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Background: Endocan is a soluble dermatan sulfate proteoglycan (50 kDa) secreted by endothelial cells and expressed by dermal, coronary, pulmonary and adipose tissue microvasculature. It plays an important role in the pathogenesis of vascular disorders, inflammatory state, endothelium dysfunction and neoangiogenesis. Aims of the study were to compare fasting serum endocan levels between children with obesity and healthy controls and to investigate the relationships between endocan, body mass index (BMI) and other indices of cardiometabolic risk. Methods: This single-center, observational, retrospective study included 19 pediatric patients with obesity aged 11.94 ± 0.52 years and 19 lean matched controls. Each patient underwent clinical and auxological examination and laboratory investigations including routine organs function tests and lipid profile. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Fasting endocan serum levels were measured using an enzyme-linked immunosorbent assay (ELISA). Results: Compared to healthy subjects, serum endocan levels were found to be significantly upraised in children with obesity. Endocan resulted significantly correlated with insulin levels (rho 0.47; p = 0.04); in addition, an association with HOMA-IR values with a trend toward the statistical significance (rho 0.43; p = 0.07) was found. No significant correlation with fasting blood glucose values and lipid serum levels was demonstrated. Although not statistically significant, a correlation between endocan and the presence and grading of liver steatosis on ultrasound (rho 0.51; p = 0.08 and rho 0.51; p = 0.08, respectively) was found. Conclusions: These findings confirm the association between endothelial damage and insulin resistance in children with obesity. Endocan could be used as a biomarker of early endothelial dysfunction in children with obesity and could be a valid predictor of future cardiovascular risk in adulthood. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic and disabling diseases that affect patient health-related quality of life (HRQoL). IBD patients are frequently exposed to high levels of stress and psychological distress. Biological drugs have been proven to reduce inflammation, hospitalization, and most of the complications that characterize IBDs; their potential contribution to patients' HRQoL remains to be explored. Aim: To evaluate and compare any change in the HRQoL and markers of inflammation in IBD patients undergoing biological drugs (infliximab or vedolizumab). Material and Methods: A prospective observational study was conducted on a cohort of IBD patients, aged >18 years, who were prescribed with infliximab or vedolizumab. Demographic and disease-related data at baseline were collected. Standard hematological and clinical biochemistry parameters, including C-reactive protein (CRP), white blood cells count (WBC), erythrocytes sedimentation rate (ESR), and α1 and α2 globulins were measured after a 12-h fast at baseline (T0), after 6 weeks (T1), and at 14 weeks (T2) of biological treatment. Steroid use, disease activity as measured by the Harvey–Bradshaw index (HBI) and partial Mayo score (pMS) for the CD and UC, respectively, were also recorded at each timepoint. The Short Form 36 Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT-F), and Work Productivity and Activity Impairment–General Health Questionnaire (WPAI:GH) were administered to each patient at baseline, T1, and T2 to address the study aims. Results: Fifty eligible consecutive patients (52% with CD and 48% with UC) were included in the study. Twenty-two patients received infliximab and twenty-eight received vedolizumab. We noted a significant reduction in the CRP, WBC, α1, and α2 globulins from T0 to T2 (p = 0.046, p = 0.002, p = 0.008, and p = 0.002, respectively). Participants showed a significant decrease in steroid administration during the observation period. A significant reduction in the HBI of CD patients at all three timepoints and a similarly significant decrease in the pMS of UC patients from baseline to T1 were recorded. Statistically significant changes were observed in all questionnaires during follow-up as well as an overall improvement in the HRQoL. The interdependence analysis carried out between the biomarkers and the scores of the individual subscales showed a significant correlation between the variation (Δ) of the CRP, Hb, MCH, and MCV with physical and emotional dimensions of the SF-36 and FACIT-F tools; work productivity loss expressed by some of the WPAI:GH items negatively correlated with the ΔWBC and positively with the ΔMCV, ΔMCH, and Δ α1 globulins. A sub-analysis according to the type of treatment showed that patients receiving infliximab experienced a more pronounced improvement in their HRQoL (according to both SF-36 and FACIT-F) compared with patients receiving vedolizumab. Conclusions: Both infliximab and vedolizumab played an important role in contributing to the improvement of the HRQoL in IBD patients by also reducing inflammation and, consequently, steroid use in patients with an active disease. HRQoL, being one of the treatment goals, should also be assessed when taking charge of IBD patients to assess their clinical response and remission. The specific correlation between the biomarkers of inflammation and life's spheres, as well as their possible role as clinical markers of HRQoL, should be further investigated. [ABSTRACT FROM AUTHOR]

High energy density physics is the field of physics dedicated to the study of matter and plasmas in extreme conditions of temperature, densities and pressures. It encompasses multiple disciplines such as material science, planetary science, laboratory and astrophysical plasma science. For the latter, high energy density states can be accompanied by extreme radiation environments and super-strong magnetic fields. The creation of high energy density states in the laboratory consists in concentrating/depositing large amounts of energy in a reduced mass, typically solid material sample or dense plasma, over a time shorter than the typical timescales of heat conduction and hydrodynamic expansion. Laser-generated, high current–density ion beams constitute an important tool for the creation of high energy density states in the laboratory. Focusing plasma devices, such as cone-targets are necessary in order to focus and direct these intense beams towards the heating sample or dense plasma, while protecting the proton generation foil from the harsh environments typical of an integrated high-power laser experiment. A full understanding of the ion beam dynamics in focusing devices is therefore necessary in order to properly design and interpret the numerous experiments in the field. In this work, we report a detailed investigation of large-scale, kilojoule-class laser-generated ion beam dynamics in focusing devices and we demonstrate that high-brilliance ion beams compress magnetic fields to amplitudes exceeding tens of kilo-Tesla, which in turn play a dominant role in the focusing process, resulting either in a worsening or enhancement of focusing capabilities depending on the target geometry. [ABSTRACT FROM AUTHOR]

