Search

Abstract The ongoing COVID-19 pandemic caused by SARS-CoV-2 has affected millions of people worldwide and has significant implications for public health. Host transcriptomics profiling provides comprehensive understanding of how the virus interacts with host cells and how the host responds to the virus. COVID-19 disease alters the host transcriptome, affecting cellular pathways and key molecular functions. To contribute to the global effort to understand the virus’s effect on host cell transcriptome, we have generated a dataset from nasopharyngeal swabs of 35 individuals infected with SARS-CoV-2 from the Campania region in Italy during the three outbreaks, with different clinical conditions. This dataset will help to elucidate the complex interactions among genes and can be useful in the development of effective therapeutic pathways.

Abstract Background The functional results of total elbow arthroplasty (TEA) are controversial and the medium- to long-term revision rates are relatively high. The aim of the present study was to analyze the stresses of TEA in its classic configuration, identify the areas of greatest stress in the prosthesis–bone–cement interface, and evaluate the most wearing working conditions. Materials and methods By means of a reverse engineering process and using a 3D laser scanner, CAD (computer-aided drafting) models of a constrained elbow prosthesis were acquired. These CAD models were developed and their elastic properties, resistance, and stresses were studied through finite element analysis (finite element method—FEM). The obtained 3D elbow-prosthesis model was then evaluated in cyclic flexion–extension movements (> 10 million cycles). We highlighted the configuration of the angle at which the highest stresses and the areas most at risk of implant mobilization develop. Finally, we performed a quantitative study of the stress state after varying the positioning of the stem of the ulnar component in the sagittal plane by ± 3°. Results The greatest von Mises stress state in the bone component for the 90° working configuration was 3.1635 MPa, which occurred in the most proximal portion of the humeral blade and in the proximal middle third of the shaft. At the ulnar level, peaks of 4.1763 MPa were recorded at the proximal coronoid/metaepiphysis level. The minimum elastic resistance and therefore the greatest stress states were recorded in the bone region at the apex of the ulnar stem (0.001967 MPa). The results of the analysis for the working configurations at 0° and 145° showed significant reductions in the stress states for both prosthetic components; similarly, varying the positioning of the ulnar component at 90° (− 3° in the sagittal plane, 0° in the frontal plane) resulted in better working conditions with a greater resulting developed force and a lower stress peak in the ulnar cement. Conclusion The areas of greatest stress occur in specific regions of the ulnar and humeral components at the bone–cement–prosthesis interface. The heaviest configuration in terms of stresses was when the elbow was flexed at 90°. Variations in the positioning in the sagittal plane can mechanically affect the movement, possibly resulting in longer survival of the implant. Level of evidence: 5

In this study, we present a new instrument, the Participation and Engagement Scale (PES), for the evaluation of the students' involvement in STEM-oriented activities. The instrument was administered to about 1000 secondary school students who participated in the activities of the Italian "Piano Nazionale Lauree Scientifiche" in Biology, Chemistry and Physics. The activities were carried out in a remote modality due to the COVID-19 restrictions. Through an exploratory and confirmatory factor analysis, it was possible to validate a two-factor structure of the instrument: satisfaction towards the activities and value of the activities. The proposed factor structure shows a good model fit, with each of the obtained scales displaying excellent reliability. Construct-related validation evidence was obtained through the Rasch analysis, which allowed further psychometric improvement of the instrument. Convergent validation evidence was established through a correlation with the academic motivation and perceived difficulties scales. Using the proposed instrument, we found no statistically significant relationships between engagement, the different types of science activities attended, and the intention to enroll in a STEM course. Implications of the study for the evaluation of public understanding of science activities in both remote and in-presence modalities are also discussed.

