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Background West Nile Disease (WND) is a zoonotic mosquito‐borne infection involving viral pathogens, human and animal hosts, vectors and environment. Cooperation among medical, veterinary and entomological fields has been promoted by the Italian Public Health Authorities, and an integrated West Nile Virus (WNV) Surveillance Plan has been in force in Italy since 2016 to prevent the transmission risk of WND to humans through an early detection of viral circulation by animal and entomological surveillance. This managing model is unique in Europe. Objectives This survey aimed at presenting the ‘One Health’ approach applied in 2016 to the first autochthonous human case of West Nile Neuroinvasive Disease (WNND) in Sicily (Southern Italy). Methods Serological (anti‐WNV IgM and IgG ELISA, anti‐WNV neutralizing antibodies) and molecular tests were conducted on blood, liquor and urine of a 38‐year‐old man with encephalitis and meningitis. Overall, 2704 adult culicides from 160 mosquito catches were morphologically identified. Female mosquitoes were analysed in pools for WNV RNA detection. Serological (anti‐WNV IgM and IgG ELISA) and molecular analyses for WNV were carried out in 11 horses, 271 chickens and two dogs sampled in farms around the man's residence. Results and conclusions WNND was confirmed by serological analysis on patient's liquor and serum. Collected mosquito species included Culex pipiens (93.56%, CI95% 92.64%–94.49%), Aedes albopictus (5.25%, CI95% 4.41%–6.09%), Culex hortensis (0.59%, CI95% 0.30%–0.88%), Culiseta longiareolata (0.55%, CI95% 0.27%–0.83%) and Anopheles maculipennis s.l. (0.04%, CI95% –0.04% to 0.11%). Mosquito pools were negative for WNV RNA. Two dogs (100%) and two horses (18.18%, CI95% –4.61 to 40.97%) resulted positive for anti‐WNV specific antibodies. The ‘One Health’ approach allowed to report the first human neuroinvasive WND in Sicily and to confirm the local circulation of WNV in animals of the same area where the clinical case occurred, defining the autochthonous origin of the infection., Description of the first neuroinvasive human case of West Nile disease in Sicily.Detection of West Nile Virus antibodies in dogs and horses in the surrounding area.Presence of the main West Nile Virus vector Culex pipiens in the investigated area.

In humans, blood groups are associated with varying prevalence of infections. The aim of this study was to determine if associations exist between the feline AB blood group system and haemoplasma infection.Data from two studies were combined. In the first study, DNA samples from 131 haemoplasma-infected and 132 haemoplasma-uninfected UK cats underwent pyrosequencing to determine their blood genotype as AA, Ab or bb. In the second study, blood samples from 160 Italian cats of known blood phenotype A, B or AB underwent PCR testing for feline haemoplasma species DNA.Haemoplasma infection was demonstrated in cats of all phenotypes and genotypes. A significantly higher number of Ab genotype cats tested positive for overall haemoplasma infection status (p = 0.04) and for Mycoplasma haemofelis infection (p = 0.03).Haemoplasma-infected Italian cats were few, possibly increasing the chance of type II error, and the presence of purebred cats in the sample population may have had a confounding effect.Feline haemoplasmas do not appear to preferentially use either blood type A or B antigens as attachment sites for erythrocyte colonisation. Further investigations in a larger number of haemoplasma-infected cats of known blood phenotype are warranted to explain the association between genotype Ab and haemoplasma infection.

