Colorectal cancer detection in an asymptomatic population: fecal immunochemical test for hemoglobin vs. fecal M2-type pyruvate kinase

Introduction

Screening programs for colorectal cancer (CRC) are mainly based on a first-line fecal immunochemical test for hemoglobin (FIT). Fecal M2-type pyruvate kinase (M2-PK) has been evaluated in clinical settings showing promising results for early CRC detection. However, the impact of fecal M2-PK assessment on the performance of first-round CRC screening programs is not known. We investigated whether fecal M2-PK alone or in combination with FIT may improve CRC screening efficacy in the general population.

Materials and methods

A total of 1027 asymptomatic subjects (median age 66 [59-74] years; females 504 [49.1%]), identified through the general practitioners’ rosters, were invited for the collection of 2 fecal samples for FIT and M2-PK evaluation. Participants with at least positive one fecal test were referred for colonoscopy. Quality indicators for screening performance were calculated and analyzed using Fisher’s exact test.

Results

Overall, 572 subjects underwent both FIT and M2-PK assessment (participation rate 55.7%): 93 participants showed positive results for at least one test (positivity rate 16.3%). Only 10 patients were positive for both tests. Attendance rate to colonoscopy was 86.0% and a total of 65 adenomas and 7 cancers were detected. Combined use of FIT and fecal M2-PK permitted the identification of 18 more neoplasm (25%) without improving colonoscopy workload, as deduced by the comparable number needed to scope (P = 0.402).

Conclusion

The addition of M2-PK testing to FIT offers the potential to detect additional neoplasms that either do not bleed or only bleed intermittently without reducing participation rate and without increasing endoscopy workload.Key words: biomarker, colorectal cancer, occult blood, M2-type pyruvate kinase, screening     

Concurrent and longitudinal predictors of calculation skills in preschoolers

Early calculation abilities in preschoolers are predictive of mathematics achievement in subsequent grades (e.g., Jordan et al. 2009). Two studies were conducted to evaluate concurrent and longitudinal predictors of early calculation skills. In the first study, 102 preschoolers (57.8 % female; mean age?=?60.57?±?8.66 months) were given vocabulary, language comprehension, and verbal working memory tasks and a test battery that evaluated components of early number competence (quantity comparison, counting, number line, size seriation, semantic knowledge of digits, visual-spatial memory). The children were also asked to complete early calculation tasks, including addition and subtraction calculations. The results of this task constituted the dependent variable. The results showed that vocabulary, size seriation, and visual-spatial memory were significant concurrent predictors of early calculation competence. In the second study, 43 children completed the early number competence battery at time 1 (53.5 % female; mean age?=?59.30?±?3.46 months) and the linguistic and early calculation tasks at time 2, about 10 months later (mean age?=?69.43?±?3.31 months). The analysis of the longitudinal predictors of early calculation showed significant effects for counting and size seriation. The implications for preschool assessment and intervention are discussed.     

Spectroscopic methods for the analysis of celadonite and glauconite in Roman green wall paintings

One set of samples from wall paintings of the X^th Regio of Italy containing green colours was analysed exploiting different spectroscopic techniques, aiming to identify the pigments used. The possibility to distinguish between glauconite and celadonite, the most common green pigments used in such paintings, was of particular interest. Samples of celadonite from Monte Baldo and glauconite from Belgium were considered as standard materials for comparison. The results obtained using FTIR, EDS, AAS, Colorimetry, Raman and EPR spectroscopies were compared for the identification of the green pigments.     

Physiological correlates to off-road cycling performance

The aim of this study was to examine the relationships between maximal and submaximal tests for aerobic fitness and performance in an off-road cross-country circuit race. Thirteen competitive off-road male cyclists participated in the study. Peak oxygen uptake (VO2peak), peak power output, and lactate thresholds corresponding to 1 mmol x l(-1) above baseline (lactate threshold) and to 4 mmol x l(-1) (onset of blood lactate accumulation) were measured during an incremental cycling test. Race time and final ranking within the same group of cyclists were determined during a cross-country off-road competition. All correlations between the measured parameters of aerobic fitness and off-road cycling performance were significant, particularly between race time and physiological parameters scaled to body mass0.79 (r = -0.68 to -0.94; P < 0.05) and between final ranking and physiological parameters expressed relative to body mass0.79 (r = -0.81 to - 0.96; P < 0.001). Moreover, there was a large difference (effect sizes = 1.12-1.70) in all measured parameters of aerobic fitness between the group of six cyclists with a race time above the median and the group of six cyclists with a race time below the median (P < 0.05). In conclusion, the results of this study provide empirical support to the widespread use of these maximal (VO2peak, peak power output) and submaximal (lactate thresholds) parameters of aerobic fitness in the physiological assessments of off-road cyclists. Furthermore, our results suggest body size should be taken into account when evaluating such athletes.     

