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Abstract Background The prognosis of patients with Relapsed/Refractory Osteosarcoma (R/R OS) remains dismal without an agreement on systemic therapy. The use of High-Dose Ifosfamide (14 g/sqm) with an external pump in outpatient setting (14-IFO) in R/R OS patients is limited. This study represents the first retrospective cohort analysis focused on evaluating the activity and toxicity of 14-IFO in this setting. Patients and methods The study investigated 14-IFO activity, in terms of tumour response according to RECIST 1.1 criteria, as well as survival rates and toxicity, according to CTCAE v.5. Results The trial enrolled 26 patients with R/R OS. The Overall Response Rate (ORR) and Disease Control Rate (DCR) obtained was 23% and 57.5%, respectively. Patients with relapsed OS showed a higher ORR (45%) and DCR (82%) compared to refractory patients, irrespective of the number of prior treatment lines received. The achievement of disease control with 14-IFO administration enabled 27% of patients to undergo new local treatment. Four-month Progression-Free Survival (PFS) was 54% for all patients and 82% for the relapsed OS sub-group. Median Overall Survival (OSurv) was 13.7 months, with 1-year OSurv of 51% for all patients and 71% for relapsed patients. Age over 18 years and the presence of refractory disease were identified as negative prognostic factors for this patient cohort. A total of 101 cycles were evaluated for toxic assessment, demonstrating a tolerable profile without grade 3–4 non-haematological toxicities. Conclusions 14-IFO should be considered a viable treatment option for R/R OS, particularly due to its well tolerated toxicity profile and the potential for home-administration, which can improve patient quality of life without compromising efficacy.

Introduction: Osteosarcoma (OS) and Ewing sarcoma (ES) represent the pediatric population’s most common malignant bone tumors. 18-Fluorodeoxyglucose positron emission tomography has been shown to be effective in both the diagnostic and staging phases of cancer treatment. In recent years, some studies have also explored the possibility that FDG-PET could have a prognostic role. Aim: Our research aimed to evaluate if maximum standardized uptake value (SUVmax) variations after chemotherapy could be correlated with tissue necrosis and be linked with patients’ survival rates. Materials and methods: This observational retrospective study included all cases treated for skeletal OS or ES in our institution between 2006 and 2018. We recorded patients’ SUVmax values before and after chemotherapy, the necrosis grade (for those who received surgery), and survivorship. Forty-one cases (17 OS and 24 ES) were included. Among the 36 cases that received surgery, 15 were responders, and 20 were non-responders. Results: Our data suggested a statistically significant correlation between tumor necrosis and differential SUVmax after neoadjuvant treatment (p=0.007). In particular, cases with differential SUVmax higher than 4.7 or a variation higher than 63% had better oncological outcomes. Conclusion: Our study testifies to the effectiveness of FDG-PET in predicting tissue necrosis on ES and OS, thereby representing a promising prognostic factor.

As is well known, forced labour was a fixture of almost every poor relief institution that popped up throughout Europe from the late 16th century onwards. Those institutions were not primarily conceived at the time as places of punishment: instead, they were intended to provide the poor with actual assistance, be it of the material or the spiritual kind. Considering a series of discourses produced by a handful of prominent Italian thinkers and institutions between the end of the 17th and the first half of the 18th century, this contribution is intended to show how labour could be framed then in terms of charitable provision to the poor, while also highlighting the issues this peculiar framing implied.

ABSTRACT Objective: To evaluate the clinical profile, pain improvement, and the need for surgical interventions in patients undergoing transforaminal block with the use of corticosteroids and anesthetics. Methods: This is a prospective, randomized, double-blind study with 45 patients with unilateral radicular pain in their lower limbs and a single-segment lumbar disc herniation diagnosis. In the intervention group, transforaminal blocks with bupivacaine, dexamethasone, and clonidine were applied and in the control group, distilled water and bupivacaine. The Oswestry questionnaire was applied. Results: We included 24 female (53.4%) and 21 male patients (46.6%). Of those with an occupation, 85.71% (n = 30) were relieved from their duties due to their illness and 14.29% (n = 5) continued to work with limitations. Those who underwent transforaminal block with an injection of corticosteroids, clonidine, and anesthetics showed immediate relief. However, such effect failed to alleviate patients’ symptoms after three weeks. We observed that 52% of patients showed varying degrees of improvement. The control group experienced mild pain relief after one week, which also failed to last after three weeks. Moreover, 50% of patients improved in varying degrees. Conclusion: Further studies with larger samples, new epidemiological data, and longer follow-ups are necessary to validate our hypotheses. Level of Evidence II, Prospective Study.

