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During the complementary feeding period, any nutritional deficiencies may negatively impact infant growth and neurodevelopment. A healthy diet containing all essential nutrients is strongly recommended by the WHO during infancy. Because vegetarian diets are becoming increasingly popular in many industrialized countries, some parents ask the pediatrician for a vegetarian diet, partially or entirely free of animal-source foods, for their children from an early age. This systematic review aims to evaluate the evidence on how vegetarian complementary feeding impacts infant growth, neurodevelopment, risk of wasted and/or stunted growth, overweight and obesity. The SR was registered with PROSPERO 2021 (CRD 42021273592). A comprehensive search strategy was adopted to search and find all relevant studies. For ethical reasons, there are no interventional studies assessing the impact of non-supplemented vegetarian/vegan diets on the physical and neurocognitive development of children, but there are numerous studies that have analyzed the effects of dietary deficiencies on individual nutrients. Based on current evidence, vegetarian and vegan diets during the complementary feeding period have not been shown to be safe, and the current best evidence suggests that the risk of critical micronutrient deficiencies or insufficiencies and growth retardation is high: they may result in significantly different outcomes in neuropsychological development and growth when compared with a healthy omnivorous diet such as the Mediterranean Diet. There are also no data documenting the protective effect of vegetarian or vegan diets against communicable diseases in children aged 6 months to 2–3 years.

Several institutions propose responsive feeding (RF) as the caregivers’ relational standard when nurturing a child, from breast/formula feeding onwards. Previous systematic reviews (SRs) on caregivers’ feeding practices (CFPs) have included studies on populations from countries with different cultures, rates of malnutrition, and incomes, whereas this SR compares different CFPs only in healthy children (4–24 months) from industrialized countries. Clinical questions were about the influence of different CFPs on several important outcomes, namely growth, overweight/obesity, risk of choking, dental caries, type 2 diabetes (DM2), and hypertension. The literature review does not support any Baby Led Weaning’s or Baby-Led Introduction to SolidS’ (BLISS) positive influence on children’s weight–length gain, nor their preventive effect on future overweight/obesity. RF-CFPs can result in adequate weight gain and a lower incidence of overweight/obesity during the first two years of life, whereas restrictive styles and coercive styles, two kinds of non-RF in CF, can have a negative effect, favoring excess weight and lower weight, respectively. Choking risk: failure to supervise a child’s meals by an adult represents the most important risk factor; no cause–effect relation between BLW/BLISS/RF/NRCF and choking could be found. Risks of DM2, hypertension, and caries: different CFPs cannot be considered as a risky or preventive factor for developing these conditions later in life.

Adequate and balanced nutrition is essential to promote optimal child growth and a long and healthy life. After breastfeeding, the second step is the introduction of complementary feeding (CF), a process that typically covers the period from 6 to 24 months of age. This process is, however, still highly controversial, as it is heavily influenced by socio-cultural choices, as well as by the availability of specific local foods, by family traditions, and pediatrician beliefs. The Società Italiana di Pediatria Preventiva e Sociale (SIPPS) together with the Federazione Italiana Medici Pediatri (FIMP), the Società Italiana per lo Sviluppo e le Origine della Salute e delle Malattie (SIDOHaD), and the Società Italiana di Nutrizione Pediatrica (SINUPE) have developed evidence-based recommendations for CF, given the importance of nutrition in the first 1000 days of life in influencing even long-term health outcomes. This paper includes 38 recommendations, all of them strictly evidence-based and overall addressed to developed countries. The recommendations in question cover several topics such as the appropriate age for the introduction of CF, the most appropriate quantitative and qualitative modalities to be chosen, and the relationship between CF and the development of Non-Communicable Diseases (NCDs) later in life.

Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.

