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Background. Vasoactive drugs are considered an important therapeutic tool in managing phlebolymphologic disease. The current study was performed to evaluate the results of a high-dose diosmin-based combination (Venoplant 2g) in symptomatic patients with chronic venous disease (CVD), treated with endovascular venous surgery, regarding the efficacy of this treatment and the clinical signs and patients’ compliance. Methods: We identified, between April 2022 and March 2023, 50 patients with symptomatic CVD who underwent endovenous ablation and additionally were administered high-dose micronized diosmin. Parameters analyzed in the pre- and post-operative period were the venous clinical severity score (VCSS), the calf circumference, and a VEINES-QOL/Sym questionnaire. Treatment efficacy was assessed in post-operative follow-ups at 1 month and 2 months. Results: Quality-of-life analysis showed a significant improvement between t1 and t2 in both tests administered (VEINES-QOL/Sym: 55.2 ± 2.9, 39.2 ± 12.3, p: 0.001) (VCSS: 6.6 ± 1, 5.1 ± 0.7, p: 0.001). At the secondary endpoint, the results maintained the same improvement trend. Calf circumference was significantly reduced between t1 and t3 (41.7 ± 5.1, 38.3 ± 3.4, p: 0.001). Conclusion: High-dose diosmin, combined with sweet clover 320 mg, Centella asiatica 40 mg, and Vitamin C 200 mg, in patients treated with endovenous ablation, can be significantly effective in terms of clinical results in treating superficial venous disease. A patient’s calf circumference was also found to have decreased considerably during follow-up. No adverse effects have been recorded to date.

Phlogopite solid-solutions have a wide pressure–temperature (P-T) stability field and are ubiquitous in a wide variety of geological settings, from deep lithosphere magmatic environments to upper crust metamorphic domains. Phlogopite composition represents therefore a valuable physical–chemical archive and may provide important information regarding its crystallization and the petrogenesis of the host-rock. In this paper we examine the phlogopite phenocrysts from the well-known Fort Regent mica-bearing lamprophyre minette from St. Helier (Island of Jersey, UK). Phlogopite phenocrystals from lamprophyres generally show normal-step and continuous compositional zoning, however those from the Fort Regent minette show a peculiar texture characterized by dark brown high-Ti (average TiO2 ≈ 8.5 wt.%) cores enveloped by euhedral low- to mid-amplitude zonation due to oscillatory contents in Ti, Fe and Mg. Thermo-barometry modelling based on biotite-only composition yields relatively high P-T estimates (T ≈ 970 ± 54 °C at P ≈ 0.73 ± 0.13 GPa) for cores whereas lower values (T ≈ 790 ± 54 °C at P ≈ 0.29 ± 0.13 GPa) are obtained for the outer rims. Comparable temperatures (T ≈ 1075 ± 54 °C) but extremely high and anomalous pressure values (P ≈ 1.82 ± 0.13 GPa) are obtained for the yellowish inner rims. The combination of electron micro probe (EMP) analysis and single-crystal infra-red (FTIR) imaging in the OH-stretching region shows that the exceptional and oscillatory Ti contents are due to the Ti-vacancy substitution, typical of crystallization and growth processes of HP/HT environments. Raman imaging provides additional insight for this process, confirming the dominant dioctahedral nature for the Ti-Fe-rich cores and outer rims. Interpretation of thermobaric estimates obtained from the phlogopite composition-only model, based on the fine-scale compositional evolution, shows that pressure–temperature values from low-Ti high-Mg domains should be carefully evaluated because the substitution mechanisms during the dark mica growth are not univocally related to pressure–temperature variation of the crystallizing environment. Our results demonstrate how a multidisciplinary approach based on the combination of chemical investigations and vibrational spectroscopies could represent a valuable tool to evaluate pressure–temperature estimates from biotite composition-only thermo-barometry models and therefore to correctly unravel HP/HT petrogenetic processes at a very fine scale.