Accidental digitoxin intoxication: an interplay between laboratory and clinical medicine

Introduction:

Two Italian adults arrived at the Emergency Department referring diarrhea, nausea and vomiting for 4 days; weakness, fatigue and visual hallucinations were also complained of. Patients reported the ingestion of some leaves of a plant, which they supposed to be “donkey ears”, a week before. Physical examination showed hypotension and bradycardia and ECG examination disclosed sinus rhythm and repolarization abnormalities (scooping of the ST-T complex) in both patients and a 2:1 AV block in the man.

Materials and methods:

Digoxin concentration was evaluated twice for each patient (at the admission and after 4 hours) by the automated immunoassay system ADVIA Centaur^®. Digitoxin concentration was evaluated by liquid chromatography-mass spectrometry (LC-MS/MS).

Results:

Despite clinical picture was suggestive of digitalis intoxication, digoxin levels were undetectable. Due to the more severe clinical picture, the male patient was treated with anti-digoxin antibodies (Digifab^®) achieving a good clinical improvement and remission of the AV block within two hours. Initial diagnosis was confirmed by LC-MS/MS showing high digitoxin concentrations, but digoxin was undetectable. Patients remained stable and 48 hours later were discharged from the hospital.

Conclusion:

Whereas digoxin determination frequently relies on monoclonal antibodies which do not cross-react to digitoxin, polyclonal antibodies constituting Digifab^® recognize a large spectrum of cardiac glycosides, including digitoxin. This report emphasizes the primary role of the clinical approach to patients in the emergency setting and how an active communication and a continuous sharing of professional experiences between Laboratory and Clinicians ensure an early and correct diagnosis.     

Physiological and biomechanical responses to walking underwater on a non-motorised treadmill: effects of different exercise intensities and depths in middle-aged healthy women

Abstract

Non-motorised underwater treadmills are commonly used in fitness activities. However, no studies have examined physiological and biomechanical responses of walking on non-motorised treadmills at different intensities and depths. Fifteen middle-aged healthy women underwent two underwater walking tests at two different depths, immersed either up to the xiphoid process (deep water) or the iliac crest (shallow water), at 100, 110, 120, 130 step-per-minute (spm). Oxygen consumption (VO₂), heart rate (HR), blood lactate concentration, perceived exertion and step length were determined. Compared to deep water, walking in shallow water exhibited, at all intensities, significantly higher VO₂ (+13.5%, on average) and HR (+8.1%, on average) responses. Water depth did not influence lactate concentration, whereas perceived exertion was higher in shallow compared to deep water, solely at 120 (+40%) and 130 (+39.4%) spm. Average step length was reduced as the intensity increased (from 100 to 130 spm), irrespective of water depth. Expressed as a percentage of maximum, average VO₂ and HR were: 64–76% of peak VO₂ and 71–90% of maximum HR, respectively at both water depths. Accordingly, this form of exercise can be included in the “vigorous” range of exercise intensity, at any of the step frequencies used in this study.     

Teachers’, school staff’s and parents’ efficacy beliefs as determinants of attitudes toward school

Self- and collective efficacy beliefs were examined as correlates of attitudes toward school of teachers, school staff, and parents. 726 teachers, 387 staff members, and 1994 parents from 18 junior high schools in Milan and Rome, Italy, were administered questionnaires assessing self-efficacy beliefs, perceptions about colleagues’ bahavior, collective efficacy beliefs, affective commitment and job satisfaction of teachers and school staff and parents satisfaction with school. Path analyses corroborated a conceptual model in which self- and collective efficacy beliefs represent, respectively, the distal and proximal determinants of affective commitment and job satisfaction for teachers and staff and of satisfaction with school for parents. Perceptions that teachers, staff and parents hold about the behavior of their colleagues largely mediated the links between self- and collective efficacy beliefs. collective efficacy beliefs, in turn, largely mediated the influence that self-efficacy beliefs and perceptions of school constituencies’ behaviors exert on attitudes toward school of teachers, staff and parents.     

Departmental organization,legitimacy, and faculty militancy: Structural sources of pro union sentiment in a public university

This paper examines the influence of departmental organization on faculty sentiments for social change via unionization. Two structural sources (inequalities of resources between departments; goal-rewarded discontinuities within departments) and one individual source (discontent with departmental governance) of attitudinal militancy are specified in path models and empirically examined using a sample of 338 faculty in 38 departments in a large, public university. Results lend limited support for inequalities of resources between departments as a source of militancy. Departmental discontinuities have important effects on the legitimacy of rewards, but only a weak indirect effect on militancy. Governance discontent has a strong impact on the legitimacy of rewards and an interesting indirect effect on militancy.     