Every year, new compounds contained in consumer products, such as detergents, paints, products for personal hygiene, and drugs for human and veterinary use, are identified in wastewater and are added to the list of molecules that need monitoring. These compounds are indicated with the term emerging contaminants (or Contaminants of Emerging Concern, CECs) since they are potentially dangerous for the environment and human health. To date, among the most widely used methodologies for the removal of CECs from the aquatic environment, adsorption processes play a role of primary importance, as they have proven to be characterized by high removal efficiency, low operating and management costs, and an absence of undesirable by-products. In this paper, the adsorption of ibuprofen (IBU), a nonsteroidal anti-inflammatory drug widely used for treating inflammation or pain, was performed for the first time using two different types of geopolymer-based materials, i.e., a metakaolin-based (GMK) and an organic–inorganic hybrid (GMK-S) geopolymer. The proposed adsorbing matrices are characterized by a low environmental footprint and have been easily obtained as powders or as highly porous filters by direct foaming operated directly into the adsorption column. Preliminary results demonstrated that these materials can be effectively used for the removal of ibuprofen from contaminated water (showing a concentration decrease of IBU up to about 29% in batch, while an IBU removal percentage of about 90% has been reached in continuous), thus suggesting their potential practical application.

ABSTRACTCurrent treatment for celiac disease (CD) is adhering to a gluten-free diet (GFD), although its long-term molecular effects are still undescribed. New molecular features detectable in stool may improve and facilitate noninvasive clinical management of CD. For this purpose, fecal small non-coding RNAs (sncRNAs) and gut microbiome profiles were concomitantly explored in CD subjects in relation to strict (or not) GFD adherence over time. In this observational study, we performed small RNA and shotgun metagenomic sequencing in stool from 63 treated CD (tCD) and 3 untreated subjects as well as 66 sex- and age-matched healthy controls. tCD included 51 individuals on strict GFD and with negative transglutaminase (TG) serology (tCD-TG-) and 12 symptomatic with not strict/short-time of GFD adherence and positive TG serology (tCD-TG+). Samples from additional 40 healthy adult individuals and a cohort of 19 untreated pediatric CD subjects and 19 sex/age matched controls were analyzed to further test the outcomes. Several miRNA and microbial profiles were altered in tCD subjects (adj. p

Abstract Background The 8q24 locus is enriched in cancer‐associated polymorphisms and, despite containing relatively few protein‐coding genes, it hosts the MYC oncogene and other genetic elements connected to tumorigenesis, including microRNAs (miRNAs). Research on miRNAs may provide insights into the transcriptomic regulation of this multiple cancer‐associated region. Material and methods We profiled all miRNAs located in the 8q24 region in 120 colorectal cancer (CRC) patients and 80 controls. miRNA profiling was performed on cancer/non‐malignant adjacent mucosa, stool, and plasma extracellular vesicles (EVs), and the results validated with The Cancer Genome Atlas (TCGA) data. To verify if the 8q24‐annotated miRNAs altered in CRC were dysregulated in other cancers and biofluids, we evaluated their levels in bladder cancer (BC) cases from the TCGA dataset and in urine and plasma EVs from a set of BC cases and healthy controls. Results Among the detected mature miRNAs in the region, 12 were altered between CRC and adjacent mucosa (adj. p

Background: There is still no consensus on perioperative pain control techniques in patients undergoing laparoscopic surgery; protocols of conventional therapy can be improved by the use of perioperative anaesthesiologic techniques, such as epidural or loco-regional analgesic administration as transversus abdominis plane (TAP) block. The aim of this evaluation was to investigate the role of laparoscopic-assisted TAP block during repair of diastasis recti associated with primary midline hernias in term of post-operative pain relief. Materials and Methods: This was a retrospective evaluation of a prospectively maintained database including patients undergoing laparoscopic repair of diastasis recti associated with primary ventral hernia. Patients were divided into two groups: Group A patients (n = 34) received laparoscopic-assisted bilateral TAP-block of 7.5 mg/ml ropivacaine for each side and Group B patients (n = 29) received conventional post-operative therapy. All patients received 24 h infusion of 20 mg morphine; pain was checked at 6, 24 and 48 h after surgery by numeric rating scale (NRS) score. A rescue analgesia by was given if NRS score was >4 or on patient request. Results: No differences in operative time, complications and post-operative stay, no complications related to TAP-block technique were found. Post-operative pain scores (determined by NRS) were found to be significantly different between groups. Group A patients showed a significant reduction in NRS score at 6, 24 and 48 h (P < 0.005) and in the number of patients requiring further analgesic drugs administration (P < 0.005) compared to Group B patients. Conclusions: Laparoscopic-guided TAP-block can be considered safe and effective in the management of post-operative pain and in the reduction of analgesic need in patients undergoing laparoscopic repair of diastasis recti and ventral hernias. The non-randomised nature of the study and the lack of a consistent series of patients require further evaluations.

