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Association between device-detected subclinical atrial fibrillation and diabetes in patients with implantable cardioverter-defibrillators: A propensity score-matched analysis
No full textBackground and objective: Device-detected subclinical atrial fibrillation (DDAF) and diabetes mellitus (DM) are common in patients with cardiac implantable devices. Our objective was to compare DDAF incidence between diabetic and non-diabetic patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D), using propensity score (PS) matching to adjust for confounders. Methods: Data from the Home Monitoring Expert Alliance dataset were analyzed for patients with ICD or CRT-D and no prior clinical AF. The primary endpoint was time to the first DDAF, categorized by four different burden thresholds: ≥15 min, ≥5 h, ≥24 h, and ≥7 days. The impact of new-onset DDAF on mortality was also assessed. Results: Among 1619 patients (median age 69 years, 79 % male), 363 (22.4 %) had DM. Over a median follow-up of 2.3 years, DM patients had higher incidence of DDAF lasting ≥15 min (3-year: 65.7 % vs. 57.7 %, P = 0.032) and ≥5 h (3-year: 62.0 % vs. 52.2 %, P = 0.010) compared to non-diabetics; however, after PS matching, these differences were nonsignificant (P ≥ 0.15). No differences were found for ≥24 h and ≥7 days DDAF in unmatched or matched analyses. Using a landmark approach, DDAF was associated with increased mortality risk in DM patients (hazard ratio: 4.20, 95 %CI: 1.89-9.33, P < 0.001), whereas no effect was observed in non-diabetics (hazard ratio: 1.76, 95 %CI: 0.89-3.46, P = 0.099). Conclusions: In ICD/CRT-D recipients without AF history, DM was not linked to higher DDAF incidence. However, DDAF in diabetic patients was associated with poorer outcomes, emphasizing the importance of continuous atrial rhythm monitoring in this group
Accuracy of Dynamic Computer-Aided Implant Surgery for Biconometric Implant Positioning: A Retrospective Case Series Analysis
Get PDFBackground/Objectives: This retrospective study assessed the accuracy of implant positioning with dynamic computer-aided implant surgery (dCAIS) for Toronto Bridge fabrication, using a conometric prosthetic concept and a new intraoral splinting technique (CLIKSS). It compared discrepancies across various anatomical regions, bone qualities, and implant sites.
Methods: This study involved 52 patients undergoing full-arch rehabilitation (17 in the mandible, 30 in the maxilla, and 5 in both), with 366 implants placed (125 in the mandible, 241 in the maxilla; 128 in post-extraction sites, and the remainder in healed sites). All implants were immediately loaded. Precision was assessed by measuring linear and three-dimensional (3D) angular deviations between planned and actual implant positions.
Results: Measurement errors for apical linear and 3D deviations at the apex and entry point ranged from 0.24 ± 0.10 to 0.55 ± 0.57 mm, and angular deviations varied from 0.32 ± 0.65° to 0.35 ± 0.71°. Maxillary measurements were significantly higher at the entry, apical, and vertical levels, even when comparing anterior and posterior regions with the corresponding mandibular areas, while no differences were found in the angular deviation. Significant discrepancies were observed among different mandibular bone types. Maxillary post-extraction sites exhibited significantly greater deviations than mandibular sites in all parameters except angular deviation. No significant differences were found between healed and post-extraction sites within the same jaw.
Conclusions: dCAIS improved implant placement accuracy, leading to predictable prosthetic outcomes, especially during parallel multi-implant insertions. This report introduced dCAIS for conometric/biconometric implant placement combined with the innovative CLIKSS technique as an effective intraoral split method for this prosthesis connection
Soil-borne viral diseases in durum wheat: searching the Global Durum Wheat Panel (GDP) for novel genomic regions implicated in resistance and development of rapid diagnostic tools
No full textIl grano duro (Triticum turgidum L. subsp. durum (Desf.) Husn.) è una coltura di grande rilevanza nel bacino del Mediterraneo. Questo cereale è suscettibile a numerosi patogeni, tra cui diversi virus, che ne riducono la resa. Alcuni di questi virus sono trasmessi attraverso il suolo, e per questo sono detti “soil-borne”. Le infezioni, pur essendo diffuse in tutto il mondo, mostrano sintomi (mosaici e giallumi fogliari, taglia ridotta) che sono spesso difficili da associare a questi virus, poiché possono facilmente confondersi con quelli derivanti, ad esempio, da stress fisiologici e carenze nutrizionali. In Europa, i virus del grano trasmessi attraverso il suolo più conosciuti sono Furovirus cerealis (soil-borne cereal mosaic virus, SBCMV), appartenente al genere Furovirus, e Bymovirus tritici (wheat spindle streak mosaic virus, WSSMV), appartenente al genere Bymovirus. Entrambi questi virus presentano un genoma composto da 2 molecole di RNA lineare (ssRNA) e sono trasmessi da Polymyxa graminis Led., un plasmodiophoromycota che vive nel suolo, in grado di sopravvivere fino a vent'anni anche in assenza di piante ospiti.