Background & Aims: Alcohol abuse and metabolic disorders are leading causes of hepatocellular carcinoma (HCC) worldwide. Alcohol-related aetiology is associated with a worse prognosis compared with viral agents, because of the lower percentage of patients diagnosed with HCC under routine surveillance and a higher burden of comorbidity in alcohol abusers. This study aimed to describe the evolving clinical scenario of alcohol-related HCC over 15 years (2006–2020) in Italy. Methods: Data from the Italian Liver Cancer (ITA.LI.CA) registry were used: 1,391 patients were allocated to three groups based on the year of HCC diagnosis (2006–2010; 2011–2015; 2016–2020). Patient characteristics, HCC treatment, and overall survival were compared among groups. Survival predictors were also investigated. Results: Approximately 80% of alcohol-related HCCs were classified as cases of metabolic dysfunction-associated fatty liver disease. Throughout the quinquennia,

Drafting a comprehensive survey of recent literature in any given disciplinary field is always a daunting task, especially since academic globalisation, the prevalence of English as the lingua franca in scientific-academic contexts, and the increasing digitization of scholarly content have provided access to an almost unlimited number of works published in all four corners of the world. To these general difficulties, the specific case of institutional history adds its own set of problems. They all essentially revolve around one question: what exactly is institutional history? Which, of course, boils down to finding a satisfactory definition of its particular object, i.e., institutions. For this survey, I have chosen to concentrate on new books, published in the last five years, and to confine myself to Western—and specifically English, French, German, Italian, and Spanish—scholarship. Keywords: History of Institutions, Institutional History, Institution (Definition of), Methods of Historiography, Literature Survey

Roberto de Sire,1 Nicola Imperatore,1,2 Maria D’Armiento Snr,3 Pietro Coccoli,1 Imma Di Luna,1 Simona Ricciolino,1 Fabiana Castiglione,1 Antonio Rispo1 1Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy; 2Gastroenterology and Endoscopy Unit, AORN Antonio Cardarelli, Naples, Italy; 3Pathology, Department of Public Health, University Federico II of Naples, Naples, ItalyCorrespondence: Roberto de SireGastroenterology Unit, Department of Clinical Medicine and Surgery, University “Federico II” of Naples, Via Pansini 5, Naples, 80131, ItalyEmail roberto.desire@libero.itAbstract: Sclerosing mesenteritis (SM) is an idiopathic disorder affecting mesentery, characterized by fat necrosis, chronic inflammation and fibrosis. The clinical presentation varies from asymptomatic cases to acute abdomen. The diagnosis is suggested by imaging but can be definitely established only by biopsies. In this paper, we discuss ultrasonography-based management of SM.Keywords: sclerosing mesenteritis, mesenteric lipodystrophy, mesenteric panniculitis, retractile mesenteritis, ultrasonography

