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IntroductionFactors influencing vaccine immune priming in the first year of life involve both innate and adaptive immunity but there are gaps in understanding how these factors sustain vaccine antibody levels in healthy infants. The hypothesis was that bioprofiles associated with B cell survival best predict sustained vaccine IgG levels at one year.MethodsLongitudinal study of plasma bioprofiles in 82 term, healthy infants, who received standard recommended immunizations in the United States, with changes in 15 plasma biomarker concentrations and B cell subsets associated with germinal center development monitored at birth, soon after completion of the initial vaccine series at 6 months, and prior to the 12-month vaccinations. Post vaccination antibody IgG levels to Bordetella pertussis, tetanus toxoid, and conjugated Haemophilus influenzae type B (HiB) were outcome measures.ResultsUsing a least absolute shrinkage and selection operator (lasso) regression model, cord blood (CB) plasma IL-2, IL-17A, IL-31, and soluble CD14 (sCD14) were positively associated with pertussis IgG levels at 12 months, while CB plasma concentrations of APRIL and IL-33 were negatively associated. In contrast, CB concentrations of sCD14 and APRIL were positively associated with sustained tetanus IgG levels. A separate cross-sectional analysis of 18 mother/newborn pairs indicated that CB biomarkers were not due to transplacental transfer, but rather due to immune activation at the fetal/maternal interface. Elevated percentages of cord blood switched memory B cells were positively associated with 12-month HiB IgG levels. BAFF concentrations at 6 and 12 months were positively associated with pertussis and HiB IgG levels respectively.DiscussionSustained B cell immunity is highly influenced by early life immune dynamics beginning prior to birth. The findings provide important insights into how germinal center development shapes vaccine responses in healthy infants and provide a foundation for studies of conditions that impair infant immune development.

A larger use of mitral valve repair is recommended in case of mitral regurgitation. Anterior leaflet repair is generally more difficult than posterior. Presence of atrial fibrillation or dysfunction of left ventricle appears to be independent preoperative factors of failure in case of involvement of the anterior leaflet. In experienced hands anterior leaflet repair can be effective and safe and should theoretically not limit a conservative technique instead of a replacement. This would therefore lead to being more aggressive in the treatment of this pathological condition in the earlier stages of the disease.

International audience; Recent developments in quantum technology have resulted in a new generation of sensors for measuring inertial quantities, such as acceleration and rotation. These sensors can exhibit unprecedented sensitivity and accuracy when operated in space, where the free-fall interrogation time can be extended at will and where the environment noise is minimal. European laboratories have played a leading role in this field by developing concepts and tools to operate these quantum sensors in relevant environment, such as parabolic flights, free-fall towers, or sounding rockets. With the recent achievement of Bose–Einstein condensation on the International Space Station, the challenge is now to reach a technology readiness level sufficiently high at both component and system levels to provide “off the shelf” payload for future generations of space missions in geodesy or fundamental physics. In this roadmap, we provide an extensive review on the status of all common parts, needs, and subsystems for the application of atom-based interferometers in space, in order to push for the development of generic technology components.

Summary Background Gender-based violence affects 35–45% of women worldwide, mostly coming from domestic violence. A good screening procedure in clinical practice is useful, but WHO does not advise universal screening, recommending further research. Aim (i) To report the frequency of domestic violence cases among admissions to the Emergency Room of a major Italian Hospital in 2020, including during complete ‘Lockdown’ period; (ii) to document acute and chronic health effects of domestic violence and (iii) to asses usefulness of the WHO screening as a tool for uncovering cases which would otherwise remain hidden. Design and methods A database containing all the information recorded for each of 19 160 patients in the Emergency Room was constructed by a keyword search (‘violence’, ‘assault’, ‘trauma’) to filter the data and retrieve cases of violence in the period between 1 January and 2 June 2020. The self-administered questionnaire of the WHO Multi-country Study on Women’s Health and Domestic Violence against Women was used in women referred to the emergency room for any cause, excluding trauma. Results A recent history of domestic violence was disclosed by 22.67%, after completing the WHO questionnaire. Of those not participating in the survey, diagnosis of domestic violence was only 0.6% (128/19 160). Conclusion Power of detection of domestic violence by the WHO questionnaire is very high, while the frequency of occurrence of these events in this population was considerable. Seemingly, it elicits the responsiveness to the topic of the volunteer interviewees. Its use should be firmly recommended, reasonably, while Covid-19 pandemic is affecting health, rights and response.