Biting midges of the genus Culicoides are known vectors of arboviruses affecting human and animal health. However, little is known about Culicoides imicola microbiota and its influence on this insect's biology. In this study, the impact of biotic and abiotic factors on C. imicola microbiota was characterized using shotgun-metagenomic sequencing of whole-body DNA samples. Wild-caught C. imicola adult nulliparous females were sampled in two locations from Sicily, Italy. The climatic variables of temperature and soil moisture from both localities were recorded together with potential host bloodmeal sources. Shared core microbiome among C. imicola populations included Pseudomonas, Escherichia, Halomonas, Candidatus Zinderia, Propionibacterium, and Schizosaccharomyces. Specific and unique taxa were also found in C. imicola from each location, highlighting similarities and differences in microbiome composition between the two populations. DNA and protein identification showed differences in host preferences between the two populations, with Homo sapiens and Canis lupus familiaris L. being the preferred bloodmeal source in both locations. A principal component analysis showed that the combined effect of host preferences (H. sapiens) and local soil moisture factors shape the microbiome composition of wild-caught populations of C. imicola. These results contribute to characterizing the role of the microbiome in insect adaptation and its utility in predicting geographic expansion of Culicoides species with potential implications for the control of vector-borne diseases.

UNLABELLED • PREMISE OF THE STUDY Information about geographic distribution of cytotypes can provide insight into the origin and maintenance of autopolyploid complexes and builds a foundation for understanding cytotype differentiation and the dynamics of mixed-ploidy populations. Here, we investigate environmental correlates of the geographic distributions of 6x and 9x individuals in the ecologically dominant grass Andropogon gerardii to examine the role of climate in shaping patterns of cytotype distribution in this species.• METHODS Flow cytometry was used to estimate ploidy level in 352 individuals from 32 populations across North America. Ecological differentiation of cytotypes was tested by relating BIOCLIM variables to cytotype distribution using principal components analysis and partial linear regression.• KEY RESULTS Broad geographic sampling confirmed two primary cytotypes-6x (hexaploid) and 9x (enneaploid)-and revealed that 9x plants are more common than previously thought. Enneaploids occur frequently in the southern portions of the range, with hexaploids dominating in northern regions. Mixed-ploidy populations were common (46.9%). Principal components analysis and partial linear regression indicated that reduced summer precipitation and increased variation in diurnal and seasonal temperature range were significant predictors of the frequency of 9x plants in a population.• CONCLUSIONS Results indicate that (1) geographic distribution of 6x and 9x individuals is nonrandom; (2) environmental variables are associated with cytotype distribution in A. gerardii; and (3) nearly half of populations surveyed include both 6x and 9x individuals. The persistence of mixed-ploidy populations may reflect a combination of recurrent polyploid formation and the prevalence of clonal reproduction.

Anthocyanins, the major colourants of strawberries, are polar pigments that are positively charged at low pH. Herein, we have assessed a new analytical method for the separation of anthocyanins using CZE. Acidic buffer solutions (pH a2) were employed in order to maintain pigments in the cation flavylium form and achieve high molar absorptivity at 510 nm. These spectral properties enabled us to identify strawberry anthocyanins in a preliminary stage by detection in the visible range, although the method was optimised at 280 nm to obtain the best S/N. The effects of buffer composition highlighted the necessity of adding an organic modifier to the running buffer to obtain a suitable separation. The electrophoretic method permitted the separation of the three main anthocyanins of strawberry extracts, namely pelargonidin 3-glucoside (Pg-glu), pelargonidin 3-rutinoside and cyanidin 3-glucoside. The electrophoretic results, expressed as retention time and separation efficiency of the major anthocyanin (Pg-glu), were compared to those achieved in HPLC, the analytical technique traditionally used for the investigation of anthocyanins in vegetable matrix. The content of Pg-glu in strawberries (cv. Camarosa), calculated with HPCE and HPLC methods, resulted respectively in 11.41 mg/L and 11.37 mg/L.

