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The advent of computerized medical recording systems in healthcare facilities has made data retrieval tasks easier, compared to manual recording. Nevertheless, the potential of the information contained within medical records remains largely untapped, mostly due to the time and effort required to extract data from unstructured documents. Natural Language Processing (NLP) represents a promising solution to this challenge, as it enables the use of automated text-mining tools for clinical practitioners. In this work, we present the architecture of the Virtual Dementia Institute (IVD), a consortium of sixteen Italian hospitals, using the NLP Extraction and Management Tool (NEMT), a (semi-) automated end-to-end pipeline that extracts relevant information from clinical documents and stores it in a centralized REDCap database. After defining a common Case Report Form (CRF) across the IVD hospitals, we implemented NEMT, the core of which is a Question Answering Bot (QABot) based on a modern NLP model. This QABot is fine-tuned on thousands of examples from IVD centers. Detailed descriptions of the process to define a common minimum dataset, Inter-Annotator Agreement calculated on clinical documents, and NEMT results are provided. The best QABot performance show an Exact Match score (EM) of 78.1%, a F1-score of 84.7%, a Lenient Accuracy (LAcc) of 0.834, and a Mean Reciprocal Rank (MRR) of 0.810. EM and F1 scores outperform the same metrics obtained with ChatGPTv3.5 (68.9% and 52.5%, respectively). With NEMT the IVD has been able to populate a database that will contain data from thousands of Italian patients, all screened with the same procedure. NEMT represents an efficient tool that paves the way for medical information extraction and exploitation for new research studies.

Objectives: The aim of this study was to perform a descriptive analysis of oropharyngeal adverse events (AEs) related to drugs and/or vaccines in order to provide useful information for clinicians., Methods: Data related to three regions of Italy were analyzed from 2019 to 2021 by using the National Pharmacovigilance database., Results: Among overall 67,384 cases, 2773 (4.1%) reported at least one oropharyngeal AE. Most cases referred to females (71.0%) and adults (70.8%). The majority of cases were reported as not serious (68.4%) and the outcome was mainly positive (73.5%). The cases related to drugs (52.2%) were slightly more than those related to vaccines (47.8%), the latter nearly completely represented by COVID-19 vaccines. Among 3324 oropharyngeal AEs, the most commonly reported were oropharyngeal conditions (65.9%). The most reported AEs related to vaccines were paresthesia oral and oropharyngeal pain, whereas the most reported AEs related to drugs were throat tightness and angioedema. A marked under-reporting of osteonecrosis of the jaw (2.9%) was observed, despite this risk was well documented in the same country., Conclusions: This analysis suggested an under-reporting of oropharyngeal AEs and the need to better train dentists, dental hygienists, and also general practitioners., (© 2024 The Author(s). Oral Diseases published by John Wiley & Sons Ltd.)

Objective: This study aimed to determine whether invisible social control provided by a romantic partner is associated with improved objective glucose outcomes for patients with Type 2 diabetes. Social control reflects a partner's attempt to modify or influence a patient's health behaviors. We hypothesized that the best outcome for all continuous glucose monitoring measures would be captured by an interaction condition reflecting invisible social control., Method: Patients with Type 2 diabetes and their partners ( N = 63 couples) completed an 8-day daily diary period between 2016 and 2017. Self-report measures of social control receipt and provision were obtained each evening from patients and partners and patients wore a continuous glucose monitor throughout the diary period. Outcomes of daily glucose mean, standard deviation, time in range, and coefficient of variation were computed and two-way interactions between social control receipt and social control provision were probed and plotted., Results: The two-way interaction significantly predicted daily glucose mean, standard deviation, and time in range, such that when patients reported no social control receipt, but partners reported social control provision, patients showed improvements in objective glucose measures. We found no significant effect for coefficient of variation., Conclusions: This study was the first to use an invisible social control framework to examine the daily dyadic associations between partner social control provision, patient social control receipt, and four objectively measured continuous glucose monitoring outcomes. Findings suggest that the visibility of social control provided by a romantic partner may be predictive of glycemic control in patients with Type 2 diabetes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose: Partners of breast cancer (BC) survivors report high rates of psychological distress including fear of cancer recurrence (FCR). Research suggests that partners may have poorer physical health outcomes than the general population, but little research has examined the physiological biomarkers by which distress may impact partner health outcomes. The current study examined the associations between FCR and changes in hair cortisol among BC partners., Methods: Male partners (N = 73) of early-stage BC survivors provided hair samples during two visits, one after completion of survivors' adjuvant treatment (T1) and again 6 months later (T2). Two subscales from the Fear of Cancer Recurrence Inventory and one subscale from the Concerns about Recurrence Scale comprised a latent FCR factor at T1. A latent change score model was used to examine change in cortisol as a function of FCR., Results: Partners were on average 59.65 years of age (SD = 10.53) and non-Hispanic White (83%). Latent FCR at T1 was positively associated (b = 0.08, SE = 0.03, p = .004, standardized β = .45) with change in latent hair cortisol from T1 to T2., Conclusions: Results indicated that greater FCR was associated with increases in hair cortisol in the months following adjuvant treatment. This is one of the first studies to examine the physiological correlates of FCR that may impact health outcomes in BC partners., Implications for Cancer Survivors: Findings highlight the need for further research into the relationship between FCR and its physiological consequences. Interventions to address partner FCR are needed and may aid in improving downstream physical health outcomes., (© 2024. The Author(s).)

The widespread and increasing use of plastic-based goods in the present-day world has been raising many concerns about the formation of microplastics, their release, their impacts on the environment and, ultimately, on living organisms. These concerns are even greater regarding nanoplastics, i.e., nanosized microplastics, which may have even greater impacts. In this brief review, although without any claim or intention to exhaustively cover all the aspects of such a complex and many-sided issue, the very topical problem of the formation of microplastics, and the even more worrisome nanoplastics, from polymer-based products was considered. The approach is focused on a terse, straightforward, and easily accessible analysis oriented to the main technological engineering aspects regarding the sources of microplastics and nanoplastics released into the environment, their nature, some of the consequences arising from the release, the different polymers involved, their technological form (i.e., products or processes, with particular attention towards unintentional release), the formation mechanisms, and some possible mitigation pathways.

