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Background: Couple distress is a crucial point in premature ejaculation (PE). PE has been associated with significant bother, interpersonal problems, and dissatisfaction with sexual intercourse for both men and their partners. Objectives: The primary objective of this study was to assess the effect of PE on female sexuality in female partners of men affected from PE. Secondary objectives were to assess the impact of PE on female sexual quality of life, to assess the presence of sexual problems of the male partner, and to evaluate the prevalence and characteristics of comorbidities. Materials and methods: Adult women aged 18 to 80years old, sexually active, were randomly sampled from the patient lists of General Practitioners in Italy and were included in this observational, non-interventional, cross-sectional epidemiological study. Subjects were asked to fill: a general questionnaire regarding anthropometric data, lifestyle, marital status, education, occupation, economic conditions, general health status, comorbidities, and sexual habits; the Sexual Quality of Life Questionnaire-Female (SQoL-F); the Female Sexual Distress Scale (FSDS-R-PE); the Self-rating Depression Scale (SDS); and Self-rating Anxiety Scale (SAS). In addition, females reported about their partner's ejaculation time and the presence of sexual dysfunctions. Results: A total of 3,104 women were included. Mean age was 45.1years. Woman with PE partners presented a higher percentage of sexual dysfunction and reported more anxiety compared with female partners of men not affected from PE (42.69% vs. 20.56% and 30.95% vs. 15,34%, respectively). In addition, they referred more sexual dysfunction in their partners. Hypertension, hypercholesterolemia, arthritis, heart diseases, thyroid disease, a history of menopause, or hysterectomy resulted in significantly more prevalence in women with PE partners. Discussion and conclusions: Female partners of PE patients present an increased prevalence of sexual distress, a reduced quality of sexual life, and an increased anxiety score when compared to women whose partners are not affected from PE.

This paper aims at proposing a possible alternative point of view to investigate the vulnerability of urban systems. The basic ideal refers to the possibility of thinking about vulnerability as deriving by the interactions of several risks that can affect the urban system and by the interactions among them. In this sense, it is possible to refer to an “integrated territorial risk”. Considering the city as a complex and dynamic system that while evolving produce entropy is the main theoretical reference supporting this study. The loss of energy during the evolution of the system corresponds to some conditions of inefficiency that involve the whole system and, as such, this lost energy can be assumed as a “systemic entropy”. Is it possible to measure the levels of this vulnerability of the urban system when it stays in ordinary conditions, namely not during stress states that modify the state of equilibrium of the system itself? It is possible to assess the production of this “internal entropy”? In order to answer to these questions in mind, this study aims at analyzing dyscrasias that can occur within the main components of the urban system in order to individuate possible strategies able both to mitigate the fragility of the urban system and to improve its resilience., Highlights • The city has to be considered as complex and dynamic systems. • Entropy can be assumed as resulting from dyscrasias within the urban system. • Urban risks and entropy are connected each other. • Resilience is an internal force shifting the system towards an equilibrium. • The assessment of dyscrasias represents a tool for managing urban transformations.

Aim of the Study: We aimed to compare the diagnostic accuracy of three Tesla BiparametricMagnetic Resonance Imaging (bpMRI) of the prostate, Prostate Specific Antigen Density (PSA-D) and their combination for the detection of clinically significant Prostate Cancer (PCa). Materials and Methods: We performed a retrospective study. Patients with clinical suspicion of PCa and PSA value between 2.5 and 10 ng/dL who underwent three Tesla bpMRI and subsequent prostate biopsy in a single institution were included into the study. Patients with history of previous prostate biopsy were excluded. PSA-D value was calculated based on prostate volume obtained during bpMRI. PCa lesions with an International Society of Urological Pathology (ISUP) score = or >3 were considered clinically significant PCa. Sensitivity and specificity in detecting clinically significant PCa were determined for bpMRI, PSA-D, and their combination. Receiver operating characteristic (ROC) curves were calculated. A p < 0.05 was considered statistically significant. Results: A total of 114 patients who underwent bpMRI and prostate biopsy between January 2015 and September 2017 were included into the study. bpMRI imaging consisted of T2-weighted imaging and diffusion weighted imaging acquisitions (b-values 0, 400, 1500) and was evaluated with a Likert score based on PI-RADS v2. All patients received 16-core transrectal prostate biopsy by a single operator. The sensitivity of bpMRI ad PSA-D in detecting clinically significant PCawas 93% and 77%, respectively (p < 0.005). ROC curves analysis showed that area under the curve (AUC) of bpMRI, PSA-D and combinationwas 0.87, 0.79 and 0.91, respectively (Figure 1). Based on the results of ROC curves, combination showed no significant improvement versus bpMRI alone. Discussion: bpMRI has a greater sensitivity and similar specificity compared to the PSA-D in the detection of clinically significant PCa. bpMRI combined with PSA-D does not provide superior results compared to bpMR alone. Our analysis suggests a possible independent role for bpMRI in the detection of clinically significant PCa.