Abstract Raman spectroscopy shows great potential as a diagnostic tool for thyroid cancer due to its ability to detect biochemical changes during cancer development. This technique is particularly valuable because it is non-invasive and label/dye-free. Compared to molecular tests, Raman spectroscopy analyses can more effectively discriminate malignant features, thus reducing unnecessary surgeries. However, one major hurdle to using Raman spectroscopy as a diagnostic tool is the identification of significant patterns and peaks. In this study, we propose a Machine Learning procedure to discriminate healthy/benign versus malignant nodules that produces interpretable results. We collect Raman spectra obtained from histological samples, select a set of peaks with a data-driven and label independent approach and train the algorithms with the relative prominence of the peaks in the selected set. The performance of the considered models, quantified by area under the Receiver Operating Characteristic curve, exceeds 0.9. To enhance the interpretability of the results, we employ eXplainable Artificial Intelligence and compute the contribution of each feature to the prediction of each sample.

IntroductionUrinary tract infections (UTI), among which the main etiological factor is uropathogenic Escherichia coli (UPEC, E. coli), remain an important issue for clinicians. The aim of the study was to demonstrate clear differences in the pathogenic properties of urine-derived E. coli compared to other extraintestinal E. coli clinical isolates (derived from: blood, lower respiratory tracts, sputum, reproductive tract, body fluids, perianal pus, other pus, wound, postoperative wound and other sources).MethodsThe collection of 784 E. coli isolates was collected from various materials of hospitalized patients. They were analyzed in terms of virulence-associated genes (papC, sfaD/sfaE, cnf1, usp., fimG/H, hlyA), belonging to phylogenetic groups and the presence of CRISPR-Cas regions using PCR. In addition, the epidemiological data and the antibiotic resistance profiles provided by the hospital’s microbiology department were included for statistical analyses.ResultsUrine-derived E. coli showed significantly greater virulence potential compared to other isolates, but they were generally unremarkable in terms of drug resistance. The isolates most often belonged to phylogenetic group B2. Drug resistance was negatively correlated with CRISPR 2 presence and high average virulence score, but positively correlated with CRISPR 4 presence. To the best of our knowledge, we are the first to report significant differences in sputum-derived isolates—they revealed the lowest virulence potential and, at the same time, the highest drug resistance.DiscussionIn conclusion, we demonstrated significant differences of urinary-derived E. coli compared to other clinical E. coli isolates. We would like to suggest excluding penicillins from use in E. coli infection at this time and monitoring strains with a high pathogenicity potential.

Coastal areas are extremely exposed to litter pollution. In this work, we assessed the abundance and distribution of microlitter in the water column and surface waters, as well as its summertime transport trajectories in the northern Latium coastal area (Tyrrhenian Sea, Italy). Microlitter items were classified according to their different shapes (fragments, films, and filaments), sizes, colours, and types by visual sorting and by optical microscopy; their composition was addressed via spectroscopic (Raman and FTIR) microanalysis. Microplastics (MPs) were abundant in all water samples; polypropylene, polyethylene, and poly-methyl methacrylate were identified. The results show a higher concentration of microlitter items in the water column (average concentration of 5.9 ± 1.38 items/m³) compared to surface waters (average concentration of 0.16 ± 0.03 items/m³). These abundances are similar to those found in the Mediterranean Sea and Oceanic waters. The sampling sites closer to the coast showed a higher abundance of particles, especially filaments, in the water column compared to the offshore areas. This feature can be explained based on the presence of land-based pollution sources, bathing areas, and the resuspension of microlitter items from the bottom. Analysis of the surficial trajectories pointed to a general northward transport direction of microlitter and the presence of possible enrichment spots along the coast.

