Role of genetic investigation in the diagnosis of short stature in a cohort of Italian children

BACKGROUND

Short stature (SS) is defined as height more than 2 standard deviations below the mean for age and sex. Hypothyroidism, celiac disease, growth hormone deficiency, hormonal abnormalities, and genetic conditions are among its causes. A wide range of conditions often due to largely unknown genetic variants can elude conventional diagnostic workup.

AIM

We used next-generation sequencing (NGS) to better understand the etiology of SS in a cohort of Italian children.

PATIENTS AND METHODS

The study sample was 125 children with SS of unknown origin referred to our Institute between 2015 and 2021. All had undergone complete auxological and hormonal investigations to exclude common causes of SS. Genetic analysis was performed using a NGS panel of 104 genes. Clinical data were reviewed to clarify the pathogenicity of the variants detected.

RESULTS

In this cohort, 43 potentially causing variants were identified in 38 children. A syndromic genetic condition was diagnosed in 7: Noonan syndrome in 3, Leri-Weill syndrome in 3, and hypochondroplasia in 1. Moreover, 8 benign variants and other 37 like benign variants were found. In 88 children, 179 variants of uncertain significance (VUS) were identified. No variant was found in 16 children.

CONCLUSION

Genetic analysis is a useful tool in the diagnostic workup of patients with SS, in adapting management and treatment, and in identifying syndromes with mild atypical clinical features. The role of VUS should not be underestimated, particularly when multiple VUS with possible mutual worsening effects are present in the same child.

Coeliac Disease High-Risk Human Leukocyte Antigen Alleles in a South African Type One Diabetic Population

BACKGROUND

Coeliac disease (CD) is an autoimmune disorder strongly associated with Human Leukocyte Antigen (HLA) genes DQ2 and DQ8. These alleles are also associated with other autoimmune diseases including type 1 dia-betes (T1D) and these patients are consequently at a higher risk of developing CD. We examined the frequency of high-risk HLA alleles in a cohort of South African T1D pediatric patients.

METHODS

A total of 22 pediatric participants were recruited at an endocrinology clinic in a public sector hospital in Johannesburg, South Africa. Clinical details were collected, and all patients were HLA typed at the DQ loci.

RESULTS

Of our T1D patients, 63.6% had at least 1 high-risk HLA type alleles associated with CD. Of the patients with high-risk alleles, DQ2 was found in the majority which is consistent with CD literature.

CONCLUSIONS

This study provides preliminary insight into the frequency of the HLA-DQ types associated with CD in a South African population. The high prevalence of high-risk alleles in our T1D population motivates continual monitoring and further investigations into CD in South Africa.

Production and characterization of 111Ag radioisotope for medical use in a TRIGA Mark II nuclear research reactor

Radio Pharmaceutical Therapy (RPT) comes forth as a promising technique to treat a wide range of tumors while ensuring low collateral damage to nearby healthy tissues. This kind of cancer therapy exploits the radiation following the decay of a specific radionuclide to deliver a lethal dose to tumor tissues. In the framework of the ISOLPHARM project of INFN, ¹¹¹Ag was recently proposed as a promising core of a therapeutic radiopharmaceutical. In this paper, the production of ¹¹¹Ag via neutron activation of ¹¹⁰Pd-enriched samples inside a TRIGA Mark II nuclear research reactor is studied. The radioisotope production is modeled using two different Monte Carlo codes (MCNPX and PHITS) and a stand-alone inventory calculation code FISPACT-II, with different cross section data libraries. The whole process is simulated starting from an MCNP6-based reactor model producing the neutron spectrum and flux in the selected irradiation facility. Moreover, a cost-effective, robust and easy-to-use spectroscopic system, based on a Lanthanum Bromo-Chloride (LBC) inorganic scintillator, is designed and characterized, with the aim of using it, in the future, for the quality control of the ISOLPHARM irradiated targets at the SPES facility of the Legnaro National Laboratories of INFN. ^natPd and ¹¹⁰Pd-enriched samples are irradiated in the reactor main irradiation facility and spectroscopically characterized using the LBC-based setup and a multiple-fit analysis procedure. Experimental results are compared with theoretical predictions of the developed models, showing that inaccuracies in the available cross section libraries prevent an accurate reproduction of the generated radioisotope activities. Nevertheless, models are normalized to our experimental data allowing for a reliable planning of the ¹¹¹Ag production in a TRIGA Mark II reactor.