Restless Legs Syndrome (RLS) is a common sleep disorder characterized by an urge to move the legs that is responsive to movement (particularly during rest), periodic leg movements during sleep, and hyperarousal. Recent evidence suggests that the involvement of the adenosine system may establish a connection between dopamine and glutamate dysfunction in RLS. Transcranial magnetic stimulation (TMS) is a non-invasive electrophysiological technique widely applied to explore brain electrophysiology and neurochemistry under different experimental conditions. In this pilot study protocol, we aim to investigate the effects of dipyridamole (a well-known enhancer of adenosinergic transmission) and caffeine (an adenosine receptor antagonist) on measures of cortical excitation and inhibition in response to TMS in patients with primary RLS. Initially, we will assess cortical excitability using both single- and paired-pulse TMS in patients with RLS. Then, based on the measures obtained, we will explore the effects of dipyridamole and caffeine, in comparison to placebo, on various TMS parameters related to cortical excitation and inhibition. Finally, we will evaluate the psycho-cognitive performance of RLS patients to screen them for cognitive impairment and/or mood-behavioral dysfunction, thus aiming to correlate psycho-cognitive findings with TMS data. Overall, this study protocol will be the first to shed lights on the neurophysiological mechanisms of RLS involving the modulation of the adenosine system, thus potentially providing a foundation for innovative "pharmaco-TMS"-based treatments. The distinctive TMS profile observed in RLS holds indeed the potential utility for both diagnosis and treatment, as well as for patient monitoring. As such, it can be considered a target for both novel pharmacological (i.e., drug) and non-pharmacological (e.g., neuromodulatory), "TMS-guided", interventions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lanza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: Most people with major depressive episodes meet the criteria for the anxious distress (AD) specifier defined by DSM-5 as the presence of symptoms such as feelings of tension, restlessness, difficulty concentrating, and fear that something awful may happen. This cross-sectional study was aimed at identifying clinical correlates of AD in people with unipolar or bipolar depression., Methods: Inpatients with a current major depressive episode were included. Data on socio-demographic and clinical variables were collected. The SCID-5 was used to diagnose depressive episodes and relevant specifiers. The Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were used to assess the severity of depressive and manic (mixed) symptoms, respectively. Multiple logistic regression analyses were carried out to identify clinical correlates of AD., Results: We included 206 people (mean age: 48.4 ± 18.6 yrs.; males: 38.8%) admitted for a major depressive episode (155 with major depressive disorder and 51 with bipolar disorder). Around two-thirds of the sample (N = 137; 66.5%) had AD. Multiple logistic regression models showed that AD was associated with mixed features, higher YMRS scores, psychotic features, and a diagnosis of major depressive disorder ( p  < 0.05)., Conclusion: Despite some limitations, including the cross-sectional design and the inpatient setting, our study shows that AD is likely to be associated with mixed and psychotic features, as well as with unipolar depression. The identification of these clinical domains may help clinicians to better contextualize AD in the context of major depressive episodes.

Parkinson's disease (PD) is a multisystem and multifactorial disorder and, therefore, the application of modern genetic techniques may assist in unraveling its complex pathophysiology. We conducted a clinical-demographic evaluation of 126 patients with PD, all of whom were Caucasian and of Sicilian ancestry. DNA was extracted from the peripheral blood for each patient, followed by sequencing using a Next-Generation Sequencing system. This system was based on a custom gene panel comprising 162 genes. The sample underwent further filtering, taking into account the allele frequencies of genetic variants, their presence in the Human Gene Mutation Database, and their association in the literature with PD or other movement/neurodegenerative disorders. The largest number of variants was identified in the leucine-rich repeat kinase 2 ( LRRK2 ) gene. However, variants in other genes, such as acid beta-glucosidase ( GBA ), DNA polymerase gamma catalytic subunit ( POLG ), and parkin RBR E3 ubiquitin protein ligase ( PRKN ), were also discovered. Interestingly, some of these variants had not been previously associated with PD. Enhancing our understanding of the genetic basis of PD and identifying new variants possibly linked to the disease will contribute to improved diagnostic accuracy, therapeutic developments, and prognostic insights for affected individuals., Competing Interests: Author Angela Cordella was employed by the company Genomix4Life Srl. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Introduction: The objective of this study was to characterize the experiences and overall satisfaction of patients and providers with the March 2020 transition to telehealth in a psychiatric setting (telepsychiatry). The study also investigated how socio-demographic and clinical characteristics impact an individual's experiences and satisfaction with telepsychiatry., Methods: Responses were collected from 604 patients and 154 providers engaged in clinical care at one of three participating Johns Hopkins Medicine outpatient psychiatric clinics between January 2020-March 2021. Survey data were collected by self-report via Qualtrics or telephone follow-up., Results: Respondents were predominately female and White. Over 70% of patients and providers were generally satisfied with telepsychiatry. However, providers were more likely to favor in-person care over telepsychiatry for post-pandemic care 48% to 17% respectively, while 35% rated both modalities equivalently. Patients were more evenly divided with 45% preferring telepsychiatry compared to 42% for in-person care, and only 13% rating them equivalently. Among providers, technical difficulties were significantly associated with both less satisfaction and lower preference for telepsychiatry [odds ratio for satisfaction (OR S ) = 0.12; odds ratio for preference (OR P ) = 0.13]. For patients, factors significantly associated with both lower satisfaction and lower preference for telepsychiatry included technical difficulties (OR S  = 0.20; OR P  = 0.41), unstable access to the internet (OR S  = 0.46; OR P  = 0.50), worsening depression (OR S  = 0.38; OR P  = 0.36), and worsening anxiety (OR S  = 0.41; OR P  = 0.40). Factors associated with greater satisfaction and higher preference for telepsychiatry among patients included higher education (OR S  = 2.13; OR P  = 1.96) and a decrease in technical difficulties over time (OR S  = 2.86; OR P  = 2.35)., Discussion: Patients and providers were satisfied with telepsychiatry. However, there were greater differences between them in preferences for continuing to use telepsychiatry post-pandemic. These findings highlight factors that influence patient and provider preferences and should be addressed to optimize the use of telepsychiatry in the future., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Morreale, Cohen, Van Wert, Beccera, Miller, Narrow, Schweizer, Straub, Zandi and Ruble.)

Versatility of the anionic algal polysaccharide carrageenan has long been discussed and explored, especially for their affinity towards water molecules. While this feature is advantageous in certain applications such as water remediation, wound healing, etc., the usefulness of this biopolymer is extremely limited when it comes to applications such as food packaging. Scientists around the globe are carrying out research works on venturing diverse methods to integrate hydrophobic nature into these polysaccharides without compromising their other functionalities. Considering these foregoing studies, this review is designed to have an in-depth understanding of diverse methods and techniques adopted for tuning the hydrophobic nature of carrageenan-based bionanocomposites, both via surface alterations or by changes made to their chemical structure and attached functional groups. This review article mainly focuses on how the hydrophobicity of carrageenan bionanocomposites varies as a function of the type and refinement of carrageenan, and with the incorporation of additives including plasticisers, nanofillers, bioactive agents, etc. Incorporation of nanofillers such as polysaccharide-based nanoparticles, nanoclays, bioceramic and mineral based nanoparticles, carbon dots and nanotubes, metal oxide nanoparticles, etc., along with their synergistic effects in hybrid bionanocomposites are also dealt with in this comprehensive review article.

