient-tailored strategy with a case-by-case approach is needed to prevent major complications such as infections, potentially precluding liver transplantation the only curative therapy.

Summary Background Older age and comorbidities are the main risk factors for adverse COVID‐19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims To assess risk factors for adverse outcomes of COVID‐19 in IBD patients and use the identified risk factors to build risk indices. Methods Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS‐CoV‐2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID‐19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune‐mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID‐19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID‐19 outcomes, but anti‐TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID‐19 in CD. Conclusion The course of COVID‐19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID‐19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID‐19 re‐vaccination or for therapies for SARS‐CoV‐2 infection., The course of COVID‐19 in patients with IBD patients is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID‐19 outcomes. IBD medications do not pose additional risks.

Background Few data exist regarding the long‐term effectiveness of golimumab in ulcerative colitis. No data have been reported on real‐world continuous clinical response. Objective This study aimed to describe the long‐term outcomes in a large cohort of patients on golimumab who had ulcerative colitis. Methods Consecutive patients with active ulcerative colitis, started on golimumab, were enrolled and prospectively followed up. The primary end point was to evaluate the long‐term persistence on golimumab therapy. Results A total of 173 patients with ulcerative colitis were studied. Of these, 79.2% were steroid dependent, and 46.3% were naïve to anti‐tumour necrosis factor alpha agents. The median duration of golimumab therapy was 52 weeks (range: 4–142 weeks). The cumulative probability of maintaining golimumab treatment was 47.3% and 22.5% at 54 and 108 weeks, respectively. Biological‐naïve status (odds ratio [OR] = 3.02, 95% confidence interval [CI]: 1.44–6.29; p = 0.003) and being able to discontinue steroids at Week 8 (OR = 3.32, 95% CI: 1.34–8.30; p = 0.010) and Week 14 (OR = 2.94, 95% CI: 1.08–8.02; p = 0.036) were associated with longer persistence on therapy. At Week 54, 65/124 (52.4%) postinduction responders were in continuous clinical response. A continuous clinical response was associated with a lower likelihood of golimumab discontinuation throughout the subsequent year of therapy (p

Objective The aim of this study was to conduct a survey of the different complications of partial, total or extended sacrectomy for the treatment of spinal tumors. Method This study is a descriptive analysis of medical records from a series of 18 patients who underwent sacrectomy between 2010 and 2019 at a tertiary center specializing in spinal tumor surgeries. The variables analyzed were sex, age, hospitalization time, oncologic diagnosis, posterior fixation pattern, rate of complications, and Frankel, ASA and ECOG scales. Results Of the 18 patients, 10 (55.5%) were male and 8 (44.5%) were female, and the mean age was 48 years. The mean hospitalization time was 23 days. Of the 18 patients, 8 (44.5%) contracted postoperative infections requiring surgery. Perioperative complications included liquoric fistula (22.25%), hemodynamic instability requiring vasoactive drugs in the immediate postoperative period (22.25%), wound dehiscence (11.1%), acute obstructive abdomen (11.1%), occlusion of the left external iliac artery (11.1%), immediate postoperative death due to acute myocardial infarction (11.1%), and intraoperative death due to hemodynamic instability (11.1%). Conclusions Partial, total or extended sacrectomy is a complex procedure with high morbidity and mortality, even in centers specializing in the treatment of spinal tumors. Level of evidence IV; case series study. RESUMO Objetivo O objetivo deste estudo é fazer um levantamento das diferentes complicações da sacrectomia parcial, total ou estendida para tratamento de tumores da coluna vertebral. Métodos O estudo é uma análise descritiva de prontuários de uma série de 18 pacientes submetidos à sacrectomia entre 2010 e 2019 em um centro terciário especializado em cirurgias de neoplasia na coluna. As variáveis analisadas foram sexo, idade, tempo de internação, diagnóstico oncológico, padrão de fixação posterior, taxa de complicações e escalas de Frankel, ASA e ECOG. Resultados Dos 18 pacientes, 10 (55,5%) eram homens e 8 (44,5%) mulheres com média de idade de 48 anos. O tempo médio de internação foi de 23 dias. Dos 18 pacientes, 8 (44,5%) contraíram infecções pós-operatórias com necessidade de cirurgia. As complicações perioperatórias incluíram fistula liquórica (22,25%), instabilidade hemodinâmica com necessidade de medicação vasoativa no pós-operatório imediato (22,25%), deiscência da ferida operatória (11,1%), abdome obstrutivo agudo (11,1%), oclusão da artéria ilíaca externa esquerda (11,1%), óbito pós-operatório imediato por infarto agudo do miocárdio (11,1%) e óbito intraoperatório por instabilidade hemodinâmica (11,1%). Conclusões A sacrectomia parcial, total ou estendida é um procedimento complexo com alta taxa de mortalidade e morbidade, mesmo em centros especializados no tratamento de tumores na coluna. Nível de evidência IV; Série de casos. RESUMEN Objetivo El objetivo de este estudio es evaluar las diferentes complicaciones de la sacrectomía parcial, total o extendida para el tratamiento de tumores vertebrales. Métodos El estudio es un análisis descriptivo de las historias clínicas de 18 pacientes sometidos a sacrectomía entre 2010 y 2019 en un centro terciario especializado en cirugías de neoplasia de columna. Las variables analizadas fueron sexo, edad, estancia hospitalaria, diagnóstico de cáncer, patrón de fijación posterior, tasa de complicaciones, escalas de Frankel, ASA y ECOG. Resultados De los 18 pacientes, 10 (55,5%) eran hombres y 8 (44,5%) mujeres con una edad promedio de 48 años. La estancia hospitalaria promedio fue de 23 días. De los 18 pacientes, 8 (44,5%) contrajeron infecciones posoperatorias que requirieron cirugía. Las complicaciones perioperatorias incluyeron fístula de líquido cefalorraquídeo (22,25%), inestabilidad hemodinámica que requirió medicación vasoactiva en el posoperatorio inmediato (22,25%), dehiscencia de la herida quirúrgica (11,1%), abdomen obstructivo agudo (11,1%), oclusión de la arteria ilíaca externa izquierda (11,1%), muerte posoperatoria inmediata por infarto agudo de miocardio (11,1%) y muerte intraoperatoria por inestabilidad hemodinámica (11,1%). Conclusiones La sacrectomía parcial, total o extendida es un procedimiento complejo con una alta tasa de mortalidad y morbilidad, incluso en centros especializados en el tratamiento de tumores de la columna. Nivel de evidencia IV; Series de casos

