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Elisabetta Cavalcanti,1 Francesco De Michele,1 Giulio Lantone,2 Alba Panarese,3 Maria Lucia Caruso11Histopathology Unit, National Institute of Gastroenterology “S. de Bellis,” Research Hospital, Castellana Grotte, Bari, Italy; 2Surgery Unit, National Institute of Gastroenterology “S. de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy; 3Gastroenterology and Endoscopy Unit, National Institute of Gastroenterology “S. de Bellis”, Research Hospital, Castellana Grotte, Bari, ItalyIntroduction: Endoscopic submucosal dissection is widely employed in early gastric cancer (EGC). Foveolar phenotypes should be distinguished from the other differentiated EGC (DEGC) types because of their increased malignant potential. The phenotypic classification could be useful not only for investigating EGC tumorigenesis but also for evaluating the tumor aggressiveness to guide treatment decision making.Methods: On surgical tissue specimens, we studied the mucin phenotype of EGC to distinguish cases with a worse prognosis dictating different therapeutic options or a very close surveillance program. DEGC in our series were classified as mucin foveolar (51%) or mucin intestinal (49%) phenotype. We evaluated correlations among foveolar and intestinal phenotypic markers, tumor patterns, clinicopathologic features and prognostic and therapeutic implications. Immunohistochemistry (IHC) for MUC5AC and CDX2 was performed on 63 EGC patient specimens. MUCA5C was employed as gastric foveolar phenotypic marker and CDX2 as intestinal phenotypic marker.Results: Foveolar DEGC was significantly associated with larger tumor size (p=0.01), high grade (G2-G3) (p=0.001), vessel permeation (p=0.05), lymph node metastasis (p=0.001) and ulceration (p=0.001), whereas intestinal type DEGC was associated with low grade (p=0.001).Conclusion: IHC determination of the mucin phenotype is an easy, inexpensive method that can provide useful, sensitive markers distinguishing the foveolar or intestinal phenotype in DEGC. The precise identification of the foveolar type, featuring a poorer prognosis, should sound a warning bell mandating very close study of the lesion before endoscopic treatment or contraindicating endoscopic resection in favor of the open surgery option.Keywords: DEGC, MUC5AC, CDX2, ESD

Treatment of rectal cancer has improved over the years thanks to a multidisciplinary approach. A correct staging has a fundamental role for risk stratification and to define the best treatment for each patient. Unfortunately, approximately 30% of patients with locally advanced rectal cancers will experience tumor recurrence. Thus, the identification of novel clinical-pathological and radiological prognostic factors represents an urgent unmet clinical need. Here we report the case of a patient with radically resected localized rectal cancer who developed an impressive early pelvic recurrence. To better understand the clinical scenario, we have studied the possible factors related to the aggressiveness of the disease. The only poor prognosticfactor that was evidenced at histological report was perineural invasion. Therefore, we questioned whether we could evaluate perineural invasion with imaging, similar to head and neck tumors. Learning from this clinical case, we believe that improving the risk stratification and radiology reporting is necessary to provide the best care for the patient and allow for a better prognosis prediction. Of course, our data should be considered as hypothesis generating and should be further investigated and validated in larger and prospective studies.

Brazil’s extensive coastline, tropical and subtropical climate, and well-preserved environment represent a conducive setting for dirofilariosis, a zoonotic mosquito-borne disease. Although this condition has long been recognised in the country, it has been relatively under-studied, and it is currently considered to be an emerging disease. Diagnosis, treatment, and control remain challenging due to the extensive gaps in knowledge. In order to help address this issue, this review aims to (i) summarise the available literature on the distribution of Dirofilaria spp. in Brazilian dogs over the last decade, (ii) review case reports of dirofilariosis in cats, wild animals, and humans over the last twenty years, and (iii) highlight the benefits of taking a One Health approach to managing this disease. While there have been several prevalence studies in dogs, disease distribution is poorly characterised in cats, and little is known about the occurrence of the parasite in wildlife. Human cases are sporadically reported, and no large-scale studies have been undertaken to date. Evidence indicates that Dirofilaria immitis is the main species circulating in Brazil, although Dirofilaria repens has also been detected. Molecular studies have also suggested the circulation of a highly virulent form of D. immitis, which may be genetically distinct from those of the Old World. A programme of epidemiological, ecological, genomic, and pathogenicity-based studies is required to quantify the impact of dirofilariosis in Brazil on both veterinary and public health and to inform others on its control.