Per promuovere studi sull’attuale diffusione del SBCMV e del WSSMV e per velocizzare gli screening varietali di genotipi di grano per studi sulla resistenza/suscettibilità a queste virosi è importante lo sviluppo di tecniche di rilevamento rapide, sensibili, di facile utilizzo e che permettano di poter eseguire le analisi in pieno campo. A questo scopo i primi due studi presentati riguardano lo sviluppo di due sistemi diagnostici rapidi di reverse transcription loop-mediated isothermal amplification (RT-LAMP) da estratti fogliari. Questi protocolli si sono dimostrati specifici nel rilevare SBCMV e WSSMV, offrono una sensibilità comparabile a quella dei test PCR, sono di facile utilizzo, molto veloci e ideali per analisi in campo tramite l’ausilio di dispositivi portatili.
Data la mancanza di tecniche efficaci per l’eradicazione del vettore nei campi infestati e dell'assenza di metodi di controllo delle virosi, l'identificazione di genotipi di grano duro resistenti a questi virus e di geni implicati nella resistenza è importante per la gestione di questi virus in campo. A questo scopo il terzo studio presentato riguarda la valutazione della resistenza o suscettibilità al SBCMV e al WSSMV in una selezione di oltre 200 genotipi/landraces di grano duro provenienti da una collezione internazionale di germoplasma. È stato condotto un esperimento di inoculazione naturale dei virus in condizioni semi-controllate in vasi contenenti terreno infetto mantenuti all’aperto sotto una rete di protezione, soggetti alle temperature invernali e ad una umidità elevata del suolo. I campioni raccolti sono stati analizzati mediante RT-qPCR per la quantificazione delle cariche virali. I genotipi testati hanno mostrato risposte diversificate nei confronti dei due virus: tutti i genotipi sono risultati infetti da WSSMV (la maggior parte con carica virale da media ad alta), mentre SBCMV è stato rilevato con cariche virali molto diversificate tra i genotipi. I risultati ottenuti non hanno evidenziato correlazioni tra le cariche virali dei due virus. Sono stati identificati 23 genotipi che presentano basse cariche virali per entrambi i virus e sintomatologia assente o molto limitata. Uno studio di associazione genome-wide (GWAS) preliminare, effettuato sui dati genotipici (SNPs) e i dati fenotipici ottenuti tramite le analisi RT-qPCR, ha permesso di identificare nuove regioni genomiche presumibilmente associate alla resistenza al SBCMV e al WSSMV, nonché possibili geni candidati coinvolti nella resistenza.Durum wheat (Triticum turgidum L. subsp. durum (Desf.) Husn.) is an important agricultural crop in the Mediterranean region. This cereal may be affected by numerous plant pathogens, including viruses that can significantly reduce yield. Soil-borne viruses are widely distributed globally. However, the damage they cause is very difficult to evaluate, due to a symptomatology that can be easily confused with physiological stresses. In Europe, the most well-known soil-borne viruses affecting wheat are Furovirus cerealis (soil-borne cereal mosaic virus, SBCMV), which belongs to the genus Furovirus, and Bymovirus tritici (wheat spindle streak mosaic virus, WSSMV), which belongs to the genus Bymovirus. Both viruses are characterized by a genome composed of two linear RNA molecules (ssRNA) and are transmitted by Polymyxa graminis Led., a soil-inhabiting plasmodiophoromycota. This organism can survive in absence of host plants for up to twenty years.
