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The anticoccidial activity of thymol, carvacrol, and saponins was assessed in an in vitro model of coccidiosis. Eimeria spp. sporozoites were collected from field samples, characterized and used for 2 different invasion assays on Madin-Darby Bovine Kidney cells (MDBK). The cells were challenged with 5 x 104 sporozoites without (control) or with various treatments: saponins (10 ppm), thymol and carvacrol (7 ppm each), or a combination of saponins, thymol, and carvacrol at 2 doses; MIX 1 (saponins 5 ppm, thymol 3.5 ppm and carvacrol 3.5 ppm) and MIX 2 (saponins 10 ppm, thymol 7 ppm and carvacrol 7 ppm). The treated cells were incubated at 37°C for 24 hours (invasion assay 1) and for 2, 24, and 48 hours (invasion assay 2). The efficiency of invasion was determined by counting the sporozoites left in the supernatant that were not able to invade the cells, while intracellular Eimeria DNA was detected by qPCR to confirm the data. Data were analyzed with ANOVA and differences were considered significant when p-value was ≤ 0.05. Data from invasion assay 1 showed that the thymol and carvacrol-containing blends significantly reduced invasion, especially in combination with saponins at the highest dose. Saponins alone did not have a strong inhibiting activity but acted synergistically with the other molecules. Interestingly, in invasion assay 2 it was found that the effect of the highest dose of the blend of saponins, thymol and carvacrol was already visible at 2 hours post infection, while the other treatments were significantly successful at 24 hours post infection. The invasion assay protocol was designed to screen molecules in vitro starting from field fecal samples and it can respresent a potential tool in Eimeria research. Moreover this study shows that invasion in MDBK cells by Eimeria sporozoites is inhibited in presence of thymol, carvacrol and saponins, thus highlighting the anticoccidial potential of these compounds.

Necrotic enteritis causes economic losses estimated to be up to 6 billion US dollars per year. Clinical and sub-clinical infections in poultry are also both correlated with decreased growth and feed efficiency. Moreover, in a context of increased antibiotic resistance, feed additives with enhanced antimicrobial properties are a useful and increasingly needed strategy. In this study, the protective effects of a blend of thymol and organic acids against the effects of Clostridium perfringens type A (CP) on chicken intestinal epithelial cells were investigated and compared to bacitracin, a widely used antibiotic in poultry production. Primary chicken intestinal epithelial cells were challenged with CP for a total time of 3h to assess the beneficial effect of two doses of citric acid, dodecanoic acid, and thymol-containing blend, and compare them with bacitracin. During the challenge different parameters were recorded, such as transepithelial electrical resistance, cell viability, mRNA expression, and reactive oxygen species production. CP induced inflammation with cytokine production and loss of epithelial barrier integrity. It was also able to induce reactive oxygen species production and increase the caspase expression leading to cellular death. The high dose of the blend acted similarly to bacitracin, preventing the disruptive effects of CP and inducing also an increase in zonula occludens-1 mRNA expression. The low dose only partially prevented the disruptive effects of CP but successfully reduced the associated inflammation. This study shows that the usage of thymol combined with two organic acids can protect primary chicken intestinal epithelial cells from CP-induced damages creating a valid candidate to substitute or adjuvate the antibiotic treatment against necrotic enteritis.

Through utilizing a mixed-method approach, this study critically reviews and synthesis work-family research in the hospitality contexts. Academic research on work and family relationships of hospitality employees has developed over the last 20 years, and findings have been inconsistent. The present study provides an up-to-date assessment of work-family research in hospitality occupations. First, a narrative literature review identified research progress and trends in terms of publication outlets, research methods, participants, contexts, theories, and terminology. Second, meta-analytic techniques were used to describe the relationships between work-family conflict and some factors that affect it. Both consistent and conflicting information were identified. Work-family conflict significantly relates to employees’ work, family and life attitudes. However, there is no evidence indicating that work-family conflicts vary across demographic groups of employees. Managers in hospitality organizations should notice individually specific work-family episodes of their subordinates and take appropriate actions to provide assistance. This is one of the first studies in tourism and hospitality that offers a synthesis of work-family research in hospitality. It offers specific discussions related to theoretical and practical implications. Suggestions for future research are also provided.

