Ca’ Granda,an avant-garde hospital between the Renaissance and Modern age: a unique scenario in European history

The Ospedale Maggiore, known as Ca’ Granda, was founded in 1456 by will of Francesco Sforza, Duke of Milan, and was considered for almost five centuries a model for Milanese, Italian and even European healthcare. Attracting patients from all over Europe, the Ca’ Granda distinguished itself for the introduction of new treatments and innovative health reforms. In the burial ground of the hospital still lie the bodies of the deceased patients, who came from the poorest strata of the population. The study of their remains aims to give back a general identity and a story to each of these persons as well as reconstruct a fraction of the sixteenth century population of Milano as concerns lifestyle and disease and examine practises and therapy of this exceptional hospital. It is estimated that about two million commingled bones and articulated skeletons rest in the crypt, together with other types of findings (e.g., ceramic, coins, clothing). These remains are the object of a large project involving various disciplines ranging from humanities to hard sciences. The aim of this paper is to bring this historical gem to the attention of scholars and provide a glimpse of what its contents have already revealed.     

Effect of instrument preference for operative deliveries on obstetrical and neonatal outcomes

Objectives

To examine the relationship between physicians’ instrument preference and obstetrical and neonatal outcomes.

Study design

A retrospective cohort study comparing obstetrical and neonatal outcomes of second stage deliveries between obstetricians who prefer forceps (forceps ≥90%) with obstetricians with no preference to forceps (either instrument <90%) was completed using the McGill Obstetrical and Neonatal Database. Logistic regression analysis was used to obtain an adjusted odds ratio controlling for maternal, intrapartum and neonatal confounders.

Results

Two thousand and three hundred thirteen infants were delivered by 5 obstetricians who preferred forceps, and 9261 infants were delivered by 15 obstetricians with no instrument preference. Baseline characteristics were similar between the two groups. As compared to obstetricians who preferred forceps, obstetricians with no instrument preference had a higher rate of operative vaginal deliveries 1.5 (1.1–2.0), a higher cesarean section rate 2.5 (1.3–4.9) and a higher episiotomy rate in non-operative vaginal deliveries 3.4 (2.7–4.3). Infants delivered by obstetricians with no instrument preference were less likely to have significant bruising 0.3 (0.2–0.6) but more likely to have a cephalohematoma 3.0 (1.1–8.3).

Conclusion

Physician instrument preference is an important determinant of outcomes that should be considered in studies evaluating instrumental deliveries.     

Targeting the Virus Capsid as a Tool to Fight RNA Viruses

Several strategies have been developed to fight viral infections, not only in humans but also in animals and plants. Some of them are based on the development of efficient vaccines, to target the virus by developed antibodies, others focus on finding antiviral compounds with activities that inhibit selected virus replication steps. Currently, there is an increasing number of antiviral drugs on the market; however, some have unpleasant side effects, are toxic to cells, or the viruses quickly develop resistance to them. As the current situation shows, the combination of multiple antiviral strategies or the combination of the use of various compounds within one strategy is very important. The most desirable are combinations of drugs that inhibit different steps in the virus life cycle. This is an important issue especially for RNA viruses, which replicate their genomes using error-prone RNA polymerases and rapidly develop mutants resistant to applied antiviral compounds. Here, we focus on compounds targeting viral structural capsid proteins, thereby inhibiting virus assembly or disassembly, virus binding to cellular receptors, or acting by inhibiting other virus replication mechanisms. This review is an update of existing papers on a similar topic, by focusing on the most recent advances in the rapidly evolving research of compounds targeting capsid proteins of RNA viruses.     

High Hydrostatic Pressure Processing of Human Milk Increases Apelin and GLP-1 Contents to Modulate Gut Contraction and Glucose Metabolism in Mice Compared to Holder Pasteurization

Background: High hydrostatic pressure (HHP) processing is a non-thermal method proposed as an alternative to Holder pasteurization (HoP) for the sterilization of human breast milk (BM). HHP preserves numerous milk bioactive factors that are degraded by HoP, but no data are available for milk apelin and glucagon-like peptide 1 (GLP-1), two hormones implicated in the control of glucose metabolism directly and via the gut–brain axis. This study aims to determine the effects of HoP and HHP processing on apelin and GLP-1 concentrations in BM and to test the effect of oral treatments with HoP- and HHP-BM on intestinal contractions and glucose metabolism in adult mice. Methods: Mice were treated by daily oral gavages with HoP- or HHP-BM during one week before intestinal contractions, and glucose tolerance was assessed. mRNA expression of enteric neuronal enzymes known to control intestinal contraction was measured. Results: HoP-BM displayed a reduced concentration of apelin and GLP-1, whereas HHP processing preserved these hormones close to their initial levels in raw milk. Chronic HHP-BM administration to mice increased ileal mRNA nNos expression level leading to a decrease in gut contraction associated with improved glucose tolerance. Conclusion: In comparison to HoP, HPP processing of BM preserves both apelin and GLP-1 and improves glucose tolerance by acting on gut contractions. This study reinforces previous findings demonstrating that HHP processing provides BM with a higher biological value than BM treated by HoP.     

