This paper aims to ascertain the provenance of white and greyish marbles used for decorating the Heliocaminus Baths, one of the most ancient thermal complexes inside the Hadrian's Villa at Tivoli ...(Italy).
Fifteen marble samples have been macroscopically described and investigated by means of mineralogical and petrographic observations of thin sections, XRF chemical analyses of major and some trace elements, and stable isotope ratio analysis of carbon and oxygen.
The collected data show that the majority of the marbles analysed come mainly from the Apuan Alps basin (Carrara) and subordinately from several Greek (Mt. Penteli and Thasos Islands) and Turkish (Afyon and probably Ephesus districts) quarrying areas.
VIA PRENESTINA / VIA CASILINA Blanco, Alessandro; Nepi, Daniele; Vella, Alessandro
Bullettino della Commissione archeologica comunale di Roma (Roma),
01/2013, Letnik:
114
Journal Article
Ghrelin,the ligand of growth hormone secretagogue receptor 1a,takes part in several functions of the digestive system,including regulation of appetite,energy homeostasis,gastric acid secretion and ...motility.Ghrelin has also immunoregulatory properties and is supposed to inhibit some inflammatory pathways that can mediate gastric damage.Interestingly,ghrelin synthesis is reduced in the gastric mucosa of patients with Helicobacter pylori(H.pylori)infection,a worldwide condition inducing a T helper(Th)1/Th17 cell responsedriven gastritis,which may evolve towards gastric atrophy and cancer.In this article,we review the available data on the expression of ghrelin in H.pylori infection and discuss how the defective ghrelin synthesis may contribute to sustain the ongoing inflammatory response in this disease.
Malignant gastric outlet obstruction (MGOO) is a clinical condition characterized by the mechanical obstruction of the pylorus or the duodenum due to tumor compression/infiltration, with consequent ...reduction or impossibility of an adequate oral intake. MGOO is mainly secondary to advanced pancreatic or gastric cancers, and significantly impacts on patients' survival and quality of life. Patients suffering from this condition often present with intractable vomiting and severe malnutrition, which further compromise therapeutic chances. Currently, palliative strategies are based primarily on surgical gastrojejunostomy and endoscopic enteral stenting with self-expanding metal stents. Several studies have shown that surgical approach has the advantage of a more durable relief of symptoms and the need of fewer re-interventions, at the cost of higher procedure-related risks and longer hospital stay. On the other hand, enteral stenting provides rapid clinical improvement, but have the limit of higher stent dysfunction rate due to tumor ingrowth and a subsequent need of frequent re-interventions. Recently, a third way has come from interventional endoscopic ultrasound, through the development of endoscopic ultrasound-guided gastroenterostomy technique with lumen-apposing metal stent. This new technique may ideally encompass the minimal invasiveness of an endoscopic procedure and the long-lasting effect of the surgical gastrojejunostomy, and brought encouraging results so far, even if prospective comparative trial are still lacking. In this Review, we described technical aspects and clinical outcomes of the above-cited therapeutic approaches, and discussed the open questions about the current management of MGOO.
Three innovative operational strategies were successfully evaluated to improve the quality of biomethane in an outdoors pilot scale photobioreactor interconnected to an external absorption unit: i) ...the use of a greenhouse during winter conditions, ii) a direct CO2 stripping in the photobioreactor via air stripping during winter conditions and iii) the use of digestate as make-up water during summer conditions. CO2 concentrations in the biomethane ranged from 0.4% to 6.1% using the greenhouse, from 0.3% to 2.6% when air was injected in the photobioreactor and from 0.4% to 0.9% using digestate as make up water. H2S was completely removed under all strategies tested. On the other hand, CH4 concentrations in biomethane ranged from 89.5% to 98.2%, from 93.0% to 98.2% and from 96.3% to 97.9%, when implementing strategies i), ii) and iii), respectively. The greenhouse was capable of maintaining microalgae productivities of 7.5 g m−2 d−1 during continental weather conditions, while mechanical CO2 stripping increased the pH in order to support an effective CO2 and H2S removal. Finally, the high evaporation rates during summer conditions allowed maintaining high inorganic carbon concentrations in the cultivation broth using centrate, which provided a cost-effective biogas upgrading.