Abstract Background Objective Methods Results Conclusion Cerebrospinal fluid (CSF) leak through petrosal air cells is a known complication after drilling the posterior wall of the internal acoustic canal (IAC) for resection of vestibular schwannoma (VS). Whereas mild pneumocephalus is common after retrosigmoid craniotomy, tension pneumocephalus has been rarely documented.To testify a case of fatal tension pneumocephalus after VS resection in a patient with ventriculo-peritoneal (VP) shunt and to propose possible recommendations to limit the risk of this dramatic complication.A case of fatal tension pneumocephalus after VS resection in presence of hidden CSF fistula is illustrated with pre- and post-operative images.In the uneventful situation of concomitant post-operative CSF fistula in presence of VP shunt, tension pneumocephalus may occur. The negative pressure created by the shunt system and the presence of osteo-dural defect allow the air to enter and, at the same time, prevent the outflow.After VS resection, tension pneumocephalus can occur as a consequence of CSF fistula from petrosal air cells in the presence of functioning VP shunt. Precautions as pre-operative increase to ‘virtual-off’ the pressure of the valve, subsequences CT scans after surgery and sealing of the petrous air cells are recommended to avoid such as fatal complication. [ABSTRACT FROM AUTHOR]

A dosimetric calibration of three types of radiochromic films (GafChromicTM HD-V2, MD-V3, and EBT3) was carried out for absorbed doses (D) ranging up to 100 kGy using a 130 TBq C o 60 γ-ray source. The optical densities (ODs) of the irradiated films were acquired with the transmission-mode flatbed film scanner EPSON GT-X980. The calibration data were cross-checked using the 20-MeV proton beam from the azimuthally varying field cyclotron at the Research Center for Nuclear Physics in Osaka University. These experimental results not only present the measurable dose ranges of the films depending on the readout wavelength, but also show consistency with our hypothesis that the OD response curve [log(OD)–log(D) curve] is determined by the volumetric average of the absorption dose and does not strongly depend on the type of radiation for the excitation. [ABSTRACT FROM AUTHOR]

Postoperative spinal epidural hematoma is a rare complication of anterior cervical discectomy and fusion. This condition may rapidly produce severe neurologic deficits, often requiring a prompt surgical decompression. A multilevel extension of the epidural bleeding has been rarely described after anterior cervical procedures. In such cases, the choice of the most suitable surgical approach may be challenging. Herein, we describe an effective surgical decompression of a C2-T1 ventral epidural hematoma following anterior cervical discectomy and fusion at the C5-C6 level. By reopening the previous approach, the C5-C6 intersomatic cage was removed and the surgical field inspected for bleeding. After removal of the spinal epidural hematoma at this level, a lumbar external drainage catheter was inserted into the epidural space to perform multiple irrigations with saline solution until the washing fluid was clear. Immediate postoperative cervical computed tomography and magnetic resonance imaging revealed gross total removal of the epidural hematoma and complete decompression of the spinal cord all along the affected tract. Early postoperative neurologic examination revealed mild lower extremity weakness that fully recovered within hours. Although rare, multilevel epidural hematoma following anterior cervical decompression represents a serious complication. The revision of the previous anterior cervical approach may be considered the first treatment option, allowing to control the primary bleeding site. Catheter irrigation of the epidural space with saline solution may be a useful technique for removal of unexposed residual blood collection, avoiding the need for posterior laminectomy or other unnecessary bone demolition. [ABSTRACT FROM AUTHOR]

Abstract Purpose The purpose of this study was to report long-term seizure outcome in patients who underwent frontal lobe epilepsy (FLE) surgery. Method This retrospective study included 44 consecutive subjects who underwent resective surgery for intractable FLE at IRCCS NEUROMED (period 2001–2014), followed up for at least 2 years (mean: 8.7 years). All patients underwent noninvasive presurgical evaluation and/or invasive electroencephalography (EEG) monitoring when nonconcordant data were obtained or epileptogenic zone was hypothesized to be close to the eloquent cortex. Electroclinical, neuroimaging, surgical data, and histology were compared to seizure outcome. Results Mean epilepsy duration was 19 years; mean age at surgery was 31.6 years. Preoperative magnetic resonance imaging (MRI) showed a frontal lesion in 86.4 % of cases. Scalp video-electroencephalography (VEEG) monitoring detected a focal ictal onset in 90% of cases. Twenty-seven patients (61.4%) underwent invasive recordings. Resections involved dorsolateral (47.7%), medial (9%), orbital (13.6%), and rolandic (13.6%) region. Lobectomy within functional boundaries was performed in the remaining 7 cases (16%). Transient and permanent neurological deficits were observed in 2 and 3 cases, respectively. Histology revealed focal cortical dysplasia (45.5%), World Health Organization (WHO) I–II grade tumors (15.9%), gliosis (22.7%), vascular malformations (4.5%), Rasmussen encephalitis (6.8%), and normal tissue (4.5%). At last observation 68.1% of patients were in Engel's class I, 11.4% in class II, 9% in class III, and 11.4% in class IV. A favorable outcome was associated with focal ictal scalp EEG onset (p = 0.0357). Conclusion Surgery is a safe treatment option in drug-resistant FLE with a satisfying long-term outcome. These data highlight the importance of an appropriate selection of potential surgical candidates. Highlights • Surgery is a safe option in drug-resistant FLE with a satisfying long-term outcome. • The presence of focal lesions predicts favorable outcome. • Focal ictal scalp EEG onset is associated with a favorable long-term outcome. [ABSTRACT FROM AUTHOR]

Background: Gross total resection, when possible, is the first crucial treatment for high-grade gliomas, as it has been demonstrated to be associated with longer survival. Different intraoperative tools, such as neuronavigation, fluorescent agents, and intra-operative ultrasound, have been developed to help neurosurgeons to extend the resection. Methods: We describe the high-magnification microsurgery technique used during the first surgical removal for high-grade gliomas. We illustrate the key anatomical "markers" of normal brain parenchyma, which guide the surgery. Conclusion: High-magnification microsurgery is an anatomically based approach that allows the identification of key anatomical "markers" of normal brain parenchyma in order to resect high-grade gliomas safely and effectively. [ABSTRACT FROM AUTHOR]