Potato cultivation is of paramount importance for South Tyrol and represents especially for the agriculture in Pusteria valley an important source of income. The ‘Pustertaler Saatbau’cooperative stores and sells the majority of seed and regular potatoes grown in the province. The cooperative offers a selection of 25 different potato cultivars, carefully harvested and optimally stored until spring. Recently, premature germination has been observed on certain lots, possibly due to excessive nitrogen fertilisation. Therefore, a four-year trial (2016-2019) was carried out in collaboration with the Laimburg Research Centre to investigate the influence of different nitrogen (N) treatments on the storability of six different potato cultivars. In addition, two different methods for early prediction of excess use of N-fertilisation on potato lots were tested. Although in some years the over-fertilised potato cultivars were characterised by higher germination intensity during storage, our results showed that germination intensity is more likely to be influenced by a combination of factors, such as cultivar susceptibility, seasonality, weather and fertilisation. The potato cultivar selection, tailor-made cultivation practices and knowledge of their storability potential, enable the optimal marketing of this important source of income without facing unpleasant losses.

Introduction:The purine analog 6-thioguanine (6TG), an old drug approved in the 60s to treat acute myeloid leukemia (AML), was tested in the diabetic retinopathy (DR) experimental in vivo setting along with a molecular modeling approach.Methods:A computational analysis was performed to investigate the interaction of 6TG with MC1R and MC5R. This was confirmed in human umbilical vein endothelial cells (HUVECs) exposed to high glucose (25 mM) for 24 h. Cell viability in HUVECs exposed to high glucose and treated with 6TG (0.05–0.5–5 µM) was performed. To assess tube formation, HUVECs were treated for 24 h with 6TG 5 µM and AGRP (0.5–1–5 µM) or PG20N (0.5–1–5–10 µM), which are MC1R and MC5R antagonists, respectively. For the in vivo DR setting, diabetes was induced in C57BL/6J mice through a single streptozotocin (STZ) injection. After 2, 6, and 10 weeks, diabetic and control mice received 6TG intravitreally (0.5–1–2.5 mg/kg) alone or in combination with AGRP or PG20N. Fluorescein angiography (FA) was performed after 4 and 14 weeks after the onset of diabetes. After 14 weeks, mice were euthanized, and immunohistochemical analysis was performed to assess retinal levels of CD34, a marker of endothelial progenitor cell formation during neo-angiogenesis.Results:The computational analysis evidenced a more stable binding of 6TG binding at MC5R than MC1R. This was confirmed by the tube formation assay in HUVECs exposed to high glucose. Indeed, the anti-angiogenic activity of 6TG was eradicated by a higher dose of the MC5R antagonist PG20N (10 µM) compared to the MC1R antagonist AGRP (5 µM). The retinal anti-angiogenic effect of 6TG was evident also in diabetic mice, showing a reduction in retinal vascular alterations by FA analysis. This effect was not observed in diabetic mice receiving 6TG in combination with AGRP or PG20N. Accordingly, retinal CD34 staining was reduced in diabetic mice treated with 6TG. Conversely, it was not decreased in diabetic mice receiving 6TG combined with AGRP or PG20N.Conclusion:6TG evidenced a marked anti-angiogenic activity in HUVECs exposed to high glucose and in mice with DR. This seems to be mediated by MC1R and MC5R retinal receptors.

