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Ageing is not only a chronological matter. The following contributions at the crossroad of STS, material gerontology, design, and medical sociology offer alternative views on ageing and care. Ageing emerges as a boundary object through which authors explore the relationship with technologies and technology-based processes and practices. Authors point out that becoming older is a sociomaterial process and emphasize the importance of thinking with care when designing technology as well as the relevance of the socio-technical imaginary in conceptualizing older people.

This special issue contributes to the new academic field known as Socio-gerontechnology, which has emerged at the cross-section of STS and Age Studies. All contributions published in the following pages explore what happens when theories meet practice in the relation between ageing and technology, by pointing out the role of design(ers) in configuring and reconfiguring such a relation. In line with the so-called “engaged program” in STS, these articles address different topics of political importance and pragmatic relevance. Indeed, they share the critique of ageist images that underlie public and specialist discourses around ageing and technology. By combining the emancipatory thrive of critical studies of age and ageing and the nuanced STS approach to the study of the entanglements of ageing and technology, this special issue offers a collection of theoretical elaborations and methodological considerations developed along with empirical analyses. Overall, they explore the practical politics of technology, within the growing field of Socio-gerontechnology.

This paper investigates the physical reasons for the apparently poor conductivity of galvanized steel plates (GSP), which has not yet received a proper explanation. Apparent conductivities as low as 0.1 MS/m were reported in the past, which are incongruously low compared to the DC conductivity of steels (4 to 8 MS/m), or zinc (16.7 MS/m), the most common coating agent used against corrosion in steel products. A comprehensive review of results from metallurgy and materials science is presented, providing insights about the multi-layered structure of zinc-based coatings. These are found to be made of a limited set of intermetallic zinc-iron compounds each characterized by a steeply decreasing conductivity as their iron percentage increases. Depending on the galvanization process the relative thickness of these layers can vary widely, explaining the seemingly random apparent conductivity of GSP. Theoretical modeling of these structures shows that their apparent conductivity scales linearly with the frequency, suggesting that it can be far lower than acknowledged so far. An extensive analysis of power-dissipation data from the literature of GSP-based reverberation chambers confirms these predictions, with multiple instances of apparent conductivities as low as 10 kS/m. The conclusion is not that GSP are hopelessly poorly conductive, but rather that care should be taken in selecting the right coating technology, not only based on corrosion protection and minimizing costs, but also in view of its impact on GSP conductivity.

BackgroundAccording to the international literature, the percentage of nursing home (NH) residents with renal insufficiency is very high, ranging between 22 and 78%. Diminished kidney function represents a risk factor for drug overdosage, adverse drug reactions, end-stage renal disease, disability, morbidity, and mortality. Several studies suggested that screening for chronic kidney disease (CKD) in high-risk and older populations may represent a cost-effective approach to reducing progression to renal failure and CKD mortality.ObjectiveThis study aimed (i) to investigate to what extent CKD may be staged interchangeably by three different creatinine-based estimated glomerular filtration rate (eGFR) equations in a sample of older adults living in long-term care facilities; (ii) to investigate factors explaining differences among eGFR equations; and (iii) to compare the predictivity of different creatinine-based eGFR equations with respect to all-cause mortality.MethodsA total of 522 residents aged 65 years and older participated in a prospective cohort study of 9 long-term care facilities in Calabria. eGFR was calculated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Berlin initiative study (BIS), and full age spectrum (FAS) equations. Disability in at least one activity of daily living (ADL), depression, cognitive impairment, comorbidity, and malnutrition was considered in the analysis. Statistical analysis was carried out by Bland–Altman analysis, and 2-year mortality was investigated by Kaplan–Meier curves and Cox regression analysis.ResultsDepending on the adopted equation, the prevalence of NH residents with impaired renal function (eGFR < 60 ml/min/1.73 m2) ranged between 58.2% for the CKD-EPI and 79.1% for the BIS1 equation. The average difference between BIS and FAS was nearly negligible (0.45 ml/min/1.73 m2), while a significant bias was detected between CKD-EPI and BIS and also between CKD-EPI and FAS (6.21 ml/min/1.73 m2 and 6.65 ml/min/1.73 m2, respectively). Although the eGFR study equations had comparable prognostic accuracy in terms of mortality risk, BIS and FAS were able to reclassify NH residents pertaining to a low-risk group with CKD-EPI, and this reclassification improves the discriminative capacity of CKD-EPI with respect to overall mortality.ConclusionDespite the relatively good correlation between eGFRs calculated using all adopted equations, the findings in this study reported clearly demonstrated that CKD-EPI and BIS/FAS equations are not interchangeable to assess eGFR among older people and particularly in institutionalized and frail older subjects.

The paper presents the application of some Virtual Reality technologies developed in the Horizon 2020 i-MARECulture project to the case study of the sunken “Villa con ingresso a protiro”, dated around the II century AD, and located in the Marine Protected Area - Underwater Park of Baiae (Naples).The i-MARECulture project (www.imareculture.eu), in fact, aims to improve the public awareness about the underwater cultural heritage by developing new tool and techniques that take advantage of the virtual reality technologies to allow the general public to explore the archaeological remains outside of the submerged environment.To this end, the paper details the techniques and methods adopted for the development of an immersive virtual tour that allow users to explore, through a storytelling experience, a virtual replica and a 3D hypothetical reconstruction of the complex of the “Villa con ingresso a protiro”.

Since the U.S. military began fighting in Iraq and Afghanistan in 2002, approximately two million military children have seen a parent deploy into harm's way at least once, and many families have experienced multiple deployments. Most deployments end with a parent's safe return home, but more than 50,000 service members have been physically injured in combat, and even more are later diagnosed with traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD). In the worst case, deployed parents do not return at all. This article examines the impact on dependent children of deployments that result in visible or physical injuries (for example, amputations or burns); invisible injuries, including TBI and PTSD; and a parent's death. Seven recommendations for service providers and policy makers are detailed. The article concludes that ultimately more research is needed to evaluate the effectiveness of existing programs and disseminate the findings so that resilience-based family programs can be expanded to providers in the community where families live and receive care.

