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Pyrolysis of lignocellulosic biomass and waste plastics has been intensely studied in the last few decades to obtain renewable fuels and chemicals. Various pyrolysis devices have been developed for use in a laboratory setting, operated either in batch or continuously at scales ranging from milligrams per hour to tenths of g per hour. We report here the design and operation of a novel staged free-fall (catalytic) pyrolysis unit and demonstrate that the concept works very well for the (catalytic) pyrolysis of pinewood sawdust, paper sludge, and polypropylene as representative feeds. The unit consists of a vertical tube with a pretreatment section, a pyrolysis section, a solid residue collection section, a gas–liquid separation/collection section, and a catalytic reaction section to optionally perform ex situ catalytic upgrading of the pyrolysis vapor. The sample is placed in a tube, which is transported by gravity through various sections of the unit. It allows for rapid testing with semicontinuous feeding (e.g., 50 g h–1) and the opportunity to perform reactions under an (inert) gas (e.g., N2) at atmospheric as well as elevated pressure (e.g., 50 bar). Liquid yields for noncatalytic sawdust pyrolysis at optimized conditions (475 °C and atmospheric pressure) were 63 wt % on biomass intake. A lower yield of 51 wt % (on a biomass basis) was obtained for the noncatalytic pyrolysis of paper sludge, likely due to the presence of minerals (e.g., CaCO3) in the feed. The possibility of using the unit for ex situ catalytic pyrolysis (pyrolysis at 475 °C and catalytic upgrading at 550 °C) was also successfully demonstrated using paper sludge as the feed and H-ZSM-5 as the catalyst (21 wt % catalyst on biomass). This resulted in a biphasic liquid product with 25.6 wt % of an aqueous phase and 11 wt % of an oil phase. The yield of benzene, toluene, and xylenes was 1.9 wt % (on a biomass basis). Finally, the concept was also proven for a representative polyolefin (polypropylene), both noncatalytic as well as in situ catalytic pyrolysis using H-ZSM-5 as the catalyst at 500 °C. The liquid yield of thermal, noncatalytic plastic pyrolysis was as high as 77 wt % on plastic intake, while in situ catalytic pyrolysis gave a combined 7.8 wt % yield of benzene, toluene, and xylenes on plastic intake.

Purpose: Nearly, 40% of the causes of male infertility remain idiopathic. The only suggested treatment in idiopathic oligo- and/or asthenozoospermia in normogonadotropic patients is the FSH. In the current clinical practice, efficacy is exclusively assessable through semen analysis after 3 months of treatment. No molecular markers of treatment efficacy are appliable in clinical practice. The aim of the present work is to evaluate the combination of extracellular signal regulated kinase (ERK) 1 and 2 and prolactin inducible peptide (PIP) as potential markers of idiopathic infertility and FSH treatment efficacy. Methods: Western blot and confocal microscopy were performed to analyze the modulation of PIP and ERK1/2 in idiopathic infertile patients (IIP) sperm cells. Taking advantage of mass spectrometry analysis, we identified these proteins unequivocally in sperm cells. Results: We demonstrated a significant decrease of both PIP protein and of ERK1/2 levels in spermatozoa obtained from IIP in comparison to healthy fertile patients (HFP). Conversely, we reported a significant increase of these markers comparing infertile patients before and after 3 months of FSH treatment. Importantly, this correlated with an increase in total number of sperm and sperm motility after FSH treatment. Finally, we identified of PIP and ERK2 proteins in sperm samples by proteomic analysis. Conclusions: The combined evaluation of ERK1/2 and PIP proteins might represent a useful molecular marker to tailor FSH treatment in the management of male normogonadotropic idiopathic infertility.

Introduction: Worldwide, arterial hypertension is the foremost preventable and modifiable cardiovascular risk factor. In addition to lifestyle changes, recent international guidelines recommend single-pill, low-dose combinations as initial treatment strategy. We investigated whether this approach is feasible in a rural sub-Saharan Africa setting. Methods: Diagnosis of hypertension was established over three sets of blood pressure measurements, performed according to the European Society of Hypertension recommendations by trained personnel, using a validated, automated, oscillometric device OMRON M7 IT-HEM-7322-E. In 98 individuals with arterial hypertension, a once-daily, single-pill combination of olmesartan, amlodipine, and hydrochlorothiazide was prescribed at an appropriate dose. Patients were instructed on its administration and potential side effects and encouraged towards lifestyle modifications. The treatment regimen was adjusted, if needed, at each outpatient clinic scheduled after 4, 8, 12, and 16 weeks. Results: Seventy-nine patients (aged 61 [53–70] years; median and interquartile range) strictly adhered to the treatment schedule, while 19 individuals (70 [65–80] years) dropped out. Blood pressure was < 140/90 mmHg after 4 weeks in 44 (56%), after 8 weeks in 62 (78%), after 12 weeks in 69 (87%), and after 16 weeks in 74 (94%) participants. Excellent tolerance was reported. Conclusions: These results provide real-life evidence that hypertension management with a once-daily, single-pill combination of olmesartan, amlodipine, and hydrochlorothiazide as initial treatment is feasible and effective also in a rural sub-Saharan setting. Single-pill combinations should be made available also in rural and remote areas in low- and middle-income countries as a reliable first-line treatment strategy.