The cause of chronic urticaria remains often elusive. The association between chronic urticaria and intake of medications have been reported in children. However, the causative role of drugs has been rarely ascertained by onset of symptoms on drug provocation test. Chronic urticaria can be mediated by immunologic and nonimmunologic mechanisms. The diagnostic work-up of chronic urticaria includes a comprehensive evaluation of triggering factors such as drugs. A diagnosis is necessary in order to permit a safely administration of drugs in children with chronic urticaria. (www.actabiomedica.it)

No consensus currently exists on the appropriate age for the introduction of complementary feeding (CF). In this paper, a systematic review is conducted that investigates the effects of starting CF in breastfed and formula-fed infants at 4, 4–6, or 6 months of age (i) on growth at 12 months of age, (ii) on the development of overweight/obesity at 3–6 years of age, (iii) on iron status, and (iv) on the risk of developing (later in life) type 2 diabetes mellitus (DM2) and hypertension. An extensive literature search identified seven studies that evaluated the effects of the introduction of CF at the ages in question. No statistically significant differences related to the age at which CF is started were observed in breastfed or formula-fed infants in terms of the following: iron status, weight, length, and body mass index Z-scores (zBMI) at 12 months, and development of overweight/obesity at 3 years. No studies were found specifically focused on the age range for CF introduction and risk of DM2 and hypertension. Introducing CF before 6 months in healthy term-born infants living in developed countries is essentially useless, as human milk (HM) and formulas are nutritionally adequate up to 6 months of age.

The aim of this article was to explore the implications of the new Euratom dose limit for occupational radiation protection in the context of medical occupational radiation exposures. The European Directive 2013/59/Euratom takes into account the new recommendations on reduction in the dose limit for the lens of the eye for planned occupational exposures released in 2012 by the International Commission on Radiological Protection (ICRP 118). Different dose-monitoring procedures and devices were considered. Occupational eye lens doses reported by previous studies were analyzed, mainly considering workers involved in interventional procedures with X-rays. The current status of eye lens radiation protection and the main methods for dose reduction were investigated. The analysis showed that the workers, potentially exceeding the new limit, are clinical staff performing interventional procedures with a relatively high X-ray dose. Regarding radiological protection issues, the considered literature reports that the proper use of personal protective equipment may reduce the eye lens absorbed dose. The evaluation of the occupational eye lens dose is essential to establish which method of personal dose monitoring should be preferred. Furthermore, education and training about the right use of personal protective equipment are important for medical staff working with ionizing radiation.

The biofouling of marine structures presents a problem for maritime industries, including increasing fuel and operational costs. There has been much work developing and evaluating chemically ‘ambiguous’ amphiphilic coatings based upon hydrophobic fluoropolymer and hydrophilic poly(ethylene glycol) (PEG). Many of these coatings have shown good fouling-release performance against diatoms, which present a fouling challenge to commercially-available state-of-the-art silicone-based fouling-release coatings. However, PEG is prone to oxidation, which limits its practical use in the marine environment, and thus an alternative hydrophilic material would be desirable in the future development of amphiphilic coatings. In this regard, zwitterionic materials are emerging as a promising class of hydrophilic antifouling material, which we hypothesized would be a suitable alternative to PEG within amphiphilic coatings. To test this hypothesis, cross-linked amphiphilic films consisting of commercially available perfluoropolyethers and the zwitterionic monomer sulfobetaine methacrylate were developed and studied. The difficulty in formulating these chemically incompatible species was overcome by careful choice of solvents and a series of prototype cross-linked films were prepared in which increasing quantities of zwitterion were systematically incorporated. The fouling-release performance of these films was tested against the diatom Navicula incerta, a common microfouling organism responsible for the formation of so-called ‘slime’ layers, and antifouling performance with cypris larvae of two barnacle species, Balanus amphitrite, and Balanus improvisus. To expand the scope of the study, the clinically-relevant biofilm-forming pathogen Staphylococcus aureus, which is a major culprit in the infection and failure of millions of indwelling medical devices, was also evaluated. Results indicate that the incorporation of zwitterion into perfluoropolyethers leads to significant improvements in fouling-release performance and these amphiphilic coatings display potential in fouling-release applications.