Dissemination and exploitation of knowledge regarding affordable clinical skills and innovative precision medicine, two current topics in active development in medicine, may contribute to improve also sepsis management. Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to infection. Sepsis is strongly related to all body organs or to systemic diseases and to the quality of the best-practice in use, which is particularly critical in surgical or intervention techniques. Trauma, surgical and mini-invasive procedures, vascular or endoscopic interventions, otolaryngology, obstetrics-gynecological and urological procedures, malnutrition, dental, skin, chronic liver, kidney and respiratory disease are frequently involved. Accordingly, apart from the clinical risk analysis and management of the process of care, the actual factors that may be easily neglected are the techniques used, the personal skills of the health professionals and the quality of the equipment. The quest for biomarkers consistent with the unmet needs of medical doctors and of their patient and the efforts for overcoming bacterial antibiotic resistances are currently the main foci of medical research. In addition, in this regard, research and innovation would benefit from greater knowledge, skills and use of bioinformatics and omics. The caveats related to in-silico approaches must be flagged: algorithms may equally warrant scientific innovations or hide the lack of them; a patient is more than a set of covariates. Epidemiology and prevention includes all the actions suitable for achieving an adequate hygiene and immunization of populations and for safer hospital policies and procedures during Patients' stays. In any subset, the most unresolved critical point in sepsis is a timely diagnosis. This is impaired by low degrees of suspicion for the possibility of emerging sepsis, by the shortage of use of the simplest microbiological testing but, equally or more, by the insufficient diffusion of non-invasive imaging skills suitable to detect and monitor the emerging sites and sources of infection. In primary care, in emergency facilities, in hospital wards and in intensive care units, inclusion of appropriate knowledge, skills, expertise and imaging equipment must be extended as much as possible. The low cost of UltraSound machines and of increasing bioinformatics literacy by e-learning, makes such investments affordable even in limited-resources contexts. Frontier educational and best practice intervention enhancing affordable clinical skills and innovative precision medicine may lead beyond the boundaries of fatal outcomes in sepsis.

We propose a new scheme for an improved determination of the Newtonian gravitational constant G and evaluate it by numerical simulations. Cold atoms in free fall are probed by atom interferometry measurements to characterize the gravitational field generated by external source masses. Two source mass configurations having different geometry and using different materials are compared to identify an optimized experimental setup for the G measurement. The effects of the magnetic fields used to manipulate the atoms and to control the interferometer phase are also characterized.

Both GRACE and GOCE have proven to be very successful missions, providing a wealth of data which are exploited for geophysical studies such as climate changes, hydrology, sea level changes, solid Earth phenomena, with benefits for society and the whole world population. It is indispensable to continue monitoring gravity and its changes from space, so much so that a GRACE follow-on mission has been launched in 2018. In this paper, a new satellite mission concept named MOCASS is presented, which can be considered as a GOCE follow-on, based on an innovative gradiometer exploiting ultra-cold atom technology and aimed at monitoring Earth mass distribution and its variations in time. The technical aspects regarding the payload will be described, illustrating the measurement principle and the technological characteristics of a cold atom interferometer that can measure gravity gradients. The results of numerical simulations will be presented for a one-arm and a two-arm gradiometer and for different orbit configurations, showing that an improvement with respect to GOCE could be obtained in the estimate of the static gravity field over all the harmonic spectrum (with an expected error of the order of 1 mGal at degree 300 for a 5-year mission) and that estimates are promising also for the time-variable gravity field (although GRACE is still performing better at very low degrees). Finally, the progress achievable by exploiting MOCASS observations for the detection and monitoring of geophysical phenomena will be discussed: the results of simulations of key geophysical themes (such as mass changes due to hydrology, glaciers and tectonic effects) with expected gravity change-rates, time constants and corresponding wavelengths, show that an improvement is attainable and that signals invisible to past satellites could be detected by exploiting the cold atom technology.