In rural sub-Saharan Africa, knowledge of non-communicable diseases such as high blood pressure (BP) is rather limited. This report provides information about a BP screening in Mata Sector, a rural region in Southern Province of Rwanda. Community-based, house-to-house screening was performed between February and July 2020 on more than 7000 inhabitants. The screening was conducted by a local team composed by 20 community health care workers, five community health care supervisors, and one nurse with hypertension surveillance training. BP and heart rate were recorded after 5 min of resting, using a validated automated oscillometric OMRON M6 IT-HEM-7322-E monitor with Intelli Wrap Cuff (HEM-FL31-E) technology. The mean of the second and third value was retained. BP was normal (<140/90 mm Hg) in 6340 (88%) and elevated in 863 (12%) participants with 95% of unawareness. Grade 1 (140–159/90–99 mm Hg) hypertensive BP readings were detected in 697 (81%), grade 2 (160–179/100–109 mm Hg) in 134 (16%), and grade 3 (≥180/≥110 mm Hg) in 32 (3.7%) individuals. The prevalence of hypertensive readings was significantly age-dependent. Additionally, a slightly greater proportion of participants with high BP (14% versus 11%) had a body mass index (BMI) ≥ 25.0 kg/m2. Also resting heart rate was higher in individuals with high BP (82 versus 77 beats/min). Although individuals identified with occasionally elevated BP values need further confirmatory measurements to establish the diagnosis of hypertension, these data suggest that high BP represents a noteworthy and preventable reason of concern within sub-Saharan Africa.

In their CMAJ article, Arya and colleagues (1) mention the ways in which Italy has dealt with the coronavirus disease 2019 (COVID-19) pandemic: the authors' statement that 'many older patients [...]

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality. Besides traditional cardiovascular risk factors, arterial stiffness is a recognized predictor of cardiovascular risk. Methods: We investigated the relationship between traditional cardiovascular risk factors, sex, and aortic pulse wave velocity in subjects living in a countryside area of Southern Switzerland. For this aim, we performed a cross-sectional analysis of data from adult participants of the Swiss Longitudinal Cohort Study, which, initiated in 2015, follows health status and disease risk factors in a Swiss countryside cohort at least 6 years of age. Results: A total of 387 people (205 women and 182 men) were included. Hyperlipidemia, overweight, and obesity were more common (p≤ 0.001) and LDL-cholesterol, triglycerides, and hemoglobin A1c were higher (p&lt; 0.03) in men than women. Systolic and diastolic brachial and aortic blood pressures were higher in men (p&lt; 0.02), whereas aortic pulse wave velocity and aortic pulse pressure were higher in women (p&lt; 0.05). The aortic pulse wave velocity was significantly higher in subjects with hypertension, hyperlipidemia, diabetes, and obesity, and significantly increased with age (p&lt; 0.0001). Multiple linear regression analysis showed a significant correlation between pulse wave velocity and age, female sex, brachial systolic blood pressure, and heart rate (p&lt; 0.005). Conclusion: Also in a countryside area, the aortic pulse wave velocity is higher in subjects with hypertension, hyperlipidemia, diabetes and obesity, and significantly increases with age. Furthermore, with advancing age, aortic pulse wave velocity is higher in women than men. Trial Registration: ClinicalTrials.gov identifier, NCT02282748.

• Magnetite pellet feed recovery from chalcopyrite dam copper flotation tailings.