Vértebra transicional é uma anomalia congênita caracterizada por uma vértebra que assume características anatômicas de outra vértebra em região adjacente e ocorre nas junções cervicotorácica, toracolombar, lombossacra e sacrococcígea. É a anomalia congênita mais comum em cães e gatos, sendo diagnosticada através da radiografia. O presente trabalho tem como objetivo relatar um caso de vértebra de transição toracolombar em um felino, de 11 anos, abordando sobre os achados radiográficos. A paciente foi recebida no Laboratório de Diagnóstico por Imagem e Cardiologia (LADIC) do Hospital de Clínicas Veterinárias da Universidade Federal de Pelotas para realização de radiografia torácica com o objetivo de investigar a presença de metástase pulmonar. Radiografias em incidências ortogonais de tórax foram obtidas e demonstraram a presença de costelas bilateralmente inseridas em primeira vértebra lombar (L1), além de espondiloses ao longo da coluna vertebral torácica. A paciente não possuía sinais clínicos compatíveis com essas alterações vertebrais. A vértebra transicional toracolombar possui grande importância na tomada de decisão de clínicos e cirurgiões perante procedimentos torácicos. O radiologista deve se atentar para essa alteração e comunicá-la para que clínico, cirurgião e tutor tomem conhecimento, evitando assim possíveis erros médicos que prejudiquem o paciente.

A dilatação vólvulo gástrica se instala quando o estômago se enche excessivamente de gás ocasionando uma dilatação, e consequentemente uma rotação do estômago sobre seu eixo mesentérico. A causa desta síndrome é desconhecida, mas exercícios após volumosas refeições favorece a ocorrência desta patologia. Por consequência da distensão seguida de torção gástrica, o estômago comprime a veia cava caudal e veia porta, acarretando em inúmeros distúrbios da circulação que prejudicam diretamente o sistema cardiorrespiratório. Diante deste e de outros fatores a alta taxa de mortalidade é uma realidade, portanto quanto antes o paciente for hospitalizado e diagnosticado, terá mais chances de sobreviver. O tratamento consiste primeiramente em estabilizar o paciente para depois seguir as metas da intervenção cirúrgico.

O traumatismo torácico está entre as afecções mais frequentes na emergência de pequenos animais, podendo se apresentar com diferentes níveis de gravidade. Os achados mais comuns são pneumotórax, hemotórax, fraturas de costelas e hérnias diafragmáticas. Nem sempre essas lesões necessitam de procedimentos cirúrgicos, porém quando o grau de acometimento é elevado, a exploração cirúrgica é aceitável para avaliar a real extensão dos ferimentos internos. O presente trabalho tem o objetivo de relatar um caso de um cão atacado na região torácica, descrevendo sobre a abordagem do paciente politraumatizado, além do diagnóstico, tratamento e cuidados no pós-operatório. O paciente foi atendido no Hospital Veterinário Dra. Renata Saccaro e no momento da consulta apresentava extensas lesões de tecidos moles, pneumotórax e fraturas de costela, resultando na perda da estabilidade do tórax. Após os primeiros atendimentos e exames complementares optou-se por encaminhar ao bloco cirúrgico, onde realizou-se a inspeção dos órgãos torácicos, seguido por toracorrafia com colocação de dreno torácico. O paciente recebeu cuidados intensivos até a sua alta médica e continuou sendo acompanhado até sua completa recuperação. Este trabalho demonstra a importância da agilidade do médico veterinário em diagnosticar as comorbidades que acompanham o paciente politraumatizado para, desta forma, encaminhá-lo para o tratamento efetivo o mais rápido possível e salvar o paciente.

The article explores the experimental didactics promoted by the project Gender, labour and technical culture in 2019, which was conducted through a methodology intersecting public history, didactics of history and fieldwork activities. The interdisciplinary and multimedia approach has been successful in involving students, involved into museums, firms and school rooms. Among them, it is worthwhile mentioning the encounter between schools and firms, which took shape thanks to some visits paid by the students to industrial plants and service companies. The campaign against gender violence, with a specific focus on the world of work, has been included in a historical path aimed at raising awareness on women’s rights, which was developed thanks to audio-visual tools and the direct contact with witnesses. The activities have been described as far as specific goals and implementation actions are concerned, with reference to specific experience able to exemplify how the main principle of history teaching came into practice.

Abstract Background To study the covariation between palatal and craniofacial skeletal morphology in Class III growing patients through geometric morphometric analysis (GMM). Methods In this retrospective study, 54 Class III subjects (24F,30M;7.6 ± 0.8yy) were enrolled following these inclusion criteria: European ancestry, Class III skeletal and dental relationship, early mixed dentition, prepubertal skeletal maturation, familiarity for Class III malocclusion, no pseudo Class III malocclusion. Each patient provided upper digital cast and cephalogram before starting the therapy. Landmarks and semilandmarks were digitized (239 on the casts;121 on the lateral radiographs) and GMM was used. Procrustes analysis and principal component analysis (PCA) were applied to show the principal components of palatal and craniofacial skeletal shape variation. Two-block partial least squares analysis (PLS) was used to assess pattern of covariation between palatal and craniofacial morphology. Results Regarding palatal shape variation, PC with largest variance (PC1) described morphological changes in the three space dimensions, while, concerning the craniofacial complex components, PC1 revealed morphological differences along the vertical plane. A significant covariation was found between palatal and craniofacial shape. PLS1 accounted for more than 61,7% of the whole covariation, correlating the craniofacial divergence to palatal height and width. Conclusions In Class III subjects increments of angle divergence are related to a narrow and high palate.

A tireoide é a glândula endócrina mais importante para regulação da taxa metabólica do organismo animal, sendo assim, as enfermidades que a afetam são de suma importância na clínica médica veterinária. O hipotireoidismo é o distúrbio endócrino que mais afeta os caninos, e existe uma relação importante entre essa moléstia e algumas alterações cardiovasculares, tais como a depressão da atividade cardíaca, uma vez que os hormônios tireoideos estão relacionados com a expressão de algumas estruturas dos cardiomiócitos, tais como os β receptores, que são ativados pelas catecolaminas e assim induzem o aumento da frequência e força de contração cardíaca. Arritmias, ateroesclerose, cardiomiopatia dilatada e até mesmo distúrbios neuromusculares são possíveis patologias secundárias ao hipotireoidismo. O eletrocardiograma contínuo (Holter), é uma importante modalidade para diagnosticar e monitorar o envolvimento cardíaco.