3D printable fully biomass-based composite using poly(furfuryl alcohol) as binder and cellulose as a filler

Nowadays, composite materials are widely used in different sectors owing to their improved mechanical and functional properties compared to bulk materials and efficient manufacturing processes. Nevertheless, the majority of these materials are still petroleum-based, which is incompatible with the recent environmental awareness. As a result, in the current study, a fully biomass-based composite material was produced employing poly(furfuryl alcohol) (PFA) as a bio-based matrix coupled with cellulose powder as fillers and processing aid agent. The addition of cellulose powder increased the viscosity of the uncured composite paste and conferred it a shear-thinning thixotropic making it suitable for 3D printing using the liquid deposition modeling technique (LDM). After curing, the combination of these raw materials yields a renewable and cost-effective composite for additive manufacturing by the LDM technique with high interlayer and interfilament adhesion, good mechanical performances, and adequate shape fidelity.

Monomers and Macromolecular Materials from Renewable Resources: State of the Art and Perspectives

A progressively increasing concern about the environmental impacts of the whole polymer industry has boosted the design of less aggressive technologies that allow for the maximum use of carbon atoms, and reduced dependence on the fossil platform. Progresses related to the former approach are mostly based on the concept of the circular economy, which aims at a thorough use of raw materials, from production to disposal. The latter, however, has been considered a priority nowadays, as short-term biological processes can efficiently provide a myriad of chemicals for the polymer industry. Polymers from renewable resources are widely established in research and technology facilities from all over the world, and a broader consolidation of such materials is expected in a near future. Herein, an up-to-date overview of the most recent and relevant contributions dedicated to the production of monomers and polymers from biomass is presented. We provide some basic issues related to the preparation of polymers from renewable resources to discuss ongoing strategies that can be used to achieve original polymers and systems thereof.

Furfuryl alcohol/tung oil matrix-based composites reinforced with bacterial cellulose fibres

Polymeric materials have drastically changed the society in the last century. However, their non-renewable origin, together with their indiscriminate use and disposal, resulted in a huge accumulation of waste in the environment and raised a wide discussion about the emission of greenhouse gases, which must be considerably reduced to minimize global warming. Thus, the establishment of a consolidated production of polymers prioritizing the use of renewable sources of raw materials became a hot research topic. Vegetable oils are protagonists of this initiative, and their carbon-carbon double bonds are convenient reactive sites for chain growth polymerization reactions. However, typical vegetable oil-based homopolymers often do not display competitive thermo-mechanical properties, and the preparation of the corresponding copolymers and composites is therefore an interesting alternative strategy. Herein, the preparation of composites based on a tung oil/furfuryl alcohol co-continuous network reinforced with bacterial cellulose fibers is described. For this purpose, the cellulose nanofibers were suspended in furfuryl alcohol, and different amounts of the ensuing suspension were mixed with tung oil in the presence of trifluoroacetic acid as cationic initiator. Fourier-transform infrared spectroscopy analysis of all samples indicated the association of both tung oil and furfuryl alcohol in the final materials, with peaks belonging to cellulose superposed at the fingerprint regions of composites. Differential scanning calorimetry and thermogravimetry demonstrated an interesting relationship between the composition and the corresponding thermal properties, and the morphology of the materials was assessed by scanning electron microscopy (SEM), which revealed a homogeneous distribution of cellulosic fibers at lower concentrations. The results gathered here contribute to the development of original macromolecular materials exclusively based on the renewable platform.

The Prospering of Macromolecular Materials Based on Plant Oils within the Blooming Field of Polymers from Renewable Resources

This paper provides an overview of the recent progress in research and development dealing with polymers derived from plant oils. It highlights the widening interest in novel approaches to the synthesis, characterization, and properties of these materials from renewable resources and emphasizes their growing impact on sustainable macromolecular science and technology. The monomers used include unmodified triglycerides, their fatty acids or the corresponding esters, and chemically modified triglycerides and fatty acid esters. Comonomers include styrene, divinylbenzene, acrylics, furan derivatives, epoxides, etc. The synthetic pathways adopted for the preparation of these materials are very varied, going from traditional free radical and cationic polymerizations to polycondensation reactions, as well as metatheses and Diels-Alder syntheses. In addition to this general appraisal, the specific topic of the use of tung oil as a source of original polymers, copolymers, and (nano)composites is discussed in greater detail in terms of mechanisms, structures, properties, and possible applications.