The Author criticizes a recent revirement of the Court of cassation, according to which the divorce allowance should be granted only to the person deprived of sufficient means to live in dignity, that is, to meet the basic needs of life. However, the centrality of marriage-relationship imposes a reading of the rules governing the property consequences of the crisis, in the light of the constitutional principles of equal dignity and moral and legal equality of the spouses (arts. 2, 3 and 29 of Italian Constitution) and of the principle of solidarity, because it is valued the figure of the weaker spouse equitably balancing the economic positions of the spouses at the time of termination of marriage, although the protection of the weaker party is to accentuate for its greatest vulnerability. In our system the right to separate and divorce are fundamental rights of the person, because they guarantee his freedo and their exercise can not find an obstacle in the opposition of the other spouse. But this does not disregard the responsibilities and expectations related to marriage, on which the notion of post-marital solidarity is based, transposed by a decision of the United Sections of 1990, responding to the social need to protect the weaker spouse, respecting its personal dignity. The conflicting jurisprudence that emerged with the revirement raises a need for legal certainty. So the question was referred to the United Sections of the Court of Cassation; but it would be advisable, in the opinion of the Author, an intervention by the legislator, who can identify a solution of family equity. Otherwise, if the orientation of the Supreme Court will consolidate, according to the Author, the protection of the weaker spouse could be obtained only in a preventive way, enhancing the private autonomy of the spouses, with a good law on premarital agreements that overcomes the debate of the doctrine and jurisprudence about their admissibility. [ABSTRACT FROM AUTHOR]

Background BK virus (BKV)-associated nephropathy (BKVAN) is often associated with renal graft dysfunction. When renal transplant recipients present with high clinical suspicion for BKVAN (high serum and urine BKV titer with graft dysfunction) but their graft biopsies stain negatively for BKV, non-correlated situations between the two tests often lead to a dilemma about how to treat them. Methods This retrospective investigation was conducted to determine how real-time quantitative PCR (qPCR) for BKV, routinely applied to serum and urine, could be helpful in identifying the existing BKV in biopsy tissue stained negatively for BKV. Results DNA was extracted from each specimen through the use of five 10-μm curls from the tissue block with use of the QIAamp DNA FFPE Tissue Kit (Qiagen), followed by BKV qPCR to determine copies of BKV/μg of biopsy tissue DNA. Group 1 (11 negative renal controls for BKV) demonstrated 0 to 9 BKV copies/μg DNA. Except for 3 focally staining cases showing low BKV, the remaining 10 positive renal controls in group 2 (13 positive transplant biopsies staining positively) demonstrated elevated BKV up to 160 million copies/μg DNA. Group 3 transplants (13 uncertain transplants with negative BKV staining but positive liquid BKV) were negative for BKV (0–12 copies/μg) in 4 of 13, had low BKV copies (36–346 copies/μg) in 5 of 13, and had high BKV copies (17,240–526,945 copies/μg) in 4 of 13 cases, through the use of qPCR. Conclusions The data indicate that qPCR from paraffin-embedded tissue as a backup test is sensitive for ruling in/out BKV infection in renal transplant biopsies, particularly in uncertain cases. [ABSTRACT FROM AUTHOR]

Germany is well known around the world for the strength of its economy, its industry and for the ‘German model’ for higher engineering education based on developing technological skills at a very high level. In this article, we firstly describe the former and present model of engineering education in Germany in a context of the globalisation of the world economy and of higher education, in order to understand how it covers the current demand for engineering resources. Secondly, we analyse the impact of globalisation from a technological perspective. To this end, we describe initiatives for innovation driven by the German federal government and engineering societies, and summarise the first impacts on engineering education and on social competence for engineers. Thirdly, we explore to what extent engineering education in Germany trains engineers in social and intercultural competency to comply with the future demands of the challenge of globalisation. [ABSTRACT FROM AUTHOR]

We present the general challenges of plasma diagnostics for laser-produced plasmas and give a few more detailed examples: spherically bent crystals for X-ray imaging, velocity interferometers (VISAR) for shock studies, and proton radiography. [ABSTRACT FROM AUTHOR]

Pesticide presence in streams is a potential threat to Endangered Species Act listed salmonids in the Hood River basin, Oregon, a primarily forested and agricultural basin. Two types of passive samplers, polar organic chemical integrative samplers (POCIS) and semipermeable membrane devices (SPMDs), were simultaneously deployed at four sites in the basin during Mar. 2011–Mar. 2012 to measure the presence of pesticides, polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs). The year-round use of passive samplers is a novel approach and offers several new insights. Currently used pesticides and legacy contaminants, including many chlorinated pesticides and PBDEs, were present throughout the year in the basin’s streams. PCBs were not detected. Time-weighted average water concentrations for the 2-month deployment periods were estimated from concentrations of chemicals measured in the passive samplers. Currently used pesticide concentrations peaked during spring and were detected beyond their seasons of expected use. Summed concentrations of legacy contaminants in Neal Creek were highest during July–Sept., the period with the lowest streamflows. Endosulfan was the only pesticide detected in passive samplers at concentrations exceeding Oregon or U.S. Environmental Protection Agency water-quality thresholds. A Sensitive Pesticide Toxicity Index (SPTI) was used to estimate the relative acute potential toxicity among sample mixtures. The acute potential toxicity of the detected mixtures was likely greater for invertebrates than for fish and for all samples in Neal Creek compared to Rogers Creek, but the indices appear to be low overall (<0.1). Endosulfans and pyrethroid insecticides were the largest contributors to the SPTIs for both sites. SPTIs of some discrete (grab) samples from the basin that were used for comparison exceeded 0.1 when some insecticides (azinphos methyl, chlorpyrifos, malathion) were detected at concentrations near or exceeding acute water-quality thresholds. Early life stages and adults of several sensitive fish species, including salmonids, are present in surface waters of the basin throughout the year, including during periods of peak estimated potential toxicity. Based on these data, direct toxicity to salmonids from in-stream pesticide exposure is unlikely, but indirect impacts (reduced fitness due to cumulative exposures or negative impacts to invertebrate prey populations) are unknown. [ABSTRACT FROM AUTHOR]

Objective The α 2 agonist dexmedetomidine (DEX) is an anesthetic agent that can provide sedation and analgesia without respiratory depression or changes in neuronal activity during microrecordings. The aim of our study was to confirm the efficacy and safety of anesthesia with DEX for unilateral deep brain stimulation of the subthalamic nucleus (STN) in patients with Parkinson disease. Methods In 2013 and 2014, a series of 11 consecutive patients received continuous low-dose DEX infusion during unilateral deep brain stimulation of the STN. Intraoperative microrecordings, stimulation results, and patient reaction times in executing verbal and motor tasks were retrospectively analyzed. Functional outcomes were evaluated by comparing preoperative and 1-year postoperative Unified Parkinson's Disease Rating Scale Part III scores. Results Typical activity of the STN was recorded in all patients, and the delay in the execution of both motor and verbal tasks was ≤2 seconds. No hemorrhagic complications occurred, and no postoperative side effects were observed. The mean percentage of Unified Parkinson's Disease Rating Scale Part III improvement at last follow-up was 39.01% (range, 23.70%–55.60%). The mean percentage of levodopa equivalent dose reduction was 45.86% (range, 21.50%–65.70%). Conclusions The results of our study confirm that the use of DEX in managing patients with Parkinson disease during unilateral deep brain stimulation of the STN is safe and effective and can be considered a promising option for sedation during this type of procedure. [ABSTRACT FROM AUTHOR]