Objective: Ibuprofen is a widely used nonsteroidal anti-inflammatory drug, which has been occasionally associated with hypokalemia and metabolic acidosis. The objective of this report is to analyze the literature on this issue and to address the underlying pathophysiology.Data Sources: Excerpta Medica, the National Library of Medicine, and Web of Science were searched from inception to July 16, 2021.Study Selection and Data Extraction: Papers reporting individually documented humans on ibuprofen with hypokalemia, acidosis, or both were retained. Data were extracted using a checklist.Data synthesis: For the final analysis, we evaluated 41 reports describing 50 cases (26 males and 24 females; 36 adults and 14 children) with often profound hypokalemia, acidosis, or both after ingestion of ibuprofen. Twenty-six cases were acute and 24 long term. Hypokalemia and acidosis occurred not only after ingestion of very high doses but also after ingestion of moderately high or even normal doses of ibuprofen. Laboratory values consistent with an excessive urinary potassium excretion or an altered urinary acidification were often disclosed in most cases. Discontinuation of ibuprofen resulted in a resolution of hypokalemia and acidosis within days in 47 cases. The course was lethal in 3 cases.Relevance to Patient Care and Clinical Practice: This review highlights potentially fatal side effects of ibuprofen and can help doctors who are confronted with such a situation.Conclusions: These data highlight the potential of ibuprofen to occasionally induce hypokalemia and acidosis of renal origin. Discontinuation of ibuprofen results in a resolution within days.

Nach unfallbedingtem Frontzahnverlust eines bleibenden Zahns bis zum 10. Lebensjahr stehen der Zahnärztin bzw. dem Zahnarzt nur wenige Behandlungsmöglichkeiten zur Verfügung, um den fehlenden Zahn festsitzend zu ersetzen, die Ästhetik wiederherzustellen und den Fortschritt des lokalen Kieferwachstums zu erhalten. Eine Milcheckzahntransplantation sollte in diesem Zusammenhang mit allen Beteiligten zumindest diskutiert werden. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2008.01683.x Byline: Piera Ranieri (*[dagger]), Angelo Bianchetti (*[dagger]), Alessandro Margiotta (*[dagger]), Adriana Virgillo (*[dagger]), Enrico M. Clini ([double dagger]), Marco Trabucchi ([dagger]) Keywords: COPD exacerbation; 6-month mortality; elderly; frailty Abstract: OBJECTIVES: To identify clinical outcomes and variables associated with 6-month mortality in very elderly patients admitted for nonacidotic acute exacerbation of chronic obstructive pulmonary disease (AECOPD). DESIGN: Prospective cohort study. SETTING: General medicine acute care ward. PARTICIPANTS: Two hundred forty-four elderly patients with COPD (mean age[+ or -]standard deviation 82[+ or -]7, 55.7% female) admitted to the hospital because of non-acidotic AECOPD. MEASUREMENTS: Cognitive and mood status and physiological variables were measured. Self-reported comorbidities were assessed using the Charlson Comorbidity Index. In-hospital and long-term mortality and clinical outcomes were recorded. RESULTS: At admission, this elderly population with AECOPD had low cognitive performance (mean Mini-Mental State Examination score 21[+ or -]5), no presence of significant depressive symptoms (Geriatric Depression Scale score 4[+ or -]3), good nutritional status (body mass index (BMI) 25.1[+ or -]5.5), moderate comorbidity (Charlson Comorbidity Index 4.0[+ or -]1.9), high functional disability (Barthel Index (BI) 52[+ or -]34), and moderate severity of acute exacerbation (Acute Physiology and Chronic Health Evaluation (APACHE) II score 9.7[+ or -]4.2). Two hundred twenty-five inpatients with AECOPD were successfully discharged, whereas 15 were transferred to the intensive care unit, and four died in the hospital. The 6-month cumulative mortality rate in discharged patients with AECOPD was 20%. Multivariate Cox analysis shows that lower BMI ([beta]=-0.16; 95% confidence interval (CI)=0.73-0.99), higher APACHE II score ([beta]=0,17; 95% CI=1.03-1.36), and lower BI at discharge ([beta]=-0.02; 95% CI=0.96-0.99) were independently associated with 6-month mortality. CONCLUSION: Malnutrition, severity of exacerbation and disability status could be identified as risk factors associated with 6-month mortality of elderly patients admitted for nonacidotic AECOPD. Author Affiliation: (*)Department of Internal Medicine, Istituto Clinico S. Anna, Brescia, Italy ([dagger])Geriatric Research Group, Brescia, Italy ([double dagger])Department of Oncology and Pneumology, University of Modena-Reggio Emilia, Modena, Italy. Article note: Address correspondence to Piera Ranieri, MD, Geriatric Research Group, via Romanino 1, 25121 Brescia, Italy. E-mail: piera.ranieri@grupposandonato.it

Caregivers may assess the activities of daily living (ADLs) in dementia patients differently than independent observers. Depending on the sense of burden and depression reported by the caregivers of 111 dementia patients, agreement of ADLs varied widely except on motor performance (walking). Specifically, observed handling of money, toilet or telephone use, and shopping skills differed from the generally poorer impressions of caregivers. Discrepancies between ADL scores were often related to the demands placed on the caregiver's time.

The shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora.

Evans syndrome (ES) is a rare condition, defined as the presence of 2 autoimmune cytopenias, most frequently autoimmune hemolytic anemia and immune thrombocytopenia (ITP) and rarely autoimmune neutropenia. ES can be classified as primary or secondary to various conditions, including lymphoproliferative disorders, other systemic autoimmune diseases, and primary immunodeficiencies, particularly in children. In adult ES, little is known about clinical features, disease associations, and outcomes. In this retrospective international study, we analyzed 116 adult patients followed at 13 European tertiary centers, focusing on treatment requirements, occurrence of complications, and death. ES was secondary to or associated with underlying conditions in 24 cases (21%), mainly other autoimmune diseases and hematologic neoplasms. Bleeding occurred in 42% of patients, mainly low grade and at ITP onset. Almost all patients received first-line treatment (steroids with or without intravenous immunoglobulin), and 23% needed early additional therapy for primary refractoriness. Additional therapy lines included rituximab, splenectomy, immunosuppressants, thrombopoietin receptor agonists, and others, with response rates >80%. However, a remarkable number of relapses occurred, requiring ≥3 therapy lines in 54% of cases. Infections and thrombotic complications occurred in 33% and 21% of patients, respectively, mainly grade ≥3, and correlated with the number of therapy lines. In addition to age, other factors negatively affecting survival were severe anemia at onset and occurrence of relapse, infection, and thrombosis. These data show that adult ES is often severe and marked by a relapsing clinical course and potentially fatal complications, pinpointing the need for high clinical awareness, prompt therapy, and anti-infectious/anti-thrombotic prophylaxis.

Quasi Monte Carlo (QMC) and Global Sensitivity Analysis (GSA) techniques are applied to pricing and hedging of representative financial instruments with increasing complexity. We compare standard Monte Carlo (MC) vs. QMC results using Sobol' low‐discrepancy sequences, different sampling strategies, and various analyses of performance. We find that QMC outperforms MC in most cases, including the highest‐dimensional simulations, showing faster and more stable convergence. Regarding greeks computation, we compare standard approaches, based on finite difference (FD) approximations, with Adjoint Algorithmic Differentiation (AAD) methods providing evidence that, when the number of greeks is small, switching from MC to QMC simulation, the FD approach can lead to the same accuracy as AAD, thanks to increased convergence rate and stability, thus saving a lot of implementation effort while keeping low computational cost. Using GSA, we are able to fully explain our findings in terms of reduced effective dimension of QMC simulation, allowed in most cases by Brownian bridge discretization or Principal Component Analysis (PCA) construction. We conclude that, beyond pricing, QMC is a very efficient technique also for computing risk measures, greeks in particular, as it allows us to reduce the computational effort of high‐dimensional Monte Carlo simulations typical of modern risk management.

The impact of iridium (Ir) doping on the oxygen vacancies, relative stability, crystallite size, surface area, and anatase-to-rutile transition of TiO2was comprehensively investigated in this study. Ir-doped TiO2(Ir-TiO2) was synthesized through a sol–gel technique, and the samples were annealed in the temperature range of 400–700 °C. Density functional theory calculations showed that the energy cost of an oxygen vacancy formation for Ir-TiO2was lower, as compared to that of the pristine TiO2, with the formation of Ir3+states in the band gap. Ir could provide more rutile nucleation sites and accelerate the rutile formation through the crystal strain relaxation. The entropy of mixing was reduced by the incorporation of Ir, which could induce the rutile formation with an increase in Gibbs free energy at temperatures below the normal phase transition temperature for pure TiO2. The rutile formation of Ir-TiO2could take place at a low annealing temperature (400 °C) compared to pristine TiO2(600 °C), indicating that the activation energy for phase transition could be decreased by incorporating Ir. XPS revealed the spin–orbit coupling of Ir 4f peaks, Ir 4f7/2(61.96 eV) and Ir 4f5/2(64.77 eV), due to the presence of Ir3+. Raman studies indicated the formation of charge-compensating oxygen vacancies and the presence of d states by Ir doping. It is concluded that the defects originated because the incorporation of Ir could facilitate rutile nucleation sites and thereby accelerate the phase transition through strain relaxation.