IntroductionStroke-like syndrome (SLS) is a rare subacute neurological complication of intrathecal or high-dose (≥500 mg) Methotrexate (MTX) administration. Its clinical features, evoking acute cerebral ischaemia with fluctuating course symptoms and a possible spontaneous resolution, have elicited interest among the scientific community. However, many issues are still open on the underlying pathogenesis, clinical, and therapeutic management and long-term outcome.Materials and MethodsWe retrospectively analyzed clinical, radiological and laboratory records of all patients diagnosed with SLS between 2011 and 2021 at 4 National referral centers for Pediatric Onco-Hematology. Patients with a latency period that was longer than 3 weeks between the last MTX administration of MTX and SLS onset were excluded from the analysis, as were those with unclear etiologies. We assessed symptom severity using a dedicated arbitrary scoring system. Eleven patients were included in the study.ResultsThe underlying disease was acute lymphoblastic leukemia type B in 10/11 patients, while fibroblastic osteosarcoma was present in a single subject. The median age at diagnosis was 11 years (range 4–34), and 64% of the patients were women. Symptoms occurred after a mean of 9.45 days (± 0.75) since the last MTX administration and lasted between 1 and 96 h. Clinical features included hemiplegia and/or cranial nerves palsy, paraesthesia, movement or speech disorders, and seizure. All patients underwent neuroimaging studies (CT and/or MRI) and EEG. The scoring system revealed an average of 4.9 points (± 2.3), with a median of 5 points (maximum 20 points). We detected a linear correlation between the severity of the disease and age in male patients.ConclusionsSLS is a rare, well-characterized complication of MTX administration. Despite the small sample, we have been able to confirm some of the previous findings in literature. We also identified a linear correlation between age and severity of the disease, which could improve the future clinical management.

Hepatic encephalopathy (HE) is a severe complication of advanced liver disease and acute liver failure. The clinical spectrum ranges from minor cognitive dysfunctions to lethargy, depressed consciousness, and coma and significantly impact the quality of life, morbidity, and mortality of the patients. It is commonly accepted that the gut milieu is essential for the development of HE; however, despite intensive research efforts, the pathogenesis of HE is still not fully elucidated. As our knowledge of gut microbiota moves from the pioneering era of culture-dependent studies, the connection between microbes, inflammation, and metabolic pathways in the pathogenesis of HE is becoming increasingly clear, providing exciting therapeutic perspectives. This review will critically examine the latest research findings on the role of gut microbes in the pathophysiological pathways underlying HE. Moreover, currently available therapeutic options and novel treatment strategies are discussed.

Reviews of Outka, Viral Modernism. The Influenza Pandemic and Interwar Literature, Columbia UP 2020; Ascheri, Rimedi contro le epidemie. I consigli di diritto europeo dei giuristi (secoli XIV-XVI), Aracne 2020; Henderson, Florence Under Siege: Surviving Plague in an Early Modern City, Yale UP 2019.

Modern learning frameworks take advantage of the interconnection among individuals, multimedia artifacts, places, events, and physical objects. In this perspective, smart cities are primary providers of data, learning stimuli and realistic hands-on laboratories. Unfortunately, the development of smart-city-enabled learning frameworks leads to many privacy and security risks since they are built on top of IoT nodes, wireless sensors networks and cyber-physical systems. To efficiently address such issues, a suitable holistic approach is needed, especially to reveal the interdependence between different actors, e.g., cloud infrastructures, resource-constrained devices and big data sources. Therefore, this paper introduces a model to help the engineering of novel learning frameworks for smart cities by enlightening the problem space characterizing security.

Abstract Background The evidence on the role of gut microbiota in post-infectious irritable bowel syndrome (PI-IBS) is convincing. Lactobacillus spp. positively affect IBS symptoms, although the mechanisms through which probiotics exert their beneficial effects are largely unknown. The aim of the study is to evaluate the role of Lactobacillus casei DG (LC-DG) and its postbiotic (PB) in modulating the inflammatory/immune-response in PI-IBS in an ex-vivo organ culture model. Methods Ex vivo cultures of ileal and colonic mucosa from 10 PI-IBS, diarrhea predominant subtype (D) patients, and 10 healthy controls (HC) were treated with LPS, LC-DG and PB. Interleukin (IL)-1α, IL-6, IL-8 and IL-10 mRNA levels were assessed by real-time PCR and Toll like receptor 4 (TLR-4) protein expression by Western blotting. Results At baseline, IL-1α, IL-6 and IL-8 mRNA levels as well as TLR-4 protein expression were significantly higher while IL-10 mRNA levels were lower in PI-IBS D than in HC in both ileum and colon. LC-DG and PB significantly reduced the mRNA levels of pro-inflammatory cytokines and TLR-4 while increased that of IL-10 after LPS stimulation. The protective effect was more pronounced for PB than LC-DG treatment. Conclusion LC-DG and its PB attenuate the inflammatory mucosal response in an ex-vivo organ culture model of PI-IBS D.