Luigi Capuana's entire theatrical itinerary is here quickly but not roughly crossed, showing that it was one of the main activities of the writer of Mineo, not only due to economic reasons. Since his early youth Capuana tries the theatre writings that he will never leave except for some inevitable intermittence. In his best results he anticipates solutions of which Pirandello will be inspired by, and always, thanks to his experimentation attitude, he makes the very first attempts of free verse in Italy in the field of libretto. [ABSTRACT FROM AUTHOR]

We describe an experiment performed at the LULI laser facility using an advanced radiographic technique that allowed obtaining 2D, spatially resolved images of a shocked buried-code-target. The technique is suitable for applications on Fast Ignition as well as Warm Dense Matter research. In our experiment, it allowed to show cone survival up to Mbar pressures and to measure the shock front velocity and the fluid velocity associated to the laser-generated shock. This allowed obtaining one point on the shock polar of porous carbon. [ABSTRACT FROM AUTHOR]

We present experimental results of laser-to-proton conversion efficiency as a function of lateral confinement of the refluxing electrons. Experiments were carried out using the T-Cubed laser at the Center for Ultrafast Optical Science, University of Michigan. We demonstrate that the laser-to-proton conversion efficiency increases by 50% with increased confinement of the target from surroundings with respect to a flat target of the same thickness. Three-dimensional hybrid particle-in-cell simulations using LSP code agree with the experimental data. The adopted target design is suitable for high repetition rate operation as well as for Inertial Confinement Fusion applications. [ABSTRACT FROM AUTHOR]

Video-EEG monitoring with intracranial subdural electrodes is a useful assessment tool for the localization of the epileptogenic zone in patients with drug-resistant focal epilepsy. We aimed at assessing the morbidity related to electrode implantation and the surgical outcome in patients who underwent epilepsy surgery after intracranial EEG monitoring. All patients ( N = 58) admitted to our Epilepsy Surgery Centre for drug-resistant focal epilepsy who underwent resective surgery after intracranial monitoring with subdural electrodes and were followed up for at least 2 years were included in the study. Their mean age was 30.4 years (range 8-60 years), 25 (43 %) were female, and 44 (76 %) had a preoperatively detected structural lesion. The mean duration of invasive recording was 2.3 days (range 1-14 days). Extraoperative ECoG allowed the identification of the epileptogenic focus in all cases. The temporal lobe was involved in 21 (36 %) patients, whereas extratemporal foci were identified in 24 (41 %) patients. Thirteen patients (23 %) had multilobar involvement. Functional brain mapping was performed in 15 (26 %) patients. Transient complications related to electrode implantation occurred in three patients. Among patients with evidence of lesion on preoperative MRI, lesionectomy alone was performed in 12 cases (27 %), while it was combined with tailored cortical resection in the remaining cases. Tailored cortical resection was also performed in patients without evidence of lesion on MRI. After resective surgery, transient neurological deficits occurred in five cases, while another patient experienced permanent lateral homonymous hemianopia. At the last follow-up observation, 34 (57 %) patients were seizure-free (Engel class I). This study suggests that invasive EEG recording with subdural electrodes may be useful and fairly safe for many candidates for epilepsy surgery. [ABSTRACT FROM AUTHOR]

The two Morvern Callars—Alan Warner's 1995 novel and Lynne Ramsay's 2002 film adaptation—are key contemporary Scottish texts yet represent two quite different moments in Scotland's recent cultural history. Warner's novel is decidedly devolutionary in its handling of Scotland and Scottishness. Although superficially faithful to its source text, Ramsay's film is actually far more faithful to its depoliticized—or differently politicized—early post-devolutionary moment. Examining the two Morvern Callars in light of Robert Stam's theory of adaptation helps us understand both their complex relationship and the ideological consequences of aesthetic choices. [ABSTRACT FROM PUBLISHER]

Mucorales have been increasingly reported as cause of invasive fungal infections in immunocompromised subjects, particularly in patients with haematological malignancies or uncontrolled diabetes mellitus and in those under deferoxamine treatment or undergoing dialysis. The disease often leads to a fatal outcome, but the pathogenesis of the infection is still poorly understood as well as the role of specific virulence determinants and the interaction with the host immune system. Members of the order Mucorales are responsible of almost all cases of invasive mucormycoses, the majority of the etiological agents belonging to the Mucoraceae family. Mucorales are able to produce various proteins and metabolic products toxic to animals and humans, but the pathogenic role of these potential virulence factors is unknown. The availability of free iron in plasma and tissues is believed to be crucial for the pathogenesis of these mycoses. Vascular invasion and neurotropism are considered common pathogenic features of invasive mucormycoses. [ABSTRACT FROM AUTHOR]

James Robertson's well-deserved reputation as a historical novelist has obscured the role that the Gothic plays in his work. Manifesting itself in distinctively Scottish fashion, Robertson's Gothicism is tied to the 'broader national culture' in general and to post-devolutionary Scotland in particular. Not only does his transformation of the Gothic into the historical novel's uncanny other resist the modern novel's tendency towards increasing privatisation. It also results in work that diverges from much post-devolutionary Scottish fiction in that his stories and novels are, by virtue of the density of their Scottishness, deeply connected to the local and to folk culture. [ABSTRACT FROM AUTHOR]