Abstract Clonal hematopoiesis of indeterminate potential (CHIP) is characterized by the presence of clones of mutated blood cells without overt blood diseases. In the last few years, it has emerged that CHIP is associated with atherosclerosis and coronary calcification and that it is an independent determinant of cardiovascular mortality. Recently, CHIP has been found to occur frequently in patients with calcific aortic valve disease (CAVD) and it is associated with a poor prognosis after valve replacement. We assessed the frequency of CHIP by DNA sequencing in the blood cells of 168 CAVD patients undergoing surgical aortic valve replacement or transcatheter aortic valve implantation and investigated the effect of CHIP on 12 months survival. To investigate the pathological process of CAVD in CHIP carriers, we compared by RNA-Seq the aortic valve transcriptome of patients with or without CHIP and non-calcific controls. Transcriptomics data were validated by immunohistochemistry on formalin-embedded aortic valve samples. We confirm that CHIP is common in CAVD patients and that its presence is associated with higher mortality following valve replacement. Additionally, we show, for the first time, that CHIP is often accompanied by a broad cellular and humoral immune response in the explanted aortic valve. Our results suggest that an excessive inflammatory response in CHIP patients may be related to the onset and/or progression of CAVD and point to B cells as possible new effectors of CHIP-induced inflammation.

Cytoplasmic accumulation of RNA binding protein, hnRNPK in cancer cells is associated with poor prognosis. Here the authors show that SCFFbxo4 E3 ubiquitin ligase-mediated polyubiquitylation of hnRNPK restricts c-Myc translation and limits cancer progression.

Abstract Background Ovarian cancer (OC) is characterized by a low response rate and high frequency of resistance development to currently available treatments. The therapeutic potential of histone methyltransferase DOT1L inhibitor in OC cells has been demonstrated, but optimal efficacy and safety of this targeted therapy approach still require improvement. We set forth to evaluate if this problem can be overcome by combinatorial targeting of this epigenetic modifier and menin, one of its functional partners in chromatin. Methods siRNA-mediated gene knock-down and pharmacological inhibition of menin, a key component of the MLL/SET1 complex and a fitness gene in OC cells, coupled to cell proliferation assays on a panel of high grade serous OC cell lines, including chemotherapy-sensitive and -resistant clones, were applied in order to evaluate how depletion or blockade of this enzyme influences growth and viability of OC cells. RNA sequencing was applied to identify menin target genes and pathways, and the effects of combined inhibition of menin and DOT1L on growth and transcriptome of these OC models were evaluated. Results Silencing and pharmacological inhibition of menin exert antiproliferative effects in all OC cells tested and, in PEO1 and PEO4 cells, a profound impact on transcriptome via down-regulation of cell cycle regulatory pathways, aryl hydrocarbon receptor, MYC and KRAS signalling. We demonstrated association of menin and DOT1L in OC cells and identified a subset of genes co-regulated by the two factors. Interestingly, co-treatment with DOT1L and menin pharmacological inhibitors exerts an additive effect on growth inhibition on chemotherapy-sensitive and -refractory OC cells mediated by transcriptome changes controlled by menin and DOT1L activities. Conclusion These results indicate that menin functionally cooperates with DOT1L in OC cells modulating transcription of genes involved in key cellular functions including, among others, cell proliferation and survival, that are strongly affected by combined inhibition of these two epigenetic regulators, suggesting that this may represent a novel therapeutic strategy for chemotherapy-resistant OCs. Trial registration NA; The manuscript does not contain clinical trials.

