Our knowledge of monochorionic pregnancies’ complications is largely based on the extensive ongoing research on monochorionic placental structure. Previous studies on the concordance of umbilical ...cord insertions are limited. This study aimed to evaluate placental anastomoses and cord insertions as independent risk factors for neonatal adverse outcomes.
This was a prospective study conducted at Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy from April 2021 to December 2022. Seventy-six women with a monochorionic pregnancy were enrolled at their first-trimester scan. After delivery, all placentas that were confirmed to be monochorionic were analyzed according to standard protocols, including those of complicated monochorionic twin pregnancies. The primary outcomes were a Composite Monochorionic Pregnancy Outcome (CMPO) and a Composite Neonatal Adverse Outcome (CNAO). The secondary outcome was the birth weight discordance between the neonates.
The CMPO occurred in 15.8 % pregnancies, and the CNAO occurred in 67.1 % pregnancies. The analysis confirmed a significant association between velamentous cord insertions and neonatal adverse events (p = 0.003). Also, a significant positive association (p = 0.0326) between twin birth weight discordance and discordance in twins umbilical cord insertions’ sites was found. No significant association between the number and type of the anastomoses and both the CMPO or CNAO was detected.
Our data suggest that the routine sonographic assessment of umbilical cords' insertion sites during the first trimester could be helpful in predicting fetal and neonatal adverse events. We believe that this sonographic assessment should start to be implemented in our routine care of monochorionic pregnancies.
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•Velamentous insertions are significantly associated with neonatal adverse events.•Twin cord insertions are classified in concordant, intermediate, discordant.•Twin weight discordance increases with discordance in umbilical cord insertions.•Sonographic assessment of umbilical cords could predict neonatal adverse events.
Abstract only
Background:
cardiac magnetic resonance (CMR) is central for diagnosis, follow up and prognostic stratification of acute myocarditis. Late gadolinium enhancement (LGE) extent and ...persistence at follow-up represents a negative prognostic marker. However, time course of oedema resolution and LGE stabilization and optimal timing to repeat CMR are unclear.
Hypothesis:
we assessed time course of oedema and LGE evolution to identify optimal timing to repeat CMR in acute myocarditis.
Methods:
36 acute myocarditis patients (35M, 28,8±10,3 years) underwent CMR at clinical presentation (CMR-1), after 3 months (CMR-2) and after 12-months (CMR-3). We assessed oedema and LGE and measured left ventricular ejection fraction (LVEF) and indexed mass (iLVM). After CMR-3 all patients were followed up yearly with clinical evaluation, Holter ECG and echocardiography.
Results:
all patients had oedema and LGE at CMR-1. At CMR-2 significant reduction of oedema (T2 positive segments 0,4±0,9 vs 4,1±3,2 p<0.0001) and LGE (4,3±3,9 vs 7,5±5,6 p<0.0001) was observed compared to CMR-1, with improvement of LVEF (62,7±5,6 vs 58,5±12,2% p<0.05) and reduction of iLVM (71,2±13,7 vs 78,1±15,2 g/m2 p<0.0001). At CMR-3 no further LGE reduction nor LVEF and iLVM improvement were observed. At 60±23-months follow-up, no major cardiovascular events nor myocarditis recurrences occurred. At Holter ECG 8/36 patients (28%) had non-sustained ventricular tachycardias. Ventricular arrhythmias were associated with lower LVEF at CMR-1 (46.25±19.55 vs 62.00±6.02 p=0.001) and higher LGE at CMR-2 (10.19±8.01 vs 3.60±3.14 p=0.007) but not with LGE at CMR-1 (10.05±7.14 vs 6.80±4.65 p=0.13).
Conclusions:
most patients with acute myocarditis present oedema resolution and LGE stabilization after 3 months. LVEF at baseline and LGE extension at second CMR correlates with ventricular arrhythmias persistence. Our findings redefine follow up and imaging-based prognostic stratification of acute myocarditis.