The ICRP Publication 118 introduced new threshold doses for tissue reactions and other non cancer effects on lens:the new threshold doses resulted significantly lower than previous scientific evidences. Lenses are often involved in brain radiotherapy treatment volumes and the risk of cataratta becomes relevant. Our study compares the results obtained from treatment plans calculated with both Rapid Arc technique and a new SSW IMRT template, for each patient recruited in the study, in terms of lens maximum absorbed doses. 10 patients with brain tumours diagnosis (PTV medium size af about 90 cc) localized in different areas were treated with the new SSW IMRT template, that consists in five fields spreading over a The dose prescription for all patients was 60 Gy in 2 Gy daily fractions. On the same patients, Rapid Arc plans were conformed with equal optimization objectives. The target coverage was at least 97% of prescription dose to 95 % of volume in both calculated plans. All the patiens treated with the SSW IMRT technique received a lower maximum omolateral lens dose (range from 0.4 to 2.4 Gy; mean value 1.7 Gy) compared to doses obtained with Rapid Arc plans (range from 0.5 to 4.4 Gy; mean value 2.4 Gy). Relatively to contralateral dose lens, we obtained a mean value of max dose of 1.5 Gy (range 0.4–2.2 Gy) for SSW IMRT plans and 2.2 Gy (range 0.5–4.6 Gy) for Rapid Arc plans. Patients treated with the new SSW IMRT template showed a lens dose sparing of about the 28% compared to doses they would have received with Rapid Arc plans.The other OAR involved as chiasm, optical nerve and brainstem are widely lower than the corresponding constraints. The new SSW IMRT template could be applied to treat target with different size, shape and anatomical position. Furthermore, the lens maximum dose reduction could potentially reduce the risk of cataract.

Fluorinated polyurethanes characterized by a segmented structure, containing hard segments based on 4,4′-methylenebis (phenylisocyanate) (MDI), chain-extender 1,4 n-butandiol (BDO), and soft blocks like perfluoropolyether (PFPE), and poly-e-caprolactone (PCL) were synthesized keeping constant the equivalent ratio among reagents, but varying the experimental conditions. Copolymers show a complex micro- and macrostrucrture with different morphology and calorimetry, similar tensile properties and undistinguishable, but strongly upgraded surface properties. The morphology should be governed by the different fluorine content of the polymeric chains along with the hard segment structure; tensile properties are little influenced by the morphology. All these characteristics are interpreted in terms of polymerization procedure which results to be a key parameter for ruling the composition of the different polymeric chains, due to a very limited mutual solubility of the reagents. Surprisingly, a beneficial effect of the catalyst dibutyltindilaurate for the increase of the reaction kinetics among segregated phases in the reaction mass was observed.

In this work, we provide a simple and straightforward method for the fabrication of stable highly hydrophobic and oleophobic surfaces by applying stereolithography (SL) to perfluoropolyethers (PFPEs). Inspired by the liquid repellency widely shown in nature, our approach enables to easily mimic the interplay between the chemistry and physics by microtexturing low surface tension PFPEs. To this end, UV-curable resins suitable for SL-processing were formulated by blending multifunctional (meth-)acrylates PFPEs oligomers with photoinitiator and visible dyes whose content was tuned to tailor resin SL sensitivities. Photocalorimetric studies were also performed to investigate the curing behavior of the different formulations upon SL light exposure. Being the first example of stereolithography applied to PFPEs, stereolithographic processability of new developed PFPEs photopolymer was compared with a standard photoresist taken as benchmark (DL260®). Optimized formulations were characterized by reduced laser penetration depth (