Biodegradable polymers have recently become popular; in particular, blends of poly(lactic acid) (PLA) and poly(butylene adipate terephthalate) (PBAT) have recently attracted significant attention due to their potential application in the packaging field. However, there is little information about the thermomechanical properties of these blends and especially the effect induced by the addition of PBAT on the shape memory properties of PLA. This work, therefore, aims at producing and investigating the microstructural, thermomechanical and shape memory properties of PLA/PBAT blends prepared by melt compounding. More specifically, PLA and PBAT were melt-blended in a wide range of relative concentrations (from 85/15 to 25/75 wt%). A microstructural investigation was carried out, evidencing the immiscibility and the low interfacial adhesion between the PLA and PBAT phases. The immiscibility was also confirmed by differential scanning calorimetry (DSC). A thermogravimetric analysis (TGA) revealed that the addition of PBAT slightly improved the thermal stability of PLA. The stiffness and strength of the blends decreased with the PBAT amount, while the elongation at break remained comparable to that of neat PLA up to a PBAT content of 45 wt%, while a significant increment in ductility was observed only for higher PBAT concentrations. The shape memory performance of PLA was impaired by the addition of PBAT, probably due to the low interfacial adhesion observed in the blends. These results constitute a basis for future research on these innovative biodegradable polymer blends, and their physical properties might be further enhanced by adding suitable compatibilizers.

3D printability of green composites is currently experiencing a boost in importance and interest, envisaging a way to valorise agricultural waste, in order to obtain affordable fillers for the preparation of biodegradable polymer-based composites with reduced cost and environmental impact, without undermining processability and mechanical performance. In this work, an innovative green composite was prepared by combining a starch-based biodegradable polymer (Mater-Bi ® , MB) and a filler obtained from the lignocellulosic waste coming from Solanum lycopersicum (i.e., tomato plant) harvesting. Different processing parameters and different filler amounts were investigated, and the obtained samples were subjected to rheological, morphological, and mechanical characterizations. Regarding the adopted filler amounts, processability was found to be good, with adequate dispersion of the filler in the matrix. Mechanical performance was satisfactory, and it was found that this is significantly affected by specific process parameters such as the raster angle. The mechanical properties were compared to those predictable from the Halpin-Tsai model, finding that the prepared systems exceed the expected values., Competing Interests: The authors declare no conflict of interest.

Objective: Attention deficit hyperactivity disorder is a frequent comorbid condition in adults with bipolar disorder. We performed a meta-analysis aimed at assessing sociodemographic and clinical correlates of attention deficit hyperactivity disorder in bipolar disorder., Method: We searched main electronic databases up to June 2021. Random-effects meta-analyses, with relevant meta-regression and quality-based sensitivity analyses, were carried out to estimate the association between attention deficit hyperactivity disorder and putative correlates, grading the quality of evidence., Results: We included 43 studies, based on 38 independent samples. Attention deficit hyperactivity disorder participants were more likely to be males (odds ratio = 1.46; p  < 0.001) and unemployed (odds ratio = 1.45; p  = 0.045), and less likely to be married (odds ratio = 0.62; p  = 0.014). They had an earlier onset of bipolar disorder (standardized mean difference = -0.36; p  < 0.001); more mood episodes (standardized mean difference = 0.35; p  = 0.007), particularly depressive (standardized mean difference = 0.30; p  = 0.011) and mixed (standardized mean difference = 0.30; p  = 0.031) ones; higher odds of using antidepressants (odds ratio = 1.80; p  = 0.024) and attempted suicides (odds ratio = 1.83; p  < 0.001) and lower odds of psychotic features (odds ratio = 0.63; p  = 0.010). Moreover, they were more likely to have generalized anxiety disorder (odds ratio = 1.50; p  = 0.019), panic disorder (odds ratio = 1.89; p  < 0.001), social phobia (odds ratio = 1.61; p  = 0.017), eating disorders (odds ratio = 1.91; p  = 0.007), antisocial personality disorder (odds ratio = 3.59; p  = 0.004) and substance (odds ratio = 2.29; p  < 0.001) or alcohol (odds ratio = 2.28; p  < 0.001) use disorders. Quality of the evidence was generally low or very low for the majority of correlates, except for bipolar disorder onset and alcohol/substance use disorders (high), and suicide attempts (moderate)., Conclusion: Comorbid bipolar disorder/attention deficit hyperactivity disorder may have some distinctive clinical features including an earlier onset of bipolar disorder and higher comorbid alcohol/substance use disorder rates. Further research is needed to identify additional clinical characteristics of this comorbidity.

