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Background. Enterobacter cloacae complex producing extended-spectrum beta-lactamase - ESBL (ECCOE) is a group of gram-negative pathogens responsible for nosocomial outbreaks in vulnerable patients, among whom neonatal patients represent one of the highest risk groups. Methods. We present data from an ECCOE outbreak identified at the Cremona hospital in January 2024, when a case of ECCOE bacteremia was diagnosed in patient admitted to the Neonatology ward. Following the identification of the index case, an infection prevention and control (IPC) program was implemented, based on: isolation of all positive patients with contact precautions, weekly screening of all hospitalized patients, environmental sampling, a program to improve adherence to hand hygiene, enhanced disinfection procedures, and regular data feedback to the ward staff. Results. The retrospective analysis identified a second infection in January 2024. In 2023, no clinical cases were identified and only one positivity for ECCOE emerged from 301 microbiological screening swabs (0.3%). The prospective analysis did not reveal other infections in the following 11 months. Patient surveillance through swabs showed a baseline prevalence of ECCOE of 15.4% in January, which rose to 30.8% in February, significantly decreased in March, then increased again to 38.5% in June and finally dropped to zero in August. The environmental sampling highlighted only one positivity out of 79 samples (1.3% of the samples). The consumption of alcohol hand rub solution, very low at the start of the outbreak (26 L/1,000 patient days - PD), increased to 113 L/1,000 PD, and then decreased by 70% after the outbreak ended. Conclusions. A rapid and complex IPC intervention focusing on improving hand hygiene can help control an ECCOE outbreak in neonatology. However, maintaining adequate adherence to hand hygiene over time remains very challenging.

FLIM (Fluorescence Lifetime Imaging Microscopy) is a powerful technique used to study protein–protein interactions, enzyme kinetics dynamics, and cellular metabolism. It is also used in studying diseases like cancer, where changes in fluorescence lifetimes can indicate alterations in cellular physiology of malignancies. Recently, FLIM technology in fluorescence guidance has been applied in receptor-targeted clinical applications. Here, we propose the application of FLIM in two animal models of esophageal adenocarcinoma, xenograft and orthotopic with a HER-2 targeting probe (Nanofitin-IRDye800CW, NF-800 hereafter) previously developed. Moreover, the technique was used to further investigate the determinants of lifetime during probe-receptor interactions. The presented data indicates that FLIM is a powerful technique and, when coupled with NF-800, it could enhance tumor contrast, leading to new clinical applications in fluorescence guided surgery.

There are well-known limitations associated to the use of antibodies in the non-invasive detection of HER-2 expression. In fact, current procedures recommended for diagnostic purposes of HER-2 status are still invasive techniques. Here, a novel, smaller diagnostic probe, the anti-HER-2 Nanofitin conjugated to the fluorophore IRDye800CW (NF-800), underwent an in vitro/in vivo proof of concept study by Optical Imaging. NF-800 showed high affinity and specificity for the cellular target, and the ability to internalize into HER-2 positive cells. By ex vivo analysis, NF-800 showed a selective tumor accumulation in xenograft tumor models, and also a good tumor targeting efficacy in translational preclinical setups, such as orthotopic and patient-derived xenograft (PDX) models. In the latter, NF-800 was compared to the anti-HER-2 antibody Trastuzumab, displaying a large diagnostic advantage. Interestingly, NF-800 did not seem to share the same binding site with Trastuzumab and Pertuzumab, opening specific theragnostic opportunities for NF-800 in combination with standard-of-care antibodies.

Photodynamic therapy (PDT) is a technique based on the use of photosensitizers activated by light to destroy cancer cells in the presence of oxygen. This enables localized cancer treatment and, in some settings, fluorescence-guided visualization. However, the efficacy and clinical translation of PDT have been limited by the low specificity of traditional photosensitizers. The aim of the study is to create a ligand-guided PDT approach for pancreatic ductal adenocarcinoma (PDAC) using a peptide-conjugated photosensitizer binding to integrin αvβ6, which is a receptor linked to tumor growth and prevalent in PDAC cells. Current treatment options for this tumor are limited, with surgical resection and chemotherapy only effective when the tumor is detected early. Given the limited treatment options for PDAC, PDT via αvβ6 offers a new pathway for precision treatment. The cyclic peptide cyclo[FRGDLAFp(NMe)K], recognized for its high affinity to αvβ6, was chosen to guide a phthalocyanine-class photosensitizer toward αvβ6-expressing PDAC models. The PDT approach was further refined by developing 3D spheroid models and in vivo BxPc3 xenograft models in NOD/SCID mice, where its therapeutic efficacy was assessed. In the absence of a non-targeted control photosensitizer, a contribution from non-specific accumulation and EPR effects in the in vivo setting cannot be fully ruled out. This study highlights the potential of a peptide-guided photosensitizer, demonstrating uptake and photodynamic activity in spheroids, with moderate in vivo results addressing tumor microenvironment challenges. Optimization of PDT dosing, laser precision, and preclinical models, such as patient-derived xenografts, are crucial to enhance clinical translation.

