Search

The ideal management of teeth in the line of mandibular fractures is unclear and controversial. The aim of this study was to analyze the characteristics and management of teeth in the line of mandibular fractures treated with open reduction and internal fixation.Medical records of patients with mandibular fractures in the symphysis, body and angle regions seen between July 2019 and January 2021 were evaluated. Personal data, etiology, location of fractures, characteristics of the teeth involved in the fracture lines and management were collected. The relationship between the fracture lines and the periodontium was classified according to KambooziaPunnia-Moorthy. Fractures were divided into two groups according to the management of the tooth in the fracture line: removal and retention. The likelihood ratio test was used (p .050).During the study period, 52 patients with mandibular fractures were seen, of which 42 patients (83.3% men) with a mean age of 29.6 years and 54 fractures were included. The most frequent location was the angle of the mandible (41.3%) (p .001). The removal group represented 35.2% of the fractures, and the retention group represented 64.8%. The most frequently removed tooth was the third molar (p .001), and the most frequent classification of dental involvement in the fracture line was type II (p = .047). There was no correlation between age, gender, or etiology and the management of the teeth involved.The retention of teeth in the fracture line predominated, and the third molar in angle fractures was the most often removed tooth when the fracture line followed the root surface but did not cross the apical region, probably due to the greater frequency of this type of relationship between the fractures and the periodontium.

Background and aim The application of laparoscopy in elderly patients with gastric cancer is controversial, especially in Western population. The aim of the study is to evaluate the feasibility of a laparoscopic approach and compare short-term outcomes with results obtained using traditional open surgery. Methods Data concerning 52 elderly patients (≥70 years), who underwent distal gastrectomy at our institution from January 2017 to August 2020, were retrospectively analyzed. We divided the population into two cohorts according to the surgical technique (laparoscopic or open surgery) and we compared the short-term outcomes. The open and laparoscopic cohorts were compared in terms of demographics, ASA score, pTNM stage, the pathological pattern according to Lauren classification, time of surgery, selected type of gastrointestinal reconstruction, the extension of lymphadenectomy and number of lymph nodes resected, postoperative complications classified according to modified Clavien-Dindo system, length of stay (LOS), postoperative mortality within 30 days. Univariate and multivariate analyses were performed for length of stay, including age, sex, duration of surgery, BMI, technique, tumor localization, grading, reconstruction, ASA, Lauren stage, extension of lymphadenectomy, TNM stage, and neoadjuvant chemotherapy as variables. Results Demographics, pathological characteristics and surgical outcomes were comparable in both cohorts, except for the length of hospital stay (LOS) that was significative longer in the open cohort (12,31 vs 8,42 P = 0.02). Number of harvested lymph nodes and complete resection (R0) rate were similar, leading to comparable oncological results. Based on the univariate analysis, in addition to the approach, ASA score was another factor significantly associated to LOS (ASA 2 8,4 ± 2,1 days vs ASA 3 13,5 ± 7,8 days). A multiple regression was run to predict LOS from ASA and surgical approach. The multiple regression model statistically significantly predicted LOS, F(3,44) = 6,906, P Conclusion Laparoscopic distal gastrectomy is effective and safe in elderly patients with similar short-term outcomes compared to open distal gastrectomy. The main advantage of laparoscopic technique is a shorter length of hospital stay.

Directly operated relief valves often exhibit abnormal or unstable behavior resulting in noise, premature wear, degraded performance, and failure. In this work, an investigation is carried out to assess the role of the hydraulic damper on the poppet element. The article reports the details of the investigation approach, integrating specific experimental tests with lumped-parameter modelling.Starting from a reference layout, the hydraulic behavior of different damper configurations is characterized (ranging from undamped to strongly damped poppets), for pressure and flow-rate conditions typically encountered in micro-hydraulic power packs. Depending on the damper design, the poppet operation ranges from unacceptability (due to noise) to fine-tuned response. The investigation give the chance to highlight how the damper layout impacts on the valve behaviour, in terms of pressure overshoot and settling time and provides the necessary information for relief valve design, modelling and analysis.