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•3 successful innovative operational strategies for biogas upgrading are presented.•The use of a greenhouse upgraded the biogas with a CH4 content between 90 and 98%.•CO2 stripping in the HRAP resulted in a CH4 content between 93 and 98%.•The use of digestate as a make-up water provided a CH4 content between 96 and 98%.•CH4 content validates the innovative operational strategies for biogas upgrading.
Background
The coronavirus disease 2019 (COVID-19) has led to a policy of severe restrictions in almost all countries strongly involved by the pandemic. National Health System is among activities ...suffering from the COVID-19 and the lockdown.
Aim
To evaluate the impact of COVID-19 in colorectal cancer (CRC) prevention.
Methods
We report the change in the hospital organization to meet the growing healthcare needs determined by COVID-19. The limitations of CRC prevention secondary to COVID-19 and their effects on the healthcare are analyzed considering the features of the CRC screening programs in the average-risk population and endoscopic surveillance in patients with inflammatory bowel diseases (IBD).
Results
The interruption of CRC prevention may lead to a delayed diagnosis of CRC, possibly in a more advanced stage. The economic burden and the impact on workload for gastroenterologists, surgeons, and oncologists will be greater as long as the CRC prevention remains suspended. To respond to the increased demand for colonoscopy once COVID-19 will be under control, we should optimize the resources. It will be necessary to stratify the CRC risk and reach an order of priority. It should be implemented the number of health workers, equipment, and spaces dedicated to performing colonoscopy for screening purpose and in subjects with alarm symptoms in the shortest time. To this aim, the funds earmarked for healthcare should be increased.
Conclusion
The economic impact will be dramatic, but COVID-19 is the demonstration that healthcare has to be the primary goal of humans.
Nowadays the particle physics has entered an era where high precision calculations are required in order to compare the theoretical predictions with the experimental data. In this paper, we ...explicitly compute the virtual contributions for the space-like one-jet processes, ∅→g⋆gg,∅→g⋆qq¯,∅→g⋆gH and ∅→g⋆q¯qe+e− within the auxiliary parton method. Our results, which are expected to play an important role in high precision description of small x physics, explicitly confirm the conjecture developed in Ref. 1, thus helping to bridge the gap between lowest order calculations and NLO corrections within hybrid kT-factorization scheme.
Summary Background Early cognitive intervention is the only routine therapeutic approach used for amelioration of intellectual deficits in individuals with Down's syndrome, but its effects are ...limited. We hypothesised that administration of a green tea extract containing epigallocatechin-3-gallate (EGCG) would improve the effects of non-pharmacological cognitive rehabilitation in young adults with Down's syndrome. Methods We enrolled adults (aged 16–34 years) with Down's syndrome from outpatient settings in Catalonia, Spain, with any of the Down's syndrome genetic variations (trisomy 21, partial trisomy, mosaic, or translocation) in a double-blind, placebo-controlled, phase 2, single centre trial (TESDAD). Participants were randomly assigned at the IMIM-Hospital del Mar Medical Research Institute to receive EGCG (9 mg/kg per day) or placebo and cognitive training for 12 months. We followed up participants for 6 months after treatment discontinuation. We randomly assigned participants using random-number tables and balanced allocation by sex and intellectual quotient. Participants, families, and researchers assessing the participants were masked to treatment allocation. The primary endpoint was cognitive improvement assessed by neuropsychologists with a battery of cognitive tests for episodic memory, executive function, and functional measurements. Analysis was on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov , number NCT01699711. Findings The study was done between June 5, 2012, and June 6, 2014. 