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Abstract. As a result of rising life expectancy the indication for radical cystectomy is registered more and more frequently also in elderly and multimorbid patients. This work is aimed to estimate the importance of cystectomy in patients older than 70 years. The study was designed as a comparative analysis of two patients groups of 70-75 (group I) and over 75 (group II) years old with respect to following parameters: preoperative morbidity (Charlson Comorbidity-index), stat. length of hospital stay, transfusion rate, early and late complications, mortality and postoperative life expectancy. The data revealed that patients over 75 years old, who were higher cardiopulmonary preloaded, had a longer hospital stay and exhibited a higher transfusion rate. The early and late complication rates, assessed with the Clavien-Dindo classification, were identical in both groups. At the same time the internal medicine and major complications (CDC 3-5) dominated in the group of over 75 years old patients. The younger patients lived twice as long as the older patients. While having the same 30 days mortality in both groups, the 90 days mortality was higher in the older group. The 5-year survival was significantly higher in the group I. Thus, the radical cystectomy should be strived in older age expecting acceptable higher complication rates and mortality even in multi-morbid patients after more accurately risk stratification and evaluation of individual biological constellation.

BackgroundThe Phase 1/2 Treat_CCM randomized controlled trial for people with familial cerebral cavernous malformations (FCCMs) confirmed the safety of propranolol and suggested beneficial effects on intracerebral hemorrhage or new focal neurological deficits, but the effects on patient-reported outcome measures have not been reported.MethodsParticipants completed self-reported questionnaires at baseline, 1 and 2 years. Depression was assessed with the Beck Depression Inventory-II (BDI-2); Anxiety with the State–Trait Anxiety Inventory X1 and X2 (STAI X-1 and STAI X-2); and Quality of Life with the Short Form 36 (SF-36), split into the physical and mental component scales (PCS and MCS). Differences between treatment groups and the general population were assessed. Change over time by treatment was assessed by means of mixed models.ResultsIn total, 71 participants (48 propranolol and 23 standard care) were enrolled, of whom 61 (73%) completed questionnaires at baseline and 2-year FU. At baseline, no differences between treatment groups for any of the questionnaires were present. Twenty (31.7%) patients were considered depressed at baseline, while this proportion was lower in the propranolol group after 2 years (28.6% vs. 55.5%, p = 0.047). The STAI X-1 and X-2 scores were stable over time. PCS was lower in FCCM patients as compared with the general Italian population, while the MCS was similar to the general population. No effect of propranolol was found for both PCS and MCS.ConclusionDepression is common among patients with FCCM. Patients randomized to propranolol had a lower proportion of participants with depression after 2 years.Clinical trial registration: https://clinicaltrials.gov/, identifier (NCT03589014).

In the setting of infectious diseases, antibodies show different functions beyond neutralizing activity. In this study, we investigated the activation of NK cells in vitro in the presence of human cytomegalovirus (HCMV)-specific antibodies and their potential role in the control of HCMV infection through antibody-dependent cell cytotoxicity (ADCC). Retinal pigmented epithelial cells (ARPE-19) infected with the HCMV strain VR1814 were co-cultured with cytokine-activated peripheral blood mononuclear cells (PBMCs) in the presence of sera collected from 23 HCMV-seropositive and 9 HCMV-seronegative donors. Moreover, 13 pregnant women sampled 3 and 6 months after HCMV primary infection and 13 pregnant women with pre-conception immunity were tested and compared. We determined the percentage of activated NK cells via the analysis of CD107a expression as a marker of degranulation. Significantly higher levels of NK-cell activation were observed using 1/100 and 1/10 dilutions of sera from HCMV-seropositive individuals, and when cells were infected for 96 and 120 h, suggesting that NK cells are activated by antibodies directed against late antigens. In the absence of serum NK cells, activation was negligible. In seropositive subjects, the median percentages of CD107a-positive NK cells in the presence of autologous serum and pooled HCMV-positive serum were similar (14.03% [range 0.00–33.56] and 12.42% [range 1.01–46.00], respectively), while NK-cell activation was negligible using an HCMV-negative serum pool. In HCMV-seronegative subjects, the median percentage of activated NK cells was 0.90% [range 0.00–3.92] with autologous serum and 2.07% [0.00–5.76] in the presence of the HCMV-negative serum pool, while it was 8.97% [0.00–26.49] with the pool of HCMV-positive sera. NK-cell activation using hyperimmune globulin is comparable to what is obtained using autologous serum. Sera from subjects at 3 and 6 months post primary infection showed a lower capacity of NK-cell activation than sera from subjects with past infection (p < 0.001). NK activation against HCMV-infected epithelial cells is dependent on the presence of HCMV-specific antibodies. This serum activity increases with time after the onset of HCMV infection. The protective role of NK-cell activation by HCMV-specific serum antibodies should be verified in clinical settings.