Silvia Tavazzi,1,2 Federica Cozza,1,2 Gabriele Nigrotti,2 Chiara Braga,2 Natalia Vlasak,3 Silvano Larcher,4 Fabrizio Zeri1,2,5 1Department of Materials Science, University of Milano Bicocca, Milan, Italy; 2Research Centre in Optics and Optometry (COMiB), University of Milano Bicocca, Milan, Italy; 3Hoya Vision Care, Amsterdam, the Netherlands; 4Hoya Lens Italy, Milan, Italy; 5Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UKCorrespondence: Silvia Tavazzi Email silvia.tavazzi@unimib.itPurpose: The work was aimed at comparing contrast sensitivity performance in an indoor environment with two filters, which differ only in the presence of a band at 450± 20 nm in the transmittance spectrum.Patients and Methods: Thirty-nine subjects participated. The filters were the Standard (ST) and Professional (PRO) Drive lenses (Hoya, Japan), the latter showing the attenuation band at 450 nm. Photopic contrast sensitivity (CS) was measured at different spatial frequencies from 1.5 to 18 cpd through Functional Acuity Contrast Test with both lenses (LogCSST and LogCSPRO, respectively). The areas under the curves of LogCSST and LogCSPRO as a function of the spatial frequency were also considered.Results: In the range of the measured values of LogCSST for the thirty-nine participants, at each spatial frequency and also for the areas, the difference Δ = LogCSPRO – LogCSST was found to decrease and change sign from positive to negative as a function of LogCSST, thus allowing to deduce a threshold (LogCSthreshold) for LogCSST corresponding to Δ=0. Significant CS worsening was found with the PRO compared to the ST lens for the subjects showing LogCSST > LogCSthreshold. Vice versa, CS improvement was found when LogCSST < LogCSthreshold.Conclusion: In the choice of a blue-filtering lens, practitioners should take into consideration that the attenuation of light in the range 420– 470 nm is expected to produce a CS worsening in subjects showing a relatively high initial CS (higher than a threshold CS). For these subjects, the general reduction of transmitted light intensity prevails on possible advantages. On the contrary, subjects showing a relatively low initial CS are expected to show a CS improvement because the attenuation of light in the range 420– 470 nm is expected to reduce intraocular scattering and to mimic the effect as an optical filter of the human macular pigment, advantages which prevail on the reduction of the transmitted light intensity.Keywords: optometry practice, blue filtering, optics and spectroscopy, intraocular scattering, macular pigment

Abstract Background Salmonella enterica subsp. enterica serovar Napoli (S. Napoli) is among the top serovars causing human infections in Italy, although it is relatively uncommon in other European countries; it is mainly isolated from humans and the environment, but neither the reservoir nor its route of infection are clearly defined. This serovar is characterized by high genomic diversity, and molecular evidences revealed important similarities with typhoidal serovars. Results 179 S. Napoli genomes as well as 239 genomes of typhoidal and non-typhoidal serovars were analyzed in a comparative genomic study. Phylogenetic analysis and draft genome characterization in terms of Multi Locus Sequence Typing (MLST), plasmid replicons, Salmonella Pathogenicity Islands (SPIs), antimicrobial resistance genes (ARGs), phages, biocide and metal-tolerance genes confirm the high genetic variability of S. Napoli, also revealing a within-serovar phylogenetic structure more complex than previously known. Our work also confirms genomic similarity of S. Napoli to typhoidal serovars (S. Typhi and S. Paratyphi A), with S. Napoli samples clustering primarily according to ST, each being characterized by specific genomic traits. Moreover, two major subclades of S. Napoli can be clearly identified, with ST-474 being biphyletic. All STs span among isolation sources and years of isolation, highlighting the challenge this serovar poses to define its epidemiology and evolution. Altogether, S. Napoli strains carry less SPIs and less ARGs than other non-typhoidal serovars and seldom acquire plasmids. However, we here report the second case of an extended-spectrum β–lactamases (ESBLs) producing S. Napoli strain and the first cases of multidrug resistant (MDR) S. Napoli strains, all isolated from humans. Conclusions Our results provide evidence of genomic plasticity of S. Napoli, highlighting genomic similarity with typhoidal serovars and genomic features typical of non-typhoidal serovars, supporting the possibility of survival in different niches, both enteric and non-enteric. Presence of horizontally acquired ARGs and MDR profiles rises concerns regarding possible selective pressure exerted by human environment on this pathogen.

Abstract Background Lung cancer is the leading cause of cancer‐related death. NSCLC accounts for 80–90% of cases. In young patients, adenocarcinoma is the most frequent histotype and 3–7% expresses the rearrangement of ALK oncogene, sensitive to TKIs. Crizotinib is the first ALK inhibitor approved by the FDA. Case We present a case of a 17‐year‐old male with metastatic treatment‐naïve ALK‐positive adenocarcinoma. He was treated with crizotinib and obtained a prolonged response with PFS of 33 months. Conclusion Crizotinib can be extremely effective in adolescents with treatment‐naïve ALK‐positive NSCLC but fail to prevent a central nervous system relapse. Resistance mechanisms need to be investigated.