BACKGROUND: Functional gastrointestinal disorders (FGIDs) are chronic or recurrent gastrointestinal symptoms without structural or biochemical abnormalities. FGIDs are multifactorial conditions with different pathophysiologic mechanisms including altered motility, visceral hyperalgesia, brain-gut disturbance, genetic, environmental and psychological factors. Although in most cases gastrointestinal symptoms are transient and with spontaneous resolution in infancy multiple dietary changes and pharmacological therapy are often started despite a lack of evidence-based data. Our aim was to update and critically review the current literature to assess the effects and the clinical appropriateness of drug treatment in early (occurring in infants and toddlers) FGIDs. METHODS: We systematically searched the Medline and GIMBE (Italian Group on Medicine Based on Evidence) databases, according to the methodology of the Critically Appraised Topics (CATs). We included reviews, clinical studies, and evidence-based guidelines reporting on pharmacological treatments. Systematic reviews and randomized controlled trials (RCTs) concerning pharmacologic therapies in children with early FGIDs were included, and data were extracted on participants, interventions, and outcomes. RESULTS: We found no evidence-based guidelines or systematic reviews about the utility of pharmacological therapy in functional regurgitation, infant colic and functional diarrhea. In case of regurgitation associated with marked distress, some evidences support a short trial with alginate when other non pharmacological approach failed (stepped-care approach). In constipated infants younger than 6 months of age Lactulose is recommended, whilst in older ages Polyethylene glycol (PEG) represents the first-line therapy both for fecal disimpaction and maintenance therapy of constipation. Conversely, no evidence supports the use of laxatives for dyschezia. Furthermore, we found no RCTs regarding the pharmacological treatment of cyclic vomiting syndrome, but retrospective studies showed a high percentage of clinical response using cyproheptadine, propanolol and pizotifen. CONCLUSION: There is some evidence that a pharmacological intervention is necessary for rectal disimpaction in childhood constipation and that PEG is the first line therapy. In contrast, for the other early FGIDs there is a lack of well-designed high-quality RCTs and no evidence on the use of pharmacological therapy was found.

Urethane reactions of cycloaliphatic and aromatic diisocyanates with hydroxy-terminated fluoropolyethers (FPEs) of various molecular weights and structure, at NCO: OH = 2, have been studied by monitoring, by IR analysis, the rate of decrease in NCO absorbance at 2264-2268 cm -1 . Different diisocyanates have been tested, among them the following: 4,4'-dicyclohexylmethane diisocyanate (H 12 MDI); 5-isocyanato-1,3,3-trimethylcyclohexylmethyl isocyanate or isophorone diisocyanate (IPDI); 2,4-toluene diisocyanate (TDI). Ethyl acetate (EA), methyl isobutyl ketone (MIBK), and hexafluoroxylene (HFX) have been used as solvents in presence of dibutyltin dilaurate (DBTDL) or 1,4-diazabicyclo[2,2,2]octan (DABCO) as catalysts. These reactions gave rise to NCO-end-capped FPE-oligourethanes. Preliminary solubility tests for HO-terminated FPEs in various solvents made it possible to select proper candidates for carrying out reaction in homogeneous conditions at high concentrations of reagents (30-50% w/w). The second-order kinetic mechanism was shown to be valid. Positive deviations from linearity for the second-order kinetics around 40-80% conversion, found for most of the FPE diols, were attributed to the autocatalysis of the isocyanate-hydroxyl reaction by the arising urethane groups. Uncatalyzed reactions with cycloaliphatic diisocyanates are very slow at 40°C. The tertiary amine DABCO is a much less effective catalyst than DBTDL. FPEs having terminal OH groups separated from the perfluorinated main molecular chain by -(OCH 2 CH 2 ) n - segments (n = 1-2) are generally more reactive than FPEs with end -CH 2 OH groups.

Perfluoropolyether polymers have been described as high performance fouling-release materials for marine coatings. Moreover, they have a good potential to be exploited in the biomedical field too. In this article several perfuoropolyether photopolymers were characterized in terms of surface and mechanical properties outlining the relationship between these properties and the polymer molecular structure. In particular the anti-fouling and fouling-release performances, evaluated using Bovine Serum Albumin as testing protein, was correlated to other material properties, like a parameter considering both surface tension components γ and elastic modulus E . A good correlation between the anti-fouling/fouling-release of perfluoropolyethers and ( E * γ polar ) 1/2 can actually be established. Our results show that perfluoropolyether photopolymers are good protein anti-fouling/fouling-release materials.