Purpose: Breast cancer (BC) survivors and their intimate partners face several adverse consequences from the cancer experience, including sleep disturbance, which is a common side effect of BC and its treatment. Sleep has been conceptualized and examined as an individual phenomenon despite most adults sharing a bed/room with a partner. Limited research has examined the associations between daily relationship processes and sleep in couples coping with cancer. Using an intensive longitudinal design, the present study examined the daily, within-person links between attempted and perceived partner responsiveness and subjective sleep., Methods: Immediately following adjuvant treatment, 72 early-stage BC survivors and their intimate partners (144 paired individuals) reported on daily attempted and perceived partner responsiveness each evening and subjective sleep each morning for 21 consecutive days., Results: Survivor and partner reports of partner responsiveness were associated with their own subjective sleep, such that greater attempted and perceived partner responsiveness were associated with improvements in one's own subjective sleep. Effects of one participant's partner responsiveness on their partner's sleep were not observed., Conclusions: Findings suggest that among couples coping with early-stage BC, increased partner responsiveness is associated with subsequent improvements in subjective sleep., Implications for Cancer Survivors: Sleep disturbance is a serious concern for BC survivors and their intimate partners. Future research should assess intimacy processes as a potential method to improve BC survivor and partner sleep., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Abstract: Electroconvulsive therapy (ECT) is a highly therapeutic and cost-effective treatment for severe and/or treatment-resistant major depression. However, because of the varied clinical practices, there is a great deal of heterogeneity in how ECT is delivered and documented. This represents both an opportunity to study how differences in implementation influence clinical outcomes and a challenge for carrying out coordinated quality improvement and research efforts across multiple ECT centers. The National Network of Depression Centers, a consortium of 26+ US academic medical centers of excellence providing care for patients with mood disorders, formed a task group with the goals of promoting best clinical practices for the delivery of ECT and to facilitate large-scale, multisite quality improvement and research to advance more effective and safe use of this treatment modality. The National Network of Depression Centers Task Group on ECT set out to define best practices for harmonizing the clinical documentation of ECT across treatment centers to promote clinical interoperability and facilitate a nationwide collaboration that would enable multisite quality improvement and longitudinal research in real-world settings. This article reports on the work of this effort. It focuses on the use of ECT for major depressive disorder, which accounts for the majority of ECT referrals in most countries. However, most of the recommendations on clinical documentation proposed herein will be applicable to the use of ECT for any of its indications., Competing Interests: D.F.M. has received research support for the clinical study of ketamine in depression and past travel expenses for program and research development from the National Network of Depression Centers. He has research support from Janssen at present. He has past research funding from Neuronetics and St. Jude Medical in the past 10 years; Mustafa Husain has received support from the National Institutes of Health (NIH), National Institute of Mental Health (NIMH), National Institute on Aging (NIA), National Institute of Neurological Disorders and Stroke, Brain Initiative, and the Stanley Medical Research Institute. He has received industry grant support from Abbott, Cyberonics, Neuronetics, Brainsway, and NeoSync; William M. McDonald is a member of the American Psychiatric Association Council on Research representing electroconvulsive therapy and neuromodulation therapies. He is compensated as the chair of the Data Safety and Monitoring Board (DSBM) for an NIA multicenter study. He is on the Board of Skyland Trail and 3Keys. He is a paid consultant for Signant Health. He has received past funding from the Stanley Foundation, Soterix, Neuronetics, NeoSync, and Cervel Neurotherapeutics. He has an endowed chair funded by the JB Fuqua Foundation. S. Selek received internal funding from the University of Texas Health Science Center at Houston McGovern Medical School, Louis A. Faillace Department of Psychiatry. S.M.M. has received research funding from the NIH and is a consultant for the Pearson Assessment. E.A. has received funding from the NIA. J.H.W. is a consultant or has equity interest at Mindstreet Inc; American Psychiatric Publishing, Inc; Guilford Press; and Simon and Schuster Book Royalties. He has received grant support from the Agency for Healthcare Research and Quality. T.S. has received funding from the NIH and the Foundation of Hope for Research and Treatment of Mental Illness. W.I. has received funding from the NIMH T32 Psychiatric Epidemiology Training Program (T32MH014592-41). I.M.R. was supported by the NIMH (R01 MH121542) and The Jager Family Foundation. P.P.Z., M.M., R.W.S., S.K.C., K.R., B.R.C., S.J.S., P.D.P., R.D.W., N.F.R., M.T.B., M.C., K.G., A.F., N.T.T., O.F.P., M.J.D., K.K., S. Sampson, and Y.S. have no conflicts of interest or financial disclosures to report., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: Compare awake evaluation (modified Mallampati score-MMs, Müller maneuver-MM) to drug-induced sleep endoscopy (DISE) findings according to NOHL (nose-oropharynx-hypopharynx-larynx) classification in moderate-to-severe OSAHS patients., Methods: 43 moderate-to-severe OSAHS patients referred to our ENT department were enrolled over a 2-year period. In this observational prospective study, each patient was evaluated by the same ENT team both in wakefulness and during pharmacologically induced sleep. Level and severity of the obstruction were described., Results: The comparison of degree of collapsibility was statistically significative only at hypopharyngeal level: 41.8% of the patients showed a hypopharyngeal obstruction in wakefulness whereas 88.3% in DISE (p = 0.000). Laryngeal level was found in 18.6% patients during awake examination, conversely DISE demonstrated laryngeal obstruction in 4.6%. DISE identified significantly higher incidence of multilevel collapses (p = 0.001). However, the incidence of oropharyngeal obstruction in patients classified as MMs I and II was significantly higher in DISE compared to MM (p = 0.021)., Conclusion: DISE is the best predictor of hypopharyngeal obstruction, whereas MM underestimates the severity of the collapse at this level. DISE is more reliable than MM to identify the obstruction in patients with MMs score I and II., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In this work, an innovative green composite was produced by adding Hedysarum coronarium (HC) flour to a starch-based biodegradable polymer (Mater-Bi ® , MB). The flour was obtained by grinding together stems, leaves and flowers and subsequently sieving it, selecting a fraction from 75 μm to 300 μm. Four formulations have been produced by compression molding (CM) and fused deposition modeling (FDM) by adding 5%, 10%, 15% and 20% of HC to MB. The influence of filler content on the processability was tested, and rheological, morphological and mechanical properties of composites were also assessed. Through CM, it was possible to obtain easily homogeneous samples with all filler amounts. Concerning FDM, 5% and 10% HC-filled composites proved also easily printable. Mechanical results showed filler effectively acted as reinforcement: Young's modulus and tensile strengths of the composites increased from 74.3 MPa to 236 MPa and from 18.6 MPa to 33.4 MPa, respectively, when 20% of HC was added to the pure matrix. FDM samples, moreover, showed higher mechanical properties if compared with CM ones due to rectilinear infill and fibers orientation. In fact, regarding the 10% HC composites, Young's modulus of the CM and FDM ones displayed a relative increment of 176% and 224%, respectively.

Background: Obsessive-compulsive personality disorder (OCPD) is characterized by pervasive and persistent traits including preoccupation with orderliness, perfectionism, and control. Relatively little is known about the potential relationship between OCPD traits and physical health., Methods: We investigated the association between OCPD traits and several self-reported medical conditions in 249 individuals followed prospectively from 1981 until 2004/2005 as part of the Epidemiological Catchment Area., Results: The OCPD trait score was inversely related to hypertension in males, in models unadjusted (OR = 0.66; 95% CI, 0.45-0.90) and adjusted (OR = 0.70; 95% CI, 0.47-0.95) for sociodemographic variables. Perfectionism was inversely related to hypertension in the unadjusted models for men (OR = 0.34; 95% CI, 0.12-0.89). Indecisiveness was positively associated with heart conditions in adjusted models for women (OR = 3.46; 95% CI, 1.11-10.52)., Conclusion: OCPD traits are associated with cardiovascular health in both sexes. Further studies are needed to understand the specificity of these relationships, as well as to determine the underlying mechanism., (© 2021 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.)