Attachments are specific features of clear aligner treatment designed to ensure the aligner’s retention and the predictability of tooth movements. The properties of composite resin used for their reproduction play a relevant role to preserve their integrity and shape over the time. Thus, the aim of the present evaluation was to compare the mechanical properties and the wear performance of two nanocomposite by means of mechanical and tribological tests. Twelve samples for both flowable nanocomposite (FNC) and conventional nanocomposite (CNC) were created. The two nanocomposites differ in terms of filler volume and viscosity of the mixture. The following tests were performed: thermal analysis and burning test; flat instrumented indentation test and a compression stress relaxation test; tribological analysis. Wear evaluation was performed by means of a contact probe surface profiler and a TayMap software for the 3D analysis. A customized step-sliding test was conducted to simulate the clinical application of materials with a polymethyl methacrylate (PMMA) ball used as counterpart. Wear evaluation of both resin surfaces and PMMA ball was performed. No differences were found in terms of polymeric nature and quantity of nanoparticles in the matrix. FNC showed lower density values (1.62 g/cm3 ± 0.02) and inorganic percentage residue (41%) than the CNC (respectively 1.95 g/cm3 ± 0.01 and 23%). Significant differences in terms of decrement of stress values, elastic modulus (1,114.12 ± 91.39 MPa), and stress relaxation rate (24.39% ± 3.23) were observed for the CNC when compared to the FNC (respectively, 835.04 ± 184.73 MPa and 40.19% ± 4.65). FNC showed higher values of dynamic friction coefficient (0.72 ± 0.017) and more worn and deeper profiles than the conventional ones. The step-sliding test with a PMMA ball confirmed a higher friction coefficient for FNC and a greater wear of the PMMA surfaces when used against flowable samples. Lower viscosity of FNC ensures a better adaptation during clinical attachment fabrication, whereas it has a negative impact on mechanical properties. CNC showed greater performance and resistance under mechanical stresses than the flowable ones, resulting in being more suitable for clinical needs.

The purpose of the research was to analyze the premolar and canine anchorage loss observed during maxillary molars distalization in subjects with Class II malocclusion treated with clear aligners. A total of 49 subjects (27 females, 22 males, mean age 14.9 ± 6 years) derived from the Department of Orthodontics of the University of Rome “Tor Vergata” were selected according to the following inclusion criteria: Caucasian ancestry, Class I or minor Class II skeletal malocclusion, Class II occlusal relationship, permanent dentition with fully erupted second molars, and good compliance with aligners. Each patient underwent the same non-extractive molar distalization protocol with no auxiliaries other than attachments and Class II elastics. Prior to treatment (T1) and at the end of the first maxillary molars distalization movement (T2), digital dental casts were taken by using an iTero intraoral scanner. Linear measurements were performed in order to evaluate the anchorage loss at the level of the second and first premolars and the canines. The statistical comparison of T2 and T1 values was obtained using a paired t-test (p < 0.05). A statistically significant distalization of the maxillary first permanent molars (2.5 mm) was observed; a slight and not significant anchorage loss of the first and second premolars was assessed, while a statistically significant mesial movement of upper canines (1.33 mm) was highlighted. Clear aligner treatment was effective in obtaining a molar distalization movement. However, during molar distalization, an anchorage loss at the level of upper canines was observed.

Epigenetics, referring to heritable gene regulatory information that is independent of changes in DNA sequences, is an important mechanism involved both in organism development and in the response to environmental events. About the epigenetic marks, DNA methylation is one of the most conserved mechanisms, playing a pivotal role in organism response to several biotic and abiotic stressors. Indeed, stress can induce changes in gene expression through hypo- or hyper-methylation of DNA at specific loci and/or in DNA methylation at the genome-wide level, which has an adaptive significance and can direct genome evolution. Exploring DNA methylation in responses to abiotic stress could have important implications for improving stress tolerance in algae. This article summarises the DNA methylation pattern in algae and its impact on abiotic stress, such as heavy metals, nutrients and temperature. Our discussion provides information for further research in algae for a better comprehension of the epigenetic response under abiotic stress, which could favour important implications to sustain algae growth under abiotic stress conditions, often related to high biosynthesis of interesting metabolites.

In Cynthia Selfe's "Technology and Literacy: A Story about the Perils of Not Paying Attention," she advises that composition teachers "have to pay attention to technology." Similar to Brittany B. Cottrill's discussion of issues of access, this reflective piece pays attention to another issue concerning technology, specifically focusing on computer-equipped classroom designs. Not only has the author questioned the various ways that she uses technology in the classroom, such as blogs, wikis, and social networking sites, but she has also reflected on the advantages and disadvantages of computer-equipped classroom settings. Drawing heavily on Valerie Balester's "The Evolving Computer Classroom for English Studies," where she focuses on the effects of design on student learning, the author has realized how her previous lesson plans oftentimes became difficult to manage in certain computer classroom environments. In this article, she shares what she has learned based on her observations and teaching experience by first describing two computer-equipped classroom settings: University B (UB), a four-year, mid-size, rural, public university located in the Midwest, and University N (UN), a four-year, small-size, rural, private university located in the east. The author discusses how both UB's and UN's classroom designs can affect teaching philosophies and ideologies. Finally, she concludes by reflecting on how teachers can overcome the physical technological environment when design negatively affects their pedagogical goals and student learning.

Trends in International Mathematics and Science Study raised the concern that the United States (US) mathematics teachers place less emphasis on topics and teach a variety of content strands (Goldsmith, Mark & Kantrov, 2000; Kerachsky, 2008). The overall pattern in the US mathematics classrooms today is that primary and upper elementary teachers cover numerous topics before students achieve mastery (Cogan & Schmidt, 1999; National Center for Education Statistics, 1997). To solve this problem, US teachers need to find ways to focus fewer curriculum and study topics with a more in-depth agenda. Curriculum Focal Points for pre-kindergarten through grade 8 mathematics: a quest for coherence (National Council of Teachers of Mathematics, 2006) provides a strong framework that may assist teachers in creating a more coherent and focused mathematics program for students. In this article, the authors discuss example lessons that were implemented and observed in pre-kindergarten, fourth grade and sixth grade classrooms during a year-long professional development program. The overarching goal of this program was to provide appropriate instruction for teachers to organize mathematics standards-based curriculum in geometry, algebra and measurement, using a curriculum that emphasizes a strong conceptual framework. As an outcome of this exploratory research agenda, the authors' intentions were to circulate "best practices" and encourage international connections and discussion when using Curriculum Focal Points (CFP) in global classrooms.