The colonization of Mediterranean Europe and of other temperate regions by Aedes albopictus created in the last decades an unprecedented nuisance problem in highly infested areas, as well as a new public health threat due to the species competence to transmit exotic arboviruses, such as dengue, chikungunya and zika. The Sterile Insect Technique (SIT) and the Incompatible Insect Technique (IIT) are insecticide-free mosquito-control methods relying on mass release of irradiated/manipulated males which are believed to have a potential in complementing existing and only partially effective control tools. Testing and implementing these approaches are challenging and selection of study sites is an instrumental and crucial step. We carried out a 4-year study in Procida Island (Gulf of Naples, Italy) in strict collaboration with local administrators and citizens to estimate: i) the temporal dynamics, spatial distribution, and population size of Ae. albopictus; and ii) the dispersal and survival of irradiated males. Overall, results provide insights on the bionomics of the mosquito in Southern Europe and draw attention to Procida Island as an ideal site to test innovative control programs against Ae. albopictus which may be used in other Mediterranean and temperate areas.”

Background Most cases of pancreatic ductal adenocarcinoma (PDAC) are asymptomatic in early stages, and the disease is typically diagnosed in advanced phases, resulting in very high mortality. Tools to identify individuals at high risk of developing PDAC would be useful to improve chances of early detection. Objective We generated a polygenic risk score (PRS) for PDAC risk prediction, combining the effect of known risk SNPs, and carried out an exploratory analysis of a multifactorial score. Methods We tested the associations of the individual known risk SNPs on up to 2851 PDAC cases and 4810 controls of European origin from the PANcreatic Disease ReseArch (PANDoRA) consortium. Thirty risk SNPs were included in a PRS, which was computed on the subset of subjects that had 100% call rate, consisting of 839 cases and 2040 controls in PANDoRA and 6420 cases and 4889 controls from the previously published Pancreatic Cancer Cohort Consortium I-III and Pancreatic Cancer Case-Control Consortium genome-wide association studies. Additional exploratory multifactorial scores were constructed by complementing the genetic score with smoking and diabetes. Results The scores were associated with increased PDAC risk and reached high statistical significance (OR=2.70, 95% CI 1.99 to 3.68, p=2.54x10(-10) highest vs lowest quintile of the weighted PRS, and OR=14.37, 95% CI 5.57 to 37.09, p=3.64x10(-8), highest vs lowest quintile of the weighted multifactorial score). Conclusion We found a highly significant association between a PRS and PDAC risk, which explains more than individual SNPs and is a step forward in the direction of the construction of a tool for risk stratification in the population.

In this paper, an advanced critical state compatible Bounding Surface (BS) plasticity model for the cyclic response of clays is developed based on a prior version of a Simple Anisotropic CLAY plasticity (SANICLAY) model. With the proposed model, named SANICLAY-BS and abbreviated as S-BS, it is possible to capture the presence of a cyclic stress threshold above which large strains develop leading to the effective stress failure. In addition, the number of cycles to failure can be controlled for a wide range of applied CSRs. Peculiarity of the formulation is the incorporation of a novel activation mechanism into the destructuration law. Model performances in capturing a cyclic resistance curve are shown against the experimental data of Cloverdale clay.

BACKGROUND Over the two past decades, GreenLight laser therapy has been considered a valid alternative for the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia/benign prostatic obstruction (BPH/BPO). However, the debate on the effectiveness of laser therapy compared to conventional techniques is still open. The aim of our study is to analyze and describe the use of GreenLight laser prostate surgery in Italy, with regard to the surgical techniques performed and the surgical and functional outcomes at mid-term follow-up. METHODS From March 2012 to July 2018, patients who underwent GreenLight laser prostate surgery for LUTS due to BPH/BPO from 19 Italian centers were included. The following parameters were evaluated in the population: age, prostate volume, prostate adenoma volume, PSA tot, Q max at uroflowmetry (UFM), International Prostatic Symptoms Score (IPSS), previous therapy for LUTS, use of anticoagulants and antiplatelet drugs. We recorded also the kind of anesthesia, mean laser time (min), mean irradiation time (min), TURP conversion/completion rate, postoperative day of catheter removal, postoperative acute urinary retention (AUR), hospital stay, variation of hematocrit (Ht) and hemoglobin levels (Hb). Early complications were classified according to the Clavien-Dindo classification, the re-operation rate within 30 days and after 30 days, the late complications and the Patient Global Impression of Improvement were also collected. Changes over time in terms of blood loss and functional outcomes (IPSS and Q max at the UFM at 6 and 12 months) were tested with Student's test for paired samples. We assumed P≤0.05 as level of statistical significance. RESULTS Overall, 1077 were enrolled in the study, 554 (56.4%) were treated with standard vaporization and 523 (48.6%) with anatomical vaporization. Student's t-test for paired samples showed no statistically significant differences in terms of reduction of Ht preoperative vs. Ht postoperative (42.80±3.91 vs. 39.93±5.35 95% CI P=0.3) and preintervention and postintervention Hb levels (14.28±1.46 vs. 13.72 P=0.35). Compared with the preoperative Q max (8.60±2.64), the 6- and 12-month UFM showed a significant improvement [19.56±6.29, P