Hydroxy bifunctional fluoropolyether oligomers (ZDOL) are presented suitable for use as resins or for the preparation of polyurethane, polyester and polyether higher OH functionality resins. The synthesis procedures are described and discussed, and the effect of fluorine content and resin structure on glass transition temperature Tg and viscosity of final resin is stressed. It appears that the highly fluorinated polyether type resins, like the tetraolic derivative (TOL) and its mixtures with ZDOL, are characterized by only one, extremely low Tg and minimum viscosity values. Solvent–resin interactions and criteria for obtaining compatibility with polyisocyanate crosslinkers are discussed, pointing out the key role of hydrogen bonding. High solid coatings (solvent content less than 30%) are obtained by curing with blocked aliphatic polyisocyanates, and a preliminary characterization of final materials based on their thermal transitions and mechanical properties is reported.

New fluoropolyether polyolic resins are presented suitable to be cured with conventional hardeners as polyisocyanates or melamines. These resins are prepared by addition of fluoropolyether macrodiols (Fomblin® ZDOLTX) of various molecular weights to isophorone diisocyanate (IPDI) to give oligomeric NCO-terminated prepolymers. The final hydroxy functionality is obtained by the reaction of those prepolymers with trimethylolpropane (TMP). The viscosity of the resins is measured at various concentrations (weight fraction 0.8 – 0.4) and temperatures (T = 25–65°C). The results are discussed in terms of the Erickson equation (η vs. concentration) and using the WLF and Arrhenius models (η vs. T). The thermal behavior is studied by DSC for both the resins and cured films indicating the presence of two Tgs, corresponding to the segregated fluorinated and hydrogenated phases, the former particularly evident with the highest molecular weights of the fluorinated macromer. Tensile curves of selfsupported films are then analyzed showing an evident tough-plastic behavior especially for the isocyanate-cured films. The application of such materials as high-durability clear coats is finally proposed. Neuartige Fluoropolyether-Polyol-Harze, die mit konventionellen Hartern wie Polyisocyanaten oder Melaminen aushartbar sind, wurden hergestellt. Zunachst wurden oligomere NCO-terminierte Prepolymere durch Addition von Fluorpolyether-Makrodiolen unterschiedlicher Molekulargewichte an Isophorondiisocyanate erhalten. Durch die Reaktion dieser Prepolymeren mit Trimethylolpropan wurden endstandige Hydroxygruppen eingefuhrt. Die Viskositat von Losungen dieser Harze wurde bei unterschiedlichen Konzentrationen (Massenbruch 0,4–0,8) und Temperaturen (25°C–65°C) gemessen. Die erhaltenen Werte wurden auf der Basis der Erickson-Gleichung (Konzentrationsabhangigkeit von η) und unter Berucksichtigung des WLF-und des Arrhenius-Modells (Temperaturabhangigkeit von η) diskutiert. Das thermische Verhalten der Harze und von ausgeharteten Filmen wurde mit DSC bestimmt. Dabei wurden zwei Glasubergange beobachtet, die den separierten fluorhaltigen und nicht-fluorhaltigen Phasen zugeordnet werden konnen. Die Analyse des Zugverhaltens der Filme zeigte besonders bei den mit Isocyanat geharteten Proben ein ausgepragtes hart-plastisches Verhalten. Diese Werkstoffe erscheinen fur die Anwendung als hoch-wertige, dauerfeste und klare Beschichtungen geeignet.