Background: Yeasts are a common cause of invasive fungal infections in critically ill patients. Antifungal susceptibility testing results of clinically significant fungal strains are of interest to physicians, enabling them to adopt appropriate strategies for empiric and prophylactic therapies. We investigated the antifungal susceptibility of yeasts isolated over a 2-year period from hospitalised patients with invasive yeast infections. Methods: 638 yeasts were isolated from the blood, central venous catheters and sterile fluids of 578 patients on general and surgical intensive care units and surgical wards. Etest strips and Sensititre panels were used to test the susceptibility of the isolates to amphotericin B, anidulafungin, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole in 13 laboratories centres (LC) and two co-ordinating centres (CC). The Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method was used at the CCs for comparison. Results: Etest and Sensititre (LC/CC) MIC90 values were, respectively: amphotericin B 0.5/0.38, 1/1 mg/L; anidulafungin 2/1.5 and 1/1 mg/L; caspofungin 1/0.75 and 0.5/0.5 mg/L; fluconazole 12/8 and 16/16 mg/L; itraconazole 1/1.5, 0.5/0.5 mg/L; posaconazole 0.5 mg/L and voriconazole 0.25 mg/L for all. The overall MIC90 values were influenced by the reduced susceptibility of Candida parapsilosis isolates to echinocandins and a reduced or lack of susceptibility of Candida glabrata and Candida krusei to azoles, in particular fluconazole and itraconazole. Comparison of the LC and CC results showed good Essential Agreement (90.3% for Etest and 92.9% for Sensititre), and even higher Categorical Agreement (93.9% for Etest and 96% for Sensititre); differences were observed according to the species, method, and antifungal drug. No cross-resistance between echinocandins and triazoles was detected. Conclusions: Our data confirm the different antifungal susceptibility patterns among species, and highlight the need to perform antifungal susceptibility testing of clinically relevant yeasts. With the exception of a few species (e. g. C. glabrata for azoles and C. parapsilosis for echinocandins), the findings of our study suggest that two of the most widely used commercial methods (Etest and Sensititre) provide valid and reproducible results. [ABSTRACT FROM AUTHOR]

Abstract: In the fast ignition approach to inertial confinement fusion (ICF), the ignition is expected to be triggered by an ultra-high intensity laser-produced fast electron beam, propagating and releasing its energy at the core of the shock-compressed deuterium–tritium (DT) capsule. Therefore the study of fast electron generation and transport is crucial for fast ignition science. As a consequence of fast electron transport, K-shell ionization of the medium atoms is produced with the subsequent emission of a K-alpha photon. The imaging of K-α sources is therefore very useful to obtain both quantitative and qualitative information on fast electron transport. Spherically bent crystals can provide 2-D spatially resolved and mono-energetic images of the K-α source and are widely used in several fast ignition oriented experiments. [ABSTRACT FROM AUTHOR]

Abstract: The recent “fast ignition approach” to ICF relies on the presence of fast electrons to provide the “external” ignition spark triggering the nuclear fusion reaction in the compressed core of a thermonuclear target. Such fast electron beam is produced by the interaction of a short-pulse high-intensity laser with the target itself. In this context, it becomes essential to characterize the density of fast electrons and their average energy (i.e. the “laser to fast electron” energy conversion efficiency) but also the finer details of the velocity and angular distribution. In this work we will discuss several techniques used to determine the fast electron distribution function. [ABSTRACT FROM AUTHOR]

The article profiles the late U.S. novelist Kurt Vonnegut Jr. He escaped the firebombing as a German-American soldier at the Battle of the Bulge in Dresden, Germany during World War II, published his first novel "Player Piano" in 1952, and taught at the University of Iowa Writer's Workshop for two years. The article cites the plagiarism of Vonnegut's work by Scottish writer Alasdair Gray in his novel "Lanark." All of the main characters in the work of Vonnegut are alone. His son, Mark, became an author and a doctor who helps others suffering from schizophrenia.

We studied the induced plasma heating in three different kinds of targets: mass limited, foam targets, and large mass targets. The experiment was performed at Alisé Laser Facility of CEA/CESTA. The laser system emitted a ∼1 ps pulse with ∼10 J energy at a wavelength of ∼1 μm. Mass limited targets had three layers with thicknesses of 10 μm C8H8, 1 μm C8H7Cl, and 10 μm C8H8 with size of 100×100 μm2. Detailed spectroscopic analysis of x rays emitted from the Cl tracer showed that it was possible to heat up the plasma from mass limited targets to a temperature of ∼250 eV with density of ∼1021 cm-3. The plasma heating is only produced by fast electron transport in the target, being the 10 μm C8H8 overcoating thick enough to prevent any possible direct irradiation of the tracer layer even taking into account mass-ablation due to the prepulse. These results demonstrate that with mass limited targets, it is possible to generate a plasma heated up to several hundreds eV. It is also very important for research concerning high energy density phenomena and for fast ignition (in particular for the study of fast electrons transport and induced heating). [ABSTRACT FROM AUTHOR]

Anidulafungin is an antifungal drug belonging to the echinocandin class with a potent in vitro fungicidal activity against a wide range of Candida species, including C. glabrata and C. krusei. Anidulafungin is also active in vitro against moulds belonging to the genus Aspergillus and some dematiaceous genera. Furthermore, anidulafungin demonstrates in vitro activity against Candida spp, growing as biofilms. Resistance to anidulafungin remains very rare based on recent epidemiological data. Paradoxical or trailing effects should be considered in echinocandin susceptibility testing. The in vitro activity profile of anidulafungin makes it a useful addition to the Italian antifungal armamentarium. [ABSTRACT FROM AUTHOR]