The development of rapid, sensitive, and easy-to-use detection techniques is a crucial step in the study of the current spread of SBCMV and WSSMV. Such techniques would facilitate screening of wheat genotypes for resistance or susceptibility to these viruses. For this purpose, two studies were conducted regarding the development of two reverse transcription loop-mediated isothermal amplification (RT-LAMP) protocols for the detection of SBCMV and WSSMV using crude extracts of durum wheat leaves. These protocols have shown high specificity and sensitivity, they are ideal for field use with portable devices, simple to use, and offer the additional benefit of rapid analysis.
Due to the lack of effective vector eradication techniques in infested fields and the absence of virus control methods, the identification of virus-resistant durum wheat genotypes and genes implicated in resistance is important for the management of these viruses. The third study focused on the evaluation of resistance to SBCMV and WSSMV in a selection of over 200 durum wheat genotypes/landraces from an international germplasm collection. A natural virus inoculation experiment was conducted in semi-controlled conditions, in pots containing soil infected by the vector and the two viruses. Pots were maintained outdoor under a net screen to reproduce the natural conditions and watered weekly. The samples, collected at the end of the winter period, were analyzed by RT-qPCR to quantify SBCMV and WSSMV. The tested genotypes exhibited variable responses to the two viruses. All the genotypes were infected by WSSMV (most with medium to high viral loads), while SBCMV showed a high degree of diversification in viral load among the genotypes. The results obtained did not reveal correlation between the viral loads of the two viruses. Twenty-three genotypes were identified exhibiting low viral loads for both viruses and reduced symptoms. A preliminary genome-wide association study (GWAS), conducted on genotypic (SNPs) and phenotypic data obtained by RT-qPCR analyses, identified novel genomic regions putatively associated with resistance to SBCMV and WSSMV, as well as potential candidate genes involved in resistance
Diagnostic Performance of Magnetic Resonance Sequences in Staging Lymph Node Involvement and Extranodal Extension in Head and Neck Squamous Cell Carcinoma.
Get PDFObjectives
This study aimed to evaluate the diagnostic performance of various MRI sequences in detecting nodal metastasis (N+) and extranodal extension (ENE+) in patients with head and neck squamous cell carcinoma (HNSCC).
Methods
A retrospective analysis was conducted on 42 patients with HNSCC who underwent preoperative MRI and subsequent surgical lymph node dissection between June 2021 and December 2023. Lymph node MRI features were evaluated on five different MRI sequences. For each rN+ case, the presence of radiological extranodal extension (rENE+) was assessed independently in every MRI sequence by analyzing three characteristics. ENE was deemed positive if at least one of three criteria considered was present.
Results
All of the MRI sequences demonstrated slightly high accuracy (~76%) for detecting N+, with T1WI, STIR, and CE THRIVE showing comparable sensitivities (60–65%). The STIR sequence exhibited the highest sensitivity (75%) and nearly the highest accuracy (91%) for detecting ENE+. Capsular irregularity and necrosis showed high specificity across sequences, while the loss of fatty hilum and nodal size had lower performance.
Conclusions
Tailoring MRI protocols to leverage the strengths of specific sequences can significantly improve the diagnostic accuracy, aiding in better patient management and treatment outcomes
Una volontà di missione, una scelta per vocazione
No full textL'insegnamento universitario è una vocazionale opportunità nella vita di studio e di lavoro, una missione formativ
Transverse Self-Propulsion Enhances the Aggregation of Active Dumbbells
No full textWe investigate a two-dimensional system of active Brownian dumbbells using molecular dynamics simulations. In this model, each dumbbell is driven by an active force oriented perpendicular to the axis connecting its two constituent beads. We characterize the resulting phase behavior and find that, across all values of activity, the system undergoes phase separation between dilute and dense phases. The dense phase exhibits hexatic order, and for large enough activity, we observe a marked increase in local polarization, with dumbbells predominantly oriented towards the interior of the clusters. Compared to the case of axially self-propelled dumbbells, we find that the binodal region is enlarged towards lower densities at all activities. This shift arises because dumbbells with transverse propulsion can more easily form stable cluster cores, serving as nucleation seeds, and show a highly suppressed escaping rate from the cluster boundary. Finally, we observe that clusters exhibit spontaneous rotation, with the modulus of the angular velocity scaling as ω ∼ rg^-2 , where rg is the cluster’s radius of gyration. This contrasts with axially propelled dumbbells, where the scaling follows ωg ∼ r^-1 . We develop a simplified analytical model to rationalize this scaling behavior