A Sustainable Route to a Terephthalic Acid Precursor

A new synthetic pathway for the production of p-toluic acid has been developed starting from reagents derived from renewable resources. A Diels-Alder reaction between sorbic and acrylic acids is followed by a combined dehydrogenation/ decarboxylation process, providing p-toluic acid in high yields. This route permits to use milder conditions compared to other Diels-Alder approaches reported in the literature, and therefore can contribute to a more sustainable terephthalic acid production.

A minimalist furan–maleimide AB-type monomer and its thermally reversible Diels–Alder polymerization

An original approach to prepare and polymerize the shortest Diels–Alder AB monomer.

N-(furfural) chitosan hydrogels based on Diels-Alder cycloadditions and application as microspheres for controlled drug release

In this study, chitosan was chemically modified by reductive amination in a two-step process. The synthesis of N-(furfural) chitosan (FC) was confirmed by FT-IR and (1)H NMR analysis, and the degrees of substitution were estimated as 8.3 and 23.8%. The cross-linkable system of bismaleimide (BM) and FC shows that FC shared properties of furan-maleimide chemistry. This system produced non-reversible hydrogel networks by Diels-Alder cycloadditions at 85 °C. The system composed of BM and FC (23.8% substitution) generated stronger hydrogel networks than those of FC with an 8.3% degree of substitution. Moreover, the FC-BM system was able to produce hydrogel microspheres. Environmental scanning electron microscopy revealed the surface of the microspheres to be non-porous with small protuberances. In water, the microspheres swelled, increasing their volume by 30%. Finally, microspheres loaded with methylene blue were able to release the dye gradually, obeying second-order kinetics for times less than 600 min. This behavior suggests that diffusion is governed by the relaxation of polymer chains in the swelled state, thus facilitating drug release outside the microspheres.

Recycling tires? Reversible crosslinking of poly(butadiene)

Furan-modified poly(butadiene) prepared by the thiol-ene click reaction is crosslinked with bismaleimides through the Diels-Alder reaction, giving rise to a novel recyclable elastomer. This is possible because of the thermal reversibility of the adducts responsible for the formation of the network. The use of this strategy provides the possibility to produce recyclable tires.

Study of the Diels–Alder and retro-Diels–Alder reaction between furan derivatives and maleimide for the creation of new materials

This study showed a way to increase the endo/exo ratio in favor of the endo adduct in furan derivatives/maleimide systems.

Triticale crop residue: a cheap material for high performance nanofibrillated cellulose

Nanofibrillated cellulose from triticale straws were produced using high-pressure homogenization and conventional high-speed blender for the disintegration process. The energy demand for the disintegration process was shown to depend on delignification and pretreatment.

Multicenter validation study of pathologic response and tumor thickness at the tumor-normal liver interface as independent predictors of disease-free survival after preoperative chemotherapy and surgery for colorectal liver metastases

BACKGROUND

To validate pathologic markers of response to preoperative chemotherapy as predictors of disease-free survival (DFS) after resection of colorectal liver metastases (CLM).

METHODS

One hundred seventy-one patients who underwent resection of CLM after preoperative chemotherapy at 4 centers were studied. Pathologic response-defined as the proportion of tumor cells remaining (complete, 0%; major, <50%; minor, ≥50%) and tumor thickness at the tumor-normal liver interface (TNI) (<0.5 mm, 0.5 to <5 mm, ≥5 mm)-was assessed by a central pathology reviewer and local pathologists.

RESULTS

Pathologic response was complete in 8% of patients, major in 49% of patients, and minor in 43% of patients. Tumor thickness at the TNI was <0.5 mm in 21% of patients, 0.5 to <5 mm in 56% of patients, and ≥5 mm in 23% of patients. On multivariate analyses, using either pathologic response or tumor thickness at TNI, pathologic response (P = .002, .009), tumor thickness at TNI (P = 0.015, <.001), duration of preoperative chemotherapy (P = .028, .043), number of CLM (P = .038, . 037), and margin (P = .011, .016) were associated with DFS. In a multivariate analysis using both parameters, tumor thickness at TNI (P = .004, .015), duration of preoperative chemotherapy (P = .025), number of nodules (P = .027), and margin (P = .014) were associated with DFS. Tumor size by pathology examination was the predictor of pathologic response. Predictors of tumor thickness at the TNI were tumor size and chemotherapy regimen. There was near perfect agreement for pathologic response (κ = .82) and substantial agreement (κ = .76) for tumor thickness between the central reviewer and local pathologists.

CONCLUSIONS

Pathologic response and tumor thickness at the TNI are valid predictors of DFS after preoperative chemotherapy and surgery for CLM.