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Background: There is ongoing discussion around the optimal course of treatment for metastatic colorectal cancer (mCRC) following the second line. Trifluridine/tipiracil (T) and regorafenib (R) have been the mainstay of therapy in this situation, as they both increased overall survival (OS) in comparison to a placebo. Despite the paucity of evidence, therapy rechallenge is also recognized as an option for practical use. In the third-line scenario of mCRC, we planned to investigate the survival outcomes using (T) and (R), both with and without prior rechallenge treatment. Materials and methods: Between 2012 and 2023, we examined the medical records of 1156 patients with refractory mCRC who were enrolled in the multicenter retrospective ReTrITA study. We then separated the patients into two cohorts based on the rechallenge therapy that was given before regorafenib and/or trifluridine/tipiracil at 17 Italian centres. Results: A total of 981 patients underwent T and/or R therapy, while 175 patients had therapy rechallenge before T and/or R. The median overall survival (mOS) for patients treated with T/R and R/T sequences in the rechallenge therapy cohort was 14.5 months and 17.6 months, respectively (p = 0.1955). A statistically significant survival benefit was observed in patients who received monotheraphy with R (mOS: 6 months) compared to the T group (mOS: 4.2 months) (p = 0.0332). In the same cohort, a median progression-free survival (mPFS) benefit was demonstrated in favour of the R/T group (11.3 months) vs. 9 months of the reverse sequence (p = 0.4004). In the no-rechallenge cohort, the mOS was statistically longer in the R/T sequence than in the T/R sequence (16.2 months vs. 12.3 months, respectively; p = 0.0014). In terms of the mPFS, we saw the same significant result for the adoption of R/T treatment (11.5 months vs. 8.4 months, respectively; p < 0.0001). The two monotherapy groups did not reveal any significant differences. Conclusions: This study suggests that rechallenge therapy may improve survival rates in the third-line treatment of mCRC, particularly if it is administered before sequential R/T treatment. This could allow for the extension of mCRC treatment choices until prospective studies are finished or randomised trials are performed.

Lignin, one of Earth’s most abundant biopolymers, is rich in phenolic and aliphatic functional groups, offering significant potential for chemical modification. Technical lignin, a byproduct of the kraft process, is produced in large quantities annually and can be used to enhance the properties of polymer matrices such as polypropylene (PP). PP, a widely used nonpolar polymer, suffers from low surface free energy, leading to poor adhesion properties. Combining PP with polar, renewable-source polymers like lignin can improve these properties. This study investigates the direct acetylation of kraft lignin (KL) to improve its dispersion in the PP matrix and enhance wettability and adhesion. The acetylation of KL was confirmed through FTIR and DSC analyses. PP and acetylated KL (AKL) were combined and processed via continuous extrusion. The blends’ thermal and mechanical properties, lignin dispersion, and wettability were evaluated. Additionally, PP and PP–lignin films were bonded to aluminized biaxially oriented polypropylene (BOPP) for peel tests. Results showed increased surface free energy and improved adhesion, particularly in samples with AKL due to better dispersion. This direct acetylation route significantly enhances PP’s surface free energy and adhesion, presenting a sustainable alternative to fossil-based materials and promoting the use of lignin, a renewable and low-cost polymer.

In Europe, transjugular intrahepatic portosystemic shunt (TIPS) is considered the primary treatment for gastric varix (GV) bleeding to reduce portal hypertension. However, in Asian countries, balloon-occluded retrograde transvenous obliteration (BRTO) and its variants plug/coil assisted transvenous retrograde obliteration (PARTO/CARTO) are the preferred approaches. The purpose of this study is to report a European single-center experience in the use of PARTO/CARTO techniques for the treatment of GVs in patients with portal hypertension, focusing on the effectiveness and safety of the procedure. All the procedures involving the PARTO/CARTO techniques performed from 2019 to 2023 were retrospectively evaluated. Technical success was defined as the complete obliteration of both the GVs and the gastro-renal (GR) shunt on review of the Computed Tomography (CT) scan performed 3 days after the procedure. The obliteration rate was also evaluated through performing CT scans 1 and 12 months after the procedure, and through endoscopic follow-up at 3 and 6 months. Additionally, major and minor complications were reported. The study involved seven patients, with a technical success of 100%. During follow-up, there were no episodes of variceal rebleeding or upper gastrointestinal bleeding. Two patients developed ascites, which resolved with medical therapy. One patient exhibited focal portal thrombosis, which was successfully treated with heparin. PARTO/CARTO techniques demonstrated high technical and clinical success rates, offering advantages over traditional BRTO. The use of coils and plugs simplifies the procedure, eliminates sclerosing agents, and prevents complications associated with balloon guiding catheters.