Background: Hospitalized older patients are particularly exposed to adverse health outcomes.Objective: In this study, we aimed at investigating the prognostic interactions between disability in basic activities of daily living (BADL), cognitive impairment, low handgrip strength, anticholinergic cognitive burden (ACB), and depression on 1-year mortality.Setting and Subjects: Our series consisted of 503 older patients discharged from acute care hospitals.Methods: Disability in at least one BADL, ACB, depression, cognitive impairment, and low handgrip strength was considered in the analysis. One-year mortality was investigated by Cox regression analysis and prognostic interactions among study variables were assessed by survival tree analysis.Results: Basic activities of daily living disability, ACB, cognitive impairment, and low handgrip strength were significantly associated with 1-year mortality. Survival tree analysis showed that patients with BADL disability and high ACB carried the highest risk of poor survival [hazard ratio (HR): 16.48 (2.63–74.72)], followed by patients with BADL disability and low ACB (HR: 8.43, 95% CI: 1.85–38.87). Patients with cognitive impairment and no BADL disability were characterized by a lower but still significant risk of mortality (HR: 6.61, 95% CI: 1.51–28.97) and those with high ACB scores and good cognitive and functional performance (HR: 5.28, 95% CI: 1.13–24.55).Conclusion: Basic activities of daily living dependency, cognitive impairment, and ACB score were the three main predictors of 1-year mortality among patients discharged from acute care hospitals; the interaction between BADL dependency and ACB score wasfound to significantly affect survival. Early identification of such high-risk patients may help tailor targeted interventions to counteract their detrimental effects on prognosis.

Selenoproteins are translated via animal domain-specific elongation machineries that redefine dedicated UGA opal codons from termination of translation to selenocysteine (Sec) insertion, utilizing specific tRNA species and Sec-specific elongation factors. This has made recombinant production of mammalian selenoproteins in E. coli technically challenging but recently we developed a methodology that enables such production, using recoding of UAG for Sec in an RF1-deficient host strain. Here we used that approach for production of the human glutathione peroxidases 1, 2 and 4 (GPX1, GPX2 and GPX4), with all these three enzymes being important antioxidant selenoproteins. Among these, GPX4 is the sole embryonically essential enzyme, and is also known to be essential for spermatogenesis as well as protection from cell death through ferroptosis. Enzyme kinetics, ICP-MS and mass spectrometry analyses of the purified recombinant proteins were used to characterize selenoprotein characteristics and their Sec contents. This revealed a unique phenomenon of one-codon skipping, resulting in a lack of a single amino acid at the position corresponding to the selenocysteine (Sec) residue, in about 30% of the recombinant GPX isoenzyme products. We furthermore confirmed the previously described UAG suppression with Lys or Gln as well as a minor suppression with Tyr, together resulting in about 20% Sec contents in the full-length proteins. No additional frameshifts or translational errors were detected. We subsequently found that Sec-containing GPX4 could be further purified over a bromosulfophthalein-column, yielding purified recombinant GPX4 with close to complete Sec contents. This production method for homogenously purified GPX4 should help to further advance the studies of this important selenoprotein.

Purpose: The purpose of this paper is to describe how organizational members became storywriters of an important process of organizational change. Writing became a practice designed to create a space, a time and a methodology with which to author the process of change and create a learning context. The written stories produced both the subjectivity of practical authors and reflexively created the con/text for their reproduction. Design/methodology/approach: A storywriting workshop inspired by a processual and participatory practice-based approach to learning and knowing was held in a research organization undergoing privatization. For six months, 31 organizational members, divided into two groups, participated in writing one story per week for six weeks. The written story had to refer to a fact that had occurred in the previous week, thus prompting reflection on the ongoing organizational life and giving a situated meaning to the change process. Findings: Storywriting is first and foremost a social practice of wayfinding, that is of knowing as one goes. Writing proved to be an effective practice that involved the authors, their narratives and the audiences in a shared experience where all these practice elements became connected and through their connection acquired agency. Originality/value: Narrative knowledge has been studied mainly in storytelling, while storywriting by organizational members has received less attention. This paper explores storywriting both as a situated, relational and material practice and as the process that produces narratives which can be considered for their content and their style.

Purpose: Testicular germ cell tumors are the fourth most common neoplasm in adolescents, accounting for 8% of all tumors in the age group 15–19 years. On rare instances, the primary testicular lesion is not clinically or radiologically evident while nodal or visceral metastases represent the clinical manifestations of the disease. This phenomenon is described as “burned-out testicular tumor.” In this paper, the authors report a single-institution experience with burned-out testicular tumors in adolescents and discuss their clinical implications.Patients and Methods: All the patients diagnosed with metastatic testicular germ cell tumors at Bambino Gesù Children Hospital between January 1, 2010, and June 30, 2020, were included in the study. Patients were categorized into two groups: “primary testicular” and “burned out.” All the patients were staged and treated according to the AIEOP–TCGM 2004 protocol.Results: Eleven patients were classified as “primary testicular,” and five patients were classified as “burned out.” “Burned-out” tumors were associated with the presence of systemic symptoms compared to “primary testicular” tumors (80 vs. 0%; p = 0.0027) and higher aFP, hCG, and LDH levels (p < 0.00001). The “burned-out” population had a statistically significant higher incidence of relevant toxicity than the “primary testicular” population (80 vs. 18%; p = 0.0357) and a worse outcome in terms of both mean overall survival (15 vs. 43 months; p = 0.0299) and mean event-free survival (12 vs. 38 months; p = 0.0164).Conclusion: “Burned-out” testicular tumors seem to be a well-distinct clinical entity with a high treatment-related toxicity and poor prognosis. Further studies are needed to clarify the “burned-out phenomenon” and to identify more effective therapeutic strategies for these patients.

We report a rare case of a 32-year-old male who ingested 32.4 to 54 mg of colchicine and presented after 44 hours. He developed progressive multiple organ failure with shock, acute kidney failure, troponemia, pancytopenia, absolute neutropenia, disseminated intravascular coagulation, acute liver failure, rhabdomyolysis, and lactic acidosis. He also developed electrolyte abnormalities and refractory hypoglycemia. Initial treatment consisted of activated charcoal, fluids, and broad-spectrum antibiotics with supportive treatment of mechanical ventilation, hemodialysis, vasopressors, N-acetylcysteine, colony-stimulating factors, and blood products. Literature shows potential benefit of colchicine-specific Fab fragments for acute toxicity with limited studies and is not currently available in the United States. Further research for N-acetylcysteine protocol for acute liver failure in colchicine toxicity and potential use of colchicine-specific Fab fragments is needed. Our case demonstrates the importance of early use of activated charcoal for ingestion overdose with the incorporation of poison control into multidisciplinary team for coordinated patient care.