To Niagara Mohawk Power Corporation's nuclear division (NM-Nuclear), the numbers have taken on a significance like the "billions sold" sign under McDonald's golden arches. The 1,200-member generating staff of the [...]

Background: COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. Aims: To evaluate the impact of COVID-19 on health status in home-dwelling patients. Methods: 848 home-dwelling outpatients with dementia contacted from April 27 to 30 and evaluated by a semi-structured interview to evaluate possible health complication due to COVID-19 from February 21 to April 30. Age, sex, education, clinical characteristics (including diagnosis of dementia) and flu vaccination history were obtained from previous medical records. Items regarding change in health status and outcome since the onset of the outbreak were collected. COVID-19 was diagnosed in patients who developed symptoms according to WHO criteria or tested positive at nasal/throat swab if hospitalized. Unplanned hospitalization, institutionalization and mortality were recorded. Results: Patients were 79.7 years old (SD 7.1) and 63.1% were females. Ninety-five (11.2%) patients developed COVID-19-like symptoms. Non COVID-19 and COVID-19 patients differed for frequency of diabetes (18.5% vs. 37.9%, p &lt; 0.001), COPD (7.3% vs. 18.9%, p&lt; 0.001), and previous flu vaccination (56.7% vs. 37.9%, p&lt; 0.001). Diabetes and COPD were positively associated with COVID-19, whereas higher dementia severity and flu vaccination showed an inverse association. Among COVID-19 patients, 42 (44.2%) were hospitalized while 32 (33.7%) died. Non COVID-19 patients’ hospitalization and mortality rate were 1.9% and 1.2%, respectively. COVID-19 and COPD were significantly associated with the rate of mortality. Discussion/conclusions: A high proportion of adverse outcome related to COVID-19 was observed in home-dwelling elderly patients with dementia. Active monitoring though telehealth programs would be useful particularly for those at highest risk of developing COVID-19 and its adverse outcomes.

The question of when and how to drain a malignant biliary obstruction (MBO), both intrinsic or extrinsic, remains a controversial point among endoscopists. An important factor that influences the decision to drain an MBO or not is if the patient is a surgical candidate or not and, in the former case, if the patients must undergo neoadiuvant chemotherapy or not. Other questions arising during biliary drainage in MBO patients is which type of stent should be chosen, plastic or metal, and if endoscopic biliary sphincterotomy must be performed or not when a stent is placed. The present review attempts to answer these questions and summarizes the optimal approach toward patients with MBO based on the available evidence.

The SARS-CoV-2 pandemic has led to a dramatic crisis of Health Care Systems worldwide, and older people have been among the most disadvantaged. Specific recommendations and reports have been released both at International and National level, regarding the diagnosis and management of COVID-19 in the elderly. However, little has been proposed for an appropriate response to older, frail and multimorbid patients in different settings of care (acute care units, long term care facilities, nursing homes and primary care) and for the management of geriatric syndromes (i.e. delirium, sarcopenia, falls). We presume that the current pandemic of will leads to substantial changes in health care systems, and we suggest some key guide principles that could inspire the provision of healthcare services to older people and their families. These principles are primarily directed to physicians and nurses working in the geriatric field but could also be useful for other specialists.

Background: Hip fractures (HF) are a major issue worldwide. We aimed at evaluating the practices in delivering care to patients with HF among several Italian Orthogeriatric centers. Methods: The study took place from February 2016 to July 2018. Seven performance indicators (pre-surgical cognitive assessment, surgery performed ≤ 48 h from fracture, removal of urinary catheter/absence of delirium/start of physiotherapy on the first post-operative day, prescription of bone protection at discharge, and discharge toward rehabilitation) were collected. Results: The 14 participating hospitals totally recruited 3.017 patients. Patients were old (median age 86 years; Inter Quartile Range [IQR] 80–90), mostly females (77%). Nearly 55% of them were already impaired in mobility and about 10% were nursing home residents. Median time-to-surgery was 41 h (IQR 23–62). Models of care greatly varied among centers, only 49.3% of patients being co-managed by geriatricians and orthopedics. There was high variability across centers in four indicators (“pre-surgical cognitive assessment”, “bone protection prescription”, “use of urinary catheter” and “start of physiotherapy”), moderate in two indicators (“surgery performed ≤ 48 h from fracture” and “discharge toward rehabilitation” and low in one (“absence of delirium on day following surgery”). Comparison with international studies suggests very different ways of providing care to HF Italian patients. Conclusions: The study results suggest high inter-center variability in the key-performance indicators, and different approaches in providing care to our HF patients in comparison to other countries. A National debate on the topic is required in Italy to harmonize practices of orthogeriatric care.