Based on fundamental symmetries, molecules cannot have a permanent electric dipole moment although it is commonly used in the literature to explain the different molecular spectra for heteronuclear and homonuclear molecules. Electric-dipole rotational and vibrational spectra can indeed be observed in heteronuclear molecules while they are missing in molecules with identical nuclei. I show that the missing spectral features can be explained as an effect of the exchange symmetry for identical particles., Comment: Revised argument, results unchanged. Corrected typos. Added references

Infections and pandemics will condition us in an increasingly predominant way regarding diagnostic, medical, and surgical activities in all specialist areas. Particularly cardiovascular disease represents an important field also during other health crisis like COV19 pandemia. A common strategy in the future, to cohabit with pandemic events and to be able to continue an elective and not only emergency cardiac surgery program represents an imperative.

In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-term.The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain.Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-to-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/mEarly administration of G-CSF exerted a beneficial effect on top of SOC in patients with LV dysfunction after extensive ST-segment-elevation myocardial infarction in terms of global systolic function, adverse remodeling, scar size, and myocardial strain.URL: https://www.clinicaltrials.gov. Unique identifier: NCT01969890.

Atom interferometers have been developed in the last three decades as new powerful tools to investigate gravity. They were used for measuring the gravity acceleration, the gravity gradient, and the gravity-field curvature, for the determination of the gravitational constant, for the investigation of gravity at microscopic distances, to test the equivalence principle of general relativity and the theories of modified gravity, to probe the interplay between gravitational and quantum physics and to test quantum gravity models, to search for dark matter and dark energy, and they were proposed as new detectors for the observation of gravitational waves. Here I describe past and ongoing experiments with an outlook on what I think are the main prospects in this field and the potential to search for new physics.

HIV-associated neurocognitive disorders persist despite early antiretroviral therapy (ART) and optimal viral suppression. We examined the relationship between immunopathogenesis driven by various pathways of immune activation and discrete neurocognitive performance domains in youth with HIV (YWH).Observational cross-sectional study.YWH, ages 20-28 years, enrolled in Adolescent Medicine Trials Network 071/101 were assessed for biomarkers of macrophage, lymphocyte activation, and vascular inflammation using ELISA/multiplex assays. Standardized neurocognitive tests were performed, and demographically adjusted z-scores were combined to form indices of attention, motor, executive function, verbal, and visuospatial memory. Cross-sectional analysis of the relationship between 18 plasma inflammatory biomarkers and each neurocognitive domain was performed. Linear regression models were fit for each combination of log-transformed biomarker value and neurocognitive domain score, and were adjusted for demographics, socioeconomic status, substance use, depression, CD4 T-cell count, HIV viral load, and ART status.Study included 128 YWH [mean age 23.8 (SD 1.7) years, 86% men, 68% African American]. Verbal and visuospatial memory domains were most significantly impaired in the cohort (z = -1.59 and -1.0, respectively). Higher sCD14 was associated with impaired visuospatial memory, which remained robust after adjusting for other biomarkers, demographics, and HIV-associated covariates. Among biomarkers of vascular inflammation, sICAM-1 was negatively associated with verbal memory and attention, whereas sVCAM-1 was positively associated with executive function and visuospatial memory. Specific neurocognitive domains were not associated with sCD163, LPS, or CCL2 levels.Impaired visuospatial memory in YWH is associated with immune activation, as reflected by higher sCD14.

Both HIV infection and tenofovir disoproxil fumarate (TDF) treatment adversely impact bone metabolism and may lead to osteopenia, which has critical implications for youth with HIV (YWH). This study evaluates changes in the biomarkers of bone metabolism and inflammation among YWH receiving initial treatment with TDF- and non-TDF-containing antiretroviral therapies (ARTs). YWH [n = 23, median age 21 years (range 18–24), 87% male, 61% African American] were assessed for inflammatory and bone metabolism biomarkers at enrollment, after 48 weeks of TDF-containing ART, and 96 weeks of ART without TDF with continued viral suppression. Spearman's rank correlation evaluated biomarker associations. Bone alkaline phosphatase, parathyroid hormone, and osteopontin increased after TDF treatment. All fell after TDF was discontinued. Levels of RANKL and osteoprotegerin did not change throughout the study. There was little correlation between biomarkers of bone metabolism and either macrophage or lymphocyte activation at any time point. Our results establish baseline associations between bone metabolism and immune biomarkers for this population, and find that before CD4 T cell decline chronic inflammation does not perturb biomarkers of bone metabolism among YWH. The adverse effects of TDF on bone health may be marginal for YWH at the early stages of disease.