The article investigates the wear and friction properties of oscillating strips used for interproximal enamel reduction (IPR) to validate the importance of a standardized sequence for preserving efficiency and lifetime. Topics discussed include the mechanical and tribological evaluation of the strips, qualitative and quantitative assessments of wear patterns, and the impact of prolonged usage on strip performance.

O objetivo do estudo foi estimar a prevalência de nematódeos intestinais em equinos da região sul do Rio Grande do Sul, Brasil. Doze propriedades foram incluídas no estudo. Foram analisados 385 equinos, machos e fêmeas, com idade entre seis meses e 27 anos. As fazendas foram consideradas infectadas quando pelo menos um equino analisado foi positivo. A pesquisa parasitológica foi realizada por meio das técnicas de McMaster e Coprocultura. Ciatostomíneos foram encontrados em todas as propriedades e Strongylus vulgaris em apenas duas. A prevalência de nematódeos intestinais nos equinos foi: Ciatostomíneos (96,36%), Parascaris equorum (12,21%), Oxyuris equi (10,13%) e Strongyloides westeri (3,12%). O conhecimento acerca da prevalência dos nematódeos intestinais poderá contribuir para elaboração de programas de controle parasitário na região.

Background/Aim: Genetic and environmental etiologic factors have been described for maxillary canine impaction, except for the trabecular bone characteristics in the impacted area. The aim of this study was to evaluate the surface area and bone density using cone-beam computed tomography (CBCT) images of patients with maxillary impacted canines.

Abstract Background The aim of the present investigation was to evaluate enamel reduction efficiency, abrasive property decay, and enamel effects between oscillating mechanical and manual systems for interproximal enamel reduction (IPR). Methods Three oscillating strips and three manual strips were tested on twelve freshly extracted premolars blocked in an acrylic cylinder pot by means of a material testing machine. Each strip underwent one test of 8 cycles (30 s each). Both abrasive tracks and teeth surfaces were qualitative evaluated before and after IPR by means of SEM analysis. Efficiency and abrasive property decay of both IPR systems were investigated by the amount of enamel reduction within the eight-cycle testing. Independent t-test was used to evaluate differences in variables between the two systems. Results Mechanical IPR system showed higher efficiency in terms of enamel reduction (p

A radiação ionizante é muito utilizada na medicina diagnóstica e aplicada nos exames de radiografia e tomografia computadorizada. Contudo, é capaz de causar efeitos deletérios aos organismos expostos através de mutações genéticas em células somáticas e germinativas, podendo culminar em morte celular, câncer, lesões de pele e glândulas anexas, lesões oftálmicas e malformações e morte fetal. Portanto, através de um questionário com questões objetivas de múltipla escolha disponibilizado na plataforma Formulários Google avaliou-se o conhecimento da população de Pelotas (RS) sobre os métodos de exames diagnóstico por imagem, os possíveis efeitos maléficos da exposição à radiação ionizante e levantou-se dados acerca do uso de proteção radiológica nos serviços de radiologia. Também foram questionados gênero, escolaridade e sobre possuir ou não formação na área da saúde, buscando correlacionar essas informações às respostas. Observou-se que a maior parte dos respondentes não está esclarecida sobre os exames de diagnóstico por imagem e quais utilizam radiação ionizante. A maioria tem conhecimento sobre alguns riscos da radiação ionizante sobre organismo, porém muitos relataram não lhes ser oferecido equipamentos de proteção radiológica e instrução verbal no momento da realização de exames radiográficos. O presente estudo mostrou a necessidade eminente de se prestar mais esclarecimentos à população sobre o assunto, sobretudo entre profissionais da saúde.

Abstract Background Lab tests on saliva could be useful because of low invasivity. Previous reports indicated that creatinine, uric acid, and potassium are measurable in saliva. For these analytes the study investigated methodology of saliva tests and correlations between plasma and saliva levels. Methods The study enrolled 15 healthy volunteers for methodological analyses and 42 nephropathic patients for plasma-saliva correlations (35 non-dialysis and 7 dialysis). Saliva was collected by synthetic swap right after venipuncture for blood withdrawal. Blood and saliva, unless otherwise indicated, were collected early in the morning after overnight fast and lab tests were performed in fresh samples by automated biochemistry (standard). Methodological analyses included blind duplicates, different collection mouth sites, day-to-day variability, different collection times, and freezing-thawing effects. Analyses on plasma-saliva correlations included post-dialysis changes. Results For saliva lab tests of all analytes, blind duplicates, samples from different mouth sites or of different days were not significantly different but were significantly correlated (differences ≤14.4%; R ≥ 0.620, P ≤ 0.01). For all analytes, mid-morning saliva had lower levels than but correlated with standard saliva (differences ≥15.8%; R ≥ 0.728, P ≤ 0.01). Frozen-thawed saliva had lower levels than fresh saliva for uric acid only (− 17.2%, P

Abstract Background Aim of the study was to evaluate the gelatinolytic activity in the saliva and gingival crevicular fluid from a sample group of subjects with Marfan syndrome. Methods Two groups were analyzed in this case-control study. A group of 28 subjects with Marfan syndrome (MG) was recruited from the Centre for Rare Disease, Marfan Clinic of Tor Vergata University Hospital. The second sample, 23 subjects, with the same characteristics and without any syndrome, was the control group (CG). Saliva and gingival crevicular fluid were collected and transferred to a sterile test tube and stored frozen at − 20 °C until analysis at the Medical Chemistry Laboratory. Gelatin substrate zymography was used for the evaluation and characterization of saliva and crevicular fluid proteinases. Correlation test and Student’s t-test have been used to analyze data. Results In all samples different gelatin-degrading activities were observed. Two bands, which are related to the molecular weights of pro-MMP-9 and active MMP-9, respectively, were detectable in 100% of Marfan and control samples. MMP-2 activity was higher in Marfan group. Additional bands (55/48 kDa), corresponding to the activated forms of collagenase (MMP-13), were observed in saliva samples of both groups. Conclusions The association of an enhanced activity by MMP-13 with an increased amount of active MMP-9 might be an important biomarker for the diagnosis of Marfan syndrome.