Abstract Background Proximal humeral fractures are commonly observed in elderly patients. Management of these injuries is controversial. Literature comparing locking plate fixation, arthroplasty, and conservative treatments show no clear advantages for any of these management strategies. Thus far, no study has considered anatomically reduced fractures obtained after locking plate treatment. To clarify the best surgical procedure in middle-aged patients, we considered outcomes and major complications leading to surgical revision following an anatomically reduced fracture fixed with locking plate and reverse shoulder arthroplasty (RSA) in the treatment of type B/C fractures in patients between 50 and 75 years of age. Methods This is a retrospective study including 59 patients between 50 and 75 years of age with type B/C proximal humeral fracture treated with RSA or with locking plate fixation (resulting in an anatomical reduction) between January 2010 and December 2018. Preoperative radiographs and computed tomography (CT) were evaluated in all patients. Clinical and radiologic follow-up was performed using range of motion (ROM), the Constant–Murley Score (CMS), the Oxford Shoulder Score (OSS), the Simple Shoulder Test (SST), the Subjective Shoulder Value (SSV), and visual analog scale (VAS). Major complications were considered. Results In the plate fixation group, ROM, CMS, SST, and VAS were higher than in the RSA group. Lower complication rates compared with the literature were observed in both groups. Anatomically reduced fracture fixed with plate and screw could outperform RSA in terms of outcome. In second-level centers where traumatology is performed by surgeons with great expertise in upper limb trauma, the choice between plate fixation and reverse arthroplasty should be made during surgery. Conclusion Anatomically reduced fractures showed better outcomes compared with RSA in type B/C fractures. Surgeons should always try to perform a reduction of the fracture in order to understand if a plate fixation could be feasible. If it is impossible to perform an anatomical reduction, we suggest to consider RSA. This is a retrospective observational study.

Plasmonic and Photonics applications of superconducting materials, suggested at first by the necessity to minimize the dissipative losses of conventional metals in the high frequency ranges, are topics of growing interest in Optics. In this perspective, GdSr2RuCu2O8-δ (Gd1212) Rutheno-Cuprate Superconductor presents very promising properties, showing both superconducting and magnetically ordered phases coexisting in the same cell. To investigate its features, the fabrication of macroscopic crystallographically oriented samples is necessary. The use of melt texturing techniques has shown to be among the most effective ways to achieve the best characteristics, although the fabrication of high-quality Gd1212 samples is intrinsically difficult. To reach a better understanding of Gd1212 incongruent melting reaction, a series of bulk samples annealed at temperatures below and above the melting temperature was prepared. Raman Microscopy and Mapping performed on molten and re-solidified samples revealed the presence of different phases, corresponding to those identified in our previous studies. These observations were also confirmed by XRD, TGA-DTA, and SEM+EDS characterisations. Secondary phases formation showed a strong dependence on the temperature of the annealing treatments. Susceptibility and magnetization measurements show both superconducting and magnetic transitions and a contribution of different spurious magnetic phases as suggested by EDS.

In the framework of the activities coordinated by the EUROfusion consortium, the Water thermal-HYDRAulic (W-HYDRA) experimental platform is being built at the ENEA Brasimone Research Centre in order to support the development of the Water-Cooled Lead Lithium (WCLL) Breeding Blanket (BB). In particular, this infrastructure will make possible the installation and testing of prototypical mock-ups under relevant working conditions, such as the First Wall (FW), the manifold and the Steam Generator (SG). Moreover, it will represent an integral test facility for the investigation of phenomena characteristic of WCLL BB concept, such as the PbLi/water interaction. Finally, the collection of data coming from the different planned experimental campaigns will allow to qualify and validate numerical models and codes currently adopted for the design of components, as well as for the modelling of complex phenomena typical of the WCLL BB. In order to come to a definitive design of the different facilities constituting the experimental platform, several design analyses assessing the thermal, hydraulic and structural performances of the different facilities and components are necessary. The paper reports a highlight of the W-HYDRA platform with a general description of the facilities. Some of the most relevant design studies carried out so far are reported as well, highlighting their impact on the evolution of the design.

An overview is presented of the progress since 2021 in the construction and scientific programme preparation of the Divertor Tokamak Test (DTT) facility. Licensing for building construction has been granted at the end of 2021. Licensing for Cat. A radiologic source has been also granted in 2022. The construction of the toroidal field magnet system is progressing. The prototype of the 170 GHz gyrotron has been produced and it is now under test on the FALCON facility. The design of the vacuum vessel, the poloidal field coils and the civil infrastructures has been completed. The shape of the first DTT divertor has been agreed with EUROfusion to test different plasma and exhaust scenarios: single null, double null, X-divertor and negative triangularity plasmas. A detailed research plan is being elaborated with the involvement of the EUROfusion laboratories.