(1) Background: Pulp canal obliteration (PCO) is a common condition characterized by an abnormal dentinal apposition within the canal wall, which often rises as a consequence of dental trauma. In recent years, “guided endodontics” has offered a reliable and safer procedure for endodontic access in case of PCO. The present case report aims to introduce a new endodontic guided system with a sleeveless, open-frame titanium guide designed to reduce costs compared to traditional templates. (2) Methods: The patient is a 19-year-old female who was referred to a private clinic to treat a calcified and symptomatic tooth (3.3) with apical periodontitis. Following the first unsuccessful treatment attempt using the operating microscope, a three-dimensional cone beam computed tomography (CBCT) examination and an optical impression were performed in agreement with the patient. The Digital Imaging and Communications in Medicine (DICOM) and Standard Tessellation Language (STL) files were sent to the lab for the template packaging, and the patient was scheduled for a second appointment. The endodontic guide was accurately positioned, and shaping and filling were concluded with success. The canal was sealed with the single-cone technique and bioceramic sealer. (3) Results: The patient reported no significant post-operative symptoms. Notably, the treatment achieved total symptom resolution, as evidenced by radiographic assessments conducted 3 and 24 months post-treatment, confirming the procedure’s success. (4) Conclusions: This innovative sleeveless, open-frame static titanium guide presents a promising advancement in guided endodontics for PCO treatment. The advantages include preserving healthy dental tissue, reduced chairside operating time, and cost savings compared to conventional templates. This approach holds promise for enhancing the quality and efficiency of endodontic procedures in cases of PCO. While the static guide holds promise, larger prospective studies are necessary to validate its efficacy, safety, and broader applicability in routine endodontic procedures.

In this paper, we attempt to investigate the pedagogical value of visual social media platforms, specifically Instagram, for the development of the online social presence of language classes. Students in intermediate university-level French and Italian classes used Instagram for a six-week period to reply to a series of questions prompted by the instructor as a way to engage in interaction with their own classmates. This research examines how students establish a community of inquiry (CoI) and investigates the development of social presence in students' posts. Using a mixed methods approach, we performed a content analysis of the transcripts of Instagram posts, coding for social presence. Given the visual nature of Instagram, we also conducted a visual analysis of representative posts to investigate the multimodal projection of social presence. Additionally, we administered voluntary pre-questionnaires to capture demographic data and students' experience with Instagram. We analyzed the data using the social presence density calculation and performed basic statistical analyses. Findings indicate that students did build online social presence, which can promote the development of a CoI. Both language groups performed in similar ways, which may be a result of the tool rather than the language and context. This finding is consistent with the general use of visual social media as a tool for self-expression, self-identity, and community building.

Introduction. Missing anatomy is one of the main causes of endodontic failures, and accurate knowledge of teeth anatomy is a prerequisite for adequate root canal treatment. The aim of the present cone beam computed tomography (CBCT) study was to describe the anatomical characteristics of the mesiobuccal (MB) root canals of maxillary molars and to understand if a correlation exists between the position of the canal orifices and the anatomical features of the root. Methods. For the purposes of the study, a total of 100 CBCT scans of maxillary molars with two MB canals were selected and studied. The features of root canal anatomy of the MB root of the same teeth were analyzed and recorded (root length, confluence, and Vertucci classification). The distance between MB1 and MB2 orifices and the palatal orifice were recorded, as well as the distance between the orifices and the line joining the palatal orifice and the others. A statistical analysis was performed by providing descriptive measures, the measure of the correlation between different parameters, and the influence of some of these measures on the presence of a confluence between MB1 and MB2. Results. It resulted that the most frequent configuration is type II Vertucci. The length measured on the sagittal plane was significantly correlated to the presence of a confluence in the MB root. When the root length was higher than 14.56 mm, the confluence is three times more frequent than when the length is lower (OR = 3.635). The area under the curve (AUC) of the receiver operator characteristic (ROC) curve for length on the sagittal plane was 0.632 (P=0.036). Conclusions. The presence of a confluence between the MB canals of maxillary molars is correlated to the length of the root that could be measured on the sagittal plane and to the distance between the canal orifices. The relative position of the root canal orifices in relation to anatomic landmarks needs to be further explored.