Aim of the Study: To evaluate the efficacy of combination therapy with Low Intensity Shock Wave Therapy (LISWT) and Tadalafil 5 mg daily (TAD oad) in diabetic patients with ED and to compare protocols of LISWT characterized by different number of shock waves for session. Materials and Methods: We performed a retrospective observational case-control study. We enrolled diabetic patients with ED naïve for ED treatment. The case group (Group 1) consisted of patients who received TAD oad bed-time for 12 weeks and LISWT. Shockwaves were delivered by a probe attached to an electrohydraulic unit with a focused shockwave source. Shockwaves were delivered to the distal, mid, and proximal penile shaft, and the left and right crura. The duration of each LI-ESWT session was about 20 min. Energy density was set at 0.09 mJ/mm2 and frequency at 120/min. The number of number of shock waves delivered during each session varied from 1500 to 2400. Treatment protocol consisted of 2 treatment sessions per week for 3 weeks. Patients with same demographic and clinical characteristics who received only TAD oad for 12 weeks served as controls (Group 2). International Index of Erectile Function (IIEF-5) scores recorded at baseline, at 4 and 12 weeks after the end of the treatment were compared. A subgroup analysis was performed according to the number of shock waves administered during each session (1500, 1800, 2400). Results: Thirty-one and 10 patients were enrolled in Group 1 and 2, respectively. Eleven, 10 and 10 patients belonging to the Group 1 received 1500, 1800 and 2400 hits, respectively. Mean baseline IIEF-5 scores were 16.8 and 15 in Group 1 and 2, respectively (p = 0.09). A statistically significant improvement of mean IIEF-5 score was observed in both groups at 4 weeks follow-up (19.7 and 18.3 in Groups 1 and 2, respectively) (p < 0.05 vs baseline). Mean IIEF-5 scores recorded at 12 weeks did not varied significantly in comparison to values recorded at 4 weeks (p = 0.1 in both groups). Inter-group analysis did not show significant differences at 4 and 12 weeks (p = 0.2 in both cases). Subgroup analysis revealed a statistically significant improvement of mean IIEF-5 score at 12 weeks with respect to 4 weeks only in patients who received 2400 hits (Figure 1). The percentage of patients in which it was registered a normalization of erectile function after 12 weeks of treatment was 20%, 27.2%, 20% and 50%, in Group 2 and in the subgroups of Group 1 treated with 1500,1800 and 2400 hits, respectively Discussion: The combination of TAD oad and LISWT leads to a statistically significant improvement of erectile function in diabetic patients with concomitant ED at 4 weeks follow-up, with a stable trend over time up to 12 weeks. The administration of 2400 hits for session allows to get an additional, significative improvement of erectile function at 12 weeks follow-up.

Enhancing Raman signals of living cells has long been a challenge, and so far it has been achieved in most cases through cell labeling with gold nanoparticles. This work demonstrates the feasibility of analytical biosensors capable to detect living cells and assess their operation at the interface with the substrate based on gold-coated nanoporous alumina (APA) as an active SERS surface. Thin films of APA with increasing pore diameter and constant pore pitch were fabricated starting from evaporated Al with ∼500 nm thickness. After coating with a 25 nm-thick gold layer (Au-APA), preliminary characterization with test molecules proved such surfaces to be large area SERS substrates. Raman measurements were then performed on living cells cultured on Au-APA, which confirmed to be biocompatible, yielding Raman peaks related to the different components of the cells. The use of Au-APA allows the enhancement of the Raman scattering signals of those components, which become easily detectable with low laser power and short acquisition times and without the need of additional labels such as metal nanoparticles.