Construction and demolition waste (CDW) management in developing countries is a global concern. The analysis of scenarios and the implementation of life cycle assessment (LCA) support decision-makers in introducing integrated CDW management systems. This paper introduces the application of an LCA in La Paz (Bolivia), where CDW is mainly dumped in open areas. The aim of the research is to evaluate the benefits of inert CDW recycling in function of the selective collection rate, defined as the amount of waste (%wt.) sorted at the source in relation to the total waste amount produced, and the distances from the CDW generation to the material recycling facility. The outcomes of the research suggest that increasing the selective collection rates (5% to 99%) spread the importance of transportation distances planning since it affects the magnitude of the environmental impacts (1.05 tCO2-eq to 20.7 tCO2-eq per km traveled). Transportation limits have been found to be lower than about 40 km in order to make recycling beneficial for all environmental impacts and for all selective collection rate, with the eutrophication potential as the limiting indicator. The theoretical analysis suggests implementing LCA with primary data and involving statistics related to the transportation of virgin materials avoided thanks to recycling. The outcomes of the research support the implementation of CDW recycling in developing countries since it has been found that material recovery is always beneficial.

Background Italian data currently available in managing ulcerative colitis (UC) and Crohn's disease (CD) patients with vedolizumab (VDZ) are coming just from secondary and tertiary centers. The present study aimed to assess the real-life efficacy and safety of VDZ to achieve remission in inflammatory bowel diseases (IBD) outpatients in primary gastroenterology centers. Methods Clinical activity was scored according to the Mayo score in UC and to the Harvey-Bradshaw Index (HBI) in CD. The primary endpoints were the achievement of clinical remission and safety. Secondary endpoints were clinical response to treatment, achievement of mucosal healing (MH), and steroid discontinuation. Results One hundred and thirty-six pts. were enrolled (91 UC and 45 CD pts). During an 18-month median follow-up, clinical remission was present in 63 (46.3%) pts.: in particular, it occurred in 48 (52.7%) patients in UC group and in 15 (33.3%) patients in CD group (p = 0.003). more in UC group. Fecal calprotectin ≥400 μg/g and presence of comorbidities were factors significantly related to the failure of remission in UC and CD, respectively. Ten (7.3%) cases of adverse events were recorded (2 required suspension of treatment). Clinical response was present in 105 (72.2%) pts.: 71 (78.0%) in UC and 34 (75.5%) in CD group. MH occurred in 47 (62.7%) UC and in 9 (50.0%) CD patients. Steroids discontinuation occurred in 92 (67.6%) pts.; 61 (67.0%) UC and 31 (68.9%) CD pts. Conclusion VDZ is effective and safe in IBD outpatients, especially in UC patients.

Peracetic acid (PAA) has been used to sterilize biomaterial scaffolds and allografts before their implantation. Although the antimicrobial effectiveness of PAA is widely known, there are no studies investigating its cytotoxicity on keratinocytes. This study aimed to investigate the cytotoxicity of PAA concentrations on keratinocytes by growing HaCaT cells in culture medium. Different concentrations of PAA (control-untreated, 0.01, 0.1, 1, 10, 100, 200, 400, 800, 1200, 1600, and 2000 ppm) were added to the culture wells and allowed to be in direct contact with cells for up to 24 hours. Cytotoxicity was quantitatively and qualitatively determined by cell viability assay and analysis of morphological changes. Statistical analysis was performed with 1-way analysis of variance and Tukey test at 5% significance. Cells treated with 0.01 and 0.1 ppm followed the same morphological pattern of untreated cells, whereas cells treated with 1.0 ppm presented about 20% of floating cells and dark cytoplasmic granules. More than 50% of the cells treated with 10 and 100 ppm were destroyed, whereas the attached ones showed unclear and interrupted cell membranes. Concentrations of 1 ppm or greater had less than 64.4% of viable cells compared with the control group. This study concluded that exposure of keratinocytes to concentrations of 1 ppm or greater of PAA resulted in strong cytotoxic effects.

Background The purpose of this study was to assess the efficacy and safety of biosimilar infliximab (IFX) CT-P13 in treating outpatients with inflammatory bowel disease (IBD) in Italian primary gastroenterology centers. Methods Consecutive IBD outpatients who completed the induction treatment were evaluated retrospectively. Clinical activity was scored according to the Mayo score for ulcerative colitis (UC) and to the Harvey-Bradshaw Index (HBI) for Crohn's disease (CD). The primary endpoint was the achievement of clinical remission (Mayo score ≤2 in UC and HBI ≤5 in CD). Secondary endpoints were clinical response to treatment, achievement of mucosal healing, and safety. Results One hundred forty-one patients (96 UC and 45 CD) were enrolled. Previous treatment with anti-tumor necrosis factor (TNF)α had been provided to 26% of UC patients and 28.9% of CD patients. Remission was achieved in 57.3% UC patients and in 75.6% CD patients during a median (interquartile range) follow up of 24 (6-24) months. Clinical response and mucosal healing were achieved in 87.5% and 75.0% of UC patients and in 84.4% and 84.2% of CD patients, respectively. By both univariate and multivariate analysis, age >40 years, presence of comorbidities, and naivety to anti-TNFα were significantly related to remission. Only one (0.7%) adverse event was reported in the CD group. Surgery was performed in 2.1% of UC patients and 6.7% of CD patients. Switching from IFX originator to biosimilar did not influence the maintenance of the clinical remission. Conclusion This study confirmed the long-term efficacy and safety of CT-P13 therapy in IBD, in both naive patients and those switching from IFX originator.