The study explores the application of natural biocides (oregano essential oil and eugenol, directly applied in solutions or encapsulated within silica nanocapsules) for safeguarding stone cultural heritage from biodeterioration, using green algae (Chlorococcum sp.) and cyanobacteria (Leptolyngbya sp.) as common pioneer biodeteriogens. Core-shell nanocontainers were built for a controlled release of microbicidal agents, a safe application of chemicals and a prolonged efficacy. The qualitative and quantitative evaluations of biocide efficiency at different doses were periodically performed in vitro, after six scheduled intervals of time (until 100 days). The release kinetics of composite biocide-embedding silica nanocapsules were characterized by the UV-Vis spectroscopy technique. Data showed both promising potential and some limitations. The comparative tests of different biocidal systems shed light on their variable efficacy against microorganisms, highlighting how encapsulation influences the release dynamics and the overall effectiveness. Both the essential oils showed a potential efficacy in protective antifouling coatings for stone artifacts. Ensuring compatibility with materials, understanding their differences in biocidal activity and their release rates becomes essential in tailoring gel, microemulsion or coating products for direct on-site application.

BackgroundDental therapy is a category of mid-level oral health professional that was introduced to address inequities in oral health service provision in South Africa within a constrained human resource for health context. However, low numbers of registered dental therapists and attrition threaten this strategy.AimThis study explored reasons for this attrition, building on the Hertzberg Two-Factor Theory.MethodsThrough a qualitative exploratory study design, in-depth interviews were conducted with former dental therapists to explore their reasons for leaving the profession. They were recruited using snowball sampling. All interviews were audio recorded, transcribed verbatim, and coded in NVIVO12. A team of researchers applied thematic analysis to agree on themes and sub-themes, guided by Hertzberg's ideas of intrinsic and extrinsic factors.FindingsAll 14 former dental therapists interviewed expressed their passion for the profession, even though their motivations to join the profession varied. Many of their reasons for leaving aligned with extrinsic and intrinsic factors defined in Hertzberg's Two-Factor Theory. However, they also spoke about a desire for a professional identity that was recognized and respected within the oral health profession, health system, and communities. This is a novel study contribution.ConclusionDental therapist attrition in South Africa is mainly caused by job dissatisfaction and motivation issues resulting from health system level factors. While the Hertzberg Two-Factor Theory helped identify extrinsic and intrinsic factors at an individual level, we used the Human Resources for Health System Development Analytical Framework to identify solutions for dental therapist production, deployment, and retention. Addressing these issues will enhance retention and accessibility to oral health services in the country.

BackgroundEnsuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.AimTo explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.MethodsA qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.FindingsMultiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.ConclusionReasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels.

Raffaele Serra,1,2,* Umberto Marcello Bracale,3,* Nicola Ielapi,4 Luca Del Guercio,3 Maria Donata Di Taranto,5 Maurizio Sodo,3 Ashour Michael,6 Teresa Faga,6 Egidio Bevacqua,7 Federica Jiritano,7 Giuseppe Fliberto Serraino,7 Pasquale Mastroroberto,7 Michele Provenzano,8 Michele Andreucci6 1Interuniversity Center of Phlebolymphology (CIFL), “Magna Graecia” University, Catanzaro, Italy; 2Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy; 3Department of Public Health, University of Naples “Federico II”, Naples, Italy; 4Department of Public Health and Infectious Disease, “Sapienza” University of Rome, Roma, 00185, Italy; 5Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, Naples, Italy; 6Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy; 7Department of Experimental and Clinical Medicine, University of Catanzaro, Catanzaro, 88100, Italy; 8Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy*These authors contributed equally to this workCorrespondence: Raffaele SerraDepartment of Surgical and Medical Sciences, Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, ItalyTel +39 09613647380Email rserra@unicz.itAbstract: Chronic kidney disease (CKD) is a clinical condition characterized by high morbidity and mortality. Globally, CKD is also increasing in prevalence and incidence. The two principal kidney measures namely estimated glomerular filtration rate (eGFR) and albuminuria have been found to be predictors of renal and cardiovascular (CV) endpoints including peripheral artery disease (PAD). The prevalence of PAD was increased in CKD patients and, particularly, in patients with more severe CKD stages. Despite the fact that revascularization strategies are suitable in CKD patients in similar fashion to non-CKD patients, few CKD patients underwent these procedures. In fact, if it is true that revascularization improves prognosis in PAD patients irrespective of baseline eGFR, it was also demonstrated that CKD patients, who underwent revascularization, were at higher risk for amputations, mortality, re-intervention and perioperative complications. With the present review article, we have examined the association between CKD, PAD and peripheral revascularization highlighting data about epidemiology, pathophysiologic mechanisms, and results from previous observational and intervention studies. We have also examined the future perspectives and challenges of research around the association between CKD and PAD.Keywords: chronic kidney disease, CKD, peripheral artery disease, PAD, ESKD, amputations, albuminuria

