Human duodenal submucosal glands contain a defined stem/progenitor subpopulation with liver-specific regenerative potential

BACKGROUND & AIMS

Common precursors for the liver, biliary tree, and pancreas exist at an early stage of development in the definitive endoderm forming the foregut. We have identified and characterised endodermal stem/progenitor cells with regenerative potential persisting in the adult human duodenum.

METHODS

Human duodena were obtained from organ donors, and duodenal submucosal gland cells were isolated after removal of the mucosa layer. Cells were cultured on plastic or as organoids and were transplanted into severe combined immunodeficient (SCID) mouse livers.

RESULTS

In situ studies of submucosal glands in the human duodenum revealed cells expressing stem/progenitor cell markers that had unique phenotypic traits distinguishable from intestinal crypt cells. Genetic signature studies indicated that the cells are closer to biliary tree stem cells and to definitive endodermal cells than to adult hepatocytes, supporting the interpretation that they are endodermal stem/progenitor cells. In vitro, human duodenal submucosal gland cells demonstrated clonal growth, capability to form organoids, and ability to acquire functional hepatocyte traits. In vivo, transplanted cells engrafted into the livers of immunocompromised mice and differentiated to mature liver cells. In an experimental model of fatty liver, human duodenal submucosal gland cells were able to rescue hosts from liver damage by supporting repopulation and regeneration of the liver.

CONCLUSIONS

A cell population with clonal growth and organoid formation capability, which has liver differentiation potency in vitro and in vivo in murine experimental models, is present within adult duodenal submucosal glands. These cells can be isolated, do not require reprogramming, and thus could potentially represent a novel cell source for regenerative medicine of the liver.

IMPACT AND IMPLICATIONS

Cell therapies for liver disease could represent an option to support liver function, but the identification of sustainable and viable cell sources is critical. Here, we describe a cell population with organoid formation capability and liver-specific regenerative potential in submucosal glands of the human duodenum. Duodenal submucosal gland cells are isolated from adult organs, do not require reprogramming, and could rescue hepatocellular damage in preclinical models of chronic, but not acute, liver injury. Duodenal submucosal gland cells could represent a potential candidate cell source for regenerative medicine of the liver, but the determination of cell dose and toxicity is needed before clinical testing in humans.

Trocar vs. Seldinger small bore pleural drains: does the technique influence the outcomes? A prospective single-centre study

OBJECTIVE

The aim of this study is to compare two positioning techniques of 12-French (Fr) thoracic drains in terms of efficacy, safety, and patient comfort.

PATIENTS AND METHODS

This is a prospective, non-randomized, competitive, non-inferiority study comparing the Seldinger vs. Trocar technique. The primary endpoint was an analysis of the factors that led to unsuccessful drainage positioning. Between the two groups, clinical variables, procedure times, pain, and complications were compared.

RESULTS

Seventy-two patients were enrolled in group 1 (Seldinger) and 45 in group 2 (Trocar). The mean procedural time was 7.93±3.02 min vs. 7.09±3.67 min, respectively (p: 0.33). The mean VAS for procedural pain was 2.22±1.47 vs. 2.80±1.88, p: 0.07, and the mean at day 2 was 3.6±1.2 in the SBWGD group vs. 2.7±1.1 in the Unico Group (p: 0.04). There was no difference in terms of complications, residual effusion, and pneumothorax at the first post-procedural chest X-ray. Four days after the procedure, the drain removal rate was 11.6% in group 1 vs. 25% in group 2 p: 0.063). The chest tube was removed after a mean period of 8.87±7.20 days after resolution of pleural effusion or tube dislodgement (7 cases in group 1 vs. 11 in group 2, p: 0.053).

CONCLUSIONS

The two techniques resulted in comparable pain and complication rates. Both drains are well-tolerated and efficient at draining pleural effusion, with very low rates of complications and failure. We recommend inserting a longer tube for patients who require chest drainage for an extended period of time.

Knowledge on causes and consequences of Climate Change in a cohort of Italian students

BACKGROUND

Climate change (CC) is the greatest threat to the health of the planet. The scientific community has established its connection to human activities and its role in emerging and premature diseases. Our study helps to understand how students of various backgrounds and academic fields retrieve information on CC and highlights the knowledge on the main causes and consequences of global warming and on the role of healthcare workers in the fight towards this threat.

METHODS

A cross-sectional study was performed through an online questionnaire administered to university students between January and December 2020. Univariable analyses were performed, Chi-square was calculated and multivariable analysis was used to investigate the relationship between the answers and socio-demographic variables. Statistical significance was set at a p-value of less than 5%.

RESULTS

More than 80% of the sample correctly identifies as major consequences of CCs the increase in Earth's temperature (95.0%), melting of ice caps (89.4%), rising sea levels (81.8%), and the more frequent occurrence of climate-related natural disasters. Across courses of study, the frequency on how CC is addressed differs (p<0.001): 31.5% of the students from the medical field reported the topic to be taught in class, compared to 49.0% from humanities and 63.4% from science and technology.

CONCLUSION

The study shows that medical students are less prepared and less aware of the consequences and causes of CC than students in other faculties. Since CC will play a role in every aspect of patients' lives, barriers to health care will have to be overcome through the knowledge and skills acquired during undergraduate courses.

Working in "smart" mode during the Covid-19 pandemic. Validation of a questionnaire in the healthcare sector

Conclusions

The present tool is adequate to investigate attitudes towards Smart Working among healthcare workers.