Graphical abstractDisplay Omitted Superhydrophobic surface constituted with micropillars.Single strand DNA and dsDNA spectroscopic analysis.Low concentrated biomolecules Raman analysis.Non-enhanced Raman spectroscopy for DNAs molecules.Distinction of ss and dsDNAs via Raman spectroscopy. A novel approach for the study of low concentrated DNAs (60pM) using microRaman spectroscopy is reported. A superhydrophobic substrate with array of microPillars is fabricated over which the sample was drop casted. The substrate concentrates the molecules in a very small area with higher molecular density, enabling to carry out the microRaman measurements. Two different DNAs (single strand and double strand) were used to investigate through Raman technique. A spectral Raman difference was found to distinguish the ssDNA and dsDNAs. The approach can be of interest for a wide variety of applications ranging from biological materials interactions characterization to the biomedical field.

OBJECTIVE Pendred's syndrome is an autosomal recessive disorder characterized by goitre, sensorineural deafness and iodide organification defect. It is one of the most frequent causes of congenital deafness, accounting for about 10% of hereditary hearing loss. It is caused by mutations in the pendrin (PDS) gene, a 21 exon gene located on chromosome 7. The aim of this study was to examine an Italian family affected with Pendred's syndrome at the molecular level. PATIENTS Thirteen subjects belonging to a family from Southern Italy were evaluated for the clinical and genetic features of Pendred's syndrome. MEASUREMENTS Exons 2–21 of the PDS gene were amplified from peripheral leucocytes by the polymerase chain reaction; mutation analysis was performed by single strand conformation polymorphism, direct sequencing and restriction analysis. RESULTS The index patient had the classical triad of the syndrome and harboured two mutations in the PDS gene in the form of compound heterozygosity. He was found to be heterozygous for a cytosine to adenosine mutation at nucleotide 1523 in exon 13 and for a IVS 1001 + 1G → A mutation. The former is a novel mutation which results in a change of 508 threonine to asparagine in the putative eleventh transmembrane domain. The latter mutation in the donor splice site has already been described in other patients and is thought to lead to aberrant splicing and premature protein truncation. Three subjects who were heterozygous for one mutation had normal phenotypes. Two subjects had sensorineural deafness and were heterozygous for a single mutation. Goitre was found only in patients with Pendred's syndrome and was absent in all other individuals, albeit residing in an iodine-deficient area. CONCLUSIONS We have identified a novel mutation in the pendrin gene causing Pendred's syndrome, and confirm that molecular analysis is a useful tool for a definitive diagnosis. This is particularly relevant in cases such as in the subjects of our family in which the clinical features might be misleading and other genetics factors might be responsible for deafness.

Optofluidic microsystems are key components towards lab-on-a-chip devices for manipulation and analysis of biological specimens. In particular, the integration of optical tweezers (OT) in these devices allows stable sample trapping, while making available mechanical, chemical and spectroscopic analyses.

The nutritional assessment of the elderly shows several interpretative difficulties due to the lack of standard parameters. Moreover chronic age-related diseases can interfere with the physiological nutritional status. Anthropometric (triceps skinfold, arm muscle area, total body muscle mass, fat mass and Body Mass Index (BMI)), biochemical (serum prealbumin, transferrin, ceruloplasmin, total protein and albumin) and immunological (serum lymphocytes) parameters were measured in 583 out-patients aged 60 years or over selected on the basis of clinical and biochemical criteria and with BMI/= 30. The subjects were classified into four age-groups (60-64, 65-69, 70-74,/= 75) for each sex. The F-test analysis for all anthropometric parameters except BMI showed significant differences with respect to age (P0.05) and sex (P0.05). Among biochemical parameters, prealbumin showed a significant difference for age (P0.05) and sex (P0.05) (males, 30.3 +/- 8.2; females, 29.1 +/- 7.5) while ceruloplasmin showed a significant difference for sex only (P0.05) (males, 40.9 +/- 9.3; females, 43.8 +/- 8.2). When the biochemical mean values obtained in this study were compared with those utilized in the daily routine of the hospital central laboratory, ceruloplasmin and prealbumin resulted in significantly higher (P0.05) while total protein and albumin were significantly lower values (P0.05).

Nanoparticles can be composed of many different types of material, however in order to be considered as suitable candidates for drug delivery purpose, they need to follow a precise tailored biological behavior. Here we propose nanoporous silicon nanoparticles as optimal nanocarriers with tunable physicochemical properties, and we present a simple few-step fabrication process and an accurate description of nanoparticles considerable features. The performed measurements show that proposed water soluble nanoparticles have excellent loading capacity with no chemical modification on the adsorbed drug. Furthermore, they can degrade releasing the carried drug in a reasonable period of time producing non toxic substances, and show photoluminescent and Raman scattering properties that are useful tools for monitoring them. Raman analyses indicate that nanoporous silicon nanoparticles are distinguished from bulk silicon by a Raman shift to low frequencies and that annealing processes at 260^oC allows to maintain intact the crystalline structure, while complete disappearance appears for annealing at 700^oC. In this way Raman spectroscopy is a useful technique to follow the changes in composition of the nanoparticles after treatments.