We characterize the performance of a gravimeter and a gravity gradiometer based on the $^{1}$S$_{0}$-$^3$P$_0$ clock transition of strontium atoms. We use this new quantum sensor to measure the gravitational acceleration with a relative sensitivity of $1.7\times10^{-5}$, representing the first realisation of an atomic interferometry gravimeter based on a single-photon transition. Various noise contributions to the gravimeter are measured and characterized, with the current primary limitation to sensitivity seen to be the intrinsic noise of the interferometry laser itself. In a gravity gradiometer configuration, a differential phase sensitivity of 1.53~rad/$\sqrt{Hz}$ was achieved at an artificially introduced differential phase of $\pi/2$~rad. We experimentally investigated the effects of the contrast and visibility based on various parameters and achieve a total interferometry time of 30~ms, which is longer than previously reported for such interferometers. The characterization and determined limitations of the present apparatus employing $^{88}$Sr atoms provides a guidance for the future development of large-scale clock-transition gravimeters and gravity gradiometers with alkali-earth and alkali-earth-like atoms (e.g., $^{87}$Sr, Ca, Yb)., Comment: 32 pages, 14 figures

Maria Concetta Interrigi,1 Francesca M Trovato,2,3 Daniela Catalano,3,4 Guglielmo M Trovato3,5 1Accident and Emergency Department, Ospedale Cannizzaro, Catania, 2Accident and Emergency Department, Ospedale Civile, Ragusa, 3Department of Clinical and Experimental Medicine, TheSchool of Medicine, University of Catania, 4Postgraduate School of Clinical Ultrasound, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Policlinico, University of Catania, 5Postgraduate School of e-Learning and ICT in Health Sciences, The School of Medicine, University of Catania, Catania, Italy Purpose: Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results: Three hundred and seventy emergency TUS scans (excluding trauma patients) were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion); in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed tomography (CT). In seven patients, even if chest disease was identified by CXR, such diagnoses were significantly modified by ultrasound, and CT confirmed that TUS was more appropriate. The overall respective individual performances of CXR and TUS for the diagnosis of a pleural–pulmonary disease in emergency are good, with accuracy >95%. Conclusion: About 20% of pneumonia cases were detectable only by CXR and 20% only by TUS and not by CXR; ie, about 40% of patients may have been misdiagnosed if, by chance, only one of the two tools had been used. The concurrent use of TUS and CXR increases the overall sensitivity and specificity. The contribution of expert telementoring and final reappraisal is a valuable and sustainable element for emergency physicians’ training and performance, contributing reasonably to mitigation of clinical risks. Keywords: echography, pneumonia, pneumothorax, pleural effusion, diagnostic performance

We present a gravity gradiometer with the strontium optical clock transition by integrating a double lattice launch technique to develop two atomic samples vertically and a new method to add an artificial phase shift between two samples. We experimentally characterize the launch performance and the robustness of adding the artificial phase shift. The tunable differential phase shift is particularly important for characterizing the performance of a gravity gradiometer when the separation of the two clouds is limited by the geometrical constraints. Moreover, numerical simulation results indicate that the systematic error of the differential phase measurement can be largely reduced when the ellipse phase approaches ±π/2 rad by simply tuning the relative phase between two RF signals.

We propose and analyse a method that allows for the production of squeezed states of the atomic center-of-mass motion that can be injected into an atom interferometer. Our scheme employs dispersive probing in a ring resonator on a narrow transition of strontium atoms in order to provide a collective measurement of the relative population of two momentum states. We show that this method is applicable to a Bragg diffraction-based atom interferometer with large diffraction orders. The applicability of this technique can be extended also to small diffraction orders and large atom numbers by inducing atomic transparency at the frequency of the probe field, reaching an interferometer phase resolution scaling $\Delta\phi\sim N^{-3/4}$, where $N$ is the atom number. We show that for realistic parameters it is possible to obtain a 20 dB gain in interferometer phase estimation compared to the Standard Quantum Limit., Comment: 5 pages, 4 figures