Obiettivo di questo studio pilota è indagare un aspetto del processo di ragionamento attivato dagli educatori socio-pedagogici in formazione, durante le loro esperienze di tirocinio. Nello specifico individuare e mappare gli assunti alla luce dei quali gli studenti giungono a decidere in favore di una specifica azione (compreso il non agire). Presupposto è che l’abduzione sia la tipologia di ragionamento maggiormente pertinente per comprendere e decidere in merito ad eventi sempre nuovi, come spesso sono quelli vissuti nella pratica educativa. L’analisi tematica del diario di bordo, come strumento di indagine, restituisce, da una parte un facile accesso degli studenti alla messa a fuoco degli impliciti alla base dell’azione scelta (94%), dall’altra una complessità degli impliciti stessi (tra assunti, ipotesi esplicativa e scopo) che richiede tanto ulteriori indagini in merito, quanto un’attenzione didattica nell’ottica di sollecitare un appropriato apprendimento dall’esperienza.

Thermoplastic elastomer gels based on styrenic triblock copolymers have been increasingly used as dielectric elastomers, particularly due to the possibility of tailoring their properties based on their composition. However, these materials have a low relative permittivity, primarily attributed to their low dipole moment. Consequently, this characteristic poses a challenge for their application as dielectric elastomers. In this work, we aim to assess the impact of adding kraft lignin on the dielectric properties of thermoplastic elastomer gels. Additionally, we investigate the effects of kraft lignin dispersion on their viscoelastic and mechanical properties. For this purpose, we used two types of kraft lignin: acidic and alkaline (ac-KL and alk-KL). The alk-KL demonstrated higher dispersibility in the polymer, mainly attributed to the deprotonation of its structure during its production process. As a result, the dielectric elastomer with alk-KL showed a 50% increase in relative permittivity compared to the pristine polymer without compromising its mechanical and viscoelastic properties. Moreover, these samples demonstrated a greater actuation strain capability in response to an electrical stimulus. Thus, the incorporation of lignin demonstrates promise as a valuable reinforcement in the development of advanced dielectric materials, enhancing their electro-mechanical performance.

The deterioration of stone heritage in urban environments is mainly the product of sources of air pollution like vehicular traffic and domestic heating. The results of these phenomena usually manifest as acid rain and particulate patinas, acting on the surface of stone monuments to form the so-called “black crusts”, a typical stone degradation product, mainly composed of gypsum. The aims of this study were to investigate the extent of these phenomena on the decorative apparatus of the frontal façade of Gesù Nuovo Church, in the historical centre of Naples (Italy). Preliminary diagnostics consisted of XRD and FTIR to analyse the composition of stone materials and inquire about previous restorations. The chemical characterization of black crusts was performed, using a diverse array of techniques, to highlight how different compounds are distributed along a vertical gradient and considering the proximity of specific sources of pollution (vehicle engine ignition, incense combustion, domestic heating products). Finally, molecular biology techniques were employed to identify the organisms which typically dwell in this formation and speculate about their contribution to the degradation of stone.

Heat exchangers are essential for various thermal applications, and their performance could be improved by optimization of layout/operating conditions or materials. The layout/operating conditions optimization has been widely subjected to research and development, while the implementation of different materials has been limited to the available joining solutions. Joining by forming allows to circumvent the existent limitations, since it utilizes plastic deformation to produce multi-material mechanical joints between thin sheets and thin-walled tubes. Here, joining by forming is adopted for the first time, to manufacture multi-material transversal finned tube heat exchangers. The numerical-experimental analysis explores the production of tube compression beads obtained by plastic instability to fix and support fins, and therefore manufacture a novel design of finned heat exchanger with improved performance. A case study is carried out with the help of computational fluid dynamics simulations to find an optimal layout. Then, finite element simulations are employed to analyse the joining by forming process. A prototype model of transversal finned tube heat exchangers was finally manufactured and experimentally tested. Results show considerable gains in comparison with conventional finned tube heat exchangers made from steel tubes and fins, being the multi-material heat exchanger effectiveness doubled with respect to traditional designs.