Universal access to electricity in isolated areas is a social imperative and a substantial challenge for service providers. One such area is the Pantanal, which is one of the world’s largest wetlan...

This paper investigates municipal solid waste management future scenarios of La Paz, developing big city of Bolivia, for improving the selective collection of recyclable materials. The objective of the paper is to suggest a multidimensional approach, both quantitative and qualitative, for planning sustainable waste management systems in areas with no data availability. The research assessed six different long-term management plans, considering all recycling settings feasible for La Paz. For that purpose, a multi-criteria decision analysis has been introduced, supported by environmental and financial impact assessment concerning transportation, final disposal, and material recovery. Results suggest that the inclusion of the informal sector could be the most feasible option from an economic and technological point of view. Moreover, the curbside collection of organic waste could be considered the best solution for reducing the global warming potential and for improving the useful life of the sanitary landfill. The approach introduced, as well as the combination of solutions evaluated, could be of interest for stakeholders of Latin America for reducing environmental impacts and introducing a new business. Though the multi-criteria decision analysis and the impact-assessment do not provide a dynamic view of future scenarios, their combination could offer a first integrated insight into the possible challenges and opportunities for developing a new municipal solid waste management system in developing cities, encouraging the circular economy and sustainable development.

Background No data are available on the variability in the clinical management of ulcerative colitis (UC) patients by Italian gastroenterologists. Therefore, improving the standards of UC care as provided by the National Welfare Clinical Path (PDTA), in accordance with the European Crohn’s and Colitis Organization (ECCO) guidelines for UC, is not easy. Aims To assess the management of UC by Italian gastroenterologists in a real-life setting taking into account its variability. Methods This prospective, cross-sectional, observational study included IBD-specialized gastroenterologists (GSIBDs) and general gastroenterologists (GGs) working in Italian public hospital units. Consecutive patients with an UC flare were enrolled and the medical treatment evaluated. For each center, the physician in charge of the study (16 GSIBDs and 10 GGs) was administered two electronic questionnaires. Results Among 26 units, 573 UC patients were enrolled. Good adherence to the European guidelines was reported; GSIBDs reported greater adherence than GGs with a higher prescription of rectal and combination therapy in mild to moderate distal disease and a higher rate of hospitalization in severe UC. Conclusion The management of UC by Italian gastroenterologists in clinical practice is good according to the ECCO consensus recommendations, though some discrepancies are present between GSIBDs and GGs.

The introduction of effective solid waste management strategies in developing countries should be considered for improving sustainability at global level. Many barriers should be overcome, concerning the introduction of environmental policies, effective investments, social inclusion and public awareness, which are significant issues in low-middle income countries. The Circular Economy could represent the answer for improving current solid waste management activities worldwide, since denote the principle of waste valorization and recycling for boosting developing economies. This paper is focused on this theme, analyzing main opportunities for improving the current state of solid waste management in developing big cities. The solid waste management of two countries are reviewed: Romania is the emerging country where Circular Economy is becoming a future objective due to economic aids and strength regulations which the European Union (EU) established for the nations forming parts the alliance; as a comparison, Bolivia is reported for evaluating main differences founded for developing recycling systems in a no-EU country. These two case studies could be of interest for highlighting main pros and cons of the participation into a wide organization like the EU for introducing in short terms Circular Economy principles. Moreover, a theoretical Circular Economy model for developing big cities in low-middle income countries is described within the study for effectively comparing which chances can spread for these countries as regard municipal solid waste exploitation. Despite the economic level, Romania and Bolivia are both facing with many solid waste management issues although in different magnitude. For the Romanian case study, it is visible how it cannot achieve the European goals for 2020 due the need of change in public recycling behavior. Bolivia, instead, represents the case where international aids and new investments are required, considering the informal sector into the formal management system as a real opportunity for improving local recycling rate. In conclusion, the comparison suggests how external supports led to implement the principles of the Circular Economy within a developing region. The model of Circular Economy proposed is recommended for developing big cities in order to advance a new form of safe employment, encouraging the activities that are still in action (i.e. informal sector) and boosting the principles of sustainable development.