Interest in the development of graphene-based materials for advanced applications is growing, because of the unique features of such nanomaterials and, above all, of their outstanding versatility, which enables several functionalization pathways that lead to materials with extremely tunable properties and architectures. This review is focused on the careful examination of relationships between synthetic approaches currently used to derivatize graphene, main properties achieved, and target applications proposed. Use of functionalized graphene nanomaterials in six engineering areas (materials with enhanced mechanical and thermal performance, energy, sensors, biomedical, water treatment, and catalysis) was critically reviewed, pointing out the latest advances and potential challenges associated with the application of such materials, with a major focus on the effect that the physicochemical features imparted by functionalization routes exert on the achievement of ultimate properties capable of satisfying or even improving the current demand in each field. Finally, current limitations in terms of basic scientific knowledge and nanotechnology were highlighted, along with the potential future directions towards the full exploitation of such fascinating nanomaterials.

Three dimensional-printability of green composites is recently growing in importance and interest, especially in the view of feasibility to valorize agricultural and marine waste to attain green fillers capable of reducing bioplastic costs, without compromising their processability and performance from an environmental and mechanical standpoint. In this work, two lignocellulosic fillers, obtained from Opuntia ficus indica and Posidonia oceanica , were added to PLA and processed by FDM. Among the 3D printed biocomposites investigated, slight differences could be found in terms of PLA molecular weight and filler aspect ratio. It was shown that it is possible to replace up to 20% of bioplastic with low cost and ecofriendly natural fillers, without significantly modifying the processability and the mechanical performance of the neat matrix; at the same time, an increase of surface hydrophilicity was found, with possible positive influence on the biodegradability of such materials after disposal.

The research on cellulose fiber-reinforced nanocomposites has increased by an unprecedented magnitude over the past few years due to its wide application range and low production cost. However, the incompatibility between cellulose and most thermoplastics has raised significant challenges in composite fabrication. This paper addresses the behavior of plasma-modified polyethylene (PE) reinforced with cellulose nanofibers extracted from isora plants (i.e., isora nanofibrils (INFs)). The crystallization kinetics of PE-INF composites were explained using the Avrami model. The effect of cellulose nanofillers on tuning the physiochemical properties of the nanocomposite was also explored in this work. The increase in mechanical properties was due to the uniform dispersion of fillers in the PE. The investigation on viscoelastic properties confirmed good filler-matrix interactions, facilitating the stress transfer.

It is well known that the need for more environmentally friendly materials concerns, among other fields, the food packaging industry. This regards also, for instance, nets used for agricultural product (e.g., citrus fruits, potatoes) packaging. These nets are typically manufactured by film blowing technique, with subsequent slicing of the films and cold drawing of the obtained strips, made from traditional, non-biodegradable polymer systems. In this work, two biodegradable polymer systems were characterized from rheological, processability, and mechanical points of view, in order to evaluate their suitability to replace polyethylene-based polymer systems typically used for agricultural product net manufacturing. Furthermore, laboratory simulation of the above-mentioned processing operation paths was performed. The results indicated a good potential for biodegradable polymer systems to replace polyethylene-based systems for agricultural product packaging.

Given the biopsychosocial model of pain, it is not surprising that a strong degree of association exists between cancer pain and psychological distress., (© 2021. Springer Nature Switzerland AG.)

Purpose of Review: The purpose of this review is to provide an overview of psychiatric medications that impact blood pressure in adult patients either as a direct side effect or indirectly, via negative metabolic impact or interactions with other medications. In addition, pertinent interactions between psychiatric medications and antihypertensive agents will be discussed., Recent Findings: Although the novel intranasal antidepressant, esketamine, has been shown to increase blood pressure shortly after dosing, treatment with antihypertensive medications is not typically required. In addition, no increase in serious adverse cardiac events was reported with this medication. The negative metabolic impact of antipsychotic medications has been shown to occur within the first month of treatment and necessitates early monitoring. When compared with the general population with cardiovascular disease, mortality risk in patients with severe and persistent psychiatric illness is higher, and death occurs 10 years earlier. There are several psychiatric treatments that increase blood pressure directly as well as indirectly, via negative metabolic impact and drug/diet interactions. Fortunately, there are no absolute contraindications for use of any psychiatric medication in patients with pre-existing hypertension. Given data which suggests that patients diagnosed with more severe psychiatric disorders are known to receive inadequate medical care for hypertensive illness and experience increased mortality risk from cardiovascular disease, it is important for all physicians to be aware of the increased risk in this population and for both thorough assessment and treatment to occur.

In this paper, gas permeability studies were performed on materials based on natural rubber/acrylonitrile butadiene rubber blends and nanoclay incorporated blend systems. The properties of natural rubber (NR)/nitrile rubber (NBR)/nanoclay nanocomposites, with a particular focus on gas permeability, are presented. The measurements of the barrier properties were assessed using two different gases-O 2 and CO 2 -by taking in account the blend composition, the filler loading and the nature of the gas molecules. The obtained data showed that the permeability of gas transport was strongly affected by: (i) the blend composition-it was observed that the increase in acrylonitrile butadiene rubber component considerably decreased the permeability; (ii) the nature of the gas-the permeation of CO 2 was higher than O 2 ; (iii) the nanoclay loading-it was found that the permeability decreased with the incorporation of nanoclay. The localization of nanoclay in the blend system also played a major role in determining the gas permeability. The permeability of the systems was correlated with blend morphology and dispersion of the nanoclay platelets in the polymer blend.

The formulation of polymeric films endowed with the abilities of controlled release of antimicrobials and biodegradability is the latest trend of food packaging. Biodegradable polymer (Bio-Flex ® )-based nanocomposites containing carvacrol as an antimicrobial agent, and a nanoclay as a filler, were processed into blown films. The presence of such hybrid loading, while not affecting the overall filmability of the neat matrix, led to enhanced mechanical properties, with relative increments up to +70% and +200% in terms of elastic modulus and elongation at break. FTIR/ATR analysis and release tests pointed out that the presence of nanoclay allowed higher carvacrol loading efficiency, reasonably hindering its volatilization during processing. Furthermore, it also mitigated the burst delivery, thereby enabling a more controlled release of the antimicrobial agent. The results of mass loss tests indicated that all the formulations showed a rather fast degradation with mass losses ranging from 37.5% to 57.5% after 876 h. The presence of clay and carvacrol accelerated the mass loss rate of Bio-Flex ® , especially when added simultaneously, thus indicating an increased biodegradability. Such ternary systems could be, therefore, particularly suitable as green materials for food packaging applications, and for antimicrobial wrapping applications.