Background To prepare for surgery, surgeons often recur to surgical videos, with YouTube being reported as the preferred source. This study aimed to compare the evaluation of three surgical trainees and three senior surgeons of the 25 most viewed laparoscopic appendectomy videos listed on YouTube. Additionally, we assessed the video conformity to the published guidelines on how to report laparoscopic surgery videos (LAP-VEGaS). Methods Based on the number of visualization, the 25 most viewed videos on laparoscopic appendectomy uploaded on YouTube between 2010 and 2018 were selected. Videos were evaluated on the surgical technical performance (GOALS score), critical view of safety (CVS), and overall video quality and utility. Results Video image quality was poor for nine (36%) videos, good for nine (36%), and in high definition for seven (28%). Educational content (e.g., audio or written commentary) was rarely present. With the exception of the overall level of difficulty, poor consistency was observed for the GOALS domains between senior surgeons and trainees. Fifteen videos (60%) demonstrated a satisfactory CVS score (≥ 5). Concerning the overall video quality, agreement among senior surgeons was higher (Cronbach’s alpha 0.897) than among trainees (Cronbach’s alpha 0.731). The mean overall videos utility (Likert scale, 1 to 5) was 1.92 (SD 0.88) for senior examiners, and 3.24 (SD 1.02) for trainee examiners. The conformity to the LAP-VEGaS guidelines was weak, with a median value of 8.1% (range 5.4–18.9%). Conclusion Laparoscopic videos represent a useful and appropriate educational tool but they are not sufficiently reviewed to obtained standard quality. A global effort should be made to improve the educational value of the uploaded surgical videos, starting from the application of the nowadays-available LAP-VEGaS guidelines.

Objectives Growing evidence supports the role of the intestinal microbiome in the carcinogenesis of colorectal cancers, but its impact on colorectal cancer surgery outcomes is not clearly defined. This systematic review aimed to analyze the association between intestinal microbiome composition and postoperative complication and survival following colorectal cancer surgery. Methods A systematic review was conducted according to the 2009 PRISMA guidelines. Two independent reviewers searched the literature in a systematic manner through online databases, including Medline, Scopus, Embase, Cochrane Oral Health Group Specialized Register, ProQuest Dissertations and Theses Database, and Google Scholar. Human studies investigating the association between the intestinal microbiome and the short-term (anastomotic leakage, surgical site infection, postoperative ileus) and long-term outcomes (cancer-specific mortality, overall and disease-free survival) of colorectal cancer surgery were selected. Patients with any stage of colorectal cancer were included. The Newcastle-Ottawa scale for case-control and cohort studies was used for the quality assessment of the selected articles. Results Overall, 8 studies (7 cohort studies and 1 case-control) published between 2014 and 2018 were included. Only one study focused on short-term surgical outcomes, showing that anastomotic leakage is associated with low microbial diversity and abundance of Lachnospiraceae and Bacteroidaceae families in the non-cancerous resection lines of the stapled anastomoses of colorectal cancer patients. The other 7 studies focused on long-term oncological outcomes, including survival and cancer recurrence. The majority of the studies (5/8) found that a higher level of Fusobacterium nucleatum adherent to the tumor tissue is associated with worse oncological outcomes, in particular, increased cancer-specific mortality, decreased median and overall survival, disease-free and cancer-specific survival rates. Also a high abundance of Bacteroides fragilis was found to be linked to worse outcomes, whereas the relative abundance of the Prevotella -co-abundance group (CAG), the Bacteroides CAG, and the pathogen CAG as well as Faecalibacterium prausnitzii appeared to be associated with better survival. Conclusions Based on the limited available evidence, microbiome composition may be associated with colorectal cancer surgery outcomes. Further studies are needed to elucidate the role of the intestinal microbiome as a prognostic factor in colorectal cancer surgery and its possible clinical implications.