Abstract Translational research for the evaluation of physical activity habits and lifestyle modifications based on nutrition and exercise has recently gained attention. In this study, we evaluated the effects of serum samples obtained before and after a 12-week home-based lifestyle intervention based on nutrition and exercise in breast cancer survivors in terms of modulation of the tumorigenic potential of breast cancer cells. The home-based lifestyle intervention proposed in this work consisted of educational counselling on exercise and nutritional behaviors and in 12 weeks of structured home-based exercise. Triple-negative breast cancer cell line MDA-MB-231 was cultured in semi-solid medium (3D culture) with sera collected before (PRE) and after (POST) the lifestyle intervention program. Spheroid formation was evaluated by counting cell colonies after 3 weeks of incubation. Results show a slight but significant reduction of spheroid formation induced by serum collected POST in comparison to those obtained PRE. Moreover, statistical analyses aimed to find physiologic and metabolic parameters associated with 3D cell proliferation revealed the proliferative inducer IGF-1 as the only predictor of cell tumorigenic potential. These results highlight the importance of lifestyle changes for cancer progression control in a tertiary prevention context. Translational research could offer a useful tool to identify metabolic and physiological changes induced by exercise and nutritional behaviors associated with cancer progression and recurrence risk.

Limoncella of Mattinata, a rare and ancient Mediterranean citrus fruit, was investigated by sequence analysis of the ribosomal internal transcribed spacer regions, which assigns it as a variety of Citrus medica L. Morphological, chemical, and biomolecular approaches, including light and electron microscopy, HPLC-ESI-MS/MS, and antioxidant and anti-inflammatory assays, were used to characterize the flavedo and albedo parts, usually rich in bioactive compounds. The morphological findings showed albedo and flavedo cellular structures as “reservoirs” of nutritional components. Both albedo and flavedo hydroalcoholic extracts were rich in polyphenols, but they were different in compounds and quantity. The flavedo is rich in p-coumaric acid and rutin, whereas the albedo contains high levels of hesperidin and quercitrin. Antioxidant, anti-inflammatory, and genoprotective effects for albedo and flavedo were found. The results confirmed the health properties of flavedo and highlighted that albedo is also a rich source of antioxidants. Moreover, this study valorizes Limoncella of Mattinata’s nutritional properties, cueing its crops’ repopulation.

Androgen insensitivity syndrome (AIS) is one of the most common Disorders of Sexual Differentiation (DSDs). AIS is characterized by an X-linked recessive inheritance pattern associated with variants in the androgen receptor (AR) gene that affects the masculinization process in individuals with XY karyotype. Here, we report a neonatal case of a very early diagnosis of complete AIS due to a novel variant in the AR gene. In the present case, after the clinical evaluation, the infant has undergone the following tests: biochemical analyses, including newborn screening workflow, karyotype analysis, and Next-Generation Sequencing (NGS) panel of 50 genes involved in DSDs. The NGS analysis identified a missense variant, c.2108C>A, in the AR gene. According to a cytogenetic analysis, the patient presented a 46, XY karyotype, thus the resulting hemizygote for the AR gene variant. The variant is not currently described in the literature nor in the ClinVar database. However, according to computational models, the variant could have a pathogenetic effect. This clinical case reveals a novel variant of the AR gene with a possible pathogenetic effect associated with AIS and highlights the importance of a multidisciplinary approach for the timely diagnosis and appropriate follow-up of the patient.

The association between type 1 diabetes (T1D) and coeliac disease (CD) is well known. Metabolic control of thirty-seven patients aged between 1 and 18 years, with coexisting T1D and CD were evaluated. The control group includes 37 patients affected only by diabetes. All data relating to the metabolic control of all patients were acquired through examination of medical records and CMG reports available on dedicated online platforms. Glucose variability was expressed as Coefficient of Variation (CV) and Standard Deviation of blood glucose values (SD). The formula used for CV computation is: CV (%) = 100 × SD (daily glycemia)/Mean (daily glycemia). Patients with T1D and CD showed a significant reduction in rapid pre-prandial insulin. The same reduction was present if we consider only patients using CGM. In patients without CGM, there was no difference in the doses of basal, pre-prandial and total insulin. Indicators of metabolic control were overlapping between the two groups in patients who used CGM. On the contrary, diabetic and coeliac patients without CGM had increased levels of glycaemic variability indicators and HbA1c. Finally, the percentage of target glycaemic values and >250 mg/dL glycaemic values were significantly decreased and increased, respectively in T1D and CD patients without CGM. With this study we wanted to demonstrate if CGM could improve metabolic control of patients with coexisting T1D and CD. Our data show a worse metabolic control in patients with T1D and CD who did not use CGM. Instead, patients who use CGM, regardless of the concomitant CD, manage to achieve the same glycaemic targets through an adjustment of titration of pre-prandial insulin doses.