The environmental performance of biodegradable materials has attracted attention from the academic and the industrial research over the recent years. Currently, degradation behavior and possible recyclability features, as well as actual recycling paths of such systems, are crucial to give them both durability and eco-sustainability. This paper presents a review of the degradation behaviour of biodegradable polymers and related composites, with particular concern for multi-layer films. The processing of biodegradable polymeric films and the manufacturing and properties of multilayer films based on biodegradable polymers will be discussed. The results and data collected show that: poly-lactic acid (PLA), poly-butylene adipate-co-terephthalate (PBAT) and poly-caprolactone (PCL) are the most used biodegradable polymers, but are prone to hydrolytic degradation during processing; environmental degradation is favored by enzymes, and can take place within weeks, while in water it can take from months to years; thermal degradation during recycling basically follows a hydrolytic path, due to moisture and high temperatures (β-scissions and transesterification) which may compromise processing and recycling; ultraviolet (UV) and thermal stabilization can be adequately performed using suitable stabilizers., Competing Interests: The authors declare no conflict of interest.

The use of polyamide/polyolefin blends has gained importance and concern for years, but they also show some issues to be adequately addressed, such as the incompatibility between the two components. This is usually overcome by using suitable compatibilizers, typically based on functionalized polyolefins. However, there is only little information about the use of a degraded polyolefins to induce compatibilization. This is even truer, as far as polyamide 6/polypropylene (PA6/PP) blends are concerned. In this work, compatibilization of PA6/PP blends by using small amounts of photo-oxidized PP was investigated; furthermore, the effects due to the presence of the photo-oxidized PP were studied also in relationship to the spinning operation, where the existence of the non-isothermal elongational flow can lead to significant, further morphological changes. It was found that isotropic samples showed significant enhancements of the tensile properties upon adding the photo-oxidized PP. Under non-isothermal elongational flow conditions, the presence of the photo-oxidized PP was particularly effective in improving the mechanical properties in comparison to the uncompatibilized blend fibers. Furthermore, an important result was found: The elongational-flow processing allowed obtaining anisotropic samples where the improvements of the properties, in comparison to the isotropic samples, were similar to those achieved by using a compatibilizer.

Polyamide/polyolefin blends have gained attention from the academia and the industry for several years. However, in order to optimize their properties, some drawbacks such as chemical incompatibility must be adequately overcome. This can be done by adding suitable compatibilizers. On the other hand, it is less known that suitable processing techniques may also lead to significant results. In a previous work on a low-density polyethylene/polyamide 6 (LDPE/PA6) blend, we found that the orientation due to elongational flow processing conditions could lead to an unexpected brittle⁻ductile transition. In this work, this phenomenon was further investigated and the attention was mainly focused on the effects that processing can have on the morphology and, as a consequence, on the final properties of a polymer blends. With regard to LDPE/PA6 blend, an important result was found, i.e., the effects on the ductility induced by the elongational flow orientation are similar to those obtained by using an ethylene-glycidyl methacrylate compatibilizer.

Objectives: To apply advanced diffusion MRI methods to the study of normal-appearing brain tissue in MS and examine their correlation with measures of clinical disability., Methods: A multi-compartment model of diffusion MRI called neurite orientation dispersion and density imaging (NODDI) was used to study 20 patients with relapsing-remitting MS (RRMS), 15 with secondary progressive MS (SPMS), and 20 healthy controls. Maps of NODDI were analyzed voxel-wise to assess the presence of abnormalities within the normal-appearing brain tissue and the association with disease severity. Standard diffusion tensor imaging (DTI) parameters were also computed for comparing the 2 techniques., Results: Patients with MS showed reduced neurite density index (NDI) and increased orientation dispersion index (ODI) compared with controls in several brain areas ( p < 0.05), with patients with SPMS having more widespread abnormalities. DTI indices were also sensitive to some changes. In addition, patients with SPMS showed reduced ODI in the thalamus and caudate nucleus. These abnormalities were associated with scores of disease severity ( p < 0.05). The association with the MS functional composite score was higher in patients with SPMS compared with patients with RRMS., Conclusions: NODDI and DTI findings are largely overlapping. Nevertheless, NODDI helps interpret previous findings of increased anisotropy in the thalamus of patients with MS and are consistent with the degeneration of selective axon populations.

Objective: The central nervous system (CNS) may be involved in a variety of inflammatory diseases of the blood vessels, generally known as vasculitis. The clinical diagnosis of such involvement in early stages is difficult, since a mild cognitive impairment can be the only symptom. It was hypothesized that brain-perfusion SPECT would be able to reveal CNS involvement and to monitor the course of the disease. The purpose of this study was assess if and when an improvement of cerebral perfusion can be registered by SPECT during the follow-up of these diseases., Material and Methods: Eighteen patients affected by Systemic Lupus Erythematosus (SLE), 22 by undifferentiated vasculitis (UV), 5 by Behcet's disease (BD) and 5 by primary Sjogren's Syndrome (pSS) were enrolled in this prospective study. A 99m Tc-HMPAO brain perfusion SPECT was performed before the treatment and was repeated during the follow-up at different time intervals. Image analysis was performed on 10 cerebral areas using a specific software., Results: In the SLE patients, no significant improvement of brain perfusion was found. On the contrary, in the UV the cerebral uptake of the tracer significantly improved from the twenty-fourth month (18/22 patients). Patients with BD showed an improvement of scintigraphic findings (5/5 patients), while a similar result was obtained only in 2 of the patients with pSS., Conclusions: In conclusion, brain SPECT seems to be able to monitor the disease in UV, indicating the moment when an improvement of the cerebral perfusion is achieved. In SLE patients this scintigraphic technique did not show a significant improvement in CNS perfusion., (Copyright © 2017. Publicado por Elsevier España, S.L.U.)