The use of technologies based on soft polymer particles represents an effective way to deliver target molecules with a specific function. To design a well-performing delivery system, it is fundamental to rationalize both the aggregation and the structural properties of such particles. In this study, we present the kinetic and structural characterization over time of poly(vinyl alcohol) (PVA) microgels obtained through a salting-out process in the presence of NaCl. We have analyzed how both the polymer and salt concentrations affect the aggregation process. The aggregation rate as well as the morphology and physico-chemical parameters, such as mass and chain density of the microgels, have been determined through static and dynamic light scattering and discussed in the framework of the diffusion-limited and reaction-limited colloid aggregation. Insights into the polymer chain arrangements and their dynamics have been gained by means of small-angle neutron scattering and neutron spin-echo measurements. As a result, it was found that NaCl induces a liquid phase separation in solution with the formation of spherical PVA microaggregates, which grow under a reaction-limited aggregation mechanism. The particles increase their size and compactness over time. Within the aggregate, the polymer chains are locally organized to form randomly oriented lamellae with a thickness of about 60 Å. The internal dynamics is a complex mixture of diffusion, Zimm dynamics, and possibly effects from crowding with the transition to a Rouse-like behavior. The microparticle preparation based on the salting-out process constitutes a novelty, if compared to the methods already existing and based on the use of chemical cross-linkers, and is a cheap and easy protocol that allows tuning both particle size and density by varying the salt concentration.

Polyphenols are a class of natural compounds that act as antioxidants, neutralising harmful free radicals that would damage cells and increase the risk of diseases such as cancer, diabetes and heart disease. They also reduce inflammation, which is thought to be at the root of many chronic diseases.

•This is the first multicenter study to assess the prevalence of motor subtypes of delirium in older patients admitted to acute hospital and rehabilitation settings.•The most frequent delirium subtype was the hypoactive delirium followed by the mixed, hyperactive and non-motor subtype of delirium.•All three delirium motor subtypes were associated with pre-existing dementia.•Atypical antipsychotics were statistically less likely to be prescribed for patients identified with hypoactive delirium.•Mixed delirium was associated with an increased number of intravenous lines.

Monitoring the assembly of macromolecules to design entities with novel properties can be achieved either chemically creating covalent bonds or by noncovalent connections using appropriate structural motifs. In this report, two self-associating peptides (named K3 and E3) that originate from p53 tetramerization domain were developed as tools for highly specific and noncovalent heterotetramerization of two biomolecules. The pairing/coupling preferences of K3 and E3 were first evaluated by molecular modeling data and confirmed using circular dichroism spectroscopy, size-exclusion chromatography, and biological assays. Regardless of the moieties fused to K3 and E3, these two peptides self-assembled into dimers of dimers to form bivalent heterotetrameric complexes that proved to be extremely stable inside living cells. The benefits of the multivalency in terms of avidity, specificity, and expanded functional activity were strikingly revealed when the proliferating cell nuclear antigen (PCNA), which is essential for DNA replication, was targeted using a heterotetramer presenting both an antibody fragment against PCNA and a specific PCNA binder peptide. In vitro heterotetramerization of these two known PCNA ligands increased their binding efficiencies to PCNA up to 80-fold compared to the best homotetramer counterpart. In cellulo, the heterotetramers were able to efficiently inhibit DNA replication and to trigger cell death. Altogether, we demonstrate that these two biselective self-assembling peptidic domains offer a versatile noncovalent conjugation method that can be easily implemented for protein engineering.

Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. This analysis, from the “Delirium Day 2015”, a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4: possible delirium; scores 1–3: possible cognitive impairment). Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19–2.16) and delirium (2.45, 95% CI 1.73–3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52–3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1–3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence.