Abstract Background Targeting vulnerabilities of cancer cells by inhibiting key regulators of cell proliferation or survival represents a promising way to overcome resistance to current therapies. In breast cancer (BC), resistance to endocrine therapy results from constitutively active or aberrant estrogen receptor alpha (ERα) signaling to the genome. Targeting components of the ERα pathway in these tumors represents, therefore, a rational way toward effective new treatments. Interaction proteomics identified several proteins associated with ERα in BC cells, including epigenetic complexes controlling gene transcription comprising the scaffold protein menin and the histone methyltransferase Dot1L. Methods We combined chromatin immunoprecipitation, transcriptome sequencing, siRNA-mediated gene knockdown (kd), pharmacological inhibition coupled to cellular and functional assays and interaction proteomics in antiestrogen (AE)-sensitive and AE-resistant human BC cell models to: map menin and Dot1L chromatin localization, search for their common and specific target genes, measure the effects of single or combinatorial knockdown or pharmacological inhibition of these proteins on cell proliferation and survival, and characterize their nuclear interactomes. Results Dot1L and menin associate in MCF-7 cells chromatin, where they co-localize in a significant fraction of sites, resulting in co-regulation of genes involved, among others, in estrogen, p53, HIF1α and death receptor signaling, regulation of cell cycle and epithelial-to-mesenchymal transition. Specific inhibitors of the two factors synergize with each other for inhibition of cell proliferation of AE (tamoxifen or fulvestrant)-sensitive and AE-resistant BC cells. Menin and Dot1L interactomes share a sizeable fraction of their nuclear partners, the majority being known BC fitness genes. Interestingly, these include B-WICH and WINAC complexes that share BAZ1B, a bromodomain protein comprising a tyrosine–protein kinase domain playing a central role in chromatin remodeling and transcriptional regulation. BAZ1B kd caused significant inhibition of ERα expression, proliferation and transcriptome changes resulting in inhibition of estrogen, myc, mTOR, PI3K and AKT signaling and metabolic pathways in AE-sensitive and AE-resistant BC cells. Conclusions Identification of a functional interplay between ERα, Dot1L, menin and BAZ1B and the significant effects of their co-inhibition on cell proliferation and survival in cell models of endocrine therapy-resistant BC reveal a new therapeutic vulnerability of these aggressive diseases.

Abstract Background Neuroendocrine neoplasms (NENs) represent a heterogeneous class of rare tumors with increasing incidence. They are characterized by the ability to secrete peptide hormones and biogenic amines but other reliable biomarkers are lacking, making diagnosis and identification of the primary site very challenging. While in some NENs, such as the pancreatic ones, next generation sequencing technologies allowed the identification of new molecular hallmarks, our knowledge of the molecular profile of NENs from other anatomical sites is still poor. Methods Starting from the concept that NENs from different organs may be clinically and genetically correlated, we applied a multi-omics approach by combining multigene panel testing, CGH-array, transcriptome and miRNome profiling and computational analyses, with the aim to highlight common molecular and functional signatures of gastroenteropancreatic (GEP)-NENs and medullary thyroid carcinomas (MTCs) that could aid diagnosis, prognosis and therapy. Results By comparing genomic and transcriptional profiles, ATM-dependent signaling emerged among the most significant pathways at multiple levels, involving gene variations and miRNA-mediated regulation, thus representing a novel putative druggable pathway in these cancer types. Moreover, a set of circulating miRNAs was also selected as possible diagnostic/prognostic biomarkers useful for clinical management of NENs. Conclusions These findings depict a complex molecular and functional landscape of NENs, shedding light on novel therapeutic targets and disease biomarkers to be exploited.

