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Introduction: We report the case of a neonate diagnosed with severe hemophilia A (HA) and conduct a literature review of cases of severe HA presenting at the neonatal age to help define the clinical diagnostic findings and existing differences between the sporadic and familial onset of this condition. Report of a Case: A 6-day-old newborn presented with worsening pallor, inappetence, and hyporeactivity for 48 h. The diagnosis was severe hemophilia A (HA), leading to an unfavorable outcome. A literature review focusing on case reports and series focusing on the clinical expression of HA in neonates was conducted, documenting clinical presentation, family history, and outcomes. Literature review: Forty patients were included. HA was observed in five cases (12.5%) of very preterm births (≤32 weeks) and in four cases (10%) of moderately or late preterm births. Seventeen patients (43%) had a family history, with inheritance being sporadic (21 newborns, 53%) or acquired (2 cases, 4%). Clinical onset typically occurred within the first week of life (approximately 8 out of 10 cases), while only three cases (7.5%) had onset after the first month. Inherited cases presented with hemorrhagic states (nine cases), hypovolemic shock (five cases), or intracranial hypertension (two cases). Sporadic cases showed localized bleeding (11 cases), hypovolemic shock (5 cases), or neurological symptoms like seizures and anisocoria (5 cases). Acquired cases included severe intracranial hemorrhage in one case. Conclusions: Neonatal HA can manifest with severe symptoms and rapid progression, making early diagnosis crucial. Non-specific signs and the absence of coagulophaty disorders in family history can delay diagnosis. Symptoms like prolonged bleeding, cutaneous hematomas, or intracranial bleeding necessitate ruling out major coagulopathy, and neurological signs require immediate imaging to exclude intracranial bleeding. [ABSTRACT FROM AUTHOR]

Background: Thirty years ago, the first attempt by Saliba and colleagues was made to reduce the negative effects (hypercarbia) of exogenous surfactant (ES) by slowing its administration. Sixteen years later, we observed the first less invasive surfactant administration (LISA) attempt by Kribs and colleagues. Many studies, since that time, have tried to minimize the invasiveness of ES and subsequent cerebral blood flow perturbations through studies using near-infrared spectroscopy (NIRS). We sought to address this medical challenge by identifying a less problematic modality of ES administration by delivering multiple aliquots of ES instead of a single one, as typically performed. The aim of this study was to test the hypothesis that a different way of administering ES using more aliquots could be a safe alternative that should be assessed in further studies. Methods: Patients between 26 + 0 and 35 + 6 weeks of gestational age (GA) requiring ES administration were enrolled (April 2023–February 2024). Differently fractioned doses were delivered according to an arbitrary standard dosage (0.3 mL per aliquot in babies < 29 weeks; 0.6 mL in babies ≥ 29 weeks), while NIRS and transcutaneous CO2 (tCO2) monitoring were always performed. ES's effectiveness was assessed based on the reduction in the Oxygen Saturation Index (OSI) after administration. Persistent desaturation, bradycardia, and airway obstruction were defined as adverse effects and used to evaluate safety during ES administration, as well as variability in NIRS-rSO2 values and tCO2. Results: Twenty-four patients were enrolled with a median GA of 29 weeks (IQR 4.5) and BW of 1223 ± 560 g. In addition, 50% of the cohort received fewer than three aliquots, whereas the other 50% received more than three. Monitoring was started before the procedure and continued 30′ after the last ES aliquot administration. The variability in NIRS-SpO2 values was significantly higher in the group (p = 0.007) with a lower number of aliquots administered. Similarly, increased NIRS-rSO2 values (p = 0.003) and increased tCO2 levels (p = 0.005) were observed in infants who underwent an ES split after the administration of a low number of aliquots. Conclusions: Our data obtained from the group with > 3 fractionated doses of ES seem to justify the preparation of a more robust study, as the combination of reduced NIRS variability and reduced tCO2 maximum levels is consistent with more stable cerebral blood flow during the challenging time of ES administration. [ABSTRACT FROM AUTHOR]