Ewing sarcoma (EWS) is a paediatric aggressive malignant tumour of bones and soft tissues. Multidisciplinary chemotherapies, surgical resection, and radiation represent the only strategies counteracting the disease, however spreading and relapse of disease still remain a clinical issue. Circulating tumour cells (CTCs) are an important feature of EWS but the prognostic significance has not been, yet, clarified. CTCs have been found both in patients with localized disease and in those who recur or metastasize. The identification of markers that can detect recurrences and metastasis remains an important challenge for research. Unfortunately, even most of patients with localized cancer relapsed and the reason has not yet been fully understood. In this clinical study on EWS patients, we evaluated the expression of CD99 antigen and beta-3 adrenergic receptor (β3-AR) on CTCs and bioptic derived cells by flow cytometry. The preliminary data revealed a higher β3-AR expression on cells derived from metastatic or relapsed patients, suggesting a role for the β3-AR as a possible predictive maker of disease recurrence in both patients with metastatic and localized disease.

Nowadays, the Internet connects people, multimedia and physical objects leading to a new-wave of services. This includes learning applications, which require to manage huge and mixed volumes of information coming from Web and social media, smart-cities and Internet of Things nodes. Unfortunately, designing smart e-learning systems able to take advantage of such a complex technological space raises different challenges. In this perspective, this paper introduces a reference architecture for the development of future and big-data-capable e-learning platforms. Also, it showcases how data can be used to enrich the learning process.

This paper discusses possible motivations to adopt cognitive computing-based solutions in the field of healthcare and surveys some recent experiences. From a very practical point of view, the use of cognitive computing techniques can provide machines with human-like reasoning capabilities, thus allowing them to face heavy uncertainties and to cope with problems whose solution may require computing intensive tasks. Moreover, empowered by reliable networking infrastructures and cloud environments, cognitive computing enables effective machine-learning techniques, resulting in the ability to find solutions on the basis of past experience, taking advantage from both errors and successful findings. Owing to these special features, it is perceptible that healthcare can greatly benefit from such a powerful technology. In fact, clinical diagnoses are frequently based on statistics and significant research advancements were accomplished through the recursive analysis of huge quantity of unstructured data such as in the case of X-ray images or computerized axial tomography scans. As another example, let us consider the problem of DNA sequence classification with the uncountable combinations that derive from such a complex structure.

This conference report describes the training activities that took place in the frame of the Integrated in Situ Chemical MApping probe (SCHeMA) summer school organized from the 14th to the 16th of June 2016 in Bilbao (Spain).

The presence of significant fibrosis is an indicator for liver disease staging and prognosis. The aim of the study was to determine reproducibility of real-time shear wave elastography using a hepatic biopsy as the reference standard to identify patients with chronic liver disease. Forty patients with chronic liver disease and 12 normal subjects received shear wave elastography performed by skilled operators. Interoperator reproducibility was studied in 29 patients. Fibrosis was evaluated using the Metavir score. The median and range shear wave elastography values in chronic liver disease subjects were 6.15 kPa and 3.14-16.7 kPa and were 4.49 kPa and 2.92-7.32 kPa in normal subjects, respectively. With respect to fibrosis detected by liver biopsy, shear wave elastography did not change significantly between F0 and F1 (p = 0.334), F1 and F2 (p = 0.611), or F3 and F4 (0.327); a significant difference was observed between the F0-F2 and F3-F4 groups (p = 0.002). SWE also correlated with inflammatory activity (Rs = 0.443, p = 0.0023) and ALT levels (Rs = 0.287, p = 0.0804). Age, sex and body mass index did not affect shear wave elastography measurements. Using receiver operator characteristic curves, two threshold values for shear wave elastography were identified: 5.62 kPa for patients with fibrosis (≥F2; sensitivity 80%, specificity 69.4%, and accuracy 77%) and 7.04 kPa for patients with severe fibrosis (≥F3; sensitivity 88.9%, specificity 81%, and accuracy 89%). Overall interobserver agreement was excellent and was analysed using an interclass correlation coefficient (0.94; CI 0.87-0.97).This study shows that shear wave elastography executed by skilled operators can be performed on almost all chronic liver disease patients with high reproducibility. It is not influenced by age, sex or body mass index, identifies severely fibrotic patients and is also related to inflammatory activity.