Purpose Multidrug-resistant tuberculosis (MDR-TB) is a major burden to public health in low incidence countries in Europe. The aim of this study was to attempt to have a better insight into the trends of MDR-TB in the metropolitan area of Rome, within the Italian and the foreign-born population, based on microbiological and demographic data. Patients and methods We performed a prospective study, collecting microbiological data based on phenotypic drug-resistant testing (DST) of TB strains consecutively isolated in a referral hospital in Rome, the capital city of a low TB incidence country, over a 6-year period, and correlated them to the geographical origin of patients. This study was carried out in a referral hospital for patients with drug-resistant TB from the whole region. Results Drug-resistance data from 926 patients with a microbiological diagnosis of TB from 2011 to 2016 show a 5.5% rate of MDR-TB, mostly occurring in patients born in a single East European country, that has a high incidence of MDR-TB. The strains isolated from these patients frequently carry additional resistances, leading to an increased risk of developing extensively drug-resistant (XDR) TB. Conclusion In the great metropolitan area of Rome, MDR-TB more frequently occurs in patients who were born in a single country from Eastern Europe known to have high rates of MDR-TB and long-time residents in Italy. Recent immigrants from non-European countries do not appear to contribute to the rates of MDR-TB reported in this article. This knowledge of local TB trends could help improve the measures of surveillance and prevention of disease.

Timely diagnosis of tuberculosis (TB) is essential for effectively controlling and managing the disease. Although international guidelines recommend acid-fast bacilli staining and culture as the 'gold standard', new molecular methods are available to safely and rapidly identify positive samples.To evaluate the performance of the newer and fully automated version of a molecular assay for rRNA amplification (TRCReadyOf four diagnostic protocols employed, best results were obtained when TRCReady M.TB was used together with microscopy on the first respiratory sample, followed by microscopy alone on a second one. The sensitivity and specificity were respectively 97% and 100%, with a turnaround time of 24 h. We propose a possible laboratory algorithm for rapid identification of patients with TB.TRCReady offers the advantages of full automation and avoidance of cross-contamination. As such, it should be considered as a more economical option for TB screening than other commercial assays that are currently available.

In the last decades significant technological advances together with improved modeling capabilities fostered a rapid development of geophysical monitoring techniques in support of hydrological modeling. Geophysical monitoring offers the attractive possibility to acquire spatially distributed information on state variables. These provide complementary information about the functioning of the hydrological system to that provided by standard hydrological measurements, which are either intrinsically local or the result of a complex spatial averaging process. Soil water content is an example of state variable, which is relatively simple to measure pointwise (locally) but with a vanishing constraining effect on catchment-scale modeling, while streamflow data, the typical hydrological measurement, offer limited possibility to disentangle the controlling processes. The objective of this work is to analyze the advantages offered by coupling traditional hydrological data with unconventional geophysical information in inverse modeling of hydrological systems. In particular, we explored how the use of time-lapse, spatially distributed microgravity measurements may improve the conceptual model identification of a topographically complex Alpine catchment (the Vermigliana catchment, South-Eastern Alps, Italy). The inclusion of microgravity data resulted in a better constraint of the inversion procedure and an improved capability to identify limitations of concurring conceptual models to a level that would be impossible relying only on streamflow data. This allowed for a better identification of model parameters and a more reliable description of the controlling hydrological processes, with a significant reduction of uncertainty in water storage dynamics with respect to the case when only streamflow data are used.