Our aim is to develop a fully automatic computer-assisted diagnosis (CAD) system for lung cancer screening using chest spiral CT scans. A screening program on 1000 subjects aims at quantification of the effectiveness of low dose spiral CT scans for early diagnosis of lung cancer, and evaluation of its possible impact on improving the mortality rate of cancer patients. The paper presents an image analysis system for 3D reconstruction of the lungs and trachea, detection of lung abnormalities, identification/classification of these abnormalities with respect to specific diagnosis, and distributed visualization of the results over computer networks. We present two novel approaches for segmentation of the lung tissues from the surrounding structures in the chest cavity, and detection of abnormalities in the lungs. The segmentation algorithm is hierarchical, first isolating the background from the chest cavity, then isolating the lungs from surrounding structures (e.g., ribs, liver, and other organs). Abnormalities in the lungs are detected by analyzing the segmented lung tissues and extracting the isolated lumps that appear in various connected regions. 3D reconstructions are also generated for these abnormalities, to be used for subsequent identification/classification steps. Results on 50 subjects are shown, and have been evaluated against radiologists. Our image analysis approach has provided comparable results with respect to the experts. The approach is quite fast, and lends itself to distributed visualization over computer networks.

This study assessed hemostatic effects of an HMC-CoA reductase inhibitor, atorvastatin, on different parameters in 32 hypercholesterolemic patients of both sexes. In the patients and in 25 control subjects, plasma levels of tissue-type plasminogen activator, plasminogen activator inhibitor (PAI-1), D-dimer, prothrombin fragment 1 + 2 (F1 + 2), total cholesterol, triglycerides and fibrinogen had been measured. All these parameters were evaluated in patients after 6 and 12 months of treatment with atorvastatin at a dosage of 20 mg/day. This treatment significantly lowered the total cholesterol level in all patients. Moreover, after 6 months of atorvastatin treatment, PAI-1 and F1 + 2, which were both increased at baseline, were significantly reduced. This reduction continued after 12 months. The present results show that a reduction of hemostatic abnormalities, which exist in hypercholesterolemia, may be another important effect of the atorvastatin therapy.

Pendred's syndrome is an autosomal recessive disorder characterized by goitre, sensorineural deafness and iodide organification defect. It is one of the most frequent causes of congenital deafness, accounting for about 10% of hereditary hearing loss. It is caused by mutations in the pendrin (PDS) gene, a 21 exon gene located on chromosome 7. The aim of this study was to examine an Italian family affected with Pendred's syndrome at the molecular level.Thirteen subjects belonging to a family from Southern Italy were evaluated for the clinical and genetic features of Pendred's syndrome.Exons 2-21 of the PDS gene were amplified from peripheral leucocytes by the polymerase chain reaction; mutation analysis was performed by single strand conformation polymorphism, direct sequencing and restriction analysis.The index patient had the classical triad of the syndrome and harboured two mutations in the PDS gene in the form of compound heterozygosity. He was found to be heterozygous for a cytosine to adenosine mutation at nucleotide 1523 in exon 13 and for a IVS 1001 + 1G --A mutation. The former is a novel mutation which results in a change of 508 threonine to asparagine in the putative eleventh transmembrane domain. The latter mutation in the donor splice site has already been described in other patients and is thought to lead to aberrant splicing and premature protein truncation. Three subjects who were heterozygous for one mutation had normal phenotypes. Two subjects had sensorineural deafness and were heterozygous for a single mutation. Goitre was found only in patients with Pendred's syndrome and was absent in all other individuals, albeit residing in an iodine-deficient area.We have identified a novel mutation in the pendrin gene causing Pendred's syndrome, and confirm that molecular analysis is a useful tool for a definitive diagnosis. This is particularly relevant in cases such as in the subjects of our family in which the clinical features might be misleading and other genetics factors might be responsible for deafness.