This paper looks at the relationship between project and rights. At first, it discusses the redefinition of housing rights in the space of the city, by observing a workers' district of Geneva, the neighborhood of Les Grottes, that was the object of struggles and occupations in the eighties. Today it is an eco-neighborhood like many in Europe, where the right to housing, forcefully demanded during the past urban struggles, has broken down into an ensemble of superimposed fragments. Pluralization of the right to housing refers to two different perspectives. The first originates from the influence of social analysis, according to which our current condition is an expression of neo-liberal policies. In this perspective, the broken down of rights is the other side of rights retraction of its modern form. The second refers to pragmatism and its democratic individualism. Here the multiplication of subjective rights, no longer hierarchical or competitive, is an expression of what each individual considers a right way of living. The project needs to be prepared to manage any gaps arising between these dimensions. [ABSTRACT FROM AUTHOR]

We assess and discuss several technical aspects of the multifractal statistical analysis applied to time series of dynamic speckle intensity signals. Due to the complexity of this goal, we implemented an optical setup that mimics the light scattering effect from the illuminated object using a spatial light modulator. The multifractal spectrum of the obtained dynamic speckle intensity signals is quantified by utilizing a mathematical framework based on the decomposition of wavelet leaders’ functions. The propagated light that is scattered utilizing the spatial light modulator verifies the well-known first- and second-order statistics of the obtained speckle images and also a given temporal correlation function determined by a copula algorithm adding several classes of fractional Gaussian noises. To experimentally implement these issues, we load appropriate dynamic temporal phase screens in the spatial light modulator working on phase-only mode and guide the light propagation through an optical setup composed of a 4f correlator. Different types of statistical trends in the scaling properties as a function of frequency sampling, intensity signal discretization, mean size of speckle, temporal correlation length, and vanishing moments of the elected mother wavelet analysis are theoretically and experimentally tested and compared.

The purpose of this study was to examine the tools used in Italy to diagnose mild cognitive impairment (MCI). In collaboration with the Luigi Amaducci Research Consortium, the Italian Network of Alzheimer Evaluation Units prepared a questionnaire to describe how MCI is diagnosed in the Italian Centres for cognitive disorders and dementia (CCDD). Most of the ninety-two CCDDs participating in the survey were located in hospitals (54.7%); large percentages were coordinated by neurologists (50.8%) and geriatricians (44.6%). Almost all (98.5%) used the Mini Mental State Examination to diagnose MCI; the Clock Drawing Test was also frequently used (83.9%). Other neuropsychological, imaging and biomarker tests were utilized less frequently and a wide diversity in the instruments used was noted. According to the results, diagnoses of MCI are based on a multitude of instruments, with major differences in the clinical assessment of geriatricians and neurologists. Standardized testing protocols, validated instruments and cut-off points need to be identified and adopted by the CCDDs for assessing MCI.

Intestinal infections caused by a shigatoxin-positive Escherichia coli(mostly of the serogroups O26, O45, O103, O111, O121, O145 and especially O157) are a common cause of hemolytic-uremic syndrome. Hemolytic-uremic syndrome was first linked with an E. coliurinary tract infection 40 years ago. We conducted a systematic review of the literature addressing the association between E. coliurinary tract infection and hemolytic-uremic syndrome. For the final analysis, we retained 23 original reports published since 1979. Five unselected pediatric case series addressed the possible occurrence of hemolytic-uremic syndrome after an acute symptomatic E. coliurinary tract infection among 266 cases and found the mentioned association in 8 (3.0%) cases. We also found 28 individual cases (17 females and 11 males) of hemolytic-uremic syndrome preceded by an E. coliurinary tract infection: 16 children aged from 2 days to 6.0 years and 12 adults aged from 22 to 75 years. Testing for shigatoxin, performed in 19 cases, was positive in 15 cases. E. coliserotyping was performed in 18 cases: testing for serotype O157, O103 and O145 was positive in one, one and two cases, respectively, while testing for serotype O26, O45, O111 and O121 was always negative. Hemolytic-uremic syndrome rarely occurs after an acute E. coliurinary tract infection. It affects both children and adults and is mostly caused by germs that are shigatoxin-positive.

Background

It's still not clear whether results in secondary care translate to primary care EDITOR--Kalra et al's paper looking at the efficacy of anticoagulation for stroke prevention in atrial fibrillation[1] essentially [...]

In the confined zone between a bidimensional material and a metal surface, unexpected effects can take place. In this study, we show that when a nonregular two-dimensional h-BN layer is grown on a Cu(111) surface, metal adatoms spontaneously pop up from the bulk to fill the holes in the structure. We provide ample theoretical support to our findings based on a large set of dispersion-corrected density functional theory calculations and on a detailed analysis of the electronic properties and of the chemical processes at this peculiar interface. The observation can be rationalized in terms of a high affinity of Cu adatoms toward N-donor species. Defective h-BN, exposing N-terminated edges, behaves like a giant multi-N-donor macrocyclic ligand that can encapsulate metal atoms as a consequence of a huge stabilization deriving from the Cu–N bond formation. Our conclusions could apply to other metal surfaces and could even stimulate the idea of trapping different metal atoms from those of the underlying surface (e.g., more precious but more active metals) for catalytic purposes.