Sustainability research has emerged as an interdisciplinary area of knowledge about how to achieve sustainable development, while political actions toward the goal are still in their infancy. A sustainable world is mirrored by a healthy environment in which humans can live without jeopardizing the survival of future generations. The main aim of this contribution was to carry out a systematic mapping (SM) of the applications of digital technologies in promoting environmental sustainability. From a rigorous search of different databases, a set of more than 1000 studies was initially retrieved and then, following screening criteria based on the ROSES (RepOrting standards for Systematic Evidence Syntheses) procedure, a total of N = 37 studies that met the eligibility criteria were selected. The studies were coded according to different descriptive variables, such as digital technology used for the intervention, type of sustainable behavior promoted, research design, and population for whom the intervention was applied. Results showed the emergence of three main clusters of Digital Technologies (i.e., virtual/immersive/augmented reality, gamification, and power-metering systems) and two main Sustainable Behaviors (SBs) (i.e., energy and water-saving, and pollution reduction). The need for a clearer knowledge of which digital interventions work and the reasons why they work (or do not work) does not emerge from the outcomes of this set of studies. Future studies on digital interventions should better detail intervention design characteristics, alongside the reasons underlying design choices, both behaviourally and technologically. This should increase the likelihood of the successful adoption of digital interventions promoting behavioral changes in a more sustainable direction.

Abstract Iodine deficiency represents a public health problem worldwide. To increase the amount of iodine in the diet, biofortification strategies of plants have been tried. They rely on the exogenous administration of iodine to increase its absorption and accumulation. However, iodine is not stable in plants and can be volatilized as methyl iodide through the action of specific methyltransferases encoded by the HARMLESS TO OZONE LAYER (HOL) genes. The release of methyl iodide in the atmosphere represents a threat for the environment due to its ozone depletion potential. Rice paddies are among the strongest producers of methyl iodide. Thus, the agronomic approach of iodine biofortification is not appropriate for this crop, leading to further increases of iodine emissions. In this work, we used the genome editing CRISPR/Cas9 technology to knockout the rice HOL genes and investigate their function. OsHOL1 resulted a major player in methyl iodide production, since its knockout abolished the process. Moreover, its overexpression reinforced it. Conversely, knockout of OsHOL2 did not produce effects. Our experiments helped elucidating the function of the rice HOL genes, providing tools to develop new rice varieties with reduced iodine emissions and thus more suitable for biofortification programs without further impacting on the environment.

Abstract Background For patients over the age of 70 years, sacral neuromodulation (SNM) is often not considered a potential therapeutic option. We therefore report on our results from performing SNM in elderly patients ≥70 years. Methods Between 01/09 and 12/18, a total of 95 patients with refractory overactive bladder (OAB) or chronic non-obstructive urinary retention underwent SNM testing at our department. In the overall sample, 20 patients were aged 70 years or older (21%, group B), and 75 patients were under 70 years old (79%, group A). The mean follow-up period was 50.2 ± 36.2 months. Pre-, peri- and postoperative parameters were compared between the two groups. Statistical analysis was carried out with SPSS 25.0 (p

Abstract Background Improving yield and yield-related traits is the crucial goal in breeding programmes of cereals. Meta-QTL (MQTL) analysis discovers the most stable QTLs regardless of populations genetic background and field trial conditions and effectively narrows down the confidence interval (CI) for identification of candidate genes (CG) and markers development. Results A comprehensive MQTL analysis was implemented on 1052 QTLs reported for yield (YLD), grain weight (GW), heading date (HD), plant height (PH) and tiller number (TN) in 122 rice populations evaluated under normal condition from 1996 to 2019. Consequently, these QTLs were confined into 114 MQTLs and the average CI was reduced up to 3.5 folds in compare to the mean CI of the original QTLs with an average of 4.85 cM CI in the resulted MQTLs. Among them, 27 MQTLs with at least five initial QTLs from independent studies were considered as the most stable QTLs over different field trials and genetic backgrounds. Furthermore, several known and novel CGs were detected in the high confident MQTLs intervals. The genomic distribution of MQTLs indicated the highest density at subtelomeric chromosomal regions. Using the advantage of synteny and comparative genomics analysis, 11 and 15 ortho-MQTLs were identified at co-linear regions between rice with barley and maize, respectively. In addition, comparing resulted MQTLs with GWAS studies led to identification of eighteen common significant chromosomal regions controlling the evaluated traits. Conclusion This comprehensive analysis defines a genome wide landscape on the most stable loci associated with reliable genetic markers and CGs for yield and yield-related traits in rice. Our findings showed that some of these information are transferable to other cereals that lead to improvement of their breeding programs.

Due to the environmental and health impact of the private transport sector, social scientists have largely focused on psychosocial and contextual factors associated with people's choice over transport means. This study aims to contribute to this line of research by applying a user-centered approach, with the objective of taking into account the specific environmental and social context of the metropolitan area of Cagliari city (Sardinia, Italy). To accomplish this aim, four groups of people were matched according to their shared starting point: car users vs. public transport users (Study 1), and light-rail users vs. non-light-rail users (Study 2). Groups were interviewed using a focus group method. Participants were invited to discuss their everyday travel experiences and to exchange their ideas on different sustainable (e.g., bicycles and public transport) and less sustainable (i.e., private cars) means of transport. Both consolidated drivers/barriers in the field of environmental psychology (e.g., perceived behavioral control, social norms) and public transportation design features (e.g., lighting) have been investigated. Other than highlighting the importance of socio-psychological factors to promote more sustainable transport choices like in previous studies, the present research offers an insight into how these aspects and factors are shaped and experienced in the narratives of residents.