Cognitive computing is the new wave of Artificial Intelligence (AI), relying on traditional techniques based on expert systems and also exploiting statistics and mathematical model. In particular, cognitive computing systems can be regarded as a "more human" artificial intelligence. In fact, they mimic human reasoning methodologies, showing special capabilities in dealing with uncertainties and in solving problems that typically entail computation consuming processes. Moreover, they can evolve, exploiting the accumulated experience to learn from the past, both from errors and from successful findings. From a theoretical point of view, cognitive computing could replace existing calculators in many fields of application but hardware requirements are still high, even if the cloud infrastructure, which is expected to uphold its rapid growth in the very next future, can support their diffusion and ease the penetration of such a novel variety of systems, fostering new services as well as changes in many settled paradigms. In this paper, we focus on benefits that this technology can bring when applied in the education field and we make a short review of relevant experiences.

Gamification techniques are commonly used in e-learning to enhance the effectiveness of educational activities and the learners’ partaking. In fact, owing to the engagement effect, they can improve learning processes in diverse disciplines, empowering the traditional methods of acquisition of competences and skills. This approach is giving results in informal education activities both in traditional Learning Management Systems and in Massive Open Online Course platforms, mostly based on the consumption of video- lessons. In this context, we describe the gamification-oriented design choices made for the realization of a video-course for the training on the use of office automation software programs. Specifically, we planned the revamping of a course produced in 2012, whose lessons are made by short fictional videos, animated tutorials, and screen captures that show how to perform common operations. The design of the gamification process is following the hype for the launch of the new Star WarsTM, Episode 7, and, as a consequence, will be delivered as “Star Words”. In the paper we present the gamification methodologies adopted to create the first prototype of Star Words, also analyzing the criticisms that emerged.

The diffusion of modern mobile devices and applications coupled with the pervasive use of social network services and communications tools, are dramatically changing the way people work, live and learn. In this perspective, this work will discuss an innovative proposal, to be considered as a new paradigm in mobile learning. In particular, we present the use of a Web-radio channel as an educational tool in a mobile-learning environment. Such a medium has unique characteristics of an interactive tool and, furthermore, interaction among users can be enabled by the integration with social networking. Therefore, given the special characteristics of such a medium, it is quite natural to design educational activities relying on social networking, which can be implemented in a mobile environment, according to a novel Web-radio social networking mobile education model.

This paper discusses the use of a collaborative learning environment, specifically designed for computer science education. In particular, we investigate how students (may) meaningfully learn computer science and how web technologies (may) support them in this process. For a comprehensive view of the problem, different instructional theories are considered, as well as specific requirements for computer science education, driving the research to the adoption of semantic technologies and to the definition of a specific semantic-wiki-based framework. In this scenario, the authors present an on- going research project, named Semantic-WikiSUN, which aims to investigate innovative strategies for learning and teaching computer science in the context of higher education. It is based on the use of semantic-wiki to support the sharing and acquiring of knowledge in this specific knowledge domain, enabling the application of basic pedagogical principles.

Topic Maps are a methodology whose aim is describing knowledge structures and associating them with information resources. XML Topic Maps (XTM) is an XML-based encoding scheme to represent topic maps and similar knowledge structures (e.g. semantic networks, associative networks, concept maps, mind maps, etc.). In this paper Topic Maps and XTM are proposed as a knowledge representation system to be exploited in e-learning environments for a suited integration with semantic web technologies. They may be a useful tool to facilitate the design of learning contents and their delivery in diverse contexts. After a short survey of the Topic Maps standardization process, in this paper key elements and characteristics of TM and XTM paradigm are described. Then it is briefly discussed about Topic Maps applications in e-learning context and also a short survey of related works is presented.