Aiming to contribute to the energy transition, this study provides an integrated picture of the geothermal system hosted in the West Netherlands Basin and shows how the reconstruction of the basin's geological history can contribute to the correct exploration and exploitation of its geothermal resources. In the West Netherlands Basin, the main geothermal targets are found in the Cretaceous and Jurassic strata that were deposited during the rifting and post-rifting stages and were deformed during the subsequent basin inversion. Despite multiple studies on the tectonic setting, the timing and tectono-stratigraphic architecture of the rift system and its overall control on the development and evolution of geothermal systems are still to be fully deciphered. In this study, a detailed seismo-stratigraphic interpretation of the syn- and post-rift intervals in the West Netherlands Basin will be given within the framework of geothermal exploration. A recently released and reprocessed 3D seismic cube is used, covering a large portion of the onshore section of the basin. We identified two major Jurassic rifting episodes and a Late Cretaceous inversion event. During the Jurassic rifting phases, the compartmentalization of the basin and the creation of accommodation space led to the deposition of the Late Jurassic Nieuwerkerk Formation, which is the main regional geothermal producing target. Within this formation, we individuate growth synclines located in the central portions of the Jurassic half-grabens as sites that show good potential for geothermal exploration. [ABSTRACT FROM AUTHOR]

The sodium rhodizonate test is a simple colorimetric technique used to identify traces of lead and barium. A positive test provides rapid and photographically documentable results for shots fired at distances not exceeding 50 cm. Usually, this method is not used for identification of the firing hand, which is detected by electron microscopy with energy dispersive analysis (SEM-EDX), requiring the removal of any particles on the surface to be analyzed by STUB. The use of Sodium Rhodizonate, which is undoubtedly less selective, has the disadvantage of target element solubilization (lead and barium) and thus the loss of the preliminary morphological investigation of the particles. The purpose of this paper is to demonstrate that the two indicated methods can be considered complementary in the following order: 1. buffer sampling for electron microscopy investigation (STUB); 2. and subsequent performance of the Sodium Rhodizonate Test. In some special cases, when it is necessary to obtain the result more quickly, with regards to respecting the chronology of the aforementioned tests, it may be useful to carry out the Sodium Rhodizonate Test first, especially when particular and perhaps antiquated weapons were used for suicidal purposes causing considerable gas dispersion and shot residues from the mechanisms. This research illustrates how significant results were obtained substantiating the suicide hypothesis, following the use of an old revolver (year of manufacture around 1915-1920). [ABSTRACT FROM AUTHOR]

Aims: Retropharyngeal abscess (RPA) is a deep neck infection occurring in childhood. The gold standard technique for diagnosis is computerised tomography (CT) with a contrast medium. The aim of this study is to answer the question of whether magnetic resonance imaging (MRI) can be an alternative in diagnosing RPA and predicting pus drainage at surgery. Methods: This is a retrospective study conducted at the paediatric emergency department of a tertiary level children hospital. The medical records of 31 children admitted to the Otorhinolaryngology and Paediatric ward, with a suspected diagnosis of RPA, were reviewed. The primary study outcome was the diagnostic accuracy of CT and MRI in predicting the amount of pus during surgery. Results: Twenty‐two patients (71%) underwent surgery. Among them, 18 had imaging before surgery. Eleven patients evaluated with CT scan underwent surgery: four had non‐significant purulent drainage, three of them were reported to have a significant fluid collection (negative predictive value 66% and positive predictive value of 55%). Nine patients evaluated with MRI underwent surgery: four cases had non‐significant purulent drainage, three of them showed a significant fluid collection at MRI (negative predictive value of 60%; positive predictive value of 56%). Conclusion: MRI and CT scans showed similar accuracy in predicting successful pus drainage during surgery; therefore, it could be a valid alternative in the diagnosis of RPA in children. [ABSTRACT FROM AUTHOR]