Aloe arborescens Miller, belonging to the Aloe genus (Liliaceae family), is one of the main varieties of Aloe used worldwide. Although less characterized than the commonest Aloe vera, Aloe arborescens is known to be richer in beneficial phytotherapeutic, anticancer, and radio-protective properties. It is commonly used as a pharmaceutical ingredient for its effect in burn treatment and ability to increase skin wound healing properties. However, very few studies have addressed the biological effects of Aloe at molecular level. The aim of the research is to provide evidences for the antiproliferative properties of Aloe arborescens crude leaf extract using an integrated proteomic and cellular biological approach. We analysed the composition of an Aloe arborescens leaf extract by gas chromatography-mass spectrometry analysis. We found it rich in Aloe-emodin, a hydroxylanthraquinone with known antitumoral activity and in several compounds with anti-oxidant properties. Accordingly, we show that the Aloe extract has antiproliferative effects on several human transformed cell lines and exhibits prodifferentiative effects on both primary and immortalized human keratinocyte. Proteomic analysis of whole cell extracts revealed the presence of proteins with a strong antiproliferative and antimicrobial activity specifically induced in human keratinocytes by Aloe treatment supporting its application as a therapeutical agent.

Background: Injuries are a common reason for emergency department (ED) visits by older patients. Although injuries in older patients can be serious, 75% of these patients are discharged home after their ED visit. These patients may be at risk for short-term functional decline related to their injuries or treatment. Objectives: The objectives were to determine the incidence of functional decline in older ED patients with blunt injuries not requiring hospital admission for treatment, to describe their care needs, and to determine the predictors of short-term functional decline in these patients. Methods: This institutional review board-approved, prospective, longitudinal study was conducted in two community teaching hospital EDs with a combined census of 97,000 adult visits. Eligible patients were >/= 65 years old, with blunt injuries Language: en

The cone and 1,2,3 alternate isomers of calix[6]arene bis-crown-4 were investigated computationally. Structural optimizations, energies, bond distances, and Mulliken charges were calculated by the application of the B3LYP/6-31g(d) method/basis, followed by NMR calculations via both B3LYP/6-31g(d) and HF/6-31g(d). Calculations were completed at three different levels of imposed symmetry, and two calculations investigated the chloroform solvent effects. Better NMR results were obtained from HF/6-31g(d) calculations that did not impose molecular symmetry constraints. Consideration of solvent effects improved ground state energies, but other improvements were minimal and not significant enough to justify the added computational expense of solvent calculations. Overall results are consistent with known experimental assignments and were valuable for assigning previously unknown NMR peaks. Net charges, electrostatic forces, and local dipoles – but not bond lengths – are strongly correlated to spectroscopic manifestations of steric compression. Copyright © 2009 John Wiley & Sons, Ltd.

The firmness of green prickly pear fruits (Opuntia ficus indica) impregnated with a sucrose isotonic solution (IS) was evaluated. Whole fresh-peeled prickly pears were processed under different combinations of vacuum pressure (pv), vacuum application time (tv) and relaxation time (tr). Puncture test was applied to impregnated and fresh whole prickly pears. The maximum force (Fmax), average force (Fav) and the work (Wp) required to puncture 3 cm in the fruits were measured. Second order models provided good fits to the experimental data of Fmax (R2 = 0.754), Fav (R2 = 0.788) and Wp (R2 = 0.792). Impregnation factors pv, tr, tv–tr significantly affected firmness parameters (P ≤ 0.05). Firmness parameters of fresh-peeled prickly pear were Fmax = 10.934 ± 1.571 N, Fav = 2.152 ± 0.270 N and Wp = 5.930 × 10−2 ± 0.0054 Nm. Firmness reduction of impregnated fruits was linked to the IS impregnation levels and deformation-relaxation phenomena. PRACTICAL APPLICATIONS The aim of this study was to assess the influence of impregnation conditions on firmness of whole peeled prickly pear, as excessive softening is the main factor limiting consumer acceptability. This study helps to identify the better impregnation conditions for maintaining firmness. This information could be useful for the application of vacuum impregnation in the development of fruits and vegetables products, in which the impregnating solution is used as a carrier of active agents. To date, very limited studies have been conducted in whole fruits involving only peeling and impregnation operations.