Non-alcoholic fatty liver disease (NAFLD) is a common diagnosis and is increasing in prevalence worldwide. NAFLD is usually asymptomatic at presentation; progression of the disease is unpredictable, leading to the development of a variety of techniques for screening, diagnosis and risk stratification. Clinical methods in current use include serum biomarker panels, hepatic ultrasound, magnetic resonance imaging, and liver biopsy. NAFLD is strongly associated with the metabolic syndrome, and the most common cause of death for people with the condition is cardiovascular disease. Whether NAFLD is an independent cardiovascular risk factor needs exploration. NAFLD has been associated with surrogate markers of cardiovascular disease such as carotid intima-media thickness, the presence of carotid plaque, brachial artery vasodilatory responsiveness and CT coronary artery calcification score. There is no effective medical treatment for NAFLD and evidence is lacking regarding the efficacy of interventions in mitigating cardiovascular risk. Health care professionals managing patients with NAFLD should tackle the issue with early identification of risk factors and aggressive modification. Current management strategies therefore comprise lifestyle change, with close attention to known cardiovascular risk factors.

Background & Aims Fatty liver is associated with alcohol habits and/or overweight/obesity. We challenged several lifestyle features associated with fatty liver and, particularly, with non-alcoholic fatty liver disease (NAFLD). Among them, sleep shortage as a result of nightlife habits and a preference for plus-size fashion were assessed. The latter consists of fashionable plus-sized clothing for actual individuals' size and reflects a frequent attitude of some social or age groups, conceivably indicating more global and widespread trend and behaviour. Methods We studied a group of 708 non-diabetic youngsters, 458 women and 250 men, 21.72 ± 3.71 years old (range 15–35 years), referred for minor digestive ailments for clinical assessment, ultrasound detection of fatty liver and nutritional counselling. Details of personal history regarding lifestyle, food intake frequency and alcohol intake, dietary and physical exercise profile, sleep duration and clothing preferences were recorded. Results The prevalence of NAFLD in this cohort of youngsters is 67/708 (9.4%). Even if it is quantitatively very low in both groups, the average alcohol intake, always below 20 g/day, is greater in NAFLD subjects (5.83 ± 4.32 g) vs. subjects with normal liver (2.02 ± 3.20 g). The number of meals/day and adherence to a Mediterranean diet profile are smaller in NAFLD subjects. By multiple regression, BMI, sedentary life, plus-sized clothing for their actual size, sleep shortage and lower frequency of daily food intake are associated with the presence of NAFLD. Conclusions Onset and continuation of fatty liver disease, beyond food and exercise quantity and quality, with their effects on obesity, may also be associated with other aspects of lifestyle.

The Space Optical Clocks project aims at operating lattice clocks on the ISS for tests of fundamental physics and for providing high-accuracy comparisons of future terrestrial optical clocks. A pre-phase-A study (2007- 10), funded partially by ESA and DLR, included the implementation of several optical lattice clock systems using Strontium and Ytterbium as atomic species and their characterization. Subcomponents of clock demonstrators with the added specification of transportability and using techniques suitable for later space use, such as all-solid-state lasers, low power consumption, and compact dimensions, have been developed and have been validated. This included demonstration of laser-cooling and magneto-optical trapping of Sr atoms in a compact breadboard apparatus and demonstration of a transportable clock laser with 1 Hz linewidth. With two laboratory Sr lattice clock systems a number of fundamental results were obtained, such as observing atomic resonances with linewidths as low as 3 Hz, non-destructive detection of atom excitation, determination of decoherence effects and reaching a frequency instability of 1×10-16.

About 300 experiments have tried to determine the value of the Newtonian gravitational constant, G, so far, but large discrepancies in the results have made it impossible to know its value precisely. The weakness of the gravitational interaction and the impossibility of shielding the effects of gravity make it very difficult to measure G while keeping systematic effects under control. Most previous experiments performed were based on the torsion pendulum or torsion balance scheme as in the experiment by Cavendish in 1798, and in all cases macroscopic masses were used. Here we report the precise determination of G using laser-cooled atoms and quantum interferometry. We obtain the value G=6.67191(99) x 10^(-11) m^3 kg^(-1) s^(-2) with a relative uncertainty of 150 parts per million (the combined standard uncertainty is given in parentheses). Our value differs by 1.5 combined standard deviations from the current recommended value of the Committee on Data for Science and Technology. A conceptually different experiment such as ours helps to identify the systematic errors that have proved elusive in previous experiments, thus improving the confidence in the value of G. There is no definitive relationship between G and the other fundamental constants, and there is no theoretical prediction for its value, against which to test experimental results. Improving the precision with which we know G has not only a pure metrological interest, but is also important because of the key role that G has in theories of gravitation, cosmology, particle physics and astrophysics and in geophysical models., 3 figures, 1 table