Validation of an Image Analysis Method for Evaluating the Chemical Resistance of Glass Fibers to Alkaline Environments

This article is focused on the comparison of the reliability of the results obtained by image analysis (newly proposed evaluation method) with well-known methods of evaluation of long-term corrosion resistance of glass fibers in an alkaline environment (pH > 12). The developed method is based on the analysis of scanning electron microscopy images (diameter and structures on the fiber surface). An experiment (52 weeks) was performed to evaluate two types of glass fibers: anticorrosive glass fibers (ARGFs) and E-glass fibers (EGFs). Three media were used to treat the fibers (23 ± 2 °C): H₂O, Ca(OH)₂, and K₂SiO₃. The ARGFs’ tensile strength did not reduce; a decrease by 68% was observed for EGFs in H₂O. Tensile strength decreased by 32% and 85–95% in K₂SiO₃; by 50% and 64% in Ca(OH)₂ for the ARGF and EGF, respectively. Statistical analysis was performed to validate the reliability and plausibility of the developed method. ARGFs and EGFs did not show any relationship between the fiber diameter and weight in H₂O; however, the linear trends may predict this relationship in Ca(OH)₂ and K₂SiO₃. For the ARGF and EGF, the cubic trend was suitable for predicting the change in fiber weight and diameter over time in Ca(OH)₂ and K₂SiO₃.     

Investigation of outbreak cases infected with the SARS-CoV-2 B.1.640 variant in a fully vaccinated elderly population,Normandy, France,November to December 2021

Three confirmed infections with the SARS-CoV-2 B.1.640 variant under monitoring were reported in Normandy, north-western France in late November 2021. Investigations led to the identification of two events linked to the same cluster. A total of 75 confirmed and probable B.1.640 cases were reported. All had completed the primary vaccination series. Sixty-two cases were older than 65 years. Fifty-six cases had symptoms and four were hospitalised. This investigation provides preliminary results concerning a variant with limited information currently available.     

New biomaterials for Ni biosorption turned into catalysts for Suzuki–Miyaura cross coupling of aryl iodides in green conditions

In parallel with increasing Ni production and utilisation, Ni pollution in the soil–water continuum has become an alarming and global problem. Solutions for removing Ni from industrial effluents have been widely investigated and biosorption has emerged as an efficient, cost-effective, scalable and sustainable alternative for water treatment. However, the biosorption capacity is limited by the chemical composition of the biomaterial and the Ni-enriched biomaterials are rarely valorised. In this work, the biosorption capacity of three abundant biomaterials with different chemical properties – water hyacinth, coffee grounds and pinecones – was studied before and after functionalization, and reached a maximum biosorption capacity of 51 mg g⁻¹ of Ni(ii). A bioinspired functionalization approach was investigated introducing carboxylate moieties and was conducted in green conditions. The Ni-enriched biomaterials were valorised by transformation into catalysts, which were characterised by MP-AES and XRPD. Their characterisation revealed a structure similar to nickel formate, and hence the Eco-Ni(HCOO)₂ catalysts were tested in Suzuki–Miyaura reactions. Several aryl iodides were successfully cross-coupled to phenylboronic acids using Eco-Ni(HCOO)₂ without any ligand, a mild and green base in a mixture of green solvents.

New biomaterials were functionalised for biosorption of Ni from aqueous solutions and valorised as ecocatalysts in Suzuki–Miyaura green reactions.     

The perineal midsagittal view in male fetuses — pivotal for assessing genitourinary disorders

A wide range of genitourinary pathologies can be diagnosed in utero, from a simple vesicoureteral reflux to a more complex disorder of sexual differentiation. The prognosis and neonatal management of these conditions differ significantly. Evaluation of the fetal perineal anatomy is paramount to making the right diagnosis. The aim of this pictorial essay is to show sonographers how to acquire a perineal midsagittal view in a male fetus, and to demonstrate how this specific view allows assessment of the urethra and penis, to differentiate various genitourinary pathologies.