Background and Aims: In clinical practice, most patients with symptoms suggestive of gastroesophageal reflux disease (GERD) undergo esophago-gastro-duodenoscopy (EGD), despite its low sensitivity in detecting reflux stigmata. Gastrin 17 (G-17) has been proposed to be related with GERD, due to the negative feedback between acid secretion and this hormone. We assessed the clinical usefulness of fasting G-17 serum determination for a non-invasive diagnosis of GERD in patients with typical symptoms. Methods: We consecutively enrolled patients complaining of typical GERD symptoms in two different settings: a single referral center and a primary care setting. Control groups consisted of dyspeptic patients. All subjects underwent assessment of serum levels of G-17 and EGD. Results: At the academic hospital, 100 GERD patients (n=89 with erosive esophagitis and 11 with Barrett’s esophagus) had statistically significant low levels of G-17 as compared with 184 dyspeptic patients (1.7±1.2 pg/L vs 8.9±5.7 pg/L p

Background: Current literature still lacks studies evaluating the effectiveness and safety of switching from Infliximab originator to SB2 biosimilar in Inflammatory Bowel Diseases (IBDs). We aimed to verify the ability of SB2 to maintain the clinical and biochemical response induced by originator after switching. As secondary outcome, we aimed to verify safety, tolerability and immunogenicity of SB2 biosimilar compared with its IFX originator. Methods: We prospectively enrolled all patients who switched from originator to SB2 at three Italian IBD Units from August 2018 to April 2020. We collected clinical and biochemical data at the time of switch (T0), and at the first (T1) and the second (T2) visits after switching (mean time from switching: 135 and 329 days, respectively). In addition, data regarding therapeutic drug monitoring at T0 and T1 were recorded. Results: Eighty-five IBD patients (28 with Ulcerative Colitis and 57 with Crohn’s Disease) were included in the study. At T1, we observed statistically significant modifications in clinical activity of disease (70 patients were in clinical remission at baseline and 60 at T1 p = 0.02), but not at T2 (p = 0.3). Fecal calprotectin values were not different both at T1 and T2 (both p = 0.9) as well as the rate of concomitant treatment with steroids (p = 0.2 and p = 0.1) or immunosuppressants (p = 0.1 and p = 1.0). Moreover, the need for therapeutic optimization from T0 to T1 and from T1 to T2 was found significant (both p = 0.01). No anti-drug antibodies were identified at T1, and no serious adverse events were recorded. Conclusions: Overall, our data show that most of the patients switching from Infliximab originator to SB2 maintain the clinical and biochemical remission for at least 1 year. Further data are necessary to understand the clinical implications of these findings in the long term.

To date, data on effectiveness and safety of Adalimumab (ADA) biosimilars in inflammatory bowel diseases (IBDs) are lacking. Therefore, we aimed to verify the ability of ABP501 and SB5 to maintain the clinical and biochemical response induced by the ADA originator, after switching to them. We prospectively analyzed data collected from 55 patients with IBD who switched to ABP501, and 25 patients with IBD who switched to SB5, from ADA originator at four IBD Units between 2018 and 2020. In addition, we included an age and sex-matched control group (n = 38) who continued ADA originator for at least two years and who did not switch to a biosimilar drug. Clinical and biochemical data (C-Reactive Protein (CRP), fecal calprotectin (FC)), concomitant steroid and/or immunosuppressant therapy at the time of the switch and after six months were collected. At six months, in the ABP501 group, we did not observe statistically significant modifications in clinical activity of disease (p = 0.09) and FC values (p = 0.90). Some patients (n = 8) needed to add steroids at six months after switching (p = 0.01), however the need for optimization was not significant between the two timepoints (p = 0.70). Finally, 14.5% patients stopped therapy after six months. Similarly, in the SB5 group we observed a stability of clinical activity and FC values (p = 0.90 and p = 0.20), and a concomitant statistically significant decrease in CRP (p = 0.03). There were no differences in steroids/immunosuppressants need or optimizing biological therapy in this group. Finally, drug survival curves of patients who switched from originator to ABP501 and those who continued ADA originator were similar (p = 0.20). Overall, biosimilar drugs seem to be as effective and safe as the originator. Further larger and longer studies are mandatory to understand the clinical implications of these findings.

Background: Adalimumab is an effective and safe biological drug for the treatment of inflammatory bowel disease (IBD). Nowadays, several biosimilar agents are available, but data regarding their efficacy and safety in patients with IBD are still lacking. We aimed to compare the effectiveness and tolerability between adalimumab originator, ABP501 and SB5 biosimilars in patients with IBD in the short term (after induction and after 6 months of treatment) through a propensity score-weighted multicenter cohort study. Methods: We included 156 patients with IBD, 69 patients with ulcerative colitis and 87 patients with Crohn’s disease (CD) receiving ABP501 or SB5 biosimilars from January 2019 to April 2020 for moderate-to-severe disease. For comparison, a group of age- and sex-matched patients treated with adalimumab originator was used. We collected clinical and biochemical data after induction and at 6 months of treatment. Endoscopic data were recorded only at baseline. Results: Overall, clinical benefit was achieved by 86.4% and 85.3% after induction and at 6 months, respectively, without a statistically significant difference between the three treatment groups ( p = 0.68 and p = 0.46). However, after induction, we found significant differences between the two types of the disease (ulcerative colitis or CD, p = 0.004), with a greater clinical benefit achieved by patients with CD. Also, the therapeutic optimization rate between the three drugs was not statistically significant different ( p = 0.30). All treatments showed a good safety profile, with only 10 patients who needed to stop therapy because of adverse events. Conclusion: Adalimumab biosimilars seem to be as effective and safe as the originator in patients with IBD. Surely, they represent a great opportunity to reduce the costs of biological therapies, however larger and longer real-life studies are necessary.

The implementation of waste selective collection (SC) schemes in low-income countries is a challenge although it is one important way for improving environmental sustainability. The inclusion of the population is necessary for gaining effective results, and social surveys are support methods for understanding citizens’ involvement and behaviour. The aim of the research is to assess the support of the citizens concerning the formal and informal recycling in a low–middle income country. The study presents a questionnaire survey conducted in 2018 in La Paz, Bolivia, where 774 citizens were interviewed for evaluating their support to the formal and informal SC systems. Two questionnaires were submitted to two different users’ categories: users of the formal recyclable waste gathering points; and citizens of the neighbourhoods. Evidence of the survey shows that about 8% of the population supports the formal SC while about 48% are used to selecting their waste at home. About 79.2% of them bring the waste to the informal recycling shops or provide it to waste pickers, throwing the waste into or nearby the mixed containers in order to facilitate their collection. This research demonstrates how social inclusion is important for planning recycling systems within a developing big city, starting from the SC. Results suggest that the informal sector can be an effective means for improving the recycling behaviour of the citizens. The study can be of interest to stakeholders involved in introducing recycling policies in developing cities where the SC rate is still low, and informal waste collection exists.