Background

During the most difficult phases of the Covid-19 he-alth emergency, when access to the usual work location was not allowed due to the constraints related to the pandemic, Smart Working enabled business continuity in the face of the ongoing health emergency. Mo-dern technology serves a new way of working, allowing workers to effectively manage their professional and personal spheres in a world that increasingly requires them to optimize their time. The main objective of this research is to validate a Smart Working questionnaire administered to healthcare workers.

Methods

The questionnaire, reported in Annex I, consisting of 30 questions and submitted electronically through Google Forms, was administered in Italian to healthcare personnel of the Teaching hospi-tal Umberto I and Sapienza University of Rome between September and October 2020. The questionnaire analyzed the characteristics of the sample and investigated the perception and attitude of healthcare personnel towards seven different aspects of Smart Working. A descriptive analysis of the sample examined and an internal consistency analysis was performed through the use of the SPSS (Statistical Package for Social Science) program version 25.0. Cronbach's alpha statistical indicator, which measures reprodu-cibility over time, reliability, and homogeneity of questions, was used for the analysis.

Results

A total number of 53 health care providers answered the online questionnaire. The majority of the respondents were female (60.4%); 73.6% of respondents reported having a college degree or a higher educational level. The analysis showed an overall standardized Cronbach's Alpha of 0.709, which corresponds to a good reliability. In the items analysis, the alpha value ranged from a minimum of 0.652 to a maximum of 0.756.

COVID-19 and young Italians: results of a cross-sectional study

Background

At the end of 2019, a novel pneumonia-causing Coronavirus called Sars-CoV-2 was first identified in Wuhan, Hubei Province, China. It subsequently spread throughout China and elsewhere, becoming a global health emergency. In February 2020, WHO designated the disease COVID-19, which stands for Coronavirus disease 2019. The aim of this study was to evaluate the impact of the COVID-19 epidemic on the perception of young Italians and to assess their knowledge and attitudes about the disease.

Methods

An online survey was conducted on 3rd-4th-5th February 2020 with the collaboration of “Skuola.net”, an important Italian Website for students. Young people had the opportunity to participate in the survey by answering an ad hoc questionnaire created to investigate knowledge and attitudes about the new Coronavirus, using a link published on the homepage.

Results

5234 responses were received of which 3262 were females and 1972 were males, aged from 11 to 30. 82,4% were students (50,4% high school students) while 17,6% did not attend school or university. Regarding knowledge, 80% of the participants knew that the infection occurs through droplets from infected people; 63% knew that symptoms can appear up to 14 days after exposure; 80% knew that a vaccine has not yet been discovered. Regarding attitudes, 36% admitted that their attitude towards Chinese tourists has significantly worsened; 26% did not buy from Chinese run stores and 24% avoided Chinese restaurants.

Conclusions

Although most of the participants seem correctly informed about COVID-19, young Italians are at risk of assuming irrational behavior due to psychosis.

Key messages

The global emergency of COVID-19 needs adequate information to avoid the spread of dangerous psychoses. Young people, usual users of social networks as a means of information, are more at risk of being influenced by fake news and adopting wrong behaviors.

The condom use among young adults and its determinants: an Italian study

Numerous health risk behaviours have been identified as an issue in early adulthood, especially among university students, a particularly high-risk category for sexual and reproductive health. The aim of this study is to examine the condom use and its determinants among young adult in Italy. The hypothesis is that individuals' demographic characteristics (gender, faculty, to have a committed partner, to be resident) and the risk perception may play a role in condom use. The results indicate that the frequency of condom use is related to the magnitude of risk perception of certain STIs and to demographic characteristics. All the STI risks perception and the risk perception of unintended pregnancy are statistically significant associated with frequency of condom use (p<0.001). By contrast the frequency of condom use is not statistically significant associated with the following demographic characteristics: gender, faculty, to have a committed partner, to be resident. Furthermore association with age groups is observed (p=0.030). Findings suggest that universities have an opportunity to access young people's sexual health risk behaviours and at the same time to impact on sexual health promotion. University health educators and staff at student health centers could play an active role in educational campaigns.

[New bibliometric indicators for the scientific literature: an evolving panorama]

INTRODUCTION

Bibliometrics is a science which evaluates the impact of the scientific work of a journal or of an author, using mathematical and statistical tools. Impact Factor (IF) is the first bibliometric parameter created, and after it many others have been progressively conceived in order to go beyond its limits. Currently bibliometric indexes are used for academic purposes, among them to evaluate the eligibility of a researcher to compete for the National Scientific Qualification, in order to access to competitive exams to become professor.

OBJECTIVE

Aim of this study is to identify the most relevant bibliometric indexes and to summarized their characteristics.

METHODS

A revision of bibliometric indexes as been conducted, starting from the classic ones and completing with the most recent ones.

RESULTS

The two most used bibliometric indexes are the IF, which measures the scientific impact of a periodical and bases on Web of Science citation database, and the h-index, which measures the impact of the scientific work of a researcher, basing on Scopus database. Besides them other indexes have been created more recently, such as the SCImago Journal Rank Indicator (SJR), the Source Normalised Impact per Paper (SNIP) and the CiteScore index. They are all based on Scopus database and evaluate, in different ways, the citational impact of a periodic. The i10-index instead is provided from Google Scholar database and allows to evaluate the impact of the scientific production of a researcher. Recently two softwares have been introduced: the first one, Publish or Perish, allows to evaluate the scientific work of a researcher, through the assessment of many indexes; the second one, Altmetric, measure the use in the Web of the academic papers, instead of measuring citations, by means of alternative metrics respect to the traditional ones.

CONCLUSIONS

Each analized index shows advantages but also criticalities. Therefore the combined use of more than one indexes, citational and not, should be preferred, in order to correctly evaluate the work of reserchers and to finally improve the quality and the development of scientific research.