BackgroundIn an attempt to improve knowledge about childhood Goodpasture’s disease, we performed a retrospective analysis of patients with Goodpasture’s disease from several pediatric nephrology centers.MethodsWe analyzed the responses to 27 questions that elicited information about the following: incidence, demographics, patient history and clinical presentation, diagnostics performed, acute and chronic therapy, course of disease, and outcome.ResultsGoodpasture’s disease, which is extremely rare in this age group, may manifest in 2-year-old toddlers and does not typically present with pulmonary findings before puberty. Goodpasture’s disease has a poor outcome with more than 50% of patients progressing to end-stage renal disease. No deaths were reported in this cohort, and renal improvement was observed in children with severe biopsy findings who required renal replacement therapy during the acute phase.ConclusionThe present investigation gives detailed information about childhood Goodpasture’s disease under real-life conditions and reveals that very few pediatric cases have been reported. Nearly 50% of children progressed to end-stage renal disease. However, long-term outcome in children might be better than in adults. Aggressive immunosuppressive therapy might be necessary for all affected children, even in patients who require renal replacement therapy or have severe biopsy findings.

Certain features of the social environment could maintain and even improve not only psychological well-being, but also health and cognition of the elderly. We tested the association between social network characteristics and the number of chronic diseases in the elderly. A randomized sample of the elderly population of Brescia, Italy, was evaluated (N= 200, age ≥65 years). We performed a comprehensive geriatric assessment, including information on socio-demographic variables (family, friendships, and acquaintance contacts). We measured each person’s social network, i.e., degree, efficiency, and variety. The sample included 118 women and 82 men, mean age 77.7 years. The mean number of chronic diseases was 3.5. A higher social network degree, i.e., more social connections, was associated with fewer diseases. We also found that having more contacts with people similar to each other or intense relationships with people who do not know each other were associated with fewer diseases. More healthy people tend to share certain characteristics of social networks. Our study indicates that it is important to look at diseases and health as complex phenomena, which requires integrating different levels of analysis.

The physio-pathologic interrelationships between endothelium and GvHD have been better elucidated and have led to definition of the entity ‘endothelial GvHD’ as an essential early phase prior to the clinical presentation of acute GvHD. Using the CellSearch system, we analyzed circulating endothelial cells (CEC) in 90 allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients at the following time-points: T1 (pre-conditioning), T2 (pre-transplant), T3 (engraftment), T4 (onset of GvHD) and T5 (1 week after steroid treatment). Although CEC changes in allo-HSCT represent a dynamic phenomenon influenced by many variables (that is, conditioning, immunosuppressive treatments, engraftment syndrome and infections), we showed that CEC peaks were constantly seen at onset of acute GvHD and invariably returned to pre-transplant values after treatment response. Since we showed that CEC changes during allo-HSCT has rapid kinetics that may be easily missed if blood samples are drawn at pre-fixed time-points, we rather suggest an ‘on demand’ evaluation of CEC counts right at onset of GvHD clinical symptoms to possibly help differentiate GvHD from other non-endothelial complications. We confirm that CEC changes are a suitable biomarker to monitor endothelial damage in patients undergoing allo-transplantation and hold the potential to become a useful tool to support GvHD diagnosis (ClinicalTrials.gov NCT02064972).

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02581.x Byline: Piera Ranieri (*[dagger]), Angelo Bianchetti (*[dagger]), Davide Robecchi ([double dagger]), Marco Trabucchi (s.) Author Affiliation: (*)Department of Internal Medicine, Istituto Clinico S. Anna, Brescia, Italy ([dagger])Geriatric Research Group, Brescia, Italy ([double dagger])Department of Radiology, Istituto Clinico S. Anna, Brescia, Italy (s.)Geriatric Research Group, Brescia, Italy

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02337.x Byline: Piera Ranieri (*[dagger]), Angelo Bianchetti (*[dagger]), Marco Trabucchi ([dagger]) Author Affiliation: (*)Department of Internal Medicine, Istituto Clinico S. Anna, Brescia, Italy ([dagger])Geriatric Research Group, Brescia, Italy