Background context The North American Spine Society's (NASS) Evidence Based Clinical Guideline for the Diagnosis and Treatment of Low Back Pain features evidence-based recommendations for diagnosing and treating adult patients with nonspecific low back pain. The guideline is intended to reflect contemporary treatment concepts for nonspecific low back pain as reflected in the highest quality clinical literature available on this subject as of February 2016. PURPOSE The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with nonspecific low back pain. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition. Study design This is a guideline summary review. Methods This guideline is the product of the Low Back Pain Work Group of NASS’ Evidence-Based Clinical Guideline Development Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questions to address in the guideline. The literature search strategy was developed in consultation with medical librarians. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in webcasts and in-person recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guideline was submitted to an internal and external peer review process and ultimately approved by the NASS Board of Directors. Results Eighty-two clinical questions were addressed, and the answers are summarized in this article. The respective recommendations were graded according to the levels of evidence of the supporting literature. Conclusions The evidence-based clinical guideline has been created using techniques of evidence-based medicine and best available evidence to aid practitioners in the diagnosis and treatment of adult patients with nonspecific low back pain. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flowchart, suggestions for future research, and all of the references, is available electronically on the NASS website at https://www.spine.org/ResearchClinicalCare/QualityImprovement/ClinicalGuidelines.aspx

A functional inequality, called supermigrativity, was recently introduced for bivariate semi-copulas and applied in various problems arising in the study of aging properties of stochastic systems. Here, we revisit this notion and extend it to the case of aggregation functions in higher dimensions. In particular, we show how supermigrativity can be expressed via monotonicity of a function with respect to logarithmic majorization ordering of real vectors. Various alternative characterizations of supermigrativity are illustrated, together with some of its weaker versions. Several examples show similarities and differences between the bivariate and the general case.

Introduction Permanent hearing impairment is the most common sensory disorder in newborns. The Universal Newborn Hearing Screening (UNHS) is widely adopted as a cost-effective procedure to achieve early identification and treatment of congenital hearing impairment, with the final goal of an improved linguistic and cognitive outcome for hearing impaired children. The Italian Ministry of Health has recently comprised UNHS in the Essential Level of Health Assistance. Nevertheless, programs still vary both across and within Italian Regions in terms of coverage, testing, referral and tracking protocols. In Friuli-Venezia Giulia region the program for the early identification of newborn and childhood hearing impairment is operative since 2012. In order to minimize the lost to follow-up cases, UNHS and childhood hearing surveillance activities have been organized in close collaboration among birth centres, paediatric audiology services, territorial Family Paediatricians and the sole regional centre for paediatric hearing loss management. Material and methods We performed a five years’ retrospective analysis of the UNHS experience in Friuli-Venezia Giulia comparing the UNHS activity of year 2013 and year 2017. The focus of the study concerns the “missing” cases. Three different typologies of “miss” cases (“documentation-miss”, “access-miss” and “pathway-miss”) have been defined in correspondence with main reasons for their occurrence. Results Births in Friuli-Venezia Giulia were 9465 and 8432, respectively in 2013 and 2017. International quality indicators improved with a gain of efficiency in 5 years’ experience. However, “missing” cases were 486 in 2013 and 321 in 2017, mainly due to the lack of an efficient documentation system. Conclusion UNHS programs have proven to be valuable and cost-effective in Friuli-Venezia Giulia and other Italian regions. New resources and efforts are required to achieve a complete standardization and informatisation of the UNHS data to avoid documentation gaps. A possible strategy would point to the opportunity to unify data management systems for all the ongoing newborn screening programs (metabolic, hearing and visual), linking the integrated IT system with the regional repository of current datasets.

Advanced MRI findings in two patients with probable chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) are presented. Diffusion tensor imaging indices (fractional anisotropy and mean diffusivity), evaluated in both patients at baseline MRI examination before treatment and during follow-up, indicated white matter structural changes not only affecting the brainstem, which represents the primary site of inflammatory damage, but also projection (corona radiata) and associative tracts in both patients, while alterations within the corpus callosum were detected in patient 1# at follow-up. Susceptibility weighted imaging (SWI) revealed hypointense lesions in both patients, MRI spectroscopy (MRS) indicated a mildly increased Cho/NAA ratio with no evidence of lipids/lactate peaks, indicating that it may be used as a non-invasive marker to identify CLIPPERS cases suspected for progression to lymphoma.

Pediatric cardiomyopathies of genetic origin directly involving the heart muscle – i.e. not related to metabolic causes - are rare, yet serious diseases of the heart with an annual incidence of 1.1 to 1.5 per 100,000 children. Cardiomyopathies are a prevalent cause of heart failure and the most common cause of heart transplantation in children older than 1 year of age. Dilated and hypertrophic cardiomyopathy (HCM) have the largest prevalence, whereas restrictive cardiomyopathy and left ventricular non-compaction are very rare. The epidemiology, natural history and prognostic indicators of pediatric cardiomyopathies were poorly understood before the 1990s, and many gaps in knowledge remain to this day. Advances in cardiac imaging and genomic characterization, including genome-wide analysis, are providing fresh insights into the etiology and outcome of children with cardiomyopathy. While morphological and clinical manifestations are similar to those of adult patients, pediatric cardiomyopathies tend to have more severe outcomes and may respond less well to pharmacological treatment. The present review aims to examine familial cardiomyopathies in children, focusing particularly on the risk predictors and outcome of HCM, probably the field with the most impressive advances in recent years.

