Acute mesenteric ischemia and duodenal ulcer perforation: a unique double pathology

Background: Acute mesenteric ischaemia and duodenal perforation are surgical emergencies with serious consequences. Patients presenting with acute mesenteric ischaemia alone face a high mortality rate as high as 60% whereas those presenting with peptic ulcer perforation the mortality rates range from 6-14%. There are very few reported cases of patients presenting with this dual pathology. Case presentation: We report a unique case of a 53 year old Italian lady who presented with acute mesenteric ischaemia and duodenal perforation. This is the first report of massive bowel ischaemia and duodenal perforation with no apparent underlying common pathophysiology leading to this presentation. Conclusion: Early management in the intensive care unit and appropriate surgical intervention maximised the patient’s chances of survival despite the poor prognosis associated with her dual pathology. The rare pathology of the patient described can be explained by two possible hypotheses: peptic ulcer disease causing duodenal ulceration, which precipitated ischaemic infarction of the small bowel. The second hypothesis is the patient developed a stress related ulcer following ischaemic bowel infarction secondary to arterial thrombosis

Addressing Mental Health Needs After a Public Health Crisis in Southern Switzerland: Stakeholders’ Perspectives

ObjectivesThis paper examines a stakeholder engagement initiative to develop public health recommendations for addressing mental health gaps after the COVID-19 pandemic in southern Switzerland. It explores local healthcare professionals’ experiences with the pandemic’s impact on mental health and service use.MethodsWe used a stakeholder dialogue methodology based on participatory research. After mapping, we selected participants based on their power and interest on the subject. Data were gathered through two structured dialogues. We conducted thematic content analysis to identify and interpret patterns within dialogues. We used multi-step coding to assign codes to text segments, grouping similar patterns into themes and subthemes while ensuring consistency and exclusivity.ResultsThirty-two healthcare stakeholders from diverse sectors across urban and rural southern Switzerland participated in the dialogues. They emphasized flexible mental health service restructuring to address evolving patient needs and advocated for stronger prevention and promotion efforts, especially for vulnerable groups.ConclusionEngaging local healthcare stakeholders turned up as an effective strategy to derive public health recommendations to improve mental health prevention and promotion along with the access and use of related services

Adrenal Ganglioneuroma with Multifocal Retroperitoneal Extension: A Challenging Diagnosis

A ganglioneuroma (GN) is the rarest and most benign of the neuroblastic tumors and originates from neural crest cells wherever sympathetic nervous tissue exists, such as in the retroperitoneum and adrenal gland. The diagnosis can be very challenging, given the rarity and asymptomatic presentation of this neoplasia, and can be achieved only by means of histological evaluation. Although benign, a few cases of metastatic GNs have been reported in the literature. The prognosis, however, seems to be excellent after surgical resection. We describe a rare case of multifocal retroperitoneal GN, diagnosed incidentally in a 46-year-old woman, with para-aortic and adrenal localizations. After intraoperative pathological diagnosis was made, complete excision of all the visible masses was performed. The postoperative period was uneventful and she was recurrence free 3 months after surgery. To our knowledge, this is the first case report of a multifocal retroperitoneal GN. Among the broad differential diagnoses of adrenal incidentalomas, an adrenal location of neuroblastic tumors should not be forgotten

Simulations in agricultural buildings: a machine learning approach to forecast seasonal energy need

A fast and reliable estimation of building energy need is essential in agricultural building design, nonetheless, a large number of simulations is required to obtain better energy saving solutions. The aim of this work is to understand if machine learning can substitute numerical simulations and speed up the building design process and assess the incidence of specific architectural elements. Supervised regression models has been trained and tested in a data-set of thousands simulations performed on a case-study agricultural building. Among the algorithms, the tree-based Extreme Gradient Boosting showed the best performance. A study on model explainability has been carried out using SHAP and features importance, which is fundamental to help academics and professionals devise better design strategies for both new constructions and retrofitting interventions

Hypoxia-Induced miR-675-5p Supports \u3b2-Catenin Nuclear Localization by Regulating GSK3-\u3b2 \ua0Activity in Colorectal Cancer Cell Lines