New fluorinated thermoplastic elastomers (FTE) with perfluoropolyether (PFPE) blocks have been synthesized by reacting a fluorinated macrodiol with aromatic diisocyanates in the presence of a solvent, followed by subsequent chain extension with low molecular weight aliphatic or aromatic diols. Tensile properties measurements and dynamical-mechanical analysis (DMA) have been carried out and the relationship between chemical structure and final properties has been determined. These new thermoplastic fluorinated polyurethanes show an elastomeric behavior over a wide temperature range (between −75 and 100°C), thanks to their multiphase morphology consisting of a continuous fluorinated phase with a very low Tg (−120°C) and a dispersed high melting hydrogenated hard phase, as verified by a calorimetric and dynamic-mechanical analysis. At the same time, some of the outstanding properties of fluorinated oligomers, such as chemical inertness and low surface tension, are retained in the final polymers. Thanks to these characteristics this new class of polymeric materials provides new opportunities for the application of thermoprocessable elastomers in advanced technological fields. © 1996 John Wiley & Sons, Inc.

We present a software for choosing the best radiotherapy treatment schedule for head and neck cancers as a beginning radiotherapy plan or a temporarily interrupted plan. Its application occurs according to two modalities: the first adopts the best estimates for model parameters; the second takes into account the parameters' uncertainty too. In both cases, the choice becomes the schedule with the highest uncomplicated tumor control probability (UTCP). In the UTCP valuation, the normal tissue complication probability (NTCP) of each organ is related to the gravity of its possible late injury. For NTCP calculation, it has been adopted the empirical LKB (Lyman-Kutcher-Burman) model corrected for dose/fraction via linear-quadratic model and the incomplete repair effect. The tumor control probability (TCP) model is Poisson based and contains corrections for dose/fraction and regrowth effect; optionally, it can be accounted for the incomplete repair effect as well. At the end of processing, a detailed file with all informations about UTCP, TCP and single organ NTCP is furnished for every examined schedule. Moreover, a useful 3-D graphic representation of the schedule's UTCP is available, allowing the physician to easily understand the schedules with the highest radiotherapeutic efficacy. The open source characteristic allows the program to adapt to the individual clinical case as well as to be a valid support in radiobiological research.

The synthesis of new functionalised macromers containing perfluoropolyether structures (PFPE) is reported. They are obtained by reaction of bis-CH 2 OH terminated PFPE with isocyanato-ethyl methacrylate (EIM). giving rise to the formation of perfluoropolyether bisurethane methacrylate (PFEUMA) oligomers. The products are characterised by NMR and FTIR analyses. The thermal behaviour reveals two amorphous phases, corresponding to the fluorinated and the hydrogenated moieties, while a crystalline phase can be present depending on the macromer structure. The functionalised macromers are UV-cured in the presence of a photoinitiator and the complete disappearance of the double bonds is obtained. The cured films are characterised by differential scanning calorimetry (DSC) and dynamic mechanical thermal analysis (DMTA) confirming the presence of a multiphasic structure. Moreover the optical properties and the surface properties of the cured systems are investigated and discussed.

Copolymers of tetrafluoroethene (TFE) with hexafluoropropene (HFP) have been prepared in the 0-14mol% HFP composition range. Their melting temperatures (Tm), enthalpies (ΔHf) and entropies (ΔSf) of first and second fusion, and crystallinities (X) according to x-ray diffraction(x.r.d.) and differential scanning calorimetry (d.s.c.) have been determined. The results indicate that ΔHf/Xx.r.d of the polymer crystals decreases with higher HFP content.

New functionalised macromers containing perfluoropolyether (PFPE) structures and methacrylic end groups were synthesised and used as modifying additives for acrylic UV-curable systems. Their chemical structure is Rh-Rf-Rh, where Rh= -CH 2 O-CONH-CH 2 CH 2 OCOC(CH 3 )=CH 2 and Rf=-CF 2 O-(CF 2 CF 2 O) p (CF 2 O) q -CF 2 - with p ≃ q. Notwithstanding their very low concentration, below 0.5 wt.-%, the fluorinated macromers cause a dramatic change of the surface properties of the films, without changing their curing conditions and their bulk properties. X-ray photoelectron spectroscopy (XPS) measurements showed that the macromers are able to concentrate selectively at the surfaces of the films, depending on their chemical structure and on the kind of substrate employed.