When the cost of an experiment depends on the values of the variables not all the experiments are equally expensive. Since in all the standard Designs of Experiments the experiments are symmetrically distributed, in case of finite resources the number of experiments is limited by the cost of the most expensive ones. The approach here shown produces asymmetrical designs, with an increase of the number of the cheapest experiments and a decrease of the number of the expensive ones. Compared to the standard designs having the same total cost, the information obtained by this strategy is slightly worse in the region corresponding to the most expensive experiments, but much better in the region corresponding to the cheapest experiments. This approach was successfully applied to the micronization of an Active Pharmaceutical Ingredient.

This research took a phenomenological approach to delineate shared tourism experiences of people who need assistance when traveling and their caregivers. If travel represents a temporary escape of everyday routines for an average traveler, travel for this group was found to represent a magnifying everydayness as they continue to be challenged with limitations as a result of disability. As demonstrated in the intensity of emotions and the mixed nature of them, tourism represents an extraordinary experience for this traveler segment despite the ordinary nature of their travel activities. Important insights are drawn with relation to the role of travel in the development of resistance strategies adopted by individuals with disabilities and their caregivers, as well as their value tendency for eudaimonic wellness.

OBJECTIVE Sacral neuromodulation (SNM) is proposed to treat different anorectal dysfunctions but its mechanism of action is not yet known. Our previous study demonstrated how SNM can significantly increase neuronal nitric oxide synthase NOS (n-NOS) and inducible NOS (i-NOS) expression in the anus and rectum of rats. There are no reports regarding the relation between SNM and NOS in colonic cells: our aim was to assess NOS expression in colonic rat model after SNM. MATERIALS AND METHODS Twenty-six female Sprangue-Dawley rats were considered: group I, normal control rats; group II, sham treatment rats, in whom electrodes for electrical stimulation were placed in S1 foramen bilaterally and left in place, without performing neuromodulation; group III, rats in whom SNM was performed. After 14 days, the rats were sacrificed and we evaluated n-NOS and i-NOS in colonic specimens by immunohistochemistry and Western Blot analysis. RESULTS Western Blot analysis showed that levels of n-NOS and i-NOS were higher in colon of the III group rats respect to the others; in particular, immunohistochemistry revealed that, after neuromodulation, n-NOS expression in the muscle cells and i-NOS expression in glandular epithelium and nervous cells were highly represented (p

We investigated the efficacy of colistin combined with teicoplanin or daptomycin in an experimental mouse model of multiresistant Acinetobacter baumannii infection. Animal received intraperitoneally 1ml saline containing 2×1010CFU of A. baumannii. Colistin, daptomycin, teicoplanin, and colistin plus daptomycin or teicoplanin were given by intraperitoneal administration 2h after bacterial challenge. A control group received sodium chloride solution. In the in vitro study A. baumannii showed to be susceptible only to colistin with MIC of 2mg/l. In the in vivo study, colistin alone showed a good antimicrobial efficacy. When combined with teicoplanin or daptomycin, colistin produced the lowest bacterial and the best survival rates. In immunological studies, when colistin was associated to daptomycin or teicoplanin, both the number and the cytotoxic activity of NK cells increased. In conclusion, colistin combined with teicoplanin or daptomycin may improve the therapy of multiresistant A. baumannii infection.

Recent data from mitochondrial genomics and proteomics research demonstrate the existence of several atypical mitochondrial protein-coding genes (other than the standard set of 13) and the involvement of mtDNA-encoded proteins in functions other than energy production in several animal species including humans. These results are of considerable importance for evolutionary and cellular biology because they indicate that animal mtDNAs have a larger functional repertoire than previously believed. This review summarizes recent studies on animal species with a non-standard mitochondrial functional repertoire and discusses how these genetic novelties represent promising candidates for studying the role of the mitochondrial genome in speciation.

Glycosaminoglycans (GAGs) are charged polysaccharides ubiquitously present at the cell surface and in the extracellular matrix. GAGs are crucial for cellular homeostasis, and their metabolism is altered during pathological processes. However, little consideration has been given to the regulation of the GAG milieu through pharmacological interventions. In this review, we provide a classification of small molecules affecting GAG metabolism based on their mechanism of action. Furthermore, we present evidence to show that clinically approved drugs affect GAG metabolism and that this could contribute to their therapeutic benefit.

This study examined the intrinsic motivation for hospitality jobs and the effects of job characteristics on job satisfaction, job stress, and life satisfaction. Data were obtained from the survey responses of 401 frontline employees working at six full-service, upscale hotels in China. Results indicated that autonomy, task identity, and task significance reduced job stress, feedback increased job satisfaction, and task significance enhanced life satisfaction. Surprisingly, skill variety was negatively associated with job satisfaction, but positively associated with job stress. The composite Motivating Potential Score was positively associated with job satisfaction, but negatively associated with job stress. One recommendation is for hospitality organizations to analyze their service jobs to improve the intrinsic motivation of their employees.