Pancreatic ductal adenocarcinoma (PDAC) is expected to be the second leading cause of cancer mortality by 2030. PDAC remains resistant to the majority of systemic chemotherapies. In this paper, we explore if epigenetic sensitization can improve chemotherapy response in PDAC. Multiple PDAC cell lines were tested with serial concentrations of the epigenetic modulators 5-azacitidine (Aza) and guadecitabine (SGI-110). Guadecitabine was effective at inhibiting the expression of DNA Methyltransferase 1 (DNMT1) and in decreasing cell viability at nanomolar concentrations. We also report that guadecitabine has increased efficacy following a delay period or as we reference, a 'rest period'. Sensitization with guadecitabine improved response to the chemotherapeutic agent-Irinotecan- as measured by decreased cell viability and accompanied by an increase in caspase activity. Additional studies are needed to understand the mechanism of action., Competing Interests: N.A. has licensed a biomarker for early detection of pancreas cancer to Cepheid and has grant funding from Astex Pharmaceuticals. H.K. reviewed the manuscript; he is a scientific contributor and Vice President at Astex Inc. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

The use of biodegradable/bio-based polymers is of great importance in addressing several issues related to environmental protection, public health, and new, stricter legislation. Yet some applications require improved properties (such as barrier or mechanical properties), suggesting the use of nanosized fillers in order to obtain bio-based polymer nanocomposites. In this work, bionanocomposites based on two different biodegradable polymers (coming from the Bioflex and MaterBi families) and two different nanosized fillers (organo-modified clay and hydrophobic-coated precipitated calcium carbonate) were prepared and compared with traditional nanocomposites with high-density polyethylene (HDPE) as matrix. In particular, the injection molding processability, as well as the mechanical and rheological properties of the so-obtained bionanocomposites were investigated. It was found that the processability of the two biodegradable polymers and the related nanocomposites can be compared to that of the HDPE-based systems and that, in general, the bio-based systems can be taken into account as suitable alternatives.

Leiomyosarcomas are rare mesenchymal neoplasms characterized by a smooth muscle differentiation pattern. Due to the extremely poor prognosis in patients, the development of novel chemotherapeutic regimens remains critically important. In this study, multiple leiomyosarcoma cell lines, SK-UT1, SK-LMS1, and MES-SA were treated with varying doses of the DNA Methyltransferase Inhibitors (DNMTi) 5-azacitidine (Aza), 5-aza-2-deoxycytidine (DAC), and guadecitabine (SGI-110). The effect of these epigenetic modulators was measured using both in-vitro and in-vivo models. Of the three epigenetic modulators, Guadecitabine was the most effective at decreasing cell survival in LMS cell lines. SK-UT1 was found to be the more sensitive to all three epigenetic modulators, while SK-LMS1 and MES-SA were more resistant. The contrast in sensitivity seen was also represented by the increase in apoptosis in Aza and guadecitabine. In parallel with Aza, guadecitabine was observed to also arrest the cell cycle. Treatment with guadecitabine led to a decrease in growth across the spectrum of sensitivity in LMS cell lines, both in a delayed in vitro and in vivo model; in parallel experiments, apoptotic pathways were activated in sensitive and less sensitive lines. Additional studies are required to explore potential therapeutic applications and mechanisms for leiomyosarcoma treatment., Competing Interests: CONFLICTS OF INTEREST Ahuja has licensed biomarkers for early detection of pancreas cancers to Cepheid, consultant- Celgene, research support–Astex.

Although natalizumab (anti- α 4 integrin) represents an effective therapy for relapsing remitting multiple sclerosis (RRMS), it is associated with an increased risk of developing progressive multifocal leukoencephalopathy (PML), caused by the polyomavirus JC (JCV). The aim of this study was to explore natalizumab-induced phenotypic changes in peripheral blood T-lymphocytes and their relationship with JCV reactivation. Forty-four patients affected by RRMS were enrolled. Blood and urine samples were classified according to natalizumab infusion number: 0 ( N 0), 1-12 ( N 12), 13-24 ( N 24), 25-36 ( N 36), and over 36 ( N > 36) infusions. JCV-DNA was detected in plasma and urine. T-lymphocyte phenotype was evaluated with flow cytometry. JCV serostatus was assessed. Ten healthy donors (HD), whose ages and sexes matched with the RRMS patients of the N 0 group, were enrolled. CD8 effector (CD8 E) percentages were increased in natalizumab treated patients with detectable JCV-DNA in plasma or urine compared to JCV-DNA negative patients (JCV-) ( p < 0.01 and p < 0.001, resp.). Patients with CD8 E percentages above 10.4% tended to show detectable JCV-DNA in plasma and/or urine (ROC curve p = 0.001). The CD8 E was increased when JCV-DNA was detectable in plasma or urine, independently from JCV serology, for N 12 and N 24 groups ( p < 0.01). As long as PML can affect RRMS patients under natalizumab treatment with a negative JCV serology, the assessment of CD8 E could help in the evaluation of JCV reactivation.

Genetic counselors (GCs) are trained to identify and attend to distress; however, GCs may have patients with distress better managed by mental health professionals (MHPs). To understand the GCs' role in mental health care, we explored patient cues prompting GCs to refer to MHPs and where GCs thought their expertise in managing patient distress ended. We recruited GCs who have referred a patient for mental health services within the last year to participate in an interview study. A twelve-question interview guide explored GC demographics, reasons for referrals to MHPs, the obstacles to referrals, and perceived differences in counseling competencies between GCs and MHPs. Twenty-eight semi-structured interviews were conducted, recorded, and transcribed verbatim. Transcripts were analyzed using an inductive approach, consisting of reading a subset of transcripts and assigning codes to meaningful segments of text. Common reasons for referral included the GC's perception of the patient having limited social support, or when the patient indicated significant anxiety related to their at-risk status or recent diagnosis. GCs felt they referred when they were limited by time and training to provide adequate psychosocial services. The participants in this study acknowledged that their scope of practice is limited to short-term, client-centered counseling. Our findings are a first step in helping increase GCs' awareness of factors that contribute to the referral process to MHPs.

Triple-negative breast cancer is a group of aggressive cancers with poor prognosis owing to chemoresistance, recurrence and metastasis. New strategies are required that could reduce chemoresistance and increases the effectiveness of chemotherapy. The results presented in this paper, showing that parthenolide (PN) prevents drug resistance in MDA-MB231 cells, represent a contribution to one of these possible strategies. MDA-MB231 cells, the most studied line of TNBC cells, were submitted to selection treatment with mitoxantrone (Mitox) and doxorubicin (DOX). The presence of resistant cells was confirmed through the measurement of the resistance index. Cells submitted to this treatment exhibited a remarkable increment of NF-E2-related factor 2 (Nrf2) level, which was accompanied by upregulation of catalase, MnSOD, HSP70, Bcl-2 and P-glycoprotein. Moreover, as a consequence of overexpression of Nrf2 and correlated proteins, drug-treated cells exhibited a much lower ability than parental cells to generate ROS in response to a suitable stimulation. The addition of PN (2.0  μ M) to Mitox and DOX, over the total selection time, prevented both the induction of resistance and the overexpression of Nrf2 and correlated proteins, whereas the cells showed a good ability to generate ROS in response to adequate stimulation. To demonstrate that Nrf2 exerted a crucial role in the induction of resistance, the cells were transiently transfected with a specific small interfering RNA for Nrf2. Similarly to the effects induced by PN, downregulation of Nrf2 was accompanied by reductions in the levels of catalase, MnSOD, HSP70 and Bcl-2, prevention of chemoresistance and increased ability to generate ROS under stimulation. In conclusion, our results show that PN inhibited the development of the resistance toward Mitox and DOX, and suggest that these effects were correlated with the prevention of the overexpression of Nrf2 and its target proteins, which occurred in the cells submitted to drug treatment., Competing Interests: The authors declare no conflict of interest.