Children at the Dawn of the Internet: Exploratory research on current and potential use at home and in school

Use of the Internet in Italy is in its early stages. Social representation and public discourse spread by mass media have emphasised the risks for children, at the expense of its opportunities. Such concerns are today largely hypothetical. This paper presents the initial results of an exploratory research project, using both quantitative and qualitative approaches, aimed at investigating the use of the Internet by children in a number of areas, mainly within the family and at school. The study found that children using the Internet as pioneers at home belong to a privileged elite, provided by the family with appropriate instruments and adequate technical and cultural resources. Far from being abandoned to the Internet, such children are supervised and led by parents-indeed often too much, as they are left little room to explore cyberspace independently. The establishment of the Internet in schools is rapid, but faces structural inadequacies while the use made of it is not always in keeping with its particular characteristics. L'emploi d'Internet en Italie se trouve encore dans sa phase initiale. Une analyse menée sur le plan social et le débat public renforcépar les mass media ont révélél'existence de risques pour les enfants au détriment des potentiels offerts par l'Internet. Actuellement nous n'en sommes qu'au stade d'hypothèses. Cet article présente les premiers résultats d'un projet de recherche dont l'objectif est d'étudier l'usage que font les enfants d'Internet, principalement dans les milieux de la famille et de l'école, et ce aussi bien d'un point de vue qualitatif que quantitatif. Cette étude a révéléque les enfants qui naviguent en pionniers sur Internet à la maison, appartiennent à la catégorie des privilégiés dotés, par les familles, d'instruments opportuns mais aussi de ressources techniques et culturelles. En effet ces enfants sont loin d'être abandonnés sur le réseau, mais bien guidés et contrôlés par leurs parents, parfois même d'une façon excessive puisqu'on ne leur laisse guère la possibilitéd'explorer de façon autonome le cyberespace. La diffusion d'Internet dans les écoles est assez rapide malgré le manque de structures, alors que l'usage que l'on en fait ne correspond pas toujours à ses caractéristiques particulières. El uso de Internet en Italia se encuentra actualmente en una fase inicial. El análisis del plano social y el debate público mantenido por los medios de comunicación, han puesto en evidencia posibles riesgos para los niños, en detrimento de las oportunidades que se ofrecen. En la actualidad se trata de preocupaciones hipotéticas. Este artículo presenta los primeros resultados de un proyecto de investigación realizado con el objetivo de estudiar el uso de Internet por parte de los niños principalmente en el ámbito de la familia y de la escuela, utilizando un doble enfoque cualitativo y cuantitativo. El estudio ha puesto en evidencia que los niños que utilizan Internet como pioneros en casa pertenecen a una categoría privilegiada, dotada de instrumentos apropriados asícomo de adecuados recursos técnicos y culturales. A estos niños no sólo no se les deja abandonados en la red, sino que reciben seguimiento y supervisión constante de los padres, a menudo en modo excesivo, en la medida que se les dejan pocas oportunidades para explorar por ellos mismos el ciberespacio. Si bien la difusión de Internet en las escuelas se produce con gran rapidez a pesar de las carencias estructurales, el uso que se hace de Internet no siempre toma en cuenta las posibilidades que éste ofrece. Die Benutzung von Internet in Italien befindet sich in seiner Anfangsphase. Die von den Medien übermittelte soziale Darstellung und öffentliche Auseinandersetzung hat die Risiken für Kinder hervorgehoben, auf Kosten seiner Möglichkeiten. Solche Bedenken sind heutzutage grösstenteils hypothetisch. Diese Studie enthält die ersten Ergebnisse eines untersuchenden Forschungsprojektes, dessen Ziel darin besteht, die Benutzung von Internet durch Kinder auf verschiedenen Gebieten zu untersuchen, hauptsächlich innnerhalb der Familie und in der Schule, mit einem sowie quantitativen als auch qualitativen Ansatz. Diese Untersuchung stellte fest, dass Kinder, die als Pioniere zu Hause Internet benutzt haben, zu einer ausgewählten Elite gehören, die von der Familie durch passende Instrumente und angemessene technische und kulturelle Mitteln unterstützt wurden. Auch wenn sie nicht dem Netz völlig überlassen werden, werden diese Kinder doch zu sehr von ihren Eltern überwacht und geleitet, so dass ihnen wenig Zeit bleibt unabhängig den Cyberspace auf eigene Faust zu erkundigen. Die Verbreitung von Internet in den Schulen geht ziemlich schnell vor sich an, trifft jedoch auf strukturelle Schwierigkeiten wobei sein Gebrauch nicht immer den spezifischen Eigenschaften entspricht.