Background: Patients with refractory mCRC rarely undergo third-line or subsequent treatment. This strategy could negatively impact their survival. In this setting, regorafenib (R) and trifluridine/tipiracil (T) are two key new treatment options with statistically significant improvements in overall survival (OS), progression-free survival (PFS), and disease control with different tolerance profiles. This study aimed to retrospectively evaluate the efficacy and safety profiles of these agents in real-world practice. Materials and Methods: In 2012–2022, 866 patients diagnosed with mCRC who received sequential R and T (T/R, n = 146; R/T, n = 116]) or T (n = 325]) or R (n = 279) only were retrospectively recruited from 13 Italian cancer institutes. Results: The median OS is significantly longer in the R/T group (15.9 months) than in the T/R group (13.9 months) (p = 0.0194). The R/T sequence had a statistically significant advantage in the mPFS, which was 8.8 months with T/R vs. 11.2 months with R/T (p = 0.0005). We did not find significant differences in outcomes between groups receiving T or R only. A total of 582 grade 3/4 toxicities were recorded. The frequency of grade 3/4 hand-foot skin reactions was higher in the R/T sequence compared to the reverse sequence (37.3% vs. 7.4%) (p = 0.01), while grade 3/4 neutropenia was slightly lower in the R/T group than in the T/R group (66.2% vs. 78.2%) (p = 0.13). Toxicities in the non-sequential groups were similar and in line with previous studies. Conclusions: The R/T sequence resulted in a significantly longer OS and PFS and improved disease control compared with the reverse sequence. R and T given not sequentially have similar impacts on survival. More data are needed to define the best sequence and to explore the efficacy of sequential (T/R or R/T) treatment combined with molecular-targeted drugs.

Apples are rich in phytochemicals useful for human health. However, environmental factors can greatly affect the accumulation of these compounds. To face this problem, the callus culture technique was used to obtain large quantities of phytochemicals. Specifically, two callus cultures were obtained from ripe Annurca apple pulp (Malus pumila cv Miller) and cultivated under different light conditions: darkness and an 18-h photoperiod. The hydro-alcoholic extracts from the calli underwent analysis using GC-MS, GC-FID, and HPLC-DAD-ESI-MSn to determine the qualitative and quantitative content of phenolic and triterpenic acids. The study revealed the predominant presence of triterpenic compounds in both calli. Furthermore, we investigated their radical scavenging and antioxidant activities through DPPH, ABTS, ORAC assays, and lipoxygenase inhibition activity. Genoprotection was evaluated via nicking assay, and the anti-inflammatory effect was investigated via Griess assay on LPS-injured murine macrophages. All the analyses performed were compared with peel and pulp hydroalcoholic extracts. The results showed that both calli primarily show anti-inflammatory activity and moderate antioxidant effect and can protect DNA against oxidative stimuli. This data encouraged further research aimed at utilizing callus as a bioreactor to produce secondary metabolites for use in preventive and therapeutic applications to combat acute or chronic age-associated diseases.

Many etiological factors causing short stature have already been identified in humans. In the last few years, the advent of new techniques for the detection of chromosomal and molecular abnormalities has made it possible to better identify patients with genetic causes of growth failure. Some of these factors directly affect the development and growth of the skeleton, since they damage the epiphyseal growth plate, where linear growth occurs, influencing chondrogenesis. In particular, defects in genes involved in the organization and function of the growth plate are responsible for several well-known conditions with short stature. These genes play a pivotal role in various mechanisms involving the extracellular matrix, intracellular signaling, paracrine signaling, endocrine signaling, and epigenetic regulation. In this review, we will discuss the genes involved in extracellular matrix disorders. The identification of genetic defects in linear growth failure is important for clinicians and researchers in order to improve the care of children affected by growth disorders.