Semantic Wiki consentono, tramite un linguaggio comprensibile agli elaboratori e formalmente definito, l’annotazione semantica dei contenuti delle pagine Wiki e la rappresentazione esplicita delle relazioni di significato tra essi presenti. Essi offrono la possibilità di sfruttare sia i vantaggi delle tecnologie basate su ontologie sia i meccanismi collaborativi propri dei Wiki. L’articolo descrive un progetto, denominato Semantic WikiSUN, avviato per indagare le prospettive didattiche di tali sistemi. Esso è basato su un quadro teorico complesso che integra evidenze neurocognitive, teorie dell’apprendimento e modelli costruttivisti-sociali della conoscenza. Obiettivo del contributo è, sulla base della esperienza intrapresa, discutere potenzialità e criticità didattiche dei Semantic Wiki, estendendo talvolta la riflessione a considerazioni più generali sui processi di apprendimento mediati da tecnologie semantiche.

This paper outlines possible evolution trends of e-learning, supported by most recent advancements in the World Wide Web. Specifically, we consider a situation in which the Semantic Web technology and tools are widely adopted, and fully integrated within a context of applications exploiting the Internet of Things paradigm. Such a scenario will dramatically impact on learning activities, as well as on teaching strategies and instructional design methodology. In particular, the models characterized by learning pervasiveness and interactivity will be greatly empowered.

The rapid evolving of web technologies has brought to the increasingly diffusion of applications making the Web an interactive social network environment. The World Wide Web Consortium and several research centers are working on the integration of such technologies into the project of a Semantic Web. Consequently, e-learning systems and tools supporting instructional content design could take advantage of these advancements. In this scenario, according to a social-constructivist approach, the authors discuss the adoption of Semantic Wiki as a collaborative environment to design educational contents. The paper will outline the application perspectives and the strategies to adopt, in order to facilitate meaningful learning processes, and the potential advantages that Semantic Wikis would bring from the point of view of knowledge management, as well as for the re-use of learning resources.

The Semantic Web seems to offer great opportunities for educational systems aiming to accomplish the AAAL: Anytime, Anywhere, Anybody Learning. In this scenario, two different research projects are here introduced: CADDIE (Content Automated Design & Development Integrated Editor), developed at the DIST of the University of Genoa, and IWT (Intelligent Web Teacher), developed at the DIIMA of the University of Salerno, each of them characterized by the use of ontologies and semantic technologies in order to support instructional design and personalized learning processes. The former aims to develop a learning resources and instructional paths authoring tool based on a logical and abstract annotation model, created with the goal of guaranteeing the fexibility and personalization of instructional design, the reusability of teaching materials and of the related whole knowledge structures. The latter represents an innovative e-learning solution able to support teachers and instructional designers to model educational domains knowledge, users’ competences and preferences by a semantic approach in order to create personalized and contextualized learning activities and to allow users to communicate, to cooperate, to dynamically create new content to deliver and information to share as well as enabling platform for e-learning 2.0.

This work reports on the process of integration of the EifFE-L open source e-learning platform within the Eclipse open source development platform, with the aim to create an open framework for both distance education and knowledge management. The fusion of the two environments can lead several advantages: EifFE-L has earned in fexibility having acquired the possibility to take advantage of a powerful and easy to use development environment and has thus be been able to evolve following the ever growing requirements of e-learning; Eclipse has made a further step ahead in the direction of becoming an e-learning tool for the programming languages and for the management of virtual laboratories and simulation environments.