84 of 87 participants with Down's syndrome were included in the intention-to-treat analysis at 12 months (43 in the EGCG and cognitive training group and 41 in the placebo and cognitive training group). Differences between the groups were not significant on 13 of 15 tests in the TESDAD battery and eight of nine adaptive skills in the Adaptive Behavior Assessment System II (ABAS-II). At 12 months, participants treated with EGCG and cognitive training had significantly higher scores in visual recognition memory (Pattern Recognition Memory test immediate recall, adjusted mean difference: 6·23 percentage points 95% CI 0·31 to 12·14, p=0·039; d 0·4 0·05 to 0·84), inhibitory control (Cats and Dogs total score, adjusted mean difference: 0·48 0·02 to 0·93, p=0·041; d 0·28 0·19 to 0·74; Cats and Dogs total response time, adjusted mean difference: −4·58 s –8·54 to −0·62, p=0·024; d −0·27 –0·72 to −0·20), and adaptive behaviour (ABAS-II functional academics score, adjusted mean difference: 5·49 2·13 to 8·86, p=0·002; d 0·39 –0·06 to 0·84). No differences were noted in adverse effects between the two treatment groups. Interpretation EGCG and cognitive training for 12 months was significantly more effective than placebo and cognitive training at improving visual recognition memory, inhibitory control, and adaptive behaviour. Phase 3 trials with a larger population of individuals with Down's syndrome will be needed to assess and confirm the long-term efficacy of EGCG and cognitive training. Funding Jérôme Lejeune Foundation, Instituto de Salud Carlos III FEDER, MINECO, Generalitat de Catalunya.
To our knowledge, no randomized clinical trial has compared the invasive and conservative strategies in frail, older patients with non-ST-segment elevation acute myocardial infarction (NSTEMI).
To ...compare outcomes of invasive and conservative strategies in frail, older patients with NSTEMI at 1 year.
This multicenter randomized clinical trial was conducted at 13 Spanish hospitals between July 7, 2017, and January 9, 2021, and included 167 older adult (≥70 years) patients with frailty (Clinical Frailty Scale score ≥4) and NSTEMI. Data analysis was performed from April 2022 to June 2022.
Patients were randomized to routine invasive (coronary angiography and revascularization if feasible; n = 84) or conservative (medical treatment with coronary angiography for recurrent ischemia; n = 83) strategy.
The primary end point was the number of days alive and out of the hospital (DAOH) from discharge to 1 year. The coprimary end point was the composite of cardiac death, reinfarction, or postdischarge revascularization.
The study was prematurely stopped due to the COVID-19 pandemic when 95% of the calculated sample size had been enrolled. Among the 167 patients included, the mean (SD) age was 86 (5) years, and mean (SD) Clinical Frailty Scale score was 5 (1). While not statistically different, DAOH were about 1 month (28 days; 95% CI, -7 to 62) greater for patients managed conservatively (312 days; 95% CI, 289 to 335) vs patients managed invasively (284 days; 95% CI, 255 to 311; P = .12). A sensitivity analysis stratified by sex did not show differences. In addition, we found no differences in all-cause mortality (hazard ratio, 1.45; 95% CI, 0.74-2.85; P = .28). There was a 28-day shorter survival in the invasive vs conservatively managed group (95% CI, -63 to 7 days; restricted mean survival time analysis). Noncardiac reasons accounted for 56% of the readmissions. There were no differences in the number of readmissions or days spent in the hospital after discharge between groups. Neither were there differences in the coprimary end point of ischemic cardiac events (subdistribution hazard ratio, 0.92; 95% CI, 0.54-1.57; P = .78).
In this randomized clinical trial of NSTEMI in frail older patients, there was no benefit to a routine invasive strategy in DAOH during the first year. Based on these findings, a policy of medical management and watchful observation is recommended for older patients with frailty and NSTEMI.
ClinicalTrials.gov Identifier: NCT03208153.
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