Ostracod associations coming from the Upper Triassic ( Tropites subbullatus/Anatropites spinosus zones of the Tuvalian substage) clays and sandstones of the Mufara Formation outcropping along the west side of Monte Gambanera (Castel di Iudica, central-eastern Sicily) have been analysed for the first time. The specimens are relatively abundant, silicified, well preserved and often preserved as complete carapaces. Over 200 specimens have been determined. They belong to the families Healdiidae, Bairdiidae, Bythocyprididae, Acratiidae, Cytheruridae, Limnocytheridae, Candonidae, Cavellinidae, Polycopidae and Thaumatocyprididae. Thirty-seven species are identified of which nine species are new: Hungarella forelae n.sp., Hungarella siciliiensis n.sp., Bairdia andrecrasquini n.sp., Bairdia gambaneraensis n.sp., Ptychobairdia iudicaensis n.sp., Ptychobairdia leonardoi n.sp., Petasobairdia jeandercourti n.sp., Kerocythere dittainoensis n.sp. and Mockella barbroae n.sp. Pour la première fois est ici analysée une association d’ostracodes provenant du Trias supérieur (zones à Tropites subbullatus/Anatropites spinosus du sous étage Tuvalien) dans les argiles et grés de la Formation Mufara affleurant le flanc ouest du Mont Gambanera (Castel di ludica, Sicile Centre Est). Les spécimens, silicifiés, sont relativement abondants, bien préservés et les plus souvent retrouvés sous formes de carapaces complètes. Plus de 200 spécimens ont été identifiés. Ils appartiennent aux familles Healdiidae, Bairdiidae, Bythocyprididae, Acratiidae, Cytheruridae, Limnocytheridae, Candonidae, Cavellinidae, Polycopidae and Thaumatocyprididae. Trente-sept espèces sont reconnues dont sont nouvelles: Hungarella forelae n.sp., Hungarella siciliiensis n.sp., Bairdia andrecrasquini n.sp., Bairdia gambaneraensis n.sp., Ptychobairdia Iudicaensis n.sp., Ptychobairdia leonardoi n.sp., Petasobairdia jeandercourti n.sp., Kerocythere dittainoensis n.sp. and Mockella barbroae n.sp.

In this work, results related to the temperature influence on the homo-epitaxial growth process of 3C-SiC is presented. The seed for the epitaxial layer was obtained by an innovative technique based on silicon melting: after the first step of the hetero-epitaxial growth process of 3C-SiC on a Si substrate, Si melts, and the remaining freestanding SiC layer was used as a seed layer for the homo-epitaxial growth. Different morphological analyses indicate that the growth temperature and the growth rate play a fundamental role in the stacking faults density. In details, X-ray diffraction and micro-Raman analysis show the strict relationship between growth temperature, crystal quality, and doping incorporation in the homo-epitaxial chemical vapor deposition CVD growth process of a 3C-SiC wafer. Furthermore, photoluminescence spectra show a considerable reduction of point defects during homo-epitaxy at high temperatures.

The aim of this work was a deep spectroscopical characterization of a thick 4H SiC epitaxial layer and a comparison of results between samples before and after a thermal oxidation process carried out at 1400 °C for 48 h. Through Raman and photoluminescence (PL) spectroscopies, the carrier lifetimes and the general status of the epilayer were evaluated. Time-resolved photoluminescence (TRPL) was used to estimate carrier lifetime over the entire 250 µm epilayer using different wavelengths to obtain information from different depths. Furthermore, an analysis of stacking fault defects was conducted through PL and Raman maps to evaluate how these defects could affect the carrier lifetime, in particular after the thermal oxidation process, in comparison with non-oxidated samples. This study shows that the oxidation process allows an improvement in the epitaxial layer performances in terms of carrier lifetime and diffusion length. These results were confirmed using deep level transient spectroscopy (DLTS) measurements evidencing a decrease in the Z1/2 centers, although the oxidation generated other types of defects, ON1 and ON2, which appeared to affect the carrier lifetime less than Z1/2 centers.

Due to the great development of light sources for several applications from displays to lighting, great efforts are devoted to find stable and efficient visible emitting materials. Moreover, the requirement of Si compatibility could enlarge the range of applications inside microelectronic chips. In this scenario, we have studied the emission properties of bismuth doped yttrium oxide thin films grown on crystalline silicon. Under optical pumping at room temperature a stable and strong visible luminescence has been observed. In particular, by the involvement of Bi ions in the two available lattice sites, the emission can be tuned from violet to green by changing the excitation wavelength. Moreover, under electron beam at low accelerating voltages (3 keV) a blue emission with high efficiency and excellent stability has been recorded. The color is generated by the involvement of Bi ions in both the lattice sites. These peculiarities make this material interesting as a luminescent medium for applications in light emitting devices and field emission displays by opening new perspectives for the realization of silicon-technology compatible light sources operating at room temperature.