Background Long-term acute care hospitals (LTACHs) care for chronically, critically ill patients with high utilization of central lines and high risk for morbidity from central line-associated bloodstream infections (CLABSIs). Our 38-bed LTACH noted a substantial increase in the incidence of CLABSIs (as defined by the National Healthcare Safety Network) between fiscal year (FY) 2016 and FY 2018 (Figure 1). Detailed case review identified a large number of CLABSIs which were clinically consistent with blood culture contaminants from central lines. Feedback from bedside staff also suggested gaps between practice and evidence-based measures for central line care. Methods A three-pronged CLABSI prevention project was implemented in July 2018 consisting of (1) staff education regarding daily chlorhexidine (CHG) bathing for all patients, combined with an electronic audit report to identify patients without active CHG orders; (2) change in practice to the use of venipuncture alone for blood culture collection, combined with an electronic audit report to identify blood cultures collected from central lines; and (3) a recurring 6-part educational series for nurses focused on central line care. The pre-intervention period was defined as the 12-month period between July 1, 2017 and June 30, 2018 (FY 2018). The primary outcome was the fiscal year CLABSI rate. A secondary outcome was the proportion of blood cultures drawn from central lines. Results After 9 months of the intervention, one CLABSI had been reported for FY 2019 year-to-date at a rate of 0.4 per 1,000 CL-days, representing an 86% decrease from the FY 2018 rate of 2.8 per 1,000 CL-days. The 12-month rolling CLABSI rate decreased to 1.6 per 1,000 CL-days (Figure 2). The proportion of blood cultures collected from central lines decreased from 10.5% (69/658) to 4.5% (15/334), representing a 57% reduction. The proportion of patients ordered and receiving CHG bathing in the intervention period was >95%. Conclusion A multidisciplinary effort focused on CHG bathing, central line care, and blood culture collection led to a substantial reduction in CLABSIs in our LTACH. The use of electronic audit reports was particularly useful in achieving high adherence to practice changes. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Abstract: The activity of voriconazole was tested in vitro against 1996 clinical yeast isolates collected in 20 Italian microbiology laboratories. Voriconazole susceptibility testing was carried out with the broth microdilution (NCCLS M27-A2), Etest and disk diffusion methods. The minimum inhibitory concentrations at which 90% of the isolates were inhibited (MIC90) obtained with the NCCLS method were 0.03mg/L for Candida albicans, 0.5mg/L for Candida non-albicans and 0.25mg/L for other genera; those obtained with Etesting were, respectively, 0.032mg/L, 0.125mg/L and 0.125mg/L. With the disk diffusion method, the majority of isolates (92.3%) showed inhibition zone diameters between 21mm and 40mm. Using a tentative MIC cut-off of 1mg/L as indicative of in vitro susceptibility, 98.1% of the isolates tested in our study would be classified as susceptible, and only 28 (1.4%) of the isolates, with MICs higher than 2mg/L, would be classified as resistant to the drug. Our findings confirm the broad-spectrum in vitro activity of voriconazole against yeasts, including Candida species that are generally less susceptible to other azoles. [Copyright &y& Elsevier]

Aims: The persistent circulation of hepatitis A virus (HAV) in the Mediterranean area suggests the need for monitoring its presence in the environment. A reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the presence of HAV in several consecutive raw sewage and final effluent samples, collected over an 8-month period from an activated sludge treatment plant in southern Italy. Methods and Results: Two distinct purification protocols, either based on antigen-capture with monoclonal antibody (AC) or RNA extraction, were compared. The possible influence of the antibody used in the AC phase was evaluated in preliminary experiments on HAV-spiked samples, using two different monoclonal antibodies. Hepatitis A virus RNA was detected in all but one sewage environmental sample examined. The contemporary presence of enteroviruses, reoviruses and phages was observed, while HAV growth in cell culture was hampered. Conclusions: The RT-PCR technique was confirmed to be a valuable tool for the rapid monitoring of HAV in sewage samples. In addition, this study demonstrated that application of different sample purification methods can result in different levels of sensitivity of the assay and that, in the antigen-capture method, the choice of antibody can have a crucial role. Significance and Impact of the Study: This work underlines the need for technical uniformity in environmental studies from different laboratories for a correct and useful comparison of the results. [ABSTRACT FROM AUTHOR]

Explores the reception of the British government towards the play `Death and the Maiden,' by Ariel Dorfman. Representation of Chilean political issues in the play; Impact of the play's critical and commercial success on theater; Factors contributing the play's success to address and adapt different political and theatrical contexts; Evolution of political theater.

• The first characterization of the nociceptive specific neurons in the CFA-induced vulvodynia. • The hypertrophic microglia occur in the dorsal horn of spinal cord in the CFA-induced vulvodynia. • Appearance of a depressive-like behaviour in vulvodynia. Vestibulodynia is a complex pain disorder characterized by chronic discomfort in the vulvar region, often accompanied by tactile allodynia and spontaneous pain. In patients a depressive behaviour is also observed. In this study, we have used a model of vestibulodynia induced by complete Freund's adjuvant (CFA) focusing our investigation on the spinal cord neurons and microglia. We investigated tactile allodynia, spontaneous pain, and depressive-like behavior as key behavioral markers of vestibulodynia. In addition, we conducted in vivo electrophysiological recordings to provide, for the first time to our knowledge, the characterization of the spinal sacral neuronal activity in the L6-S1 dorsal horn of the spinal cord. Furthermore, we examined microglia activation in the L6-S1 dorsal horn using immunofluorescence, unveiling hypertrophic phenotypes indicative of neuroinflammation in the spinal cord. This represents a novel insight into the role of microglia in vestibulodynia pathology. To address the therapeutic aspect, we employed pharmacological interventions using GABApentin, amitriptyline, and PeaPol. Remarkably, all three drugs, also used in clinic, showed efficacy in alleviating tactile allodynia and depressive-like behavior. Concurrently, we also observed a normalization of the altered neuronal firing and a reduction of microglia hypertrophic phenotypes. In conclusion, our study provides a comprehensive understanding of the CFA-induced model of vestibulodynia, encompassing behavioral, neurophysiological and neuroinflammatory aspects. These data pave the way to investigate spinal cord first pain plasticity in vestibulodynia. [ABSTRACT FROM AUTHOR]

We have investigated space and astrophysical phenomena in nonrelativistic laboratory plasmas with long high-power lasers, such as collisionless shocks and magnetic reconnections, and have been exploring relativistic regimes with intense short pulse lasers, such as energetic ion acceleration using large-area suspended graphene. Increasing the intensity and repetition rate of the intense lasers, we have to handle large amounts of data from the experiments as well as the control parameters of laser beamlines. Artificial intelligence (AI) such as machine learning and neural networks may play essential roles in optimizing the laser and target conditions for efficient laser ion acceleration. Implementing AI into the laser system in mind, as the first step, we are introducing machine learning in ion etch pit analyses detected on plastic nuclear track detectors. Convolutional neural networks allow us to analyze big ion etch pit data with high precision and recall. We introduce one of the applications of laser-driven ion beams using AI to reconstruct vector electric and magnetic fields in laser-produced turbulent plasmas in three dimensions. [ABSTRACT FROM AUTHOR]

Discusses the trend in American fiction intended for international market. American fiction in the eighties; Foreign writers who examined and extend fiction's range and formal capacities; Status of the American fiction in the nineties.

Examines Robert Coover's use of the conflict between self and other as a basic plot for his play, stories and novels. Information on the individual's search for self-awareness in Coover's writings; Coover's writings as an evidence of a sympathetic understanding of the human need for community and ritual; Plot of the book 'The Kid.'