Class IV-S lupus nephritis is often associated with more necrosis and fewer subendothelial immune deposits compared to class IV-G lupus nephritis, suggestive of necrotising glomerular inflammation found in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. ANCAs are present in a significant proportion of patients with lupus nephritis. Here we determine whether ANCAs are associated with distinct clinical and histopathologic features of lupus nephritis. Thirty-two ANCA-positive biopsies were compared to 222 ANCA-negative biopsies from patients with lupus nephritis. The majority (82%) of ANCA-positive patients had antimyeloperoxidase antibodies. Class IV-S lupus nephritis and glomerular necrosis were significantly more common (36% vs. 16% and 35% vs. 15%, respectively) and isolated Class V lupus nephritis significantly less common (10% vs. 29%) in the ANCA-positive group. ANCA-positive patients had significantly higher dsDNA titers (335u/ml vs. 52u/ml), significantly lower serum C4 concentrations (0.125g/L vs. 0.15g/L) and significantly higher serum creatinine (130μmol/L vs. 84μmol/L) at the time of biopsy. Hence ANCAs appear to influence the histological pattern of lupus nephritis and are associated with worse baseline renal function and more active lupus serology. There was no significant difference in outcome between groups when matched for severity of disease and treatment using propensity scoring. Thus, further studies are needed to examine whether ANCAs in patients with lupus nephritis have a pathogenic role and whether they are associated with worse renal outcomes or are simply a marker of more severe disease., (Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Creep behavior of polymer nanocomposites has not been extensively investigated so far, especially when its effects are combined with those due to photooxidation, which are usually studied in completely independent ways. In this work, the photooxidation behavior of a low density polyethylene/organomodified clay nanocomposite system was monitored by measuring the creep curves obtained while subjecting the sample to the combined action of temperature, tensile stress, and UV radiation. The creep curves of the irradiated samples were found to be lower than those of the non-irradiated ones and progressively diverging, because of the formation of branching and cross-linking due to photooxidation. This was further proved by the decrease of the melt index and the increase of the intrinsic viscosity; at the same time, the formation of carbonyl groups was observed. This behavior was more observable in the nanocomposite sample, because of its faster photooxidation kinetics., Competing Interests: The authors declare no conflict of interest.

Polymer composites containing natural fibers are receiving growing attention as possible alternatives for composites containing synthetic fibers. The use of biodegradable matrices obtained from renewable sources in replacement for synthetic ones is also increasing. However, only limited information is available about the creep behavior of the obtained composites. In this work, the tensile creep behavior of PLA based composites, containing flax and jute twill weave woven fabrics, produced through compression molding, was investigated. Tensile creep tests were performed at different temperatures (i.e., 40 and 60 °C). The results showed that the creep behavior of the composites is strongly influenced by the temperature and the woven fabrics used. As preliminary characterization, quasi-static tensile tests and dynamic mechanical tests were carried out on the composites. Furthermore, fabrics (both flax and jute) were tested as received by means of quasi-static tests and creep tests to evaluate the influence of fabrics mechanical behavior on the mechanical response of the resulting composites. The morphological analysis of the fracture surface of the tensile samples showed the better fiber-matrix adhesion between PLA and jute fabric.

Background and Aims: In experimental investigations conducted in rats, raising serum uric acid (SUA) levels resulted in the stimulation of intrarenal renin expression. Studies in humans exploring the association of SUA with plasma renin activity (PRA) yielded conflicting results. Moreover, little is known about the relationship of SUA with plasma aldosterone concentration (PAC). The study aimed to assess the relationship between SUA levels, PRA, and PAC and the influence of age, gender, body mass index (BMI), and hyperuricemia on these relationships in subjects with essential hypertension (EH)., Methods and Results: We enrolled 372 hypertensive patients (mean age 45 ± 12 years, men 67%) with uncomplicated EH that was not pharmacologically treated. The study population was divided in tertiles according to SUA levels. While PRA did not differ significantly across the three tertiles, PAC was higher in subjects belonging to the uppermost tertile of SUA than those in the lower ones (p = 0.0429); however, this difference lost statistical significance after adjustment for age, sex, BMI, and serum creatinine. Univariate correlation analyses showed significant associations of SUA with PRA (r = 0.137; p = 0.008) and PAC (r = 0.179; p < 0.001). However, these relationships were not significant after correcting for confounding factors in multiple linear regression analyses. We did not observe statistically significant effect modification by gender, age, BMI, and hyperuricemia., Conclusion: SUA levels are weakly associated with PRA and PAC in adults with untreated EH. These relationships were lost after adjustment for age, sex, BMI, and serum creatinine., (Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

The nuclear magnetic resonance (NMR)-based metabolomic approach was used as analytical methodology to study the urine samples of chronic inflammatory rheumatic disease (CIRD) patients. The urine samples of CIRD patients were compared to the ones of both healthy subjects and patients with multiple sclerosis (MS), another immuno-mediated disease. Urine samples collected from 39 CIRD patients, 25 healthy subjects, and 26 MS patients were analyzed using 1 H NMR spectroscopy, and the NMR spectra were examined using partial least squares-discriminant analysis (PLS-DA). PLS-DA models were validated by a double cross-validation procedure and randomization tests. Clear discriminations between CIRD patients and healthy controls (average diagnostic accuracy 83.5 ± 1.9%) as well as between CIRD patients and MS patients (diagnostic accuracy 81.1 ± 1.9%) were obtained. Leucine, alanine, 3-hydroxyisobutyric acid, hippuric acid, citric acid, 3-hydroxyisovaleric acid, and creatinine contributed to the discrimination; all of them being in a lower concentration in CIRD patients as compared to controls or to MS patients. The application of NMR metabolomics to study these still poorly understood diseases can be useful to better clarify the pathologic mechanisms; moreover, as a holistic approach, it allowed the detection of, by means of anomalous metabolic traits, the presence of other pathologies or pharmaceutical treatments not directly connected to CIRDs, giving comprehensive information on the general health state of individuals. Graphical abstract NMR-based metabolomic approach as a tool to study urine samples in CIRD patients with respect to MS patients and healthy controls.