Using the “user-centered” design perspective and the construct of design “humanization” as theoretical underpinnings, this field study verified the role of “objective” design quality of residential facilities for the elderly in the prediction of “subjective” users’ psychological responses. A sample of over-65-year-old adults (N = 114) was recruited in eleven residential facilities, which differed for the degree of “objective” design humanization (rated on the basis of a design expert assessment). Participants had to fill in a questionnaire including measures of both specific perceived environmental qualities (spatial-physical and social-relational) and more general psychological responses (such as residential satisfaction and psychological well-being). Outcomes revealed that older residents living in high-humanization structures show higher scores of residential satisfaction, psychological well-being and perceived environmental qualities than those living in low-humanization structures. Moreover, significant correlations emerged between specific perceived environmental qualities of the facility and general psychological outcomes. These results confirm the importance of design features for supporting elders’ needs and fostering their quality of life.

This paper shows a straightforward, but surprisingly effective approach to detect genomic regions of importance, illustrated on two Simmental cattle populations. Medium density genomic data of 42 German/Austrian (denoted as “Western“) and 38 Russian Simmental cattle were used to identify the most frequent haplotypes within the two populations. The haplotypes were defined as non-overlapping segments of ten single nucleotide ploymorphisms (SNP). The phasing was done with the SHAPEIT software, with a follow up analysis of haplotypes using the GHap package. Despite the low sample size a number of high frequency haplotypes could be identified across the whole genome. The identified genes residing directly in these high frequency haplotypes were extremely relevant for the dual purpose Simmental cattle. A large part of these genes influenced growth rate and carcass traits, others were relevant for the milk production. A smaller proportion was connected to the reproduction, immune system and cellular processes, with indirect influence on production traits.

Aim: Ludwig's angina is a rare aggressive infection, often of dental origin, characterized by a rapid spread of cellulitis in the submandibular and sublingual spaces. Ludwig's angina is potentially fatal, if it obstructs the airways and if it is not treated with appropriate antibiotic therapy. Summary: The case report describes the diagnosis and the management of a Ludwig's angina caused by an endodontic infection in a 16 years-old female patient. The infection has been caused by a decay of the second lower right molar. After hospitalization and systemic antibiotic therapy, in accordance with the patient and the parents endodontic and restorative treatments of the tooth were performed. After 3 and 5 years, the radiological examination revealed no periapical lesions around right lower second molar and the presence of lamina dura. Key learning points: This aggressive infection may often be undervalued and this may cause dangerous consequences to the patient's life. The infection can be prevented by periodic dental care and interventions, which can avoid odontogenic infections. In the case of Ludwig's angina, early diagnosis is fundamental to save the patient's life. After the initial antibiotic therapy and once the life of the patient is no longer at risk, an appropriate endodontic therapy can be considered a valid therapy for this disease. Riassunto: Obiettivi: L’angina di Ludwig è un’infezione aggressiva, spesso di origine odontogena, caratterizzata da una raccolta cellulitica a rapida evoluzione che coinvolge gli spazi sotto-mandibolare e sotto-linguale. Essa può ostruire le vie respiratorie ed essere potenzialmente fatale se non tempestivamente trattata con cure antibiotiche appropriate. Riassunto: In questo articolo viene descritto un caso di diagnosi e trattamento di un’angina di Ludwig causata da un’infezione odontogena in una ragazza di 16 anni. L’infezione é stata causata da una carie a carico del secondo molare inferiore di destra. Dopo il ricovero ospedaliero ed una terapia antibiotica sistemica parenterale, con il consenso dei genitori abbiamo è stata eseguita una terapia endodontica e la successiva ricostruzione con materiali adesivi dell’elemento dentario in questione. Dopo 3 e 5 anni gli esami radiografici mostrano assenza di lesioni periapicali e la presenza della lamina dura. Punti chiave di apprendimento: Questa infezione aggressiva è spesso sottovalutata e ciò può causare conseguenze gravi per la vita del paziente. Tali infezioni possono essere prevenute con controlli periodici del cavo orale. In caso di angina di Ludwig una diagnosi tempestiva è fondamentale per salvare la vita del paziente. Dopo l’iniziale terapia antibiotica ed aver messo in sicurezza la salute generale del paziente, la terapia endodontica può essere considerata una valida alternativa per questa patologia. Keywords: Ludwig's angina, Endodontic therapy, Endodontic infection, CBCT, Management infection, Parole chiave: Angina di Ludwig, Terapia endodontica, Infezione endodontica, CBCT, Gestione dell’infezione