Within the EUROfusion roadmap for the technological development of the European-DEMOnstration (EU-DEMO) reactor, a key point has been identified in the discontinuous operation (pulse-dwell-pulse) of the machine. Water Cooled Lithium Lead (WCLL) Breeding Blanket (BB) Primary Heat Transfer Systems (PHTSs) adopt technology and components commonly used in nuclear fission power plants, whose performances could be negatively affected by the above mentioned pulsation, as well as by low-load operation in the dwell phase. This makes mandatory a full assessment of the functional feasibility of such components through accurate design and validation. For this purpose, ENEA Experimental Engineering Division at Brasimone R.C. aims at realizing STEAM, a water operated facility forming part of the multipurpose experimental infrastructure Water cooled lithium lead -thermal-HYDRAulic (W-HYDRA), conceived to investigate the water technologies applied to the DEMO BB and Balance of Plant systems and components. The experimental validation has the two main objectives of reproducing the DEMO operational phases by means of steady-state and transient tests, as well as performing dedicated tests on the steam generator aiming at demonstrating its ability to perform as intended during the power phases of the machine. STEAM is mainly composed of primary and secondary water systems reproducing the thermodynamic conditions of the DEMO WCLL BB PHTS and power conversion system, respectively. The significance of the STEAM facility resides in its capacity to amass experimental data relevant for the advancement of fusion-related technologies. This capability is attributable to the comprehensive array of instruments with which the facility will be equipped and whose strategic location is described in this work. The operational phases of the STEAM facility at different power levels are presented, according to the requirements of the experiments. Furthermore, a preliminary analysis for the definition of the control strategy for the OTSG mock-up was performed. In particular, two different control strategies were identified and tested, both keeping the primary mass flow constant and regulating the feedwater mass flow to follow a temperature set-point in the primary loop. The obtained numerical results yielded preliminary feedback on the regulation capability of the DEMO steam generator mock-up during pulsed operation, showing that no relevant overtemperature jeopardized the facility integrity, thanks to the high system responsivity to rapid load variations.

The Spike protein of SARS-CoV-2 acts as an enterotoxin able to induce chloride secretion and production of reactive oxygen species (ROS), involved in diarrhea pathogenesis. L. rhamnosus GG (LGG) is recommended in pediatric acute gastroenteritis guidelines as a therapy independent of infectious etiology. We tested a postbiotic preparation of LGG (mLGG) in an in vitro model of COVID-associated diarrhea. Caco-2 cell monolayers mounted in Ussing chambers were exposed to Spike protein, and electrical parameters of secretory effect (Isc and TEER) were recorded in the Ussing chambers system. Oxidative stress was analyzed by measuring ROS production (DCFH-DA), GSH levels (DNTB), and lipid peroxidation (TBARS). Experiments were repeated after mLGG pretreatment of cells. The Isc increase induced by Spike was consistent with the secretory diarrhea pattern, which was dependent on oxidative stress defined by a 2-fold increase in ROS production and lipid peroxidation and variation in glutathione levels. mLGG pretreatment significantly reduced the secretory effect (p = 0.002) and oxidative stress, namely ROS (p < 0.001), lipid peroxidation (p < 0.001), and glutathione level changes (p < 0.001). LGG counteracts Spike-induced diarrhea by inhibiting the enterotoxic effect and oxidative stress. The LGG efficacy in the form of a postbiotic depends on metabolites secreted in the medium with antioxidant properties similar to NAC. Because SARS-CoV-2 is an enteric pathogen, the efficacy of LGG independent of etiology in the treatment of acute gastroenteritis is confirmed by our data.

Unexplained and unexpected pediatric deaths are a major challenge in global healthcare. The role of the forensic pathologist is crucial in determining the cause and manner of death in these cases, although to date, there are many limitations in post-mortem diagnosis. The role of the autopsy and related forensic investigations become a fundamental tool to investigate and give an explanation for an unacceptable event, considering the young age of the victims. From this point of view, even today, it is necessary that this phenomenon is correctly recorded through standardized systems and universally accepted methods. Furthermore, it is essential that scientific research on this topic is increased through the implementation of universally accepted operating protocols recognizing real risk factors in order to prevent such events. The purpose of the study is to offer a review of the state of the art about unexplained pediatric death and, above all, to propose an international reporting platform, extending proper investigations not only to judicial cases but also to all the other cases of unexpected pediatric death.

Highlights Anatomical variants of the intraarticular portion of the long head of the biceps tendon should be studied with MR arthrography. Some anatomical variants are more frequently associated with supraequatorial lesions. The higher frequency of lesions in the presence of certain anatomical variants is probably related to the limited excursion of the intraarticular long head biceps tendon.