Interest in transthoracic ultrasound (US) procedures increased after the availability of portable US equipment suitable for use at the patient's bedside. It is possible to detect space-occupying lesions of the pleura, pleural effusion, focal or diffuse pleural thickening and subpleural lesions of the lung, even in emergency settings. Transthoracic US is useful as a guidance system for thoracentesis and peripheral lesion biopsy, where it minimises the occurrence of pneumothorax and haemorrhage. Transthoracic US imaging is strongly influenced by physical interaction of the ultrasonic beam at the tissue/air interface, which gives rise to reverberations classified as simple (A-line), "comet tail" and "ring down"(B-line) artifacts. Although these artifacts can be suggestive of a disease condition, they are essentially imaging errors present even in normal subjects and in empty-pleura post-pneumonectomy patients. In order to clarify some confusion and to report on the state of the art, we present a review of the literature on transthoracic US in diseases of the pleura and peripheral lung regions and our own clinical experience over 3 decades. The review focuses on quality assurance procedures and their value in diagnostic imaging and patient monitoring and warns against possible inappropriate indications and misleading information. Thoracic US is much more than "fishing for the moon in the well".

Summary Background & aims Non-alcoholic fatty liver disease (NAFLD) is mostly related to increased BMI and sedentary life, even if it not directly attributable only to these or to single specific factors. Unhealthy lifestyle and obesity are the most probable causes, also in non-diabetic and without alcohol abuse patients, even if lean individuals can be involved. NAFLD treatment is currently warranted and driven by comprehensive lifestyle intervention, a valuable objective that is more often wished for than actually achieved. The aim is to re-assess the effectiveness of an intervention focused to increase the Adherence to Mediterranean Diet Score (AMDS) and the level of physical exercise, investigating the factors associated with failure and reporting the time that must elapse before such intervention becomes effective. Methods The study included 90 (F 46, M 44) non-alcoholic non-diabetic patients, aged 50.13 ± 13.68 years, BMI 31.01 ± 5.18 with evidence of fatty liver by ultrasound. Results A significant decrease of Bright Liver Score (BLS) was observed only after 6 months of intervention: differently, at the first and third month of monitoring fatty liver changes were still not significant. By a multiple linear regression model Adherence to Mediterranean Diet change ( p :0.015) and body mass index changes ( p : R 2 = 0.519; p Conclusion Adherence to Mediterranean Diet is a significant predictor of changes in the fat content of the liver in overweight patients with NAFLD. The effect of the diet is gradual and favorable and it is independent of other lifestyle changes.

Obesity is associated with numerous metabolic comorbidities. Weight loss is an effective measure for alleviating many of these metabolic abnormalities. However, considering the limited success of most medical weight-management approaches in producing a sustained weight loss, approaches that improve obesity-related metabolic abnormalities independent of weight loss would be extremely attractive and of practical benefit. Metabolically healthy obesity supports the notion that a better metabolic profile is possible despite obesity. Moreover, adequate expansion of adipose tissue appears to confer protection from obesity-induced metabolic comorbidities. To this end, the 10th Stock conference examined new approaches to improve metabolic comorbidities independent of weight loss. In particular, human adenovirus 36 (Ad36) and specific gut microbes were examined for their potential to influence lipid and glucose homeostasis in animals and humans. While these microbes possess some undesirable properties, research has identified attributes of adenovirus Ad36 and gut microbes that may be selectively harnessed to improve metabolic profile without the obligatory weight loss. Furthermore, identifying the host signalling pathways that these microbes recruit to improve the metabolic profile may offer new templates and targets, which may facilitate the development of novel treatment strategies for obesity-related metabolic conditions.

Amplitude modulation of a tilted optical lattice can be used to steer the quantum transport of matter wave packets in a very flexible way. This allows the experimental study of the phase sensitivity in a multimode interferometer based on delocalization-enhanced Bloch oscillations and to probe the band structure modified by a constant force., Comment: 8 pages, 3 figures, Submitted to EPJ Special Topics for the special issue on "Novel Quantum Phases and Mesoscopic Physics in Quantum Gases"

We report on the latest determination of the Newtonian gravitational constant G using our atom interferometry gravity gradiometer. After a short introduction on the G measurement issue we will provide a description of the experimental method employed, followed by a discussion of the experimental results in terms of sensitivity and systematic effects. Finally, prospects for future cold atom-based experiments devoted to the measurement of this fundamental constant are reported.