Abstract Background Marfan syndrome is a rare autosomal dominant inherited disease of the connective tissue associated with various craniofacial abnormalities. Aim of the present study was to assess the variability of palatal shape in a sample of 31 Marfan patients compared to a control group of no syndromic subjects, in two stages of dentition, by using 3D geometric morphometric analysis. Methods Thirty one growing subjects with Marfan syndrome were selected and divided into two subgroups: MG1 with mixed dentition (10 M, 6F, mean age 7+/− 0.7 years), MG2 with permanent dentition (8 M, 7F, mean age 13+/− 0,5 years). Each subgroup was compared to a control group (CG1 mixed dentition, 9 M, 7F, mean age 7.6+/− 0.5 years; CG2 permanent dentition, 9 M, 6F, mean age 12.8+/− 0.7 years) matched on age, sex distribution, stage of dentition and skeletal maturation. Then the two subgroups were compared one to each other. For each patient maxillary dental casts were taken, scanned and digitized. 3D geometric morphometric methods were applied. Procrustes analysis was used and principal component analysis was performed to reveal the main patterns of palatal shape variation. Results Both Marfan subgroups showed important reductions in the transversal plane associated with a deep palatal vault when compared to the control groups (MG1 vs CG1 P = 0,003; MG2 vs CG2 P = 0,07). Moreover a statistically significant difference between the palatal shape of MG1 and MG2 was found (P = 0.017) showing a significant worsening of palatal depth and constriction from mixed to permanent dentition in Marfan subjects. Conclusion Marfan subjects showed a specific palatal morphology with maxillary constriction and deeper palatal vault when compared to a control group of healthy subjects. The constriction and the depth of the palatal vault in Marfan patients worsen from mixed dentition to permanent dentition more then in no syndromic subjects.

Abstract Background Maxillary protraction with facemask (FM) is an orthopedic approach for treatment of Class III growing patients. Aim of the present investigation was to analyze tension loads produced by two different facial mask (FM) designs on facial skin of subject with skeletal Class III. Methods A three-dimensional (3D) geometry of Delaire and Petit FM models were reconstructed from the original Computer Aided Design (CAD) 3D prototype using software package (ANSYS 5.7). A traction load of 9.8 N inclined of 30° to the occlusal plane was applied combining analytical FM models with a 3D facial model. Resulting stresses and deformations on the skin layer were tested through the von Mises yield criterion. Results Overall tensions were mostly developed on the chin area, while lower stresses were observed on forehead area for both FM designs. When Delaire FM model was tested, maximum stresses were observed on the upper border of the chin cup corresponding to the inferior lip and to marginal gingiva of lower incisors. After Petit FM application, maximum stresses were more extensively localized at the level of both upper border and central area of the chin. Stresses measured on the chin area were significantly higher with Petit FM when compared with Delaire FM (44 KPa versus 29 KPa, respectively). Conclusions Delaire FM determined lower stresses and tensile tensions than Petit FM model. Highest tensions were observed at the level of chin cup area for both Delaire and Petit FM. Stresses following Delaire FM application were mostly observed on the upper border of the chin cup, while Petit FM determined stresses more extensively distributed to the central area of the chin.

The objective of this study was to examine the distal rotation of mesial rotated maxillary first permanent molars in a sample of Class II dental malocclusion adult patients treated with Invisalign Clear Aligners (CA). Forty patients (20 males, 20 females, 22.4 ± 3.9 years) were included in the study sample (Department of Orthodontics of University of Rome “Tor Vergata”). Inclusion criteria were: Caucasian ancestry, complete permanent dentition with fully erupted upper second molars, Class II molar relationship, absence of tooth or craniofacial anomalies or caries and periodontal diseases. Pre-treatment (T1), post-treatment (T2) digital casts, and final ClinCheck simulation models (T2CC) were analysed. To measure the rotation of maxillary first molars, Henry’s angle (H°) was evaluated. Maxillary first molars with an H° > 11° were considered mesio-rotated (in total 59 teeth). The treatment CA protocol included disto-rotation without distalization movements. At T1, T2 and T2CC five measurements on the collected dental casts were analysed: Henry’s angle (H°); mesial buccal expansion (ME); distal buccal expansion (DE); mesial buccal sagittal (MS); and distal buccal sagittal (DS). A comparison between the results of T2-T1 and T2CC-T2 was performed using a paired t-test. The differences between T2-T1 highlighted a significant distal rotation of the maxillary first molars (−7.4°) and an expansion movement of 2.20 mm for ME and 1.50 mm for DE. In the post-treatment, the mesial buccal cusps shifted of 1.0 mm, while the distal buccal cusps showed a distal movement of 0.9 mm. Analysing the H° comparison between T2CC-T2, the difference was −1.1°. The T2CC-T2 comparison in the sagittal plane showed a difference of 0.9 mm for the MS and 0.7 mm for the DS. The accuracy was 82% for molar derotation movement. In conclusion, CA provides the upper arch expansion associated with the upper first molars’ distal rotation. These movements provide 2 mm of improvement in arch perimeter and molar intercuspation.

Background: The objective of this retrospective study was to analyze the morphological changes of the upper arch after two protocols of expansion, the Invisalign® First system and rapid maxillary expansion (RME), in mixed dentition by means of geometric morphometric analysis (GMM). Methods: Digital dental casts of 32 children treated either with RME (RME group: 17 subjects; mean age 8.1 years) or the First system (First group: subjects; mean age 8.4 years) were collected. For both the RG and FG, pre-(T1) and post-treatment(T2) digital models were created. A total of 14 landmarks were digitized and GMM was applied. Procrustes analysis and principal component analysis (PCA) were performed. Results: The PC1 resulting from the T2–T1 comparison in the RG g showed statistically significant morphological changes in the posterior region of the upper arch shape, without significant variations in the anterior region. The comparison of the T2–T1 changes in the FG showed an increase in the transverse dimension at the level of the canine and the first deciduous molar widths, with morphological variation in the anterior region due to frontal teeth alignment. Conclusions: The First system induced shape modifications of the upper arch during expansion in contrast to RME. The FG presented an improvement in the maxillary arch shape, while the RG maintained the initial triangular shape.