Introduction Homicide-suicide is a rarer phenomenon than homicides or suicides alone. However, this event shows a devastating psychological impact on relatives with effects on the mental health of survivors. The possibility of early intervention through the identification of psychopathological risk factors in offenders remains a challenge of current forensic psychiatry, also for the geographic heterogeneity of the phenomenon. Objectives The purpose of the work is to offer a homogeneous review of the state of the art on the homicide-suicide phenomenon, focusing attention on the psychopathological characteristics of the offenders and related prevention. Methods A literature review was carried out through the PubMed NCBI search engine by entering the keywords “homicide-suicide” and psychiatry. A screening of the titles was carried out, with reading of the abstracts and full texts only in the selected papers that respected the research objectives. Results The search evidenced 71 papers and only 20 met the inclusion criteria. The review revealed in the vast majority of offenders, most often male, the presence of mental disorders such as major depression and schizophrenia, especially in the context of relationship problems, with triggers such as the fear of separation or partner unfaithfulness. In these cases, the relationship between victim and killer shows pathological dependence or extreme possession. The event can involve children or relatives (filicide/familicide suicides). The review showed the frequent association with psychiatric depressive disorders, and obsessive-compulsive, paranoid, or narcissistic traits, with a lack of specialist consultations and very poor adherence to psychiatric treatment. Firearms were the most widely used means. In the history of perpetrators there were frequent episodes of domestic violence, previous suicide attempts and substance abuse. In rarer cases, the event takes place in the context of mass murder-suicides in which the offender assumes positions of responsibility (eg. Airplane pilot) or acts in extremist religious contexts. Conclusions The review showed an association with mental health disorders and the need for early identification of risk signals. Appropriate psychiatric prevention programs, through the close collaboration of the family, social community and the mass media, are necessary in the management of the phenomenon, especially through the reporting of episodes of domestic violence or self-harming attempts. Disclosure of Interest None Declared

Introduction Suicide is one of the main cause of death in the world. It’s an important public health problem that is growning on new generations. Objectives The manners used to die have always been studied from psychiatry to understand which mental illness induced victim to various ways of suicide. They are multiples and are influenced by different factors. This study includes suicides cases defined “atypical”. Methods The cases were examined at the Insitute of legal Medicine Institute of Magna Graecia University of Catanzaro. Methods used were autopsies, and psycological autopsies. The study of the three cases also included the first level toxicological tests.. Results In the first case, the victim died for cut injuries by using a kitchen knife on the lateral-cervical region of neck; the inspection revealed superficial lesions (test cuts) which, with progressive depth, reached the vascular-nervous bundle. In the second case, in a family contest of apparent welfare, the victim decided to go out home in the middle of the night, to reach an isolated place: there, when he still was in his car, he spilled on his head flammable liquid to accelerate fire effects. In the case number 3, the victim was found at the bottom of a cliff with earplugs; maybe she was hearing voices in her mind that induced her to death. At home, police found a message on paper about her autopsy will. Conclusions The autopsy findings on the cases described are atypical. In every three cases of atypical suicide, the victim was not being treated with therapy, and all victims, probably, were very able to hide their socio-relational malaise. Forensic investigations for the study of suicides must not be limited to the study of fatal injuries. Forensic study about the modalities used to commit suicide wants to be a help to improve knowledge on certain psychiatric pathologies at high risk of suicide. Disclosure of Interest None Declared

Introduction There are about 10 million inmates in the world, of which 6 million are held in American prisons. While in Europe there was a 6.6% reduction in the detention rate, in Italy the number of prisoners is constantly growing. Due to the worldwide importance of the phenomenon in the field of public health, it is necessary to analyze the relationship between detention and prisoner health, as well as the change in the psychophysical state of a subject after a period of incarceration. Objectives The analysis of the results deriving from the completion of forensic examinations was carried with the aim of assessing the compatibility of the health conditions of prisoners with imprisonment. Methods We report the results of a preliminary study on a sample of fifty prisoners held in Southern and Central Italy prisons. Results The average age of the prisoners was 41. The prevalence of psychiatric disorders in the sample examined was about 39 %. 45 % of subjects with mental disorders made one suicide attempt in prison at least. We emphasize the pathogenic role of prison in the development or aggravation of psychiatric disorders. This happens particularly in subjects coming from degraded socio-family backgrounds. Conclusions In order to reduce the prevalence of psychiatric disorders and the risk of suicide, it is necessary to carry out careful medical and psychological evaluation at each new entry, so as to be able to frame the inmate’s state of health and plan periodic monitoring of diagnosed diseases. This evaluation should include a psychiatrist, so as to be able to set up an adequate drug treatment when it’s necessary. The correct management of psychiatric disorders is essential in order to improve the inmate’s mental health and prevent medico-legal consequences for health workers. Disclosure of Interest None Declared

