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Surgical Correction of Unicoronal Synostosis: Fronto-Orbital Distraction versus Calvarial Switch
No full textBackground: There is a need for a new, less-invasive surgical option for unicoronal synostosis (UCS). The aim of this study was to compare the resulting morphology and symmetry in patients with UCS after fronto-orbital distraction (FOD) or calvarial switch (CS). Methods: A total of 79 patients with isolated UCS operated on between 2005 and 2021 were analyzed. Follow-up was until 3 years of age. Angles describing orbital dystopia and anterior cranial fossa deviation and cant were measured. Key linear dimensions, cranial cavities, and indices were calculated. Results: A total of 66 patients were included (14 in the FOD group and 52 in the CS group). The 3-year follow-up revealed significant improvement in all angles in both groups, with significant superiority in orbital dystopia correction after FOD (median improvement of 5.7 degrees as compared with 3.3 degrees after CS). In addition, nasal and orbital volumes tended to be smaller, especially after CS; however, FOD resulted in a smaller absolute difference in orbital volume. Asymmetry in the orbital, nasal, and sphenoid regions also improved at the 3-year follow-up in both groups, although FOD resulted in normalization of the affected orbital shape and significantly improved overall asymmetry relative to that observed in the CS group. Conclusions: This study found that FOD achieves superior overall symmetry, as well as better shape correction of the cranium, as compared with CS, while also being less invasive. These findings suggest FOD as a safe and effective alternative to correct UCS and, possibly, the preferred surgical method
NMR Investigations of Honey: Chemical Composition, Chemical Physical Properties and Molecular Dynamics
No full textHoney is the best known and a widely used bee product, as well as one of the most defrauded foods. This paper focuses on the analysis of honey by different NMR techniques, complemented by some conventional methods to characterize food. Twenty-six honey samples of different botanical and geographical origins have been investigated. The chemical composition of honey samples in terms of water content and sugar concentrations was determined, and high-resolution 1H NMR spectroscopy was used to identify, and in some cases to quantify, some of the minor chemical compounds considered important to discriminate the botanical origin of honey. Finally, we developed a model for molecular dynamics in honey, which was tested to analyse the 1H NMR relaxation dispersions as studied by fast field-cycling NMR relaxometry. In conclusion, an array of NMR techniques, ranging from high to low resolution, was applied to a broad set of honey samples from diverse botanical and geographical origins. The outcomes provide a foundation for future research and potential applications in honey authentication and characterization
Cortico-Cancellous Collagenic Porcine Bone for Alveolar Ridge Preservation: A Cohort Comparative Study
No full textObjectives: The primary aim of this study was to compare the histomorphometric characteristics of two different cortico-cancellous collagenic porcine bone (CCPB) formulations combined with a stabilizing agent used for alveolar ridge preservation (ARP), and the secondary aim was to evaluate and compare clinical and aesthetic outcomes of dental implants placed in augmented sites. Materials and Methods: This was a prospective, cohort-comparative study conducted on patients requiring a tooth extraction followed by ARP and subsequent implant placement. Tooth extractions were performed trying to reduce the surgical trauma as much as possible, and then ARP was performed using two different formulations of CCPB combined with a thermogel in different ratios (50:50 hand-mixed and 80:20 pre-mixed). After 4 months of healing, implant placement was performed, and a bone biopsy was retrieved from the surgical site for histomorphometric analyses. Implants were rehabilitated 3 months following placement with screw-retained crowns, then patients were re-evaluated 1 year following prosthetic loading. Results: We report the clinical and histomorphometric outcomes of 20 patients divided into the two study groups (10 patients per group). ARP performed with a hand-mixed biomaterial in a 50:50 ratio had higher percentages of newly formed bone (36.15% vs. 27.18%) when compared to a pre-mixed biomaterial in an 80:20 ratio, even though the difference was not statistically significant (p = 0.064). Implants placed in ARP-treated sites showed a very low mean marginal bone loss at the 1-year follow-up in both experimental groups (0.06 ± 0.15 mm in the 50:50 group and 0.25 ± 0.35 mm in the 80:20 group) with no statistically significant differences (p = 0.42), as well as the aesthetic outcomes assessed through the pink aesthetic score. Conclusions: Both biomaterials showed effective and favorable outcomes, and the histomorphometric differences observed in our sample did not have any impact on the final clinical and aesthetic outcomes
Validation of a Digital Twin Model for Three‐Dimensional Noninvasive Functional Substrate Prediction in Scar Related Ventricular Tachycardia
No full textBackground: High density electroanatomical mapping (EAM) is the standard for identifying functional substrate in scar‐
related ventricular tachycardia (VT), but it is limited by its two‐dimensional nature and increased procedural complexity.
Imaging‐based strategies provide anatomical characterization but lack functional information. We evaluated a novel digital twin
model (CardioMat) to non‐invasively predict functional substrate in three‐dimensions.
Objective: To validate a novel digital twin model for noninvasive prediction of functional substrate in scar‐related ventricular
tachycardia.
Methods: Fifteen patients with ischemic or nonischemic cardiomyopathy undergoing VT ablation were retrospectively ana-
lyzed. High‐density EAM, cardiac magnetic resonance (CMR) post‐processing with ADAS3D, and CardioMat modeling were
performed. CardioMat‐generated three‐dimensional activation maps were integrated into the CARTO EAM suite. Deceleration
zones (DZs) identified by CardioMat were compared with EAM‐derived DZs and CMR‐based heterogeneous tissue channels
(HTCs) and scar areas.