Approximately 20% of patients with ulcerative colitis (UC) develop acute severe UC (ASUC), for which intravenous systemic steroid therapy and possibly infliximab-based rescue therapy are generally imposed. However, there are no significant guideline recommendations on ASUC regarding vedolizumab as an alternative in this setting. A case report was presented where a patient with steroid-dependent UC developed ASUC induced by second-line chemotherapy. Treatment with intravenous methylprednisolone was imposed, but there was no reduction in bowel movements in the days following admission. Rescue therapy with infliximab was contraindicated because of the oncologic history. Surgical consultation, contraindicated colectomy, and administration of vedolizumab 300 mg were initiated. After infusion with vedolizumab, there was a significant reduction in bowel movements starting the day after infusion until normalisation of bowel movements within three days and the concomitant normalisation of inflammatory indices. The patient is currently in clinical remission, on therapy with vedolizumab 108 mg subcutaneously every two weeks, and is in oncologic follow-up for pulmonary neoplasm. This case highlights the novel potential of vedolizumab as a possible rescue therapy in ASUC, especially in special populations, where it may offer a better safety profile. Although cyclosporine and infliximab still represent the mainstays of salvage therapy for steroid-refractory ASUC, new therapeutic agents may also be effective, such as vedolizumab, ustekinumab, and anti-Janus kinase agents.

Peritoneopericardial diaphragmatic hernia (PPDH) is an opening between the pericardial sac and the pleuroperitoneal membrane. Pneumopericardium is an infrequent complication of PPDH. This condition is a serious circumstance in which free gas accumulates in the pericardial sac. The present report describes the occurrence of pneumopericardium and pericardial effusion after elective ovariectomy in a dog affected by PPDH. The presence of an umbilical and diaphragmatic hernia was highlighted during ovariectomy, and a pneumopericardium was seen during an X-ray exam. At the time of admission to the hospital, the dog was asymptomatic. The diagnosis was performed by X-ray and ultrasonographic exams. Computed tomography examination confirmed the diagnosis and directed for a surgical approach of the congenital defect. Surgery resulted in resolution of PPDH and of pneumopericardium.

Synchronous tumors of the rectum and anus are sporadic. Most cases in the literature are rectal adenocarcinomas with concomitant anal squamous cell carcinoma. To date, only two cases of concomitant squamous cell carcinomas of the rectum and anus are reported, and both were treated with up-front surgery and received abdominoperineal resection with colostomy. Here, we report the first case in the literature of a patient with synchronous HPV-positive squamous cell carcinoma of the rectum and anus treated with definitive chemoradiotherapy with curative intent. The clinical-radiological evaluation demonstrated complete tumor regression. After 2 years of follow-up, no evidence of recurrence was observed.

Over the last two decades, vector-borne pathogens (VBPs) have changed their distribution across the globe as a consequence of a variety of environmental, socioeconomic and geopolitical factors. Dirofilaria immitis and Dirofilaria repens are perfect exemplars of European VBPs of One Health concern that have undergone profound changes in their distribution, with new hotspots of infection appearing in previously non-endemic countries. Some areas, such as the United Kingdom, are still considered non-endemic. However, a combination of climate change and the potential spread of invasive mosquito species may change this scenario, exposing the country to the risk of outbreaks of filarial infections. Only a limited number of non-autochthonous cases have been recorded in the United Kingdom to date. These infections remain a diagnostic challenge for clinicians unfamiliar with these “exotic” parasites, which in turn complicates the approach to treatment and management. Therefore, this review aims to (i) describe the first case of D. repens infection in a dog currently resident in Scotland, (ii) summarise the available literature on Dirofilaria spp. infections in both humans and animals in the United Kingdom and (iii) assess the suitability of the United Kingdom for the establishment of these new VBPs.