Clinical assessment and workup of patients referred to cardiologists may need an extension to chest disease. This requires more in-depth examination of respiratory co-morbidities due to uncertainty or severity of the clinical presentation. The filter and integration of ecg and echocardiographic information, addressing to the clues of right ventricular impairment, pulmonary embolism and pulmonary hypertension, and other less frequent conditions, such as congenital, inherited and systemic disease, usually allow more timely diagnosis and therapeutic choice. The concurrent use of thoracic ultrasound (TUS) is important, because, despite the evidence of the strict links between cardiac and respiratory medicine, heart and chest US imaging approaches are still separated. Actually, available expertise, knowledge, skills and training and equipment's suitability are not equally fitting for heart or lung examination and not always already accessible in the same room or facility. Echocardiography is useful for study and monitoring of several respiratory conditions and even detection, so that this is nowadays an established functional complementary tool in pulmonary fibrosis and diffuse interstitial disease diagnosis and monitoring. Extending the approach of the cardiologist to lung and pleura will allow the achievement of information on pleural effusion, even minimal, lung consolidation and pneumothorax. Electrocardiography, pulse oximetry and US equipment are the friendly extension of the physical examination, if their use relies on adequate knowledge and training and on appropriate setting of efficient and working machines. Lacking these premises, overshadowing or misleading artefacts may impair the usefulness of TUS as an imaging procedure.

Chronic lymphocytic leukemia (CLL) can be immunosuppressive in humans and mice, and CLL cells share multiple phenotypic markers with regulatory B cells that are competent to produce interleukin (IL)-10 (B10 cells). To identify functional links between CLL cells and regulatory B10 cells, the phenotypes and abilities of leukemia cells from 93 patients with overt CLL to express IL-10 were assessed. CD5(+) CLL cells purified from 90% of the patients were IL-10-competent and secreted IL-10 following appropriate ex vivo stimulation. Serum IL-10 levels were also significantly elevated in CLL patients. IL-10-competent cell frequencies were higher among CLLs with IgV(H) mutations, and correlated positively with TCL1 expression. In the TCL1-transgenic (TCL1-Tg) mouse model of CLL, IL-10-competent B cells with the cell surface phenotype of B10 cells expanded significantly with age, preceding the development of overt, CLL-like leukemia. Malignant CLL cells in TCL1-Tg mice also shared immunoregulatory functions with mouse and human B10 cells. Serum IL-10 levels varied in TCL1-Tg mice, but in vivo low-dose lipopolysaccharide treatment induced IL-10 expression in CLL cells and high levels of serum IL-10. Thus, malignant IL-10-competent CLL cells exhibit regulatory functions comparable to normal B10 cells that may contribute to the immunosuppression observed in patients and TCL1-Tg mice.

Adenoviruses Ad36 and Ad37 increase adiposity in animals and are associated with obesity in humans; effects on the liver have been reported. The association of Adenovirus Ad36 seropositivity (Ad36+) with obesity but not with the severity of nonalcoholic fatty liver disease (NAFLD) has been previously shown. We investigate whether nondiabetic Ad37+ patients show a different prevalence of NAFLD and ultrasound Bright Liver score.A total of 268 adult nondiabetic patients (146 men, 122 women) were included after lifestyle counseling including a personalized Mediterranean diet, increase in physical activity, and smoking withdrawal. After an Ad37+/Ad36+ assay, overweight obesity, insulin resistance, C-reactive protein, and bright liver prevalence and severity were compared according to Ad37+.Sixty-five of 268 patients were Ad37+ and 82/268 patients were both Ad37 seronegative (Ad37-) and Ad36-. The prevalence of obesity, defined as body mass index≥30, was not significantly different in Ad37+ (11/65; 16.9%) vs. Ad37- (15/82; 18.2%) patients; Bright Liver was present in 22/65 (33.8%) Ad37+ patients vs. 13/82 (15.8%) Ad37- patients (P0.019). By odds ratio (OR), a consistent risk for NAFLD was associated with Ad37+, greater insulin resistance, and C-reactive protein. By a predictive multiple linear regression model, 40.0% of variance toward NAFLD and 50.4% toward the severity of Bright Liver score was explained significantly and independently by Ad37+ and by body mass index.Ad37+ status in nondiabetic patients on an appropriate diet is significantly associated with NAFLD; because fatty liver improves even without weight loss by a "healthy" diet, and not only by lower food caloric intake, Ad37+ may be an adjunctive hallmark of an unfavorable clinical-metabolic profile, if not a causative factor of NAFLD.