The structure of 74Se at low energy was investigated via spectroscopy of internal conversion electrons at the INFN Legnaro National Laboratories (LNL). A set of internal K-conversion coefficients and monopole transition strengths was measured. A large ρ2(E0;22+→21+)⋅103=210(130) value was deduced. This result, in addition to a low upper limit for the 03+→02+ electron transition, casts in doubt a simple interpretation of the 74Se low-lying structure, in particular the recently proposed spherical, vibrational character. New microscopic beyond-mean-field calculations generally agree with the experimental results and are capable of producing a large ρ2(E0;22+→21+) value, even if still a factor ≈7 smaller than the experiment. Triaxiality and a complex shape-coexistence and mixing scenario seem responsible for this unexpected experimental result.

BackgroundIn triple negative breast cancer patients treated with neoadjuvant chemotherapy, residual disease at surgery is the most relevant unfavorable prognostic factor. Current guidelines consider the use of adjuvant capecitabine, based on the results of the randomized CREATE-X study, carried out in Asian patients and including a small subset of triple negative tumors. Thus far, evidence on Caucasian patients is limited, and no real-world data are available.MethodsWe carried out a multicenter, observational study, involving 44 oncologic centres. Triple negative breast cancer patients with residual disease, treated with adjuvant capecitabine from January 2017 through June 2021, were recruited. We primarily focused on treatment tolerability, with toxicity being reported as potential cause of treatment discontinuation. Secondarily, we assessed effectiveness in the overall study population and in a subset having a minimum follow-up of 2 years.ResultsOverall, 270 patients were retrospectively identified. The 50.4% of the patients had residual node positive disease, 7.8% and 81.9% had large or G3 residual tumor, respectively, and 80.4% a Ki-67 >20%. Toxicity-related treatment discontinuation was observed only in 10.4% of the patients. In the whole population, at a median follow-up of 15 months, 2-year disease-free survival was 62%, 2 and 3-year overall survival 84.0% and 76.2%, respectively. In 129 patients with a median follow-up of 25 months, 2-year disease-free survival was 43.4%, 2 and 3-year overall survival 78.0% and 70.8%, respectively. Six or more cycles of capecitabine were associated with more favourable outcomes compared with less than six cycles.ConclusionThe CaRe study shows an unexpectedly good tolerance of adjuvant capecitabine in a real-world setting, although effectiveness appears to be lower than that observed in the CREATE-X study. Methodological differences between the two studies impose significant limits to comparability concerning effectiveness, and strongly invite further research.

The deterioration of stone heritage in urban environments is mainly the product of sources of air pollution like vehicular traffic and domestic heating. The results of these phenomena usually manifest as acid rain and particulate patinas, acting on the surface of stone monuments to form the so-called "black crusts", a typical stone degradation product, mainly composed of gypsum. The aims of this study were to investigate the extent of these phenomena on the decorative apparatus of the frontal façade of Gesù Nuovo Church, in the historical centre of Naples (Italy). Preliminary diagnostics consisted of XRD and FTIR to analyse the composition of stone materials and inquire about previous restorations. The chemical characterization of black crusts was performed, using a diverse array of techniques, to highlight how different compounds are distributed along a vertical gradient and considering the proximity of specific sources of pollution (vehicle engine ignition, incense combustion, domestic heating products). Finally, molecular biology techniques were employed to identify the organisms which typically dwell in this formation and speculate about their contribution to the degradation of stone. [ABSTRACT FROM AUTHOR]

Abstract Background A significant number of chest pain patients had previous cardiac imaging tests (CIT) performed before being presented to the Emergency Department (ED). The HEART (history, electrocardiogram, age, risk factors, and troponin) score has been used to risk-stratify chest pain patients in the ED, but not particularly for patients with CIT performed. We aim to modify the current HEART score with the addition of most recent CIT findings (referred to as HEART2 score), to predict a 30-day major adverse cardiac event (MACE) among ED chest pain patients, compare the performance accuracy of using HEART versus HEART2 score for 30-day MACE outcome predictions, and further determine the value of HEART2 in a subset group of ED chest pain patients (i.e., ones with previous CIT). Methods This is a single-center observational study. We included chest pain patients with HEART scores calculated during their index ED visits. A modified HEART2 score was developed with the addition of CIT findings as one of the HEART2 components. Patients were divided into three groups, including low (≤ 3), moderate (4–6), and high-risk HEART/HEART2 scores (≥ 7). MACE occurrence of a patient with different risks of HEART and HEART2 scores and overall performance accuracy of HEART versus HEART2 score predicting MACE outcomes were compared. Results We included a total of 9419 chest pain patients at ED, among which one out of five patients (1874/9419) had previous CIT performed. Fewer (38.2%) of such patients had low-risk HEART scores in comparison to 55.5% of low-risk HEART2 scores (p