Solid waste open dumping is a big issue in the developing world. Environmental and social impacts due to this practice affect population health, increasing the spread of diseases and child mortality. The safe collection of waste is the first step for reducing these impacts. This research assesses households’ waste collection in a Bolivian developing city with the aim to find a solution to fostering waste safe disposal and recycling. The novelty of the study consists in implementing field analysis together with the use of geographic information systems and the life cycle assessment approach where the lack of data is challenging. Following the results of the research, the system optimization, compared to the current scenario, implies that: (1) collection distances increase by 8%, while the selective collection increases them by 27.8%; (2) the collection coverage increase from 51% to 94% and selective collection switch from zero to 6.7%; (3) about 75% of CO2-eq emissions are reduced, as well as the eutrophication potential (about 55%); (4) recycling reduces the human toxicity potential of 260% and depletion of abiotic resources of 30%; (5) finally, the cost per ton of waste collected reduces from 36.2USD t−1 to 26.5USD t−1, and rises to 39.7USD t−1 if the selective collection is applied. The research demonstrates how waste collection optimization can be implemented obtaining enormous benefits in developing cities. The methods and outcomes presented can be of reference for policymakers and stakeholders of the developing world for addressing safe collection toward sustainable development.

Objective The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. Method Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. Results We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). Conclusion Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.

Despite advances in breast cancer (BC) treatment, its mortality remains high due to intrinsic or acquired resistance to therapy. Several ongoing efforts are being made to develop novel drugs to treat this pathology with the aim to overcome resistance, prolong patient survival and improve their quality of life. We have previously shown that the non-hypercalcemic vitamin D analogues EM1 and UVB1 display antitumor effects in preclinical studies employing conventional cell lines and animal models developed from these cells. In this work, we explored the antitumor effects of EM1 and UVB1 employing BC cells derived from patient-derived xenografts (PDXs), which are a powerful preclinical tool for testing new drugs. We demonstrated that the analogues reduced the viability of HER2-positive and Triple Negative BC-PDXs. Moreover, using an in vitro model of acquired resistance to Trastuzumab-emtansine, UVB1 displayed anti-proliferative actions under 2D and 3D culture conditions. It inhibited both formation and growth of established organoids. In addition, a direct correlation between UVB1 antitumor effects and VDR expression in PDXs was found. In conclusion, all the results reinforce the potential use of these vitamin D analogues as antitumor agents to treat HER2-positive and Triple Negative BC. Fil: Ferronato, María Julia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina Fil: Nadal, Serrano Mercedes. Universidad Autonoma de Barcelona. Hospital Vall D' Hebron. Instituto de Investigación Vall D'hebron; España Fil: Arenas Lahuerta, Enrique Javier. Universidad Autonoma de Barcelona. Hospital Vall D' Hebron. Instituto de Investigación Vall D'hebron; España Fil: Morales, Cristina Bernadó. Universidad Autónoma de Barcelona. Hospital Vall D' Hebron; España Fil: Paolillo, Giuliana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina Fil: Martinez Sabadell, Aliguer Alex. Universidad Autónoma de Barcelona. Hospital Vall D' Hebron; España Fil: Mascaró, Marilina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina Fil: Vitale, Cristian Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Química del Sur. Universidad Nacional del Sur. Departamento de Química. Instituto de Química del Sur; Argentina Fil: Fall, Yagamare. Universidad de Vigo; España Fil: Arribas, Joaquín. Universidad Autónoma de Barcelona. Hospital Vall D' Hebron; España. Universitat Autònoma de Barcelona; España. Centro de Investigación Biomédica en Red de Cáncer; España. Institució Catalana de Recerca i Estudis Avancats; España Fil: Facchinetti, María Marta. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina Fil: Curino, Alejandro Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina

Technological development towards automation has been taking place for years and a wide range of autonomous systems (AS) have been introduced in homes and retailing spaces. Although these AS seem to be riskless, if they are exploited they can endanger private information of users, which opens a new stage for the security of AS. Humans have an initial and positive bias towards automation that might lead to errors related to unintentional actions or lack of actions. Therefore, the effective adoption of AS relies on users’ attitudes, like the propensity to take risks and the calibration of human trust to avoid situations of mistrust, over trust, and distrust, increasing the systems’ security. This study conducted an online questionnaire to investigate the relationship between an individual’s propensity to take risks and trust in automation. We found that participants with low risk seeking tendencies will trust more in AS when compared to high risk seeking participants. Moreover, other individual differences like age, gender, and education led to interesting results. Thus, our study provides valuable information about the human factors that mediate human and autonomous systems interactions and thereby influence trust.

Earth fissures accompanying anthropogenic land subsidence due to excessive aquifer exploitation create significant geohazards in China. Numerical models represent a unique scientific approach to predict the generation and development of earth fissures. However, the common geomechanical simulators fail to reproduce fissure development because they cannot be effectively applied in discontinuous mechanics. An innovative modelling approach developed recently is applied to develop a software to simulate fissure development. The pressure changes are used as forcing factors in a 3D geomechanical model, which combines Finite Elements and Interface Elements to simulate the deformation of the continuous aquifer system and the generation and sliding/opening of earth fissures. The approach has been applied to simulate the earth fissures at Guangming Village in Wuxi, China with land subsidence of more than 1 m caused by the overexploitation of the second confined aquifer. The modelling results highlight that the earth fissures at Guangming Village have been caused by tension and shear stresses. Based on the developed modelling approach and the application case study, a software platform is developed to provide a fast preliminary evaluation of the risk of fissure occurrence associated to land subsidence. The software allows for the simulation of a simplified 2D conceptual geologic model of earth fissures, which can be used to investigate how the main factors controlling the geomechanical response of the aquifer system, such as pressure changes, geometry of aquifer system, geomechanical properties, and depth of bedrock/fault etc.