Anidulafungin is a new echinocandin with potent in vitro activity against Aspergillus and Candida species, including those resistant to fluconazole and amphotericin B. Results of several clinical trials indicate that anidulafungin is effective in treating oesophageal candidiasis, including azole-refractory disease. The results of a single randomized clinical trial comparing fluconazole and anidulafungin demonstrated that anidulafungin was noninferior to fluconazole in the treatment of candidaemia and invasive candidiasis. Studies evaluating the concomitant use of anidulafungin and either amphotericin B, voriconazole or ciclosporin did not demonstrate significant drug-drug interactions or adverse events. Anidulafungin appears to have an excellent safety profile: alterations of liver enzymes have been reported and slow infusion is recommended to prevent histamine-like reactions. On the basis of early clinical experience, it appears that anidulafungin will be a valuable option in the management of serious and difficult-to-treat fungal infections. [ABSTRACT FROM AUTHOR]

Objective: The coronavirus disease 2019 (COVID-19) pandemic and its associated restrictions have adversely affected clinical and psychological well-being, especially in elderly subjects with type 2 diabetes (T2D). The aim of the stuy was to evaluate the impact of the restrictions imposed by the COVID-19 pandemic on metabolic parameters, diabetes quality of life (DQoL), and locus of control (LOC) in elderly outpatients with T2D, also taking into account potential gender differences. Methods: Major clinical parameters, DQoL, and LOC were evaluated in a group of consecutive elderly T2D patients on oral hypoglycemic drugs before and after 12 months of the lockdown period. Results: The glycemic control of the study subjects (n = 94; age 65-89 years) did not significantly change during the observation period. Overall, QoL slightly improved, mainly due to a reduction in the impact domain, which explores the consequences of diabetes on daily life. Regarding the LOC questionnaire, the internal score increased, and the scores of the external and chance domains decreased, indicating a lower attribution of disease control to chance or other people. These changes were more evident in men than in women. Conclusion: In this group of elderly T2D outpatients with good glycemic control, the restrictions imposed by the COVID-19 pandemic did not negatively impact health-related QoL and increased the awareness of patients’ role, especially in men. [ABSTRACT FROM AUTHOR]

In this work we report the successful implementation of plasma mirror (PM) technology on an LFEX laser facility at the Institute of Laser Engineering, Osaka University. The LFEX laser pulse was successfully refocused at the target chamber center (TCC) by means of a spherical plasma mirror, resulting in 5  ×  1018 W cm−2 laser intensity, with 45% reflectivity at a laser flux of about 90 J cm−2 on the PM. Experimental results show stable focusing and pointing of the LFEX pulse after PM refocusing. The contrast improvement was demonstrated by both cooler fast electron slope temperature distribution as well as by the ability to shoot sub-µm plastic foils obtaining proton beams with maximum energy exceeding 20 MeV. Experimental results are qualitatively reproduced by 2D particle in cell simulations. [ABSTRACT FROM AUTHOR]

Transient global amnesia, both persistent and transient, is a very common neuropsychiatric syndrome. Among animal models for amnesia and testing new drugs, the scopolamine test is the most widely used for transient global amnesia (TGA). This study examined the scopolamine-induced deficits in working memory, discriminative memory, anxiety, and motor activity in the presence of intranasal PEA-OXA, a dual antagonist of presynaptic α2 and H3 receptors. Male C57BL/6 mice were treated with intraperitoneal scopolamine (1 mg/kg) with or without pre-treatment (15 min) or post-treatment (15 min) with intranasal PEA-OXA (10 mg/kg). It was seen that scopolamine induced deficits of discriminative and spatial memory and motor deficit. These changes were associated with a loss of synaptic plasticity in the hippocampal dentate gyrus: impaired LTP after lateral entorhinal cortex/perforant pathway tetanization. Furthermore, hippocampal Ach levels were increased while ChA-T expression was reduced following scopolamine administration. PEA-OXA either prevented or restored the scopolamine-induced cognitive deficits (discriminative and spatial memory). However, the same treatment did not affect the altered motor activity or anxiety-like behavior induced by scopolamine. Consistently, electrophysiological analysis showed LTP recovery in the DG of the hippocampus, while the Ach level and ChoA-T were normalized. This study confirms the neuroprotective and pro-cognitive activity of PEA-OXA (probably through an increase in the extracellular levels of biogenic amines) in improving transient memory disorders for which the available pharmacological tools are obsolete or inadequate and not directed on specific pathophysiological targets. [ABSTRACT FROM AUTHOR]

Collimated transport of ultrahigh intensity electron current was observed in cold and in laser-shocked vitreous carbon, in agreement with simulation predictions. The fast electron beams were created by coupling high-intensity and high-contrast laser pulses onto copper-coated cones drilled into the carbon samples. The guiding mechanism--observed only for times before the shock breakout at the inner cone tip--is due to self-generated resistive magnetic fields of ~0.5-1 kT arising from the intense currents of fast electrons in vitreous carbon, by virtue of its specific high resistivity over the range of explored background temperatures. The spatial distribution of the electron beams, injected through the samples at different stages of compression, was characterized by side-on imaging of hard x-ray fluorescence. [ABSTRACT FROM AUTHOR]

Peroxisome proliferator-activated receptor alpha (PPARa) has been involved in the regulation of somatotroph tumour cells and may be targeted by different drugs, some of them are in current clinical use. The aim of this study was to investigate the expression of PPARa in additional phenotypes of pituitary adenomas (PA), the relationship between PPARa and its potential molecular partner aryl hydrocarbon receptor interacting protein (AIP) in these tumours, and the effects of PPARa agonists on lactotroph cells. Seventy-five human PA - 57 non-functioning (NFPA) and 18 prolactinomas (PRL-PA) - were characterised for PPARa and AIP expression by real time RT-PCR and/or immunohistochemistry (IHC), and the effects of fenofibrate and WY 14 643 on MMQ cells were studied in vitro. PPARa was expressed in a majority of PA. PPARa immunostaining was observed in 93.7% PRL-PA vs. 60.6% NFPA (p = 0.016), the opposite being found for AIP (83.3% in NFPA vs. 43.7% in PRL-PA, p = 0.003). PPARa expression was unrelated to gonadotroph differentiation in NFPA, but positively correlated with tumour volume in PRL-PA. Both drugs significantly reduced MMQ cell growth at high concentrations (100-200 µM). At the same time, despite modest stimulating effects on PRL secretion were observed, these were overcome by the reduction in cell number. In conclusion, PPARa is commonly expressed by PRL-PA and NFPA, regardless of AIP, and may represent a new target of PPARa agonists. [ABSTRACT FROM AUTHOR]