The reduction of oxygen partial pressure in growing tumors triggers numerous survival strategies driven by the transcription factor complex HIF1 (Hypoxia Inducible Factor-1). Recent evidence revealed that HIF1 promotes rapid and effective phenotypic changes through the induction of non-coding RNAs, whose contribution has not yet been fully described. Here we investigated the role of the hypoxia-induced, long non-coding RNA H19 (lncH19) and its intragenic miRNA (miR-675-5p) into HIF1-Wnt crosstalk. During hypoxic stimulation, colorectal cancer cell lines up-regulated the levels of both the lncH19 and its intragenic miR-675-5p. Loss of expression experiments revealed that miR-675-5p inhibition, in hypoxic cells, hampered \u3b2-catenin nuclear localization and its transcriptional activity, while lncH19 silencing did not induce the same effects. Interestingly, our data revealed that miRNA inhibition in hypoxic cells restored the activity of Glycogen Synthase Kinase 3\u3b2 (GSK-3\u3b2) reducing the amount of P-Ser9 kinase, thus unveiling a role of the miR-675-5p in controlling GSK-3\u3b2 activity. Bioinformatics analyses highlighted the serine/threonine-protein phosphatases PPP2CA, responsible for GSK-3\u3b2 activation, among the miR-675-5p targets, thus indicating the molecular mediator through which miR-675-5p may control \u3b2-catenin nuclear localization. In conclusion, here we demonstrated that the inhibition of the hypoxia-induced non-coding RNA miR-675-5p hampered the nuclear localization of \u3b2-catenin by regulating GSK-3\u3b2 activity, thus proposing the miR-675-5p as a new therapeutic target for the treatment of colorectal cancer

Sirtuins and Hypoxia in EMT Control

Epithelial–mesenchymal transition (EMT), a physiological process during embryogenesis, can become pathological in the presence of different driving forces. Reduced oxygen tension or hypoxia is one of these forces, triggering a large number of molecular pathways with aberrant EMT induction, resulting in cancer and fibrosis onset. Both hypoxia-induced factors, HIF-1α and HIF-2α, act as master transcription factors implicated in EMT. On the other hand, hypoxia-dependent HIFindependent EMT has also been described. Recently, a new class of seven proteins with deacylase activity, called sirtuins, have been implicated in the control of both hypoxia responses, HIF-1α and HIF-2α activation, as well as EMT induction. Intriguingly, different sirtuins have different effects on hypoxia and EMT, acting as either activators or inhibitors, depending on the tissue and cell type. Interestingly, sirtuins and HIF can be activated or inhibited with natural or synthetic molecules. Moreover, recent studies have shown that these natural or synthetic molecules can be better conveyed using nanoparticles, representing a valid strategy for EMT modulation. The following review, by detailing the aspects listed above, summarizes the interplay between hypoxia, sirtuins, and EMT, as well as the possible strategies to modulate them by using a nanoparticle-based approach

Active degassing across the Maltese Islands (Mediterranean Sea) and implications for its neotectonics

The Maltese Islands, located in the central Mediterranean Sea, are intersected by two normal fault systems associated with continental rifting to the south. Due to a lack of evidence for offshore displacement and insignificant historical seismicity, the systems are thought to be inactive and the rift-related deformation is believed to have ceased. In this study we integrate aerial, marine and onshore geological, geophysical and geochemical data from the Maltese Islands to demonstrate that the majority of faults offshore the archipelago underwent extensional to transtensional deformation during the last 20 ka. We also document an active fluid flow system responsible for degassing of CH4 and CO2. The gases migrate through carbonate bedrock and overlying sedimentary layers via focused pathways, such as faults and pipe structures, and possibly via diffuse pathways, such as fractures. Where the gases seep offshore, they form pockmarks and rise through the water column into the atmosphere. Gas migration and seepage implies that the onshore and offshore faults systems are permeable and that they were active recently and simultaneously. The latter can be explained by a transtensional system involving two right-stepping, right-lateral NW-SE trending faults, either binding a pull-apart basin between the islands of Malta and Gozo or associated with minor connecting antitethic structures. Such a configuration may be responsible for the generation or reactivation of faults onshore and offshore the Maltese Islands, and fits into the modern divergent strain-stress regime inferred from geodetic data

Role of SIRT3 in Microgravity Response: A New Player in Muscle Tissue Recovery

Life on Earth has evolved in the presence of a gravity constraint. Any change in the value of such a constraint has important physiological effects. Gravity reduction (microgravity) alters the performance of muscle, bone and, immune systems among others. Therefore, countermeasures to limit such deleterious effects of microgravity are needed considering future Lunar and Martian missions. Our study aims to demonstrate that the activation of mitochondrial Sirtuin 3 (SIRT3) can be exploited to reduce muscle damage and to maintain muscle differentiation following microgravity exposure. To this effect, we used a RCCS machine to simulate microgravity on ground on a muscle and cardiac cell line. During microgravity, cells were treated with a newly synthesized SIRT3 activator, called MC2791 and vitality, differentiation, ROS and, autophagy/mitophagy were measured. Our results indicate that SIRT3 activation reduces microgravity-induced cell death while maintaining the expression of muscle cell differentiation markers. In conclusion, our study demonstrates that SIRT3 activation could represent a targeted molecular strategy to reduce muscle tissue damage caused by microgravity