La hiperplasia condilar unilateral ha sido estudiada en diferentes aspectos y continua siendo controversial; aun asi, el tratamiento en base a condilectomia se establece como parte del protocolo de trabajo. El objetivo de esta investigacion es reconocer la reparacion osea observada en condilos operados despues de 1 ano mediante tomografia computadorizada cone beam (TCCB). Nueve sujetos fueron incluidos en este estudio (6 sexo femenino y 3 sexo masculino) con una edad promedio de 18,5 anos; en ellos se realizo el diagnostico de hiperplasia condilar unilateral activa mediante estudio de SPECT, seguimiento clinico de la asimetria facial progresiva y TCCB. Se realizo la cirugia de condilectomia exclusiva con sistema piezoelectrico sin reposicion de disco, cirugia ortognatica u otro tipo de procedimiento quirurgico adjunto; posteriormente, los pacientes fueron tratados ortodoncicamente para compensacion dentaria o para preparacion previa a cirugia ortognatica. Se realizo TCCB dentro del primer mes postquirurgico y despues de 1 ano de realizada la cirugia para analisis de variables. Se observo en la TCCB de 1 mes un corte nitido y neto del condilo, sin defectos o irregularidades; la distancia desde el remanente condilar hasta la fosa articular llego hasta 8,5 mm en el caso maximo. Despues de 1 ano, se observo remodelacion osea condilar, con areas de curvatura lateral y superior caracteristicas de condilos normales, con presencia de hueso cortical y con una distancia maxima de 4,5 mm desde la fosa condilar. Se puede concluir que la reparacion y remodelacion condilar es viable de obtenerse en este tipo de cirugias y que la morfologia de condilos resecados despues de 1 ano es bastante proxima de la anatomia macroscopica normal.

BACKGROUND Phytotherapy has been used to treat patients with lower urinary tract symptoms (LUTS). We evaluated the efficacy and tolerability of combination therapy between Serenoa Repens (SeR), Lycopene (Ly), and Selenium (Se) + tamsulosin versus single therapies. METHODS PROCOMB trial (ISRCTN78639965) was a randomized double-blinded, double-dummy multicenter study of 225 patients between 55 and 80 years old, PSA ≤ 4 ng/ml, IPSS ≥12, prostate volume ≤60 cc, Qmax ≤15 ml/sec, postvoid residual urine (PVR)

Dental pulp stem cells (DPSCs) are stem cells found in the dental pulp. The ability of DPSCs to differentiate towards odontoblastic and osteoblastic phenotype was reported first in the literature, then in the following years, numerous studies on odontogenesis were carried out, starting from mesenchymal stem cells isolated from tissues of dental and oral origin. The aim of this research was to evaluate the behaviour of DPSCs grown on silicon nanoporous and mesoporous matrices and differentiated towards the osteogenic phenotype, but also to investigate the use of DPSCs in pilot studies focused on the biological compatibility of innovative dental biomaterials. Twenty-eight silicon samples were created with standardized procedures. These scaffolds were divided into samples made of silicon bulk, nanoporous silicon, mesoporous silicon, nanoporous silicon functionalized with (3-Aminopropyl) Trimethoxysilane (APTMS) and methanol (MeOH), nanoporous silicon functionalized with (3-Aminopropyl) Trimethoxysilane (APTMS)/toluene, mesoporous silicon functionalized with (3-Aminopropyl) Trimethoxysilane (APTMS) and methanol (MeOH) andmesoporous silicon functionalized with (3-Aminopropyl) Trimethoxysilane (APTMS)/toluene. DPSC proliferation on the tested silicon scaffolds was analyzed at 3 and 5 days. The assay showed that DPSCs proliferated better on mesoporous scaffolds functionalized with APTMS/toluene compared to a silicon one. These results show that the functionalization of silicon scaffold with APTMS/toluene supports the growth of DPSCs and could be used for future applications in tissue engineering.