Chylothorax is a pleural effusion of >110 mg/dL of triglycerides with a milky appearance with transudative being rare. In this article, we present a case of transudative chylothorax with concurrent chylous ascites that is secondary to congestive heart failure (CHF). A 70-year-old male with CHF with ejection fraction of 10%, coronary artery disease status post coronary artery bypass graft, sleep apnea, chronic kidney disease stage 3, and chronic obstructive pulmonary disease presented with worsening abdominal distention, shortness of breath, and increased lower extremities edema. He denied any cough or fever but had orthopnea and paroxysmal nocturnal dyspnea. He requires monthly paracentesis with drainage of 5 to 9 L each time. On physical examination, he had crackles bilaterally with no wheezes or jugular venous distension. His cardiac examination was unremarkable. He did have abdominal distension with dullness to percussion and a positive fluid wave. There was +2 bilateral pitting edema of lower extremities. He had a diagnostic paracentesis where 9.2 L of cloudy milky fluid was drained and therapeutic thoracentesis where 1.1 L of milky fluid was drained. Pleural fluid for triglycerides was 280. His peritoneal fluid had triglycerides of 671 confirming chylous ascites. CHF can lead to chylous ascites due to the increased lymph production in the abdomen, which flows to the thoracic duct. Due to the stiffness at the lymphatic junction, there is high pressure for less flow. The diaphragm plays a role allowing the chylous ascites to be absorb into the thorax.

Introduction Obtaining informed consent (IC) is an essential medical practice. Utilization of IC role-playing training with medication study cards and self-peer-supervisor review should improve student fund of knowledge and strengthen IC skills for clerkship-level medical students. Methods Between 2017 and 2020, approximately 555 clerkship medical students used our formative role-playing exercise tools. Students independently prepared psychotropic medication study cards and role-played IC during group didactics. Peer and supervisor reviews were not recorded but were discussed as a group. Students completed routine anonymous postclerkship surveys regarding the IC exercise. An enhanced IC curriculum was deployed in 2020, adding a training video and peer/supervisor feedback form. Student feedback and specialty shelf exam scores were reviewed to assess the exercise's effectiveness. Results Surveys indicated satisfaction with the exercise and increased confidence in obtaining IC. Interestingly, the student group that received enhanced IC training had fewer shelf exam failures than those without, perhaps indicating improved fund of psychotropic medication knowledge. Discussion Peer role-playing IC training is well accepted by students, allows practice of essential elements of IC and shared decision-making, and provides an engaging way to improve medication fund of knowledge. Our clerkship has initiated development of an IC objective structured clinical examination station and is adapting the exercise across specialties for longitudinal learning in response to the positive feedback and ease of use. Structured review of psychotropics and peer IC role-playing can be tailored for other specialties, medications, and procedures and further developed for use in pre- and postclerkship education.

The objective of this study was to assess the efficacy of commercial anthelmintics in horses naturally infected with gastrointestinal nematodes from the southern Rio Grande do Sul state, Brazil. The anthelmintic efficacy was assessed by fecal egg count reduction test (FECRT) and coproculture. Fecal samples were collected from 110 animals in seven farms located in the southern region of the state of Rio Grande do Sul, in the south of Brazil. Criteria used to suspect anthelmintic resistance included percentages of efficacy lower than 95% and a lower limit of the confidence interval below 90%. Anthelmintic resistance was detected in five of the seven farms studied. Coproculture results show that, even after horses were treated with anthelmintics, infection by nematodes of the subfamily Cyathostominae was still present in animals from five farms.

Methanol (MeOH) dehydration for Dimethyl ether (DME) production is one of the possible pathways to produce a green, synthetic fuel that can substitute fossil/conventional ones in automotive/transportation applications. DME synthesis in gas phase usually occurs in presence of an acid catalyst at moderate temperature (up to 250 °C). This work deals with the use of MFI-type zeolitic catalysts. H form and desilicated zeolite samples were synthesized, characterized, and tested to investigate their catalytic activity in MeOH dehydration reaction. Ammonia temperature-programmed desorption (NH3-TPD) and Fourier-transform Infrared spectroscopy (FT-IR) analyses were carried out to elucidate the amount and the nature of acid sites. Zeolite sample desilicated for 60 minutes presented a higher amount of Bronsted acid sites (that can be correlated to the superior catalytic activity), while the Turnover frequency (TOF) referred to the amount of Bronsted acid sites is very similar for the investigated samples. Finally, preliminary kinetic investigation via linear fitting of experimental data on the Arrhenius plot was carried out for simple first and second order kinetic models.

The direct synthesis of H2O2 on Pd-based catalysts, although recognized as a potential route for the sustainable production of H2O2, is still limited by the low catalytic selectivity and safety concerns. Here, the calcination treatment effect, with the dispersion of Pd NPs and its interaction with Al2O3, is investigated. Catalysts have been prepared by the sol-immobilization procedure (SI) on Al2O3 as asymmetric alumina membranes (AAS) and tested in both reduced and calcined form (450°C, 1°C/min, 8 h) for the direct synthesis of H2O2. Finally, the catalytic performance was compared with other catalysts, prepared by hydrazine-reduction (NRC) and impregnation-decomposition (IDC) already reported in a previous paper and calcined for a shorter time (450°C, 1°C/min, 6 h). TEM micrographs showed the formation of Pd NPs with average diameters of 12 (NR), 3.8 (IDC), and 3.3 nm (SI), respectively. The reduced SI catalyst has shown a 2-4% selectivity. However, after calcination (SIC), a 69 % selectivity to H2O2 was reached. Compared with NRC and IDC catalysts, the selectivity increased within the series NRC < IDC < SIC. The kinetic analysis of calcined catalysts showed an overall decrease of the hydrogenolysis and direct combustion routes in the series NRC > IDC > SIC. The SIC catalyst's improved performance was related to the increased interaction with the support, stabilizing Pd in its oxidized form.