In order to improve manufacturing processes and their automated integration, RoboTViRMo (Robot Teaching in Virtual Reality Mode) is aimed at designing and developing a user friendly system for the robot off-line programming in a virtual environment. The project, aiming at increasing the automation level in the small-medium enterprise plants by robot, proposes to develop tools for users, experts in the manufacturing processes, but who don't know programming languages for robotised systems. Using a Data Glove, or a 3D pointer, and Head Mounted Display (HMD), or stereoscopic glasses, it will be possible to program a robot for deburring operations without the knowledge of robot programming languages and of 3D graphical simulators, thanks to the use of the natural language performed by the user's hand movement and based on his experience. The system is composed by 4 main integrated environments: two are virtual environments, one is a 3D graphical simulator and one is a real deburring cell. The first environment allows the user to locate the burrs on the piece surface and to model, within a virtual environment and starting from the original 3D CAD model, the 3D model of the work piece. The second one allows the user to perform the virtual deburring on the piece: it could be done automatically, through a software for the deburring trajectory research (RATS project), or manually, through virtual operations of the user, that can select whether to furnish just few information (i.e. tool orientation, starting points, etc.) to the automatic system in order to decrease the time needed for the trajectory research or to perform the whole deburring process in the virtual environment. The third environment is a graphical 3D simulator that, on one hand, allows to value the designed tracks (automatic or manual ones) doing the feasibility analysis and the collision detection, and, on the other hand, realizes the down load on the real robot control for the physical deburring through a post-processor. The last environment is the physical one, where an anthropomorphic robot for the deburring operation onto sample pieces is modeled as described in the paper. The original and innovative approach is the application field, that is a complex manufacturing one that requires the presence of an expert of the job and, nowadays, a computer expert for technical support. RoboTViRMo helps the expert in utilizing the informative system without any middle-person and directly uses the expert experience in the simulation developing. The authors present the first prototype for deburring operations and the hardware and software configuration that allows to reach them.

Video-endoscopic surgery developed from laparoscopic removal of the gallbladder and can be used for treatment of certain disease processes of the chest. The major application of this technique is the performance of pulmonary resections (lobectomies and pneumonectomies). Video-thoracoscopic lobectomy requires general anesthesia with a double lumen intubation. After collapse of the involved lung, two intercostal incisions are performed (the first one in seventh space, mid axillary and the second one in fifth space, below the angle of the scapula) and an additional mini-thoracotomy (submammillary in the fifth space) is made. The lobar arteries, veins and bronchus are occluded with an automatic endoscopic stapling device. Seven cases of pulmonary neoplasms (stage I) have been treated by video pulmonary lobectomy (3 right lower lobectomies, 2 right upper lobectomies, 2 left lower lobectomies). Two procedures have been converted for an advanced neoplastic stage that required a radical pneumonectomy and an uncontrolled bleeding. This new procedure has the advantage of greatly reducing the pain and ventilatory disability associated with conventional open thoracic surgery.

A membrane fraction enriched with plasma membranes was isolated from rat ileal brush-border cells before and after five-day starvation of the animals. Cholesterol/phospholipid ratio of the standard cell membranes decreased highly significantly (0.42 to 0.18), as did the microviscosity of the membranes determined by polarization of fluorescence (0.187 to 0.142). Concomitantly, the specific activity of Na,K-ATPase in the basolateral membranes significantly increased (59 to 83 mumol ATP hydrolyzed per mg protein per min).

In recent years, the breast has won importance from the female psychology point of view. After ablative surgery for cancer, the loss of the breast gives rise in the woman to a feeling of refusal of her new body shape. Reconstruction produces positive feelings in the patient. The best-used surgical technique for operable breast cancer is modified radical mastectomy. An immediate reconstruction of the missing breast is considered when the following conditions are fulfilled: desire for reconstruction, age of the patient, clinical and pathologic evaluation (tumor size-tumor grade-lymph-node status). After modified radical mastectomy with "en bloc" removal of axillary lymph nodes, an immediate reconstruction is performed by lining the surfaces with human fibrin glue (Tissucol) followed by the insertion of a prosthesis of appropriate size (Becker Expander Mammary Prosthesis-Type 1) in the subserratus-subpectoral position. Human fibrin lining reduces the incidence of capsular contracture and effusion production. A suction drain is placed in the axillary area and is removed after 5 days. The use of expanding-type prostheses means that the patient must return for further expanding. When the pathologic features are negative, the delayed nipple areola reconstruction is possible with the full-thickness skin grafts in the groin or in pre-existent appendectomy incision. By this procedure, adjuvant chemotherapy or radiation therapy can be performed if required. From 1987 to 1991 the procedure has been performed in 35 cases of mammary neoplasm (mean age 40 years) at INRCA Department of Surgery of Ancona). No evidence of adverse effect on the natural course of the breast disease for have been seen.(ABSTRACT TRUNCATED AT 250 WORDS)