In mid Adriatic Sea the common sea snail is the habitual snail eaten, but over the years fishermen started to capture also the long sea snail, a possible alternative for human consumption. This study ...aims to compare the quality traits of the edible fraction in the common and long sea snails. In this study, common and long sea snail samples were provided by fishermen in November 2018 and March 2019. Total weight (meat and shell), fractions of meat and shell (after having extracted the edible part), fatty acid, elements in meat, and calcium content in shells were determined. Meat quality traits showed high nutritional value without significant differences between the two species. The fatty acid profile showed n3/n6 ratio significantly different both considering the season of sampling (November: 4.1; March: 2.38) and the species of sea snail (common: 4.98; long: 2.86). The long species showed a higher yield in the total body and calcium content concentrations. However, the long sea snail showed 50% lower meat yield compared with the common sea snail. In conclusion, the long sea snail can be used as an alternative to the common sea snail for human consumption.
Proton irradiation of bulk transition‐metal dichalcogenides leads to the blistering of atomically thin domes filled with hydrogen, as described by Yuerui Lu, Antonio Polimeni, and co‐workers in ...article number 1903795. The domes stud the crystal surface and locally turn the dark bulk material into an efficient light emitter. They can be produced with ordered positions and sizes tunable from the nanometer to the micrometer scale, with important prospects for so far unattainable applications.
SARS-CoV-2 serum neutralization assay represents the gold standard for assessing antibody-mediated protection in naturally infected and vaccinated individuals. In the present study, 662 serum samples ...collected from February 2020 to January 2021 from acute and convalescent COVID-19 patients were tested to determine neutralizing antibody (NAb) titers using a microneutralization test (MNT) for live SARS-CoV-2. Moreover, anti-SARS-CoV-2 IgG, IgA, and IgM directed against different viral antigens were measured by high-throughput automated platforms. We observed higher levels of NAbs in elderly (>60 years old) individuals and in patients presenting acute respiratory distress syndrome. SARS-CoV-2 NAbs develop as soon as five days from symptom onset and, despite a decline after the second month, persist for over 11 months, showing variable dynamics. Through correlation and receiver operating characteristic (ROC) curve analysis, we set up a testing algorithm, suitable for the laboratory workload, by establishing an optimal cutoff value of anti-SARS-CoV-2 IgG for convalescent plasma donors to exclude from MNT samples foreseen to have low/negative NAb titers and ineligible for plasma donation. Overall, MNT, although cumbersome and not suitable for routine testing of large sample sizes, remains the reference tool for the assessment of antibody-mediated immunity after SARS-CoV-2 infection. Smart testing algorithms may optimize the laboratory workflow to monitor antibody-mediated protection in COVID-19 patients, plasma donors, and vaccinated individuals.
Control methods alternative to synthetic pesticides are among the priorities for both organic and conventional farming systems. Plants are potential sources of compounds with antimicrobial ...properties. In this study, the antifungal potentialities of saponins derived from Medicago species and oat grains and of brassica sprouts have been explored for the control of Verticillium dahliae, a widely distributed fungal pathogen that causes vascular wilt disease on over 200 plant species. All the tested plant extracts showed antifungal properties. Such compounds, able to reduce mycelium growth and conidia formation, deserve deeper in vivo evaluation, even in combination with a delivery system.
Electrochemical atomic layer epitaxy (ECALE), also known as electrochemical atomic layer deposition, is a method based on under potential deposition, which allows the layer by layer growth of ...compounds on single crystal substrates. This paper reports on the electrochemical and structural investigation carried out on CdS thin films grown by ECALE on Ag(110) and Ag(100). Electrochemical experiments demonstrate that the CdS thin films, grown by ECALE, are highly ordered and epitaxial. The stoichiometric composition of the thin films was calculated using the charges associated with the anodic and cathodic stripping of CdS. The results indicate a 1:1 ratio between the elements. Characterization of the samples, performed by surface X-ray diffraction and X-ray reflectivity, suggests the presence of a crystalline CdS thin films epitaxial with the substrates. Moreover, a strong influence of the substrate orientation on the film structure is observed: CdS in wurtzite structure was found on Ag(100), while on Ag(110) the two CdS crystalline forms (wurtzite and zincblende) were present.
The existing evidence is insufficient to draw conclusions about the association between maternal position in labor and obstetrical outcomes.