A 67-year-old man with pain in his right flank and hematuria over the last few weeks was admitted to our hospital due to right renal calculi revealed by an ultrasound examination of the urinary tract. An abdominal x-ray drew attention to the presence of structures of an uncertain interpretation, that mimicked multiple calculi in the right kidney and renal pelvis, but CT-scan identified a large saccular aneurysm of 76 mm with renal pelvis involvement and urinary statis of the right renal artery.A combined endovascular and laparoscopic surgical approach was chosen. The patient underwent endovascular embolization of the renal artery with an Amplatzer Vascular Plug followed by a video laparoscopic nephrectomy. After few days of hospitalization, the patient was in good general status and was discharged. A review of the literature has highlighted the unicity of our surgical approach, especially within the context of traditional vascular and general surgical practice, due to multidisciplinary consultation.

Guinea fowls are more valuable in the market in Niger than chickens; however, their ability to meet consumer demands is limited by low productivity. Therefore, suitable nutrition is an important factor for this productivity. The current study aimed to evaluate the growth performance of guinea fowl using maize, millet, and sorghum as energy sources in the diet. A total of 108 one-day-old unsexed local keets, with an average live weight of 25.5 ± 0.83 g were randomly distributed among three dietary treatments with four replicates per treatment. The keets were reared on the ground with litter at CERRA Maradi, Niger, for an 8-week experimental period, involving 36 keets per treatment and 9 keets per replication. The parameters monitored were feed intake (FI), live weight (LW), average daily gain (ADG), and feed conversion ratio (FCR). After 8 weeks of experimentation, the results indicated that the cereal used in the diet had no statistically significant effect on the keets' FI. Those fed millet-based diets had higher LW, compared to those fed maize and sorghum diets, respectively, however, this difference was not statistically significant. Millet also facilitated a higher ADG, compared to maize and sorghum, although the differences were statistically insignificant. The keets fed sorghum-based had higher FCR, compared to the FCR of the guinea fowls fed maize and millet diet. based on the growth performance assessed in this study, the recommended order for cereals in guinea fowl feed to ensure better growth is millet, followed by maize, and then sorghum. [ABSTRACT FROM AUTHOR]

Cervical cancer is largely preventable through early detection, but screening uptake remains low among black women in South Africa. The purpose of this study was to determine the prevalence and factors associated with cervical cancer screening in the past 10 years among black African women in primary health care (PHC) clinics, in Gauteng Province, South Africa. This was a cross-sectional study involving 672 consecutively recruited black women at cervical cancer screening programs in PHC clinics between 2017 and 2020. An interviewer-administered questionnaire covered socio-demographics, HIV status, sexual history, cervical cancer risk factors knowledge, and screening behaviours in the past 10 years. The mean age of participants was 38 years. More than half (63%) were aged 30-49 years. Most completed high school education (75%), were unemployed (61%), single (60%), and HIV positive (48%). Only 285 (42.4%) of participants reported screening for cervical cancer in the past 10 years. Of participants that reported receiving information on screening, 27.6% (n = 176) and 13.97% (n = 89) did so from healthcare facilities and community platforms respectively. Participants aged 30 years or more were more likely to report for cervical cancer screening as compared to other categories in the past 10 years. The study found low cervical cancer screening prevalence. This calls for health education campaigns and prevention strategies that would target individual patients' contexts and stages of behavioral change. Such strategies must also consider socio-demographic and clinical correlates of cervical cancer screening and promote better integration into PHC services in South Africa.