In the developing world, healthcare waste management is a human health and environmental burden that should be solved for improving sustainability. Solutions should be introduced in the short term, concerning management, planning, financial assistance and expertise. The paper introduces an indicator set for assessing healthcare waste management in developing cities, implemented in La Paz (Bolivia) as a case study. The objective is to suggest an integrated management tool as a first assessment technique to identify the prevailing problems with a healthcare waste management system. Results suggest that, in La Paz, the application of such indicators is useful for evaluating which priorities should be addressed for improving the healthcare waste management system. The tool was applied for introducing a study necessary for the application of new management plans, especially concerning healthcare waste treatment. The method can be replicated in other contexts worldwide, with a focus on the developing world, for comparing cities, management solutions and improvements carried out along the years. The approach is of interest for boosting sustainability and human health, improving the awareness of the actors and policy-makers involved in waste management.

Using a life cycle assessment (LCA) to evaluate municipal solid waste management (MSWM) systems is strongly recommended and the approach has been used in high-income contexts. However, stakeholders in low to middle income countries are not aware of the potential of this approach, mainly due to a lack of financial resources and technical ability. The present work introduces a LCA of MSWM system scenarios into a developing city using an academic licence for the LCA software that is available for use exclusively by researchers. The MSWM system in place in 2018 in La Paz (Bolivia) was assessed according to seven scenarios. The novelty of the research is twofold: the use of LCA academic licensing in a low to middle income region where LCA is unknown as planning tool; and discussing the potential of the approach in conjunction with local and international stakeholders with a view to starting MSWM projects. The results of the analysis allow for the consideration of energy recovery and materials recycling as the main methods by which the environmental impact of MSW can be reduced, as has also been reported by other LCA studies conducted with full licensing of the relevant software. Moreover, the research is the basis for cooperative development projects that will adopt the LCA approach as the main assessment tool. The study discusses the importance of cooperation between universities and local governments for implementing new strategies for MSWM assessment and planning. The research is a contribution towards improving technical knowledge in developing countries for boosting sustainable development.

The universal access to electricity is a very important issue for the country because it is directly related to economic and social development. In this context, Energisa Mato Grosso do Sul, which holds the power concession and distribution for the State of Mato Grosso do Sul, is looking for technical solutions economically viable to universalize the rural area at the Pantanal Sul-Matogrossense that presents challenges due to its extremely peculiar geographical, climatic and environmental characteristics. Therefore, this paper aims to subsidize the planning stages and cadastral survey of individual properties from the South Pantanal area, using geospatial techniques. These techniques include the cartographic mapping of the study area, the spatial analysis of georeferenced data and the development and customization of Geographical Information Systems (GIS). The results are almost 35 thousand linear kilometers of access roads and more than 16 thousand buildings have been mapped, of which at least 29% are still not served by the electricity distribution network. Systems to subsidize the navigation and cadastre the isolated properties were also customized and developed. All of these inputs that allowed the planning and survey steps in the field are carried out with greater efficiency and assertiveness

Schwannomas are common tumors of the nerve sheath that frequently involve the peripheral nerves of the head and neck. This benign slow-growing neoplasm is composed of nerve-supporting cells, and rarely affects the paranasal sinuses. This lesion usually occurs in the middle-aged patients, with an equal sex distribution. Schwannomas are usually solid tumors, although cystic components are rarely seen in head and neck area. MRI can prompt the diagnosis that however relies on histological examination. The present study reports a case of schwannoma of the maxillary sinus, diagnosed in a 38-year-old woman that presented nasal obstruction, pain in the right facial area and hypoesthesia in the area of right infraorbital nerve for past six months. Clinical presentation, radiologic aspects, histological features and treatment of this tumor were reported.

Municipal solid waste management (MSWM) is considered an important public health, economic and environmental concern, especially in developing countries. This paper introduces the situation of MSWM in La Paz (Bolivia) in 2016, and is based on the Wasteaware indicators and waste flow analysis, useful tools for classifying and comparing waste treatment and management plans among other countries. Taking into account the lack of technology in waste treatment and the presence of a developed informal sector, the paper analyses the main strengths and weak points for implementing a sustainable MSWM. The research conducted revealed that the MSWM of La Paz is not efficient with regard to collection, recycling (8%), financial sustainability, and equity of the service. At the same time, local Government and stakeholders are interested in implementing new MSWM methods for improving the current sanitary state of the city and many efforts were made over the last ten years. In general terms, La Paz could be considered as a good study area for developing plans for waste valorization, becoming an example for a low-middle income developing big city of Latin America. The study provided a few considerations about the affordability of the methodology applied and critically analyzed the case study proposed.