Introduction: Although regular exercise is recommended during non-complicated pregnancies to promote maternal and fetal/infant health, estimates suggest that only 15% of expectant mothers achieve current exercise recommendations. Although lack of motivation and fear related to potential fetal injury are often cited as reasons for not engaging in regular physical activity/exercise during pregnancy, less is understood about individual attitudes and practice habits of obstetrician and gynecologists (OB/GYNs) regarding exercise recommendations that may influence patient engagement in exercise during pregnancy. Purpose: To describe the attitudes, knowledge, and clinical practice of OB/GYNs regarding exercise during pregnancy. Methods: Surveys were sent via U.S. mail to 950 practicing OB/GYNs identified via publicly available databases. The survey included 11 questions regarding demographic information, exercise physiology knowledge, as well as their attitudes and clinical practice recommendations regarding exercise during pregnancy. Results: One hundred thirty-nine completed surveys were returned (14.6% response rate). Ninety-four percent of physicians surveyed agreed that there are benefits of exercise during pregnancy and/or the benefits of exercise during pregnancy outweigh the risks. Ninety-eight percent of physicians surveyed reported that they (or their medical staff) routinely advise their patients to exercise during pregnancy and 46% reported discussing exercise guidelines related to time, intensity, and type of exercise. Only 13% of physicians surveyed reported taking a semester-long exercise physiology course, yet 27% of physicians surveyed reported developing personalized exercise prescriptions for all (6%) or some (21%) of their patients. Conclusions: Low exercise engagement among expectant mothers does not appear to be due to a lack of guidance or negative views of OB/GYNs regarding exercise during pregnancy.

An analysis of the observations of Boreal Owl Aegolius funereus in the Marche region, also regarding a recent recovery of an adult of the species, which appears to be the southernmost movement in Italy.

Limoncella of Mattinata, a rare and ancient Mediterranean citrus fruit, was investigated by sequence analysis of the ribosomal internal transcribed spacer regions, which assigns it as a variety of Citrus medica L. Morphological, chemical, and biomolecular approaches, including light and electron microscopy, HPLC-ESI-MS/MS, and antioxidant and anti-inflammatory assays, were used to characterize the flavedo and albedo parts, usually rich in bioactive compounds. The morphological findings showed albedo and flavedo cellular structures as "reservoirs" of nutritional components. Both albedo and flavedo hydroalcoholic extracts were rich in polyphenols, but they were different in compounds and quantity. The flavedo is rich in p-coumaric acid and rutin, whereas the albedo contains high levels of hesperidin and quercitrin. Antioxidant, anti-inflammatory, and genoprotective effects for albedo and flavedo were found. The results confirmed the health properties of flavedo and highlighted that albedo is also a rich source of antioxidants. Moreover, this study valorizes Limoncella of Mattinata's nutritional properties, cueing its crops' repopulation. [ABSTRACT FROM AUTHOR]

In Europe, transjugular intrahepatic portosystemic shunt (TIPS) is considered the primary treatment for gastric varix (GV) bleeding to reduce portal hypertension. However, in Asian countries, balloon-occluded retrograde transvenous obliteration (BRTO) and its variants plug/coil assisted transvenous retrograde obliteration (PARTO/CARTO) are the preferred approaches. The purpose of this study is to report a European single-center experience in the use of PARTO/CARTO techniques for the treatment of GVs in patients with portal hypertension, focusing on the effectiveness and safety of the procedure. All the procedures involving the PARTO/CARTO techniques performed from 2019 to 2023 were retrospectively evaluated. Technical success was defined as the complete obliteration of both the GVs and the gastro-renal (GR) shunt on review of the Computed Tomography (CT) scan performed 3 days after the procedure. The obliteration rate was also evaluated through performing CT scans 1 and 12 months after the procedure, and through endoscopic follow-up at 3 and 6 months. Additionally, major and minor complications were reported. The study involved seven patients, with a technical success of 100%. During follow-up, there were no episodes of variceal rebleeding or upper gastrointestinal bleeding. Two patients developed ascites, which resolved with medical therapy. One patient exhibited focal portal thrombosis, which was successfully treated with heparin. PARTO/CARTO techniques demonstrated high technical and clinical success rates, offering advantages over traditional BRTO. The use of coils and plugs simplifies the procedure, eliminates sclerosing agents, and prevents complications associated with balloon guiding catheters. [ABSTRACT FROM AUTHOR]