Objectives Differences in interpretation of the residency review committee (RRC) directive concerning resident scholarly activity have resulted in inconsistencies in the practical fulfillment of this responsibility among the various training programs in emergency medicine. During a workshop organized by the SAEM Research Directors' Interest Group (RDIG), a consensus statement was developed regarding the scope, definition, and purpose of the scholarly project requirement. Methods During the workshop, the NIH model of consensus building was used to develop statements pertaining to specific questions of the goals, definition, and endpoints of the scholarly project. The program consisted of an overview of the history and issues related to the scholarly project and presentations of varying viewpoints from interested parties. A final consensus of answers to the defined questions was then developed by the workshop participants during roundtable discussions and further refined through interactive debate using the RDIG e-mail list server. Results By consensus it was agreed that the primary role of the scholarly project is to instruct residents in the process of scientific inquiry, to teach problem-solving skills, and to expose the resident to the mechanics of research. To realize these goals, the project should include the general elements of hypothesis formulation, data collection, analytic thinking, and interpretation of results. It was also thought that these elements should be documented in some written form with a literature review. Conclusions While each residency program must implement the RRC residency requirements in a manner that best suits the needs and culture of its individual environment, a concurrence of definition and approach to satisfying the scholarly project requirement would provide better consistency in resident training. Guidelines developed by consensus during the SAEM RDIG workshop may serve as a general recipe that can be used to fulfill the goals of the scholarly project and the spirit of the RRC directive.

Background: Periodic surveys of research directors (RDs) in emergency medicine (EM) are useful to assess the specialty’s development and evolution of the RD role. Objectives: To assess associations between characteristics and research productivity of RDs and EM programs. Methods: A survey of EM RDs was developed using the nominal group technique and pilot tested. RDs or surrogate respondents at programs certified by the Accreditation Council for Graduate Medical Education were contacted by e-mail in early 2005. The survey assessed programs’ research infrastructure and productivity, as well as RD characteristics, responsibilities, and career satisfaction. Three measures of research productivity were empirically defined: research publications, grant awards, and grant revenue. Results: Responses were received from 86% of 123 EM programs. Productivity was associated with the presence of nonclinical faculty, dedicated research coordinators, and reduced clinical hours for research faculty. Programs with an RD did not have greater research productivity, using any measure, than those without an RD. The majority of RDs cited pursuing their own studies, obtaining funding, research mentoring, and research administration to be major responsibilities. The majority characterized internal research funding, grant development support, and support from other faculty as inadequate. Most RDs are satisfied with their careers and expect to remain in the position for three or more years. Conclusions: Research productivity of EM residency programs is associated with the presence of dedicated research faculty and staff and with reduced clinical demands for research faculty. Despite perceiving deficiencies in important resources, most RDs are professionally satisfied. ACADEMIC EMERGENCY MEDICINE 2006; 13:637–644 a 2006 by the Society for Academic Emergency

OBJECTIVES: To describe acute asthma in younger versus older adults presenting to the emergency department (ED). DESIGN: Prospective cohort study. Asthmatic adults were divided into three age groups: 18 to 34, 35 to 54, and 55 and older. The analysis was restricted to never smokers and smokers with fewer than 10 pack-years. SETTING: ED. PARTICIPANTS: Two thousand sixty-four patients aged 18 and older with a physician diagnosis of asthma. MEASUREMENTS: Medications and peak expiratory flow. RESULTS: There were 1,158 (56%) subjects aged 18 to 34; 777 (37%) aged 35 to 54; and 129 (6%) aged 55 and older. Older patients were most likely to have a primary care provider (65%, 74%, and 91%, respectively; P< .001); most were not taking inhaled corticosteroids (39%, 55%, and 48%, respectively; P