The competition for marine space is a recognized challenge, and the implementation of new activities, such as those emerging from Blue Growth initiatives, may amplify this competition. The marine spatial planning (MSP) framework requires decision makers to analyse spatially explicit environmental and socio-economic data to determine where user conflicts are or might emerge and consider several potential management scenarios. In the present research, a spatially explicit Bayesian belief network (BBN) was applied for this purpose. The BBN was developed to analyse the potential reallocation of artisanal fishing effort to alternative sites due to the introduction of a new, non-take area: an offshore aquaculture site along the Basque continental shelf. The constructed model combined discrete, operational fisheries data, continuous environmental data, and expert judgment to produce fishing activity suitability maps for three different métiers (longlines, nets and traps). The BBN was run with various effort reallocation scenarios for each metier, and the best alternative fishing locations were identified based on environmental suitability, past revenue, and past fishing presence. The closure had a lesser effect on net and longline activity, displacing 10% and 7% of local fishing effort respectively. Comparatively, 50% of all local effort by traps took place within the closed grounds, and few alternative sites were identified. Nets were found to have the greatest number of alternative fishing grounds surrounding the aquaculture site. The present research demonstrates how BBNs can support spatially explicit scenario building and user-user conflict analysis for sustainable and successful ecosystem-based marine spatial planning. [ABSTRACT FROM AUTHOR]

Background: Glucose is one of the most frequently requested analytes in clinical laboratory. Blood glucose analysis is affected from in vitro glycolysis. In order to determine the most suitable blood collection tube for this purpose we have compared different tubes: sodium fluoride, lithium heparin, sodium fluoride/citrate buffer containing tubes and serum with clot activator tube for the measurement of glucose when the tube has been kept at room temperature (RT) for up to 4h.Methods: Venous blood was collected from 49 healthy volunteers into Sarstedt S-Monovettes for glucose analysis. Reference plasma glucose was determined in a lithium heparin tube and immediately placed in an ice/water slurry. Within 10min it was centrifuged at 4°C and plasma was separated from the blood cells. Samples have been preserved at RT for 1, 2 and 4h after drawing. Glucose has been determined using a hexokinase method.Results: Glucose levels tested in a serum with clot activator tube, in lithium heparin and in sodium fluoride/sodium EDTA tubes when compared with lithium-heparin reference plasma did not meet the desirable bias for glucose (±1.8%) when kept at RT for up to 4h. GlucoEXACT tubes, when corrected by the Sarsted recommended factor of 1.16, showed a mean (95% CI) bias of +0.96% (0.45-1.47) at 1h, +1.40% (0.88-1.93) at 2h and +0.95% (0.44-1.46) at 4h, reaching the analytical goal for the desirable bias.Conclusions: Samples collected into GlucoEXACT tubes containing sodium fluoride/citrate buffer liquid mixture are equivalent to those collected in reference plasma tubes avoiding glycolysis completely and within a 4h delay in plasma separation. [ABSTRACT FROM AUTHOR]

Background Proton pump inhibitors may foster intestinal dysbiosis and related bowel symptoms. Aim To evaluate the effect of Lactobacillus paracasei F19 on bowel symptom onset in patients on long-term proton pump inhibitors. Methods In this randomized, double-blind, placebo-controlled study, patients with typical gastroesophageal reflux disease symptoms receiving pantoprazole 40 mg/d for six months were randomly assigned to receive: (A) Lactobacillus paracasei F19 bid for three days/week for six months; (B) placebo bid for three days/week for six months; (C) Lactobacillus paracasei F19 bid for three days/week for three months and placebo bid for three days/week for the following three months; (D) placebo bid for three days/week for three months and Lactobacillus paracasei F19 bid for three days/week for the following three months. Bloating, flatulence, abdominal pain and bowel habit were assessed monthly. Results 100/312 patients were enrolled. In the parallel groups, the treatment-by-time interaction affected bloating ( p = 0.015), while Lactobacillus paracasei F19 treatment alone affected flatulence ( p = 0.011). Moreover, the treatment-by-time interaction significantly affected the mean score of bloating ( p = 0.01) and flatulence ( p < 0.0001), the mean stool form ( p = 0.03) and mean stool frequency/week ( p = 0.016). Analysis of the cross-over groups, limited to the first three months because of carry-over effect, confirmed these results. Conclusion Lactobacillus paracasei F19 supplementation prevents bowel symptom onset in patients on long-term proton pump inhibitors. [ABSTRACT FROM AUTHOR]