Simple Summary: Dirofilariosis, a zoonotic mosquito-borne disease, remains an under-studied condition in several areas of Brazil, despite its long-standing presence. This review aims to draw together prevalence data from epidemiological studies and case reports conducted in dogs over the last decade and in cats, wildlife, and humans over the last twenty years to define the distribution and prevalence of Dirofilaria spp. within the country and highlight the challenges associated with its diagnosis, treatment, and control. While Dirofilaria immitis is the main species circulating in Brazil, concerns have been raised in recent years about the presence of genetically distinct strains that may be more virulent than their Old World counterparts. In light of this and the widespread distribution of the parasite among both Brazilian coastal and non-coastal areas, further studies are required to characterise the disease. Additionally, there is a need to increase awareness of this neglected disease among health professionals in Brazil and to understand and minimise its impact on both veterinary and public health. Brazil's extensive coastline, tropical and subtropical climate, and well-preserved environment represent a conducive setting for dirofilariosis, a zoonotic mosquito-borne disease. Although this condition has long been recognised in the country, it has been relatively under-studied, and it is currently considered to be an emerging disease. Diagnosis, treatment, and control remain challenging due to the extensive gaps in knowledge. In order to help address this issue, this review aims to (i) summarise the available literature on the distribution of Dirofilaria spp. in Brazilian dogs over the last decade, (ii) review case reports of dirofilariosis in cats, wild animals, and humans over the last twenty years, and (iii) highlight the benefits of taking a One Health approach to managing this disease. While there have been several prevalence studies in dogs, disease distribution is poorly characterised in cats, and little is known about the occurrence of the parasite in wildlife. Human cases are sporadically reported, and no large-scale studies have been undertaken to date. Evidence indicates that Dirofilaria immitis is the main species circulating in Brazil, although Dirofilaria repens has also been detected. Molecular studies have also suggested the circulation of a highly virulent form of D. immitis, which may be genetically distinct from those of the Old World. A programme of epidemiological, ecological, genomic, and pathogenicity-based studies is required to quantify the impact of dirofilariosis in Brazil on both veterinary and public health and to inform others on its control. [ABSTRACT FROM AUTHOR]

Present-day educational approaches in higher education and K-12 privilege only cognitive gains from students, who are sometimes only seen as test scores, while neglecting the development of the whole human being. This article documents three unique Building Community events at a public university in the northeast, which were designed to embrace the full development of human potential. These events were created to offer novel approaches to education, highlighting and operationalizing Social Emotional Learning (SEL) through mindfulness, literacy, and social justice. The documentation is two-fold: (1) to provide descriptions of each of the three events and the connections between and among Social Emotional Learning (SEL) and mindfulness, literacy and diversity, and (2) to provide an analysis of feedback data and a descriptive framework that makes clear the processes and theories underpinning the events, all of which may provide a beginning roadmap for others to replicate this important work. Qualitative findings suggest that the integration of SEL into classroom theory and practice may be one route to improving and humanizing education.

Amyloidosis is a systemic disease characterized by the accumulation of insoluble aggregates in various organs, leading to parenchymal damage. When these amyloid fibrils are deposited in the extracellular matrix of the cardiac structures, the condition is referred to as cardiac amyloidosis (CA). The extent of organ involvement determines the degree of cardiac impairment, which can significantly impact prognosis. The two most implicated proteins in CA are transthyretin and misfolded monoclonal immunoglobulin light chains. These proteins give rise to two distinct clinical forms of CA: transthyretin amyloidosis (ATTR-CA) and light-chain amyloidosis (AL-CA). ATTR-CA is further classified into two subtypes: ATTRm-CA, which occurs at a younger age and is caused by hereditary misfolded mutated proteins, and ATTRwt-CA, which is an acquired wild-type form more commonly observed in older adults, referred to as senile amyloidosis. While AL-CA was considered the most prevalent form for many years, recent autopsy studies have revealed an increase in cases of ATTRwt-CA. This narrative review aims to describe the clinical and imaging features of CA, with a particular focus on cardiac complications and mortality associated with the AL form. Early identification and differentiation of CA from other disorders are crucial, given the higher risk and severity of cardiac involvement in AL-CA. Furthermore, emphasis is placed on the potential utility of cardiovascular magnetic resonance imaging in detecting early cases of CA.

Ozone has the potential to improve the shelf life of fruits and vegetables by its antimicrobial properties, but the influence on the aroma properties has not been studied comprehensively at the molecular level. Therefore, the impact of ozone on odour-active compounds, total titratable acidity, ascorbic acid, weight loss, and fungal growth during storage is investigated in oranges and bananas. The fruits were stored at room temperature for 11 days either with or without ozone treatment. Interestingly, no significant impact of the ozone treatment on the contents of the selected odour-active compounds in bananas and oranges was observable. Furthermore, no impact on titratable acidity, weight loss, and ascorbic acid content were observable as a consequence of the ozone treatment at the respective ozone concentrations. In addition, the inhibitive effects of the growth and sporulation of moulds were demonstrated in this study. Finally, the data from this research show that ozonation has the potential of improving the shelf life of fruits without compromising their quality.