Objectives: Pain related to the gurney is a frequent complaint of older emergency department (ED) patients. The authors hypothesized that these patients may have less pain and higher satisfaction if allowed to sit in a reclining hospital chair. Methods: A single-blind, randomized controlled trial was performed. Patients 65 years old or older who were able to sit upright, transfer, and engage in normal conversation were eligible. Severely ill or cognitively impaired patients were excluded. Patients were randomized to either remain on the gurney or transfer to the chair after initial evaluation. Patients reported pain at arrival (t0), at one hour (t1), and at two hours (t2) using a 0–10 pain scale, and satisfaction at study completion on a 0–10 scale. The primary outcome was a decrease in pain between t0 and t1 or no pain at both t0 and t1. This outcome was analyzed using a 95% confidence interval for the difference between proportions; exclusion of zero was considered significant. Results: Sixty-six patients in each group were enrolled. There was no difference in demographics between groups, but the chair patients were more likely to have pain at t0 than the gurney patients. More chair patients than gurney patients had a successful primary outcome (97% vs. 76%, 21% difference, 95% CI=10% to 32%). The mean satisfaction score was higher in the chair group than in the gurney group (8.1 vs. 6.0, 2.1 difference, 95% CI=1.4% to 2.8%). Conclusions: The simple modification of allowing older ED patients to sit in reclining chairs resulted in less pain and higher satisfaction.

Ring-opening metathesis polymerization (ROMP) of bicyclo[2,2,1]hept-2-ene (norbornene) has been effected in supercritical carbon dioxide (SC CO2) with two types of metal carbene catalysts. It has been found that the polynorbornenes prepared in SC CO2 are similar in molecular weight, molecular weight distribution and thermal stability to their counterparts prepared in tetrahydrofuran (THF). More important, the trans/cis ratio of the resulting polymers could be adjusted by varying the amount of cosolvent THF or metal carbene catalysts. However, neither the reaction temperature nor pressure significantly influenced the trans/cis ratio of the polymer. Copyright © 2005 John Wiley & Sons, Ltd.

A series of translucent interpenetrating polymer networks (IPNs) made of a reactive elastomer [linear (D) and branched (T) with varying molecular weights] (Jeffamine™), a commercially available epoxy (D.E.R. 331), and an unsaturated polyester (15:85 wt %) were prepared. DSC data indicated complete cure after 8 h at 90°C. DMTA data showed a single glass-transition temperature (Tg) for all elastomer-containing IPNs, an indication of homogeneity. As expected, all IPNs showed a decrease in Tg with incorporation of elastomer, from 16 to 114°C or lower, the largest decrease being with T-5000. Izod impact strengths were increased by 28–44%, but with no apparent pattern among structure and molecular weight variations. In several cases the standard deviation of impact data increased significantly. Flexural data were measured using a three-point bend test. The highest flexural modulus obtained was that which incorporated linear D-2000 with a decrease of only 22% upon incorporation of the elastomer, whereas other compositions dropped up to 55% in flexural modulus. The strongest material obtained was that using D-2000 with a flexural strength increase of 65% upon incorporation of the elastomer. Two of the three branched elastomer components showed flexural strength increases of about 53%, but one was only equal to the base polyester resin. TGA data were recorded for all IPNs and values compared well to that of the pure polyester resin, with the exception of T-403, which showed a 20°C decrease, and D-2000 with a 10°C decrease. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 84: 2283–2286, 2002

Background: Older patients may visit the emergency department (ED) when their illness affects their function. Objectives: To quantify the function of older ED patients, to assess whether functional decline (FD) had occurred, and to determine whether function contributes to the ED visit and hospital admission. Methods: The authors performed an institutional review board–approved, prospective, cross-sectional study in a community teaching hospital ED. Eligible patients were older than 74 years of age, with an illness at least 48 hours old. Patients from a nursing facility and those without a proxy who were unable or unwilling to complete the questions were excluded. The Older Americans Resources and Services Questionnaire, which tests seven instrumental activities of daily living (IADL) and seven physical ADLs (PADL), was used. Data are presented as means or proportions with 95% confidence intervals (95% CI), and comparisons as 95% CI for the difference between proportions. Results: The authors enrolled 90 patients (mean age, 81.6 yr [SD ± 4.9], 40% male). Dependence in at least one IADL was reported by 68% (95% CI = 57% to 77%), and in at least one PADL by 61% (95% CI = 50% to 71%). Functional decline was reported by 74% (95% CI = 64% to 83%). Two thirds of those with IADL decline and three quarters of those with PADL decline said that this contributed to their ED visit. Seventy-seven percent with, and 63% without, IADL decline were admitted (14% difference, 95% CI =−6.1% to 33%). Seventy-nine percent with and 61% without PADL decline were admitted (18% difference, 95% CI =−1.4% to 38%). Conclusions: Functional decline is common in older ED patients and contributes to ED visits in older patients; its role in admission is unclear.