Lignin, one of Earth's most abundant biopolymers, is rich in phenolic and aliphatic functional groups, offering significant potential for chemical modification. Technical lignin, a byproduct of the kraft process, is produced in large quantities annually and can be used to enhance the properties of polymer matrices such as polypropylene (PP). PP, a widely used nonpolar polymer, suffers from low surface free energy, leading to poor adhesion properties. Combining PP with polar, renewable-source polymers like lignin can improve these properties. This study investigates the direct acetylation of kraft lignin (KL) to improve its dispersion in the PP matrix and enhance wettability and adhesion. The acetylation of KL was confirmed through FTIR and DSC analyses. PP and acetylated KL (AKL) were combined and processed via continuous extrusion. The blends' thermal and mechanical properties, lignin dispersion, and wettability were evaluated. Additionally, PP and PP–lignin films were bonded to aluminized biaxially oriented polypropylene (BOPP) for peel tests. Results showed increased surface free energy and improved adhesion, particularly in samples with AKL due to better dispersion. This direct acetylation route significantly enhances PP's surface free energy and adhesion, presenting a sustainable alternative to fossil-based materials and promoting the use of lignin, a renewable and low-cost polymer. [ABSTRACT FROM AUTHOR]

Androgen insensitivity syndrome (AIS) is one of the most common Disorders of Sexual Differentiation (DSDs). AIS is characterized by an X-linked recessive inheritance pattern associated with variants in the androgen receptor (AR) gene that affects the masculinization process in individuals with XY karyotype. Here, we report a neonatal case of a very early diagnosis of complete AIS due to a novel variant in the AR gene. In the present case, after the clinical evaluation, the infant has undergone the following tests: biochemical analyses, including newborn screening workflow, karyotype analysis, and Next-Generation Sequencing (NGS) panel of 50 genes involved in DSDs. The NGS analysis identified a missense variant, c.2108C>A, in the AR gene. According to a cytogenetic analysis, the patient presented a 46, XY karyotype, thus the resulting hemizygote for the AR gene variant. The variant is not currently described in the literature nor in the ClinVar database. However, according to computational models, the variant could have a pathogenetic effect. This clinical case reveals a novel variant of the AR gene with a possible pathogenetic effect associated with AIS and highlights the importance of a multidisciplinary approach for the timely diagnosis and appropriate follow-up of the patient. [ABSTRACT FROM AUTHOR]

Seasonal variations in glycaemic patterns in children and young adults affected by type 1 diabetes are currently poorly studied. However, the spread of Flash Glucose Monitoring (FGM) and continuous glucose monitoring (CGM) systems and of dedicated platforms for the synchronization and conservation of CGM reports allows an efficient approach to the comprehension of these phenomena. Moreover, the impact that environmental parameters may have on glycaemic control takes on clinical relevance, implying a need to properly educate patients and their families. In this context, it can be investigated how blood glucose patterns in diabetic patients may have a link to outdoor temperatures. Therefore, in this study, the relationship between outdoor temperatures and glucose levels in diabetic patients, aged between 4 and 21 years old, has been analysed. For a one-year period (Autumn 2022–Summer 2023), seasonal variations in their CGM metrics (i.e., time in range (TIR), Time Above Range (TAR), Time Below Range (TBR), and coefficient of variation (CV)) were analysed with respect to atmospheric temperature. The results highlight a negative correlation between glucose in diabetic patients and temperature patterns (R value computed considering data for the entire year; Ry = −0.49), behaviour which is strongly confirmed by the analysis focused on the July 2023 heatwave (R = −0.67), which shows that during heatwave events, the anticorrelation is accentuated. The diurnal analysis shows how glucose levels fluctuate throughout the day, potentially correlating with atmospheric diurnal temperature changes in addition to the standard trend. Data captured during the July 2023 heatwave (17–21 July 2023) highlight pronounced deviations from the long-term average, signalling the rapid effects of extreme temperatures on glucose regulation. Our findings underscore the need to integrate meteorological parameters into diabetes management and clinical trial designs. These results suggest that structured diabetes self-management education of patients and their families should include adequate warnings about the effects of atmospheric temperature variations on the risk of hypoglycaemia and about the negative effects of excessive therapeutic inertia in the adjustment of insulin doses. [ABSTRACT FROM AUTHOR]