Introduction: Metabolism of iron is altered in patients infected with chronically Hepatitis C. The aim of this study is to compare compare the hepcidin levels in between individuais chronically infected with HCV and uninfected individuals. The aim of this study is to compare the hepcidin serum levels between individuals chronically infected with HCV and uninfected individuals. Methods: A cross-sectional study evaluating hepcidin serum levels of mono-infected HCV (n=29), naive, non-diabetic, non-cirrhotic and non-obese patients by means of ELISA, compared to uninfected patients (n=9) with the same characteristics. The degree of liver fibrosis, according to the METAVIR scale on liver biopsies, the lipid profile, the resistance insulin level, as calculated on HOMA-IR (homeostatic model assessment for insulin resistance), the interleukin-6 (IL-6) and the ferritin serum levels were also measured. Results: The levels of hepcidin were significantly lower in HCV patients compared to controls (8.4 pg/mL (±4.94) vs. 19.51 pg/mL (±5.51)) with p

Background: Our aims were to assess the real life effectiveness and safety of the new bismuth-containing quadruple therapy in a large population of patients infected by Helicobacter pylori. Methods: Consecutive dyspeptic H. pylori-positive patients were enrolled, both naïve for treatment and already unsuccessfully treated. Patients were treated with Pylera® 3 capsules 4 times/daily plus omeprazole 20 mg or esomeprazole 40 mg 2 times/daily for 10 days. Eradication was confirmed using a urea-breath test (at least 30 days after the end of the treatment). Efficacy and safety were assessed. Results: A total of 349 patients were treated. H. pylori eradication was achieved in 316 (90.5%, 95% CIs 80.8–1.0) patients in the intention-to-treat population, and in 93.5% (95% CIs 83.5–1.0) in the per-protocol population. No difference in the eradication rate was found between naïve and previously treated patients (91.3 vs. 90.0%, p = 0.901). Adverse events occurred in 55 patients (15.8%, 95% CIs 11.9–20.1). Five patients discontinued treatment: 2 patients suffered from severe abdominal pain, one patient from headache, one patient from diarrhea, and one patient from diffuse urticarial rush. Conclusions: Pylera® achieved a remarkable eradication rate in real life both as first treatment and as a rescue therapy, with a good safety profile.

Landfill is still the main technological facility used to treat and dispose municipal solid waste (MSW) worldwide. In developing countries, final dumping is applied without environmental monitoring and soil protection since solid waste is mostly sent to open dump sites while, in Europe, landfilling is considered as the last option since reverse logistic approaches or energy recovery are generally encouraged. However, many regions within the European Union continue to dispose of MSW to landfill, since modern facilities have not been introduced owing to unreliable regulations or financial sustainability. In this paper, final disposal activities and pre-treatment operations in an area in southern Italy are discussed, where final disposal is still the main option for treating MSW and the recycling rate is still low. Mechanical biological treatment (MBT) facilities are examined in order to evaluate the organic stabilization practices applied for MSW and the efficiencies in refuse derived fuel production, organic waste stabilization and mass reduction. Implementing MBT before landfilling the environmental impact and waste mass are reduced, up to 30%, since organic fractions are stabilized resulting an oxygen uptake rate less than 1600 mgO2 h−1 kg−1VS, and inorganic materials are exploited. Based on experimental data, this work examines MBT application in contexts where recycling and recovery activities have not been fully developed. The evidence of this study led to state that the introduction of MBT facilities is recommended for developing regions with high putrescible waste production in order to decrease environmental pollution and enhance human healthy.

Background Ustekinumab (UST) is an anti-IL12/23 antibody for the treatment of Crohn’s Disease (CD). The aim of this study was to compare the efficacy and safety of UST in a large population-based cohort of CD patients who failed previous treatment with other biologics Methods 194 CD patients (108 males and 86 females, mean age 48 years (range 38–58 years) were retrospectively reviewed. 147 patients were already treated with anti-TNFα (75.8%), and 47 (24.2%) patients were already treated with anti-TNFα and vedolizumab. Concomitant treatment with steroids was present in 177 (91.2%) patients Results At week 12, clinical remission was achieved in 146 (75.2%) patients. After a mean follow-up of 6 months, clinical remission was maintained in 135 (69.6%) patients; at that time, mucosal healing was assessed in 62 (31.9%) patients, and it was achieved in 33 (53.2) patients. Three (1.5%) patients were submitted to surgery. Steroid-free remission was achieved in 115 (59.3%) patients. Both serum C-Reactive Protein and Fecal Calprotectin (FC) levels were significantly reduced with respect to baseline levels during follow-up. A logistic regression, UST therapy as thirdline therapy (after both anti-TNFα and vedolizumab), FC >200 μg/g, and HBI ≥8 were significantly associated with lack of remission. Adverse events occurred in 5 (2.6%) patients, and four of them required suspension of treatment Conclusion Ustekinumab seemed to be really effective and safe in CD patients unresponsive to other biologic treatments, especially when used as second-line treatment.

International audience; This paper corresponds to an illustrated field key of classification of Histic humipedon. Vocabulary and diagnostic horizon definitions are in Humusica 2, article 9. The process of classification can follow a step by step way or simply be realised choosing the right diagnostic horizon on a table and composing the whole profile as in a game of construction. Examples of real profiles are given for comparison with the ones people can find in the field.

Summary Predicting the deformations of deep reservoirs due to fluid withdrawal/injection is a challenging task that could have important environmental, social, and economical impacts. Finite element models, if endowed with an appropriate constitutive law, represent a useful tool for computing the displacements, the deformations, and the stress distributions in reservoir applications. Several studies show that hypoelastic laws, based on a stress-dependent vertical compressibility, are able to provide accurate results, confirmed by in situ and satellite measurements. On the other hand, such laws present some weaknesses related to the numerical implementation, in particular due to the nonsymmetry of the tangent operator. This paper presents a new constitutive model based on 2 invariants (the mean normal and deviatoric stresses), characterized by a variable pressure-dependent bulk modulus K. This constitutive law allows for overcoming most shortcomings of the hypoelastic law, although preserving the same accuracy, reliability, and ease of use and calibration. This paper presents a procedure to identify the parameters of the new model, starting from the typically available data on the vertical compressibility. Numerical results show a good agreement between the 2 laws, suggesting the proposed approach as a valid alternative in reservoir applications.