Intramolecular [Pd2(dba)3]/tri(2‐furyl)phosphine‐catalysed (dba = dibenzylideneacetone, PhCH=CHCOCH=CHPh) cyclisations of olefinic propargylic carbonates I provided alk‐1‐enyl‐(3‐aza)bicyclo[3.1.0]‐hexanes VIII in good yields. A palladium cascade sequence I → II → III → IV → VII → VIII is proposed. Furthermore, chiral propargylic carbonates such as 23, 24 and 25 allowed diastereoselective formation of bicyclo[3.1.0]hexanes 29, 30 and 31, respectively. The first diastereoselective synthesis of the monoterpene, (−)‐α‐thujone 40 illustrates the potential of the method.

BACKGROUND Donor exposure risk and cost in platelet transfusion practice can be limited by increasing the recovery of platelets from donor units. STUDY DESIGN AND METHODS This study presents results of continuous quality improvement efforts in platelet production and compares the in vivo therapeutic efficacy of currently produced platelet concentrates (PCs) with that of apheresis platelets. Production quality improvement measures included optimization of instrument performance (rotor speed trials), process (massaging whole-blood units, using cup liners, limiting spin-expression time, and refining plasma expression technique), and staff (intensive training with observation and ongoing quality control data feedback). Corrected count increments and increments per kg were calculated for transfusions of 4 pooled PCs and apheresis platelets over a 30-day period. RESULTS The mean number of platelets per PC increased from 5.5 x 10(10) in 1975 to 9.69 x 10(10) in 1994. The mean platelet dose was 3.78 x 10(11) for 4 PCs and 4.17 x 10(11) for apheresis platelets. A total of 34 pooled PCs and 17 apheresis platelets was transfused to 21 patients. The mean increment, the increment per kg, and the corrected count increment were, respectively, 31 x 10(3) per microL, 4.8 x 10(2) per microL, and 14,700 for 4 PCs and 35.4 x 10(3) per microL, 5.4 x 10(2) per microL, and 14,700 for apheresis platelets. Differences were not significant. CONCLUSION Therapeutic efficacy comparable to that of apheresis platelets can be obtained with 4 high-yield PCs.

A practical synthesis of N-p-anisyl-N-methyl-amino-3-(9-anthryl)-propane from 9-anthraldehyde is described. All the intermediates in this simple five step sequence are crystalline and simple re-crystallisation after each step allows the preparation of this exciplex fluorescence ‘thermometer’ molecule on a preparative scale without resort to chromatography.

The de novo synthesis of the novel potent building blocks phenyl ( R )-3-acetoxymethyl-3,6-dihydro-2 H -pyridine-1-carboxylate (−)- 7 and phenyl ( S )-3-butyryl-oxymethyl-3,6-dihydro-2 H -pyridine-1-carboxylate (+)- 8 starting from commercially available methyl-1-benzyl-4-oxo-3-piperidinecarboxylate is described. The key steps are the enantioselective esterification of the racemic alcohol 6 and the enantioselective hydrolysis of the racemic acetate 5 , respectively, using lipase P from Pseudomonas caepacia .

The Lewis acidic calix[4]arene with four covalently attached diphenylmonochlorotin(IV) centers was synthesized and its stannate complex with chloride was studied by 119Sn NMR.

Alkenyl-substituted six- and seven-membered cyclic enol ethers, which are potential building blocks for the synthesis of marine polyether natural products, can be prepared in high yield (70–97%) from alkynyl ethers by ruthenium-catalysed ring-closing enyne metathesis. The carbene-bearing ruthenium complex 9 is generally the most efficient catalyst for the reaction.