Studio della relazione tra alimenti senza glutine e microbiota nei soggetti celiaci
No full textLa malattia celiaca (CeD) è una patologia autoimmune cronica scatenata dall'ingestione di glutine, che porta a infiammazione e danni alla mucosa intestinale. La gestione della CeD si basa su una dieta rigorosa priva di glutine (gluten-free, GFD), che spesso include alimenti processati. Tuttavia, gli studi recenti suggeriscono che l'inclusione di sottoprodotti alimentari ricchi di componenti bioattivi, come la buccia d'arancia e le foglie di carciofo, potrebbe arricchire tali diete, fornendo ulteriori benefici per la salute. Questi sottoprodotti, spesso scartati, sono ricchi di composti bioattivi con proprietà antiossidanti, antimicrobiche e antitumorali, che possono contribuire a migliorare la salute intestinale e generale dei pazienti celiaci. I polifenoli e i flavonoidi presenti nelle bucce d'arancia e nelle foglie di carciofo svolgono un ruolo cruciale nella riduzione dello stress ossidativo, nel miglioramento della risposta immunitaria e nella protezione delle cellule dai danni provocati dai radicali liberi. Inoltre, la loro azione antimicrobica può contribuire al mantenimento di un equilibrio sano del microbiota intestinale, riducendo il rischio di infezioni e infiammazioni, mentre le proprietà antitumorali potrebbero fornire una protezione contro lo sviluppo di malattie croniche associate. L'integrazione di questi sottoprodotti alimentari nella dieta gluten-free potrebbe quindi rappresentare una strategia innovativa per migliorare la qualità nutrizionale e il benessere complessivo dei pazienti celiaci, andando oltre la semplice eliminazione del glutine.Celiac disease (CeD) is a chronic autoimmune condition triggered by the ingestion of gluten, leading to inflammation and damage to the intestinal mucosa. The management of CeD relies on a strict gluten-free diet (GFD), which often includes processed foods. However, recent studies suggest that the inclusion of food by-products rich in bioactive components, such as orange peel and artichoke leaves, could enrich these diets, providing additional health benefits. These by-products, often discarded, are rich in bioactive compounds with antioxidant, antimicrobial, and antitumor properties, which can contribute to improving the intestinal and overall health of celiac patients. The polyphenols and flavonoids found in orange peels and artichoke leaves play a crucial role in reducing oxidative stress, enhancing immune response, and protecting cells from damage caused by free radicals. Additionally, their antimicrobial action can help maintain a healthy balance of gut microbiota, reducing the risk of infections and inflammation, while their antitumor properties could provide protection against the development of associated chronic diseases. The integration of these food by-products into the gluten-free diet could, therefore, represent an innovative strategy to improve the nutritional quality and overall well-being of celiac patients, going beyond the mere elimination of gluten
La natura giuridica del credito per imposte estere che devia dalla capital export neutrality “temperata”
No full textIl presente lavoro mira ad esaminare la natura giuridica il credito per imposte ex art. 165 TUIR. Sebbene tale posizione di vantaggio sia prevista da disposizioni di diritto interno, nella maggior parte dei casi essa costituisce attuazione di norme convenzionali, segnatamente del metodo del foreign tax credit previsto in larga parte dei Trattati contro le doppie imposizioni. Trattasi di obbligo di diritto internazionale che tende – in via principale, ma non esclusiva – a contrastare la doppia imposizione internazionale in senso giuridico. L’ipotesi di studio alla base del contributo è che il credito per imposte estere non assolva esclusivamente ad una funzione strutturale del sistema tributario, legata alla tutela del principio di capacità contributiva. Alcune fattispecie – spesso attuative della più ampia categoria dei tax sparing mechanisms – conducono infatti a finanziare lo Stato (in via di sviluppo) della fonte, deviando sensibilmente dalla politica fiscale tradizionale improntata alla capital export neutrality “temperata”
Note al nuovo Poliido di Euripide (P. Phil. Nec. 23, Col. I.39–48)
No full textThe article puts forward two proposals for supplementing the new Polyidus by Euripides (P. Phil. Nec. 23v, col. I.39–40), as well as a proposal concerning the distribution of the lines (P. Phil. Nec. 23v, col. I.39–48)