Currently, simulators are used to analyze the behavior of vehicular networks. In this research, three routing protocols were compared for behavioral and performance analysis in the urban environment. The proactive, reactive and hybrid protocols were applied in the simulator NS2 (Network Simulator), and made a study with TCP and UDP transport protocols applied with varying cars density. The results show that the proactive OLSR protocol obtained the greatest reduction of overhead, the AODV reactive protocol obtained better performance for the transfer rate at the TCP level. In addition, the hybrid protocol ZRP obtained the best results referring to the reduction of the latency and increase of the rate of delivery. Thus, it has been shown to be a potential protocol to be applied to cars density variation in systems that require high scalability as critical applications for vehicular networks.

Human respiratory syncytial virus is the main cause of respiratory infections in infants. Several HRSV genotypes have been described. Goals. To describe the main genotypes that caused infections in São Paulo (2013–2015) and to analyze their clinical/epidemiological features. Methods. 94 infants (0–6 months) with bronchiolitis were studied. Clinical/epidemiological information was collected; a search for 16 viruses in nasopharyngeal secretion (PCR-real-time and conventional, sequencing, and phylogenetic analyses) was performed. Results. The mean age was 2.4 m; 48% were male. The mean length of hospital stay was 4.4 d (14% in the Intensive Care Unit). The positive rate of respiratory virus was 98.9%; 73 cases (77.6%) were HRSV (76,7% HRSVA). HRSVA formed three clusters: ON1 (n=34), NA1 (n=1), and NA2 (n=4). All HRSVB were found to cluster in the BA genotype (BA9-n=10; BA10-n=3). Clinical analyses showed no significant differences between the genotype AON1 and other genotypes. Conclusion. This study showed a high rate of HRSV detection in bronchiolitis. HRSVA ON1, which has recently been described in other countries and has not been identified in previous studies in the southeast region of Brazil, was predominant. The clinical characteristics of the infants that were infected with AON1 were similar to infants with infections by other genotypes.

This article is related to the dissertation entitled Interfaces between the institutional assessment and management of institutions of higher learning: a study of the Sinaes. Law 10,861 of 2004, which established the National System for Assessment of Higher Education - Sinaes - and its subsequent adaptations present an implicit model of administration aimed at institutions of higher learning, by indicating actions and strategies for their management, composing indicators for final assessment. With the institutionalization of the Sinaes, the assessment came to occupy a central position in the policy for regulating the supply, quality and expansion of higher education based on indicators. The question of this study is focused on the centrality occupied by the assessment as a supplier of indicators for purposes of regulation. The central objective is to identify and analyze the interfaces of the dimensions of the Sinaes with the dimensions of the public administration, based on the management theory of Drucker (2012). The study is qualitative in nature, with a dialecticcritical approach, without neglecting the quantitative aspects in the process of analysis and discussion. Documental research was used (Laville & Dione, 2009), considering as material for analysis legal instruments, in printed and electronic form, as well as information and data obtained from consulting the Ministry of Education/National Institute of Educational Studies - MEC/Inep. The results demonstrate a clear relationship between the assessment model proposed by the MEC, through the Sinaes, and the administrative dimension of the institutions of higher learning. The dimensions of the assessment process are in line with the characteristics of the management model considered (Drucker, 2012), mainly the focus on actions and strategies for planning and their results. This assessment is inherent in public administration, but there is worry over the human character of these entities, because the performance of any management act depends on results, and it is the results that transform management. Key-words: administration, assessment, management, Sinaes, regulation.

The practice of designers has recently evolved from a relatively closed ecosystem of professional actors to an ecosystem with less clear boundaries and roles. Makers can be considered (and often are) designers or a new kind of designers working with open, peer-to-peer, distributed and DIY approaches. And both makers and designers increasingly work with social innovation initiatives, becoming thus social entrepreneurs or collaborating with them. Where are makers, designers and social entrepreneurs, how many are there, how do we reach them and network them? This article presents a first exploration of literature, cases and datasets that represent direct or indirect approaches for mapping where they can be found. These formal or informal approaches are clustered in three groups: work, place and community. Each dimension generates a different perspective with different approaches and datasets, which influences our view and definition of makers, designers and social entrepreneurs.

The analysis of municipal solid waste (MSW) selective collection (SC) scenarios is compulsory for planning future policies and actions towards circular economy. The use of geographic information system (GIS) is appropriated for obtaining reliable data about SC yields and management costs. However, in low-middle income countries, advanced assessments are difficult to introduce due to the lack of technical knowledge, financial support and the presence of the informal recycling sector. This research aims to assess the main potentialities of the introduction of SC systems in a Bolivian developing city taking into account the informal SC system in place. The study was conducted with QGIS3.8 software in order to evaluate the main advantages of the implementation of formal and informal recycling chains. Results reported that, comparing the implementation of formal SC of MSW with the scenario that considered the inclusion of the informal recycling, the activity of waste pickers allows reducing the expenses of about 10%, increasing the recycling rate of about 3.5%, and reducing the distances traveled with compactor trucks of about 7%. It means that, the annual path traveled by the collection trucks for gathering about 16,000ty-1, is reduced by 2734kmy-1, reducing the waste disposed to landfill of about 543.6ty-1 and the expenses of about €59,000 per year. The presentation of these results to policy-makers can support decision-making boosting the implementation of recycling activities including waste pickers. The study provided a contribution to the scientific literature assessing the main challenges and opportunities for implementing the circular economy in developing regions.