This study aimed to evaluate the effects of different ...maternal positions during the second stage of labor among women with and those without epidural analgesia on important obstetrical outcomes including perineal damage.
In this retrospective cohort study, we collected data of women who delivered vaginally over a 2-year period. The associations between maternal and gestational characteristics and several obstetrical outcomes were analyzed. We considered perineal damage as the primary outcome. Secondary outcomes were the incidence of operative vaginal births, duration of fetal descent, intrapartum blood loss, and 1-minute and 5-minutes Apgar scores.
A total of 2240 nulliparous, at-term pregnancies were included. Of those, 76.9% gave birth in a supine position and 23.1% gave birth in alternative positions. The results showed that regardless of the use of epidural analgesia, nonsupine positions in the second stage of labor are associated with a significant reduction in the risk of both episiotomy and perineal damage to any degree (P<.0001) and to a reduction in the duration of fetal descent (Spearman rho, 9.17; confidence interval, 3.07–15.32; P=.003). No statistically significant differences were found in the 1-minute and 5-minutes Apgar score between the 2 groups.
Our results show that nonsupine positions in the second stage of labor and at the time of birth are associated with a significant increase in having an intact perineum and a reduction in any perineal trauma and in the need for an episiotomy regardless of the use of epidural analgesia.
Since available data on pediatric non-erosive esophageal phenotypes (NEEPs) are scant, we investigated their prevalence and the phenotype-dependent treatment response in these children.
Over a 5-year ...period, children with negative upper endoscopy, who underwent esophageal pH-impedance (off-therapy) for persisting symptoms not responsive to proton pump inhibitor (PPI)-treatment, were recruited. Based on the results of acid reflux index (RI) and symptom association probability (SAP), patients were categorized into: (1) abnormal RI (non-erosive reflux disease NERD), (2) normal RI and abnormal SAP (reflux hypersensitivity RH), (3) normal RI and normal SAP (functional heartburn FH), and (4) normal RI and not-reliable SAP (normal-RI-not otherwise-specified normal-RI-NOS). For each subgroup, treatment response was evaluated.
Out of 2333 children who underwent esophageal pH-impedance, 68 cases, including 18 NERD, 14 RH, 26 FH, and 10 normal-RI-NOS were identified as fulfilling the inclusion criteria and were analyzed. Considering symptoms before endoscopy, chest pain was more reported in NERD than in other cases (6/18 vs 5/50,
= 0.031). At long-term follow-up of 23 patients (8 NERD, 8 FH, 2 RH, and 5 normal-RI-NOS): 17 were on PPIs and 2 combined alginate, 1 (FH) was on benzodiazepine + anticholinergic, 1 (normal-RI-NOS) on citalopram, and 3 had no therapy. A complete symptom-resolution was observed in 5/8 NERD, in 2/8 FH, and in 2/5 normal-RI-NOS.
FH may be the most common pediatric NEEP. At long-term follow-up, there was a trend toward a more frequent complete symptom resolution with PPI-therapy in NERD patients while other groups did not benefit from extended acid-suppressive-treatment.
Sea snails represent a common food in the world as a source of sterols, such as cholesterol and phytosterol, and minerals. Sterols play important roles in body functions and also minerals are ...important for human health, so the intake of these nutrients into human diets should be known. The aim of this study was to examine the sterol and mineral profiles of the long (Hinia reticulata) and the common (Nassarius mutabilis) sea snails. Samples of both species were collected at different catch times from November 2019 to March 2020 and transported to the University of Camerino (UNICAM) for the evaluation of their sterol and mineral profiles, including toxic elements (Cd, Cr, Pb). The results of the study showed that the average content of total lipid were 57 mg/100 g, 38 mg/100 g for cholesterol and 19 mg/100 g for phytosterol in the long sea snail, and the values were respectively 68, 48, and 20 mg/100 g in the common sea snail, without significant differences in the two examined sea snails. Additionally, the result of the mineral analysis showed that both species were significant sources of minerals, with negligible levels of toxic metals and metalloids. Therefore, the Long and the Common sea snail are suitable and safety sea products for human nutrition.
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