Lipoma is a common soft tissue benign neoplasm originating from the mesenchymal cells of connective tissue. It is a painless neoplasm characterized by slow growth. The incidence in the oral cavity is relatively rare (1–4%). A predisposing cause of the onset in the oral cavity is the continuous trauma due to the action of the teeth. Patients can live with an oral lipoma for several years before experiencing symptoms that usually coincide with speech and chewing disorders. We report a case of unusual, intraoral lip lipoma that caused discomfort to the patient. Case Report: A 72 years old man presented a soft mass in the mucous membrane of the lower lip. The patient reported that he noted the lesion for about 5 years but he decided to treat this condition after a long period since he developed discomfort during speaking and chewing. The patient underwent surgical excision of the lesion, which was then sent for histological examination. Results confirmed the initial hypothesis of lipoma. Conclusions: Lipomas of the oral cavity are slow-growing neoformations that patients usually underestimate or tolerate until they feel disturbances, especially in speaking and chewing, or if they create aesthetic problems. Although lipoma represents a benign condition surgical excision should be recommended and histopathological examination is necessary to confirm the diagnosis.

Abstract Background Elbow arthroscopy is becoming increasingly important for the treatment of a wide range of acute and chronic elbow pathologies. Even if elbow arthroscopy is technically demanding, in the pediatric population this minimally invasive technique is preferred by many surgeons for the treatment of pathologies such as osteochondritis dissecans (OCD), posttraumatic stiffness (PTS), or elbow posterior impingement (PI). The aim of this study is to evaluate outcomes and safety of elbow arthroscopy in the pediatric and adolescent population after long-term follow-up. Materials and methods In this retrospective study, 26 patients younger than 18 years old undergoing elbow arthroscopy were evaluated. All surgeries were performed by a single senior surgeon. Patients were divided into three subgroups based on preoperative diagnosis: OCD, PTS, and PI. After at least 60 months follow-up, several outcome measures, including range of motion (ROM), Mayo Elbow Performance Score (MEPS), and visual analog scale (VAS) were evaluated in relation to preoperative values. The level of patient satisfaction on a five-level Likert scale, any limitation or change in sport activity, and the onset of any possible complications were also evaluated. Results In the study population, we found an improvement in ROM (flexion of 14.4 ± 13.6°, extension of 19.5 ± 13.9°, pronation of 5.8 ± 5.7°, and supination of 8.5 ± 11.6°) and in validated outcome measures (MEPS of 21.0 ± 13.5 points and VAS of 3.8 ± 2.2 points). The satisfaction rate was 4.5, with no dissatisfaction. Eighty-seven percent of patients fully recovered their performance levels, 9% changed sport, and 4% were unable to return to sport. We identified one major and one minor complication, with an overall complication rate of 7.7%. No neurovascular injuries were detected. Conclusions Elbow arthroscopy in a pediatric population can be considered an effective and safe procedure for selected pathologies when performed by an experienced surgeon. At long-term follow-up, we reported excellent clinical outcomes (both objective and subjective), with a relatively low complication rate without permanent injuries. Level of evidence Level IV—case series.

Abstract For their stability and detectability faecal microRNAs represent promising molecules with potential clinical interest as non-invasive diagnostic and prognostic biomarkers. However, there is no evidence on how stool miRNA profiles change according to an individual’s age, sex, and body mass index (BMI) or how lifestyle habits influence the expression levels of these molecules. We explored the relationship between the stool miRNA levels and common traits (sex, age, BMI, and menopausal status) or lifestyle habits (physical activity, smoking status, coffee, and alcohol consumption) as derived by a self-reported questionnaire, using small RNA-sequencing data of samples from 335 healthy subjects. We detected 151 differentially expressed miRNAs associated with one variable and 52 associated with at least two. Differences in miR-638 levels were associated with age, sex, BMI, and smoking status. The highest number of differentially expressed miRNAs was associated with BMI (n = 92) and smoking status (n = 84), with several miRNAs shared between them. Functional enrichment analyses revealed the involvement of the miRNA target genes in pathways coherent with the analysed variables. Our findings suggest that miRNA profiles in stool may reflect common traits and lifestyle habits and should be considered in relation to disease and association studies based on faecal miRNA expression.