Results: A total of 255 cardiac segments were analyzed. CardioMat‐derived DZs demonstrated high diagnostic accuracy
(79% sensitivity, 93% specificity, 81% PPV, 92% NPV, 89% accuracy) for predicting EAM‐DZ localization, outperforming
CMR scar and HTCs. Multivariate analysis confirmed CardioMat DZs are the strongest independent predictor of EAM‐DZ
localization (OR 17.4, 95% CI 6.9–43.8, p > 0.001)
Large-Spacing Periodic Beam Scanning Arrays With Dynamic Coupling Elements for Grating Lobe Suppression
No full textThis communication presents a method for large-spacing arrays with grating-lobe-free scanning capabilities. This method achieves grating lobe (GL) suppression by transforming the large-spacing arrays into a new array with an average spacing of less than half a wavelength. Dynamic coupling elements (DCEs) terminated with a reactive load are inserted between active ones, and a coupling structure is also added to tune their coupling coefficient. Simulations and prototype measurements of a 1 × 8 large-spacing array with and without the DCEs are analyzed to verify the effectiveness of the method. The results show that the GL level is suppressed by 10.8 dB at 50°, and the main beam gain is increased by 2.2 dB compared to the array without DCEs. The proposed method provides a general solution for GL suppression of large-spacing periodic scanning arrays without introducing aperiodicity and excitation weighting
CLIP2: a novel functional player in AQP5 trafficking dynamics and implications for Sjögren’s disease
No full textBackground Sjogren's disease (SjD) is an autoimmune condition affecting exocrine glands, resulting in decreased saliva and tear production. Aquaporin 5 (AQP5) is a transmembrane water channel playing a central role in water transport. In SjD, deregulation of AQP5 expression, trafficking and interactions with various proteins contribute to the underlying disease mechanisms. Methods Co-immunoprecipitation followed by mass spectrometry, proximity ligation assay, microscale thermophoresis and in-silico modelling were carried out to investigate protein-protein interaction. CRISPR/Cas9-mediated knockout was performed in a salivary gland cell line stably transfected with AQP5. Protein colocalization and AQP5 trafficking were studied by immunofluorescence. Autoantibodies were quantified by ELISA. Results We identified CAP-Gly Domain Containing Linker Protein 2 (CLIP2) as a novel AQP5-interacting partner. Structural modeling of the AQP5-CLIP2 interaction revealed that the interaction is similar to other CAP-Gly domain complexes. Functional investigations indicated CLIP2 significantly influences AQP5 trafficking to the plasma membrane. Furthermore, interactions of CLIP2 with other AQP5 partners reveal the possible formation of multiprotein complexes in salivary glands. In SjD patients, alterations in these complexes and the presence of autoantibodies against AQP5, CLIP2, and other AQP5-interacting partners such as Ezrin and prolactin-inducible protein (PIP) may also contribute to disease pathogenesis. Conclusion Our study identifies CLIP2 as a novel player in the AQP5 interactome and sheds light on its crucial role in AQP5 trafficking. In SjD, the alterations in AQP5-CLIP2 interactions and the presence of autoantibodies against both proteins highlighted their potential as targets for future therapeutic interventions in SjD
Navigating the learning curve of robotic pancreatoduodenectomy: Competency, proficiency, and mastery in a first-generation robotic surgeon with established open pancreatic expertise
No full textObjective: This study delineates the learning curve of robotic pancreatoduodenectomy for first-generation surgeons, using the Comprehensive Complication Index to assess patient outcomes. Background: Robotic pancreatoduodenectomy is a promising alternative to open pancreatoduodenectomy, but patient safety and quality of outcomes during the learning phase remain critical. Methods: We retrospectively analyzed 313 consecutive robotic pancreatoduodenectomies performed by a single surgeon. The cumulative-sum method defined the learning curve, and Comprehensive Complication Index, adjusted for robotic pancreatoduodenectomy difficulty by PD-ROBOSCORE, was the dependent variable. Results: The median PD-ROBOSCORE was 8 (4.8–10.9), and the median Comprehensive Complication Index was 29.6 (20.9–39.5). At 90 days, severe morbidity and mortality rates were 24% and 5.4%, respectively. Three learning phases were identified: competency (63 procedures), proficiency (176), and mastery (263). Early phases involved simpler cases, whereas later phases showed greater complexity and a higher proportion of patients with ASA scores >2. Pancreatic cancer cases tripled in phases 2 and 3. Each phase showed progressive reductions in operative time and Comprehensive Complication Index. The mastery phase demonstrated further improvements in Comprehensive Complication Index, lymph node harvest, and margin status. Compared with proficiency, mastery saw improved outcomes in delayed gastric emptying, harvested lymph nodes, and R1 rates in pancreatic cancer. Operative time was longer, but morbidity and mortality remained stable. Conclusion: The robotic pancreatoduodenectomy learning process involves competency, proficiency, and mastery phases. Structured training programs may accelerate this learning curve, but high procedural volumes are essential to improve outcomes. Future studies should account for surgeon experience and case complexity when evaluating robotic pancreatoduodenectomy outcomes
Luigi Einaudi tra mercato e società: liberalismo, concorrenza e responsabilità sociale
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