In recent years, violence against minors has been the subject of in-depth study in all its historical, social and cultural dimensions, being able to be identified and treated according to rigorous scientific methodologies. The A.A. report the case of an 8-year-old girl, who disappeared in a rural area, found dead a few hours later, on the recommendation of a young man who, despite having admitted to having gone away with the child, had not provided further details. The forensic inspection revealed that the discovery area included an area with burnt undergrowth about 4 meters in diameter. Examination of the external genitalia showed that the hymen was hemorrhagic in the right hemicycle, at 11 o'clock, with laceration of the most superficial layers of the anterior face. In the present case, therefore, despite having limited historical and circumstantial data, it was possible to reconstruct the following damaging dynamic: the little girl, after having gone away with her aggressor, was first the victim of an attempt of sexual violence by the latter and later immobilized by placing a foot on the slender abdomen. She had been covered with brushwood which the attacker had set fire to, thus killing her. This reconstruction of the criminal events, proposed to the investigating magistrate, was confirmed in each passage by the confessions made by the murderer, during the various degrees of trial, so much so that the final sentence reported in full the specific steps of the medico-legal relationship. [ABSTRACT FROM AUTHOR]

A mass disaster is a situation that involves criticality between the number of victims and resources, in terms of both men and means, present on the site of an event that is mostly unexpected and sudden. In the multidisciplinary teams that intervene, the role of forensic pathologists, who are responsible for the direction and coordination of post-mortem operations, is central, and must remain so. The authors report the case of an explosion of a pyrotechnic artifice factory, as a result of which numerous victims and injuries are recorded. So, the team completed the autopsies and created a protocol to obtain biological samples (bones, blood, teeth, muscles), while the forensic pathologists contacted the families of the alleged victims and each provided a blood sample that was collected for the DNA. The geneticist, using the method of gene extraction and amplification, obtained the DNA from each bone, tooth, and muscle of blood taken from the victims and then compared it with that extracted from the blood samples of the relatives; the electropherograms showed at least one allele for each genetic marker of the "Combined DNA Index System" in common between the victims and the families, thus allowing to establish the identity of all the subjects involved in the event. Having established the identity of all workers, it was possible to determine their whereabouts in the environment at the time of the location of fires and explosions. The results of the various forensic analyzes (autopsies, genetic investigations and even traumatological investigations) have allowed us to validate a scientific method useful in all mass disasters even when any type of anthropological or forensic dental research is difficult. [ABSTRACT FROM AUTHOR]

Haemoglobin levels assessment is a crucial part of neonatal intensive care practice, the painful experience of repeated heel pricks and venepunctures blood sampling may negatively affect neonatal clinical course. To date the reliability of haemoglobin levels obtained by point-of-care testing (POCT) analysis if compared to standard blood cell count remains controversial. Retrospective study conducted on all inborn premature infants (gestational age < 32 weeks) admitted to NICU of the IRCCS Giannina Gaslini Institute during the period May 2021–April 2023. We considered blood samplings occurred within the first 28 days of life recording the laboratory haemoglobin levels (Hblab) (reference method), the point-of-care haemoglobin levels (HbPOCT) (alternative method) and the type of puncture (arterial, venous and capillary). A Bland-Altman analysis was performed to evaluate the Hb agreement, it determines the bias (mean difference between the reference and alternative methods) and limits of agreement (LOA; lower, l-LOA; upper, u-LOA) of measures. An acceptable limit of agreement was 1 g/dl according to the existing literature. We considered 845 blood samplings from 189 enrolled patients. The comparison between the reference and the alternative method showed a good agreement for the capillary sampling technique with l-LOA of −0.717 (−0.776; −0.659) and u-LOA of 0.549 (0.490; 0.607), these results were not achievable with the other techniques, with LOAs over ±1 g/dl threshold (venous