Relationships of renal function and liver disease are described in acute and chronic liver failure. The aim of the study is to investigate which relationship, if any, is present between severity of non-alcoholic fatty liver disease (NAFLD), assessed by bright liver score (BLS) versus mild-moderate renal insufficiency assessed by glomerular filtration rate (GFR) and by ultrasound intra-renal arterial resistive index (RRI). Moreover, which difference, if any, can be found in NAFLD patients with normal versus increased transaminases.The study enrolled 323 NAFLD and 176 non-NAFLD consecutive patients, comparable for age, gender distribution, GFR, and RRI referred to a university clinical day hospital after an ultrasound diagnosis of bright liver, for clinical-nutritional counselling. Personalized computerized mediterranean diet, physical activity increase, and smoking withdrawal integrated counselling were provided.In NAFLD patients, homoeostasis model (HOMA) has a significant correlation with BLS. According to the severity of BLS, grade II-III versus grade I patients have significantly higher values of HOMA, body mass index (BMI), triglycerides, and longitudinal right liver length. By odds ratio, more severe BLS, increased HOMA, and transaminases are associated with lower GFR. Increased transaminases are associated with higher grades of BLS, HOMA, and BMI. By multiple linear regression waist-to-hip ratio, RRI, and BLS, as significant independent factors (p 0.0001), explain significantly variance to GFR. This is not observed in normal control group, in which only RRI is a factor explaining GFR.Greater RRI, abdominal obesity, and greater BLS account for a lower GFR in NAFLD patients suggesting the hypothesis that inter-related factors can be operating early in the natural history of obesity-related kidney and liver disease.

A symmetric Ramsey-Borde (Mach-Zehnder geometry) atom interferometer is studied as gravitational wave detector under the hypothesis of shot noise limited sensitivity. Full gauge-invariant response function is deduced via ABCD matrices approach and the resulting sensitivity is analyzed in the frequency domain. As an example, a possible use in a specific frequency range is studied in some detail.

We describe a frequency stabilized diode laser at 698 nm used for high resolution spectroscopy of the 1S0-3P0 strontium clock transition. For the laser stabilization we use state-of-the-art symmetrically suspended optical cavities optimized for very low thermal noise at room temperature. Two-stage frequency stabilization to high finesse optical cavities results in measured laser frequency noise about a factor of three above the cavity thermal noise between 2 Hz and 11 Hz. With this system, we demonstrate high resolution remote spectroscopy on the 88Sr clock transition by transferring the laser output over a phase-noise-compensated 200 m-long fiber link between two separated laboratories. Our dedicated fiber link ensures a transfer of the optical carrier with frequency stability of 7 \cdot 10^{-18} after 100 s integration time, which could enable the observation of the strontium clock transition with an atomic Q of 10^{14}. Furthermore, with an eye towards the development of transportable optical clocks, we investigate how the complete laser system (laser+optics+cavity) can be influenced by environmental disturbances in terms of both short- and long-term frequency stability., 9 pages, 9 figures, submitted to Appl. Phys. B

The study investigates lifestyle and effective anti-hypertensive intervention in overweight-obese patients can influence insulin-resistance (HOMA-IR) and US Renal-Resistive-Index (RRI). After a 1-year interventional program (including a personalized Mediterranean diet, physical activity increase, smoking withdrawal counseling), 156 Essential Hypertension (EH) patients still have abnormal HOMA-IR, significantly higher in comparison to 159 control group patients. Body mass index (BMI) and cholesterol-high-density-lipoprotein improvement are the best predictors of a HOMA-IR decrease; RRI improves in EH according to lifestyle interventions, but no predictor to RRI is identified. Persistence of IR can be tentatively assumed as a steady sign, persistent also after extended lifestyle intervention in EH, further warranting more intensive dietary interventions.