The mitochondrial transporter, the aspartate/glutamate carrier (AGC), is a necessary component of the malate/aspartate cycle, which promotes the transfer into mitochondria of reducing equivalents generated in the cytosol during glycolysis. Without transfer of cytosolic reducing equivalents into mitochondria, neither glucose nor lactate can be completely oxidized. In the present study, immunohistochemistry was used to demonstrate the absence of AGC from retinal glia (Muller cells), but its presence in neurons and photoreceptor cells. To determine the influence of the absence of AGC on sources of ATP for glutamate neurotransmission, neurotransmission was estimated in both light- and dark-adapted retinas by measuring flux through the glutamate/glutamine cycle and the effect of light on ATP-generating reactions. Neurotransmission was 80% faster in the dark as expected, because photoreceptors become depolarized in the dark and this depolarization induces release of excitatory glutamate neurotransmitter. Oxidation of [U-14C]glucose, [1-14C]lactate, and [1-14C]pyruvate in light- and dark-adapted excised retinas was estimated by collecting 14CO2. Neither glucose nor lactate oxidation that require participation of the malate/aspartate shuttle increased in the dark, but pyruvate oxidation that does not require the malate/aspartate shuttle increased to 36% in the dark. Aerobic glycolysis was estimated by measuring the rate of lactate appearance. Glycolysis was 37% faster in the dark. It appears that in the retina, ATP consumed during glutamatergic neurotransmission is replenished by ATP generated glycolytically within the retinal Muller cells and that oxidation of glucose within the Muller cells does not occur or occurs only slowly.

To evaluate the magnetization transfer ratio (MTR) after two different cartilage repair procedures, and to compare these data with the MTR of normal cartilage.Twenty-seven patients with a proven cartilage defect were recruited: 13 were treated with autologous chondrocyte implantation (ACI) and 14 were treated with the microfracture technique (MFR). All patients underwent MRI examinations with MT-sequences before the surgical treatment, after 12 months (26 patients) and after 24 months (11 patients). Eleven patients received a complete follow-up study at all three time points (five of the ACI group and six of the MFR group). All images were transferred to a workstation to calculate MTR images. For every MT image set, different ROIs were delineated by two radiologists. Means were calculated per ROI type in the different time frames and in both groups of cartilage repair. The data were analyzed with unpaired t- and ANOVA tests, and by calculating Pearson's correlation coefficient.No significant differences were found in the MTR of fatty bone marrow, muscle and normal cartilage in the different time frames. There was a significant but small difference between the MTR of normal cartilage and the cartilage repair area after 12 months for both procedures. After 24 months, the MTR of ACI repaired cartilage (0.31+/-0.07) was not significantly different from normal cartilage MTR (0.34+/-0.05). The MTR of MFR repaired cartilage (0.28+/-0.02), still showed a significant difference from normal cartilage.The differences between damaged and repaired cartilage MTR are too small to enable MT-imaging to be a useful tool for postoperative follow-up of cartilage repair procedures. There is, however, an evolution towards normal MTR-values in the cartilage repair tissue (especially after ACI repair).

A numerical model for describing bipolar charge transport and storage in polyethylene has been developed recently. The present paper proposes a comparison of the model outputs with experimental data in three different direct current (DC) voltage application protocols (step field increase and polarization/depolarization schemes). Three kinds of measurement have been realized for the three different protocols: space charge distribution using the pulsed electro-acoustic method, external current and electroluminescence. Simulation under AC stress has also been attempted on the basis of the model parameters that were derived from the DC case. Model limitations and possible improvements are discussed.

In this paper the results of space charge and conduction current measurements performed at different temperatures and electric fields on nanocomposites based on ethylene-vinyl-acetate are reported. The nanofillers are spherical TiO2 nanoparticles with a size ranging from 5 nm to 40 nm. The results show that the size of nanoparticles influences significantly electric properties of the final nanocomposite. The specimens containing the smallest nanoparticles, in fact, present better electric properties as a function of electric field and temperature. In particular, smaller space charge accumulation, lower conductivity and lower activation energy of the conduction process are detected with respect to both base material and nanocomposite with bigger nanoparticles.

Two types of model cables having different cross-linked polyethylene (XLPE) materials are investigated in this paper. One material is a standard XLPE homopolymer; the other is high productivity XLPE compound. Electric properties of these cables were studied and compared under AC and DC field, respectively. In particular, AC voltage endurance was evaluated by means of an experimental system developed for ageing and life tests in dry condition. Additional information on the charge trapping phenomenology under DC field was obtained from the space charge measurements.

Viene presentato un algoritmo per la costruzione di un albero bayesiano fattoriale da un numero finito di esempi. Il grafo viene usato come struttura su cui operare inferenza bayesiana mediante propagazione delle probabilità. L’algoritmo è presentato in dettaglio con riferimento ad un esempio basato su un numero limitato di stringhe di caratteri.