Candida albicans and C. dubliniensis are related yeasts that differ in the expression of virulence-associated proteins involved in adherence and biofilm development. CR3-RP (complement receptor 3-related protein) is one of the surface antigens expressed by Candida species. The main objective of this research was to elucidate the effect of the polyclonal anti-CR3-RP antibody (Ab) on adherence and the biofilm formed by C. albicans SC5314 and C. dubliniensis CBS 7987 and two clinical isolates in vitro, ex vivo and in vivo. A comparison of species, and of treated vs. non-treated with the anti-CR3-RP Ab showed a reduction in adherence (22%-41%) that was dependent on the time point of evaluation (60, 90 or 120 min), but did not prove to be species-dependent. Confocal microscopy revealed a decreased thickness in biofilms formed by both species after pre-treatment with the anti-CR3-RP Ab. This observation was confirmed ex vivo by immunohistochemistry analysis of biofilms formed on mouse tongues. Moreover, anti-CR3-RP Ab administration, 1 h post-infection, has been shown to promote larval survival compared to the control group in a Galleria mellonella infection model. Our data suggest a potential activity of the anti-CR3-RP Ab relevant to immunotherapy or vaccine development against biofilm-associated Candida infections. [ABSTRACT FROM AUTHOR]

Summary: Objective: γ‐Aminobutyric acid (GABA) is the major inhibitory neurotransmitter in adult central nervous system, and profound alterations of GABA receptor functions are linked to temporal lobe epilepsy (TLE). Here we describe the functional relationships between GABA receptors type B (GABABR) and type A (GABAAR) in human temporal cortex and how TLE affects this aspect of GABAergic signaling. Methods: Miniature inhibitory postsynaptic currents (mIPSCs) were recorded by patch‐clamp techniques from human L5 pyramidal neurons in slices from temporal cortex tissue obtained from surgery. Results: We describe a constitutive functional crosstalk between GABABRs and GABAARs in human temporal layer 5 pyramidal neurons, which is lost in epileptic tissues. The activation of GABABRs by baclofen, in addition to the expected reduction of mIPSC frequency, produced, in cortex of nonepileptic patients, the prolongation of mIPSC rise and decay times, thus increasing the inhibitory net charge associated with a single synaptic event. Block of K+ channels did not prevent the increase of decay time and charge. Protein kinase A (PKA) blocker KT5720 and pertussis toxin inhibited the action of baclofen, whereas 8Br‐cAMP mimicked the GABABR action. The same GABABR‐mediated modulation of GABAARs was observed in pyramidal neurons of rat temporal cortex, with both PKA and PKC involved in the process. In cortices from TLE patients and epileptic rats, baclofen lost its ability to modulate mIPSCs. Significance: Our results highlight the association of TLE with functional changes of GABAergic signaling that may be related to seizure propagation, and suggest that the selective activation of a definite subset of nonpresynaptic GABABRs may be therapeutically useful in TLE. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) is a highly frequent condition in patients with type 2 diabetes (T2D), but the identification of subjects at higher risk of developing the more severe forms remains elusive in clinical practice. The aim of this study was to evaluate the occurrence and severity of liver fibrosis and its predictive factors in T2D outpatients without a known history of chronic liver disease by using recommended non-invasive methods. Methods: Consecutive T2D outpatients underwent a set of measurements of clinical and laboratory parameters, FIB-4 score (Fibrosis-4 index), and liver stiffness with controlled attenuation-parameter (CAP) performed by transient elastography (FibroScan) after excluding previous causes of liver disease. Results: Among the 205 T2D outpatients enrolled in the study (median age: 64 years, diabetes duration: 11 years, HbA1c: 7.4%, and BMI: 29.6 kg/m2), 54% had high ALT and/or AST levels, 15.6% had liver stiffness value > 10.1 kPa (severe fibrosis), 55.1% had CAP values > 290 dB/m (severe steatosis), and FIB-4 score was >2 in 11.2% of subjects (>2.67 in 15 subjects). Moreover, 49 (23.9%) T2D patients had clinically meaningful liver harm, with either a FIB-4 score > 2 and/or FibroScan > 10.1 kPa. At regression analysis, BMI, HbA1c, creatinine, and triglycerides values were independent predictors of liver fibrosis. Conclusions: Liver fibrosis is a frequent finding in T2D outpatients without a known history of liver disease, especially in those with obesity, hypertriglyceridemia, worse glycemic control, and high creatinine levels. [ABSTRACT FROM AUTHOR]

Abstract: Background: Hepatocellular carcinoma (HCC) is a typical hypervascular tumor. The utility of serum alpha-fetoprotein (α-FP) in its detection is questionable. Over-expression and high circulating levels of insulin-like growth factor-II (IGF-II) were reported in tissue and in serum of patients with HCC. We investigated the diagnostic application of IGF-II in the diagnosis of HCC. Methods: Serum IGF-II and α-FP levels were measured in 178 patients (82 with HCC and 96 with liver cirrhosis) and in 30 healthy controls. Spearman test, non parametric combination test and confidence interval analysis were used for statistical evaluation of data. Results: The best cut-off values selected by ROC curves were 796ng/ml for IGF-II and 132ng/ml for α-FP. IGF-II mean values were higher in patients with HCC than in those with liver cirrhosis (LC) (p =0.0001) but lower in LC than in controls (p =0.0001). Serum IGF-II levels above cut-off were found in 22% of patients with HCC, in 9.3% of those with cirrhosis and in 20% of controls. α-FP serum levels >132ng/ml were observed in 48% of HCC, in 3.1% of LC and in none of control group. By correlation study, serum IGF-II levels were significantly correlated with serum α-FP levels (r =0.427, p =0.0001) and with nodules'' diameter (r =0.252, p =0.0130) but not with nodules'' number (p >0.050). Finally, IGF-II showed lower sensitivity, specificity and predictive values than α-FP. Conclusion: Circulating IGF-II is not a useful marker for HCC. Further researches are however needed to evaluate its diagnostic accuracy before and after nutritional adjustment. [Copyright &y& Elsevier]