Synthesis of the prebiotic galactooligosaccharides from lactose fermentation by Pseudozyma tsukubaensis and Pichia kluyveri was investigated. In this study, a sequential strategy of two experimental designs was used to optimize galactooligosaccharides production. First, Plackett-Burman screening design was applied to evaluate the effects of lactose, yeast extract, urea concentration, inoculum concentration, pH and agitation rate on the response of galactooligosaccharides yield synthesized by both yeasts. The preliminary Plackett-Burman design allowed the identification of the pH and urea concentration as statistically significant variables in the range studied. In order to find the optimal conditions for galactooligosaccharides synthesis, a central composite rotational design was employed. The independent variables were lactose, yeast extract and urea concentrations, and the response taken into account was galactooligosaccharides yield produced by P. tsukubaensis . The optimized condition for this prebiotic synthesis was: lactose, yeast extract and urea at concentrations of 26.0, 0.8 and 1.8 g/100 mL, respectively. Under the optimized and validated conditions, the transgalactosylation activity of P. tsukubaensis resulted in GOS yield of 28.35 GOS (g)/100 g of lactose at 24 h, with a maximum GOS production of 73.71 g/L, and approximately 50 g/100 g of lactose hydrolysis.

This study aimed to produce biosurfactant from Pseudozyma tsukubaensis using cassava wastewater and an inoculum (biomass) for galactooligosaccharides synthesis from lactose as an integrated system. First, the use of cassava wastewater as a low cost culture medium by P. tsukubaensis to produce biomass and biosurfactant was evaluated and optimized. Then, the microbial cells (biomass) obtained from the optimized process were used to produce galactooligosaccharides from lactose. The optimum conditions for biosurfactant and biomass synthesis were found to be 80% (v/v) of cassava wastewater at 30 °C and 200 rpm for 48 h. The highest concentration of biosurfactant, that is, minimum surface tension value and maximum biomass concentration predicted were experimentally confirmed as 26.87 mN/m and 10.5 g/L, respectively. The biosurfactant obtained showed good thermal (121 °C/1 h), pH (2–11) and ionic strength (0–25% NaCl) stability. Excellent emulsifier activity was also verified, suggesting a potential application in enhanced oil recovery. Galactooligosaccharides synthesized by the Kluyveromyces genus have been extensively investigated, however, few studies have reported transgalactosylation ability by other yeast genera. The transgalactosylation activity of the yeast biomass at optimized conditions from 40% (w/w) lactose resulted in galactooligosaccharides production of 73.12 g/L and a yield of 18.28% (w/w) at pH 8.0 and 30 °C in 24 h. This research showed the technical feasibility of an integrated process: biosurfactant and GOS production from P. tsukubaensis, which takes advantage of the remarkable metabolism of this microorganism. To the best of our knowledge, this is the first study reporting the potential of P. tsukubaensis to produce two economical biotechnological products of increase interest as an integrated process.

BACKGROUND Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED. METHODS We conducted a multicenter, prospective cohort study in seven Italian EDs. For patients presenting with acute dyspnea, the emergency physician was asked to categorize the diagnosis as ADHF or noncardiogenic dyspnea after (1) the initial clinical assessment and (2) after performing LUS ("LUS-implemented" diagnosis). All patients also underwent chest radiography. After discharge, the cause of each patient's dyspnea was determined by independent review of the entire medical record. The diagnostic accuracy of the different approaches was then compared. RESULTS The study enrolled 1,005 patients. The LUS-implemented approach had a significantly higher accuracy (sensitivity, 97% [95% CI, 95%-98.3%]; specificity, 97.4% [95% CI, 95.7%-98.6%]) in differentiating ADHF from noncardiac causes of acute dyspnea than the initial clinical workup (sensitivity, 85.3% [95% CI, 81.8%-88.4%]; specificity, 90% [95% CI, 87.2%-92.4%]), chest radiography alone (sensitivity, 69.5% [95% CI, 65.1%-73.7%]; specificity, 82.1% [95% CI, 78.6%-85.2%]), and natriuretic peptides (sensitivity, 85% [95% CI, 80.3%-89%]; specificity, 61.7% [95% CI, 54.6%-68.3%]; n=486). Net reclassification index of the LUS-implemented approach compared with standard workup was 19.1%. CONCLUSIONS The implementation of LUS with the clinical evaluation may improve accuracy of ADHF diagnosis in patients presenting to the ED. TRIAL REGISTRY Clinicaltrials.gov; No.: NCT01287429; URL: www.clinicaltrials.gov